Do not want to miss list

Question 1

Full list

Answer 1

• major depression
• suicide risk
• femoral head/neck fractures
• cauda equina syndrome
• cervical melopathy
• abdominal aortic aneurysm
• deep venous thrombosis
• pulmonary embolism
• atypical myocardial infarction

Question 2

Major depression disorder

Answer 2

• patient responds yes to depression screening questions
• noting 3-4 of following: significant weight loss, insomnia or hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness or guilt, difficulty concentrating, recurrent thoughts of suicide

Question 3

Risk factors associated with MDD

Answer 3

• current or previous history of major depressive episodes
• women, especially during pregnancy or postpartum time
• significant medical history
  > diabetes
  > myocardial infarction
  > cancer
  > CVA
  > chemical dependency
• suffering significant loss
• positive family history

Question 4

Suicide risk factors

Answer 4

• gender (males = suicide completion; females = suicide attempts)
• widowed, divorced, living alone
• history of psychiatric illness
• previous suicide attempt
• history of chronic progressive illnesses
• recent significant loss
• unemployed
• sense of hopelessness
• family history of suicide completion or attempts

Question 5

Management of suicidal patients

Answer 5

• does the patient have a plan in place
• are resources related to patient’s plan readily available
  > patient states they own gun
  > patient has filled a
  medication prescription
• who should be contacted

Question 6

clinical manifestations of suicide risk

Answer 6

• “i don’t know how much longer I can take this”
• stopping therapy, with potential for continued progress
• stopping other forms of treatment
• patients expressing thoughts of death
• wishing they were dead

Question 7

femoral head/neck fractures risk factors

Answer 7

• female
• hormonal menstrual irregularites
• involvement in running, jumping, marching activites
• change in training program or routine: new activity or increased in activity intensity/change in footwear and training surface
• nutritional deficiencies
• leg length discrepancy
• diminished muscle strength
• loss of general function and mobility

Question 8

femoral head/ neck fracture clinical manifestations

Answer 8

• pain and local tenderness
• deformity
• edema
• ecchymosis
• loss of general function and mobility

30% of those suffering a hip fx die within a year

Question 9

MOI femoral head/ neck fractures

Answer 9

• trauma
• fall, slip
• sneeze
• lifting
• opening stuck window
• falling down steps

Question 10

cauda equina syndrome risk factors

Answer 10

• low back injury, central disk herniation
• congenital or acquired spinal stenosis
  > degenerative disk or facet joint disease
  > degenerative spondylolisthesis
• spinal fracture
• ankylosing spondylitis
• tuberculosis, Pott’s disease

Question 11

clincial manifestations of cauda equina

Answer 11

• urinary dysfunction
• bowel dysfunction
• sexual dysfunction
• sensory deficits
  > perineum and saddle regions
  > lower extremities
• motor deficits
  > lower limbs

Question 12

cervical myelopathy risk factors

Answer 12

• spondylotic changes in cervical spine
• age: mid 50s to 60s and older
• previous history of neck trauma
  > MVA
  > sports injury
• RA

Question 13

Clinical manifestations of cervical myelopathy

Answer 13

HISTORY

• impaired hand dexterity
• gait, balance difficulties
• numbness, paresthesia- extremities
• neck stiffness
• urinary dysfunction

PHYSICAL EXAM

• hand- intrinsic atrophy
• muscle weakness, often of triceps; hand intrinsic
• muscle weakness of lower extremities
• upper motor neuron signs

Question 14

AAA risk factors

Answer 14

• age
• male gender
• history of smoking
• hypercholesterol
• history of CAD
• family history of AAA

Question 15

Clinical manifestations of AAA

Answer 15

- usually asymptomatic, but may produce pain
> lumbar region, back
> hip and buttock
> groin
>abdominal region
- satiety, weight loss, and nausea
- palpable abdominal mass

Question 16

AAA vessel dissection

Answer 16

LBP description

• sudden, severe
• intense, persistent
• hot, searing
• ripping or tearing sensation

Question 17

DVT risk factors

Answer 17

• previous history of DVT
• history of cancer or chemotherapy
• history of CHF
• history of SLE
• major surgery of other trauma
• immobility
• hormone changes in women
• age > 60 yrs

Question 18

DVT clinical manifestations

Answer 18

• ache, tightness, tenderness
• general to pitting edema
• prominent superficial venous plexus
• increased local skin temperature

Question 19

Pulmonary Embolism risk factors

Answer 19

• previous history of PE or DVT
• immobility
• history of abdominal, pelvic surgery
• total hip, knee replacement
• late stage pregnancy
• lower limb fractures
• malignancy in pelvis of abdomen

Question 20

PE clinical manifestations

Answer 20

• dyspnea
• tachypnea
• pleuritic chest pain
• pain with deep respiration, cough
• persistent cough
• apprehension, anxiety
• tachycardia
• palpitations

Question 21

risk factors for atypical MI

Answer 21

• cigarette smoking
• high cholesterol levels
• hypertension
• diabetes
• obesity
• sedentary lifestyle
• excessive alcohol consumption
• Age (>45 men, >55 women)
• family history
• ethnicity (african americans)

Question 22

clinical manifestations of atypical MI

Answer 22

• 50% experience chest pain, with or without left UE pain
• shortness of breath
• fatigue
• sleep disturbance
• nausea, with or without vomiting
• palpitations
• dizziness
• diaphoresis
• anxiety