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History & Physical Exam Skills

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General Surgery | Physician Assistant (PA) School Study Aid

History & Physical Exam Skills
15 Picmonics to Learn | 23 mins
Acute Abdomen Differential Diagnosis: Lower Quadrants
Right Lower Quadrant
Appendicitis
Salpingitis
Left Lower Quadrant
Sigmoid Volvulus
Sigmoid Diverticulitis
Lower Quadrant (Both/Either)
Ectopic Pregnancy
Ovarian Torsion
Renal Calculi
Pyelonephritis
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2 mins
Acute Abdomen Differential Diagnosis: Midepigastrium and Diffuse
Midepigastrium
Peptic Ulcer Disease
Pancreatitis
Aortic Dissection
Myocardial Infarction
Any Place
Peritonitis
Hemorrhage or Perforation
Bowel Obstruction
Strangulation
Acute Hepatitis
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2 mins
Acute Abdomen Differential Diagnosis: Upper Quadrants
Right Upper Quadrant
Cholecystitis
Biliary Colic
Cholangitis
Perforated Duodenal Ulcer
Acute Hepatitis
Left Upper Quadrant
Splenic Rupture
IBS (Splenic Flexure Syndrome)
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2 mins
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
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2 mins
Casts in Urine (Differential Diagnosis)
Characteristics
RBC Casts
Glomerular Disease
WBC Casts
Acute Interstitial Nephritis
Acute Pyelonephritis
Fatty Casts
Maltese Cross Sign
Nephrotic Syndrome
Granular Muddy Brown Casts
Acute Tubular Necrosis (ATN)
Waxy Casts
End Stage Renal Disease (ESRD) (Chronic Renal Failure)
Hyaline Casts
Non-Specific
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2 mins
Sepsis Assessment
Signs and Symptoms
Systemic Infectious Process
Fever
Hypotension
Change in LOC
Increased WBC
Shift to the Left
Tachycardia
Tachypnea
Hyperglycemia
Edema
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2 mins
Severe Sepsis and Septic Shock Assessment
Microthrombi
DIC
Decreased Oxygen Saturation
Decreased WBC
Oliguria
High Output Heart Failure
Multiple Organ Failure
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2 mins
Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding State
Activation of Clotting Factors
Deficiency of Clotting Factors
Causes
Sepsis
Trauma
Obstetric Complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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2 mins
Motor Neuron Signs UMN and LMN
Upper Motor Neuron (Increases)
Increased DTRs
Positive Babinski
Spastic Paralysis
Clasp-Knife Reaction
Lower Motor Neuron (Decreases)
Decreased DTRs
Negative Babinski
Flaccid Paralysis
Muscle Atrophy
Fasciculations
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2 mins
Glasgow Coma Scale
LOC Assessment
Score of 3 to 15
8 or Less = Coma
Eye Opening
Verbal Response
Motor Response
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1 min
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
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38 secs
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
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1 min
Lung Sounds - Rhonchi
Location
Trachea and Bronchi
Description
Low Pitched Rumbling
Sounds Like
Gurgling
Cause
Narrowed Airway
Secretions or Bronchospasm
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49 secs
Neurovascular Assessment 6 P's
Pain
Paresthesia
Pulse
Pallor
Pressure
Paralysis
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1 min
Lung Sounds - Pleural Friction Rub
Location
Anterior Lateral Lung
Description
Dry, Rubbing, or Squeaking
Sounds Like
Rubbing a Balloon with Finger
Cause
Inflamed Pleura
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50 secs

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