Constitutional s/s, integumentary

Question 1

What are red flags when describing fatigue?

Answer 1

“tiredness” interferes with pt’s ability to carry out typical daily activities
AND
Lasts 2-4 wks (or more)

Question 2

What conditions present as chronic fatigue?

Answer 2

Connective tissue disorders
Sleep disturbance

Question 3

definition: General discomfort, sense of uneasiness, “out of sorts”

Answer 3

malaise

Question 4

Malaise is often noted with conditions that cause ____.

Answer 4

fevers

Question 5

What type of illnesses are often associated with fever, chills, and sweats?

Answer 5

systemic

Question 6

What are the red flags of fever?

Answer 6

present for 2+ weeks (pathologic)
high grade fever (urgent)

Question 7

unexplained weight loss can be associated with what?

Answer 7

Usually assoc w/ depression, cancer, GI diseases, & CVDs

Question 8

What is indicated if a pregnant woman gains > 2 - 5lbs in 1 week or has sudden wt gain in 1-2 days

Answer 8

preeclampsia

Question 9

Unexplained weight gain can be associated with what?

Answer 9

fluid retention related to CHF, liver/renal disease, and preeclampsia, depression, hypothyroidism, cushing’s

Question 10

Nausea and vomiting are usually associated with ___ disorders.

Answer 10

GI

Question 11

What are red flags for possible melanoma during a patient interview?

Answer 11

Hx of cancer
Female < 40 y/o
Male > 40 y/o
Fair skin with history of sunburns

Question 12

What are physical exam red flags for melanoma?

Answer 12

Asymmetric
Borders are notched, scalloped, or vaguely defined
Diameter > 6 mm

Question 13

What are the common places on the body to see melanoma?

Answer 13

hand
head
shoulder

Question 14

What is anemia?

Answer 14

too few RBCs

Question 15

What is polycythemia?

Answer 15

too many RBCs

Question 16

What is poikilocytosis?

Answer 16

abnormally shaped RBCs

(ex: sickle cell anemia)

Question 17

What is anisocytosis?

Answer 17

abnormal variations in RBC size

Question 18

What is hypochromia?

Answer 18

Hgb deficient RBCs

Question 19

What are s/s of RBC disorders?

Answer 19

fatigue/malaise

Question 20

What do RBCs do?

Answer 20

transport O2

Question 21

(true/false) you can reverse osteopenia and osteoporosis

Answer 21

FALSE- only osteopenia

Question 22

What is leukocytosis?

Answer 22

increased WBCs

Question 23

What range on WBCs is considered as leukocytosis?

Answer 23

> 10,000

Question 24

What is a risk of having leukocytosis?

Answer 24

can be caused by an autoimmune disorder which attacks healthy cells

Question 25

What is leukopenia?

Answer 25

decreased WBCs

Question 26

What range of WBCs is indicative of leukopenia?

Answer 26

< 5,000

Question 27

What is leukemia?

Answer 27

disease causing uncontrolled growth of immature/dysfunctional WBCs —> From bone marrow

Question 28

What are s/s of leukocyte disorders?

Answer 28

Fevers and s/s of infection

Question 29

What is thrombocytosis?

Answer 29

increased platelet count

Question 30

What is thrombocytopenia?

Answer 30

decrease in platelet count

Question 31

What platelet count is indicative of thrombocytopenia?

Answer 31

< 150,000

Question 32

What are s/s of platelet disorders?

Answer 32

excessive bleeding and bruising

Question 33

(true/false) Thrombocytosis is permanent

Answer 33

FALSE - temporary

Question 34

Splenomegaly, easy ecchymoses, and thrombosis are examples of ___.

Answer 34

Thrombocytosis

Question 35

Petechiae, epistaxis, and purpura spots are examples of ____.

Answer 35

thrombocytopenia

Question 36

What is hemophilia?

Answer 36

Muscle hemorrhage

Question 37

What are s/s of hemophilia?

Answer 37

red, swollen, position of comfort, gradual pain, altered sensation

Question 38

Hemophilia is a ___ disorder.

Answer 38

coagulation

Question 39

How many americans does DVT affect per year?

Answer 39

2 million

Question 40

DVT has a ___% mortality rate within 3 days of onset.

Answer 40

30%

Question 41

Approximately 33% of people with a DVT develop a ___.

Answer 41

PE

Question 42

What clinical test is reliable for DVT Dx?

Answer 42

wells score

Question 43

What are DVT risk factors? What are they called?

Answer 43

Virchow's triad: - venous stasis - vessel wall damage - hypercoagulability

Question 44

What are the three groups of DVTs?

Answer 44

Acquired Genetic Environmental/demographic

Question 45

What are acquired risk factors for DVT?

Answer 45

- Immobilization - Operative procedures - Trauma - Malignant neoplasms - Pregnancy (pre- and post-) - lupus anticoagulant - female hormones

Question 46

What are genetic risk factors for DVT?

Answer 46

Deficiency (C, S, antithrombin III) Mutation (Factor V, Prothrombin 20210A) High concentration for factor VIII (hyperhomocysteinemia)

Question 47

What are environmental/demographic risk factors for DVT?

Answer 47

Caucasian & African-American ethnicity > 40 yo. Obesity Hospital/nursing home confinement Traveling > 4 hours by car, train, or airplane Winter season

Question 48

How many risk factors does a child need to produce a DVT?

Answer 48

3-4

Question 49

How many risk factors does a young adult need to produce a DVT?

Answer 49

2+

Question 50

What are LE DVT screening tests?

Answer 50

Wells score Kahn score St Andre Score New Ambulatory Score (outpatient clinic)

Question 51

What score does a patient need on LE DVT assessments to have a high risk of DVT?

Answer 51

> 3 points

Question 52

What is indicated if a patient has a (-) D-dimer test?

Answer 52

no DVT

Question 53

What are the scoring criteria on UE DVT screening tests?

Answer 53

(+1) Presence of venous material such as a catheter or access device in the subclavian or jugular vein, or placement of a pacemaker (+1) Pitting edema (+1) Localized pain in the UE (1+) other Dx that are not as plausible as a DVT

Question 54

What score does a patient need on a UE DVT screening test to be high risk?

Answer 54

> 2 points