Clin Med II Systems Review Flashcards

1
Q

What is the purpose of a systems review?

A

identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional

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2
Q

The systems review is NOT a dx of a non-MSK condition

True/False

A

TRUE

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3
Q

Few RED flag S&S in isolation are _______, we should look for _________

A

informative; combinations

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4
Q

There is a consensus on which RED flags are most useful

True/False

A

False; there is NO consensus

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5
Q

Systems are determined from the _____ and ______

A

hx; observation

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6
Q

What are the constitutional symptoms or general health components requiring a systems review?

A

Fever, chills, sweats- MOST often associated with systemic illness
Prolonged (≥2 wks.)
- > 102° may require hospitalization

Weight changes, particularly loss of ≥ 5% and if unexplained

Nausea and Vomiting (N&V)

Dizziness and lt. headedness

Fatigue- prolonged (≥ 2 wks.) and limiting

Weakness- limiting

Paresthesia’s/Numbness

Malaise or ill feeling- “I feel like I’m coming down with something”

Mentation or cognitive changes

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7
Q

The kidneys, ureters, bladder, and urethra are located in what system?

A

Urinary

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8
Q

Which system….??

filters fluid from renal blood flow

removes waste

retain essential substances for fluid and contents balance i.e., electrolytes, acid base balance, etc.

Stimulates RBC production

Blood pressure regulation

Converts Vitamin D to its active form

A

Urinary System

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9
Q

Which system would be involved if a patient has P! in the trunk, flank, and or pelvic regions?

A

Urinary

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10
Q

What are the 4 urinary changes involved with the urinary system?

A
  1. frequency
  2. duration
  3. bleeding
  4. pus
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11
Q

What are the 3 dysfunctions involved with urinary system S&S?

A
  1. flow
  2. initation
  3. control
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12
Q

______ means: awake to urinate

A

Nocturia

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13
Q

Urinary System

What’s a common symptom a patient may notice with their urine?

A

discoloration

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14
Q

With the urinary system, you learn the most from the patient’s what?

A

hx

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15
Q

A patient with issues involving the urinary system may experience P! with what follow up tests?

A

kidney percussion

palpation/ percussion of system organs

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16
Q

This system is responsible for producing sex cells (eggs/sperm), creating sex hormones, and maintaining fertilized eggs for development?

A

Reproductive

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17
Q

The reproductive system and what other system work together involving hormones?

A

Endocrine

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18
Q

A patient with reproductive S&S could have P! in what areas of the body?

A

Pelvis, LB, abdominal regions and or sexual organs

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19
Q

What dysfunctions could be involved with reproductive S&S?

A

sexual
bowel/bladder (due to proximity)

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20
Q

What are some abnormal S&S involved with the reproductive system?

A

discharge from sex organs

menstruation

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21
Q

These symptoms are indications of what in women?

Polyuria
Breast Tenderness
Fatigue
N&V
Heartburn
Constipation
Abnormal discharge

A

Unknown pregnancy symptoms

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22
Q

Which system is involved with the gut, liver, adipose tissue, pancreas, kidney, and muscle?

A

Metabolic

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23
Q

Which system converts food and liquids into energy, building blocks for proteins, fats, and carbohydrates, and eliminates waste?

A

Metabolic

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24
Q

Fluid and electrolyte balance is KEY for _________ metabolism

A

cellular

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25
Q

With the metabolic system:

What electrolyte maintains fluid volume and cell function for messages to and from the CNS?

A

Sodium

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26
Q

__________ is the MOST frequent electrolyte disorder and contributor to neurological S&S

A

Hypotranemia (low blood sodium)

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27
Q

With the metabolic system:

What electrolyte maintains fluid volume?

A

Potassium

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28
Q

With the metabolic system:

What electrolyte is involved with bone health, muscle actions, nerve impulses, circulation, and hormone balance?

A

Calcium

*involved with the skeleton

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29
Q

With the metabolic system:

What electrolyte plays a CRUCIAL role with metabolism for the growth, maintenance, and repair of ALL tissues?

A

Phosphorus

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30
Q

The electrolyte phosphorus is majorly located where?

A

bone and teeth

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31
Q

With the metabolic system:

Which electrolyte works as an acid buffer?

A

Bicarbonate

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32
Q

What is the MAIN reason for loss of bicarbonate?

A

Diarrhea

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33
Q

With the metabolic system:

Which electrolyte is mainly involved in neuromuscular functions?

A

Magnesium

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34
Q

With the metabolic system:

Which electrolyte regulates fluid in and out of cells?

A

Chloride

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35
Q

The metabolic S&S are really ______

A. typical
B. varied
C. straight-forward

A

B.

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36
Q

In a systems review, if the S&S don’t match a specific system and seem widespread, it is possibly a ________ condition because altered _______ can affect MULTIPLE systems

A

metabolic; metabolism

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37
Q

With the metabolic system S&S, overall it is due to what two things?

A

Fluid and electolyte imbalances
Altered pH

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38
Q

Fluid and electrolyte imbalances is MOST commonly due to conditions involving ______ _____ and _______

A

fluid loss; dehydration

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39
Q

Name some conditions involving fluid loss and dehydration?

A

Diabetes

Kidney dysfunction

Alcoholism/dehydration

Malignancy

Medication SE ex. diuretic

Diarrhea

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40
Q

What effects might you see involving the skin with fluid and electrolyte imbalance S&S?

A

Loss of skin elasticity

Altered temperature

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41
Q

What neuromuscular effects might you see with fluid and electrolyte imbalance S&S?

A

weakness

fatigue

twitching

cramping

tetany

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42
Q

What CNS involvement might you see with fluid and electrolyte imbalance S&S?

A

memory impairment

depression

delusions/hallucinations

seizures

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43
Q

What cardiovascular changes might you see with fluid and electrolyte imbalance S&S?

A

tachycardia

postural hypotension

altered respirations

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44
Q

Fluid and electrolyte imbalance can alter ___

A

pH

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45
Q

The normal pH ranges from ____ to _______

A

7.35-7.45

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46
Q

The lungs help to balance the acidic _____ with the neutral _____

A

CO2; O2

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47
Q

The ______ work with the circulatory system to provide O2 and remove waste products of metabolism

A

lungs

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48
Q

The kidney’s remove acids and keep _____

A

bases

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49
Q

Aging can result in decreased respiration, so less _____ _____

A

gas exchange

50
Q

Aging can result in ________ where oxygen molecules lose electrons and steal them from other electrolytes and cells

A

oxidation

51
Q

What are the 4 acid-base classes?

A
  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Metabolic Acidosis
  4. Metabolic Alkalosis
52
Q

What S&S with altered pH may occur with ALL classes?

A

confusion and fatigue

53
Q

Respiratory Acidosis is a _____ _____

A

lowered pH

54
Q

Aging, pulmonary conditions, drugs that suppress respiration like opioids/muscle relaxers, and sleep apnea are conditions that are associated with _________

a. hyperventilation leading to a loss of acidic CO2

b. hypoventilation and accumulation of acidic CO2

A

B.

55
Q

Respiratory Alkalosis is a _____ _____

A

higher pH

56
Q

Pulmonary conditions, anxiety, hypoxemia disorders (ex. anemia) are all associated with?

a. hypoventilation and accumulation of acidic CO2

b. hyperventilation leading to a loss of acidic CO2

A

B.

57
Q

What is often the ONLY sign for hyperventilation?

A

SOB

58
Q

Metabolic Acidosis is a _____ _______

A

lowered pH

59
Q

What is the MOST common acid base abnormality?

A

Metabolic Acidosis

60
Q

Acummulation of acidic H+ ions is most commonly due to what condition and why?

A

diabetes, has a build up of ketone bodies or acids

61
Q

What is the condition of this description?

Rapid, deep breaths with a fruity smell, from ketone bodies, trying to get rid of of CO2 acids

A

Metabolic Acidosis

62
Q

What condition is usually indicated with these S&S?

Frequent urination (polyuria)

dry mouth

extreme thirst (polydipsia)

decreased skin turgor

blurry vision

weakness/fatigue

A

Diabetes

63
Q

Metabolic Alkalosis is a _____ ______

A

higher pH

64
Q

Accumulation of bicarbonate base may occur with:

_______ by loss of stomach acids

______ disorders or medications that keep too many bases

excessive ______, _______, or ______ medications

diarrhea

A

vomiting

kidney

antacid, laxative, diuretic

65
Q

What acid base condition is associated with these S&S?

Headache

Neuromucular excitability (paresthesia’s/numbness)

Twitching and cramping, particular in feet and hands

seizures

Muscle alterations due to associated lowering of Ca2+ (skeletal weakness, cardiac arrhythmias)

A

Metabolic Alkalosis

66
Q

Twitching and cramping particuraly in the feet and hands is known as?

A

Trousseau sign

67
Q

With metabolic system S&S, resisted or MMT will result in…

A

wide spread weakness

68
Q

With metabolic system S&S, neuro tests will result in…

A

possible wide spread altered sensations

69
Q

When high speculation of the metabolic system being involved, you should perform an abdominal assessment on which 3 areas?

A

liver

pancreas

kidney

70
Q

PT implications involving the metabolic system:

Adequate ______- likely more than just water (electrolytes)

Ensure efficient _______

Increase _______ foods (fruits and veggies)

_______ referral

A

hydration

respiration

antioxidant

urgent

71
Q

What condition is most indicated?

A

Infection

72
Q

Are lymph nodes with infection tender or non-tender and why?

A

tender; rapid onset of inflammation

73
Q

These S&S in older adults may be associated with what condition?

Mentation changes
Subnormal body temp
Bradycardia (low hear rate) or tachycardia (high heart rate)
Tachypnea (excessive respiration rate)
Fatigue
Lethargy- lack of energy
Decreased appetite

A

Infection

74
Q

What condition is most indicated?

A

Immune

75
Q

Observation with an immune condition could be…

Persistent _______ and possibly ______ edema

_____ changes

A

swelling

pitting

skin

76
Q

This system’s function defends the body against harmful substances, pathogens, and cells or non-self‘’s from internal and external threats?

A

Immune

77
Q

What condition is most indicated?

A

Cancer

78
Q

What condition is most indicated?

A

Cardiovascular

79
Q

The cardiovascular system contains…?

A

the heart and blood vessels

80
Q

The _________system is in coordination with the respiratory and nervous system

A

cardiovascular

81
Q

This system helps circulate oxygenated blood through the arterial system to cells throughout the body?

A

Cardiovascular

82
Q

With the cardiovascular system, _______ blood is carried by the venous system to the lungs for ___________

A

deoxygenated; deoxygenation

83
Q

With abnormal cardiovascular S&S, you should follow up with ??

A

auscultations w/ stethoscope

84
Q

What are abnormal vital signs w/ cardiovascular system?

A

HR
BP
RR

85
Q

What condition is most indicated?

A

Respiratory

86
Q

Which system involves the nose, mouth, pharynx, larynx, airways, lungs, and diaphragm?

A

Respiratory

87
Q

The ________ system is in coordination with cardiovascular, nervous, and immune systems to facilitate gas exchange

A

respiratory

88
Q

Which system provides nutrients and oxygen to tissues and removes carbon dioxide and waste from tissues?

A

Respiratory

89
Q

Which system if affected could experience hyperresonance with percussions?

A

respiratory

90
Q

Vital signs with an effected respiratory system would be an…?

A

altered RR

91
Q

If you were to auscultate a patient with respiratory S&S, what would you hear?

A

decreased breath sounds and pleural rub

92
Q

What condition is most indicated?

A

GI

93
Q

Which system is involved with the mouth, esophagus, stomach, intestines, to colon and rectum?

A

GI

94
Q

With the GI system:

_________- deals with the large intestines, colon, and rectum

A

Excretion

95
Q

All major categories of immune cells live where? How much %?

A

in the gut; 70-80%

96
Q

The GI system is assisted by the _______ system

A

Hepatic

97
Q

With the GI system, the abdominal quadrant should be further assessed with ???

A

Auscultation
Palpation
Percussion

98
Q

The CNS contains the: _____ and ____ _____

A

brain; spinal cord

99
Q

The PNS contains the: ________ and ________ nervous systems

A

somatic; autonomic

100
Q

Which system functions are??

Sensory processing

Involuntary and voluntary responses and actions

Maintaining system homeostasis, particularly with endocrine system

MAJOR controlling, regulatory, and communicating bodily system

A

Nervous

101
Q

The ________ system meets the nervous system at the hypothalamus- which is called the…?

A

endocrine; pituitary interface

102
Q

The __________ is the MAIN integrative center of endocrine and autonomic nervous system functions by hormonal and neural pathways

A

hypothalamus

103
Q

Is this UMN or LMN content?

Cranial nerves
Anterior gray column of spinal cord
Cauda equina
Spinal nerves to terminal nerve branches

A

LMN

104
Q

Is this UMN or LMN content?

Above anterior horn of spinal cord
Brain and MOST of spinal cord

A

UMN

105
Q

LMN or UMN?

Muscle tone is decreased or flaccid

A

LMN

106
Q

LMN or UMN?

Muscle tone is Increased or Spastic- velocity dependent resistance to lengthening; co-contractions; synkinesis- UE flexion causes LE flexion

A

UMN

107
Q

LMN or UMN?

Bowel and bladder have incontience or leakage

A

LMN

108
Q

LMN or UMN?

Bowel and bladder is spastic/retentive

A

UMN

109
Q

LMN or UMN?

Dermatomes/Paresthesia’s are often a single segment/area diminished to lt. and/or sharp touch; rarely multi-segmental

A

LMN

110
Q

LMN or UMN?

Dermatomes/Paresthesia’s are Multi-segmental and diminished to light/sharp touch plus to vibration, temperature, and/or 2 pt. discrimination into face, extremities, and/or trunk depending on spinal level and severity

A

UMN

111
Q

LMN or UMN?

DTR’s are often a single segment of hypoactivity

A

LMN

112
Q

LMN or UMN?

DTR’s are often multiple segmental hyperactivity

A

UMN

113
Q

LMN or UMN?

Myotomes; possible sexual dysfunction is often a single segment of fatiguing weakness; rarely multi-segmental

A

LMN

114
Q

LMN or UMN?

Myotomes; possible sexual dysfunction
Multi-segmental weakness/incoordination/paralysis of face, extremities and/or trunk depending on spinal level and severity

A

UMN

115
Q

LMN or UMN is associated with radiculopathy?

A

LMN

116
Q

Remember this

A
117
Q

Light strokes applied in each abdominal quadrant around the umbilicus:

_____= umbilicus moves in direction of the stroke

______= decreased or lack of umbilical movement

A

WNL; hypoactive

118
Q

These S&S are associated with what system or condition?

N&V

Dizziness

Visual or auditory dysfunction

Worst HA ever may be impending stroke

A

Neurological

119
Q

With the GI system:

_______ and ________ deal with the stomach and small intestines

A

digestion; absorption

120
Q

Polyuria means what?

A

urinating more than usual