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Differential Diagnosis > Exam II > Flashcards

Exam II Flashcards

1
Q

What controls the metabolic system?

A

-The endocrine and nervous systems

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2
Q

What are some signs and symptoms of dehydration?

A

-thirst, weight loss, lack of sweating, fever, postural hypotension, dry skin, dizziness, confusion, and increase hematocrit

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3
Q

What is water intoxication caused by?

A

-excessive water intake without solutes

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4
Q

What are some signs and symptoms of water intoxication?

A

-confusion, sleepiness, weight gain, hyperventilation, peripheral edema, increased ICP

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5
Q

What are normal blood potassium levels?

A

-3.5 to 5.0

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6
Q

Potassium levels above and below what is considered an emergency?

A

-less than 2.5, greater than 7

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7
Q

what is the most common cause of a potassium imbalance?

A

-Taking diuretic drugs

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8
Q

What are some signs and symptoms of a potassium imbalance?

A

-weakness, vomiting, tingling thirst, irregular behavior, and arrythmias

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9
Q

What should you do before exercising someone with a potassium imbalance?

A

-consult with MD

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10
Q

What are normal blood calcium levels?

A

-4.5 to 5.5

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11
Q

hypocalcemia occrus when blood calcium levels drop below what?

A

-4.5

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12
Q

What can hypocalcemia be caused by?

A

-hypothyroidism, renal failure, alkalosis and eating disorders

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13
Q

What are some signs and symptoms of hyocalcemia?

A

-bruising, general fatigue, palpitation, tingling and tetany

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14
Q

Hypercalcemia is occur when blood levels rise above what?

A

-5.5

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15
Q

what can cause hypercalcemia?

A

-Hyperparathyroidism, malignance, renal failure and pagets disease

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16
Q

What are the symptoms of hypercalcemia?

A
  • Groans (GI)
  • Moans (psych)
  • Bones (diffuse pain)
  • Stones (kidney stones)
  • Overtones (psych)
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17
Q

What causes alkalosis?

A

-increase in available bases, or loss of acids

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18
Q

Signs and symptoms of alkalosis include what?

A

-muscle twitching and cramping, weakness, confusion, parasthesia, irritability, confusion, agitation, slow breathing and coma

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19
Q

In respiratory alklosis, what happen to pH and CO2 levels?

A

-pH increases, CO2 decrease

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20
Q

In respiratory acidosis, what happens to pH and CO2?

A

-pH decreases, CO2 increases

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21
Q

In metabolic acidosis, what happens to pH and HCO3 level?

A

-pH decreases, HCO3 decreased

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22
Q

In metabolic alkalosis, what happens to pH and HCO3?

A

-pH increases, HCO3 increases

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23
Q

What is primary gout?

A

-Inherited

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24
Q

What is secondary gout?

A

-result from renal failure or idiopathic

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25
Q

What is the most commonly effected joint by gout?

A

-the big toe

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26
Q

What can gout return be anticipated after?

A

-alcohol consumption, trauma, surgury, or eating food with purine content

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27
Q

what does hemochromotosis cause?

A

-excess iron in the blood

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28
Q

Who is most likely to get hemochromotosis?

A

-men (5x > than women) over 50

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29
Q

What increases the incidence of hemachromotosis?

A

-alcohol use

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30
Q

What are some signs and symptoms of hemachromotosis?

A

-vertigo, hair loss, memory loss, arrythmias, cardiomyopathy, bronze skin, hepatomegaly, elevated liver enzymes, liver cirrhosis, DM, arthritis, and testicular atrophy

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31
Q

50% of patients with hemachromotosis develop what?

A

-Arthritis

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32
Q

Arthritis associated with hemachromotosis is common to manifest where?

A

-MCP, hips, knees and shoulders

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33
Q

How can you differentiate between RA and hemachromotosis?

A
  • Hemochromotosis affects all joints in the hands and causes bone sclreosis
  • RA affects mainly the MCPs and PIP and causes bone loss and deformities
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34
Q

What is osteomalacia?

A

-bone softening without bone loss

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35
Q

What can osteomalcia be caused by?

A

-calcium and phosphate deficiency

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36
Q

What are some risk factor associated with osteomalacia?

A

-Being elderly, living in cold areas, lack of vitamin d, chronic renal failure, renal defects,hyperparathyroidism

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37
Q

What types of medications can cause osteomalacia?

A

-tranquilizers, sedatives, anticonvulstants, muscle relaxants, diuretics, antacids with hydroxide

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38
Q

What postural deformities are associated with osteomalacia?

A

-kyphosis and bowed legs

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39
Q

What areas will be tender in a patient with osteomalacia?

A

-Ribs and proximal extremities

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40
Q

Fractures associated with osteomalacia are common where?

A

-The radius, femur, vertebral bodies, ribs and pubic ramus

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41
Q

What population is Paget’s Disease highest in?

A

-People from the Great Britains, over 50

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42
Q

What cardio manifestations are associated with Paget’s Disease?

A

-increased CO, increased blood flow to affected bone, heart failure

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43
Q

What areas are susceptible for osteoporosis?

A

-vertebra, calcaneus, metaphyseal area of long bones

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44
Q

What modifiable risk factors are associated with osteoporosis?

A

-corticosteroid use, poor nutrition and depression

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45
Q

What bone density value is associated with osteopenia?

A

-1.0 to 2,5 below SD

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46
Q

What bone density is associated with osteoporosis?

A

-2.5 or lower than SD

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47
Q

what is the bone density associated with severe osteoporosis?

A

-more than 2.5 below the SD and have had one or more osteoporotic fractures

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48
Q

Hyperthyroidism causes what effects on the nervous system?

A

-tremors, CTS, and hyperreflexia

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49
Q

Hyperthyroidism has what effect on the metabolic system?

A

-weight loss and bone loss

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50
Q

Hyper-adrenalism can have what effects on the nervous ststem?

A

-Weakness and emotional problems

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51
Q

Hypo-adrenalism can cause what problems in the metabolic system?

A

-bone loss and slow healing

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52
Q

Hyperparathyroidism can have what neruological effects?

A

-parathesia, lethargy, and fatigue

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53
Q

Hyperparathyroidism can have what effect on the metabolic system?

A

-MCP CPPD, Gout, bone loss

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54
Q

Decreased ADH can cause what neuro effects?

A

-siezures, lethargy, confusion

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55
Q

decreased ADH can cause what metabolic effects?

A

-weight gan

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56
Q

Endocrine disorders present how from the beginning?

A

-systemically

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57
Q

What immune disorders can cause CTS?

A

-hypocalcemia, gout, hemochromotosis

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58
Q

What endocrine disorders can cause CTS?

A

-acromegaly, diabetes, menopause, hyperthyroidism

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59
Q

What MSK disorders are signs and symptoms of endocrine disorders?

A

-periarthritis (of the 2nd PIP), and calcific tendinitis of th infraspinatus

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60
Q

Chondrocalcinosis is associated with what endocrine disorders?

A

-acromegaly, pseudogout, hyperthyroidism/para,

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61
Q

CPPD only affects what joints in the hand?

A

-MCPs only

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62
Q

What other joints does CPPD affect?

A

-Radiocarapal joint and patellofemoral joint, and the entire hip joint

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63
Q

what is the cluster for spondyloarthritis?

A

-age over 45, morning stiffness that is improved with exercise

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64
Q

Diabetes normally affects what first?

A

-PNS (then CNS, and ANS in advanced stages)

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65
Q

when exercising a person with diabetes, which exercises should not be included?

A

-those that increase HR above 75%, and those that place the legs above the head or trunk

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66
Q

If blood glucose levels are above 250 what type of exercise is allowed?

A

-NONE

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67
Q

what range of blood glucose levels is indicated for exercise?

A

-100-250

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68
Q

If a patient have blood glucose levels from 80-100 what should you do?

A

-give 15g of carbs and retest in 15 minutes

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69
Q

Blood glucose less than 75-80 indicated what type of exercise?

A

-NONE

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70
Q

Where should insulin injections not be injected?

A

-muscle being exercised within the next hour

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71
Q

Diabetics taking what are at a higher risk for hyperglycemia?

A

-Glucocorticoids

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72
Q

Blood glucose levels above what indicative of diabetic ketoacidosis?

A

-300

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73
Q

Cushings syndrome is caused by what?

A

-excess cortisol

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74
Q

What should a PT be aware of in a patient with cushing syndrome?

A

-the patient may have a reduced pain threshold, slow healing, and decreased heat tolerance

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75
Q

Addisons disease commonly shows muscle weakness where?

A

-anterior tibialis

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76
Q

What is a symptoms of addisons diease that PTs shoulde be aware of?

A

-orthostaic hypotension (be careful with transfers)

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77
Q

Hyperthyroidism causes muscle weakness where?

A

-proximally

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78
Q

Myxedema coma is associated with what?

A

-hypothyroidism

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79
Q

what are some signs and symptoms of myxedema coma?

A

-severe bradycardia, hypotension, hypothermia, slow and shallow breathing

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80
Q

Patients with hyperthermia should not use what in therapy?

A

-a heated pool

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81
Q

Thyroid storm (an emergency) can be precipitated by what?

A

-trauma, infection or surgery

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82
Q

hypoparathyroidism is cause by what?

A

-low calcium levels

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83
Q

hypoparathyroidism can cause spasm is what muscles?

A

-intercostals

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84
Q

What are the general signs and symptoms of immune disorders?

A

-joint of muscle involvement, poor health, nail bed and skin changes, visual and eye problems, allergies, fatigue, fever, weakness, and lymph node enlargement

85
Q

What are the early symptoms of HIV?

A

-fever, night sweats, fatigue, oral sores, vaginal infections, headache, cough, SOB, and skin lesions

86
Q

what symptoms may be the presenting symptoms of those with HIV?

A

-Neuro symptoms

87
Q

what might fibromyalgia be triggered by?

A

-stress, viral infections or truama

88
Q

What population is most effected by fibromyalgia?

A

-women more than males, most commonly between the ages of 30 and 45

89
Q

A patient with a WPI score and SS score of what will qualify a patient to have fibromyalgia?

A

-WPI greater than 7, ss score greater than 5

90
Q

If a patient has a WPI score between 3 and 6, and SS score greater than what can qualify them to have fibromyalgia?

91
Q

How else can a person be diagnosed with fibomyalgia>

A

-there is no other reason to explain the pain

92
Q

88% of patient with RA test positive for what?

A

-Rheumatoid Factor

93
Q

What condition most frequently tests positive for rhuematoid factor?

A

-Primary Sjogrens syndrome

94
Q

What condition least frequently tests positive for rheumatoid factor?

A

-Reactive Arthritis

95
Q

What population is most commonly effect by RA?

A

-Women 3x more likely than men, peak incidence betwwen 20 and 50 y/o

96
Q

RA is more likely to occur with what?

A

-thyroid disorders

97
Q

RA effects what joint surfaces?

A

-All of them

98
Q

What population is most commonly effected by Polymyalgia Rheumatica?

A

-white males over 55

99
Q

what condition is commonly associated with polymyalgia rheumatica?

A

-temportal arteritis

100
Q

Muscle pain associated with polymyalgia rheumatica commonly manifest where?

A

-neck, shoulder and pelvis

101
Q

What is the most commonly seen symptoms of systemic lupus?

A

-butterfly rash

102
Q

What is the most common symptoms of systemic lupus?

A

-low grade fever, arthritis, skin rashes

103
Q

What condition is most commonly associated with the HLA-B27 antigen?

A

-Anklosing Spondylitis

104
Q

RA is associated with the HLA-B27 antigen what percent of the time?

105
Q

AS or Marie-Stupell disease primarily effects what?

A

-SI joints, the lumbar spine, ribcage and proximal joimts

106
Q

What population does AS normally affect?

A

-males between the ages 18-30

107
Q

What might precede back pain in patients with AS?

A

-Eye irritation

108
Q

Reiter’s Disease is a triad of what?

A

-Arthritis. urethritis, and conjunctivitis

109
Q

Reiters disease mainly effects who?

110
Q

What are the systemic symptoms of Rieter’s Disease?

A

-Low fever, anorexia, weight loss

111
Q

What is often the first symptoms of rieters disease?

A

-burning urination

112
Q

Rieters disease normally affects what joints?

A

-Weight bearing joints

113
Q

Psoriatic Arthritis is commonly preceded by what?

A

-Skin problems

114
Q

Psoriatic Arthritis normally effects what joints in the hand?

115
Q

What is often the first sign of lyme disease?

A

-Red Skin rash

116
Q

What joints are normally affected by lyme disease?

A

-Knee and shoulder

117
Q

What is stage O cancer?

A

-Carcinoma in SItu

118
Q

What is stage 1 cancer?

A

-Localized

119
Q

What is stage 2 cancer?

A

-early localized advanced

120
Q

What is stage 3 cancer?

A

-late localized advanced

121
Q

What is stage 4 cancer?

A

-metastisized

122
Q

What are the most common cancers in males?

A

-prostate, lung, and colon

123
Q

Men are most likely to die from which cancers?

A

-lung, prostate, colon and pancreas

124
Q

What cancers are most common in females?

A

-breast, lung and colon

125
Q

Women are most likely to die from which cancers?

A

-lung, breast, colon and pancreas

126
Q

what male population is most commonly affected by cancer?

A

-african americans

127
Q

What race is least likely to be affected by cancer?

A

-American indian or alaskan

128
Q

What population has the highest incidence of breast cancer?

A

-white females

129
Q

What population has the lowest incidence of breast cancer?

A

-Native american females

130
Q

What female population has the highest incidence of cancer?

A

-White females

131
Q

What populations have the highest incidence of colon and rectum cancer?

A

-African american males and females

132
Q

What male population has the lowest incidence of colon or rectal cancer?

A

-American Indian

133
Q

What female population has the lowest incidence of colon or rectal cancer?

134
Q

What race (male and female) has the highest incidence of kindey and renal pelvic cancer?

A

-African americans

135
Q

What race (male and female) have the lowest rate of kidney and renal pelic cancer?

136
Q

What race (male and female) has the highest rate of liver and bile duct cancer?

137
Q

What race (male and female) has the lowest rate of liver and bile duct cancer?

138
Q

What male population has the highest incidence of lung cancer?

A

-African American

139
Q

What female population has the highest incidence of lung cancer?

140
Q

What race (males and females) has the lowest incidence of lung cancer?

141
Q

What races have the highest incidence of stomach cancer?

A

-Asian and african american

142
Q

What race has the lowest incidence of stomach cancer?

143
Q

What race has the highest incidence of prostate cancer?

A

-african american

144
Q

What race has the lowest incidence of prostate cancer?

A

-american indian

145
Q

What race has the highest incidince of uterine cancer?

146
Q

What race has the lowest incidence of uterine cancer?

A

-American Indian

147
Q

What race has the highest amount of cancer deaths?

A

-African Americans

148
Q

What population has the highest breast cancer mortality rate?

A

-African American Females

149
Q

What population has the lowest breast cancer mortality rate?

A

-Asian Females

150
Q

What race has the highest colon cancer mortality rate?

A

-African Americans

151
Q

What race has the lowest colon cancer mortality rate?

152
Q

What race has the highest kidney and renal pelvis mortality rate?

A

-American Indian

153
Q

What race has the lowest kidney and renal pelvic cancer mortality rate?

154
Q

What race has the highest liver and bile duct cancer mortality rate?

155
Q

What race has the lowest liver and biles duct cancer mortality rate?

156
Q

What race has the highest prostate cancer mortality rate?

A

-African american

157
Q

What race has the lowest prostate cancer mortality rate?

158
Q

What male population has the highest rate of lung cancer mortalities?

A

-African american men

159
Q

What female population has the highest mortality rate for lung cancer?

A

-White Females

160
Q

What male population has the lowest mortality rate for lung cancer?

161
Q

What male population has the highest mortality rate for stomach cancer?

A

-Black men

162
Q

What female population has the highest mortality rate for stomach cancer?

A

-Asian women

163
Q

What race has the lowest mortality rate for stomach cancer?

164
Q

What race has the highest mortality rate for uterine cancer?

A

-African American

165
Q

What race has the lowest death rate for uterine cancer?

166
Q

What is the order of cancer related death rates per race from highest to lowest?

A

-African American, White, American Indian, Hispanic, Asian

167
Q

What is the most common cancer in children?

A

-Leukemia (CNS is second)

168
Q

What is the most important risk factor for cancer?

A

-Being over the age of 50

169
Q

What are the 7 early warning signs of cancer?

A
  • C: change in bladder or bowel
  • A: A would that wont heal
  • U: unusual bleeding of discharge
  • T: Thickening or lump
  • I: Indigestion or dysphagia
  • O: Obvious change in mole or wort
  • N: Nagging Cough or hoarseness
170
Q

Changes in what with out a mechanical reason can be a sign of cancer?

A

-DTRs (can be hyper or hypo)

171
Q

Where might you observe weakness in a patient that has cancer?

A

-Proximal muscles

172
Q

What is usually the first symptom of cancer?

173
Q

When does visceral pain usually occur with cancer?

A

-in advanced stages

174
Q

Visceral pain with cancer is associated with what other symptoms?

A

-Hypotension, nausea, vomiting, bradycardia, and depression

175
Q

Mild to moderate pain from cancer is associated with what other symptoms?

A

-Tachycardia, hypertension, tachypnea

176
Q

Which type of cancer leads in mortality rate?

A

-Lung caner

177
Q

What is the most common site of metastasis for all cancers?

178
Q

What is the most site of metastasis from primary lung cancer?

A

-Brain (then prostate/breast and then bone)

179
Q

What syndrome might lung cancer cause?

A

-Horner’s

180
Q

What spinal nerve might be affected if there is cancer in the apical lobes of the lungs?

181
Q

What is the second most common site of metastasis for all cancers?

182
Q

What is the 4th leading cause of cancer related deaths in males?

A

-Pancreatic

183
Q

What is the 5th leading cause of cancer related deaths in males?

184
Q

Where might a patient with liver cancer be experiencing pain?

A

-Right upper quadrant and right shoulder

185
Q

Where might a patient with pancreatic cancer experience pain?

A

-Left upper quadrant and left shoulder

186
Q

What is the 3rd most common site of metastasis for all cancers?

A

-the skeleton

187
Q

What mnemonic can be used to remember what cancer commonly metastasize to the skeleton?

A
  • LEAD KETTLE (PBKTL)

- Prostate, Breast, Kidney, Thyroid, Liver

188
Q

What bones does cancer normally metastasize too?

A
  • Spine (70%)
  • 60% T-spine
  • 30% Lumbar
  • 10% Cerical
189
Q

What is the most common primary cancer that effects the spine?

A

-Multiple Myeloma

190
Q

What is the Clincal prediction rule for LPB related to cancer?

A
  • Age >50
  • Unexplained weight loss
  • History of malignancy
  • Symptoms do not improve after 4 weeks of therapy
191
Q

What is the 4th most common site for metastasis for all cancers?

A

-The Brain

192
Q

What are the most common cancers that metastasize to the brain?

A

-lungs, breast, skin, kidney, colon

193
Q

Where does brain cancers normally occur?

A

-Cerebrum (85%)
Then Cerebellum (15%)
then brainstem

194
Q

Headaches that are worse in the morning might be related to what?

A

-Brain cancer

195
Q

What is the 5th most common site for metastasis?

A

-Lymph nodes

196
Q

What might lymph cancer be precipitated by?

A

-A transplant

197
Q

what accounts for 30% of cancers in children?

198
Q

Luekemia can cause what blood disorders?

A

-Anemia, and platelet disorders

199
Q

What are the common places that leukemia might spread?

A

-spinal fluid, liver, spleen, lymph nodes, and testicles

200
Q

Where does prostate cancer most likely metastasize?

201
Q

What are the early symptoms of prostate cancer?

A

-Changes in urination stream

202
Q

What is the 3rd most common cancer?

A

-Colorectal (also 3rd in mortality rate)

203
Q

Where does colorectal cancer most commonly metastasize?

A

-the liver

204
Q

Kidney cancer is the what most common cancer in males and females?

A
  • 7th is males

- 8th in females

205
Q

Where does kidney cancer most commonly metastasize?

A

-Bones, then brain

206
Q

What is the 5th most common cancer in females?

207
Q

Where does thyroid cancer most commonly metastasize?

A

-The skeleton

208
Q

What is the condition that is signs and symptoms cause by cancer but not due to cancer cells?

A

-Paraneoplastic Syndrome

209
Q

What type of cancers normally present with paraneoplastic syndromes?

A

-lung, breast, ovaries, or lymph

Differential Diagnosis (2 decks)

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