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Patient Assessment > Conditions and tests > Flashcards

Conditions and tests Flashcards

1
Q

Abdominal aortic aneurism

A

CV: May see visible pulsing. Bruits heard. Weak pulses in lower limbs. Pale lower limbs. Cap refil. Peripheral blood pressure low. Buergers test.

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2
Q

Acoustic neuroma

A

Webers and Rinnes both positive. CN V, CN VIII.

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3
Q

Acute calific tendonitis

A

Tender to touch. Restricted Shoulder ROM, due to pain.

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4
Q

Acute cholecystitis/Cholelithiasis

A

Right hypochondrial tenderness. Rigidity worse on inspiration (Murphy’s sign). May find palpable gall bladder mass (30%). Absent bowel sounds due to gallstone ileus.

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5
Q

Acute liver failure

A

Mental changes. Sweet musty odour on breath. Yellow skin colour. Fever. Low blood pressure. Spacticity.

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6
Q

Acute pancreatitis

A

Epigastric tenderness. Absent bowel sounds due to paralytic ileus. Ascites. Pleural effusion. Discoloration of flanks (grey Turners sign) or periumbilical region (Cullen’s sign).

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7
Q

Acute pyelonephritis

A

High grade fever. 39.5C. Costovertibral angle tenderness.

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8
Q

Acute renal failure (ARF)

A

Repiratory rate increased due to acidosis. Pulmonary oedema found on percusion. Prerenal reversible: Low BP. Poor periphereral perfusion. Postural hypotension

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9
Q

Adrenal disorders - Addison’s disease (hypoadrenalism)

A

Muscle weakness. Low BP. Orthostatic BP. Hyperpigmentation on skin creases and scars, knuckles and knees.

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10
Q

Adrenal disorders - Cushing’s syndrome (hypercortisolism)

A

Reddish purple stretch marks on thighs, stomach, buttocks, arms legs or breasts. Round face. Muscle weakness

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11
Q

Alchoholic liver disease (ALD)

A

Enlaged liver. Enlarged spleen. Portal hypertension: visible collateral vessels, ascites, variceal bleeding. Hepatic insufficiency: Yellow skin colour. Other: Digital clubbing. Dupyens contracture. Right pleural effusion. Peripheral oedema.

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12
Q

Anaemia

A

Pale skin.

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13
Q

Anaphalaxis

A

No specific tests

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14
Q

Angina equivalent

A

BP high, tachycardic and gallop rhythm if in attack and shallow breathing. May be no signs if not in attack.

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15
Q

Anxiety

A

BP & pulse rate may be high. Respiration fast and shallow.

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16
Q

Aortic disection (thoracic)

A

Emergency. No time for tests.

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17
Q

Appendicitis

A

Patient prefers flexed right hip or foetal position. Obturator/psoas sign. McBurneys sign. Rebound tenderness. Posible fever and flushed face.

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18
Q

Arachnoiditis

A

SLR and braggards +ve. Kernigs sign.

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19
Q

Arrhythmia

A

Regularly irregular pulse and heart rythmn - pattern with skipped beats. Irregularly regular - no pattern. Can be atrial fibrillation (AF - irregular and fast), supraventricualr tachycardia (episodes of fast beating at rest), bradycardia (slow). May hear abnormal sounds if there is a structural anomaly. For AF juggular pulse may be visible.

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20
Q

AS

A

Reduced ROM in low back. Possible CV signs

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21
Q

Asthma

A

Percussion may show greater ares of hyperresonance. Wheezes and crackles on respiratory auscultation.

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22
Q

Atherosclerosis

A

Possible high blood pressure.

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23
Q

Autoimmune hepatitis

A

Possible fever. Signs of dhronic liver disease ( Cushingoid face with acne, hirsuitism, pink cutaneous striae on thighs and abdomen).

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24
Q

Benign Positional Vertigo.

A

Hallpike manouvre positive. Fitz ritson - moving body without head does not provoke dizziness.

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25
Q

Benign prostatic hyperplasia (BPH)

A

Possible distended bladder. If painful then emergency.

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26
Q

Bornholm disease /epidemic myalgia/coxsackie viral infection)

A

Fever

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27
Q

Brain stem or cerebellar tumour

A

CN signs. Nystagmus changes in different fields of gaze, lasts for > 1m and does not fatigue. Depression of corneal reflex (cerebellopontine angle). Cerebellar signs - Standing and walking: Veering, poor balance, intention tremor, ataxia. Tandem walk: veering. Rebound: excessive swinging. Finger to Nose: tremor or dysmetria. Rapid alternating hand: dysdiadochokinesia. Heel down shin: Lack of co-ordination.

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28
Q

Brain tumour

A

Progressive neurological signs.

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29
Q

Bronchiectasis

A

Course crackles in chest. Diminished breath sounds.

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30
Q

Carcinoid bowel tumour/carcinoid syndrome

A

No specific tests

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31
Q

Cervical facet syndrome

A

Aggrivated by extention, relieved by flexion. Max forminal compression positive with or without radicular symptoms. Distraction helps.

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32
Q

Cervical spondylosis with radiculopathy

A

Tenderness over Cx affected. Pain worse on extension, lat flex or rotation. Pain better with flexion. Bakody sign positive.

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33
Q

Cervical stenosis/Cervical myelopathy

A

Pain worse with extention, lat flex and rotation. Better with flexion. UMN signs below lesion. LMN at leesion level. Babinski.

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34
Q

Cervicogenic headache

A

Reduced ROM in neck. Neck movement makes headache worse.

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35
Q

Cholelithiasis/chronic cholecystitis

A

Right hypochondrial tenderness. Murphy’s sign. May find palpable gall bladder mass.

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36
Q

Chronic kidney disease (CKD)/ Glomerolunephritis

A

May have high BP as a cause. At end stage may present like acute renal failure. (Repiratory rate increased due to acidosis. Pulmonary oedema found on percusion. Low BP. Poor periphereral perfusion. Postural hypotension) Small kidneys.

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37
Q

Chronic liver failure

A

Nuerological signs. Changes to conciousness. Conulsions. Hyperrefexia

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38
Q

Chronic obstructive pulmonary disease (COPD)

A

Breath sounds quiet. Crackles and wheeze heard on auscultation. Larger area of resonance on percussion.

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39
Q

Chronic pancreatitis

A

Thin and malnousished looking. Skin pigmentation from using hot water bottle on abdomen and back. Epigastric tenderness.

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40
Q

Chronic pyelonephritis

A

Small kidneys. High grade fever. 39.5C. Costovertibral angle tenderness.

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41
Q

Cirrhosis of the liver

A

Enlaged liver. Enlarged spleen. Portal hypertension: visible collateral vessels, ascites, variceal bleeding. Hepatic insufficiency: Yellow skin colour. Other: Digital clubbing. Dupyens contracture. Right pleural effusion. Peripheral oedema.

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42
Q

Cluster headache

A

No specific tests

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43
Q

Coeliac disease

A

No specific tests

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44
Q

Colorectal cancer

A

No specific tests

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45
Q

Compartment syndrome

A

Sensory loss in compartment area. Peripheral pulse weak beyond area.

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46
Q

Costochondritis

A

Tenderness around ribs

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47
Q

Cranial nerve lesion

A

CN Tests positive.

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48
Q

Cystic fibrosis

A

Course crackles in chest. Diminished breath sounds. Possible hepatomegaly, murphys sign. Lack of bowel sounds.

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49
Q

Dehydration headache

A

No specific tests.

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50
Q

Dementia

A

Doesnt know time, day, date, place. Cannot name everyday objects. Cannot follow verbal instructions. Difficulty writing. Difficulty speaking, articualtion, fluency, vocabulary.

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51
Q

Diabetes mellitis

A

Stocking distribution neuropathy. Poor vibration sense. Poor peripheral perfusion. Muscle wasting and weakness. Cognitive deficit.

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52
Q

Diabetic Ketoacidosis

A

Smell of pear drops. Tachycardia.

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53
Q

Diffuse idiopathic skeletal hyperostosis (DISH).

A

Lack of ROM in flexion and extension.

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54
Q

Dorsal column lesion.

A

Tandem walk: Patient veers to the side. Rhombergs positive. Vibration sense: Impaired. Proprioception, limb repositioning and touch localisation tests positive. Graphesthesia.

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55
Q

Drug related headache

A

No specific tests

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56
Q

DVT

A

Unequal BP in legs. Homan’s sign. Weak pulse in leg. Cap refil.

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57
Q

Ectopic pregnancy

A

Palpable abdominal mass in lower abdomen.

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58
Q

Eczema

A

Observe.

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59
Q

Endometriosis

A

No specific tests

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60
Q

Facet syndrome (Lumbar)

A

Aggrivated by extention, relieved by flexion. Kemps positive but not radicular.

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61
Q

Fibromyalgia

A

No specific tests.

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62
Q

Frozen shoulder/Adhesive capsulitis

A

Symptoms on both active and passive movement. No passive ext rotation in frozen phase. Decreased abduction. Pain on A to P movement. Appley scratch +ve.

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63
Q

Gastric carcinoma

A

Signs of tumour spread to supraclavicular lymph nodes (Troisiers sign), Umbilicus (Sister Josephs nodule), Ovaries (Kruckenberg tumour) Acanthosis nigricans. Thrombophlebitis (Trousseau’s sign).

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64
Q

Gastritis

A

No specific tests

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65
Q

Gastrooesophageal reflux disease

A

No specific tests

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66
Q

Gilberts syndrome

A

No specific tests

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67
Q

Graves’ disease - (overactive thyroid)

A

Muscle weakness.Enlarged thyroid gland. Irregular heat rate, palpitations, tremor, warm moist skin, red palms, loose nails, hives, patchy hair loss, twitching in face or limbs.

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68
Q

Haemophillia

A

If any neuro signs treat as emergency.

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69
Q

Haemorrage - Cerebellar

A

Cerebellar tests.

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70
Q

Haemorrage - Intracerebral

A

High BP. Various and widespread neuro signs.

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71
Q

Haemorrage - Subarachnoid

A

Positive Kernigs sign.

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72
Q

Haemorrage - Subdural and extradural

A

Various neurological signs including sensory loss and hemiparesis.

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73
Q

Haemorrhoids (Piles)

A

No specific tests

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74
Q

Haemothorax

A

Pleral effusion. Asymmetric rib expansion. Decreased femitus. Dull sound on repiratory percussion.

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75
Q

Hashimoto’s thyroiditis or other hypothyroidism

A

Muscle weakness. Later signs: Puffy face, tachycardia, low hoarse voice, thin eyebrows, hearing loss. Anaemia.

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76
Q

Heart failure (dilated cardiomyopathy) - acute

A

High BP or low BP if in cardiogenic shock. JVP elevated. Murmer and triple gallop ryythm. Basal crepitations. Pulmonary oedema.

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77
Q

Heart failure (dilated cardiomyopathy) - chronic

A

Low BP. Raised JVP. Peripheral oedema. Acites or pleural effusion.

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78
Q

Hepatic encephalopathy

A

Diverse neuro signs may be present affecting brain function.

79
Q

Hepatic tumour - Hepatocellular carcinoma (HCC)

A

Hepatomegaly. Right hypochondrial mass. Abdominal bruit.

80
Q

Herpes Zoster (Shingles)

A

No specific tests

81
Q

Hodgkin’s lymphoma (HL) or Non-hodgkin lymphoma (NHL)

A

Lymph nodes will be enlarged but not swollen (this would be infection). Fever.

82
Q

Horner’s syndrome

A

No specific tests

83
Q

Hypertention

A

Blood pressure: Optimal under 120/80. Normal under 130/85. High-normal under 140/90. Hypertension from 140/90: grade 1 (mild) under 160/100, grade 2 (moderate) under 180/110. Grade 3 (severe)over.

84
Q

Hyperventilation syndrome

A

Pulse and BH high. Fast shallow breathing

85
Q

Hypothalamic/Pituitary - Acromegaly

A

Abnormaly large hands and feet, large prominent facial features. Abnormally tall , thick course oily skin, enlarged tongue. Protruding jaw and brow. Impaired vision.

86
Q

IBD - crohn’s disease

A

Tenderness and mass in right iliac fossa. Low grade fever. Enlarged liver.

87
Q

IBD - ulcerative colitis

A

Mild tenderness in left iliac fossa. Fever. Enlarged liver

88
Q

Infectious mononucleosis

A

Fever.

89
Q

Infective endocarditis

A

Fever. Heart murmers.Petechiae or rash. Digital clubbing or splinter heamorrhage in nails. Oslers nodes - painful red raised lesions on hands and feet.

90
Q

Infective/Septic arthritis

A

No specific tests

91
Q

Intercostal muscle injury/strain

A

Pain on active > passive movement.

92
Q

Irritable bowel syndrome

A

No specific tests. May hear altered bowel sounds.

93
Q

Labrithitis

A

Possible nystagmus. Balance problems.

94
Q

Leukemia

A

Pale skin. Possible swollen spleen and lymph nodes. Fever

95
Q

Mallory - Weiss syndrome

A

No specific tests

96
Q

Meniere’s disease

A

Nystagmus during attacks. No specific tests.

97
Q

Migraine

A

Possible transient neurological signs and symptoms.

98
Q

Mitelschmertz

A

No specific tests

99
Q

Mitral valve prolapse

A

CV exam: Check for mitral regurgitation.

100
Q

Motor Neuron Disease

A

Toe drop. Heel drop. Weak muscles. Spacticity or flaccidity. Any neuro signs.

101
Q

MS

A

Pursuit and Vergence: Nystagmus. Any other Neurological symptoms. Intention tremor. Ataxia. Spacticity.

102
Q

Multiple myeloma

A

No specific tests. Possible renal signs.Fever.

103
Q

Muscle enzyme deficiency syndrome

A

No specific tests

104
Q

Muscle strain (limb)

A

Pain on active > passive movement.

105
Q

Muscle strain (lumbar)

A

Pain on active > passive movement.

106
Q

Myesthenia gravis

A

Pursuit and vergence positive. Weak muscles.

107
Q

Myocardial Infaction (MI) - Heart attack

A

Carotid bruits may be heard. Gallop rythm (4 heart sounds).High or low BP. Tachycardia, bradycardia or irregualr heartbeat. Shallow breathing.

108
Q

Neurogenic claudication

A

Valsalvas, SLR 30 to 60, Kemps iindicate nerve root involvement. No vascualr signs.

109
Q

Oesophageal tumour

A

No specific tests

110
Q

Oral cancer

A

No specific tests

111
Q

Oral candidiasis

A

Observe tongue - white and furry.

112
Q

Oral ulcers

A

Observe in mouth. Sore patch will have grey/white centre and red halo.

113
Q

Osteoarthritis

A

Crepitus in joint when moving. Reduced ROM. Restriction. Scouring test for hip. Joint deformity.

114
Q

Osteomalacia/Rickets

A

Check for fracture - tuning fork. Observe Waddling gait, diminished stature, bent bones.

115
Q

Osteomyelitis

A

Fever. Restricted ROM. Very tender in affected area. Possible lump on the bone.

116
Q

Osteophitic Intercostal neuritis

A

No specific tests

117
Q

Osteoporosis

A

None

118
Q

Ovarian cyst

A

May be palpable in lower abdomen.

119
Q

Paget’s disease

A

Reduced ROM. Any of kemps, SLR, valsalvas. Other neuro signs.

120
Q

Pancreatic cancer (carcinoma)

A

Palpable gall bladder, hepatomegaly. Pancreatic tumour mass, sister josephs nodule. Erythema on stomach.

121
Q

Parasitic infection

A

No specific tests

122
Q

Parietal lobe lesion

A

Steriognosis. Graphesthesia. Sensory neglect. Sensory defeciency. Proprioception, limb repositioning and touch localisation tests positive. Tandem walk: Patient veers to the side. Rhombergs positive.

123
Q

Parkinsons

A

Standing and walking: Shuffling gait, resting tremor. Motor function: Cogwheel rigidity. CN I: Anosmia.

124
Q

Pelvic inflamatory disease possibly related to STD (Chlamydia, gonorrhoea)

A

Obturator sign

125
Q

Peptic ulcer - gastric or duodenal

A

Possible reduced bowel sounds if obstruction.

126
Q

Perforated ulcer

A

Low BP. Tachycardia.

127
Q

Pericarditis (or myocarditis)

A

Low grade fever.

128
Q

Peripheral artierial disease

A

Difference in BP between arm and ankle. Capillary refil.

129
Q

Piriformis syndrome

A

Piriformis test. SLR pain at > 35 degrees.

130
Q

Pituitary tumour (Benign adenoma)

A

Visual field defects.

131
Q

Pleurisy

A

Pain on rib expansion. Fever.

132
Q

Pneumonia

A

High fever. Low blood pressure. High heart rate. Reduce rib movement on breathing. Dullness on repiratory percussion. Wheezing on auscutation. Egophany sounds like “ay”. Whispered petriloquy can be heard.

133
Q

Polycystic ovary syndrome

A

No specific tests

134
Q

Polymyalgia rheumatica

A

No muscle tenderness or atrophy. No vascular signs.

135
Q

Post herpetic nueralgia

A

No speific tests

136
Q

Postural syndrome

A

Muscles tight on palpation. Observe posture.

137
Q

Primary bone tumour

A

No specific tests

138
Q

Primary dysmenorrhoea

A

No specific tests

139
Q

Primary Lung Tumours

A

Supraclavicular lymph nodes may be palpably enlarged. Rib expansion aysymatric. Tactile fremitus decreased or absent.

140
Q

Prolapsed intervertabral disc with radiculopathy (lumbar)

A

Kemps, Valsalvas, SLR at 30 to 70 egrees.

141
Q

Prostate cancer

A

No specific tests for chiropractor.

142
Q

Pulmonary embolism

A

Tachypnoea. Tachycardia. Hypotension. Raised JVP/ Right ventricular gallop rythmm. Loud P2 (separate sound of p valve closing, splitting S2 (second heart sound).

143
Q

RA

A

Possible fever. Joints tender to touch.

144
Q

Raised ICP

A

CN III or VI signs.

145
Q

Referred viceral pain - Colon

A

Negative for neuro signs. May be positive for abdominal signs

146
Q

Referred viceral pain - Gall bladder

A

Negative for neuro signs. May be positive for abdominal signs. Murphy’s sign

147
Q

Referred viceral pain - Heart (Angina, MI)

A

Negative for neuro signs. May be positive for CV signs.

148
Q

Referred viceral pain - Kidneys

A

Negative for neuro signs. May be positive for abdominal signs. Costovertebral angle tenderness.

149
Q

Referred viceral pain - Liver or gall bladder

A

Negative for neuro signs. May be positive for Abdominal signs

150
Q

Referred viceral pain - Lung or diaphram

A

Negative for neuro signs. May be positive for respiratory signs.

151
Q

Referred viceral pain - Small intestine or ovaries

A

Negative for neuro signs. May be positive for abdominal signs

152
Q

Referred viceral pain - Stomach

A

Negative for neuro signs. May be positive for Abdominal signs

153
Q

Referred viceral pain - Urinary bladder

A

Negative for neuro signs. May be positive for abdominal signs

154
Q

Renal adenocarcinoma

A

Enlarged kidney found on ballotment. Possibe high or low BP. Fever. Costovertebral angle tenderness.

155
Q

Reumatic heart disease - acute rheumatic fever.

A

Heart murmur. Fever.

156
Q

Reynauds phenomenum/disease - primary

A

None

157
Q

Reynauds phenomenum/disease - secondary

A

Check for thoracic outlet obstruction (e.g. cervical rib).

158
Q

Rib fracture

A

Tuning fork.

159
Q

Ruptured abdominal aortic aneurysm

A

Low BP. Pulsatile abdominal mass.

160
Q

Ruptured appendix/ Peritonitis

A

Fever. Tachycardia. Radid brathing. Swelling of the abdomen. Rebound tenderness.

161
Q

Ruptured ovarian cyst

A

No specific tests.

162
Q

Sacroiliac syndrome

A

Adams supported, goldthwaites, gaenslens, iliac compression, yeomans positive.

163
Q

Sarcoidosis

A

Hepatomegaly. Lymphadenopathy. Cardiac arrythmia, heart block. Splenomegaly, renal stones, , erythema nodosum. Peripheral neuropathy.

164
Q

Scheuermanns disease

A

Observed deformity.

165
Q

Slipped rib

A

Palpation of lower rib tips or hooking fingers under and lifting anterior and superior.

166
Q

Spinal tumour (Mets)

A

Possible signs of primary cancer - breast, lung, kidney.

167
Q

Spinal tumour (Primary)

A

Fever. Severe pain on manipulation.

168
Q

Spontaneous pneumothorax

A

Possible tachycardia, hypotension and cyanosis. Absent breath sounds, resonant percussion, tactile fremitus quiet or absent.

169
Q

Stable angina

A

CV exam may be normal if not in an attack.. Carotid bruits may be heard. Gallop rythm (4 heart sounds) if in an attack.

170
Q

Stress fracture

A

Tuning fork.

171
Q

Temporal Arteritis

A

Temple is tender to touch. Mild fever.

172
Q

Tension headache

A

No specific tests.

173
Q

Testicular tumour

A

No specific tests for chiropractor.

174
Q

Thoracic aortic aneurism

A

May be none.

175
Q

Thoracic outlet syndrome

A

Tenderness over TOS area. Reduced ROM. Muscle weakness, depressed DT reflexes. Roos. Adsons/Halsteads (Ant/middle Scalenes), Wrights(Pec minor), Costoclavicular (rib or costoclavicualr syndrom ). May have weak peripheral pulse or poor cap refil.

176
Q

Thyroid tumour

A

Lump or swelling in the neck.

177
Q

Tietze’s syndrome

A

Tenderness and swelling 2nd/3rd costocondral joints around ribs

178
Q

Trigeminal neuralgia

A

Face hypersensitive to touch. Possible sensory deficit for CN V.

179
Q

Tuberculosis - milary

A

Hepatosplenomegaly. Crackles on repiratory auscutation. Possible neuro signs. Anaemia.

180
Q

Tuberculosis - primary

A

High fever. Reduce rib movement on breathing. Dullness on repiratory percussion. Wheezing on auscutation. Egophany sounds like “ay”. Whispered petriloquy can be heard.

181
Q

Unstable angina

A

CV exam may be normal if not in an attack.. Carotid bruits may be heard. Gallop rythm (4 heart sounds) if in an attack.

182
Q

Urinary calculi (renal colic) /Nephrolithiasis (Kidney stones)/Obstructive nephropathy.

A

Costovertebral angle tenderness.

183
Q

Urinary tract infection (Lower UTI)

A

No specific tests

184
Q

Urinary tract infection (Upper UTI)

A

Fever of 38 or above.

185
Q

Urothelial tumour (Bladder, ureteral, urethral or Kidney tumour)

A

No specific tests. Physical examination usually unremarkable unless in advanced stage.

186
Q

URTI - cold, pharyngitis, acute bronchitis

A

Respiratory wheezing. Fever

187
Q

URTI - Influenza

A

Fever.

188
Q

URTI’s - Sinusitis

A

Fever

189
Q

Vascular claudication

A

BP less in legs. Weak pulse in leg. Cap refil.

190
Q

Venous hypertension

A

Possible change to BP?

191
Q

Viral hepatits

A

Liver tender to palpate put minimal enlargement. Mild splenomegaly. Cervical lymphadenopathy

192
Q

Whiplash

A

Reduced ROM in neck. Quabec taskforce gradings: 0. No symptoms. 1. Symptoms but no signs. 2. Decreased ROM. 3. Neuro signs. 4 Fracture or dislocation. Eliminate fracture or dislocation from diagnosis - Percussion. Vibration. Rusts sign & Bakodys sign should be -ve if no fracture or dislocation.

193
Q

Wilson’s disease

A

Liver signs. Ataxia, parkinsonism - tremor, bradykinesia and balance disorder, dystonia, dememtia. Copper rings in eyes (Kayser-Fleisher rings). Possible heart and kidney signs.

Patient Assessment (7 decks)

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