Advanced Health Assessment and Diagnostic
Midterm Exam 2022
The majority of Diagnsosis can be made on History alone?
True
Evidence Based Practice is the provision of care based on
1. The highest level of evidence
2. The wishes and desires of the patient and family
3. The expertise of the practitioner
The review of systems is the physical examination of each body system
False
A Likelihood Ratio (LR) of 1.0 means the post-test probability is exactly the same
as the pretest probability.
True
When a test result suggests that a disease is present when that disease is not
present, this is called a:
False Positive
A focused health assessment includes which of the following?
Chief Complaint, History of present illness, and physical exam
Randomized control trials are the highest level of evidence.
False- Systematic review is the highest level of evidence
Which of the following are components of the history of the present illness (HPI)?
Onset, relieving factors, and effect on function
A short list of possible diagnoses consistent with the patient's presenting signs
and symptoms is the:
Differential Diagnosis
Which of the following are tests of auditory acuity?
Whisper Test and Weber test
Risk Factors for Skin Cancer Include
Age > 50
Male
Fair, freckled, Ruddy complexion
sunburns easily
Living near the equator
Family History
Precancerous Dermatoses
Overexposure to frost, wind, UV, and radium
What thyroid problem should be suspected in a patient who presents with
swelling in the neck area, tachycardia and palpitations?
Hyperthyroidism
Signs of Skin Cancer ABC's
Asymmetry- unequal halves of mole or lesion
Borders- Irregular, notched, scalloped, or indistinct
Color- variation or change in color
Diameter- > 6mm or pencil eraser
Elevation- Raised
,Blue to Red Lesions that blanch when compressed are
Vascular lesions
Lesions that do not blanch completely when compressed are
Purpuric lesions
The best form of adequate lighting for a skin assessment is
natural light
Weber Test
Test: Place vibrating tuning fork anywhere on midline of skill
Normal- Negative weber; vibration heard equally
Abnormal- Positive weber
Rinne Test
Test: Place vibrating tuning fork on mastoid bone until patient no longer hears it, then
place in front of external auditory canal. Measure amount of seconds at each.
Normal- Positive Rinne; AC 2x BC
Abnormal- Negative Rinne; AC <2x BC
What could an abnormal Rinne test signify?
Conductive hearing loss
You have performed a Weber test on your patient and have determined it to be
positive. This means that the vibrations were heard:
More in one ear than the other
Kissing tonsils would be documented as Tonsillar grade:
4
If a patient reports seeing "halos" around the lights, you would be suspicious of
cataracts
Otitis Externa is commonly known as
Swimmers ear
Basal Skin Carcinoma
>90% of all cancerous lesions
Slow growing, nodular, superficial, rarely spreads
Squamous cell carcinoma
Small, firm, hyperkeratotic, nodule on inflamed base
It is slow growing but more likely to spread than basal!
Melanoma
Typically black or brown but can be any color.
Caused by intense, occasional, UV exposure (leading to sunburn).
Pityriasis Rosea
- Occurs between ages of 10-35
- Unknown Cause
- Starts with herald's patch (single round patch that is scaly with raised borders)
- progresses to 1-2 cm salmon colored rash on abdomen, chest, back, and legs in
CHRISTMAS TREE PATTERN
Seborrheic Dermatitis
dandruff, cradle cap, oily scales
Tinea versicolor
Fungal sun spots
Vitiligo
, Depigmentation of sections of skin; pathology is suspected to be autoimmune, genetic,
oxidative, stress, neural, or viral.
Atopic Dermatitis AKA Atopic Eczema
"The itch that rashes"
A chronic common recurring sensitive skin reaction to food and environment. Often
accompanied by asthma and hay fever.
Scratch>leak>crust
Impetigo
highly contagious infection in children and infants. Starts as a red sore that ruptures,
oozes for a few days, and then forms HONEY COLORED CRUST
Androgenic Alopecia
male pattern baldness
Telogen Effluvium
Increased loss of hair; "flooding of hairs"; due to stress, post partum, trauma, surgery,
drugs, diet, vaccination
Nail Disorders
Beau's Lines- Horizontal ridging from trauma, metabolic disease, or infection
Yellow Nails- Genetic with lung dx and lymphedema
Spoon Nails- Iron deficiency
Terry's Nails- Liver disease, CHF, DM
Oncymycosis
Tinea unguium; fungal infection of the nail
Paronchyia
Torn cuticle; bacterial or viral
Herpetic Whitlow
Herpes of the finger, Think dental profession!
Lupus
Butterfly Rash
Paget's Disease
Indicative of cancer; unilateral eczematous plaque of the nipple and areola
Acanthosis Nigricans
Seen in Diabetes; velvety darkening of skin in body folds and creases, especially the
neck, groin, and axilla; skin tags
Syphillis
Secondary stage; rash on palms and soles
Lyme Disease
Bulls Eye Target; Don't confuse with Tinea (fungal infection)
HIV/AIDS
Kaposis Sarcoma; Cancer of the lymph tissues and blood
Molluscum Contagiosum
Viral; flat, warty, non fluid-filled. Usually acquired in locker room (warm, hot)
Verruca
Warts; may be caused by HPV, slightly contagious
Battle Sign
Basilar skull fx; bruising behind ear
Cullen Sign
Midterm Exam 2022
The majority of Diagnsosis can be made on History alone?
True
Evidence Based Practice is the provision of care based on
1. The highest level of evidence
2. The wishes and desires of the patient and family
3. The expertise of the practitioner
The review of systems is the physical examination of each body system
False
A Likelihood Ratio (LR) of 1.0 means the post-test probability is exactly the same
as the pretest probability.
True
When a test result suggests that a disease is present when that disease is not
present, this is called a:
False Positive
A focused health assessment includes which of the following?
Chief Complaint, History of present illness, and physical exam
Randomized control trials are the highest level of evidence.
False- Systematic review is the highest level of evidence
Which of the following are components of the history of the present illness (HPI)?
Onset, relieving factors, and effect on function
A short list of possible diagnoses consistent with the patient's presenting signs
and symptoms is the:
Differential Diagnosis
Which of the following are tests of auditory acuity?
Whisper Test and Weber test
Risk Factors for Skin Cancer Include
Age > 50
Male
Fair, freckled, Ruddy complexion
sunburns easily
Living near the equator
Family History
Precancerous Dermatoses
Overexposure to frost, wind, UV, and radium
What thyroid problem should be suspected in a patient who presents with
swelling in the neck area, tachycardia and palpitations?
Hyperthyroidism
Signs of Skin Cancer ABC's
Asymmetry- unequal halves of mole or lesion
Borders- Irregular, notched, scalloped, or indistinct
Color- variation or change in color
Diameter- > 6mm or pencil eraser
Elevation- Raised
,Blue to Red Lesions that blanch when compressed are
Vascular lesions
Lesions that do not blanch completely when compressed are
Purpuric lesions
The best form of adequate lighting for a skin assessment is
natural light
Weber Test
Test: Place vibrating tuning fork anywhere on midline of skill
Normal- Negative weber; vibration heard equally
Abnormal- Positive weber
Rinne Test
Test: Place vibrating tuning fork on mastoid bone until patient no longer hears it, then
place in front of external auditory canal. Measure amount of seconds at each.
Normal- Positive Rinne; AC 2x BC
Abnormal- Negative Rinne; AC <2x BC
What could an abnormal Rinne test signify?
Conductive hearing loss
You have performed a Weber test on your patient and have determined it to be
positive. This means that the vibrations were heard:
More in one ear than the other
Kissing tonsils would be documented as Tonsillar grade:
4
If a patient reports seeing "halos" around the lights, you would be suspicious of
cataracts
Otitis Externa is commonly known as
Swimmers ear
Basal Skin Carcinoma
>90% of all cancerous lesions
Slow growing, nodular, superficial, rarely spreads
Squamous cell carcinoma
Small, firm, hyperkeratotic, nodule on inflamed base
It is slow growing but more likely to spread than basal!
Melanoma
Typically black or brown but can be any color.
Caused by intense, occasional, UV exposure (leading to sunburn).
Pityriasis Rosea
- Occurs between ages of 10-35
- Unknown Cause
- Starts with herald's patch (single round patch that is scaly with raised borders)
- progresses to 1-2 cm salmon colored rash on abdomen, chest, back, and legs in
CHRISTMAS TREE PATTERN
Seborrheic Dermatitis
dandruff, cradle cap, oily scales
Tinea versicolor
Fungal sun spots
Vitiligo
, Depigmentation of sections of skin; pathology is suspected to be autoimmune, genetic,
oxidative, stress, neural, or viral.
Atopic Dermatitis AKA Atopic Eczema
"The itch that rashes"
A chronic common recurring sensitive skin reaction to food and environment. Often
accompanied by asthma and hay fever.
Scratch>leak>crust
Impetigo
highly contagious infection in children and infants. Starts as a red sore that ruptures,
oozes for a few days, and then forms HONEY COLORED CRUST
Androgenic Alopecia
male pattern baldness
Telogen Effluvium
Increased loss of hair; "flooding of hairs"; due to stress, post partum, trauma, surgery,
drugs, diet, vaccination
Nail Disorders
Beau's Lines- Horizontal ridging from trauma, metabolic disease, or infection
Yellow Nails- Genetic with lung dx and lymphedema
Spoon Nails- Iron deficiency
Terry's Nails- Liver disease, CHF, DM
Oncymycosis
Tinea unguium; fungal infection of the nail
Paronchyia
Torn cuticle; bacterial or viral
Herpetic Whitlow
Herpes of the finger, Think dental profession!
Lupus
Butterfly Rash
Paget's Disease
Indicative of cancer; unilateral eczematous plaque of the nipple and areola
Acanthosis Nigricans
Seen in Diabetes; velvety darkening of skin in body folds and creases, especially the
neck, groin, and axilla; skin tags
Syphillis
Secondary stage; rash on palms and soles
Lyme Disease
Bulls Eye Target; Don't confuse with Tinea (fungal infection)
HIV/AIDS
Kaposis Sarcoma; Cancer of the lymph tissues and blood
Molluscum Contagiosum
Viral; flat, warty, non fluid-filled. Usually acquired in locker room (warm, hot)
Verruca
Warts; may be caused by HPV, slightly contagious
Battle Sign
Basilar skull fx; bruising behind ear
Cullen Sign
