Lecture 2A Flashcards
How much BW loss is signficiant?
5-10% loss unexplained
When is a fever significant?
99.5 for over 2 weeks
Dyspnea, Cough, Palpitations, Syncope, Sweats
What system is this?
Cardiovascular or pulmonary
Edema, Cold Extremities, Skin Discoloration, Open Wounds, Clubbing of nails, Wheezing
What systems is this?
Cardiovascular or pulmonary
Dyspnea, cough, clubbing of nails, wheezing
what system is this?
Pulmonary
Exertional Dyspnea, Palpitations, Anginal Pain, Fatigue, Palor, Digital Clubbing, Light Headedness
What system is this?
Hematologic system
Syncope, Drowsiness, Confusion, Easy bruising/bleeding, Fever/chill, Malaise
What system is this?
Hematologic
Difficulty swallowing
indigestion
heartburn,
Bowel Dysfunction
What system is this?
GI system
What does black tarry shiney sticky stool mean?
upper GI bleed
What does black but not sticky stool mean?
Ingestion of iron/bismuth salts (example: Pepto-bismol)
What does light gray/pale stool mean
obstructive jaundice
What does bright blood red stool mean
Lower GI bleeding
What are different indicators of a urinary problem?
Color
Frequency/urgency/retention
Decreased stream
difficulty initiating stream
incontinence
What does dark urine mean?
Red urine?
Reddish urine?
Dark urine- hepatic or billary obstructive/ rhabdomyolosis
Red (blood) - many disorders
Reddish - blood or ingestion of vegetable dyes or use of some meds
Reproductive system symptoms
Urethral/vaginal discomfort
sexual dysfunction
pain during intercourse
Number of pregnancies
menopause
Numbness/tingling, weakness, tremors, seizures, vision changes, sexual difficulties, hearing problems
What system is this?
Nervous system
Difficulty swallowing, Urinary incontinence, vomiting w/o nausea, dizziness, recent falls, balance problems
what system is this?
Nervous system
Fatigue, unexplained weight loss, personality changes, weakness, memory loss, confusion, irritability, anorexia, dysphagia, diarrhea, constipation
what system is this?
Endocrine
Impotence, intermimittent urine stream, muscle weakness, cramps, stiffness, numbness, foot ulceration, edema, impaired wound healing, temperature intolerance, visual changes, orthostatic hypertension, increased thirst
What system is this?
Endocrine
What are symptoms of a integumentary system problem?
Changes in skin, nails, hair
Change in sweating or dryness of skin
Pruritus (itching)
What is the starting point of checking the psychological system of a patient
General health checklist:
Fatigue, sleep, confusion, concentration, weightloss
What are the other things to check for the psychological system
Major clinical depression
chemical dependence
abuse
What kind of pain is this:
Pain fluctuates over 24 hours
Specific motions or activities make it worse
MSK pain
How would you describe 80% of all adverse drug reactions?
A magnification of what the drug was meant to do therapeutically
What is the most common cause of joint pain, for which PTs should be primary care providers for?
OA
What kind of problem is this?
30+ mins morning stiffness
improvement w/ exercise
no improvement with rest
pain at night
insidious onset
40+ years or older
Inflammatory backpain
What kind of problem fits these symptoms?
Males more than Females: 3:1
Autoimmune problems
40+
Rare
Non-joint conditions (IBS and uveitis)
Pain and stiffness increases with rest
decreases w/ activity
Ankylosing spondylitis
What condition is this?
Common
35-55 y/o
male female ratio 1:1
Potential pain to hip
Pain can vary or decrease with rest
Nonspecific LBP
Classification for RA: 4 or more of these in 1 year:
Morning stiffness 1+ hours
Arthritis of 3+ joints
Arthritis of hands
Symmetric arthritis
Rheumatic Nodules
Serum Rheumatoid factor
Radiographic changes
What condition is this:
Peak onset 20-50
Females more likely
Family history
Auto immune disorders
Symptoms increase w/ rest and intense activity
symptoms decrease w/ short rest and mild activity
Rheumatoid arthritis
what condition is this?
Tenderness at affected joints
severe post-rest stiffness
night pain less evident
symptoms vary from mild to severe
Also Rheumatoid Arthritis
What condition is this:
Onset 15-40
Females more likely, african americans more likely
+ Family History
Caused by infection, UV exposure, or medications
Symptoms increase w/ rest and intense activity
symptoms decrease w/ short rest and mild activity
Tenderness at affected joints
moderate post-rest stiffness
night pain less evident
symptoms vary from mild to severe
SLE
What condition is this?
Peak onset men in 50s, women in 60s, more common in males
+ family history
more likely w/ renal disorders or leukemia, chemotherapy, hypothyroidism, heavy drinking, diuretic use
Increased symptoms w/ weight bearing
decreased pain at night, but pain still there at night
Symptoms are severe
rapid progression
gout
What condition has peak onset in the 2nd and 3rd decade of life w/ arthritis followiing up to 20 years later
it has no gender predilection
causes tenderness at affected joints
psoriatic arthritis
What condition causes Psoriasis, tenderness at joints, moderate post rest stiffness
and symptoms increase w/ rest or intense activity
and decrease with short rest or mild activity
psoriatic arthritis
What condiiton is more common in men, with an acute peak onset in the 3rd decade of life
veneral or dysenteric disease
moderate to severe post-rest stiffness
not a lot of night pain, symptoms can range from mild to severe
Reactive arthritis (reiter’s syndrome)
What condition has an abrupt onset with no gender predilection
causes excruciating pain and severe symptoms with rapid progression
septic arthritis
What condition can be caused by systemic corticosteroid use, DM, infection elsewhere, has night pain, causes severe pain, and presents like gout
increased pain with WB activity
less pain with rest, but pain never goes away
Septic arthritis
What condition is commonly associated with uveitis (inflammation of the eye)
fatigue, weight loss,, maliase
cardiac/pulmonary complications?
anklosing spondylitis
What condition is associated with skin rash (malar rash most common
SLE
what condition is associated with:
Fever, fatigue, malaise, photosensitivity, dyspnea, cough, peripheral neuropathies
SLE
What disease is associated with severe joint pain, fever, malaise, tachycardia?
Gout
What condition is associated with feeling itchy, having joint pain, fever, malaise, fatigue
Psoriatic arthritis
What condition is associated w/ infection-like symptoms w/ joint pain, chills, malaise
septic arthritis
A patient presents with calf/thigh pain, antalgic gait, difficulty walking
Name 4 conditions that cause limb pain that are not typically managed by PTs
Hypothyroidism
Lyme Disease
Polymyalgia Rheumatica
Statin-Induced Myopathy
What could cause dizziness or vertigo in children?
brain tumor
Dizziness vs Vertigo
Vertigo - sensation of spinning
Dizziness - impaired spatial perception and stability
At what rate does dizziness become more common as you get older
10% increase w/ every 5 years in age
What should you be most worried about if a patient presents w/ dizziness?
serious pathological neck conditions must be ruled out
ex: Verterbral Artery Insufficiency
What are the 5 Ds and 3 Ns of Vertebral Artery Insufficency
Drop Attack
Dizziness
Dysphagia
Dysarthria
Diplopia
Nausea
Numbness
Nystagmus
+ Cranial Nerve signs
Vertebral artery insuffiency is an impending marker for what?
an impending CVA
What condition could this be:
Occipital Headache and numbness
severe limitation in neck AROM in all directions
signs of cervical myelopathy
Upper cervical ligamentous instability
What are 5 serious pathological neck conditions?
Vertebral Artery Insufficency
Upper Cervical Ligamentous Instability
Cervical Myelopathy
Neoplasm
Inflammatory or systemic disease
Vertigo definition
Sensation of spinning, caused by asymmetric involvement of vestibular system
what’s more common, peripheral vertigo or central vertigo
Peripheral vertigo
Dysequilibrium definition
Dizziness, unsteadiness and imbalance w/o vertigo
can be caused by degenerative changes
What is presyncope?
Vascular compromise to cerebellum
What are non-specific causes of dizziness
panic/anxiety
Cervicogenic
Who is more affected by headache, men or women?
Women
What is the most common kind of headache
tension headache
What kind of headache can stress/anxiety cause?
tension
note: feels like a band tightening
What are the symptoms of a migraine?
Pounding/Pulsating
Nausea, vomiting, photophobia or phonophobia
severe
what kind of headache has mild to moderate symptoms
occurs due to upper c-spine dysfunction
provoked by neck movements or sustained postures
cervicogenic
note: non-throbbing and non-pulsating
What kind of headache happens atleast every other day for 8 days,
can be due to nasal congestion, rhinorrhea, eyelid edema, sweating, restlessness, ptosis
cluster
What is the most severe kind of headache?
Cluster- Severe or very severe
migrane - severe
Physical symptoms of concussion
Headache
nausea
balance,
dizziness
fatigue
sensitivity to light
numbness
dazed/stunned
emotional symptoms of concussion
irritable
sadness
emotional
nervous
cognitive concussion symptoms
feeling foggy,slow
difficulty remembering and concentrating
forgetful of recent info, conversations
confused about recent events
answers questions slowily
repeats questions
concussion symptoms about sleep
drowsiness
more sleepy than usual
less sleepy than usual
difficult falling asleep
What are the red flags of a head injury
double vision
severe/worsening HA
Seizure/convulsion
deteriorating consciousness
vomiting/agitation/combativeness
How is a concussion diagnosed?
No validated test, the diagnosis is made clinically
Repetitive over use injury sites:
Femoral Neck
Anterior Cortex of tibia
medial malleolus
_____________
_______________
_______________
______________
tarsal navicular
base of 2nd and 5th metatarsal
talus
patella
Repetitive over use injury sites:
tarsal navicular
base of 2nd and 5th metatarsal
talus
patella
__________
__________
___________
Femoral Neck
Anterior Cortex of tibia
medial malleolus
