differential

Question 1

what are the 2 most common sites of viscerogenic pain?

Answer 1

back and shoulder

Question 2

primary prevention

Answer 2

stopping the processes that lead to development of diseases, illnesses, and other pathological conditions

Question 3

secondary prevention

Answer 3

early detection of diseases, illness and other pathological diseases through regular screening

Question 4

tertiary prevention

Answer 4

providing ways to limit the degree of disability while improving function in pts/clts w/ chronic and/or irreversible diseases

Question 5

what is the single most important tool in screening?

Answer 5

client interview ( personal/family history)

Question 6

what is the 5th vital sign?

Answer 6

pain along with BP, temp, pulse and respiration

Question 7

embryologic development

Answer 7

pain is referred to a site where the organ was located in fetal development; its nerves persist in referring sensations from the former locations

Question 8

multisegmental innervation

Answer 8

Viscera have multisegmental innervation by ANS
Ex: cardiac pain is not felt in the heart, but is referred to areas supplied by the corresponding spinal nerves (C3-T4; jaw, neck, upper traps, shoulder, arm). Pain of cardiac/diaphragmatic origin felt in shoulder b/c of C5 innervation.

Question 9

c5 innervates?

Answer 9

C5 innervates heart, diaphragm, and shoulder

Question 10

direct pressure and shared pathways

Answer 10

Pathology of organs causes inflammation, infection, and obstruction which brings them in contact with the respiratory diaphragm
Anything that impinges the central diaphragm can refer pain to the shoulder and anything that impinges the peripheral diaphragm can refer pain to the ipsilateral costal margins and/or lumbar spine

Question 11

what scale for pain is best for children?

Answer 11

face pain scale

Question 12

what pain scale is best for children 0-18 months?

Answer 12

child facial coding system

Question 13

what is the VAS?

Answer 13

visual analog scale of pain , 0 to 10 cm

Question 14

NRS is?

Answer 14

numeric rating scale

Question 15

whats is the SF-36?

Answer 15

assessment of bodily pain along with general measure of health-related quality of life

Question 16

blurred vision, double vision, scotomas or temp blindness can indicate?

Answer 16

early symptoms of MS or impending CVA

Question 17

true or false?

visceral pleura feels more pain than parital

Answer 17

false

Question 18

visceral pain is not well localized for what 2 reasons?

Answer 18

innervation of the viscera is multi segmental

there are few nerve receptors in these structures

Question 19

neuropathic pain

Answer 19

results from damage to or pathophysiologic changes of the peripheral or central nervous system (CNS)

Question 20

referred pain

Answer 20

felt in an area far from the site of the lesion but supplied by the same or adjacent neural segments

Question 21

visceral pain is not reproduced by ________ and hurts ______ and gets ___ with rest

Answer 21

movement
all the time
no better

Question 22

true or false
Ischemic pain of the viscera is sudden, intense, constant and progressive in severity and intensity. Not relieved by position or analgesics.

Answer 22

true

Question 23

joint pain in the presence of fatigue may be a red flag for?

Answer 23

cancer, anxity, depression

Question 24

true or false

joint pain is a common side effect of statins?

Answer 24

true

Question 25

risk factors for infelicitous arthritis include?

Answer 25

over 80 yo, DM, IV drugs, catheters, RA. OA, immunocompromised conditions

Question 26

radicular pain

Answer 26

results from direct irritation of axons of a spinal nerve or neurons in the DRG and is experienced in the MS system in a dermatome, sclerotome, or myotome

Question 27

Pain from pleura or trachea correlates with

Answer 27

respiratory movement

Question 28

arterial pain is said to feel like _______

Answer 28

throbbing

Question 29

if ur gallbladder hurts, u tend to_____ for relief

Answer 29

trunk flexion

Question 30

to relieve right kidney pain, one would?

Answer 30

flex and sb right

Question 31

pancreas pain is relieved by?

Answer 31

sitting up and leaning forward or knees to chest

Question 32

joint pain can refer?

Answer 32

to the joint above or below

Question 33

heart refers to

Answer 33

shoulder, neck, upper back and TMJ

Question 34

Disproportionate relief of bone pain with aspirin is red flag for

Answer 34

osteoid osteoma

Question 35

n an acute care or trauma setting the therapist may be using vital signs and the ABCGE

Answer 35

``` airway breathing circulation disability exposure ```

Question 36

what is AMPLE?

Answer 36

``` used in hx of trauma unit allergies medication past medical hx last meal events of injury ```

Question 37

metal status includes?

Answer 37

lvl of consciousness orientation ability to communicate

Question 38

iatrogenic delirium last for?

Answer 38

ususally temp but can last hours to several weeks

Question 39

delirum is much more associated with what?

Answer 39

hip fx | hip and knee joint replacements

Question 40

true of false | confusion is normal sign of aging

Answer 40

false

Question 41

fruity breath odor

Answer 41

diabetic ketoacidosis

Question 42

what is the easiest and most economic and fastest way to screen for systematic illnesses?

Answer 42

taking vital signs

Question 43

what is a paradoxic pulse?

Answer 43

pulse amp that fades with inspiration and strengthens with expiration and should be reported

Question 44

a pulse increase of more than ______ bpm lasting for more than 3 mins after rest should be reported

Answer 44

20

Question 45

normal breaths per min is?

Answer 45

12-20

Question 46

pulse pressure equals

Answer 46

systolic - dyastolic

Question 47

norm pulse pressure should be

Answer 47

40 mmHG

Question 48

pulse pressure of greater than 60-80 is a flag for

Answer 48

a fib

Question 49

narrowing pulse pressure indicative of?

Answer 49

CHF, blood loss

Question 50

in a normal person u would see a increase pulse pressure because of a raise in the ______but not the _______

Answer 50

SBP | DBP

Question 51

women taking birth control pills may be at increased risk of?

Answer 51

hypertension heart attack stroke

Question 52

true or false | the right ventricle becomes less elastic and more noncompliant as we age

Answer 52

false | left ventricle

Question 53

140/90

Answer 53

hypertension

Question 54

excessive morning BP increase is a predictor of?

Answer 54

stroke in older adults known with hypertension

Question 55

hypotensions is

Answer 55

90/60

Question 56

Virchow's node=

Answer 56

enlargement of one of the supraclavicular lymph nodes in the presence of primary carcinoma of thoracic or abdominal organsmore common on left side

Question 57

reflex ratings are

Answer 57

0=absent; no response 1+=low normal; decreased; slight muscle contraction 2+=normal; visible muscle twitch producing movement of arm/leg 3+=more brisk than normal, increased or exaggerated; may not indicate disease 4+=hyperactive; very brisk; clonus; spinal cord disorder suspected

Question 58

CN II, III, IV are screened for

Answer 58

visual problems

Question 59

PVD first signs are usually

Answer 59

skin changes

Question 60

PVD risk factors

Answer 60

: bedrest, immobility, IV catheters, obesity, MI, heart failure, pregnancy, post op, coag issues. Others include: age, smoking, HTN, HLD, claudication

Question 61

Strongest predictor of UE thrombosis

Answer 61

indwelling central venous catheter

Question 62

Murphy’s percussion test

Answer 62

sed in presence of costovertebral tenderness: used to rule out kidney involvement