Medical Screening Flashcards
Red Flag Definition
Signs and symptoms associated with a serious medical condition that require immediate medical attention or referral within 0-24 hours
Yellow Flag Definition
Signs and Symptoms associated with a potential serious condition but must attempt to rule in/out with both subjective and objective exam
Medical Screening Questions
Refer to Questionnaire for general medical screening
Potential health problems
For all patients
Unexplained Weight Loss/Gain
Yellow Flags:
Unexplained Weight Loss >5-10% over 4-6 Months (Unexplained)
-Depression, Cancer, GI Disease, Eating Disorder
Unexplained Weight Gain >5-10% over 4-6 Months (Unexplained)
-Depression, Congestive Heart Failure, Liver or Renal Disease, Hypothyroidism
Fever/chills/sweats
Normal: 98.6
Ranges from: 97-99.5
Red Flag concerns:
Exceeds greater than 10-14 days with no MD intervention OR >102 (esp. In post surgery and in elderly)
Temp exceeds range following surgery (infection)
Potential yellow flag concerns
Infection (w/o surgery)
Cancer
Connective Tissue Disorder (Ex: RA)
Special concerns with elderly
Loss of appetite, nausea and/or vomiting
Yellow flag
Adverse medication reactions (NSAIDS)
GI disturbance
Systemic illness
Neuro disorders
Pregnancy
Dizziness/Lightheadedness/Blurred Vision
Red Flag
Sudden onset – CVA
Yellow Flag
Neuro disordrs
-Cannot relieve symptoms or unpredictable
Meds interactions
Cardiac and vascular disorders
Treatable by PT
Symptoms occur only with head motions
Short durations
Pt able to inhibit symptoms with visual fixation
Fatigue
Fatigue
Yellow
Serious fatigue: interferes with ability to carry out daily activities and lasts greater than 2-4 weeks
Psychological conditions (Depresison)
Infection
Cancer
Endocrine disorders
Side effect of meds
Fatigue
Yellow Flag:
Serious fatigue: interferes with ability to carry out daily activities and lasts greater than 2-4 weeks
Psychological conditions (Depresison)
Infection
Cancer
Endocrine disorders
Side effects of meds
Malaise - “Just don’t feel right”
Yellow Flag:
Cancer
Infection
Cardiac Condition
Depression
Paresthesia, numbness or weakness
Red Flag:
Progression of weakness, reflexes or paresthesia
Saddle anesthesia/numbness (perianal region)
Associated with balance/gait disturbances
Potential Concerns
Central cord compression or cauda equina syndrome
Yellow flag:
Glove and stocking distribution
Bilateral symptoms
UE and LE symptoms
Potential Concerns
-Chronic renal failure
-MS
-Diabetes
-Hypothyroidism
Change in congnition
Red Flag
Rapid Change
Progression of changes
Associated with balance/gait disturbances/clumsiness
Immediate Red Flags
-Head Injury/Stroke
-Drug Reactions
-Infections
Yellow Flag
Dementia
During 24-hour period – Night pain worst
Yellow flag
Waking up and unable to return to sleep. Potential concerns:
Infection
Cancers
Non-mechanical nature to pain (systemic)
Not significant
Waking up due to pain but able to return to sleep when changing position
Bowel and bladder dysfunction
Red Flag
Incontinence associated with back and radiating pain
Concern with Cauda equina syndrome
Yellow
Constipation or diarrhea
Change in shape or color of stool
Change in color of urine
Incontinence in elderly
“Leaking” in female patient
Potential concerns
-GI disturbance
-Med interaction
-Pelvic Floor disorders
Dyspnea
Shortness of breath
Red Flags: Acute difficulty or pain with breathing
Sudden onset not explained by activity level
History of recent surgery/immobilization/trauma
Potential Concerns
-Pulmonary embolism
-Collapsed Lung
Yellow Flags:
Associated with visible signs of low oxygen
Related to activity or body position
Potential concerns
-Chronic heart and long disease
Syncope
Fainting
Red Flag
Sudden loss of consciousness followed by spontaneous recovery
Concerns: altered blood flow to the brain
Yellow
Concerns:
-Metabolic and psychogenic origins
-Eating disorders
Risk Factors for suicide
History of suicide attempts
Medical seriousness of previous attempts
Acute suicidal ideation
Severe hopelessness
Attraction to death
Family History of suicide
Acute overuse of alcohol
Loss/separations
Possibility of Cancer?
Non-mechanical pain. Unable to reproduce it.
Items of history that were significant for possible cancer (100% sensitivity if Negative on all 4
Age >50 years old
Previous history of cancer
Unexplained weight loss
Failure to improve with conservative treatment (4-6 Weeks, you may not choose to wait that long before referral.
We are much better at ruling cancer out than ruling it in
Most Specific: Previous history of cancer
Most Sensitive: Failure to relieve symptoms with bed rest
If you think your patient might have Cancer what do you do?
Red Flags
1. Contact another health provider for consultation
2. Refer to urgent care or ER
Provide concerns with the health care provider (SBAR)
Situation: What is the situation?
Background: Clinical background of the patient?
Assessment: What is the problem?
Recommendation: What do you recommend/request be done?
Yellow Flags
Is there an explanation?
Trying new meds
Has the patient mentioned it to a health care provider?
Has it changed or worsened?
History of symptoms
Current episode
Onset how/when
Symptoms better, worse, or the same
Specific tests to perform?
If no immediate concerns, but have some curiosity: How does the patient respond to intervention?
ChLORIDE PA
- Character (patients persception of condition) •
- Location •
- Onset •
- Radiation/Referral •
- Intensity •
- Duration
- Events ○
- Provocative events ○
- Alleviating events
Questions
Function: Loss of ROM, swelling pain
Do you feel stiffness, swelling, pain?
Is you pain in a specific location?
Is there any radiating pain?
Has the pain spread locations?
Activity: ADL, chores, dressing oneself
Any chances in your day to day movement?
Do you have any difficulty getting dress?
Any specific movement that aggrevates your symptoms?
Is there anything that eleviates your pain?
Participation:
How does this effect your work?
How does this effect your hobbies?
