All diastolic murmurs are pathological. Murmurs Grades I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM - Answer - III first time audible, IV first time thrill Fundal height 12 weeks - Answer - Fundal Height 12 weeks above symphysis pubis. EXAM Fundus 16 weeks between symphysis pubis and umbilicus. Fundus at 20 weeks is at umbilicus. 2 cm more of less from # of wk gestation is normal if more or less order US 3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you order? - Answer - Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? - Answer - Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - Answer - Mini mental exam 4 month old with strabismus, mom is worried...... - Answer - tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - Answer - Growth chart 6 month old closed anterior fontanel. - Answer - XRAY Abnormal cells on PAP, what do you do next? - Answer - Refer for Colposcopy CAGE ACRONYM - Answer - Cut down Annoyed by criticism Guilty about drinking Eye opener drink Causes of tachycardia - Answer - Fever Anemia Hypotension Cranial nerves responsible for extraocular eye movements - Answer - CN 3,4,6 Definition of metabolic syndrome - Answer - cluster of conditions that increase risk of heart disease, stroke, diabetes. diagnose trichomoniasis - Answer - wet prep Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? - Answer - Pelvic US Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? - Answer - Anterior septum Definitive diagnosis of acute bacterial prostatitis - Answer - urinalysis and culture GERD treatment - Answer - H2 is first line, give hs Grade 3 cells on Pap, treatment? - Answer - LEEP excision Fingernail hematoma treatment? - Answer - drill hole and drain blood? Increased risk of ectopic pregnancy - Answer - Salpingitis, or history of abortion, PID, Koplick spots - Answer - Measles (rubeola). Grains of salt lesions inside mouth in Measles Koplick spots - Answer - Measles (rubeola). Grains of salt lesions inside mouth in Measles Legg-Calve-Perthes Disease - Answer - Avascular necrosis of the proximal femoral head Lipid level of 1500, increased risk for? - Answer - Pancreatitis Low HGB, Low HCT, High MCV indicates what? - Answer - Macrocytic anemia, B12 Def Man with BPH, prostate feels on digital exam? - Answer - Enlarged, symmetrical, smooth Man with HTN, CAD, present femoral pulses but absent pedal - Answer - Arterial Insufficiency McMurray's Sign (+) palpable or audible click while extending with varus stress - Answer - Meniscus tears Lachman's Test - Answer - pivot shift test (ACL tear) Newborn with foot turned in, what do you do? - Answer - refer to orthopedist Osgood-Schlatter disease - Answer - Knee pain. inflammation or irritation of the tibia at its point of attachment with the patellar tendon