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Medical Issues in Athletic Training > Medical Issues Exam #3 Study Guide > Flashcards

Medical Issues Exam #3 Study Guide Flashcards

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USMLE® Step 1 flashcards
1
Q

viral gastroenteritis (stomach flu)

  • S/S-Tx
  • referral
A 
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
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2
Q

food poisoning

  • S/S
  • Tx
  • referral
  • RTP
A 
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
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3
Q

traveler’s diarrhea

  • S/S
  • Tx
  • referral
  • RTP
A 
S/S
-diarrhea
-abdominal spasm
-fatigue
Tx
-OTC meds
-avoid contamination
-supportive treatment
refer
-blood in stool
-symptoms >3 days
RTP
-symptoms completely resolved
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4
Q

parasitic infections

  • S/S
  • Tx
  • referral
A 
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
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5
Q

dyspepsia

  • S/S
  • Tx
  • referral
  • DDx
A 
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
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6
Q

gastroesophagael reflux (GERD)

  • S/S
  • Tx
  • referral
A

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

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7
Q

hiatal hernia

  • S/S
  • Tx
A 
S/S
-small HH's = no symptoms
-causes GERD
-worse when lying down
-relieved when sitting up
Tx
-medication and surgery
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8
Q

peptic ulcer

  • S/S
  • Tx
A

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

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9
Q

inflammatory bowel diseases

  • types
  • S/S
  • Tx
A 
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
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10
Q

irritable bowel syndrome

  • types
  • S/S
  • Tx
A 
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
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11
Q

appendicitis

-S/S

A

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
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12
Q

diverticulosis and diverticulitis

  • vs.
  • S/S
  • Tx
A 
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
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13
Q

hemorrhoids

  • S/S
  • Tx
A 
S/S
-blood with defecation
-pain and itching, especially during sitting
Tx
-changes in diet
-topical medications
-surgery
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14
Q

spleen trauma

-S/S

A

S/S

  • shock
  • Kerh’s sign
  • -left shoulder
  • persistent abdominal pain
  • local tenderness in the LUQ
  • abdominal rigidity
  • nausea and vomiting
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15
Q

liver trauma

-S/S

A

S/S

  • persistent abdominal pain
  • RUQ tenderness
  • upper GI signs (nausea, vomiting)
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16
Q

hepatitis

  • what is it
  • transmission
  • stages of infection
A 
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
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17
Q

cirrhosis

  • result of
  • what is it
  • S/S
  • Tx
A 
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
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18
Q

cholelithiasis

A

gallstones

account for nearly 20% of all hospital admissions among adults

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19
Q

cholecystitis

  • S/S of both
  • result when
  • specific S/S
  • -suggest what
A 
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
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20
Q

pancreatitis

  • occurs when
  • S/S
A 
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
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21
Q

LUQ structures

A 
left lobe of liver
spleen
stomach
body of pancreas
left adrenal gland
portion of left kidney
portions of ascending and transverse colon
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22
Q

RUQ structures

A 
liver
gallbladder
duodenum
head of pancreas
right adrenal gland
portion of right kidney
portions of ascending and transverse colon
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23
Q

LLQ structures

A 
lower pole of left kidney
sigmoid colon
portion of descending colon
bladder
ovary
uterus (if enlarged)
left spermatic cord
left ureter
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24
Q

LRQ structures

A 
lower pole of right kidney
cecum and appendix
portion of ascending colon
bladder
ovary
uterus (if enlarged)
right spermatic cord
right ureter
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25
Q

difference between solid and hollow organs

A

BOOK

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26
Q

which organs are

  • hollow
  • solid
A

BOOK

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27
Q

ausculation method for bowel sounds

  • what are normal findings
  • abnormal
  • what may abnormal findings indicate
A

BOOK

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28
Q

explain the process of precussing and palpating the abdomen

A

BOOK

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29
Q

common S/S associated with metabolic or endocrine disorders

A 
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
30
Q

hyperthyroidism

  • etiology
  • S/S
  • Tx
A 
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
31
Q

hypothyroidism

  • etiology
  • S/S
  • Tx
A 
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
32
Q

Graves’ disease

  • what is it
  • S/S
A 
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
33
Q

heat cramps

  • severity
  • S/S
  • Tx
A 
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
34
Q

heat syncope

  • S/S
  • Tx
A 
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
35
Q

heat exhaustion

  • S/S
  • Tx
A 
S/S
-<103 F
-profuse sweating
-increased HR
-increased respiration rate
-decreased blood pressure
-headache
-nausea
-fatigue
-weakness/dizziness
Tx
-rapid cooling
-dehydration
36
Q

exertional heat stroke

  • S/S
  • Tx
A

S/S
-clammy skin
-BOOK
Tx

37
Q

exertional hyponatremia

  • etiology
  • S/S
  • Tx
A 
Na levels drop - excessive hydration
S/S
-similar to heat stroke
-nausea
-impaired cognition
-loss of consciousness
-seizures
Tx
-refer
-administer Na
38
Q 
type 1 diabetes
-another name
-disease type
-etiology
-S/S
-Dx
management
-long-term health concerns
A 
"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
39
Q

type 2 diabetes

  • etiology
  • predictors
  • S/S
  • complications
A 
etiology
-decreased insulin receptor sensitivity
-blood glucose remains elevated
predictors
obesity
-family history
S/S
-polydipsia
-polyuria
-complications
-hyperlipidemia
-arteriosclerosis
-chronic infection
-bone changes
40
Q

hypoglycemia

  • etiology
  • level
  • S/S
  • Tx
A 
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
41
Q

hyperglycemia

  • alternate names
  • levels
  • S/S
  • Tx
A 
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
42
Q

explain steps for using a glucometer

A

BOOK

43
Q

explain components of a care plan for a diabetic athlete

A

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

44
Q

who is part of the diabetic care team

A

coach
health professionals
-school nurse and administrators (child)

45
Q

how do diabetic patients respond differently to injury

A

exaggerated hyperglycemic response to injury

-can lead to infection, poor wound and fracture healing

46
Q

what other special considerations need to be made when treating a diabetic athlete/patient

A

BOOK

47
Q

what are complications of diabetes

A 
cardiovascular
-myocardial infarction
-stroke
-peripheral arterial disease
retinopathy
nephropathy
neuropathy
48
Q

common S/S associated with renal, genitourinary and gynecological disorders
-what does each S/S potentially indicate

A 
hematuria
changes in urinary habits
nipple discharge
hypertension
anemia
sexual dysfunction
menstrual irregularities
pain
49
Q

what relevant family and personal history questions should be asked
-how do these differ between males and females

A

BOOK

50
Q

what are the different methods for performing a urinalysis

A

best method
-clean catch mid stream
needs to be tested within the hour
catheter can be used - comes with risks

51
Q

what are abnormal findings of a urinalysis

-what may these indicate

A 
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
52
Q

kidney trauma

  • S/S
  • Tx
A 
S/S
-direct blow to middle/lower back
-tenderness ribs 10 - 12
-blood in urine (emergency referral)
Tx
-treated with meds not surgery
53
Q

UTIs

  • etiology
  • S/S
  • red flags
  • Tx
  • need to determine
A 
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)
54
Q

urolithiasis

  • alternate name
  • etiology
  • S/S
  • Tx
  • decrease chances
A

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

55
Q

prostate disorders, including cancer

  • S/S due to
  • likelihood
  • etiology
  • S/S
A

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

56
Q

testicular torsion

  • etiology
  • S/S
  • Tx
A 
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
57
Q

hydrocele

  • etiology
  • rate
  • S/S
  • RTP
A 
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
58
Q

varicocele

  • etiology
  • S/S
  • RTP
A

-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

59
Q

cryptochidism

A

failure of one or both testicles to descend into the scrotum during development

60
Q

testicular cancer

  • S/S
  • Tx
  • RTP
A

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

61
Q

gonorrhea

  • cause
  • S/S
  • Tx
  • often occurs with
A 
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
62
Q 
chlamydia
-cause
-S/S
-red flags
Tx
A 
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
63
Q

syphilis

  • cause
  • S/S
  • Tx
A 
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)
64
Q

genital warts

  • cause
  • S/S
  • Tx
A 
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
65
Q

herpes

  • cause
  • S/S
  • Tx
A 
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
66
Q

endometriosis

  • etiology
  • S/S
  • Tx
A 
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
67
Q

ruptured ectopic pregnancy

  • etiology
  • S/S
  • baby…
A 
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
68
Q

what considerations should be made for pregnant athletes

A 
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
69
Q

pelvic inflammatory disorders

  • types
  • S/S
  • complications
  • Tx
A 
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
70
Q

ovarian cysts

  • etiology
  • if rupture
A 
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
71
Q

explain female athlete triad

  • what are three components
  • how are they related
  • how may this present in active individuals
A

components
-amenorrhea (any menstrual irregularity)
-disordered eating (overall energy availability)
-osteoporosis
related
-disordered eating and exercise can lead to amenorrhea and osteoporosis

72
Q

prostate cancer

  • S/S
  • Tx
  • RTP
A 
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

Medical Issues in Athletic Training (26 decks)

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