GN.2012/GN.2031 Exam 1 Blueprint Flashcards

Practice flashcards covering health history, neurological examination, mental status, and HEENOT based on the Exam 1 Blueprint.

Chief complaint

The primary symptom or reason for seeking care, usually recorded in the patient’s own words.

OLDCARTS

A mnemonic for the History of Present Illness: Onset, Location, Duration, Character, Aggravating/alleviating factors, Radiation, Timing, and Setting.

Review of Systems (ROS)

Subjective information organized system-by-system to identify symptoms the patient may be experiencing.

Subjective data

Anything the patient tells the clinician, including the chief complaint and Review of Systems (e.g., chest pain, nausea).

Objective data

Physical examination findings, including observations, lab results, and diagnostic test findings (e.g., BP $135/80$, WBC).

Comprehensive assessment

An evaluation for new patients or annual physicals that includes a complete health history and head-to-toe exam to establish a baseline.

Focused assessment

A problem-oriented evaluation for established patients or urgent care visits where the history and physical exam are restricted to the chief complaint.

Inspection

Close observation of a patient's appearance, behavior, movements, mood, skin conditions, symmetry, and gait.

Palpation

The use of tactile pressure from the palmar fingers or finger pads to assess texture, lymph nodes, pulses, organ sizes, and joints.

Percussion

Tapping one finger quickly against another finger pressed against the body to generate sounds indicating fluid, air, or organ size.

Auscultation

The use of a stethoscope to detect heart, lung, and bowel sounds, focusing on pitch and intensity.

Cranial Nerve I (Olfactory)

A sensory nerve responsible for smell reception and interpretation.

Cranial Nerve III (Oculomotor)

A motor nerve that raises eyelids and controls most extraocular movements; also responsible for pupillary constriction.

Cranial Nerve V (Trigeminal)

A nerve with motor functions for jaw clenching and chewing, and sensory functions for facial sensation and the corneal reflex.

Cranial Nerve VII (Facial)

A nerve responsible for facial expressions, labial speech sounds ($b, m, w$), taste on the anterior $2/3$ of the tongue, and saliva/tear secretion.

Cranial Nerve X (Vagus)

A nerve involved in the carotid reflex, heart and digestive tract reactions, and sensation behind the ear.

Cranial Nerve XII (Hypoglossal)

A motor nerve responsible for tongue movement for speech articulation ($l, t, d, n$) and swallowing.

Reflex Grade 4+

A reflex response that is very brisk, hyperactive, and accompanied by clonus.

Clonus

Rhythmic oscillations between flexion and extension, often seen in CNS disease.

Muscle Strength Grade 3

Active movement of the body part against gravity but not against resistance.

Muscle Strength Grade 5

Active movement against full resistance without evident fatigue, considered normal muscle strength.

Spasticity

Rate-dependent increased muscle tone where resistance increases during rapid movement, often caused by upper motor neuron lesions like stroke.

Rigidity

Increased muscle resistance that persists throughout the movement arc, independent of the rate of movement (e.g., lead-pipe or cogwheel rigidity).

Flaccidity

A loss of muscle tone (hypotonia) that causes limbs to be loose or floppy, commonly seen in Guillain–Barré syndrome.

Stereognosis

The ability to identify a familiar object, such as a key, placed in the hand.

Graphesthesia

The ability to identify a number outlined on the palm of the hand.

Ataxia

Impairment of coordination, gait, or equilibrium resulting from damage to the cerebellar system.

Spastic hemiparesis

A gait where the affected leg is stiff and extended with plantar flexion, and the foot is circled stiffly outward (circumduction).

Steppage gait

A gait where the hip and knee are elevated high to lift a plantar flexed foot; seen in foot drop or peripheral nerve disease.

Romberg test

A test of station where the patient stands with feet together and eyes closed for $30$ seconds; loss of balance is a positive result.

Lethargy

A level of consciousness where the patient appears drowsy but opens eyes to a loud voice, responds, and then falls back asleep.

Stupor

A state where the patient arouses only after painful stimuli and lapses back into unresponsiveness when stimuli cease.

Flight of ideas

A continuous flow of accelerated speech with abrupt changes from one topic to the next based on loose associations.

Confabulation

The fabrication of facts or events to fill in gaps from impaired memory.

Delusion

A false, fixed personal belief that is not amenable to change despite conflicting evidence.

Hallucination

A perception-like experience that seems real but lacks actual external stimulation (e.g., auditory or visual).

Illusion

The misinterpretation of real external stimuli.

Delirium

An acute onset, fluctuating state of disturbed consciousness and disorganized thinking, often reversible.

Dementia

An insidious, slowly progressive decline in cognitive function and memory, often months to years in duration.

PHQ-9

A depression screening tool scored from $0$ to $27$; a score of $20-27$ indicates severe depression.

MoCA (Montreal Cognitive Assessment)

A cognitive screening tool scored out of $30$, where a score of $\ge 26$ is considered normal.

CAGE

A substance abuse screening tool where a score of $2$ or more positive answers indicates a potential alcohol problem.

Shotty nodes

Small, non-tender lymph nodes that feel like BBs under the skin.

Virchow Node

A palpable supraclavicular node on the left that is a significant clue to thoracic or abdominal malignancy.

Entropion

An abnormality where the eyelid margins turn inward.

Ptosis

Drooping of the upper eyelid.

Myopia

Nearsightedness, where distant objects appear blurry.

Presbyopia

Insufficiency of accommodation due to aging, resulting in difficulty focusing on close objects after age $40$.

Conductive hearing loss

Hearing loss resulting from problems in the external or middle ear that prevent sound from reaching the cochlea.

Weber test

A hearing test where sound lateralization to the impaired ear suggests unilateral conductive hearing loss.