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Differential Diagnosis > Exam I > Flashcards

Exam I Flashcards

1
Q

What is a diagnosis most commonly based on?

A

-A cluster of clinical findings from the history and physical exam

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2
Q

What is the biggest factor in making an incorrect diagnosis?

A

-Bias

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3
Q

What is the advantage of the Heuristic appraoch to diagnosis?

A

-It is quick

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4
Q

What is the disadvantage of the heuristic approach to a diagnosis?

A

-it might ignore serious health conditions

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5
Q

What is the advantage of the hypothetic approach?

A

-all symptoms are investigated

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6
Q

What is a disadvantage of the hypothetic approach

A

-It is slow, may delay intervention

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7
Q

When a PT refers a patient out based on a single clinical finding, what approach is that an example of?

A

-Naturalistic or Event Driven

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8
Q

Many clinicians are experienced and use what approach?

A

-Hueristic

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9
Q

Less experience clinicians use what approach?

A

-Hypothetic Deductive

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10
Q

What approach is recommend to make diagnosis?

A

-Mixed Approach

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11
Q

How much information is gained from the history and interview that is needed to make a diagnosis?

A

-70-80%

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12
Q

What is the purpose of the review of systems?

A
  • To identify health problems that may have been over looked during the medical history
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13
Q

In the cardiovascular, genital/urinary, and hepatic systems, conditions usually begin as what?

A

-Non-systemic and turn Systemic when they become chronic

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14
Q

What is an example of a systemic condition involving the cardiovascular system?

A

-Congestive Heart Failure

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15
Q

What systems normally present as non-system conditions only?

A

-GI, Billiary, Pulmonary, Nonmechanical musculoskeletal

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16
Q

What systems usually present as systemic conditions only?

A

-Endocrine, Hematologic, Immune, Metabolic, Nuero, Cancer with metastasis. and drug reaction

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17
Q

If a person has systemic sysmptoms, it is important to give a checklist involving what systems?

A

-Psychological, Endocinre, Hematoligcal, Neurological, Immune, Metabolic and Drug

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18
Q

If a person is presenting with non-systemic symptoms, what should the screen incluce?

A

-Hepatic, Billiary, GI, Urogenital, Cardio and pulmonary

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19
Q

If a patient has a systemic symptom it is important to refer them if what?

A

-It has not be investigated by the physician

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20
Q

If a person has pain in the C-spine/shoulders, what systems should be checked?

A

-GI, GU, Cardio and pulmonary

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21
Q

If a person has pain in the T-spine, what systems should be checked?

A

-Cardio, GI, GU(if a t/l spine junction)

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22
Q

If a person has pain in the lumbar spine and SI joints, what systems should be checked?

A

-GI, GU, Perivascular

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23
Q

If a person has pain in either UE or LE, what systems should be checked?

A

-Perivascular

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24
Q

Is night pain a constitutional symptom?

A

-NO

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25
Q

How many people have a skin disorder that report for a consult?

A

-1 of 4

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26
Q

What is the primary lesion of a skin disorder?

A

-The 1st lesion to appear

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27
Q

What is the most common manifestation of dermatological disease?

A

-Pruritis (itching)

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28
Q

What is a vascular reaction that is marked by skin patched that appear smooth and slightly elevated?

A

-Uticaria (Hives)

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29
Q

Where to rashes normally present?

A

-Face, Trunk, Axilla and Groin

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30
Q

Changing of the skin and nail beds can be the first sign of what types of disease?

A

-Inflammatory, infection, hepatic, metabolic, and immunilogical

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31
Q

In what type of patients should skin be examined in?

A

-outpatient and bed bound

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32
Q

Palor skin can mean what?

A

-Anemia (Iron def)

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33
Q

Yellow skin can mean what?

A

-Liver disease, carotonemia, hemolysis

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34
Q

Red skin can mean what?

A

-Can be an exacerbation of other skin disorders

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35
Q

Color finding indicate what types of conditions?

A

-Systemic

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36
Q

Generalized skin malpigmentation can be the result of what type of disease?

A

-Tryoid, liver, or renal disease

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37
Q

Soft skin can be caused by what?

A

-thyrotoxicosis

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38
Q

Tight skin can be caused by what?

A

-Scleroderma

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39
Q

Rough skin can be caused by what?

A

-Hyperthyroidism

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40
Q

Dry skin can be caused by what?

A

-Vitamin A Def

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41
Q

Where should Turgor be tested?

A

-forhead, under clavicle, extensoer side of arm or hand

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42
Q

A turgor test is positive is skin remains raised for how long?

A

-5 or more seconds

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43
Q

What can a positive turgor test mean?

A

-Dehydration

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44
Q

Generalized warmth can be caused by what?

A

-Fever or hyperthyroidism

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45
Q

Coolness of the skin can be caused by what?

A

-Hypothryroidism, frostbite, hypothermia, shock or low C.O

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46
Q

Pitting Edema is a claasic sign of what?

A

-cardiac failure

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47
Q

Skin patches larger than what should raise suspicion of a pathology?

A

-1.5 cm

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48
Q

What is often the first sign of rhuemati disease?

A

-Skin lesions

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49
Q

Butterfly rash over the nose and cheeks is associated with what?

A

-Lupus in the cute stage

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50
Q

Chronic Cutaneous lupus is marked by what?

A

-chronic skin eruptions on sun exposed skin

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51
Q

Acute cutaneous lupus occurs in what percentage of clients who have systemic lupus?

A

-30-50%

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52
Q

Acute cutaneous lupus is marked by what?

A

-malar and widespread erythema (redness) and bolus lesions

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53
Q

Lesions from lupus are expected to present where?

A

-face, scalp, ears, neck and arms (sun exposed)

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54
Q

What else besides skin can be ea sign of lupus?

A

-brittle hair, bald pathes

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55
Q

Skin lesions with lupus are usually accompanied by what other symptoms?

A

-malaise, fatigue, arthritis, anemia, hair loss, white nails, uroligic symptoms

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56
Q

What diease is characterized by red patches, covered by think, dry silvery, scales?

A

-Psoriasis

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57
Q

Where are psoriasis lesions normally located?

A

-extensor surfaces, bony prominences, scalp, ears, and genitals

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58
Q

Psoriasis is ofter accompanied by what?

A

-Arthritis of small joints (fingers/hands)

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59
Q

What is the average onset of psoriasis?

A

-27 years

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60
Q

what tends to aggravate psoriasis?

A

-cold whether, sever anxiety, or emotional distress

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61
Q

What is the most common complaint of psoriasis?

A

-itching and sometimes pains for dry, cracked lesions

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62
Q

Psoriasis can cause what in nails?

A

-small indentations and yellow or brown discoloration

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63
Q

What is systemic scelerosis?

A

-A diffuse CT disease that cuases fibrosis of skin, joints, blood vessles, and internal organs

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64
Q

How is systemic sclerosis classified?

A

-the degrees and extent of skin thickening

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65
Q

Other symptoms of sclerosis include what?

A

-pain, stiffness, and swelling in the fingers and joints

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66
Q

How can systemic sclerosis cause muscle atrophy?

A

-by limited ROM secondary to skin, joint or tendon involvement

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67
Q

CI motility dusfuction cause by systemic sclerosis can affect what?

A

-esophagus, anorectal region, and can cause reful, heartburn, dysphagia and bloating after meals

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68
Q

Systemic Sclerosis targets what nerve in early stages?

A

-Median NEerve, CTS is common

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69
Q

What are the signs and symptoms of Lyme disease?

A

-Red rash (1st), and flu like symptoms

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70
Q

Lyme disease often presents with pain in what joints?

A

-Shoulder and knee

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71
Q

Maculopapular rash is associated with what?

A

-secondary syphilis

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72
Q

How does a maculupapular rash appear?

A

-“copper penny spots”

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73
Q

Where do maculopapular rashes normally occur?

A

-palms, bottom of feet, and maybe the face

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74
Q

In its second stage, maculopapular rash may present with what symptoms?

A

-flu symptoms, patchy hairloss and joint pain

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75
Q

Where do shingles normally appear?

A

-unilaterally along the path of a spinal nerve

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76
Q

What may shingles mimic?

A

-T-spine radiculopathy

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77
Q

Peak incidence of shingles occurs between what ages?

A

-50-70

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78
Q

By 80, what percent of people have experienced shingles?

A

-15%

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79
Q

What are the early symptoms of shingles?

A

-pain and tingling along spinal nerve or CN dermatome

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80
Q

How does HPV manifest?

A

-warts on hands, feet and mouth

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81
Q

Rosacea may be associated with what?

A

-Helicobacter Pylori

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82
Q

Where is rosacea normally seen?

A

-Cheeks, nose and chin

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83
Q

Where does Tinea Corporis normally appear?

A

-chest, abdomen, back of arms, face and dorsum of the feet

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84
Q

Steroids can cause what side effects on the skin?

A

-ecchymosis and cutaneous atrophy

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85
Q

Hypersensitity of the skin is common in what medications?

A

-Antibiotics (esp penecillin), sulfonamids (antiinfectives) and phenobarbital

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86
Q

Thrombocytopenia is a medical emergency that can be a result of what?

A

-radiation and chemotherapy, blood disorders and anticoagulants

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87
Q

Spider Angioma is usually present where?

A

-upper half of the body; usually the face, neck and chest

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88
Q

Spider angioma is accosiated with what?

A

-pregnancy, chronic liver disease, or estrogen therapy

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89
Q

Palmar Erythema can be cause by what?

A

-liver problems

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90
Q

How does palmar erythema present?

A

-warmth and redness in palm of hand and soles of feet

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91
Q

What should you look for when a patient presents with palmar erythema?

A

-other signs of hepatic disease; such as nail bed changes, spider angiomas, liver flap, and bilateral CTS/TTS

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92
Q

What are xanthelasmas?

A

-soft, raised, yellow plaques

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93
Q

Xanthelasmsas may be a result from what?

A

-high cholesterol

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94
Q

Where do xanthelasmas normally occur?

A

-eyes, and extensor tendons of hands, elbows, and knees

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95
Q

If a xanthelasma looks like ant bites, what does that mean?

A

-could be poorly managed diabetes; patient needs immediate medical attention

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96
Q

What should nails be screened for?

A

-color, shape, thickness, texture and presense of lesions

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97
Q

Clubbing is accosiated with what?

A

-cardiopulmonary conditions (80%) of the time

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98
Q

Splinter Hemorrhages (dark spots) under nails may be a sign of what?

A

-endocarditis

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99
Q

White spots under the nails may be caused by what?

A

-Alcohol use, nutitional deficits or MI

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100
Q

Koilonychia (spoon nails) may be a result of what?

A

-anemia, thryroid problems, or syphilis

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101
Q

Beau’s lines on the nails may be caused by what?

A

-Alcohol use, nutritional deficits, or MI

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102
Q

Nail pitting may be a sign of what?

A

-psoriasis

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103
Q

Nail thickening may be caused by what?

A

-poor circulation issues

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104
Q

A capillary refil test is positive if it takes longer than?

A

-2 seconds

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105
Q

What does the capillary refill test assess?

A

-arterial circulation, dehydration or shock

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106
Q

Any skin lesion that hasnt healed in how long should be referred for consultation?

A

-4 weeks

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107
Q

a new skin lesion in a patient with a history of what should be referred for consultation?

A

-malignancy

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108
Q

A new skin rash with what should be referred for consultation?

A

-constitutional symptoms

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109
Q

Poor capillary refill along with signs of what should call for immediate medical referral?

A

-Shock

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110
Q

A rash where should be referred for immediate medical attention?

A

-on the trunk along the spincal nerve

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111
Q

A new skin lesion in a patient with history of malignancy and what else should be referred for immediate attention?

A

-constitutional symptoms

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112
Q

What is the description of Type I skin?

A

-always burns, never tans

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113
Q

What is the description of Type II skin?

A

-usually burns, tans minimally

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114
Q

What is the description of Type III skin?

A

-sometimes burns, tans uniformly

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115
Q

What is the description of Type IV skin?

A

-Burns minimally, always tans

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116
Q

What is the description of Type V skin?

A

-Very Rarely Burns, Tans easily

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117
Q

What is the description of Type VI skin?

A

-Never burns, always tans

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118
Q

Skin cancer is most common where on males?

A

-Trunk

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119
Q

Skin is most common where on females?

A

-Trunk and legs

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120
Q

Skin cancer is most common in what race?

A

-Whites

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121
Q

Skin cancer is least common in what race?

A

-Blacks

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122
Q

What is the most common cause of basal cell carcinoma?

A

-prolonged sun exposure

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123
Q

Does basal cell carcinoma usually spread?

A

-no

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124
Q

What is the appearance of basal cell carcinoma?

A

-pearly or ivory appearance, rolled slightly elevated edges,may ulcerate in center

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125
Q

What is the 2nd most common skin cancer in whites?

A

-squamous cell carcinoma

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126
Q

Where does squamous cell carcinoma usually appear?

A

-ears, face, lips, mouth and dorsum of the hand

127
Q

80% of sqaumous cell carcinomas occur where?

A

-head and neck

128
Q

How can the borders of a squamous cell carcinoma be described?

A

-poorly defined

129
Q

How does a squamous cell carcinoma appear

A

-has an ulcer, flat red area, cutaneous hord, indurated plaque of nodule; may be flesh colored surrounded by scaly tissue

130
Q

Superficial Spreading Meanoma accounts for what percent of cutaneous melanomas?

A

-75%

131
Q

Malignamt melanomas usually arise from what?

A

-preexisting moles

132
Q

When screening for medical referral for a possible skin cancer lesion, what point scale is used?

A

-7

133
Q

On the 7 point skin cancer scale, what items are worth 2 points?

A

-CHANGES- color, size and shape

134
Q

On the 7 point skin cancer scale, what items are worth 1 point?

A

7mm or more diameter, inflammation, oozing or bleeding

135
Q

If a person scores 3 or higher on the 7 point skin cancer scale how soon should the see a dermatologist?

A

-within 2 weeks

136
Q

If a person score a 1 or a two on the 7 point skin cancer scale, how soon soon the see a dermatologist?

A

-3-4 weeks

137
Q

A person with possible skin cancer should be reffered immediately if they also have what?

A

-abnormal vitals or constitutional signs of metastasis

138
Q

What gender is depression most common in?

A

-Females (2x)

139
Q

What types of patients is depression common in?

A

-stroke, MI, Cancer and PD

140
Q

How does the onset of Depression compare to that of dementia?

A

-More abrupt

141
Q

What tends to have a longer duration, depression or dementia?

A

-Dementia

142
Q

A person with dementia will answer questions how?

A

-near-misses

143
Q

A person with depression with complain of memory loss, a person will dementia will do what with memory loss?

A

-deny it

144
Q

Scoreing higher than what on the GDS scale will indicate depression?

A

-6

145
Q

Anxiety is 2 times more likely for who?

A

-females

146
Q

75% of those with anxiety have their first onset before what age?

A

-21

147
Q

When anxiety begins later in life, what should be suspected?

A

-alcohol or durg use, or recent trauma

148
Q

Scoring what on the DASS screening will call for medial referral?

A

-7 or above

149
Q

A person with somatic symptom disorder usually seeks what?

A

-attention

150
Q

dysmorphic disorder is described as what?

A

-distorted view of body

151
Q

Dysmophic disorder is commonly due to what?

A

-Burn, Scare or amputation

152
Q

A person with an eccentric personality disorder may present as what clinically?

A

-Claim to have no pain, and no exaggerated symptoms’ may become hostile when stressed

153
Q

A person with a dramatic personality disorder will do what with symptoms?

A

-exaggerate them; like compliments; palliative intervention helpful

154
Q

An anxious personality disorder will present what challenges?

A

-wont complete HEP, has excuses, usualy pain as scapegoat

155
Q

A patient rarely shows up for appointments and doesn’t complete interventions would be considered what type of personality disorder?

A

-self defeating

156
Q

Females attempt suicide how many more times more likely than men?

A

-3

157
Q

Males are how much more likely to complete suicide than women?

A

-4x

158
Q

suicide is the what ranked cause of death in white males?

A

-8th

159
Q

73% of suicides are completed by who?

A

-White males

160
Q

80% of fire arm suicides are performed by who?

A

-white males

161
Q

Suicide is highest in what populations?

A

-white and native american males

162
Q

A patient scoring higher than what percent on stress screening should be referred?

A

-30%

163
Q

A person planning suicide with the means to do it should receive what type of referral?

A

-immediate

164
Q

What is Type I non-hemolytic anemia?

A

-Iron deficient

165
Q

What is Type Ii non-hemolytic anemia?

A

-caused by inflammatory response

166
Q

What is Type III non-hemolytic anemia?

A

Aplastic

167
Q

What is Type IV non-hemolytic anemia?

A

-Renal insufficiency (lack of erythropoetin)

168
Q

What is Type I non-hemolytic anemia?

A

-Megaloblastic

169
Q

Mild or slow onset anemia will have what symptoms?

A

-post exercise fatigue,SOB, and palpitations

170
Q

Severe or rapid developing anemia will have what symptoms?

A

-SOB, palpittions, bounding pulse, increased HR, feeling fain all at rest

171
Q

What signs in the GI tract can be observed with megaloblastic anemia?

A

-smooth, red tongue, diarrhea, and B12 deficient neuro sings

172
Q

A b12 deficiencys will cause what symptoms?-

A

-numbeness in extermities, poor coordiation, motor weakness, dementia

173
Q

Aplastic anmemia is common in what population?

A

-ashkenazi jews and leukemia patients

174
Q

What is often the first sign of aplastic anemia?

A

-bleeding

175
Q

Hemolytic Anemias are cause by what>

A

-Increased rate of RBC desctruction

176
Q

Sickle cell is considered what type of hemolytic anemia?

A

-A)synthesis of abnormal Hgb

177
Q

Thalassemias are considered what type of hemolytic anemias?

A

-b)decreased synthesis of normal Hgb

178
Q

What is the occurance rate of homosygote sickle cell in AAs?

A

-1/400

179
Q

What percent of AAs have heterozygote sickle cell?

A

-8-10%

180
Q

What is the most painful step in sickle cell?

A

-II)

181
Q

People with what decent is thalassemia prevelent in?

A

-Mediterranean (Greece, cyrus, italy), SE asian (Thailand, india, laos), and N African

182
Q

Minor or Alpha Thalassemia will cause what?

A

-Very small RBCs with minimal or mild decrease in Hgb

183
Q

Major or Beta Thalassemia will cause what?

A

-less Hbg: 4-6g/dl

184
Q

What is normal Hgb densitiy in mean?

A

-13-17 g/dl

185
Q

What is normal Hgb density in women?

A

-12-17 g/dl

186
Q

What is normal Hct percentage in men?

A

-39-49%

187
Q

What is normal Hct percentage in females?

A

-36-48%

188
Q

Hct is approx how much more the Hgb in blood?

A

-3x

189
Q

A person with <25% Hct levels can perform what level of exercise?

A

-NONE

190
Q

A person with >25% Hct levels can perform what level of exercise?

A

-Light

191
Q

A person with 30-32% Hct levels can perform what level of exercise?

A

-Resistance exercise as tolerated

192
Q

A person with <8 g/dl Hgb can perform what type of exercise?

A

-NONE

193
Q

A person with 8-10 g/dl Hgb can perform what type of exercise?

A

-Light

194
Q

A person with >10 g/dl Hgb can perform what type of exercise?

A

-Resistance exercise as tolerated

195
Q

What is Polycythemia?

A

-increased Hgb and Hct

196
Q

Primary polycythemia is what?

A

-Vera-bone marrow disorder causing excessive RBC production- increases blood viscosity

197
Q

Secondary polycythemia is cause by what?

A

-Increased erythropoietin

198
Q

What are the symptoms of polycythemia?

A

-fatigue, BOD, pressure on left side of abdomen, itching, blurred vision, weight loss, swelling common in big toe

199
Q

What are some physical finding for polycythemia?

A

-large spleen, fullness/redness of face, High BP

200
Q

What are the complications of polycythemia?

A

-clot formation, hemorrage of upper GI tract

201
Q

What is thrombostopenia?

A

-decreased platelet number

202
Q

What can thrombocytopenia be caused by?

A

-Bone marrow (aplastic anemia), immune disorders, platelet sequestartion within enlarged spleen, pregnancy

203
Q

What is a type B platelet disorder?

A

-Abnormal Platelet function (aquired or hereditary)

204
Q

What is a sign of thrombocytosis?

A

-Fish net veins

205
Q

What is NADIR?

A

-the lowest point WBC counts reach; usually occurs 7-14 days after chemo

206
Q

Signs of unknown bleeding require what?

A

-immediate medical care

207
Q

A patient with thrombocytopenia and a platelet count of 150,000-450,000 can perform what type of activity?

A

-Normal

208
Q

A patient with thrombocytopenia and a platelet count of <150,000 can perform what type of activity?

A

-progressive resistance exercise as tolerated, swimming, biking on flat ground

209
Q

A patient with thrombocytopenia and a platelet count of <50,000 can perform what type of activity?

A

-AROM, Moderate exercise

210
Q

A patient with thrombocytopenia and a platelet count of <30,000 can perform what type of activity?

A

-light exercise, AROM only

211
Q

A patient with thrombocytopenia and a platelet count of <20,000 can perform what type of activity?

A

-None or AROM, restricted ADLS with MD approval

212
Q

Physical therapy is contraindicated with PT less than or equal to what?

A

-25 seconds

213
Q

What is normal PT?

A

-10-15 seconds

214
Q

Patients with a platelet count <50,000 what its there risk of bleeding?

A

-may bleed excessivly when challendged with mild or moderate trauma as well as surgury, bruises easily

215
Q

Patients with a platelet count <20,000 what its there risk of bleeding?

A
  • may have spintaneous bleeding, has petechiae or purpura
216
Q

Patients with a platelet count <10,000 what its there risk of bleeding?

A

-risk for life threatening bleeding

217
Q

What are the two types of hemophelia?

A

-hereditary and aquired

218
Q

Where does bleeding occur with platelet disorders?

A

-superficial cites

219
Q

Where does bleeding occur with clotting factor disorders?

A

-deep tissue, muscle, joints, body cavities

220
Q

Hemophillia is suspected in a patient with PTT times, PT times and platelet counts of what?-

A

-PTT >36 sec; PT 10-15 sec (normal), and platelet count 150,000-450,000 (normal)

221
Q

80% of hemophilia cases are caused by a deficiency of what clotting factor?

A

-Clotting facotr VIII (type a)

222
Q

What is the most common musculoskeletal finding of hemophilia?

A

-hemerthrosis

223
Q

What is the 2nd most common site for hemophiliac bleeding?

A

-Muscle

224
Q

What symptoms are related to GI bleeding with hemophilia?

A

-abdominal pain, melena (tarry stools), Hematemesis (bloody vommit), groin pain, hip and trunk contracture

225
Q

How does Illiopsoas pain present?

A

-More pain with active trunk flexion, and passive hip extension than with passive hip IR

226
Q

What are the complications of hemophilia?

A

-Crippling arthritis, life threatining bleeding

227
Q

What is the medical emergency in which the organs and tissues are not receiving an adequate flow of blood or the blood is not carrying enough oxygen?

A

-Shock

228
Q

What is the shock index a ratio of?

A

-HR to systolic blood presuure

229
Q

What is the normal shock index of males aged 20-24

A

-0.63 (0.46-0.86)

230
Q

What is the normal shock index of males aged 30-34?

A

-0.60 (0.43-0.82)

231
Q

What is the normal shock index of males aged 40-44?

A

-0.57 (0.40-0.79)

232
Q

What is the normal shock index of males aged 50-54?

A

-0.55 (0.38-0.77)

233
Q

What is the normal shock index of males aged 60-64?

A

-0.61 (0.36-0.75)

234
Q

What should you refer a patient for with a history of easy bleeding and acute joint bleeding?

A

-Medical Referral

235
Q

A patient with an INR above what calls for a medical referral?

A

-3

236
Q

Patients with a history of hemophilia presenting CNS symptoms or acute joint bleeding should be referred to what?-

A
  • Emergency care
237
Q

Patients with a shock index greater than what should be referred to emergency care?

A

-0.08

238
Q

What are the cardinal signs of CVD?

A

-Chest neck or Arm pain, palpitations, dyspnea, nocturnal dyspnea, syncope, fatigue, coughing and cyanosis

239
Q

What is the most common symptoms of the vascular component of CVD?

A

-Edema and Leg pain

240
Q

Where might chest pain radiate to in a patient with Cardiovasular Disease?

A

-Neck, Jaw, Upper Trap, Upper back, shoulder, or arm

241
Q

Where is the most common site of pain from CVD to radiate?

A

-Left arm

242
Q

What can chest pain in CVD be caused by?

A

-MI, Ischemia, pericarditis, endocarditis, mitral valve prolapse, and aortic dissection

243
Q

What other signs and symptoms accompany chest pain in those with CVD?

A

-Nausea, vomiting, diaphoresis, dyspnea, fatigue, pallor and syncope

244
Q

in females, where can pain from microvascular disease radiate?

A

-sternum, above left breast and left cheek

245
Q

In males, where can pain from coronary artery disease radiate?

A

-left neck, shoulder, and ulnar border of arm and hand

246
Q

Some people may confuse the pain from angina as what?

A

-indigestion

247
Q

What is orthopnea?

A

-breathlessness relived by standing up

248
Q

What is cardiac syncope caused by?

A

-lack of oxygen to the brain

249
Q

What is vasovagal syncope caused by?

A

-intense parasympathetic response that causes global vasodilation

250
Q

What should you use to dose exercise for a person that is on medication that lowers their HR?

A

-RPE

251
Q

What is the most notable symptoms of MI?

A

-sudden sensation of pressure, described as crushing chest pain

252
Q

Where does pain from an MI radiate?

A

-arms, throat, neck and back

253
Q

What other symptoms accompany pain with an MI?

A

-Pallor, SOB, and sweating

254
Q

What is the most common myotoxic event cause by statins?

A

-Myalgia

255
Q

What symptom is common with statins?

A

-Joint pain

256
Q

if a patient on statin medication has symptoms such as pains, unexplained fever, nausea, vomiting and dark urine?

A

-refer immediately

257
Q

What are signs of liver impairment?

A

-Dark Urine, Asterixis, Bilateral CTS, Palmar Erythema, Spider Angioma, Ascitis

258
Q

Hypertension is commonly asymptomatic, but what is a common symptoms?

A

-Headache

259
Q

What is the most powerful risk factor of stroke and is strongly linked to heart attack?

A

-Systolic Hypertension

260
Q

What are some other signs of hypertension?

A

-Anxiety, Brain Damage, breathlessness, fear, hemorrhages, hyperventilation, nose bleeds and palpitations

261
Q

What is the most common symptoms of Congestive Heart Failure?

A

-Shortness of Breath

262
Q

What are the signs of Left sided CHF?

A

-(FORCED): Fatigue, Orthopnea, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended neck veins

263
Q

What are the signs of Right sided CHF?

A

-(BACONED) Bloating, Anorexia, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended NeckVeins

264
Q

Orthostatic Hypotension is a cardinal feature of what?

A

-Autonomic Dysfunction

265
Q

What is the main presentation of orthostatic hypotension in older adults?

A

-Falls, acute mental confusion, cardiac symptoms

266
Q

What are the ischemic symptoms of orthostatic hypotension?

A

-lethargy, weakness, low back ache, calf claudication, angina

267
Q

What is infective endocarditis caused by?

A

-Bacteria (strep or Staph)

268
Q

What is the most common musculoskeletal symptoms of endocarditis?

A

-Artlralgia

269
Q

What is the most common site of arthralgia with endocarditic?

A

-Shoulder
»> knee, hip, wrist, ankle, MTP, MCP, AC
(most to least)

270
Q

1/3 of endocarditic patients report what?

A

-Low back pain

271
Q

What are the symptoms of pericarditis?

A

-chest pain, dyspnea, high pulse, high temp, malaise, and myalgia

272
Q

Chest pain from endocarditic may mimic the pain of what?

A

-MI

273
Q

How does pain from pericarditis differ from MI pain?

A

-it can be releive by learning over or holding breath, MI pain doesnt change

274
Q

What is the most common site of an aneurysm?

A

-The Aorta

275
Q

95% of anueryms occur where?

A

-Just below the renal arteries (can cause back pain)

276
Q

Chest pain associated with an thoracic aneurysm can radiate where?

A

-Neck, between the scapulas, shoulders, low back and abdomen

277
Q

What are the early warning signs of an impending rupture of an abdominal aneurysm

A

-Abdominal heart beat when laying down, dull ache in left flank or lower back

278
Q

What is the most common symptoms of an abdominal aneurysm?

A

-pulsating mass in abdomen

279
Q

What are the risk factors for aneuryism?

A

-Males>females, age, being active, smoking, congenital heart disease, CAD, Marfan Syndrome, LD syndrome, Turner syndrome, EDS, Anticoagulant therapy

280
Q

What are the primary symptoms of PAD?

A
  • Sense of weakness or tiredness, pain, faigue

- May be aleviated by rest

281
Q

What are the symptoms of claudication?

A

-cramping and pain with exercise; rest releives symptoms

282
Q

Lower extremilty cluadication often occurs with what?

A

-PAD and CAD

283
Q

What symptoms can occur with LE claudication?

A

-Angina, Dyspnea

284
Q

What skin changes will you see with LE claudication?

A

-disocloration, coolness, trophic changes, and shemic pain

285
Q

What is the normal ABI value?

A

-0.91-1.3

286
Q

What ABI value represents a mild to moderate claudication?

A

-0.41-0.9

287
Q

What ABI value a severe claudication?

A

-0-0.4

288
Q

Varicose veins and chronic venous insuffeciency is known as what?

A

-chronic venous disease

289
Q

What are the signs and symptoms of a DVT?

A

-leg or calf sweeling, pain and tenderness, dilation of superficial veins, and pitting edema

290
Q

50% of individuals who get a DVT also have what?

A

-pulmonary embolism

291
Q

A rise in diastolic BP higher than what calls for the stop of exercise?

A

-20

292
Q

A fall in systoilc blood pressure of what calls for stopping exercise?

A

-10

293
Q

What visual changes can you see that would cause for exercise to be stopped?

A

-increased peripheral edema and juggular distension

294
Q

What are the signs and symptoms of hypoxemia?

A

-pale/blue skin, confusion, couhging, SOB, sweating, wheezing, rapid breathing

295
Q

75-85% of clubbing is due to what?

A

-Pulmonary disease cause by hypoxia

296
Q

persistent dry cough may be caused by what?

A

-Tumor, congestion, hypersensitive airways

297
Q

Cough with sputum may signify what?

A

-Infection

298
Q

Hemoptysis (coughing blood) may be the result of what?

A

-infection, inflammation, abscess, or tumor

299
Q

Dyspnea usually indicates what?

A

-Hypoxemia

300
Q

Pumonary pattersn of chest pain usually result where?

A

-substernal, or over the affected lung

301
Q

Where can pulmonary chest pain radiate?

A

-neck, upper trap, costal margins, t-spine, scapula and shoulder

302
Q

Any client with chest pain should be evaluated for what?

A

-Trigger points and intercostal muscle tear

303
Q

What is the most common change in breathing patterns?

A

-Hypoventilation

304
Q

What is hypercapnia?

A

-excessive retention of CO2

305
Q

What are the mild symptoms of Hypercapnia?

A

-flushed skin, inability to focus, mild headache, disorientation, abnormally tired, or exhaustion

306
Q

What are the severe symptoms of hyercapnia?

A

-confusion, paranoia, depression, abnormal muscle twitching, irregular heart beat, hyperventilation, seizures, panic attack, syncope

307
Q

Generalized myalgias from pneumonia may extend to where?

A

-Thighs and calves

308
Q

what are the signs and symptoms of tuberculosis?

A

-progressive fatigue, malaise, anorexia, weight loss, crhonic cough, hemoptosis

309
Q

What are the suggestive symptoms of TB?

A

-cough lasting longer than 3 week, especially when accompanied by weight loss, fever, night sweats, fatigue, anorexia

310
Q

What are the symptoms of chronic bronchitis?

A

-persistent cough, sputum production that is worse in the mornig and at night

311
Q

what are most cases of pulmonary edema caused by?

A

-left ventricular cardiac failure, acute hypertension, mitral valve disease

312
Q

What non cardiopulmonary condition can cause pulmonary edema?

A

-kidney and liver dysfunction

313
Q

How will sputum appear with pulmonary edema?

A

-frothy and tinged with blood

314
Q

What is the first a primary symptom of pnuemothorax?

A

-dyspenia

Differential Diagnosis (2 decks)

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