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ClinMed > Lecture 1: systems review > Flashcards

Lecture 1: systems review Flashcards

1
Q

what should you look for in terms of red flags and signs and symptoms of other underlying issues

A

look for combos

few are informative on their own

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2
Q

what are the constitutional symptoms or general health components that require a systems review (x9)

A

Fever/sweats/chill (prolonged; >102 may require hospital)
weight changes (i.e. more than 5% or unexplained)
N&V
dizzy/lightheaded
prolonged/limiting fatigue
limiting weakness
paresthesias/numbness
ill feeling
mentation/cognitive changes

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3
Q

what are some more subtle/atypical symptoms in the older adults that may be more subtle and atypical

A

mentation changes
subnormal temp
bradycardia/tachycardia
tachypnea (excessive respiration)
fatigue
lethargy
decreased appetite

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4
Q

abnormal lymph node signs

A

> 2cm
firm
immobile
tender

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5
Q

what might you palpate in an infection systems review

A

lymph nodes
heat
swelling
possible abdominal quadrant assessment

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6
Q

some symptoms common to auto immune conditions

A

GI pain/dysfunction
inflammation
myalgia/arthalgia
skin/weight changes
swollen lymph nodes (tender with acuity; non-tender if chronic)
fatigue
fever
typically affects more than one part of the body
emotional changes

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7
Q

cancer symptoms

A

history of cancer
pain- local/referred
N&V
loss of appetite
unexplained weight loss
fever/chills/sweats (night)
swollen non tender lymph nodes
fatigue
secondary infections due to low immunity

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8
Q

why might cancer patients have a fever in the absence of an infection

A

increased circulating WBC or production of pyrogen agent

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9
Q

why might cancer patients lymph nodes be not tender

A

due to limited inflammation with typical slow growth of most cancer

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10
Q

functions of integumentary system

A

protect underlying structures
insulator
regulates temp
assist fluid balance
synthesis of vitamin D
sensory detection of stimuli

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11
Q

itchy/dry/rough texture of skin indicates what

A

impaired circulation/oxygenation
associated with conditions like diabetes

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12
Q

hives or rash indicate

A

possible allergic reaction or systemic disease

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13
Q

callus indicates

A

excess friction

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14
Q

blisters indicate

A

increased friction

may indicate systemic condition

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15
Q

edema indicates

A

locally = possible inflammation, infection, or allergic reaction

generalized = likely systemic condition

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16
Q

what are the ABCDEs of melanoma

A

asymmetry
border - not well defined or regular
color - multiple shade
diameter- larger than a pencil eraser
evolution - change over time

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17
Q

what is a cafe au lait

A

may indicate underlying genetic condition
mostly benign but a concern if there are multiple spots

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18
Q

what conditions might abnormal hair indicate

A

a patch (especially on spine) may indicate underlying genetic condition

a bare patch may indicate impaired circulation

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19
Q

cyanosis discoloration of skin may indicate

A

impaired circulation/oxygenation

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20
Q

redness or red streaks on skin may indicate

A

acute inflammation, stage 1 pressure ulcer, infection, or allergic reaction

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21
Q

varicose veins indicate what

A

venous congestion

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22
Q

functions of endocrine system

A

differentiation of reproductive and nervous systems in fetus

stimulates growth/development

coordination of reproductive systems

maintains optimal internal environment/homeostasis

initiation of corrective and adaptive responses in emergency situations

23
Q

where does the endocrine system meet the nervous system

A

at hypothalamus-pituitary interface

24
Q

function of the hypothalamus in regards to the endocrine system

A

main integrative center of endocrine and autonomic nervous system functions by hormonal and neural pathways

25
Q

how might an endocrine system initially present

A

with a MSK problem that regresses in response to hormonal changes or is not progressing

26
Q

what are some MSK conditions that may be associated with endocrine problems

A

rheumatoid arthritis
osteoarthritis (particularly hands and spine)
adhesive capsulitis
bilateral carpal tunnel syndrome
osteoporosis

27
Q

persistent MSK symptoms that may indicate endocrine issues

A

muscle weakness/atrophy /pain
fatigue
stiffness
joint P!

28
Q

systemic symptoms of endocrine issues

A

growth alterations
excessive thirst - polydipsia
excessive urination - polyuria
heart palpitations
increased perspiration
deep, rapid breathing
fluid imbalance

changes in:
mention
hair quality/distribution
skin pigmentation
body fat distribution
elevated vital signs

29
Q

why is there possible pain in the upper extremity with cardiovascular issues

A

shared C4-T4 innervation

UE pain is in ulnar nerve distribution medially into little finger

30
Q

what are the peripheral vascular signs and symptoms that indicate a cardiovascular issue

A

LE edema including weight gain indicates impaired R ventricle

P! in LE due to claudication, particularly with activity and area may lose color or become Cold

diminished pulses

31
Q

what are the standard vital signs

A

temp
HR
BP
respiratory rate

32
Q

what are the components of a cardiovascular review

A

Hx and observation
standard vital signs
ankle-brachial index (ABI)

33
Q

what is the ankle-brachial index

A

pt. in supine 5-10 min

ABI = LE systolic BP/UE systolic BP

greater than or equal to 0.9 can be used for prediction of a CV event

34
Q

lymph system develops from what

A

embryologically from venous system

35
Q

functions of lymphatic system

A

moves fluid form periphery to central circulation

lymph fluid returns to R side fo the hear via subclavian veins

absorbs macromolecules like proteins and fatty acids

fluid balance

immunity

remove cellular debris and waste

36
Q

symptoms of lymphatic problems

A

pain in local area

full/heavy and or tight sensation (particularly with clothing/jewelry)

impaired ROM

paresthesias/numbness

increased extremity size

weight gain

swollen lymph nodes

37
Q

advanced cases of lymphatic issues may include what addition to symptoms

A

skin breakdowns/wounds from swelling

infection signs and symptoms

head/neck edema that interferes with speech, swallowing, and breathing

38
Q

lymphatic review consists of

A

Hx/observatin

ROM

girth measurement

palpation of lymph nodes

temp

39
Q

signs and symptoms of respiratory issues

A

P! IN NECK/UPPER SHOULDER

thorax P! (shared T2-4 innervation)
cyanosis
digital clubbing
SOB, wheezing, altered breathing pattern
cough
dercreased breath sounds
possible pleura rub of lung and rib connective tissue during respiration
hyper resonance with percussion

40
Q

respiratory review consists of

A

Hx and observation
standard vitals
breath sounds with stethoscope or auscultations
percussions

41
Q

how does the GI tract contribute to protection

A

all major categories of immune cells are in gut
70-80% of immune cells in gut

42
Q

signs of a GI issue

A

pain in neck, trunk, pelvic, and/or shoulder region (due to multiple levels of shared innervation)

dysphagia (swallowing difficulties)

N&V

food aversion/intolerances

indigestion or heart burn

full feeling

43
Q

GI review consists of

A

Hx and observation

abdominal quadrant assessment

44
Q

hepatic system functions

A

assist nearly every body system

GI/endocrine assist
lipid processling and lipoproteins
assist hematologic system with clotting/protien synthesis
assist reproductive system sex hormone metabolism/distribution
houses immune system cells - largest number of phagocytic cells

45
Q

hepatic system signs and symptoms are usually due to what

A

bilirubin increase

46
Q

symptoms of hepatic issues

A

P! in R upper quadrant
GI signs/symptoms
edema
skin changes (i.e. jaundice, spider angioma, palmar erthyema)
dark urine
discolored stool

47
Q

why might there be neurological involvement with hepatic issues? what might the symptoms be?

A

due to increase neurotoxin build up of ammonia/bile

symptoms like confusion, sleep issues, muscle tremors, and asterisks (paresthesias/numbness from ammonia build up and inability to maintain wrist extension with shoulder flexion)

48
Q

what is hepatic osteodystrophy

A

metabolic bone disease due to suppression of bile flow

may manifest as osteoporosis

49
Q

hepatic review consists of

A

Hx and observation
abdominal quadrant assessment
neurological tests

50
Q

components of LMN

A

cranial nerves
anterior gray column of spinal cord
cauda equina
spinal nerves and distal to terminal nerves

51
Q

components of UMN

A

anterior horn of spinal cord
brain and most of spinal cord

52
Q

what is the superficial abdominal reflex

A

light strokes applied in each quadrant around the umbilicus

WNL = umbilicus moves in direction of stroke

hypoactive = decreased/lack of umbilical movement

53
Q

other possible symptoms that may occur with UMN or LMN injuries

A

N&V
dizziness
visual/auditory dysfunction
worst HA ever may be impending stroke

54
Q

neurological review consists of what

A

Hx and observation
neurological tests specific to region

ClinMed (10 decks)

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