Lecture 2A Flashcards by Alexander Lee

How much BW loss is signficiant?

5-10% loss unexplained

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When is a fever significant?

99.5 for over 2 weeks

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Dyspnea, Cough, Palpitations, Syncope, Sweats

What system is this?

Cardiovascular or pulmonary

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Edema, Cold Extremities, Skin Discoloration, Open Wounds, Clubbing of nails, Wheezing

What systems is this?

Cardiovascular or pulmonary

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Dyspnea, cough, clubbing of nails, wheezing

what system is this?

Pulmonary

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Exertional Dyspnea, Palpitations, Anginal Pain, Fatigue, Palor, Digital Clubbing, Light Headedness

What system is this?

Hematologic system

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Syncope, Drowsiness, Confusion, Easy bruising/bleeding, Fever/chill, Malaise

What system is this?

Hematologic

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Difficulty swallowing

indigestion

heartburn,

Bowel Dysfunction

What system is this?

GI system

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What does black tarry shiney sticky stool mean?

upper GI bleed

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What does black but not sticky stool mean?

Ingestion of iron/bismuth salts (example: Pepto-bismol)

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What does light gray/pale stool mean

obstructive jaundice

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What does bright blood red stool mean

Lower GI bleeding

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What are different indicators of a urinary problem?

Color

Frequency/urgency/retention

Decreased stream

difficulty initiating stream

incontinence

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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

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Reproductive system symptoms

Urethral/vaginal discomfort

sexual dysfunction

pain during intercourse

Number of pregnancies

menopause

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Numbness/tingling, weakness, tremors, seizures, vision changes, sexual difficulties, hearing problems

What system is this?

Nervous system

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Difficulty swallowing, Urinary incontinence, vomiting w/o nausea, dizziness, recent falls, balance problems

what system is this?

Nervous system

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Fatigue, unexplained weight loss, personality changes, weakness, memory loss, confusion, irritability, anorexia, dysphagia, diarrhea, constipation

what system is this?

Endocrine

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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

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What are symptoms of a integumentary system problem?

Changes in skin, nails, hair

Change in sweating or dryness of skin

Pruritus (itching)

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What is the starting point of checking the psychological system of a patient

General health checklist:

Fatigue, sleep, confusion, concentration, weightloss

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What are the other things to check for the psychological system

Major clinical depression

chemical dependence

abuse

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What kind of pain is this:

Pain fluctuates over 24 hours
Specific motions or activities make it worse

MSK pain

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How would you describe 80% of all adverse drug reactions?

A magnification of what the drug was meant to do therapeutically

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What is the most common cause of joint pain, for which PTs should be primary care providers for?

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