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S7- Differential Diagnosis > CPR/Lists > Flashcards

CPR/Lists Flashcards

1
Q

WEEK 1

A

WEEK 1

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2
Q

Fracture CPR. (4)

A
  • Prolonged steroid use
  • Age >70
  • Significant trauma
  • Female
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3
Q

WEEK 2

A

WEEK 2

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4
Q

Depression

  • PHQ-2 Score ≥ __ should be further evaluated with PHQ-9.
  • PHQ-9 Score ≥ __ indicates depression.
A
  • ≥ 2

- ≥ 10

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5
Q

Cook Cervical Myelopathy Cluster. (5)

A
  1. ) Gait abnormality
  2. ) + Hoffman
  3. ) + Babinski
  4. ) + Inverted supinator sign
  5. ) Age >45
  • > /=3/5 = Rule IN
  • =1/5 = Rule OUT
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6
Q

Wells CPR for DVT:

  • High Probability = >__ (75%)
  • Moderate Probability = __-__ (17%)
  • Low Probability = __ (3%)

-What probability would warrant a referral for further screening?

A
  • High Probability = >3
  • Moderate Probability = 1-2
  • Low Probability = 0

-High/Moderate Probability would warrant a referral.

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7
Q

Wells CPR for PE:

  • High Probability = >__
  • Moderate Probability = __-__
  • Low Probability = __-__
A
  • High Probability = >6
  • Moderate Probability = 3-6
  • Low Probability = 0-2
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8
Q

WEEK 4

A

WEEK 4

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9
Q

What are (3) mechanisms to consider in regards to referred visceral pain?

A
  • Embryonic Development
  • Multisegmental Innervation
  • Direct pressure and shared pathways
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10
Q

Describe Embryologic Development mechanism for referred visceral pain. What are some examples?

A

-Pain is referred to a site where the organ was located in fetal development.

Examples

  • Chest is part of gut in embryo. Thoracic disorders can refer to abdomen.
  • Heart starts as cranial structure in embryo. MI or pericarditis can refer to abdomen.
  • Kidney and ear come from same embryonic tissue. Kidney dysfunction can refer to ear pain.
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11
Q

Describe Multi-segmental Innervation mechanism for referred visceral pain. What are some examples?

A

-Organs have multiple levels of innervation. Overlapping or same segmental projections can refer to different areas.

Examples
-Cardiac pain is not felt in the heart but referred to areas of corresponding spinal nerve. Can occur in any structure innervated by T3-T4 (jaw, neck, upper trap, shoulder, arm).

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12
Q

Describe Direct Pressure and Shared Pathways mechanism for referred visceral pain. What are some examples?

A

-Organ that is inflammed/problematic and is causing organ to be larger than normal. Irritates structures and can refer pain to areas also innervated structure being irritated.

Examples

  • Spleen → L shoulder
  • Tail of pancreas → L shoulder
  • Head of pancreas → R shoulder
  • Gallbladder → R shoulder
  • Liver → R shoulder
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13
Q

Direct Pressure and Shared Pathways:

  • Impingement on central diaphragm can refer to __________.
  • Impingement on peripheral diaphragm can refer to ___________ and/or ____________
A
  • central diaphragm = shoulder

- peripheral diaphragm = costal margins (ipsilateral) and/or lumbar region

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14
Q

Direct Pressure and Shared Pathways:

  • Spleen → __________
  • Tail of pancreas → _________
  • Head of pancreas → __________
  • Gallbladder → _________
  • Liver → ___________
A 
Spleen → L shoulder
Tail of pancreas → L shoulder
Head of pancreas → R shoulder
Gallbladder → R shoulder pain
Liver → R shoulder pain
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15
Q

Central Sensitization Inventory (CSI):

Cutoff score of ____ indicates possibility of predominant CS pain

A

-40 or greater

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16
Q

Rhabdomyolysis biggest S/Sx?

A

Reddish-brown urine

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17
Q

What are the 5 P’s that are indicative of acute arterial occlusion (ischemia)?

A
  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia
  • Paralysis
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18
Q

Night Pain:
-Cannot lie on involved side= _____
Can stay on involved side for 30 mins to an hour before symptoms present= _______
Can lie on involved side for up to 2 hours before symptoms present= ________

A
  • acute
  • subacute
  • chronic
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19
Q

WEEK 5

A

WEEK 5

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20
Q

Conditions Affecting the Heart Muscle:

  • What are the MOST COMMON conditions to mimic MSK dysfunction? (4)
  • Referral patterns include the _____, ____, ________, ______, and/or ____ pain.
A
  • Angina, MI, Pericarditis, Dissecting Aortic Aneurysm

- jaw, neck, shoulder, chest, and/or back

21
Q

Angina:
-Pain not relieved by ____ or up to __ nitroglycerin tablets in ___-___ minutes requires sending patient to ED and notifying MD.

A

-rest or up to 3 nitroglycerin tablets in 10-15 minutes

22
Q

What are the 5 D’s and 3 N’s of VBI?

A
  • Dizziness
  • Drop Attacks
  • Diplopia
  • Dysarthria
  • Dysphagia
  • Nausea
  • Numbness
  • Nystagmus

***Can also present with vertigo, nausea, and HA.

23
Q

WEEK 6

A

WEEK 6

24
Q
  • Pulmonary screening may need to be performed with patients presenting with referred pain where? (3)
  • What are the (4) most common pulmonary conditions that can mimic MSK disorders?
A
  • neck
  • shoulder
  • back
  • Pneumonia
  • Pleurisy
  • Pneumothorax
  • Pancoast’s Tumor
25
Q

What are the (5) S//Sx of pulmonary disorder? Which 2 are the most common?

A
  1. ) Cough***
  2. ) Dyspnea***
  3. ) Cyanosis
  4. ) Clubbing
  5. ) Altered Breathing Patterns
26
Q

Lung Cancer (Pancoast’s Tumor):

  • What is it?
  • Frequently involve ____ cervical and _____ thoracic nerve.
  • Presents in distribution of ___-___ dermatomes. (loss of hand function, Horner’s syndrome)
  • What is the most common initial symptom?
  • Can mimic ___________.
A
  • Tumor of the lung apex.
  • 8th cervical and 1st thoracic
  • C8-T2 dermatomes
  • sharp (posterior) shoulder pain
  • TOS
27
Q

WEEK 7

A

WEEK 7

28
Q

Abdominal Pain (Referred GI Pain Patterns):

  • Often more _______ and _________.
  • Referred pain to the MSK system can occur in the absence of visceral pain, however, _______ pain usually precedes ________ pain.
  • What are some areas referred pain can be perceived?
A
  • intense and localized
  • visceral pain usually precedes referred pain
  • shoulder, mid-back/scapular region, pelvis, flank, low back, or sacrum
29
Q

Symptoms Affected by Food:

Pain associated w/ gastric ulcers:

  • May occur within ___-___ after eating.
  • Food _________ to relieve pain.

Pain associated w/ duodenal/pyloric ulcers:

  • May occur ___-___ after eating.
  • Food _______ to relieve pain.
  • When may these patients report pain?
A

Pain associated w/ gastric ulcers:

  • 30-90 minutes
  • not likely

Pain associated w/ duodenal ulcers:

  • 2-4 hours
  • may relieve pain
  • Pain during night between 12-3am.
30
Q

Shoulder Pain:

L Shoulder Pain:

  • May be result of free air following laproscopic surgery or blood in abdominal cavity (usually from ruptured _______ or _________ bleeding).
  • Screen for precipitating trauma/injury.
  • ______ Sign: Pain in shoulder w/ pressure placed on left upper abdomen.

R Shoulder Pain:
-Perforated _________ or __________ may refer here.

L/R Shoulder Pain:
-________ cancer may refer to either shoulder.

A

L Shoulder Pain:

  • ruptured spleen or retroperitoneal bleeding
  • Kehr’s Sign

R Shoulder Pain
-duodenal or gastric ulcer

L/R Shoulder Pain:
-pancreatic

31
Q

Abdominal Pain MSK Clusters.

A
  1. ) Does coughing, sneezing, or taking a deep breathe make your pain feel worse? (YES)
  2. ) Do activities such as bending, sitting, lifting, twisting, or turning over in bed make your pain feel worse? (YES)
  3. ) Has there been any change in your bowel habit since the start of your symptoms? (NO)
  4. ) Does eating certain foods make your pain feel worse? (NO)
  5. ) Has your weight changed since your symptoms started? (NO)
32
Q

Peptic Ulcer:

  • What is it?
  • Can cause ________ or _____ pain.
  • What are some things that can cause peptic ulcers? (4)
A
  • Loss of tissue lining lower esophagus, stomach, and duodenum.
  • shoulder (usually R) or back pain
  • Infection w/ H.pylori, chronic NSAID use, erosions, chronic ulcers
33
Q

Crohn’s Disease:

  • Inflammatory disease most commonly attacks terminal end of __________ and ______.
  • Occurs more commonly in ___________/__________.

Ulcerative Colitis:

  • Inflammation and ulceration of lining of __________.
  • Cancer of ______ more common in people with UC.

IBD:

  • UC and Crohn’s disease can be accompanied by ________ component.
  • Joint problems usually are responsive to treatment of IBD but do on occasion require separate management.
A

Crohn’s Disease:

  • small intestine (ileum) and colon
  • young adults/adolescents

Ulcerative Colitis:

  • large intestine (colon/rectum)
  • colon

IBD:
-arthritic component

34
Q

Pancreatic Carcinoma:

  • ___% of pancreatic cancer arise in the head of the gland.
  • ___-___% occur in the body and tail.
  • Pain is worse with ________ and __________.
  • Pain is relieved by _______ and ___________.
A
  • 70%
  • 20-30%
  • walking and lying supine
  • sitting and leaning forward
35
Q

WEEK 9

A

WEEK 9

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42
Q

WEEK 10

A

WEEK 10

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S7- Differential Diagnosis (15 decks)

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