PA BLK Obj

What are the four components of the physical examination?

What is the importance of reviewing the history of  present illness before performing a physical examination?

What is significant for the following to be found during an examination of the head and neck?
Nasal flaring
Cyanosis 
Pursed-lip breathing
Diaphoresis
Changes in pupillary size in response to light
Deviated tracheal position
Jugular venous distension

What is the correct method for measuring jugular venous pressure and what are normal findings?

Describe how to find the topographic positioning of the following.
Suprasternal Notch
Sternal angle
vertebral spinous process C7, T1
Lung fissures oblique, horizontal
Tracheal bifurcation A/P
R/L Diaphragm A/P
Lung borders

Define:
Pectus carinatum
Pectus excavatum
Kyphosis
Scoliosis
Kyphoscoliosis
Barrel Chest
Flail Chest

Define:
Apnea
Biot's breathing
Cheyne-Stokes breathing
Kussmaul's breathing
Apneustic
Paradoxical breathing
Asthmatic

What are the breathing patterns associated with restrictive and obstructive lung disease?

What is the significance of accessory muscles and retractions or bulging?

Define:
Abdominal paradox
Respiratory alternans
Peripheral cyanosis
Central cyanosis
Hoover's sign

What are the causes of increased/decreased tactile fremitus?

What are the causes for decreased thoracic expansion as assessed during chest palpation?

Describe subcutaneous emphysema and the clinical significance?

What are the causes of increased/decreased percussion?

What are the four basic parts to a stethoscope and their use?

How do you properly auscultate the lung?

What are the four basic breath sounds?

Define and explain mechanisms responsible:
Tracheal
Bronchovesicular
Vesicular(normal)
Diminished/absent
Harsh/bronchial

Define and explain mechanisms responsible:
Crackles/rales
Wheezes
Stridor
Pleural friction rub

What are the qualifying adjectives used to describe lung sounds?

What are the significance of the following?
Monophonic wheeze
Polyphonic wheeze
Stridor
Late-inspiratory crackles
Inspiratory and expiratory crackles
Pleural friction rub

What is bronchophony and the cause?

What are the locations of the apex and base of the heart?

What,where is PMI and what are the causes for it shifting? 

Where are the best locations for auscultating  sounds of the aortic, pulmonic , mitral,and tricuspid valve?

What produces the S1,S2,S3,S4 heart sounds?

What is a gallop rhythm and what is it indicative of ?

What are the factors which increase or decrease the intensity of heart sounds?

What is the significance of hearing a loud P2?

What causes systolic and diastolic heart murmurs?

Define hepatomegaly and explain its significance in the cardiopulmonary patient.

Define and explain the significance of the following.
Digital clubbing
Cyanosis
Pedal edema

What are the components of the blood?

What are the characteristics of blood serum and how is it obtained?

What are the normal values for the following and significance of each?
White blood cell count
White cell differential
Red blood cell count
Hematocrit
Hemoglobin
Erythrocyte indices(mean cell volume, mean cell hemoglobin,mean cell hemoglobin concentration)
Reticulocyte count
Sedimentation rate
Platelet count
Coagulation studies(bleeding time, activated partial thromboplastin time, prothrombin time)

Define the leukocytosis, leukopenia and explain some common causes of each.

What are some common causes for the following white cell abnormalities?
Neutrophilia
Neutropenia
Eosinophillia
Lymphocytosis
Lymphocytopenia
Monocytosis

Describe the effects of AIDS and AIDS-related complex have on the ratio of T-helper to T-suppressor cells.

What are the characterisitics of leukemia and myeloproliferative disorders?

What is a left shift?

Define anemia and its common causes.

What are the potential effects of anemia on oxygen-carrying capacity and tissue oxygenation?

Define primary,secondary, and relative polycythemia and how it  affects blood oxygen transport and myocardial work.

What are the implications of reduced platelet count?

What are the normal values and significance of abnormalities for the following?
Electrolytes
Anion gap
Sweat electrolyte concentration
Blood urea nitrogen and creatinine
Enzymes( aspartate aminotransferase, alanine aminotransferase,alkaline phosphatase, acid phosphotase, lactic deydrogenase,creatine kinase, amylase, lipase)
Glucose
Protein(immunoglobulins,albumin)
Lipids(triglycerides,cholesterol,high/low density lipoproteins)

What are the therapuetic levels for theophylline and what factos affect metabolism and clearance.

Define:
Normal flora
Gram stain
Culture
Sensitivity

What does a Ziehl-Neelson stain identify?

How do you obtain a fresh and uncontaminated sputum sample?

What are the factors involved in macroscropic sputum examination?

What type of sputum is produced by bronchiectasis?

What are the microscopic criteria used to determine a sputum sample is reliable?

What is the significance of sputumeosinophilia?

What organisms produced pneumonia and what are the common causes of bacterial pneumonia?

Describe the indications and method of performing a bronchoalveolar lavage?

Describe the significance of the following:
Increased pleural fluid amount
Milky pleural fluid
Hemorrhagic pleural fluid
Low protein content(Less than 3g/dl)
High protein content(More than 3g/dl)
High pleural fluid lactic dehyrdrogenase

What is the significance of the following?
Specific gravity
pH
Protein content
Glucose concentration
Ketones
Bilirubin
Blood
Urobilinogen
Nitrates
Sedimentary constituents

Explain the purpose of histologic and cytologic examinations.

What are the malignant tumors responsible for producing most primary lung cancers?

What type of pulmonary samples can be obtained cytologically?

Describe the following regarding skin testing:
Disease diagnosed
Procedures for testing
Significance and causes of anergy
Use of the purified protein  derivative
When a purified protein derivative is considered positive
Effect of the bacille Calmette-Guerine vaccine on purified protein derivative