NURS 612 Exam 2 review Dr.
May
Sp’ 21
7 MC & 9 SA
Murmur pneumonic
MR. ASS ----- MR ASS = Mitral Regurgitation; Aortic Stenosis = Systolic
murmur
MS. ARD ---- MS ARD = Mitral Stenosis; Aortic Regurgitation = Diastolic
murmur
1. Primary skin lesions. Table 9.4
o Macule – flat, circumscribed area that is a change in skin color. <
1cm.
▪ Freckles, flat moles (nevil), petechiae, measles
▪ Diff Dx:
o Nodule - Elevated firm, circumscribed/confined, 1-2 cm. Deeper in
dermis than a papule. Differential Dx: Erythema nodosum, lipoma.
o Cyst - Elevated, circumscribed, encapsulated lesion. In the dermis or
SQ layer filled w/ liquid or semisolid material. Differential Dx:
Sebaceous cyst, cystic acne.
o Papule - Elevated, firm, circumscribed area. Less than 1 cm.
Differential Dx: wart (verruca), elevated mole, lichen planus.
o Patch
o Plaque
o Pustule - Elevated, superficial lesion. Similar to vesicle but filled w/
purulent fluid. Differential Dx: impetigo, acne.
o Wheal
o Tumor
o Vesicle
2. Comparison various H.A. Ch. 11
o Headaches –
▪ Patho: Common concern. Probably one of the most self-medicated
conditions.
▪ Subjective: Description (i.e. constant, severe, recurrent). Assoc
w/ tearing. Can be brought on by an exposure.
▪ Objective: No physical findings, in many cases. Neurologic
deficits, in some cases. Abnormal gait. Papilledema. Nystagmus.
o Classic Migraine –
▪ Childhood-onset. More common in women. Unilateral or
generalized. Lasts hours to days. Onset of morning or
evening. Pulsing or throbbing pain. Assoc w/ n/v. Causes:
menstruation, not eating, contraceptive use, post-stress
o Temporal Arteritis –
1
, NURS 612 Exam 2 review Dr.
May
▪ Older adults. Unilateral or bilateral. Lasts hours to days. Occurs
anytime. Throbbing. Has temporal tenderness. Causes: stress,
anger, bruxism
o Hypertensive –
▪ Adulthood. Bilateral or occiput. Lasts for hours. Occurs in the
morning. Throbbing. Remits as the day progresses
o Cluster -
▪ Adulthood, men. Unilateral. 30 min- 2 hour duration. Onset at
night. Intense burning, boring, searing, knifelike. Assoc.
personality changes, sleep disturbances. Causes: alcohol
consumption.
o Muscular tension
–
▪ Unilateral or bilateral. Hours to days long. Happen anytime
commonly in the afternoon or evening. Bandlike, constricting.
o Space-occupying lesion –
▪ Localized pain. Rapidly increasing w/ frequency. Awakens
from sleep
3. Know the difference in hypo & hyper thyroidism
o HPI questions -
▪ Have you had a change in temperature tolerance or preference?
Have you had any neck swelling, difficulty swallowing, redness, or
pain in the neck? Have you had a change in hair thickness or
texture? Has your menses changed (amount, frequency, etc.)?
Have you had a change in bowel habits? Have you had any racing
heart, palpitations? Have you been tired recently? Have you had
a change in mood or energy? Is there an increase in prominence
of eyes, visual changes, visual disturbances?
o Hypothyroidism –
▪ Pathophysiology: Primary: thyroid gland produces insufficient
amounts of thyroid hormone. Secondary: insufficient thyroid
secretion due to inadequate secretion of either TSH from the
pituitary or thyrotropin-releasing hormone (TRH) from the
hypothalamus. More common than hyperthyroidism.
▪ Subjective: Weight gain. Constipation. Fatigue. Cold intolerance.
▪ Objective: Normal size -thyroid. Goiter. Nodules.
o Hyperthyroidism –
▪ Patho: Excess thyroid hormone causes an increase in the
metabolic rate. Assoc w/ increased total body heat production
and increased heart contractility, heart rate, vasodilation.
Multinodular goiter (Plummer disease).
▪ Subjective: Weight loss. Tachycardia. Diarrhea. Heat sensitivity.
▪ Objective: Normal size thyroid. Goiter. Nodules. Fine hair.
Brittle nails. Proptosis (protrusion of the eye).
2
May
Sp’ 21
7 MC & 9 SA
Murmur pneumonic
MR. ASS ----- MR ASS = Mitral Regurgitation; Aortic Stenosis = Systolic
murmur
MS. ARD ---- MS ARD = Mitral Stenosis; Aortic Regurgitation = Diastolic
murmur
1. Primary skin lesions. Table 9.4
o Macule – flat, circumscribed area that is a change in skin color. <
1cm.
▪ Freckles, flat moles (nevil), petechiae, measles
▪ Diff Dx:
o Nodule - Elevated firm, circumscribed/confined, 1-2 cm. Deeper in
dermis than a papule. Differential Dx: Erythema nodosum, lipoma.
o Cyst - Elevated, circumscribed, encapsulated lesion. In the dermis or
SQ layer filled w/ liquid or semisolid material. Differential Dx:
Sebaceous cyst, cystic acne.
o Papule - Elevated, firm, circumscribed area. Less than 1 cm.
Differential Dx: wart (verruca), elevated mole, lichen planus.
o Patch
o Plaque
o Pustule - Elevated, superficial lesion. Similar to vesicle but filled w/
purulent fluid. Differential Dx: impetigo, acne.
o Wheal
o Tumor
o Vesicle
2. Comparison various H.A. Ch. 11
o Headaches –
▪ Patho: Common concern. Probably one of the most self-medicated
conditions.
▪ Subjective: Description (i.e. constant, severe, recurrent). Assoc
w/ tearing. Can be brought on by an exposure.
▪ Objective: No physical findings, in many cases. Neurologic
deficits, in some cases. Abnormal gait. Papilledema. Nystagmus.
o Classic Migraine –
▪ Childhood-onset. More common in women. Unilateral or
generalized. Lasts hours to days. Onset of morning or
evening. Pulsing or throbbing pain. Assoc w/ n/v. Causes:
menstruation, not eating, contraceptive use, post-stress
o Temporal Arteritis –
1
, NURS 612 Exam 2 review Dr.
May
▪ Older adults. Unilateral or bilateral. Lasts hours to days. Occurs
anytime. Throbbing. Has temporal tenderness. Causes: stress,
anger, bruxism
o Hypertensive –
▪ Adulthood. Bilateral or occiput. Lasts for hours. Occurs in the
morning. Throbbing. Remits as the day progresses
o Cluster -
▪ Adulthood, men. Unilateral. 30 min- 2 hour duration. Onset at
night. Intense burning, boring, searing, knifelike. Assoc.
personality changes, sleep disturbances. Causes: alcohol
consumption.
o Muscular tension
–
▪ Unilateral or bilateral. Hours to days long. Happen anytime
commonly in the afternoon or evening. Bandlike, constricting.
o Space-occupying lesion –
▪ Localized pain. Rapidly increasing w/ frequency. Awakens
from sleep
3. Know the difference in hypo & hyper thyroidism
o HPI questions -
▪ Have you had a change in temperature tolerance or preference?
Have you had any neck swelling, difficulty swallowing, redness, or
pain in the neck? Have you had a change in hair thickness or
texture? Has your menses changed (amount, frequency, etc.)?
Have you had a change in bowel habits? Have you had any racing
heart, palpitations? Have you been tired recently? Have you had
a change in mood or energy? Is there an increase in prominence
of eyes, visual changes, visual disturbances?
o Hypothyroidism –
▪ Pathophysiology: Primary: thyroid gland produces insufficient
amounts of thyroid hormone. Secondary: insufficient thyroid
secretion due to inadequate secretion of either TSH from the
pituitary or thyrotropin-releasing hormone (TRH) from the
hypothalamus. More common than hyperthyroidism.
▪ Subjective: Weight gain. Constipation. Fatigue. Cold intolerance.
▪ Objective: Normal size -thyroid. Goiter. Nodules.
o Hyperthyroidism –
▪ Patho: Excess thyroid hormone causes an increase in the
metabolic rate. Assoc w/ increased total body heat production
and increased heart contractility, heart rate, vasodilation.
Multinodular goiter (Plummer disease).
▪ Subjective: Weight loss. Tachycardia. Diarrhea. Heat sensitivity.
▪ Objective: Normal size thyroid. Goiter. Nodules. Fine hair.
Brittle nails. Proptosis (protrusion of the eye).
2
