8.22 Symptom Investigation Flashcards
Able to find an accurate dx from a thorough hx
2/3 of the time
Reasons for PTs to be seen first
- faster care
- 50% reduction in imaging
- higher pt satisfaction
differential dx process
- positive response to tx confirms dx
- lack of response to tx raises questions
- concern of co-morbid conditions such as visceral pathology
Questions to ask about onset and behavior of symptoms
- How did symptoms develop?
- Changes in location?
- Intensity with certain movements or rest?
- Changes with posture
- Constant or intermittent?
- Agg factors?
- Night pain?
- Ease factors?
- Non-musculoskeletal activity (food intake and defecation)
What are common words of concern?
- cramping, colicky
- throbbing, aching
- pressure
- tightness
- heaviness
- weakness
- severe/disabling
- worst pain I have ever had
When would the words of concern make you think that something was non-musculoskeletal in origin?
If coupled with other info from hx
What words are often associated with vascular disorders?
- throbbing
- pounding
- pulsating
What words are often associated with neurologic disorders
- sharp
- lancinating
- shocking
- burning
What words are often associated with visceral disorders
- aching
- squeezing
- gnawing
- burning
- cramping
What are the cancer red flags?
- persistent pain at night
- constant pain anywhere in the body
- unexplained weight loss
- loss of appetite
- unusual lumps/growths
- unwarranted fatigue
common sites and symptoms of cancer metastasis: brain
- headaches
- seizures
- vertigo
common sites and symptoms of cancer metastasis: respiratory
- cough
- hemoptysis
- dyspnea
common sites and symptoms of cancer metastasis: lymph nodes
lymphadenopathy
common sites and symptoms of cancer metastasis: liver
- hepatomegaly
- jaundice
common sites and symptoms of cancer metastasis: skeletal
- pain
- fx
- spinal cord compression
Cardiovascular red flags
- SOB
- dizziness
- pain/heaviness in chest
- pulsating pain anywhere in the body
- constant/severe pain in lower leg/arm
- discolored or painful feet
- swelling (no hx of injury)
Gastrointestinal/genitourinary red flags
- frequent/severe abdominal pain
- frequent heartburn or indigestion
- frequent nausea or vomiting
- changes/problems with bladder function (UTI, etc.)
- unusual menstrual irregularities
Neurological red flags
- changes in hearing
- frequent or severe headaches with no hx of injury
- difficulty with swallowing/speech
- visual changes
- balance problems
- fainting spells
- sudden weakness
- 5 D’s
What are the 5 D’s?
- dizziness
- diplopia
- dysarthria
- dysphagia
- drop attacks
Misc red flags
- fever or night sweats
- recent severe emotional disturbances
- swelling/redness in any joint with no hx of injury
- pregnancy
What might fever or night sweats indicate?
infection
