1A Flashcards by sophia carrasco

when did the US military health care system include PTs as an entry point

1970

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the institute of medicine defines primary care as what 4 things delivered by accountable provides of personal health services

accessible , comprehensive , coordinated and continual care

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in 2000 who challenged pts to develop a pt focused societal identities to address health care delivery in future

ruth purtilo

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how many days of direct access does texas have

10-15

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what is the 1st question that must be answer prior to any others

DO THEY BELONG

if yes then tx
if no then refer
if yes but refer , refer and tx

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what are the nine conditions on ‘do not want to miss list’

Major depression
Suicide risk
Femoral Head & neck fx’s
Cauda equina syndrome
Cervical myelopathy
Abdominal aortic aneurysm
(AAA)
Deep venous thrombosis (DVT)
Pulmonary embolism (PE)
Atypical myocardial infarction

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what is the primary relative for a risk factor from depression

family hx

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what is the percent of PTs formally screen for depression

18%

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do males or females have a higher risk factor for sucicide completion

males , females have more attempts

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HX of psychiatric illness (depression , ETOH, abuse) is a risk factor for what

suicide

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what was the 2nd leading COD in ages 10-14 and 20-34

suicide

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what 3 conditions are associated with increase fx rates

-osteoporosis
- stress/fatigue
- major trauma

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• Female
• Running, jumping, marching
• △ in training program or routine
• Nutritional deficiencies
• Leg length discrepancy
• ↓ muscle strength

these are all risk factors associated with what

fatigue FX

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what are some clinical manifestation for femoral head and neck fx

-Pain & localized tenderness in
groin/anterio-medial thigh, greater
trochanter, buttock regions
• Worse w/ WB
• Deformity (shortened limb)
• Edema
• Ecchymosis
• Loss of general function & mobility

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what 2 test are positive with femoral head and neck fxs

patellar pubic percussion test (do this first)
fulcrum test

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• Low back injury, central disc
herniation
• Congenital or acquired spinal
stenosis
• Spinal fx
• Ankylosing spondylitis
• TB, Pott’s disease

these are all risk factors for what serious condition

cauda equina

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what are the neurologic compromise clinical manifestation for cauda equina

• Motor & sensory deficits
• Urinary, bowel & sexual dysfunction
• Urinary retention most frequently
noted

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how are the onset of symptoms for cauda equina

quick or gradual

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what are 3 other clinical manifestations for cauda equina

LB &/or LE pain

gait ataxia&/or poor balance

C/O of LE “feeling heavy and weak”

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what is the most common causes of non traumatic paraparesis and quadriparesis

cervical myelopathy

• Typically, associated w/ c-spine
spondylosis
• Associated c-spine instability can&raquo_space;
spinal cord compromise
• MOST common cause of non-
traumatic paraparesis &
quadriparesis
• Wide variation in natural hx
• Neurologic S&S begin in mid-50’s to
60’s (↑’s w/ every decade of life)
• Can occur in younger folks following
significant neck trauma or RA

these are risk factors of what serious condition

cervical myelopathy

these Neurologic compromise clinical manifestations are a part of what disease

• Impaired hand dexterity
• May see atrophy in intrinsics
• Gait, balance difficulties
• Paresthesias (UEs & possibly LEs)
• Neck stiffness
• Urinary retention
• UE weakness (triceps, hand intrinsics)
• Proximal LE weakness
• UMN signs

cervical myelopathy

what is the definition for abdominal aortic aneurysm

aneurysm distal to the renal arteries (>3 cm in diameter)

when is there a risk for rupture for an AAA

when the diameter approaches 5-6 cm

• >60 y/o (risk ↑’s w/ age) • Male • Hx of smoking • Hx of hypercholesterolemia & CAD these are all risk factors for what serious condition

AAA

where will you have pain from an AAA

back , abdominal , hip , groin &/or buttock

what type of onset is an AAA

insidious

if you hear abdominal auscultations along midline and 2in superior to umbilicus what is that mean

possible AAA

if someone has a AAA and they report hot, searing , ripping or tearing pain what do you do

stop all activity

are most pateints with AA symptomatic or asymptomatic

asymptomatic

• Hx of cancer, CHF &/or SLE • Severe infection • Receiving chemo • Central venous catheter • Major surgery • Major trauma • Immobility • Limb paralysis • Women during pregnancy or are up to 6 wks post-partum • Age >60 y these are all risk factors for what serious condition

DVT

what are the 5 clinical manifestations for a DVT

• Ache, tightness, tenderness near site • General edema • Pitting edema • Prominent superficial venous plexus • ↑ local skin temperature

what percent of individuals with DVT are asymptomatic in early stages

50%

if a person scores >/= 2 points on the clinical decision rule for DVT what does that mean

dvt likely

what are some of these questions asked on the clinical decisions rule forDVT

cancer paralysis bedridden/ major sx tenderness leg swollen calf swelling pitting edem

what is the only negative scoring on clinical decision rule for DVT

alternative DX at least as likely as DVT

what is most associated with DVT , air , fat or bone marrow embolism

pulmonary embolism

what comprise the most PE’s

proximal LE DVTs

• Hx of DVT • Immobility • Hx of abdominal, pelvic surgery • Total hip, knee replacement • Late-stage pregnancy • Lower limb fx • Malignancy of pelvis or abdomen these are all risk factors for what serious conditions

• Dyspnea • Tachypnea • Pleuritic chest pain, intensified w/ deep respiration or cough • Persistent cough • Apprehension, anxiety • Tachycardia • Palpitations these are all clinical manifestations for which serious condition

what percent of deaths related to PE are potentially preventable if DX earlier

> 50

what are the numbers for th pre test probability of PE

<2 = low 2-6= moderate >6= high

what is included the clinical decision rule for PE and what is it called

clinical signs of DVT HR > 100 immobilization for 3 days previous DVT hemoptysis pt with cancer getting treatment alternative dx called wells creitiera

50% of ___ experience chest pain with MI

women

what is the leading COD in women of ALL ages

cardiac death

• Smoking • High cholesterol levels • HTN, DM • Obesity • Sedentary lifestyle • Excessive ETOH consumption • Age: women >55 y/o; men >45 y/o • Family hx • Ethnicity (highest in African-Americans these are all risk factors for what serious condition

atypical myocardial infarction

• SOB • Fatigue • Sleep disturbance • Nausea (w/ & w/o vomiting) • Palpitations • Dizziness • Diaphoresis • Anxiety • Chest pain (w/ & w/o L UE pain) • Upper abdominal, epigastric, jaw, neck &/or tooth pain • Pain may or may not be associated w/ exertion these are all clinical manifestations of what serious condition

atypical myocardial infarction

what is a major thing to do for atypical myocardial infarction

take vital signs