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PRIMARY CARE > 2a: review of systems > Flashcards

2a: review of systems Flashcards

1
Q

what is Uneasiness, feeling that ‘something isn’t right

A

malaise

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2
Q

dyspnea , cough , clubbing of nails , and wheezing/stridor indicate what system problem

A

pulmonary

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3
Q
  1. Dyspnea
  2. Cough (duration, positional,
    productive, sputum?)
  3. Palpitations
  4. Syncope
  5. Sweats
  6. Edema
  7. Cold distal extremities
  8. Skin discoloration
  9. Open wounds/ulceers

this all indicate what systems disorder

A

cardio and peripheral vascular systems

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4
Q
  1. Exertional dyspnea
  2. Palpitations
  3. Anginal pain patterns
  4. Fatigue
  5. Pallor
  6. Digital clubbing
  7. Lightheadedness
  8. Syncope
  9. Drowsiness
  10. Confusion
  11. Easy bruising & bleeding
  12. Fever, chills, sweats
  13. Malaise

these al indicate what system problem

A

hematologic system

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5
Q

for hematologic system you are looking for what

A

•Erythrocyte, leukocyte, platelet conditions
• Bleeding disorders

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6
Q

if your stool color is black , tarry , shiny and sticky what does that mean

A

upper gi bleeding

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7
Q

if your stool is black but not sticky what does that mean

A

ingestion or iron and bismuth salts , black licorice , some commercial cc cookies

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8
Q

what does light gray, pale stool color mean

A

obstructive jaundice

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9
Q

what does bright , blood red stool mean

A

lower GI bleeding

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10
Q
  1. Swallowing difficulties
  2. Indigestion, heartburn
  3. Food intolerance
  4. Bowel dysfunction
    • Color of stool
    • Shape, caliber of stool
    • Constipation
    • Diarrhea
    • Difficulty initiating (i.e. constipation)
    • Incontinence

these are all problems with what system

A

gastro intestinal systems

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11
Q

what does dark urine mean

A

hepatic or biliary obstructive disease , acute rhabdomyolysis

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12
Q

what does red blood mean

A

many GI disorders

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13
Q

what does reddish urine mean

A

blood, ingestion of vegetable dyes , beets, use of some meds (phenazopyridine)

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14
Q
  1. Flow – frequency, urgency, output,
    retention, dysuria
  2. ↓ caliber or force of urine stream
  3. Difficulty initiating urine stream
  4. Incontinence

these are all problems of what system

A

urinary system (genito urinary system)

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15
Q

Male
1. Urethral d/c
2. Sexual dysfunction
3. Pain during intercourse, ejaculation

these are problems with what system

A

reproductive system

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16
Q
  1. Numbness, tingling
  2. Weakness
  3. Tremors
  4. Seizures
  5. Vision △’s
  6. Sexual difficulties
  7. Hearing problems
  8. Difficulty swallowing
  9. Urinary incontinence
  10. Vomiting w/o nausea
  11. Dizziness
  12. Recent falls
  13. Balance problems

these are all problems of what system

A

nervous system

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17
Q
  1. △’s in skin
    • Color, sores, moles, rashes, lumps
  2. △’s in nails
    • Discoloration, thickening, ridges,
    splitting or separation from nail
    bed
  3. △’s in hair
    • Hair loss, ↑ in hair, △ in thickness
    or distribution
  4. Pruritus (itching)
  5. △ in sweating or dryness in
    skin

these are problems in what system

A

integumentary system

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18
Q
  1. General health
    • Fatigue, unexplained weight △,
    weakness
  2. Psychologic, cognitive
    • Personality △’s, memory loss, confusion, irritability
  3. GI
    • N&V, anorexia, dysphagia, diarrhea, constipation
  4. Uro-genital
    • Impotence, intermittent urine stream, dribbling, straining to void
  5. MSK
    • Muscle weakness & cramps, arthralgias, myalgias, stiffness, bone
    pain
  6. Sensory
    • Paresthesia, numbness
  7. Dermatologic
    • Foot ulcerations, edema, dry/coarse skin, impaired would healing
  8. Miscellaneous
    • Temperature intolerance, visual △’s,
    orthostatic hypotension

these are problems of what system

A

endocrine system

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19
Q

what are the chief complaint by symptom

A

joint pain

limb (not joint related pain)

dizziness

HA

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20
Q

what is the most common cause of joint pain and how many people does it effect each year

A

OA and 30 mil

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21
Q

who should be the primary care providers for OA

A

PTS

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22
Q

what are the historical symptoms of back pain

A

•morning stiffness > 30 min
• improvement w exercise but not w rest
•awaken during 2nd half of night bc pain
•alternatin butt pain

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23
Q

what is the inclusion criteria for inflammatory back pain

A

<50 years of age and a minimus of 3 months of LBP

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24
Q

what is the expert opinion of symptoms for inflammatory back pain

A

•improvement with exercise
•no improvement with rest
•pain at night
•age onset at 40 or younger
•insidious onset

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25
Q

• Autoimmune arthritis, typically in spine
• May have a (+) family hx
• Pain &/or stiffness in hip &/or neck
• Symptoms ↑ w/ rest
• Symptoms ↓ w/ activity
• Pain at night (particularly last half)
• Non-joint conditions: uveitis, irritable bowel syndrome

these are all related to what disease

A

anklosing spondylitits

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26
Q

is non specific LBP or Ankylosing Spondylitis more common

A

non specific LBP

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27
Q

• 35-55 yrs of age
• Male-female ratio – 1:1
• Degenerative arthritis
• Potential pain referral to hip
• Symptoms vary, but can ↓ w/ rest or position
△’s
• Non-joint conditions: n/a

these are all common with what pathology

A

non specific lbp

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28
Q

what is the 7 classification criteria for RA

A

•morning stiffness
•arthritis of >3 joint
•arthritis of hand joints
• symmetric arthritis
•rheumatoid nodules
•serum rheumatoid factors
• radiographic changes

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29
Q

for the classification criteria for RA … Abnormal amounts of serum rheumatoid factor determined by any method for which result has been (+) in <__ % of normal control subjects

A

5

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30
Q

how long does mornign stiffness last for RA classification criteria

A

> 1 hour before max improvement

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31
Q

____+ criteria in pt w/ disease <1 yr: sensitivity – 85%, specificity – 90%
criteria must be present for >___ weeks

A

4
6

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32
Q

when is the peak onset for SLE

A

15-40

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33
Q

are females or males more likely for SLE

A

females

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34
Q

when do SX increase and decrease for SLE

A

increase with rest , intense activity

decrease with short rest and mild activity

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35
Q

do pt with SLE have post rest stiffness > 60 mins

A

yes

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36
Q

how is night pain for people with SLE

A

less evident

37
Q

• Peak onset b/t 15-40 yrs
• Insidious
• Females more likely than males
• African-American females 3x
more likely than Caucasians
• (+) family hx
• Infection, sunlight or ultraviolet
light exposure, meds
• Sx ↑: rest, intense activity
• Sx ↓: short rest, mild activity
• Tenderness at affected joints
• Moderate post-rest stiffness >60
min
• Night pain less evident
• Can progress rapidly or slowly
• Symptoms vary from mild to
severe

these are all common demographics and medical hx for someone with what condtion

A

SLE

38
Q

when is the peak onset for gout

A

5th decade for men (40’s) and 6th decade for women (50;s)

39
Q

are men or women more likely to get gout

A

men

40
Q

Renal disorders associated w/ ↑’d
levels of uric acid, leukemia,
lymphoma, psoriasis, chemotherapy, hypothyroidism , HTN , heavy ETOH consumption , taking diuretics and salicylates are associated with what disease

A

GOUT

41
Q

when do sx increase and decrease with gout

A

increase with wb activity and joint use

decrease with rest but unrelenting

42
Q

do people woth gout have night time pain

A

yes

43
Q

• Excruciating pain
• Post-rest stiffness less evident
• Night pain (+)
• Rapid progression
• Symptoms are severe • Peak onset 5th decade for men, 6th
decade for women
• Sudden, often at night
• Males more likely than females
• (+) family hx
• Renal disorders associated w/ ↑’d
levels of uric acid, leukemia,
lymphoma, psoriasis, chemotherapy, hypothyroidism, HTN, heavy ETOH consumption, taking diuretics & salicylates
• Sx ↑: WB activity, joint use
• Sx ↓: ↓ pain w/ rest, but unrelenting

these are all commonly seen with people with what condition

A

gout

44
Q

when is the peak onset for psoriatic arthritis

A

peak onset 2nd and 3rd decades w arthritis following up to 20 years later

45
Q

how are the sx increased and decreased with psoriatic arthritis

A

increased with rest and intense activity

decreased with short rest and mild activity

46
Q

Psoriatic Arthritis is similar to what other 2 conditions ?

A

SLE and RA

47
Q

• Psoriasis: peak onset 2nd & 3rd
decades w/ arthritis following
up to 20 yrs later
• Insidious
• No gender predilection
• (+) family hx
• Psoriasis
• Sx ↑: rest, intense activity
• Sx ↓: short rest, mild activity
• Tenderness at affected joints
• Moderate post-rest stiffness >60
min
• Night pain less evident
• Can progress rapidly or slowly
• Symptoms vary from mild to
severe

these are common demographics and medical hx for what conditions

A

Psoriatic Arthritis

48
Q

when is the peak onset for reactive arthritis (reiter’s syndrome)

A

3th decade

49
Q

is Reactive Arthritis (Reiter’s Syndrome) more common in females or males

A

males

50
Q

what other disease is common with Reactive Arthritis
(Reiter’s Syndrome)

A

venereal or dysenteric disease

51
Q

when are sx increased and decreased with Reactive Arthritis
(Reiter’s Syndrome)

A

• Sx ↑: rest, intense activity
• Sx ↓: short rest, mild activity

52
Q

• Peak onset 3rd decade
• Acute
• More common in males
• Venereal or dysenteric disease
• Sx ↑: rest, intense activity
• Sx ↓: short rest, mild activity
• Moderate to severe post-rest
stiffness >60 min
• Night pain less evident
• Can progress rapidly or slowly
• Symptoms vary from mild to
severe

these are common demographics and medical hx for what condtion

A

Reactive Arthritis
(Reiter’s Syndrome)

53
Q

what arthritis has an abrupt onset , excruciating pain , post rest stiffness less evident , increased night pain , rapid profession , sx are severe and Sx ↑: WB activity, joint use, Sx ↓: less pain w/ rest, but
unrelenting and Systemic corticosteroid use,
DM, infection elsewhere, direct
penetrating joint trauma

A

septic

54
Q

what are the review os systems findings are gout

A

fever , malaise , tachycardia

55
Q

if they systems findings are Skin rash (malar rash most common)
Fever, fatigue, malaise
Photosensitivity
Dyspnea, cough
Peripheral neuropathies

what joint disorder is it

A

systemic lupus erythematosus

56
Q

what joint disorder will present with a review of systems findings of

Uveitis (20-30% of pts)
Fatigue, weight loess, fever, malaise
Cardiac & pulmonary complications

A

Ankylosing Spondylitis (AS)

57
Q

what is the systems findings for joint OA

A

nothing

58
Q

what is the systems findings for psoriatic arthritis

A

Fever, fatigue, malaise
Psoriasis

59
Q

if someone has these findings what joints disorder do they have

Urethritis
Conjunctivitis
Nausea, vomiting, diarrhea
Weight loss

A

Reactive Arthritis (Reiter’s Syndrome)

60
Q

what is the review of systems findings are septic arthritis

A

fever, chills , malaise

61
Q

what is teh chief complaints of limb (non joint related) pain

A

calf or thigh pain
antalgic gait
difficulty walking

62
Q

• Hypothyroidism
• Lyme disease
• Polymyalgia rheumatica
• Statin-induced myopathy

these are examples of what

A

conditions associated with limb pain that are not typically managed by us

63
Q

what is impairment in spatial perception and stability

A

dizziness

64
Q

what is the sensation of spinning

A

vertigo

65
Q

what should be considered when evaluating dizziness

A

serious pathologic neck conditions

66
Q

is dizziness or vertigo more common

A

dizziness

67
Q

what are the 5 D’s for vertebral artery insufficiency

A

drop attack , dizziness, dysphasia , dysarthria , diplopia

68
Q

what are 3 N’s are vertebral artery insufficiency

A

nausea, numbness , nystagmus

69
Q

what else will be positive with Vertebral Artery Insufficiency (VBI)

A

cranial nerve signs

70
Q

what does FAST stand for as a VBI S&S marker for impending CVA

A

• F – facial droop
• A – arm numbness/weakness
• S – speech difficulty
• T – time is brain (call EMS)

71
Q

• Occipital HA & numbness
• Severe limitation during neck AROM in
all directions
• Signs of cervical myelopathy

this describes what instability

A

upper cervical ligamentous instability

72
Q

what is vertigo causes by

A

asymmetrical involvement of vestibular system

73
Q

40% of dizziness is causes by ___ and 25% is causes by ___

A

peripheral
central

74
Q

• Dizziness, imbalance, unsteadiness w/o vertigo
• Degenerative △’s in brain or body

this describes what

A

Dysequilibrium

75
Q

what is presyncope

A

vascular compromise to cerebellum

76
Q

what are non CV causes for presyncope

A

hypoglycemia , certain meds

77
Q

• Panic/anxiety
• Cervicogenic

what categorie of dizziness does this respond

A

non specific (psychophysiologic)

78
Q

what is one of the most common and disabling conditions in the world

A

headaches

79
Q

are headaches more common in women or men

A

women

80
Q

what are the 4 types of headaches and which are primary and secondary

A

• Cervicogenic (2º)
• Migraine (1º)
• Cluster (1º)
• Tension-type (1º)

81
Q

which headache is the most common

A

tension type (band , tightening)

82
Q

what is tension type of HA casues by and what are the sx

A

stress, anxiety and or depression

bilateral sx

83
Q

what is the 2nd most common headache

A

cervicogenic

84
Q

what headache is Provoked by neck movements &/or sustained postures

A

cervicogenic

85
Q

are the sx unilateral or bilateral for cervicogenic

A

uni

86
Q

• 10-15% of all HAs
• Unilateral symptoms, but shifts sides
• >1 signs expected: nausea, vomiting,
photophobia, phonophobia
• Symptoms are severe

this describes what type of headache

A

Migraine (pounding, pulsating)

87
Q

• <1% of all HAs
• Come in clusters at least every other day for
8 days
• Other S&S: lacrimation, nasal congestion &/or rhinorrhea, eyelid edema, forehead & facial sweating, ptosis, sense of restlessness
or agitation
• Symptoms are severe or very severe

this describes what headache

A

cluster (crushing)

88
Q

red flags: double vision, severe or worsening HA, seizure or convulsion , LOC , deteriorating consciousness, vomiting , agitation and or combativeness … these are red flags for what trauma

A

head injury

89
Q

what are the 7 high risk sites for stress reaction and stress fx injuries

A

• Femoral neck
• Anterior cortex of tibia
• Medial malleolus
• Tarsal navicular
• Base of 2nd & 5th metatarsal
• Talus
• Patella

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