CS Flashcards
What disorders should be considered when evaluating a patient with alcohol abuse⁉️
Polysubstance abuse
Affective disorders (eg, bipolar disorder, major depression)
Anxiety disorders (eg, post-traumatic stress disorder, panic disorder)
Chronic insomnia
Personality disorders (eg, antisocial personality disorder)
Dementia
What are CAGE questions?
Have you felt you should cut down on your drinking?
Have others annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever taken a drink first thing in the morning (eye-opener) to steady your nerves?
What are the questions for history of present illness for alcohol patients?
At what age did you start drinking alcohol?
On average, how many drinks do you have in a day? In a week?
How many days a week do you drink?
Have you had any mood changes?
Do you get anxious over small things?
If you don’t drink for 2-3 days do you get any shakes (tremors)?
Has your drinking ever gotten you in trouble?
What are the alcohol past medical history?
Have you had any seizures?
Have you had liver problems?
Do you have high blood pressure?
What are the social history questions that pertains to alcohol patients?
Are you facing any stressful situations in your home?
Do you have any financial or occupational problems?
Do you smoke?
Do you use recreational drugs?
What are the family history questions you should ask and alcohol patient?
Do you have any family members with alcohol or drug problems?
What are gastrointestinal and psychiatric ROS? That can be asked for alcohol patients?
Gastrointestinal: heartburn, hematemesis, melena, abdominal distension, jaundice
Psychiatric: depression, anxiety, insomnia
What are the psychiatric examination observations?
Impaired level of consciousness
Anxious or depressed affect
Increased or decreased psychomotor activity
What should be mentioned in the closing Encounter for a alcoholic patient?
inquire about patients’ desire for treatment and provide assurance that you will continue to work with them to address their medical problems.
What are the diagnostic studies than should be done foR Alcoholic patients⁉️
CBC
Hepatic transaminases (AST, ALT, gamma-glutamyltransferase), albumin
Coagulation markers (prothrombin time, partial thromboplastin time)
Hepatitis serologies (hepatitis A, B, C)
Liver ultrasound Y
What type of lower back pain patient will have a benign etiology and will have spontaneous resolution?
Most patients with acute (<4-6 weeks), uncomplicated low back pain
What are the red flags for lower back pain?
Age >50 History of cancer Constitutional symptoms (eg, fever, weight loss) Nocturnal pain No response to appropriate treatment Significant neurologic deficits
possible infection, malignancy, or bony injury (eg, compression fracture) may require more aggressive evaluation.
What are the muscle skeletal causes for lower back pain?
Mechanical (muscle strain) Radiculopathy (herniated disc) spinal stenosis, compression fracture
What are the clues for compression fracture? Spinal stenosis?
Osteoporosis, onset followed by minor trauma.
Pseudoclaudication, relieved by leaning forward.
What are the cues for metastatic cancer been the cause of lower back pain?
Age greater than 50, pain not relieved by rest, nocturnal pain worse
What are the possible infectious causes for lower back pain? What are the causes?
Recent infection or IV drug use, fever, spine tenderness; Osteomyelitis, discitis, abscess
What clue beyond the dexa scan will point you towards osteoporosis as being a risk factor for lower back pain?
Menopausal state
What are the questions to ask for nerve root compression/reticular pain?
Do you feel the pain down your legs or feet? Do you feel lower extremity numbness weakness or tingling? Have you lost control of your bowel or bLadder?
