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Differential Diagnosis > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

VINDICATE

A

Vascular
Inflammatory
Neoplastic
Drugs
Infectious
Congenital
Autoimmune
Traumatic
Endocrine/metabolic

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2
Q

Pedal plantarflexion test

A

For vascular/intermittent claudication

Calf raise 50x - comparable to treadmill walking

Positive test = recreation of vascular pain and > 8/10 pain

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3
Q

Blood pressure ranges: Optimal, pre-hypertension, hypertension

A

Optimal: <120/<80
Pre-hypertension: 120-139/80-89
Hypertension: >140/>90

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4
Q

HR range

A

60-100 bpm, may be slightly lower in well-conditioned athletes

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5
Q

RR range: normal and abnormal

A

Normal: 15-20 bpm
Abnormal: <12 OR >25

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6
Q

Locations of atypical signs/symptoms for cardiopulmonary systems: Heart, Lungs & Bronchi, Diaphragm

A

Heart: T1-T5, cervical anterior, jaw, teeth, epigastric, left UE, right shoulder and UE
Lungs and Bronchi: T5-T6, ipsilateral thoracic spine, chest wall, cervical (diaphragm involved)
Diaphragm: C3-C5, cervical spine

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7
Q

Inflammatory: sig difference in measurement between joint circumference, terms

A

1.5cm = significant difference

Rubor - redness due to increased blood flow
Calor - heat due to increased blood flow
Dolor - pain due to pressure of interstitial fluid
Edema - swelling due to proteins and fluid moving into interstitial space
Functio Laeso - swelling to limit joint motion

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8
Q

Neoplastic: CAUTION & things to consider

A

Changes in B&B habits
A sore that does not heal in 6 weeks
Unusual bleeding or discharge (continues)
Thickening or lump (breast or elsewhere)
Indigestion or difficulty in swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

History, clinical presentation, signs and symptoms

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9
Q

VINDICATE: Drugs - what to consider

A

Dosage (especially in home health)
Side effects

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10
Q

VINDICATE: Autoimmune - what to look for

A

Typically appear as exacerbations and remissions
Be aware of polyarthritis and polymyalgia
Subcutaneous nodules over extensor area of forearm
Unusual joint swelling not linked to trauma
Skin lesions, rash, etc.
MADGE: IgM, IgA, IgD, IgG, IgE

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11
Q

VINDICATE: Trauma - signs

A

Gray-turner’s Sign: uncommon subcutaneous sign of intra-abdominal pathology, manifests as ecchymosis and/or discoloration of the flanks - related to necrotising pancreatitis
Cullin’s Sign: bruising around umbilical region indicative of hemorrhagic pancreatitis

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12
Q

Upper right quadrant

A

Liver
Galllbladder
Lower lung
Diaphragm

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13
Q

Upper left quadrant

A

Stomach
Spleen
Lower intestine
Lung/diaphragm

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14
Q

Lower right quadrant

A

Lower intestine
Appendix

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15
Q

Lower left quadrant

A

Lower bowels
Descending colon
Abdominal aorta

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16
Q

Addison’s v Cushing’s

A

Addisons - need to “add” cortisol

Cushing’s - need to “cushion” effect of increased cortisol

17
Q

Cervical myelopathy: general effects/overview, 5 diagnostic tests

A

Severe degenerative changes in the c-spine, loss of balance/clumsiness, unsteady gait, difficulty with fine motor tasks

Tests: gait deviation, Hoffman’s, Babinski, inverted supinator sign (indicative of C5-C6 lesion), >45 y/o (3+/5 positive signs)

18
Q

Babinski - what sort of lesion if + bilaterally vs unilaterally?

A

Bilateral = UMN lesion
Unilateral = LMN lesion

19
Q

Out of visual, vestibular, and somatosensory systems, which is quickest and most sensitive to balance disturbance?

A

Somatosensory

20
Q

Motor output of vestibular system

A

Oculomotor: gaze stabilization
Vestibulospinal: postural control/reflexes

21
Q

3 functions of peripheral vestibular system

A
  1. Helps maintain posture and balance under static and dynamic conditions, esp. with head motion
  2. Helps maintain a stable visual image for clear vision
  3. Provides info for spatial orientation
22
Q

3 functions of vestibular system

A
  1. Head position and movement
  2. Postural stability/balance
  3. Compensatory eye movement during head movement
23
Q

CN 3 Palsy

A

Lateral deviation
Downward deviation
Ptosis

24
Q

CN 4 Palsy

A

Upward deviation

25
Q

CN 6 Palsy

A

Medial deviation

26
Q

Central eye movements

A

Smooth pursuit - tracking moving object
Vergence system - tracking object changing in depth
Saccades - switching from one target to another

27
Q

Always do a general health screen, screen specific systems when…

A

Several red flags are revealed in general screen
Unable to determine the source of symptoms is mechanical
Pt not responding as predicted to POC
Any other changes in status indicating a need

28
Q

BP response to exercise

A

Medical consult encouraged if >140/90

Urgent referral if >200/110 or systolic pressure <80 or diastolic pressure >100

Differential Diagnosis (3 decks)

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