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Differential Diagnosis > Interviewing as a screening tool > Flashcards

Interviewing as a screening tool Flashcards

1
Q

Do’s of interviewing

A

Extend small courtesies

Use a sequence of questions that begins with open-ended questions

Leave close-ended questions for the end of interviewing to clarify

Select a private location for confidentiality

Undivided attention; re-assuring comments; eye contact

Ask one question at a time, allow time for patient to respond

Encourage patient to ask questions

Listen with attention of assessing patient’s current level of understanding and knowledge of his/her condition

Eliminate unnecessary info and speak at patient’s level of understanding

Correlate signs and symptoms with medical history and objective findings to rule-out systemic disease

Provide several choices/selections to questions that require descriptive response

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2
Q

Don’ts of interviewing

A

Jump to pre-mature conclusions based on answers to one or two questions

Interrupt or take over conversation when client speaking

Destroy helpful open-ended questions with closed-ended follow-up questions before patient has chance to respond

Use professional or medical jargon when it is possible to use common language

Overreact to info presented by the patient (including facial expressions)

Use leading questions
- Where is your pain?
(Do you have pain associated with your injury, if so tell me about it)
- Does it hurt when you first get out of bed?
(When does your back hurt?)
- Does the pain radiate down your leg?
(Do you have this pain anywhere else)
- Do you have pain in your lower back?
(Point to the exact location of your pain)

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3
Q

What are different racial or ethnic designations?

A

American Indian/Alaska Native

Asian

Black/African American

Hispanic or Latino (of any race)

Native Hawaiian/Pacific Islander

White/Caucasian

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4
Q

What are important aspects of cultural competency while interviewing?

A

Wait until patient is finished speaking before interrupting or asking questions

Allow “wait time” for some cultures (English could be 2nd language)

Be aware that eye-contact, body-space boundaries, even handshaking may differ from culture to culture

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5
Q

Keys to successful interactions via interpreter

A

Choose a competent medical interpreter

Interpreter who is older than the patient important in some cultures

Info about client’s diagnosis and condition is relayed to head of household in some cultures who makes decisions for members of family (Muslim)

Listen to interpreter, but direct gaze at patient

Watch body language while speaking for cues

Head nodding and smiling does not necessarily mean that the patient understands you

Keep remarks simple and short

Avoid using medical jargon

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6
Q

What are the topics of data that can be gleaned from a client history?

A

General demographics

Medical/Surgical history

Current conditions/Chief complaints

Functional status and activity level

Medications

Other clinical tests

Family history

Social/Health habits (past and current)

General health status (self-report, family report, caregiver report)

Living environment

Growth and development

Employment/work (job/school/play)

Social history

FIGURE 2.1

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7
Q

What age and sex is related to Guillain Barre syndrome?

A

Any age (hx of infection/alcoholism)

Men > Women

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8
Q

What age and sex is related to Multiple sclerosis?

A

15-35 y.o.

Women > Men

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9
Q

What age and sex is related to Rotator cuff degeneration?

A

30+ y.o.

No difference between sexes

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10
Q

What age and sex is related to spinal stenosis?

A

60+ y.o.

Men > Women

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11
Q

What age and sex is related to Tietze’s syndrome?

A

Before 40 y.o., including children

No differences between sexes

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12
Q

What age and sex is related to Costochondritis?

A

40+ y.o.

Women > Men

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13
Q

What age and sex is related to Neurogenic claudication?

A

40-60 y.o.

No difference between sexes

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14
Q

What age and sex is related to AIDS/HIV?

A

20-49 y.o.

Men > Women

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15
Q

What age and sex is related to Ankylosing spondylitis?

A

15-30 y.o.

Men > Women

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16
Q

What age and sex is related to abdominal aortic aneurism?

A

40-70 y.o.

(Hypertensive) Men > Women

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17
Q

What age and sex is related to Buerger’s disease?

A

20-40 y.o. (smokers)

Men > Women

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18
Q

What age and sex is related to cancer?

A

Any age; incidence rises over age of 50 y.o.

Men > Women

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19
Q

What age and sex is related to Breast cancer?

A

45-70 y.o.

Women > Men

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20
Q

What age and sex is related to Hodgkin’s disease?

A

20-40, 50-60 y.o

Men > Women

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21
Q

What age and sex is related to Osteoid osteoma?

A

10-20 y.o.

Men > Women

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22
Q

What age and sex is related to Pancreatic carcinoma?

A

50-70 y.o.

Men > Women

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23
Q

What age and sex is related to RA?

A

20-50 y.o.

Women > Men

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24
Q

What age and sex is related to skin cancer?

A

Rarely before puberty; increased incidence with age

Men = women

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25
Q

What age and sex is related to Gallstones?

A

40+ y.o.

Women > Men

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26
Q

What age and sex is related to Gout?

A

40-59 y.o.

Men > Women

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27
Q

What age and sex is related to Gynecologic conditions?

A

20-45 y.o.

Women

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28
Q

What age and sex is related to Paget’s disease of the bone?

A

60+ y.o.

Men > Women

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29
Q

What age and sex is related to Prostatitis?

A

40+ y.o.

Men

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30
Q

What age and sex is related to Primary biliary cirrhosis?

A

40-60 y.o.

Women > Men

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31
Q

What age and sex is related to Reiter’s syndrome?

A

20-40 y.o.

Men > Women

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32
Q

What age and sex is related to Renal tuberculosis?

A

20-40 y.o.

Men > Women

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33
Q

What age and sex is related to Rheumatic fever?

A

4-9; 18-30 y.o.

Girls > Boys

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34
Q

What age and sex is related to Shingles?

A

60+ y.o.; increasing incidence with age

No difference between sexes

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35
Q

What age and sex is related to Spontaneous pneumothorax?

A

20-40 y.o.

Men > Women

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36
Q

What age and sex is related to Systemic backache?

A

45+ y.o.

No difference between sexes

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37
Q

What age and sex is related to Thyroiditis?

A

30-50 y.o.

Women > Men

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38
Q

What age and sex is related to Vascular claudication?

A

40-60+ y.o.

No difference between sexes

39
Q

What are the life cycles of a woman?

A

Premenes (before start of monthly menstrual cycle; may include early puberty)

Reproductive years (including birth, delivery, miscarriage, and/or abortion history; the time period may include puberty)

Perimenopause (usually begins with obvious symptoms in the mid-30s and continues until symptoms of menopause occur)

Menopausal (may be a natural or surgical menopause)

Postmenopausal (cessation of blood flow associated with menstrual cycle)

40
Q

What are the clinical signs and symptoms of MENOPAUSE?

A

Fatigue and malaise

Depression, mood swings

Difficulty concentrating: “brain fog”

Headache

Altered sleep pattern (insomnia/sleep disturbance)

Hot flashes

Irregular menes, cessation of menes

Vaginal dryness, pain during intercourse

Atrophy of breasts and vaginal tissue

Pelvic floor relaxation (Cystosele/rectocele)

Urge incontinence

41
Q

What are the PHYSICAL clinical signs and symptoms of EATING DISORDERS?

A

Weight loss or gain

Skeletal myopathy and weakness

Chronic fatigue

Dehydration or rebound water retention; pitting edema

Discoloration or staining of the teeth from contact with stomach acid

Broken blood vessels in the eyes from induced vomiting

Enlarged parotid glands from repeated contact with vomit

Tooth marks, scratches, scars, or calluses on back of hands from induced vomiting (Russell’s sign)

Irregular or absent menstrual periods; delay of menes onset in young adolescent girls

Inability to tolerate cold

Dry skin and hair; brittle nails, hair loss and growth of downy hair all over the body, including face

Reports of heartburn, abdominal bloating or gas, constipation, or diarrhea

Vital signs: slow HR, low BP

In women/girls: irregular or absent menstrual cycles

42
Q

What are the BEHAVIORAL clinical signs and symptoms of EATING DISORDERS?

A

Preoccupation with weight, food, calories, fat grams, dieting, clothing size, body shape

Mood swings, irritability

Binging and purging (bulimia) or food restriction (anorexia); frequent visits to the bathroom after eating

Frequent comments about being fat or overweight despite looking very thin

Excessive exercise to burn off calories

Use of diuretics, laxatives, enemas, or other drugs to induce urination, bowel movements, and vomiting

43
Q

What are the physiologic effects/adverse reactions to CAFFEINE (Coffee, expresso, chocolate, OTC “alert aids,” black tea, red bull, etc)?

A

Vasoconstriction

Irritability

Enhanced pain perception

Intestinal disorders

Headaches

Muscle tension

Fatigue

Sleep disturbances

Urinary frequency

Tachypenia

Sensory disturbances

Agitation

Nervousness

Heart palpitation

44
Q

What are the physiologic effects/adverse reactions to CANNABIS (Marijuana, hashish)?

A

Short-term memory loss

Sedation

Tachycardia

Euphoria

Increased appetite

Relaxed inhibitions

Fatigue

Paranoia

Psychosis

Ataxia, tremor

45
Q

What are the physiologic effects/adverse reactions to DEPRESSANTS (Alcohol, sedatives/sleeping pills, barbiturates, tranquilizers)?

A

Agitation, mood swings, anxiety, depression

Vasodilation; red eyes

Fatigue

Altered pain perception

Excessive sleepiness/insomnia

Coma (over-dose)

Altered behavior

Slow, shallow breathing

Clammy skin

Slurred speech

46
Q

What are the physiologic effects/adverse reactions to NARCOTICS (Heroine, opium, morphine, codeine)?

A

Euphoria

Drowsiness

Respiratory depression

47
Q

What are the physiologic effects/adverse reactions to STIMULANTS (Cocaine and its derivatives, amphetimines, methamphetimine, ecstasy)?

A

Increased alertness

Excitation

Euphoria

Loss of appetite

Increase in BP

Insomnia

Increase in pulse

Agitation, increase in body temperature, hallucinations, convulsions, death

48
Q

What are the physiologic effects/adverse reactions to TOBACCO (Cigarettes, cigars, pipe smoking, smokeless tobacco products)?

A

Increase in HR

Vasoconstriction

Decreased oxygen to heart

Increase in risk of thrombosis

Loss of appetite

Poor wound healing

Poor bone grafting

Increased risk of pneumonia

Increased risk of cataracts

Disk degeneration

49
Q

What are the clinical signs and symptoms of alcohol use disorders in older adults?

A

Memory loss or cognitive impairment (new onset or worsening of previous condition)

Depression or anxiety

Neglect of hygiene and appearance

Poor appetite and nutritional deficits

Sleep disruption

Refractory (resistant) hypertension

Blood glucose control problems

Refractory seizures

Impaired gait, balance, and falls

Recurrent gastritis and esophagitis

Difficulty managing warfarin dosing

50
Q

What are the clinical signs and symptoms of alcohol withdrawal?

A

Agitation

Headache

Insomnia

Hallucinations

Anorexia, nausea, vomiting, diarrhea

Loss of balance, incoordination (apraxia)

Seizures (occurs 12-48 hrs after the last drink)

Delirium tremens (occurs 2-3 days after last drink)

Motor hyperactivity, tachycardia

Elevated BP

51
Q

Risk factors for falls secondary to AGE CHANGES

A

Muscle weakness; loss of joint motion (especially LEs)

Abnormal gait

Impaired or abnormal balance

Impaired proprioception or sensation

Delayed muscle response/increased reaction time

Decreased systolic BP

Stooped or forward bent posture

52
Q

Risk factors for falls secondary to ENVIRONMENTAL/LIVING CONDITIONS

A

Poor lighting

Throw rugs, loose carpet, complex carpet designs

Cluster of electric wires or cords

Stairs without handrails

Bathroom without grab bars

Slippery floors

Restraints

Use of alcohol or other drugs

Footwear, especially slippers

53
Q

Risk factors for falls secondary to PATHOLOGIC CONDITIONS

A

Vestibular disorders; episodes of dizziness or vertigo from any cause

Orthostatic hypotension (especially before breakfast)

Chronic pain condition

Neuropathies

Cervical myelopathy

Osteoarthritis; RA

Visual or hearing impairment; multifocal eyeglasses; change in perception of color; loss of depth perception; decreased contrast sensitivity

Cardiovascular disease

Urinary incontinence

Central nervous system disorders (stroke, PD, MS)

Motor disturbance

Osteopenia, osteoporosis

Pathologic fractures

Any mobility impairments

Cognitive impairment; dementia; depression

54
Q

Risk factors for falls secondary to MEDICATIONS

A

Antianxiety; benzodiazepines

Anticonvulsants

Antidepressants

Antihypertensives

Antipsychotics

Diuretics

Narcotics

Sedative-hypnotics

Phenothiazines

Use of more than four medications (polypharmacy/hyperpharmacology)

55
Q

Risk factors for falls secondary to OTHER

A

History of falls

Female sex; postmenopausal status

Living alone

Elder abuse/assault

Nonambulatory status (requires transfers)

Gait changes (decreased stride length or speed)

Postural instability; reduced postural control

Fear of falling; history of falls

Dehydration from any cause

Recent surgery (general anesthesia, epidural)

Sleep disorder/disturbance; sleep deprivation; daytime drowsiness; brief disorientation after waking up from a nap

56
Q

What is INTRINSIC trauma?

A

Unguarded movement that can occur during normal motion

Ex: patient who reaches to the back of a cupboard while turning his or her head away from the extended arm to reach the last inch or two–a sudden pop or twinge experienced with subsequent pain

57
Q

What is EXTRINSIC trauma?

A

Force or load external to the body is exerted against the body

Trauma we typically think of

58
Q

What is ASSAULT trauma?

A

Domestic abuse-type trauma

Any physical, sexual, or psychologic attack (verbal, emotional, economic)

Violence against women

Must be able to identify the signs of abuse

59
Q

What is ABUSE?

A

Infliction of physical or mental injury, or the depravation of food, shelter, clothing, or services needed to maintain physical or mental health

60
Q

What is SEXUAL ABUSE?

A

Sexual assault, sexual intercourse without consent, indecent exposure, deviate sexual conduct, or incest; adult using a child for sexual gratification without physical contact is considered sexual abuse

61
Q

What is NEGLECT?

A

Failure to provide food, shelter, clothing, or help with daily activities needed to maintain physical of mental well-being; client often displays signs of poor hygiene, hunger, or inappropriate clothing

62
Q

What is MATERIAL EXPLOITATION?

A

Unreasonable use of a person, power of attorney, guardianship, or personal trust to obtain, control of the ownership, use, benefit, or possession of the person’s money, assets, or property by means of deception, duress, menace, fraud, undue influence, or intimidation

63
Q

What is MENTAL ABUSE?

A

Impairment of a person’s intellectual or psychologic functioning or well-being

64
Q

What is EMOTIONAL ABUSE?

A

Anguish inflicted through threats, intimidation, humiliation, and/or isolation; belittling, embarrassing, blaming, rejecting behaviors from adult toward child; withholding love, affection, approval

65
Q

What is PHYSICAL ABUSE?

A

Physical injury resulting in pain, impairment, or bodily injury of any bodily organ or function, permanent or temporary disfigurement, or death

66
Q

What is SELF-NEGLECT?

A

Individual is not physically or mentally able to obtain and perform the daily activities of life to avoid physical or mental injury

67
Q

What are the risk factors and red flags for domestic violence?

A

Women with disabilities

Cognitively impaired adult

Chronically ill and dependent adult (especially over 75 y.o.)

Chronic pain clients

Physical and/or sexual abuse history (men and women)

Daily headache

Previous history of many injuries and accidents (including multiple MVAs)

Somatic disorders

  • Injury seems inconsistent with client’s explanation; injury in a child that is not consistent with the child’s developmental level
  • Injury takes much longer to heal than expected

Pelvic floor problems

  • Incontinence
  • Infertility
  • Pain

Recurrent unwanted pregnancies

History of alcohol abuse in a male partner

68
Q

What are warning signs of elder abuse?

A

Multiple trips to the emergency department

Depression

“Falls”/Fractures

Bruising/suspicious sores

Malnutrition/weight loss

Pressure ulcers

Changing physicians/therapists often

Confusion attributed to dementia

69
Q

What are the clinical signs and symptoms of domestic violence: PHYSICAL CUES

A

Bruises, black eyes, malnutrition

Sprains, dislocations, foot injuries, fractures in various stages of healing

Skin problems

Chronic or migraine headaches

Diffuse pain, vague or non-specific symptoms

Chronic or multiple injuries in various stages of healing

Vision and hearing loss

Chronic low back, sacral, or pelvic pain

Temporomandibular joint pain (TMJ)

Dysphagia and easy gagging

Gastrointestinal disorders

Patchy hair loss, redness, or swelling over the scalp from violent hair pulling

Easily startled, flinching when approached

70
Q

What are the clinical signs and symptoms of domestic violence: SOCIAL CUES

A

Continually missing appointments; won’t return phone calls, unable to talk on phone

Bringing all of the children to the clinic

Spouse, companion, or partner always accompanying patient

Changes physicians often

Multiple visits to the ER

Multiple car accidents

71
Q

What are the clinical signs and symptoms of domestic violence: PSYCHOLOGIC CUES

A

Anorexia/bulimia

Panic attacks, nightmares, phobias

Hypervigilance, tendency to startle easily or be very guarded

Substance abuse

Depression, anxiety, insomnia

Self-mutilation or suicide attempts

Multiple personality disorders

Mistrust of authority figures

Demanding, angry, distrustful of healthcare provider

72
Q

What are the risk factors for adverse drug reactions?

A

Age (over 65 y.o., especially over 75 y.o.)

Small physical size of stature

Sex (men and women respond differently)

Polypharmacy/hyperpharmacotherapy

Prescribing cascade (failure to recognize signs and symptoms of an ADE and treating it as the onset of a new illness)

Taking meds prescribed to someone else

Organ impairment and dysfunction

Concomitant alcohol consumption

Concomitant use of certain nutraceuticals

Previous history of ADEs

Mental deterioration or dementia

Difficulty opening medication bottles, difficulty swallowing, unable to read or understand directions

Racial/ethnic variations

73
Q

Clinical signs and symptoms of NSAID Complications: GI

A

May be asymptomatic

May cause confusion and memory loss in older adults

Indigestion, heartburn, epigastric or abdominal pain

Esophagitis, dysphagia, odynophagia

Nausea

Unexplained fatigue lasting more than 1-2 weeks

Ulcers (gastric, duodenal), perforations, bleeding

Melena

74
Q

Clinical signs and symptoms of NSAID Complications: RENAL

A

Polyuria, nocturia

Nausea, pallor

Edema, dehydration

Muscle weakness, restless leg syndrome

75
Q

Clinical signs and symptoms of NSAID Complications: INTEGUMENTARY

A

Pruritis (symptom of renal impairment)

Delayed wound healing

Skin reaction to light (photodermatitis)

76
Q

Clinical signs and symptoms of NSAID Complications: CARDIOVASCULAR

A

Elevated BP

Peripheral edema

Asthma attacks in individuals with asthma

77
Q

Clinical signs and symptoms of NSAID Complications: MSK

A

Increase symptoms after taking medication

Symptoms linked with ingestion of food (increased or decreased depending on ulcer location)

Midthoracic back, shoulder, or scapular pain

Neuromuscular

Muscle weakness (sign of renal impairment)

Restless leg syndrome (sign of renal impairment)

Paresthesias (sign of renal impairment)

78
Q

What are the risk factors for NSAID Gastropathy?

A

Back, shoulder, neck, or scapular pain in any client taking NSAIDs in the presence of the following risk factors for NSAID-induced gastropathy raises a red flag of suspicion:

  • Age ( > 65 y.o.)
  • History of peptic ulcer disease, GI disease, or RA
  • Tobacco or alcohol use
  • NSAIDs combined with oral corticosteroid use
  • NSAIDs combined with anticoagulants
  • NSAIDs combined with selective serotonin re-uptake inhibitors
  • Chronic use of NSAIDs ( > 3 months)
  • Higher doses of NSAIDs, including the use of more than one NSAID
  • Concomitant infection with Heliobactor pylori
  • Use of acid suppressants; these agents may mask the warning symptoms of more serious GI complications, leaving the patient unaware of ongoing damage
79
Q

What are the clinical signs and symptoms of anabolic steroid use?

A

Rapid weight gain

Elevated BP

Peripheral edema associated with increased BP

Acne on face and upper body

Muscular hypertrophy

Stretch marks around the trunk

Abdominal pain, diarrhea

Needle marks in large muscle groups

Personality changes (aggression, mood swings, “roid” rages)

Bladder irritation, urinary frequency, UTIs

Sleep apnea, insomnia

Altered ejection fraction (lower end of normal: under 55%)

80
Q

WHAT IS ON PAGES 50-51???

A

GENERAL HEALTH INFO,

READ IT!!

81
Q

What is the effect of NSAIDs (Naprosyn, Motrin, Anaprox, ibuprofen) on BP?

A

INCREASE IN BP

NSAIDs can be renal vasoconstrictors causing and increase in BP; resultant LE edema as sodium and water are conserved by body

82
Q

Most of the information needed to determine the cause of symptoms is contained in what?

A

SUBJECTIVE EXAM

It is well documented that 80% or more of info needed to determine cause of symptoms is gathered during interview with patient

83
Q

With what final question should you always end an interview?

A

“Is there anything else you think I should know?”

84
Q

A risk factor for NSAID-related gastropathy is the use of what?

A

ANTIDEPRESSANTS

85
Q

After interviewing a new client, you summarize what she has told you by saying, “You told me you are here because of right neck and shoulder pain that began 5 years ago as a result of a car accident. You also have a ‘pins and needles’ sensation in your third and fourth fingers but no other symptoms at this time. You have noticed a considerable decrease in grip strength, and you would like to be able to pick up a pot of coffee without fear of spilling it.”

WHAT IS THIS SCENARIO AN EXAMPLE OF?

A

PARAPHRASING TECHNIQUE

86
Q

True of false?

Screening for alcohol use would be appropriate when the client reports a history of accidents.

A

True

87
Q

What is the significance of “sweats?”

A

SIGN OF SYSTEMIC DISEASE

SIDE EFFECT OF CHEMOTHERAPY OR OTHER MEDS

POOR VENTILATION WHILE SLEEPING

88
Q

True or false?

Spontaneous uterine bleeding after 12 consecutive months w/o menstrual bleeding requires medical referral

A

TRUE

Includes women who have experienced surgical menopause (oophorectomy for ovarian cancer) or postmenopausal women not taking hormone replacements

89
Q

What are red flags to consider when screening for systemic or viscerogenic causes of neuromuscular and musculoskeletal S&S?

A

FEVER, (NIGHT) SWEATS, DIZZINESS

SYMPTOMS OUT OF PROPORTION TO INJURY

INSIDIOUS ONSET

NO POSITION OF COMFORT

90
Q

A 52 year-old man with LBP and sciatica on the left side has been referred to you by his family physician. He has had a disectomy and laminectomy on two separate occasions about 5-7 years ago. No imaging studies have been performed since that time.

What follow-up questions would you want to ask to screen for medical disease?

A

“Did you actually see your physician?”

“Are you having any other symptoms of any kind that you have not mentioned yet” (checking for constitutional symptoms)

91
Q

What physiologic effect associated with risk of HTN should be assessed for patients receiving NSAIDs?

A

WATER RETENTION

Look for sacral and pedal edema

92
Q

How should you proceed with patients with a history of HTN and arthritis?

A

INFORM THEIR PRIMARY CARE PROVIDER OF BOTH CONDITIONS

Also screen for potential adverse effects of NSAIDs and can monitor BP

93
Q

Alcohol screening tools should be…?

A

Brief, easy to administer, and non-threatening

Differential Diagnosis (5 decks)

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