Acute Problems Flashcards
What is temporal arteritis?
Temporal arteritis is a condition in which the temporal arteries, which supply blood to the head and brain, become inflamed or damaged.
What other symptoms are accompanying an URI?>
- kind of cough
- sick contacts
- confounding illness
- Treatment
Symptoms of viral infection on exam
- Nares-erythema, blue or boggy
- Oropharynx-watch for exudate/erythema
- Lymphadenopathy
- Pulmonary exam-URI vs pna
Flu vs common cold
Flu-myalgia
cold- sore throat
flu-fever, headache, fatigue, cough
Cold-sore throat, sneezing nasal congestion
How is common cold treated?
- antipyretic/analgesics
- children no medicine effective
- nasal suction
- guaifenesin, mucolytic
5.
When is it appropriate to treat a URI with antibiotic therapy?
avoid broad spectrum ABT treat for 10 days
How is Group A strep URI treated
PCN 10 day course
Treating EBV with amoxicillin is associate dwith what?
Rash
Which of the following is most likely the main indication for antibiotic treatment in children with group A Streptococcus pharyngitis?
Prevention of rheumatic fever
Symptoms of whiplash
- History of acute injury
- neck pain, reduced mobility, occipital headache
- imaging demonstrates no changes
What is cervical radiculopathy
The clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function.
Symptoms of cervical radiculopathy.
Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate anywhere from the neck into the shoulder, arm, hand, or fingers
Causes of cervical radiculopathy?
Radiculopathy may be caused by trauma either acute disc damage or exacerbation of degenerative disease
What is Spurling’s test
Reproduction of radiculopathy when the examiner rotates the patient’s neck to the ipsilateral side and extends it applying gentle downward pressure
What is the definition of ipsilateral?
belonging to or occurring on the same side of the body.
How is acute neck injury managed?
- APAP
- NSAID’s
- Muscle relaxants
- Tramadol
- Opiates
- PT
How long can whiplash last
about half of whip lash patients will continue to have neck pain at one year
What are key diagnoses to rule out when assessing a patient for back pain?
- Cauda equina syndrome
- metastatic cancer
- epidural abscess
- vertebral osteomyelitis
How is acute back pain managed in family medicine
- Analgesics
2. PT
What percentage of acute back pain becomes chronic?
20 percent
a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine
Spinal stenosis
If treatment is not working and the patient has decreased functioning when treating LBP, is imaging a next step
- yes if treatment has been effective
If analgesics and PT have failed what is the next best step in treating LBP
- Epidural glucocorticoid injection
How long does epidural injection for back pain last
3 months or less
What is the annual limit for steroid injections for LBP
6 annual limit for injections for LBP
Are glucocorticoid injections helpful for spinal stenosis?
not effective
What are the major causes of shoulder pain to consider?
- Rotator cuff tendonitis
- Adhesive capsulitis
- acromioclavicular joint disease
- Biceps tendonitis
- Glenohumeral arthritis instability
What shoulder disorder is more common among patients with diabetes and hypothyroidism?
Adhesive capsulitis
If the pain in the shoulder is located anterior/superior what is the likely cause or diagnosis?
AC joint disease
If the patient has pain with overhead activity what is the likely diagnosis?
Rotator cuff disorders
If the patient has pain with the Hawkin’s test what is the likely cause of the pain?
Rotator cuff
What is the likely diagnosis if a patient has positive pain with the empty can test?
supraspinatus tear
If a patient has positive pain during the cross body abduction test what is the likely cause of the pain?
AC joint disease is a possibility
If a patient has pain during the external rotation test what is the likely cause of the pain
Infraspinatus tendon pathology
During the speed test if a patient has pain what is a possible diagnosis?
Biceps tendonitis
If the patient has pain with the cross body abduction test what is the likely cause of pain?
AC joint disease
How is shoulder pain managed?
Modification of activity Analgesics Cortico steroids Physical Therapy Surgical referral
How did the injury occur
- Direct blow
- foot planted
- Previous injury
How is the knee assessed for injury?
- Inspection
- ROM
- Palpate pain, warmth, effusion
- Patellofemoral syndrome, crepitus on quad contraction
- Assess cruciate/collateral ligaments
- Meniscal testing with poor sensitivity
When the patient has a suspected meniscal tear what should the provider do to correctly confirm diagnosis?
MRI
The Thessaly test is useful for diagnosis an injury to the?
Menisci
Which of the following conditions is characterized by pain around or behind the patella resulting from chronic overuse and is largely a diagnosis of exclusion?
Patellofemoral pain
Anterior knee pain what type of injury would the provider consider?
- Patellar tendonitis jumpers knee
2. Patellofemoral syndrome
What type of injury should be suspected if the patients knee pain located medially on the knee?
- MCI sprain
- Medial meniscal tear
- Pes amserine bursitis
Lateral knee pain or injury could be related to?
- Lateral meniscal tear
2. iliotibial band syndrome
Patellar subluxation is more common in male or female
female
Tibial apophysitis (Osgood-Schlatter disease)
- Pain over the tibial tuberosity in adolescent s/p recent growth spurt, worse with squatting, stairs, quad strain
This in just is actually a hip injury which can be avascular necrosis, which can present as knee pain.
Slipped capital femoral epiphysis can result in referred knee pain
IT band syndrome
- Pain is worse with stairs
2. TIP lateral epicondyle 3 cm above joint line
Meniscal tear twisting motion with foot planted can be acute or chronic may present with:
- Effusion
2. MRI for diagnosis
What is patellofemoral syndrome?
- Stiff when standing
- Most common diagnosis in anterior knee pain among athletes
- Pain with climbing stairs
- J sign lateral patellar tracking as knee extended from 90 degrees flexion to full extension.
- Recommend PT
How is osteoarthritis treated
- Exercise therapy
- weight loss
- APAP
- Glucosamine/chondroitin
How are ankle sprains treated?
- Early mobilization
Achilles tendonitis
- Avoid hill workouts
2. PT