Intro to Medical Screening Flashcards
1
Q
What is medical screening
A
- medical tests that health care providers use to check for diseases and health conditions before there are any major signs or symptoms
2
Q
Why do we need to know and perform medical screening
A
- to be able to identify signs and symptoms of systemic disease that can mimic neuromuscular or musculoskeletal dysfunction
3
Q
Key factors that create need for medical screening
A
- Side effects of medications
- Comorbidities: depression, chemical dependency, HTN
- Visceral pain mechanisms
- PT role in disease prevention
- Direct access
- signed prescription
- medical specialization
- disease progression
4
Q
Describe primary prevention
A
- stopping the process that lead to the development of disease, illness, & other pathologic health conditions through education, risk factor reduction, & general health promotion
5
Q
Describe secondary prevention
A
- early detection of disease, illness, & other pathologic health conditions through regular screening
6
Q
Describe tertiary prevention
A
- providing ways to limit the degree of disability while improving function in patient/clients with chronic and/or irreversible diseases
7
Q
Describe health promotion and wellness
A
- providing education & support to help patients/clients make choices that will promote health or improve health
8
Q
Examples of contextual barriers when performing a patient interview
A
- illiteracy
- language deficits
- hearing deficits
- anger
- depression
- physical layout (environmental barriers)
9
Q
Examples of effective communication when performing a patient interview
A
- listening
- nonverbal cues
- patience
- repeated hard work
- humility
- clarity
- self criticism
10
Q
Describe a yellow flag versus a red flag
A
- Yellow: a cautionary or warning symptom that signals “slow down” and think about the need for screening
- Red: a warning symptom thought to be associated with a high risk of serious disorders such as infection, inflammation, cancer, or fracture
11
Q
Examples of AHCPR red flags in low back pain
A
- age
- trauma
- immunosuppression
- rest/night pain
- lower extremity neurological deficit
- Hx of cancer
- saddle anesthesia
- bladder dysfunction
- weight loss
- fever, chills, night sweats
- recent infection
12
Q
Pittsburgh knee clinical prediction rules for if a radiograph is required
A
- MOI = fall, blunt trauma AND (one of the following)
- age <12 or >50 y/o OR inability to walk 4 weight bearing steps
- only applies <6 days after injury
13
Q
What are the components of a comprehensive screening model
A
- past medical history
- risk factor assessment
- clinical presentation
- associated signs & symptoms
- review of systems
14
Q
Different colored flags to note during screening
A
- Red: medical
- Orange: psychiatric
- Yellow: psychosocial
- Blue: work perceptions
- Black: work context/policy
15
Q
Red flags clinical presentation
A
- no known cause
- no improvement in PT/worsening
- improvement during PT but then gets worse
- weight loss/gain w/o effort (>10% in 10-21 days)
- cyclical presentation (better/worse/better)
- unrelieved by rest
- Sx out of proportion
- Sx persist
- unable to alter Sx during examination
- no mechanical or neuromuscular pattern
- growing mass
- postmenopausal vaginal bleeding
- bilateral Sx
- change in muscle tone/ROM in pt’s with neurological conditions
16
Q
Rad flags pain pattern
A
- back or shoulder pain (common referral area)
- pain that is not consistent with emotional or psychologic overlay (Waddell’s testing)
- night pain/wakes them up (consistent & intense)
- Sx that are constant & intense
- pain made worse with activity & relieved by rest
- pain described as throbbing (vascular) knife-like, boring, or deep aching
- pain that is poorly localized
- pattern of coming & going like spasms
- pain accompanied by signs & Sx associated with a specific viscera or system
- change in Sx with food intake or medication use
17
Q
Pain patterns
A
- Vascular: throbbing, pounding, pulsing, beating
- Neurogenic: sharp, crushing, pinching, burning/hot/searing, itchy, stinging, pulling, jumping, shooting/electrical, gnawing, pricking
- Musculoskeletal: aching, sore, heavy, hurting, deep, cramping, dull
- Emotional: tiring, miserable, vicious, agonizing, nauseating, frightful, piercing, dreadful, punishing, exhausting, killing, unbearable, annoying, cruel, sickening, torturing
18
Q
Red flags associated signs and symptoms
A
- report of confusion
- constitutional symptoms or unusual vital signs
- proximal muscle weakness with change in DTRs (deep tendon reflexes)
- joint pain with skin rashes or nodules
- clustered signs/Sx of a particular organ system
- unusual menstrual cycle/symptoms
