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Differential > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What are early manifestations of thyroid or parathyroid disease?

A
  • muscle weakness, myalgia, cramps and fatigue - proximal upper/lower limb symmetrically
  • bilateral carpal tunnel syndrome
  • periarthritis and calcific tendinitis
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2
Q

What often occurs in the shoulders of people with endocrine disease?

A

periarthritis and calcific tendinitis

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3
Q

acromegaly S&S

A
  • bony enlargement
  • amenorrhea
  • DM
  • diaphoresis - excessive sweating
  • HTN
  • Carpal tunnel
  • hand pain and stiffness
  • back pain
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4
Q

What is Addison’s disease and what are S&S

A

hyposecretion by adrenal glands
- dark pigmentation of skin, especially mouth and scars
- hypotension
- progressive fatigue
- hyperkalemia
- GI issues

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5
Q

What is Cushing’s syndrome pathophys

A

increased secretion of cortisol by adrenal cortex
- cortisol suppresses the inflammatory response and an increase causes poor wound healing

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6
Q

What is a warning sign of cushing’s disease?

A

unexplained fever w/o other symptoms
- medical referral

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7
Q

Cushing’s disease S&S

A
  • moonface
  • buffalo hump
  • kyphosis and back pain
  • easy bruising
  • slow wound healing
  • masculinizing effects
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8
Q

What is Graves’ disease? What are some signs?

A

hyperthyroidism
- goiter leading to a swollen neck
- protruding eyes

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9
Q

S&S of hyperthyroidism in older adults

A
  • tremors
  • anxiety
  • palpitation
  • weight loss
  • heat intolerance
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10
Q

S&S of hyperthyroidism in younger patients

A
  • cold intolerance
  • weight gain
  • dry skin
  • constipation
  • mental and physical slowing
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11
Q

S&S of hyperthyroidism

A
  • severe tachycardia
  • hyperthermia
  • restlessness
  • chest pain
  • abdominal pain
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12
Q

risk factors for hypothyroidism

A

Depression of body metabolism
- women > 65 and increases with age

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13
Q

S&S of hypothyroidism

A
  • cold intolerance
  • excessive fatigue and drowsiness
  • HA
  • weight gain
  • irregular menstrual bleeding
  • skin dryness
  • brittle hair and nails
  • palpable nodules of thyroid
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14
Q

What is Woltman’s sign? What does this occur with?

A

Woltman’s sign - delayed relaxation phase of an elicited deep tendon reflex; more observable in the achilles

occurs with hypothyroidism

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15
Q

blood glucose levels needed to diagnosis DM

A

fasting blood glucose >/= 126 mg/dl on 2 different days
- risk factor if >/= 100 mg/dl

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16
Q

At what glucose level should exercise be postponed?

A

> 250 mg/dl

eat snack if < 100 mg/dl

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17
Q

S&S of hyperglycemia

A
  • thirst
  • hyperventilation
  • fruity breath
  • lethargy/confusion
  • cramps
  • poluria/dehydration
  • flushed face
  • elevated temp
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18
Q

S&S of hypoglycemia

A
  • pallor
  • perspiration
  • irritability/nervousness
  • weakness
  • shakiness
  • blurred vision
  • HA
  • fatigue
  • slurred speech
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19
Q

What is tophi? What is it a sign of?

A

tophi - lumps under the skin, or actual eruptions through the skin of chalky urate crystals

  • sign of gout
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20
Q

Osteoporosis T scores

A

normal - -1 or above
osteopenia - -1 - -2.5
osteoporosis - < -2.5
severe osteoporosis - < -2.5 or less with 1 or more fragility fractures

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21
Q

What is Paget’s disease?

A

localized excessive osteoclastic bone resorption f/b compensatory increased osteoblastic activity

22
Q

risk factors for paget’s disease

A
  • > 40 years old
  • Europe or Australia
  • anglo-saxon descent
  • genetic factors
23
Q

What is anisocytosis and hypochomia?

A

anisocytosis - abnormal variations in size of erythrocytes

hypochromia - erythrocytes deficient in hemoglobin

24
Q

anemia is a ___________, not a __________

A

is a symptom, not a disease

25
Q

S&S of anemia

A

too few erythrocytes

  • skin pallor or yellow-tinged skin
  • fatigue or listlessness (lack of energy)
  • dyspnea on exertion with heart palpitation and rapid pulse
  • chest pain with minimal exertion
  • decreased diastolic BP
  • nervous system manifestations
26
Q

thrombocytosis vs thrombocytopenia

A

cytosis - abnormally high

cytopenia - abnormall low

27
Q

S&S of hemophilia

A
  • progressive loss of motion
  • muscle atrophy
  • flexion contractures
28
Q

What are the most common symptoms of polycythemia? Other S&S

A
  • general malaise and fatigue
  • SOB

Other
- headache
- dizziness
- irritability
- blurred vision
- decreased mental acuity
- easy bruising
- cyanosis and digital clubbing
- HTN

29
Q

monocytes

A
  • largest circulating blood cells
  • travel to the tissues and form macrophages
30
Q

granulocytes

A

contain lysing agents (digest various foreign materials)

31
Q

S&S of leukocytosis

A
  • fever
  • symptoms of localized or systemic infection
32
Q

If a patient is leukopenia, what would require a medical referral?

A

leukopenia - decreased leukocytes
- greater risk for infection

S&S for medical referral
- fever
- chills
- diaphoresis

33
Q

S&S of leukopenia

A
  • sore throat, cough
  • high fever, chills, sweating
  • ulceration of mucous membranes
  • frequent or painful urination
  • persistent infections
34
Q

Thrombocytosis vs Thrombocytopenia

A

thrombocytosis - abnormally high platelets

thrombocytopenia - abnormally low platelets

35
Q

_____________ boosts the production of chemical activators that destroy unwanted clots.

___________ promotes coagulation

A

Exercise

Vitamin K

36
Q

S&S of thrombocytosis

A
  • thrombosis
  • splenomegaly
  • easy bruising
37
Q

S&S of thrombocytopenia

A
  • bleeding after minor trauma
  • spontaneous bleeding
  • excessive bleeding - gums and menorrhagia
  • melena (black, tarry stools)
38
Q

common sites of bleeding with hemophilia

A
  • large muscles of the LE
  • flexor surface of the forearm
39
Q

HIV results in what

A

destruction of CD4 white blood cells

40
Q

Criteria for referral of a person with early inflammatory symptoms like RA

A
  • significant discomfort on the compression of the MCP and MTP joints
  • the presence of 3 or more swollen joints
  • a report of morning stiffness lasting longer than 60 min
41
Q

S&S of RA

A
  • swelling in 1 or more joints, typically symmetrical and bilateral
  • morning stiffness lasting several hours
  • recurring pain or tenderness in any joint
  • redness and warmth in joint
    0 unexplained weight loss, fever, or weakness with joint pain
  • symptoms last > 2 weeks
42
Q

What is the most common inflammatory rheumatic disease in elderly?

A

polymyalgia rheumatica

43
Q

polymyalgia rheumatica S&S

A
  • bilateral muscle pain in proximal muscles
  • morning stiffness > 30 min
  • fatigue, malaise, anorexia
  • low-grade fever
  • headaches
  • vision loss
44
Q

Lupus characteristic

A

malar (butterfly rash across cheeks and nose)

45
Q

Lupus S&S

A
  • skin changes
  • MSK changes - joint pain and arthritis
  • neuro - seizures, depression, confusion, psychosis
  • peripheral neuropathy
46
Q

What is scleroderma?

A
  • chronic, multi-system disease
  • inflammation and fibrosis of many parts of the body
47
Q

Scleroderma S&S

A
  • circumscribed plaques w/ ivory-colored center
  • widespread skin involvement
  • muscle atrophy
  • sclerodactyly
  • telangiectasis - dilated blood vessels
48
Q

Who is at higher risk for reactive arthritis?

A
  • adults
  • women after enteric infection
  • men after venereal infection
49
Q

S&S of psoriatic arthritis

A
  • skin lesions
  • nail lesions
  • arthritis
  • morning stiffness > 30 min
  • ankylosis of the spine
  • dactylitis (sausage fingers)
  • mouth ulcers
50
Q

Lyme disease S&S

A
  • red rash
  • flu-like symptoms
  • migratory MSK pain
  • neuro symptoms - headaches, numbness/pain, poor motor control, cog dysfunction
51
Q

What is gel phenomenon?

A

stiffness in the morning 1 hour after waking, symptoms relieved with activity, recurrence of symptoms after sitting/ inactivity and then attempting to resume activity

Differential (5 decks)

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