E1-Systems Review, Oncology, Infectious Disease Flashcards
what is the purpose of a systems review
identify non MSK or red flag S&S that require a referral
what is the best way to look for red flag S&S
look for combinations, isolation is just informative
where are red flags most found
hx and observation
what are commons signs of infection
malaise
fever, chills, sweats
N&V
enlarged, tender lymph nodes
signs specific to the infected systems
what is different about the symptoms in an older individual
mentation changes
subnormal body temp
bradycardia or tachy
fatigue/lethargy
what is in a systems review for infection
hx and observation
palpation- lymph nodes, heat, swelling, possible abdominal quadrants
vitals
what are common S&S of the immune system
GI pain/dysfunction
muscle or joint pain
skin and weight changes
typically affecting more than 1 part of the body
emotional changes
what are S&S of the immune system more likely to be a cause of
autoimmune conditions
what is in an immune system review
hx and observation
temperature
palpation of lymph nodes
what are cancer S&S
hx of cancer
P!- local and referred, especially at the same time at night (due to tumors metabolic activity), no change with position change
increased WBC with absence of infection
swollen and NON tender lymph nodes
what is in the cancer review
hx and observation
palpation of lymph nodes- NON tender
temperature
what are common signs of an integumentary system
itchy/dry/rough texture
hives/rash
callus
blisters
edema
change nail appearance
why would skin with dry/rough or itchy skin be a red flag
impaired circulation/oxygenation (diabetes)
what causes callus
excessive friction
why might blisters in abundance be different that just a normal blister
blisters in abundance could mean systemic issues
what are the ABCDE for melanoma
Assemetry
border
color
diameter
evolution
what might be an issue if a patient has an abundance of cafe au lait
underlying genetic problem
why is a patch of hair on the spine might be a red flag
underlying genetic condition
loss-impaired circulation
if a pt has skin irritation involving redness/red streaks, what might that inidcate
acute inflammation, stage 1 pressure ulcer, infection, allergic reaction
what does an ulceration or wound indicate
necrotic tissue
what is in a integumentary review
hx and observation
palpation- heat, swelling, skin mobility
what conditions within the endocrine system can affect the MSK system
neuromusculoskeletal- RA, OA, adhesive capsulitis, bilateral CTS, osteoporosis
what are common endocrine S&S
growth alterations
polydipsia
polyuria
increased perspiration
fluid imbalance
what is in an endocrine review
hx and observation
selective tension testing and/ or MMT
vitals
what are common S&S of the cardiovascular system
hx of family heart attack prior to age 60
pain in chest with or without referred pain C4-T4, especially with exertion
heart palpitations
SOB/wheezing
what are peripheral vascular S&S
LE edma including weight gain indicates impaired R ventricle
diminished pulse
what is in the cardiovascular review
hx and observation
vitals
ankle-brachial index
what are common S&S of lymphatic system
full, heavy, and/or tight sensation
impaired ROM
paresthesia/numbness
increased extremity in size
weight gain
what are some advanced symptoms of lymphatic system
skin breakdown/wounds
infections
possible difficulty breathing, speech, and swallowing
what is in a lymphatic review
hx and observation
ROM
girth measures
palpation of lymph nodes
temperature
what are common S&S of respiratory system
pain in neck and upper shoulder
thorax pain
digital clubbing
SOB
decreased breath sounds
hyperresonance with percussion
why would you have pain in the neck and upper shoulder with respiratory system problems
diaphragm is innervated by C3-5 and so are those regions
what is in the respiratory review
hx and observation
vitals
breath sounds
percussions
how many immune cells are in the gut
70-80%
why is gut health so important
there is an emotional physiological connection in the gut
bad diet=bad mood
what are common S&S of the GI system
dysphagia
N&V
food eversion/intolerance
indigestion/heartburn
full feeling (bloated)
what is in a GI review
hx and observation
abdominal quadrant assessment
what system has the largest number of phagocytic cells
hepatic
what are common S&S of the hepatic system
skin changes- jaundice, spider angioma
dark urine
discolored stool
edma
neurologic involvement- confusion, muscle tremors, asterixis
what is asterixis
paresthesia/numbness from ammonia build up and inability to maintain wrist ext with shoulder flx
what is hepatic osteodystrophy
metabolic bone disease due to suppression of bile flow
may manifest as osteoporosis
what is in a hepatic review
hx and observation
abdominal quadrant assessment
neurological tests
what is hyperplasia
increased number of cells
what is metaplasia
an adult cell changes from one type to another
what is dysplasia
greater presence of abnormal cells
what is metastasis
spread of cancerous cells from the primary tumor
what is differentiation in cancer
normal cells mature or differentiate into mature types of normal tissue
altered or lost completely with malignancies
the more undifferentiated the more aggressive the cancer
what is anaplasia
loss of differentiation
how can we classify neoplasm
cell type
tissue origin- primary or secondary
degree of differentiation
benign or malignant
what is considered in stage 0 cancer
carcinoma preinvasive
what is considered in stage 1 cancer
early stage, local cancer
what is considered in stage 2 cancer
increased risk of spread because of tumor size
what is considered in stage 3 cancer
local cancer has spread but may not be metastasized to distant regions
what is considered stage 4 cancer
cancer has spread and metastasized to distant sites
what are the most prevalent cancers
lung
breast
colorectal
why are the most prevalent cancers so prevalent
all involve mucous producing glands
what are the most treatable cancers
prostate and breast
what percentage of cancers are due to genetics
5-10%
most often- prostate, breast, ovarian, and colorectal
what percentage of cancers are due to exogenous
50%
all are most preventable
what are cancer risk factors
prior cancer
lifestyle
some viruses
excessive and abnormal amounts of some hormones
inflammatory diseases
how might genes be affected by risk factors to produce cancer
chromosomal additions or subtractions
what sites are cancers more likely to metastasize to
lung
liver
bone
brain
lymph nodes
how does cancer metastasize
gains access to blood supply
hormones can sometimes influence growth
what are the contraindications for physical activity with cancer
fatigue so energy conservation for the body to fight
what are the statistics for childhood cancers
80% will survive 5 or more years
2nd leading cause of death for children 1-14
1/2 of childhood cancers involve organs with more circulatory functions
what is leukemia
cancer of T and B cells
inability to develop mature T and B cells and replacement of bone marrow
what are risk factors for leaukemia
prior cancer Rx
down syndrome
white males
what are the red flags for leukemia
transient joint pain- in large joints
cancer S&S
hepatic S&S
maybe respiratory S&S
easy bruising due to spleen enlargement
what is soft tissue sarcoma
cancer that begins in soft tissue
rhabdomyosarcoma
when does soft tissue sarcoma peak
between the ages of 2-5 years
2nd peak between 15-19 years
what is soft tissue sarcoma S&S
site dependent
painless mass in muscle
cancer S&S
what is incubation period
the period between becoming infected and having appearance of symptoms
what is the period of communicability
time period when an organism can be shed or the infectious period when one can become infected
what is a virus
dependent of host cells for life and reproduction
no antibiotics
anti-viral meds only help S&S and limit the virus
what is a bacteria
live and grow independent of host
can use antibiotics
can be classified
what is rickettsiae
bacteria that requires host
antibiotics
primarily animal pathogens
can be life threatening
what is the chain of transmission
a pathogenic agent
a reservoir
a portal of exit from the reservoir
how can microorganisms be transmitted
contact- direct/indirect
airborne
droplets
vehicle
vector borne
what is a portal of entry for microorganisms
ingestion, inhalation, skin, etc
what can decrease gut flora
compromised immune health
co morbidities
SAD
antibiotics
hospitalized/long term care pts
what is E. Coli transmission/etiology
vehicle transmission through infected food
hand to mouth direct contact
found in GI tract
who are most at risk for E coli
organ transplant pts
mechanically ventilated
urinary of vascular catheterized
traumatic injury
what are the S&S for E coli
GI and infection S&S
how is C diff transmitted
gains advantage in low gut flora environment
fecal oral route
can occur with disruption of intestinal mucosa from chemo, sx, or feeding tube
what is C diff
most common cause of persistent diarrhea
suppresses good bacteria
may lead to death
what are the risk factors for C diff
medicare age white females
what are the S&S of C diff
GI and infection S&S
what is staph
most common bacteria on the skin
what is MRSA
staph
resistant to antibiotics
serious threat to public health
biofilm for resistance
how is staph transmitted
direct contact or inhalation
greater risk with skin openings
what is strep
affects various systems
most common is strep throat
respiratory droplets
what are the most common cause of cellulitis
acute skin inflammation
possible streaks
what respiratory infections can follow the flu
most common cause of meningitis
pneumonia
what is gas gangrene
severe life threatening infection that targets muscles
post op or post traumatic muscles
what is gas gangrene patho
occlusion or thrombosis of blood vessels
may lead to hypotension or shock
what is gas gangrene S&S
sudden and severe pain due to ischemia at wound site
thick foul discharge with crepitation from gas bubbles
vascular and infection S&S
how are viral infections spread
respiration and direct contact
what are the PT implications for COVID
vaccination effective at limiting severity > preventing infection
prevention to avoid modifiable risk factors
what is lyme disease
affects multiple systems
tickborne pathogen
curable
what is lyme diseases pathology
tick requires 36 hours to feedto inject bacteria
no natural immunity develops so it can reoccur
what are the S&S for stage 1 of lyme disease
flu-like and infection S&S
red, slowly expanding singular bulls’ eye rash
what are the S&S for stage 2 of lyme disease
multiple bulls’ eye
aseptic meningitis- headache, stiff neck, impaired mentation, bells’ palsy
possible cardiopulmonary involvement and S&S
what are the S&S in stage 3 of lyme disease
joint pain- especially large joints
systemic symptoms- late stage neurological S&S
what is lyme disease post infection syndrome
rare
poorly or untreated conditions (fibromyalgia like S&S)
