Medical Issues Exam #3 Study Guide Flashcards
viral gastroenteritis (stomach flu)
- S/S-Tx
- referral
S/S -diarrhea -nausea -vomiting -abdominal spasms -fever -aches and chills -only lasts up to 48 hours Tx -supportive treatment -attention to hydration -OTC anti-diarrheals and antiemetics -BRAT diet -refer if symptoms persist >48 hours
food poisoning
- S/S
- Tx
- referral
- RTP
S/S -diarrhea -nausea -vomiting -severe abdominal cramping -high fever -lasts longer than 48 hours Tx -OTC meds. -supportive treatment refer if -blood in stool -severe symptoms RTP -symptoms have completely resolved -no fever for 24 hours
traveler’s diarrhea
- S/S
- Tx
- referral
- RTP
S/S -diarrhea -abdominal spasm -fatigue Tx -OTC meds -avoid contamination -supportive treatment refer -blood in stool -symptoms >3 days RTP -symptoms completely resolved
parasitic infections
- S/S
- Tx
- referral
S/S -giardia --significant gas --diarrhea --dull abdominal cramping and bloating -entamoeba --chronic intermittent diarrhea --bloody diarrhea --abdominal pain --weight loss Tx -prompt diagnosis and referral is paramount -physician will determine RTP and Tx guidelines
dyspepsia
- S/S
- Tx
- referral
- DDx
S/S -irritation of the mucosum in the upper GI -common heartburn -indigestion -burning under the sternum Tx -dietary changes -OTC antacids (taken after meals and before bedtime) -separate dosing of antacids with other drugs at least 2 hours Refer -stronger meds. for chronic heartburn -weight loss -abnormal masses in the abdomen -hematochezia -fever DDx -gastroesophageal reflux ulcer
gastroesophagael reflux (GERD)
- S/S
- Tx
- referral
gastroesophageal sphincter malfunctions
S/S
-more frequent and intense than dyspepsia
-heartburn
-chest pain
-belching
-regurgitation of food and acid
-possible
–asthma-like symptoms
–chronic cough and laryngitis
Tx
-changes in lifestyle behaviors (stress, food, etc.)
-PPI and H2 blockers inhibit acid production (taken before a meal)
Refer
-if Sx persists for several weeks or becomes worse
hiatal hernia
- S/S
- Tx
S/S -small HH's = no symptoms -causes GERD -worse when lying down -relieved when sitting up Tx -medication and surgery
peptic ulcer
- S/S
- Tx
intermittent pain in the upper and middle abdomen
pain can radiate to the thoracic spine, chest and neck
eating may make it better or worse
pain at night is common
recurrent vomiting and loss of appetite may cause weight loss
perforated ulcers can cause bloody vomit (hematemesis) or “coffee ground” vomit
Tx
-treat the cause
-avoid irritants
-antacids and antibiotics for H Phlori
-PPIs and H2 blockers help
-scope to make sure no tumors are present
inflammatory bowel diseases
- types
- S/S
- Tx
types -autoimmune disease --Crohn's Disease --Ulcerative Colitis S/S -abdominal pain -chronic diarrhea -hematochezia -weight loss -palpable abdominal mass -loss of appetite -skin rash -intermittent joint pain Tx -no cure -managed --diet --lifestyle changes --medication --surgery
irritable bowel syndrome
- types
- S/S
- Tx
types -diarrhea -constipation -diarrhea alternating with constipation -bloating and generalized abdominal discomfort S/S -complaints of urgency or incomplete evacuation Tx -treat cause --psychosocial events --poor diet --reasonable physical activity -OTC meds no limitations with IBS
appendicitis
-S/S
S/S
- begins as generalized abdominal pain
- pain centralizes to the LRQ in about 12 to 18 hours
- McBurney’s Point
- Jar Sign (rebound tenderness)
- nausea and loss of appetite
- -not relieved with bowel movement
- low grade fever may be present with infection
- patient has an unwillingness to stand straight up
diverticulosis and diverticulitis
- vs.
- S/S
- Tx
diverticulosis -herniations of the mucosa and submucosa through the muscular layer of the intestinal wall -10% of Americans have it diverticulitis -obstruction of the herniation (feces) S/S -diverticulosis is commonly asymptomatic -diverticulitis --severe abdominal cramping --constant pain in LLQ --radiating pain --constipation --diarrhea --fever --rectal bleeding Tx -high fiber diet -light exercise -severe cases --antibiotics --emergency surgery
hemorrhoids
- S/S
- Tx
S/S -blood with defecation -pain and itching, especially during sitting Tx -changes in diet -topical medications -surgery
spleen trauma
-S/S
S/S
- shock
- Kerh’s sign
- -left shoulder
- persistent abdominal pain
- local tenderness in the LUQ
- abdominal rigidity
- nausea and vomiting
liver trauma
-S/S
S/S
- persistent abdominal pain
- RUQ tenderness
- upper GI signs (nausea, vomiting)
hepatitis
- what is it
- transmission
- stages of infection
what is it -inflammation of the liver -viral infection or liver toxicity transmission -A: close personal contact -B-D: body fluids stages -initial: asymptomatic, virus highly communicable -icteric: general S/S --fatigue, loss of appetite, nausea, diarrhea, weight loss, joint pain recovery: >4 months -fatigue is common
cirrhosis
- result of
- what is it
- S/S
- Tx
result of -chronic liver disease and malnutrition produces cellular damage and necrosis S/S -ascites -splenomegaly -central and peripheral neurological signs -GI system S/S Tx -not curable -address the underlying cause
cholelithiasis
gallstones
account for nearly 20% of all hospital admissions among adults
cholecystitis
- S/S of both
- result when
- specific S/S
- -suggest what
gallbladder disease S/S -intermittent RUQ pain that worsens after meals that include fatty foods result when -gallstones block the cystic duct S/S -fever -jaundice -vomiting -RUQ tenderness -referred right shoulder pain all suggest an acute gallbladder attack
pancreatitis
- occurs when
- S/S
occurs when -pancreatic enzymes become active within the pancreas rather than the duodenum, resulting in self-digestion of pancreatic cells S/S -severe peritonitis -sudden and excruciating epigastric and LUQ pain -left shoulder pain -LUQ rigidity -shock -medical emergency
LUQ structures
left lobe of liver spleen stomach body of pancreas left adrenal gland portion of left kidney portions of ascending and transverse colon
RUQ structures
liver gallbladder duodenum head of pancreas right adrenal gland portion of right kidney portions of ascending and transverse colon
LLQ structures
lower pole of left kidney sigmoid colon portion of descending colon bladder ovary uterus (if enlarged) left spermatic cord left ureter
LRQ structures
lower pole of right kidney cecum and appendix portion of ascending colon bladder ovary uterus (if enlarged) right spermatic cord right ureter
difference between solid and hollow organs
BOOK
which organs are
- hollow
- solid
BOOK
ausculation method for bowel sounds
- what are normal findings
- abnormal
- what may abnormal findings indicate
BOOK
explain the process of precussing and palpating the abdomen
BOOK
common S/S associated with metabolic or endocrine disorders
skin changes diaphoresis hyperhydrosis body or breath odor polydipsia and polyuria arthralgia and amalgia muscle atrophy and weakness amenorrhea change in mental status praesthesia edema polyphagia (increased hunger) postural (orthostatic) hypotension lethargy and fatigue no pain
hyperthyroidism
- etiology
- S/S
- Tx
etiology -excess of thyroid hormone -impairs glucose metabolism S/S -core body temperature increases -heart rate response to exercise --greater than normal Tx -medication -radiation -possible removal of gland
hypothyroidism
- etiology
- S/S
- Tx
second most common endocrine disorder etiology -dificiency of T3 an dT4 -decreased cardiac output -decreased O2 and glucose available during exercise S/S -dry skin -myalgia -edema -constipation -slowed cognition -weakness -bilateral paresthesia -bradycardia -poor circulation Tx -thyroid replacement therapy
Graves’ disease
- what is it
- S/S
most common form of hyperthyroidism S/S -tremors -weakness -difficulty swallowing or speaking -fatigue -tics -enlarged thyroid gland (goiter) -heat intolerance -nervousness -sweating -weight loss
heat cramps
- severity
- S/S
- Tx
severity -earliest, least severe heat illness S/S -cramps -particularly in large muscles in the legs and trunk -fatigue -thirst -sweating Tx -removal from heat
heat syncope
- S/S
- Tx
S/S -fainting due to heat -pale skin -decreased HR -elevated body temp Tx -cool person down -remove from heat -elevate legs -check vitals often
heat exhaustion
- S/S
- Tx
S/S -<103 F -profuse sweating -increased HR -increased respiration rate -decreased blood pressure -headache -nausea -fatigue -weakness/dizziness Tx -rapid cooling -dehydration
exertional heat stroke
- S/S
- Tx
S/S
-clammy skin
-BOOK
Tx
exertional hyponatremia
- etiology
- S/S
- Tx
Na levels drop - excessive hydration S/S -similar to heat stroke -nausea -impaired cognition -loss of consciousness -seizures Tx -refer -administer Na
type 1 diabetes -another name -disease type -etiology -S/S -Dx management -long-term health concerns
"juvenile diabetes" autoimmune disease inability to regulate blood glucose S/S -polydipsia -polyuria -polyphagia -weight loss Dx -lab results must be positive on multiple days for a diagnosis commonly diagnosed before 25 management -insulin long-term health concerns -CVD -delayed wound healing -peripheral neuropathy
type 2 diabetes
- etiology
- predictors
- S/S
- complications
etiology -decreased insulin receptor sensitivity -blood glucose remains elevated predictors obesity -family history S/S -polydipsia -polyuria -complications -hyperlipidemia -arteriosclerosis -chronic infection -bone changes
hypoglycemia
- etiology
- level
- S/S
- Tx
low blood glucose levels common with type I diabetes <70 mg/dL S/S sudden onset -hunger -decreased performance -slurred speech -autonomic signs (pallor, diaphoresis, tachycardia, tremors) -confusion -headache -blurred vision -dizziness -fatigue Tx -give them sugar
hyperglycemia
- alternate names
- levels
- S/S
- Tx
names -diabetic coma -ketoacidosis level ->200 mg/dL S/S -gradual onset -thirst -dehydration -loss of consciousness -abdominal pain -fruity odor on breath -lethargy -confusion Tx -remove from activity -insulin
explain steps for using a glucometer
BOOK
explain components of a care plan for a diabetic athlete
blood glucose monitoring guidelines
-frequency of monitoring and pre-exercise exclusion values
insulin therapy guidelines
-type of insulin, dosages and adjustment strategies
list of other medications for glycemic control
guidelines for hypoglycemia recognition and treatment
-prevention, S/S, Tx
-how to use glucagon
guidelines for hyperglycemia recognition and treatment
-prevention, S/S, Tx of hyperglycemia and ketosis
emergency contact info
athletes with diabetes should have a medic alert tag with them at all times
who is part of the diabetic care team
coach
health professionals
-school nurse and administrators (child)
how do diabetic patients respond differently to injury
exaggerated hyperglycemic response to injury
-can lead to infection, poor wound and fracture healing
what other special considerations need to be made when treating a diabetic athlete/patient
BOOK
what are complications of diabetes
cardiovascular -myocardial infarction -stroke -peripheral arterial disease retinopathy nephropathy neuropathy
common S/S associated with renal, genitourinary and gynecological disorders
-what does each S/S potentially indicate
hematuria changes in urinary habits nipple discharge hypertension anemia sexual dysfunction menstrual irregularities pain
what relevant family and personal history questions should be asked
-how do these differ between males and females
BOOK
what are the different methods for performing a urinalysis
best method
-clean catch mid stream
needs to be tested within the hour
catheter can be used - comes with risks
what are abnormal findings of a urinalysis
-what may these indicate
cloudy -contains red or white blood cells, bacteria, fat, mucous, digestive fluids or pus from the bladder or kidney infection odor -foul smelling - UTI -fruity - diabetes, starvation and dehydration specific gravity -1.0005 - 1.0035 PH - normal is 4.5 - 8.0
kidney trauma
- S/S
- Tx
S/S -direct blow to middle/lower back -tenderness ribs 10 - 12 -blood in urine (emergency referral) Tx -treated with meds not surgery
UTIs
- etiology
- S/S
- red flags
- Tx
- need to determine
etiology -bacterial infection -more common in sexually active females S/S -dysuria -increased frequency -scanty flow -back pain red flags -gross hematuria -abnormal vaginal bleeding -fever Tx -urinalysis and referral is often needed -analgesics and antipruretics need to determine cause before treatment (bacterial, fungal, parasite, yeast)
urolithiasis
- alternate name
- etiology
- S/S
- Tx
- decrease chances
kidney stones
etiology
-forms due to excess salt, calcium or uric acid in the kidney filtrate
-when stones get big enough to block urine flow pain begins
-not usually any trauma
S/S
-pain in abdomen and lower back radiating to anterior thigh
-vomiting
-pallor
-tachycardia and signs of shock
Tx
-small stones treated with medication and good hydration to pass
-large stones
–fragmented with light sound or shock
proper diet/hydration decreases chances
prostate disorders, including cancer
- S/S due to
- likelihood
- etiology
- S/S
S/S
-due to chronic or acute inflammation (prostatitis)
likelihood increases with age
etiology
-most commonly due to infection, but cancer and urogenital disease as well
S/S
-dysuria
-increased volume or frequency or urination and nocturia
-dull ache in low back/scrotum
testicular torsion
- etiology
- S/S
- Tx
etiology -spermatic cord twists, compressing veins and arteries to the testicles S/S -nausea and vomiting -abdominal pain -scrotal swelling -tender testicle -elevated bilaterally Tx -manual detorsion is successful 30-70% of the time -6 hours from the onset of pain treatment will result in 80-100% salvage -12+ hours 0% salvage
hydrocele
- etiology
- rate
- S/S
- RTP
etiology -fluid collection along the scrotal sac or along spermatic cord rate -6% of adult men S/S -asymptomatic -possible aching/fullness RTP -not limited if asymptomatic
varicocele
- etiology
- S/S
- RTP
-valves in the veins fail
-veins stretch, get bigger or become swollen
S/S
-feels like a “bag or worms”
-dull ache and heaviness in scrotum
RTP
-no participation risks
cryptochidism
failure of one or both testicles to descend into the scrotum during development
testicular cancer
- S/S
- Tx
- RTP
S/S
-nodule in testicle is palpable
-unilateral testicular swelling
-pain in testicle
-rare occasions - breast tenderness and heaviness and aching in the scrotum
Tx
-removal of testicle and spermatic cord (orchiectomy)
-chemo and/or radiation therapy
RTP
-based on symptoms during treatment and physician orders
-wearing a cup[ is mandatory to protect remaining testicle
gonorrhea
- cause
- S/S
- Tx
- often occurs with
cause -bacteria S/S -men --discomfort in the urethra --moving quickly to dysuria and a purulent, yellow-green urethral discharge -women --less severe --dysuria --frequency of voiding --vaginal discharge Tx -antibiotics often occurs with chlamydia
chlamydia -cause -S/S -red flags Tx
cause -bacteria S/S -urethral discharge -dysuria -fever -meatal itching red flags -infertility -ectopic pregnancy -chronic pelvic pain -epididymitis -male urethral infections Tx -antibiotics (tetracycline) -report to health authority
syphilis
- cause
- S/S
- Tx
cause -bacteria S/S -4 stages --primary stage: infectious ---chancre (sore) at point of contact with infected person ---3-8 weeks --secondary stage ---dermatological presentations, including rash and mucous membrane erosion, CSF abnormalities --latent stage ---reappearance of infectious lesions --late, or tertiary, stage ---symptomatic but not contagious, cardiovascular syphilis marked by aortic insufficiency, coronary stenosis, aortic aneurysm Tx -primary and secondary --full sexual history (partners 3 months primary; 12 months secondary) -antibiotic (penicillin)
genital warts
- cause
- S/S
- Tx
cause -human papillomavirus S/S -genital warts look like common warts -found in warm, moist areas of the body --women: vulva, vaginal walls, cervix, and perineum --men: urethra, penile shaft Tx -removal by electrocauterization, cryotherapy, laser, or surgical excision
herpes
- cause
- S/S
- Tx
cause -virus S/S -mimic the flu -fever, sore throat -lymphadenopathy -malaise -visicles on an erythematous base -early stages are often confused with ringworm, impetigo, acne, and eczema Tx -oral antiviral medications
endometriosis
- etiology
- S/S
- Tx
etiology -when endometrial tissue grows outside of the uterus -between ages of 30-40 S/S -dysmenorrhea -increased discharge volume and menstruation -dysparenunia -dysuria -pain with bowel movements -back pain -leading cause of infertility Tx -hormone and pain therapy (progesterone) -occasionally surgical intervention
ruptured ectopic pregnancy
- etiology
- S/S
- baby…
etiology -when ovum attaches outside uterus, usually in fallopian tube -normal signs of pregnancy -once large enough, tube ruptures causing severe hemorrhaging S/S -low back pain -low quadrant tenderness -vaginal bleeding -syncope -shock babywill die no matter what surgery is to save the mother
what considerations should be made for pregnant athletes
avoid supine positions no heavy weight lifting discourage valsalva maneuver no activities that involve risk of falling avoid contact sports after the 14th week no hot tubs/whirlpools no scuba diving if previous medical condition (diabetes, hypertension, cervical defects) then Dr. will need to decide about physical activity
pelvic inflammatory disorders
- types
- S/S
- complications
- Tx
types -infection of the cervix, uterus, or fallopian tubes -chlamydia and gonorrhea are the most common culprits S/S -abdominal pain -high-grade fever -nausea -abnormal vaginal discharge complications -infertility -ectopic pregnancy -chronic pelvic pain Tx -antibiotics
ovarian cysts
- etiology
- if rupture
etiology -fibrous cysts or fluid filled sacs can form within urogenital system -may cause unusual bleeding or interference with menstrual cycle and estrogen production if rupture -internal hemorrhaging -abdominal pain -peritenosis -shock -sometimes death
explain female athlete triad
- what are three components
- how are they related
- how may this present in active individuals
components
-amenorrhea (any menstrual irregularity)
-disordered eating (overall energy availability)
-osteoporosis
related
-disordered eating and exercise can lead to amenorrhea and osteoporosis
prostate cancer
- S/S
- Tx
- RTP
S/S -no reliable S/S in early prostate cancer -fatigue -weight loss -hematuria -urinary retention -urinary incontinence -back pain Tx -radiation and hormone therapy -radiation to metastasized areas as needed RTP -during treatment is okay if they feel well enough and no significant side effects
