Exam I Flashcards
What is a diagnosis most commonly based on?
-A cluster of clinical findings from the history and physical exam
What is the biggest factor in making an incorrect diagnosis?
-Bias
What is the advantage of the Heuristic appraoch to diagnosis?
-It is quick
What is the disadvantage of the heuristic approach to a diagnosis?
-it might ignore serious health conditions
What is the advantage of the hypothetic approach?
-all symptoms are investigated
What is a disadvantage of the hypothetic approach
-It is slow, may delay intervention
When a PT refers a patient out based on a single clinical finding, what approach is that an example of?
-Naturalistic or Event Driven
Many clinicians are experienced and use what approach?
-Hueristic
Less experience clinicians use what approach?
-Hypothetic Deductive
What approach is recommend to make diagnosis?
-Mixed Approach
How much information is gained from the history and interview that is needed to make a diagnosis?
-70-80%
What is the purpose of the review of systems?
- To identify health problems that may have been over looked during the medical history
In the cardiovascular, genital/urinary, and hepatic systems, conditions usually begin as what?
-Non-systemic and turn Systemic when they become chronic
What is an example of a systemic condition involving the cardiovascular system?
-Congestive Heart Failure
What systems normally present as non-system conditions only?
-GI, Billiary, Pulmonary, Nonmechanical musculoskeletal
What systems usually present as systemic conditions only?
-Endocrine, Hematologic, Immune, Metabolic, Nuero, Cancer with metastasis. and drug reaction
If a person has systemic sysmptoms, it is important to give a checklist involving what systems?
-Psychological, Endocinre, Hematoligcal, Neurological, Immune, Metabolic and Drug
If a person is presenting with non-systemic symptoms, what should the screen incluce?
-Hepatic, Billiary, GI, Urogenital, Cardio and pulmonary
If a patient has a systemic symptom it is important to refer them if what?
-It has not be investigated by the physician
If a person has pain in the C-spine/shoulders, what systems should be checked?
-GI, GU, Cardio and pulmonary
If a person has pain in the T-spine, what systems should be checked?
-Cardio, GI, GU(if a t/l spine junction)
If a person has pain in the lumbar spine and SI joints, what systems should be checked?
-GI, GU, Perivascular
If a person has pain in either UE or LE, what systems should be checked?
-Perivascular
Is night pain a constitutional symptom?
-NO
How many people have a skin disorder that report for a consult?
-1 of 4
What is the primary lesion of a skin disorder?
-The 1st lesion to appear
What is the most common manifestation of dermatological disease?
-Pruritis (itching)
What is a vascular reaction that is marked by skin patched that appear smooth and slightly elevated?
-Uticaria (Hives)
Where to rashes normally present?
-Face, Trunk, Axilla and Groin
Changing of the skin and nail beds can be the first sign of what types of disease?
-Inflammatory, infection, hepatic, metabolic, and immunilogical
In what type of patients should skin be examined in?
-outpatient and bed bound
Palor skin can mean what?
-Anemia (Iron def)
Yellow skin can mean what?
-Liver disease, carotonemia, hemolysis
Red skin can mean what?
-Can be an exacerbation of other skin disorders
Color finding indicate what types of conditions?
-Systemic
Generalized skin malpigmentation can be the result of what type of disease?
-Tryoid, liver, or renal disease
Soft skin can be caused by what?
-thyrotoxicosis
Tight skin can be caused by what?
-Scleroderma
Rough skin can be caused by what?
-Hyperthyroidism
Dry skin can be caused by what?
-Vitamin A Def
Where should Turgor be tested?
-forhead, under clavicle, extensoer side of arm or hand
A turgor test is positive is skin remains raised for how long?
-5 or more seconds
What can a positive turgor test mean?
-Dehydration
Generalized warmth can be caused by what?
-Fever or hyperthyroidism
Coolness of the skin can be caused by what?
-Hypothryroidism, frostbite, hypothermia, shock or low C.O
Pitting Edema is a claasic sign of what?
-cardiac failure
Skin patches larger than what should raise suspicion of a pathology?
-1.5 cm
What is often the first sign of rhuemati disease?
-Skin lesions
Butterfly rash over the nose and cheeks is associated with what?
-Lupus in the cute stage
Chronic Cutaneous lupus is marked by what?
-chronic skin eruptions on sun exposed skin
Acute cutaneous lupus occurs in what percentage of clients who have systemic lupus?
-30-50%
Acute cutaneous lupus is marked by what?
-malar and widespread erythema (redness) and bolus lesions
Lesions from lupus are expected to present where?
-face, scalp, ears, neck and arms (sun exposed)
What else besides skin can be ea sign of lupus?
-brittle hair, bald pathes
Skin lesions with lupus are usually accompanied by what other symptoms?
-malaise, fatigue, arthritis, anemia, hair loss, white nails, uroligic symptoms
What diease is characterized by red patches, covered by think, dry silvery, scales?
-Psoriasis
Where are psoriasis lesions normally located?
-extensor surfaces, bony prominences, scalp, ears, and genitals
Psoriasis is ofter accompanied by what?
-Arthritis of small joints (fingers/hands)
What is the average onset of psoriasis?
-27 years
what tends to aggravate psoriasis?
-cold whether, sever anxiety, or emotional distress
What is the most common complaint of psoriasis?
-itching and sometimes pains for dry, cracked lesions
Psoriasis can cause what in nails?
-small indentations and yellow or brown discoloration
What is systemic scelerosis?
-A diffuse CT disease that cuases fibrosis of skin, joints, blood vessles, and internal organs
How is systemic sclerosis classified?
-the degrees and extent of skin thickening
Other symptoms of sclerosis include what?
-pain, stiffness, and swelling in the fingers and joints
How can systemic sclerosis cause muscle atrophy?
-by limited ROM secondary to skin, joint or tendon involvement
CI motility dusfuction cause by systemic sclerosis can affect what?
-esophagus, anorectal region, and can cause reful, heartburn, dysphagia and bloating after meals
Systemic Sclerosis targets what nerve in early stages?
-Median NEerve, CTS is common
What are the signs and symptoms of Lyme disease?
-Red rash (1st), and flu like symptoms
Lyme disease often presents with pain in what joints?
-Shoulder and knee
Maculopapular rash is associated with what?
-secondary syphilis
How does a maculupapular rash appear?
-“copper penny spots”
Where do maculopapular rashes normally occur?
-palms, bottom of feet, and maybe the face
In its second stage, maculopapular rash may present with what symptoms?
-flu symptoms, patchy hairloss and joint pain
Where do shingles normally appear?
-unilaterally along the path of a spinal nerve
What may shingles mimic?
-T-spine radiculopathy
Peak incidence of shingles occurs between what ages?
-50-70
By 80, what percent of people have experienced shingles?
-15%
What are the early symptoms of shingles?
-pain and tingling along spinal nerve or CN dermatome
How does HPV manifest?
-warts on hands, feet and mouth
Rosacea may be associated with what?
-Helicobacter Pylori
Where is rosacea normally seen?
-Cheeks, nose and chin
Where does Tinea Corporis normally appear?
-chest, abdomen, back of arms, face and dorsum of the feet
Steroids can cause what side effects on the skin?
-ecchymosis and cutaneous atrophy
Hypersensitity of the skin is common in what medications?
-Antibiotics (esp penecillin), sulfonamids (antiinfectives) and phenobarbital
Thrombocytopenia is a medical emergency that can be a result of what?
-radiation and chemotherapy, blood disorders and anticoagulants
Spider Angioma is usually present where?
-upper half of the body; usually the face, neck and chest
Spider angioma is accosiated with what?
-pregnancy, chronic liver disease, or estrogen therapy
Palmar Erythema can be cause by what?
-liver problems
How does palmar erythema present?
-warmth and redness in palm of hand and soles of feet
What should you look for when a patient presents with palmar erythema?
-other signs of hepatic disease; such as nail bed changes, spider angiomas, liver flap, and bilateral CTS/TTS
What are xanthelasmas?
-soft, raised, yellow plaques
Xanthelasmsas may be a result from what?
-high cholesterol
Where do xanthelasmas normally occur?
-eyes, and extensor tendons of hands, elbows, and knees
If a xanthelasma looks like ant bites, what does that mean?
-could be poorly managed diabetes; patient needs immediate medical attention
What should nails be screened for?
-color, shape, thickness, texture and presense of lesions
Clubbing is accosiated with what?
-cardiopulmonary conditions (80%) of the time
Splinter Hemorrhages (dark spots) under nails may be a sign of what?
-endocarditis
White spots under the nails may be caused by what?
-Alcohol use, nutitional deficits or MI
Koilonychia (spoon nails) may be a result of what?
-anemia, thryroid problems, or syphilis
Beau’s lines on the nails may be caused by what?
-Alcohol use, nutritional deficits, or MI
Nail pitting may be a sign of what?
-psoriasis
Nail thickening may be caused by what?
-poor circulation issues
A capillary refil test is positive if it takes longer than?
-2 seconds
What does the capillary refill test assess?
-arterial circulation, dehydration or shock
Any skin lesion that hasnt healed in how long should be referred for consultation?
-4 weeks
a new skin lesion in a patient with a history of what should be referred for consultation?
-malignancy
A new skin rash with what should be referred for consultation?
-constitutional symptoms
Poor capillary refill along with signs of what should call for immediate medical referral?
-Shock
A rash where should be referred for immediate medical attention?
-on the trunk along the spincal nerve
A new skin lesion in a patient with history of malignancy and what else should be referred for immediate attention?
-constitutional symptoms
What is the description of Type I skin?
-always burns, never tans
What is the description of Type II skin?
-usually burns, tans minimally
What is the description of Type III skin?
-sometimes burns, tans uniformly
What is the description of Type IV skin?
-Burns minimally, always tans
What is the description of Type V skin?
-Very Rarely Burns, Tans easily
What is the description of Type VI skin?
-Never burns, always tans
Skin cancer is most common where on males?
-Trunk
Skin is most common where on females?
-Trunk and legs
Skin cancer is most common in what race?
-Whites
Skin cancer is least common in what race?
-Blacks
What is the most common cause of basal cell carcinoma?
-prolonged sun exposure
Does basal cell carcinoma usually spread?
-no
What is the appearance of basal cell carcinoma?
-pearly or ivory appearance, rolled slightly elevated edges,may ulcerate in center
What is the 2nd most common skin cancer in whites?
-squamous cell carcinoma
Where does squamous cell carcinoma usually appear?
-ears, face, lips, mouth and dorsum of the hand
80% of sqaumous cell carcinomas occur where?
-head and neck
How can the borders of a squamous cell carcinoma be described?
-poorly defined
How does a squamous cell carcinoma appear
-has an ulcer, flat red area, cutaneous hord, indurated plaque of nodule; may be flesh colored surrounded by scaly tissue
Superficial Spreading Meanoma accounts for what percent of cutaneous melanomas?
-75%
Malignamt melanomas usually arise from what?
-preexisting moles
When screening for medical referral for a possible skin cancer lesion, what point scale is used?
-7
On the 7 point skin cancer scale, what items are worth 2 points?
-CHANGES- color, size and shape
On the 7 point skin cancer scale, what items are worth 1 point?
7mm or more diameter, inflammation, oozing or bleeding
If a person scores 3 or higher on the 7 point skin cancer scale how soon should the see a dermatologist?
-within 2 weeks
If a person score a 1 or a two on the 7 point skin cancer scale, how soon soon the see a dermatologist?
-3-4 weeks
A person with possible skin cancer should be reffered immediately if they also have what?
-abnormal vitals or constitutional signs of metastasis
What gender is depression most common in?
-Females (2x)
What types of patients is depression common in?
-stroke, MI, Cancer and PD
How does the onset of Depression compare to that of dementia?
-More abrupt
What tends to have a longer duration, depression or dementia?
-Dementia
A person with dementia will answer questions how?
-near-misses
A person with depression with complain of memory loss, a person will dementia will do what with memory loss?
-deny it
Scoreing higher than what on the GDS scale will indicate depression?
-6
Anxiety is 2 times more likely for who?
-females
75% of those with anxiety have their first onset before what age?
-21
When anxiety begins later in life, what should be suspected?
-alcohol or durg use, or recent trauma
Scoring what on the DASS screening will call for medial referral?
-7 or above
A person with somatic symptom disorder usually seeks what?
-attention
dysmorphic disorder is described as what?
-distorted view of body
Dysmophic disorder is commonly due to what?
-Burn, Scare or amputation
A person with an eccentric personality disorder may present as what clinically?
-Claim to have no pain, and no exaggerated symptoms’ may become hostile when stressed
A person with a dramatic personality disorder will do what with symptoms?
-exaggerate them; like compliments; palliative intervention helpful
An anxious personality disorder will present what challenges?
-wont complete HEP, has excuses, usualy pain as scapegoat
A patient rarely shows up for appointments and doesn’t complete interventions would be considered what type of personality disorder?
-self defeating
Females attempt suicide how many more times more likely than men?
-3
Males are how much more likely to complete suicide than women?
-4x
suicide is the what ranked cause of death in white males?
-8th
73% of suicides are completed by who?
-White males
80% of fire arm suicides are performed by who?
-white males
Suicide is highest in what populations?
-white and native american males
A patient scoring higher than what percent on stress screening should be referred?
-30%
A person planning suicide with the means to do it should receive what type of referral?
-immediate
What is Type I non-hemolytic anemia?
-Iron deficient
What is Type Ii non-hemolytic anemia?
-caused by inflammatory response
What is Type III non-hemolytic anemia?
Aplastic
What is Type IV non-hemolytic anemia?
-Renal insufficiency (lack of erythropoetin)
What is Type I non-hemolytic anemia?
-Megaloblastic
Mild or slow onset anemia will have what symptoms?
-post exercise fatigue,SOB, and palpitations
Severe or rapid developing anemia will have what symptoms?
-SOB, palpittions, bounding pulse, increased HR, feeling fain all at rest
What signs in the GI tract can be observed with megaloblastic anemia?
-smooth, red tongue, diarrhea, and B12 deficient neuro sings
A b12 deficiencys will cause what symptoms?-
-numbeness in extermities, poor coordiation, motor weakness, dementia
Aplastic anmemia is common in what population?
-ashkenazi jews and leukemia patients
What is often the first sign of aplastic anemia?
-bleeding
Hemolytic Anemias are cause by what>
-Increased rate of RBC desctruction
Sickle cell is considered what type of hemolytic anemia?
-A)synthesis of abnormal Hgb
Thalassemias are considered what type of hemolytic anemias?
-b)decreased synthesis of normal Hgb
What is the occurance rate of homosygote sickle cell in AAs?
-1/400
What percent of AAs have heterozygote sickle cell?
-8-10%
What is the most painful step in sickle cell?
-II)
People with what decent is thalassemia prevelent in?
-Mediterranean (Greece, cyrus, italy), SE asian (Thailand, india, laos), and N African
Minor or Alpha Thalassemia will cause what?
-Very small RBCs with minimal or mild decrease in Hgb
Major or Beta Thalassemia will cause what?
-less Hbg: 4-6g/dl
What is normal Hgb densitiy in mean?
-13-17 g/dl
What is normal Hgb density in women?
-12-17 g/dl
What is normal Hct percentage in men?
-39-49%
What is normal Hct percentage in females?
-36-48%
Hct is approx how much more the Hgb in blood?
-3x
A person with <25% Hct levels can perform what level of exercise?
-NONE
A person with >25% Hct levels can perform what level of exercise?
-Light
A person with 30-32% Hct levels can perform what level of exercise?
-Resistance exercise as tolerated
A person with <8 g/dl Hgb can perform what type of exercise?
-NONE
A person with 8-10 g/dl Hgb can perform what type of exercise?
-Light
A person with >10 g/dl Hgb can perform what type of exercise?
-Resistance exercise as tolerated
What is Polycythemia?
-increased Hgb and Hct
Primary polycythemia is what?
-Vera-bone marrow disorder causing excessive RBC production- increases blood viscosity
Secondary polycythemia is cause by what?
-Increased erythropoietin
What are the symptoms of polycythemia?
-fatigue, BOD, pressure on left side of abdomen, itching, blurred vision, weight loss, swelling common in big toe
What are some physical finding for polycythemia?
-large spleen, fullness/redness of face, High BP
What are the complications of polycythemia?
-clot formation, hemorrage of upper GI tract
What is thrombostopenia?
-decreased platelet number
What can thrombocytopenia be caused by?
-Bone marrow (aplastic anemia), immune disorders, platelet sequestartion within enlarged spleen, pregnancy
What is a type B platelet disorder?
-Abnormal Platelet function (aquired or hereditary)
What is a sign of thrombocytosis?
-Fish net veins
What is NADIR?
-the lowest point WBC counts reach; usually occurs 7-14 days after chemo
Signs of unknown bleeding require what?
-immediate medical care
A patient with thrombocytopenia and a platelet count of 150,000-450,000 can perform what type of activity?
-Normal
A patient with thrombocytopenia and a platelet count of <150,000 can perform what type of activity?
-progressive resistance exercise as tolerated, swimming, biking on flat ground
A patient with thrombocytopenia and a platelet count of <50,000 can perform what type of activity?
-AROM, Moderate exercise
A patient with thrombocytopenia and a platelet count of <30,000 can perform what type of activity?
-light exercise, AROM only
A patient with thrombocytopenia and a platelet count of <20,000 can perform what type of activity?
-None or AROM, restricted ADLS with MD approval
Physical therapy is contraindicated with PT less than or equal to what?
-25 seconds
What is normal PT?
-10-15 seconds
Patients with a platelet count <50,000 what its there risk of bleeding?
-may bleed excessivly when challendged with mild or moderate trauma as well as surgury, bruises easily
Patients with a platelet count <20,000 what its there risk of bleeding?
- may have spintaneous bleeding, has petechiae or purpura
Patients with a platelet count <10,000 what its there risk of bleeding?
-risk for life threatening bleeding
What are the two types of hemophelia?
-hereditary and aquired
Where does bleeding occur with platelet disorders?
-superficial cites
Where does bleeding occur with clotting factor disorders?
-deep tissue, muscle, joints, body cavities
Hemophillia is suspected in a patient with PTT times, PT times and platelet counts of what?-
-PTT >36 sec; PT 10-15 sec (normal), and platelet count 150,000-450,000 (normal)
80% of hemophilia cases are caused by a deficiency of what clotting factor?
-Clotting facotr VIII (type a)
What is the most common musculoskeletal finding of hemophilia?
-hemerthrosis
What is the 2nd most common site for hemophiliac bleeding?
-Muscle
What symptoms are related to GI bleeding with hemophilia?
-abdominal pain, melena (tarry stools), Hematemesis (bloody vommit), groin pain, hip and trunk contracture
How does Illiopsoas pain present?
-More pain with active trunk flexion, and passive hip extension than with passive hip IR
What are the complications of hemophilia?
-Crippling arthritis, life threatining bleeding
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?
-Shock
What is the shock index a ratio of?
-HR to systolic blood presuure
What is the normal shock index of males aged 20-24
-0.63 (0.46-0.86)
What is the normal shock index of males aged 30-34?
-0.60 (0.43-0.82)
What is the normal shock index of males aged 40-44?
-0.57 (0.40-0.79)
What is the normal shock index of males aged 50-54?
-0.55 (0.38-0.77)
What is the normal shock index of males aged 60-64?
-0.61 (0.36-0.75)
What should you refer a patient for with a history of easy bleeding and acute joint bleeding?
-Medical Referral
A patient with an INR above what calls for a medical referral?
-3
Patients with a history of hemophilia presenting CNS symptoms or acute joint bleeding should be referred to what?-
- Emergency care
Patients with a shock index greater than what should be referred to emergency care?
-0.08
What are the cardinal signs of CVD?
-Chest neck or Arm pain, palpitations, dyspnea, nocturnal dyspnea, syncope, fatigue, coughing and cyanosis
What is the most common symptoms of the vascular component of CVD?
-Edema and Leg pain
Where might chest pain radiate to in a patient with Cardiovasular Disease?
-Neck, Jaw, Upper Trap, Upper back, shoulder, or arm
Where is the most common site of pain from CVD to radiate?
-Left arm
What can chest pain in CVD be caused by?
-MI, Ischemia, pericarditis, endocarditis, mitral valve prolapse, and aortic dissection
What other signs and symptoms accompany chest pain in those with CVD?
-Nausea, vomiting, diaphoresis, dyspnea, fatigue, pallor and syncope
in females, where can pain from microvascular disease radiate?
-sternum, above left breast and left cheek
In males, where can pain from coronary artery disease radiate?
-left neck, shoulder, and ulnar border of arm and hand
Some people may confuse the pain from angina as what?
-indigestion
What is orthopnea?
-breathlessness relived by standing up
What is cardiac syncope caused by?
-lack of oxygen to the brain
What is vasovagal syncope caused by?
-intense parasympathetic response that causes global vasodilation
What should you use to dose exercise for a person that is on medication that lowers their HR?
-RPE
What is the most notable symptoms of MI?
-sudden sensation of pressure, described as crushing chest pain
Where does pain from an MI radiate?
-arms, throat, neck and back
What other symptoms accompany pain with an MI?
-Pallor, SOB, and sweating
What is the most common myotoxic event cause by statins?
-Myalgia
What symptom is common with statins?
-Joint pain
if a patient on statin medication has symptoms such as pains, unexplained fever, nausea, vomiting and dark urine?
-refer immediately
What are signs of liver impairment?
-Dark Urine, Asterixis, Bilateral CTS, Palmar Erythema, Spider Angioma, Ascitis
Hypertension is commonly asymptomatic, but what is a common symptoms?
-Headache
What is the most powerful risk factor of stroke and is strongly linked to heart attack?
-Systolic Hypertension
What are some other signs of hypertension?
-Anxiety, Brain Damage, breathlessness, fear, hemorrhages, hyperventilation, nose bleeds and palpitations
What is the most common symptoms of Congestive Heart Failure?
-Shortness of Breath
What are the signs of Left sided CHF?
-(FORCED): Fatigue, Orthopnea, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended neck veins
What are the signs of Right sided CHF?
-(BACONED) Bloating, Anorexia, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended NeckVeins
Orthostatic Hypotension is a cardinal feature of what?
-Autonomic Dysfunction
What is the main presentation of orthostatic hypotension in older adults?
-Falls, acute mental confusion, cardiac symptoms
What are the ischemic symptoms of orthostatic hypotension?
-lethargy, weakness, low back ache, calf claudication, angina
What is infective endocarditis caused by?
-Bacteria (strep or Staph)
What is the most common musculoskeletal symptoms of endocarditis?
-Artlralgia
What is the most common site of arthralgia with endocarditic?
-Shoulder
»> knee, hip, wrist, ankle, MTP, MCP, AC
(most to least)
1/3 of endocarditic patients report what?
-Low back pain
What are the symptoms of pericarditis?
-chest pain, dyspnea, high pulse, high temp, malaise, and myalgia
Chest pain from endocarditic may mimic the pain of what?
-MI
How does pain from pericarditis differ from MI pain?
-it can be releive by learning over or holding breath, MI pain doesnt change
What is the most common site of an aneurysm?
-The Aorta
95% of anueryms occur where?
-Just below the renal arteries (can cause back pain)
Chest pain associated with an thoracic aneurysm can radiate where?
-Neck, between the scapulas, shoulders, low back and abdomen
What are the early warning signs of an impending rupture of an abdominal aneurysm
-Abdominal heart beat when laying down, dull ache in left flank or lower back
What is the most common symptoms of an abdominal aneurysm?
-pulsating mass in abdomen
What are the risk factors for aneuryism?
-Males>females, age, being active, smoking, congenital heart disease, CAD, Marfan Syndrome, LD syndrome, Turner syndrome, EDS, Anticoagulant therapy
What are the primary symptoms of PAD?
- Sense of weakness or tiredness, pain, faigue
- May be aleviated by rest
What are the symptoms of claudication?
-cramping and pain with exercise; rest releives symptoms
Lower extremilty cluadication often occurs with what?
-PAD and CAD
What symptoms can occur with LE claudication?
-Angina, Dyspnea
What skin changes will you see with LE claudication?
-disocloration, coolness, trophic changes, and shemic pain
What is the normal ABI value?
-0.91-1.3
What ABI value represents a mild to moderate claudication?
-0.41-0.9
What ABI value a severe claudication?
-0-0.4
Varicose veins and chronic venous insuffeciency is known as what?
-chronic venous disease
What are the signs and symptoms of a DVT?
-leg or calf sweeling, pain and tenderness, dilation of superficial veins, and pitting edema
50% of individuals who get a DVT also have what?
-pulmonary embolism
A rise in diastolic BP higher than what calls for the stop of exercise?
-20
A fall in systoilc blood pressure of what calls for stopping exercise?
-10
What visual changes can you see that would cause for exercise to be stopped?
-increased peripheral edema and juggular distension
What are the signs and symptoms of hypoxemia?
-pale/blue skin, confusion, couhging, SOB, sweating, wheezing, rapid breathing
75-85% of clubbing is due to what?
-Pulmonary disease cause by hypoxia
persistent dry cough may be caused by what?
-Tumor, congestion, hypersensitive airways
Cough with sputum may signify what?
-Infection
Hemoptysis (coughing blood) may be the result of what?
-infection, inflammation, abscess, or tumor
Dyspnea usually indicates what?
-Hypoxemia
Pumonary pattersn of chest pain usually result where?
-substernal, or over the affected lung
Where can pulmonary chest pain radiate?
-neck, upper trap, costal margins, t-spine, scapula and shoulder
Any client with chest pain should be evaluated for what?
-Trigger points and intercostal muscle tear
What is the most common change in breathing patterns?
-Hypoventilation
What is hypercapnia?
-excessive retention of CO2
What are the mild symptoms of Hypercapnia?
-flushed skin, inability to focus, mild headache, disorientation, abnormally tired, or exhaustion
What are the severe symptoms of hyercapnia?
-confusion, paranoia, depression, abnormal muscle twitching, irregular heart beat, hyperventilation, seizures, panic attack, syncope
Generalized myalgias from pneumonia may extend to where?
-Thighs and calves
what are the signs and symptoms of tuberculosis?
-progressive fatigue, malaise, anorexia, weight loss, crhonic cough, hemoptosis
What are the suggestive symptoms of TB?
-cough lasting longer than 3 week, especially when accompanied by weight loss, fever, night sweats, fatigue, anorexia
What are the symptoms of chronic bronchitis?
-persistent cough, sputum production that is worse in the mornig and at night
what are most cases of pulmonary edema caused by?
-left ventricular cardiac failure, acute hypertension, mitral valve disease
What non cardiopulmonary condition can cause pulmonary edema?
-kidney and liver dysfunction
How will sputum appear with pulmonary edema?
-frothy and tinged with blood
What is the first a primary symptom of pnuemothorax?
-dyspenia
