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NPTE lectures > Other systems 2 > Flashcards

Other systems 2 Flashcards

1
Q

How much weight gain is essential for baby’s nourishment with pregnancy?

A

20 - 30 pounds

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2
Q

What are the postural changes with pregnancy?

A

Forward head, kyphosis, increased lordosis,
anterior pelvic tilt

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3
Q

Does postural stress continue after postpartum?

A

Postural stress continues even postpartum due to lifting and
carrying of baby

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4
Q

What are the treatment options for pregnancy?

A

Postural education, stretching of tight muscles and strengthening
of weaker ones, pelvic stabilization exercises, pelvic tilts

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5
Q

How does blood pressure change with pregnancy?

A

Blood pressure is low in first and second trimester and increases
in the last trimester

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6
Q

Why is supine-lying dangerous for pregnancy?

A

Supine-lying can cause compression of inferior vena cava (after
4th month). This declines CO and may cause supine hypotensive
syndrome (No supine lying after 1st trimester)

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7
Q

How does resting HR change with pregnancy?

A

Resting HR increases by 10-20 beats/min.

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8
Q

What is the best sleeping position for pregnancy?

A

Left side-lying is considered the best as it decreases compression
of IVC, maximizes CO, decreases GERD as internal organs are
relaxed and improves maternal and fetal circulation

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9
Q

Which of the following is
LEAST appropriate regarding
physiological changes related to
pregnancy?
A. Blood pressure decreases in first and
second trimester and then increases
in the third trimester.
B. Cardiac output is increased in
pregnancy
C. Resting HR is decreased during
pregnancy
D. Metabolic rate and heat production
increases during pregnancy

A

Resting HR is decreased during
pregnancy

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10
Q

After an uncomplicated vaginal
delivery of her child, patient is seen
again for PT. During the treatment,
the patient begins to report
headache and visual disturbances,
and suddenly develops a seizure.
Which condition is MOST likely seen
in this patient ?
A. Preeclampsia
B. Gestational diabetes
C. Eclampsia
D. Ectopic pregnancy

A

C. Eclampsia

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11
Q

What is preeclampsia?

A

Pregnancy induced acute hypertension after the 20th week of gestation

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12
Q

What increases with preeclampsia?

A

increase in protein in urine, hyperreflexia, edema, headache, sudden weight gain seen

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13
Q

How is preeclampsia diagnosed?

A

A blood pressure reading in excess of 140/90 mm Hg. Second
abnormal blood pressure reading four hours after the first
confirms the diagnosis

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14
Q

Is preeclampsia an emergency?

A

YES!!

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15
Q

What are the contraindications to pregnancy?

A

Hemodynamically significant heart disease
* Restrictive lung disease
* Incompetent cervix: early dilation of the cervix before full term
* Vaginal bleeding, especially second or third trimester
* Placenta previa after 26 weeks gestation: placenta is located on the uterus position in which it may
detach before the baby is delivered
* Preeclampsia or pregnancy-induced hypertension
* Rupture of membranes: loss of amniotic fluid before the onset of labor
* Premature labor: labor beginning before the 37th week of pregnancy
* Maternal type I diabetes
* Severe anemia

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16
Q

A 20-year-old female, after an uncomplicated delivery, has a 3-cm
diastasis recti and weak abdominal muscles. Which of the
following exercises is MOST appropriate for the patient?
A. Sitting on a Swiss ball
B. Head lifts with arms bracing the abdomen
C. Double leg lifts
D. Deep breathing exercises in bridging position

A

B. Head lifts with arms bracing the abdomen

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17
Q
A
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18
Q

What is the head lift treatment for diastasis recti?

A

Patient is in hook-lying position and crosses arms around the
stomach area for support. Have client exhale and lift only the head off the
floor while at the same time, using her hands to gently approximate the
rectus muscles toward midline, then lower the head slowly and relax

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19
Q

What is the head lift with pelvic tilt treatment for diastasis recti?

A

Patient is positioned in hook-lying. Arms are
crossed over the diastasis for support as described in the “head lift”
exercise. Have patient slowly lift only the head off the floor while
approximating the rectus muscles and performing a posterior pelvic tilt,
then slowly lower the head and relax.

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20
Q

With diastasis recti you should perform all abdominal contraction with

A

an exhalation to minimize
intra-abdominal pressure

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21
Q

What is GERD?

A

reflux of gastric content of gastroduodenal contents into the esophagus

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22
Q

What are he symptoms of GERD

A

Heart Burn- 30 minutes AFTER eating and at night
lying down
* Dysphagia
* Sour Taste- from regurgitation of acids
* Hoarseness of voice
* Atypical pain of the head and neck

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23
Q

What is dysphagia?

A

difficulty swallowing

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24
Q

GERD complications

A

aspiration pneumonia, asthma
esophagitis

25
Q

Which of the following guidelines is LEAST appropriate in treating
patients with GERD?
A. Any intervention requiring a supine position should be scheduled
before meals and avoided just after eating
B. Encourage the patient to sleep on right side to prevent nocturnal
reflex
C. Modification of position towards a more upright posture may be
required if symptoms persists during therapy
D. Encourage the patient to sleep on left side to reduce nocturnal
reflex

A

B. Encourage the patient to sleep on right side to prevent nocturnal
reflex

26
Q

GERD treatment

A
  • Maintain upright positions
  • Eat meals at least 3-4 hours before sleep
  • Avoid supine- tends to straighten the esophagus
  • Sleep on left side preventing nocturnal reflex
  • Exercise must be completed 2-3 hours after eating or before
    meals
  • Avoid spicy, chocolate, fatty food, peppermint
  • Drugs
    ̶Antacids
    ̶H2 receptor blockers
    ̶Proton pump inhibitors
27
Q

A 44-year-old male, who consumes excessive amounts of alcohol,
is referred to the PT clinic for knee pain. During treatment, the
patient reports right-side shoulder pain. Which of the following
structures is the MOST likely source of the referred pain?
A. Prostate
B. Appendix
C. Liver
D. Kidney

A

C. Liver

28
Q

Pain referral for mid-back/scapula

A

esophagus, gallbladder, stomach, pancreas

29
Q

Pain referral for the left shoulder

A

heart, diaphragm, spleen, tail of pancreas

30
Q

Pain referral for the right shoulder

A

gallbladder, liver, head of pancreas

31
Q

Pain referral for pelvis/low back/sacrum

A

colon, appendix, pelvic viscera

32
Q

Pancoast tumor (upper lung tumor)

A

pain referred in C8-T2 nerve distribution “mimics TOS”, pain top of shoulder, Ipsilateral shoulder

33
Q

RUQ

A

Good Luck Hot Pack
gallbladder
head of pancreas
peptic ulcer

34
Q

RLQ

A

AC
Appendix
chron’s disease

35
Q

LLQ

A

DUI
diverticulitis
ulcerative colitis
IBS

36
Q

LUQ

A

Dont banana split
diaphragm
tail of pancreas
spleen
stomach

37
Q

A 44-year-old male patient is being evaluated by a PT. The patient
reports referred pain in the left shoulder with diagnosis of a
positive Kehr’s sign. Which of the following is LEAST likely to be a
potential cause of a positive Kehr’s sign and left shoulder pain?
A. Recent laparoscopy
B. Intra-abdominal bleeding
C. Rupture of the spleen
D. Trauma to head of pancreas

A

D. Trauma to head of pancreas

38
Q

A hiatal hernia causes

A

left shoulder pain

39
Q

A femoral hernia causes

A

lateral pelvic wall pain and groin pain

40
Q

An inguinal hernia causes

A

groin pain

41
Q

Umbilical hernia causes

A

pain around the umbilical ring in the mid to lower abdomen

42
Q

A 44-year-old male patient is being evaluated by a physical
therapist. The patient underwent a hernia repair three weeks ago
and should AVOID which of the following activities?
A. Walking at a metabolic equivalent of “4” three weeks after
surgery
B. Stretching of the anterior spinal and hip musculature before
the incision is fully healed
C. Stretching of the posterior spinal and hip musculature before
the incision is fully healed
D. Wall sits performed in an upright positio

A

B. Stretching of the anterior spinal and hip musculature before
the incision is fully healed

43
Q

Cholecystitis

A

blockage or impaction of gallstones in the cystic duct resulting in inflammation of the gallbladder

44
Q

Cholecystitis s&s

A
  • Pain in right upper quadrant, radiating to the right
    scapula
  • Nausea, vomiting, low grade fever
  • Pain increases with ingestion of fatty food
45
Q

Special test for cholecystitis

A

murphy’s sign

46
Q

Gastric stomach ulcer

A

Ulcerative lesions in the stomach caused by chronic
use of NSAIDS, stress, anxiety, H. pylori bacteria

47
Q

What makes pain increase with gastric ulcers

A

with the presence of food due to acid secretion, pain after eating

48
Q

What relieve pain with gastrice ulcers

A

Pain relieved with antacids, medically treating the
H. pylori infection

49
Q

Duodenal ulcers

A

Ulcerative lesions in the duodenum caused mainly by H. pylori infection

50
Q

What increases pain with duodenal ulcers

A

pain increases with absence of food, early mornings and in between meals

51
Q

How is pain relieve with duodenal ulcers

A

Pain relieved by medically treating the H. pylori
infection

52
Q

Pain is burning, cramping in epigastric are can refer to

A

right shoulder

53
Q

Coffee ground emesis and melena (dark) tarry stools are characteristics of

A

peptic ulcer disease

54
Q

Ulcerative colitis

A

only large intestine and rectum
continous
LLQ continuous

55
Q

Chron’s disease

A

anywhere in GI
skip lesions
RLQ

56
Q

IBS

A

Spastic, nervous or irritable colon
* Causes: Emotional stress, anxiety, high fat, lactose
foods
̶Pain is relieved by defecation
̶Sharp cramps in the morning or after eating
̶N/V, bloating, foul breath, diarrhea
̶Symptoms disappear while sleeping
̶Ribbon like stools
* Left lower quadrant pain
* Treatment: Stress reduction, dietary modification,
exercis

57
Q

A patient reports left lower abdominal pain. The patient reports
low back pain accompanied with weight loss, nausea, vomiting,
and has had bloody stool lately. The patient’s pain is MOST likely
due to which diagnosis?
A. Crohn’s disease
B. Ulcerative colitis
C. Appendicitis
D. Acute pancreatitis

A

B. ulcerative colitis

58
Q

Appendicitis

A
  • Inflammation of the vermiform appendix. Progression
    can lead to a swollen/gangrenous appendix
  • If perforated can lead to peritonitis
  • S/S:
    ̶Pain in right lower quadrant, comes in waves
    progressing to steady
    ̶Anorexia, N/V, elevated temperature, leukocytosis,
    fever
    ̶Tender at McBurney’s point, Rovsing’s sign for pain
    migration, Blumberg’s sign for rebound tenderness
  • Immediate medical attention required!
59
Q

A 30-year-old male patient presents with right lower abdominal
pain. The PT performs the “pinch-an-inch,” resulting in a positive
finding. Which condition below is MOSTLY related to the
symptoms described?
A. Appendicitis
B. Diverticulitis
C. Crohn’s disease
D. Irritable bowel syndrome

A

A. Appendicitis

NPTE lectures (8 decks)

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