Other Systems Flashcards
What is HIV/AIDS?
What are the symptoms of HIV?
What are the symptoms of AIDS?
caused by virus that weakens immune system
reduced CD4 helper T cells
HIV symptoms - flu like; fever and chills, night sweats, swollen lymph glands, loss of appettie and wt loss, diarrhea, fatigue, infections
AIDS - infections, malignancies, neruo conditions, deconditioning, anxiety, depression
What is the exs protocol for AIDS patietns?
postpone during acute infections 3-4 days/wk 40-60% intensity 30-60min per day 8-10 reps for resistance avoid exhaustive exs
What is PT management consist of for chronic fatigue syndrome?
reduced activities when fatigue at max
bed rest contraindicated other than for sleep
exs - low intensity, 3-5 days/wk, 5 min progressing to 40-60min
prevent deconditioning
maintain function
What is fibromyalgia?
What is the diagnosis criteria?
widespread pain, fatigue with sleep, memory and mood disturbances
Dx - pain for at least 3 months, 11/18 tender points
What is PT management for fibromyalgia?
aerobic exs - 2-30 min progressing to 30-40, 2x/wk
aquatic
stress reduction
enviro adjustments
What are staph infections?
types?
localised infection via bacterial invasion, entry through skin wound, ulcer, burns
MRSA - patient isolated, use PPE
VRSA
What are the types of hepatitis? How are they transmitted?
A - acute illness, not chronic ; fecal-oral transmission contracted through food/water, person to person
B - mild to severe (may lead to chrnoic liver infection/cirrhosis, necrosis) ; transmitted through blood, body fluids, tisues, blood transfusion, oral or sexual contact, needles
C - acute to chronic ; transmitted a/a
D - rare ; transmitted a/a
What are the phases of hepatitis? Symptoms?
initial phase - low fever, nausea, anorexia, vomiting, fatigue, malaise, HA, abdo pain and tenderness
jaundice phase - fever, jaundice, enlarged liver and tenderness, abatement of earlier symptomes
What is tuberculosis and its symptoms?
airbourne infectious disease; use face mask!
symptoms
Pulmonary - productive cough > 3wks, rales, dyspnea, chest pain, hemoptysis
Systemic - fatigue, fever, chills, night sweats, anorexia, wt loss
What are signs and symptoms of hematological disorders?
easy bruising
spontaneous petachiae
external hematomas
orthostatic changes; drop in systolic >10, pulse and HR increase
What is the etiology of anemia?
decreased hemoglobin levels
decreased RBC production: nutritional deficiency (iron, vit B, folic acid), cell maturation defects, decreased bone marrow stimulation (hypothyroidism), bone marrow failure (leukemia, neoplasm), genetic defect
decreased RBCs: autom=immune hemolysis, sicle cell, enzyme defects, hypersplenism, parasites, chronic disease (RA, TB, Ca)
decreased blood: trauma, wound, bleeding, peptic ulcer, excessive menstruation
What are the symptoms of anemia?
fatigue, weakness, dyspnea, pallor, yellow skin, tachycardia, bleeding of gums, mucous membrane or skin bleeding in absence of trauma, hypoxic damage to liver, kidney, heart failure
What is sickle cell disease? Symptoms?
inherited, autosomal recessive RBC disorder
erythrocytes and hemoglobin are abnormal
symptoms - pain, Ha, dizziness, convulsions, coma, nystagmus, chest pain, coughing, dyspnea, tachypnea
What is PT management for sickle cell?
pain control warmth to soothe, hydro relaxation low-mod exs CONTRA - cold due to vasoconstriction and sickling
What is hemophilia? Symptoms?
Inherited recessive disorder of blood coagulation
symptoms - decreased ROM, stiffening, pain, swelling, tenderness, heat, prickling/tingling
What is PT management of hemophilia?
Acute - RICE, prevent deformity
subacute - factor replacement best before Rx, AAROM progressing to iso and open chain exs, pain mx, contracture mx
RED FLAG - PROM rarely used due to risk of myositis ossifcations
chronic - maintain ROM and aerobic fitness
What are warning signs of cancer?
unusual bleeding lump or thickening area sore that doesnt heal change in bladder/bowel habits persistant cough difficulty swallowing, indeigestion change in size/appearance of skin mole unexplained wt loss night pain
What are the stages of cancer?
0 - carcinoma in situ
1 - localised tumor,
What is PT management of cancer patients?
positioning, prevent deformities skin integrity edema control massage pain control, TENS maintain ROM maintain strength, isometric, isotonic (RED FLAGS - bony mets, OP, low platelet
What are the contraindications to exs for cancer patients?
within 24 hours of intravenous chemo
severe reaction to radiation
acute infection
severe nausea, vomit, diarrhea within 36 hours
unusual fatigue, weakness, recent bone pain
severe dyspnea
chest pain, abnormal HR, high BP
swelling in ankles
dizziness, HA, confusion, blurred vision, ataxia
What are the precautions to exs for cancer patients?
PLT count
What are the signs and symptoms of gastrointenstinal issues?
nausea and vomiting diarrhea constipation anorexia dysphagia heartburn abdo pain GI bleeding
What is GERD? Symptoms/RED FLAGS?
PT intervention?
reflux, heartburn
RED FLAGS - atypical pain in head and neck, chest pain, resp symptoms of wheezing, chronic cough, laryngeal injury, hoarsness
Pt - positional changes, dont do valsalva, lifestyle changes
What is a hiatal hernia?
protrusion of stomach upward through diaphragm
What is gastritis? What is acute and chronic?
inflammation of stomach mucosa
acute - severe burns, aspirin, NSAIDS, corticosteroids, food alergies, infections
chronic - peptic ulcer, infections, cancer, thyroid disease, Addisons
What is peptic ulcer? Symptoms?
ulcer lesions in upper GI that are exposed to acid-pepsin secretions
symptoms - epigastric pain gnawing, burning, cramps, increase pain with change of position, pain relieved with food or antacids, weakness, dizzy, hemorrhage
pain may radiate as back pain, right SH pain
stress and anxiety increase pain
What are symptoms and red flags of malabsorption syndroms (CF, Crohns, celiac, pancreitis..)
symptoms - anorexia, wt loss, abdo bloating, pain, cramps, indigestion, steatorrhea, diarrhea
red flags -
iron deficiecy anemia
vit K deficiency causing easy bruising and bleeding
muscle weakness and fatigue due to lack of protein, iron, folic acid, vit B
bone loss, pain, fracture due to lack of calcium, vit D, phosphate
neuropathy from lack of calcium, vit B and D, magnesium, potassium
muscle spasm from electrolyte and lack of calcium
peripheral edema
What is Crohn’s disease?
What is ulcerative colitis?
What are the symptoms? red flags?
Crohn’s - granulomatous inflammation anywhere in GI, skip lesions present
UC - ulcerative and exudative inflam of large intestine and rectum, no skip lesions, bloody diarrhea, musus, pus
symptoms - abdo pain, frequent diarrhea, fecal urgency, wt loss
red flags - joint pain, skin rashes, referred pain to low back, intestinal obstruction and corticosteroid toxicity, malnutrition
What is irritable bowel syndrome? Symptoms?
increased motility of small and large intestine due to stress and certain foods
symptoms - abdo pain relieved by defecation, constipation, bloating, abdo cramps, flatulence, nausea, anorexia, low back pain
regular physical activity helps
What is diverticulosis and diverticulitis? Symptoms?
diverticulosis - herniation of mucosal layer of colon through muscularis layer; minimal symptoms, rectal bleeding
diverticulitis - inflammation of one or more herias; pain, cramping in lower left quadrant, nausea, vomit, fever, elevated WBCs, back pain
regular exs helps
What is appendicitis? Symptoms? Red flags?
inflammation of vermiform appendix
symptoms - abrupt loacalised pain, increases intensity, rebound tenderness, McBurney’s point, lower right quadrant pain
red flag - WBC >20,000, need surgery
What is peritonitis? Symptoms?
inflammation of peritoneum, serous membrane of lining walls of abdo cavity
symptoms - abdo distension, pain, rebound tenderness, decreased bowel sounds, nausuea, vomit, tachycardia
What are hemorrhoids? Symptoms?
varicosities in lower rectum or anus
symptoms - local irritation, pain, rectal bleeding and itching
What is preeclampsia? Symptoms? Mx?
pregnancy induced, acute hypertension after 24th week
symptoms - hypertension, edema, sudden excessive wt gain, HA, visual disturbances, hyperreflexia
immediate physician referral
What is PT management post C section?
TENS for pain, electrodes parallel to incision
prevent pulmonary complications
gentle abdo exs with pillow over incision
kegals
precautions lifint 4-6 weeks
ambulation
friction massage
What is endometriosis? symptoms?
ectopic growth of function of endometrial tissue outside of uterus
symptoms - pain, dysmenorrhea, dyspareunia, infertility, back pain
What is prostatitis? symptoms?
infection and inflammation of prostate gland
symptoms - urinary frequency, urgency, nocturia, fever chills, malaise, myalgia, pain lower abdo, back, sacrum, groin
What type of UTI’s are there? Symptoms?
Lower UTI in bladder or urethra
symptoms - urinary frequency, burning while urinating, urine cloudy and foul smelling, pain in suprapubic, lower abdo, groin
Upper UTI in kidneys
symptoms - fever, chills, malaise, HA, tenderness over kidneys/low back or costovertebal angle, frequent/burning urination, vomiting
What is renal cystic disease and its symptoms?
cysts along nephron
symptoms - pain, hematuria, hypertension, fever
What are the symptoms of kidney stones?
radiating pain to lower abdo, bladder, perineal
nausea
vomit
skin cool and clammy
What is kidney failure? Red flags?
acute or chronic - loss of kidney function due to infection or obstruction, diabetes, uncontrolled HTN
RED FLAGS dizziness, HA, anxiety, memory loss, inability to concentrate, convulsions, coma HTN, dyspnea, HF peripheral and pulmonary edema neuropathy, cramping, restless legs osteomalacia, OP, bone pain, fracture skin allor, ecchymosis, pruritis, dry anemia decreased endurance, functional losses decreased HR, BP, orthostatic hypertension
What is dialysis? PT contraindications?
process of diffusing blood across semipermeable membrane for removal of toxic substances, maintain fluids, electrolyte and acid-base balance
contraindicated to take BP at shunt site
What are the types of urinary incontinence? What is associated with each? Stress Urge Overflow Functional
Stress - sudden release of urine; laxity of pelvic muscles, physical activity
Urge - inability to delay voiding; detrusor muscle instability
Overflow - continuously leaks secondary to urinary retention; distended bladder or incomplete emptying, anatomical obstruction
Functional - leakage associated with inability to toilet due to impaired cognition, physical function, enviro barriers
What is the function of Insulin?
glucagon?
amylin?
somatostatin?
insulin - allows uptake of glucose from blood
glucagon - stimulates glucose production
amylin - modulates nutrient delivery, suppresses release of glucagon
somatostatin - depress secretion of insulin and glycagon, decreases motility, secretion, absorption of GI
What is metabolic syndrome? Four characteristics for diagnosis?
clustor of factors that increase risk of heart disease, stroke, DM2
high abdo circumference > 40men >35 women
high cholesterol >150 triglycerides, 135-85
high blood sugar fasting >100
What is DM1 and DM2?
DM1 - insulin dependent on injection, pump, inhale insulin secretion deficiency juvenille prone to ketoacidosis
DM2 -
adult onset
insulin resistant
inappropriate glucagon secretion
What are the signs of DM?
increased blood sugar/hyperglycemia sugar in urine increased urination thirst, dry mouth hunger fatigue blurred vision HA unexplained wt loss
What are exs guidelines for DM?
hypoglycemia?
hyperglycemia?
ACSM-
50-80%, RPE 12-16, 3-7days, 20-60min
resistance - 2-3days, 60-80%, 2-3sets, 8-12reps
hypoglycemia
do not exs >70 glucose level
15g carb every hour
avoid exs 2-4 hours post injection
hyperglycemia no exs glucose level 300 eat 2 hours prior hydrate dont exs alone or extreme temps
What are the signs and symptoms of hypoglycemia vs hyperglycemia?
Hypoglycemia most common rapid onset pallor shaky fatigue excessive hunger dizzy fainting PROVIDE SUGAR
Hyperglycemia gradulal onset fruity odor to breath excessive thirst decreased appetite IMMEDIATE MEDICAL ATTENTION
What is BMI? How do you calculate it? What are the ranges?
BMI = wt(kg) / ht squared (cm)
normal 18-24
overwt 25-29
obese >30
morbid >40
What are PT exs and testing guidelines for obesity?
testing -
2-3 METS, leg/arm ergo
exs - 40-60% increasing to 50-70% 5-7 days 30-60min aerobic, circuit, short rests aquatic
What is hypothyroidism? Symptoms? Red flags?
metabolic processes are slowed due to decreased thyroid hormone secretion
symptoms - weight gain, lathargy, dry skin and hair, low blood pressure, constipation, intolerance to cold and goiter, myalgia, proximal muscle weakness
red flags - exs intolerance, weakness, apthy, myalgia, reduced CO
What is hyperthyroidism? Symptoms? Red flags?
metabolic processes accelerated due to enlarged thyroid
symptoms - nervousness, hyperreflexia, tremor, hunger, wt loss, fatigue, heat intolerance, palpiations, tachycardia, diarrhea, Grave’s disease
red flag - exs intolerance, fatigue
What is Addison’s disease? Signs?
decreased production of cortisol and aldosterone from the adreanal insufficiency
signs - increased bronze pigment weakness anorexia, wt loss, dehydration anxiety, depression decreased tolerance to cold intolerance to stress
What is Cushing’s disease? Signs?
chronic, excessive cortisol production
signs - decreased glucose tolerance round moon face obesity decreased sex hormones muscle atrophy edema hypokalema emotional changes
What is anxiety? Symptoms?
fight or flight accompany responses of
increased HR, dyspnea, hyperventilation, dry mouth, GI symptoms, palpiatations
What are red flags of depression?
loss of interest in usual pleasurable outlets poor appetite, wt loss or gain insomnia, hypersomnia, decreased energy agitation, fatigue, irritability worthlessness, guilt, hopelessness impaired concentration suicidal
What are signs of schizophrenia?
disordered thinking, speech, perception
inappropriate of affect
functional disturbances
little insight
Where does the gallbladder, pancreas, small intestine and stomach refer pain to?
mid back and scapular regions
Where does the esophagus refer pain to?
mid back
Where does the diaphragm, liver, or pericardium refer pain?
shoulder
Where does the appendix, colon, pelvic viscera refer pain?
low back, pelvis, sacrum
What is a cystocele? Rectocele? Enterocele? Uterine prolapse? Urethrocele?
cystocele - bladder pushing into vagina
rectocele - rectum pushing into vagina
enterocele - peritoneal sac containing part of small bowel pushes into vagina
uterine prolapse - uterus pushes into vagina
urethrocele - urethra into the vagina
What is associated with
Hypokalemia?
Hyperkalemia?
Hypokalemia
muscle weakness, aches, fatigue, cardiac arrythmias from diarrhea, vomit, metabolic acidosis
Hyperkalemia
weakness, arrythmias from renal fail, kidney disease, metabolic acidosis, diabetic ketoacidosis, sickle cell
What is associated with
Hyponatremia?
Hypernatremia?
Hyponatremia
confusion, signs of increased intracranial pressure, poor coordination from water intoxication
Hypernatremia
circulatory congestion, pulmonary edema, HTN, tachycardia from water deficits
What is associated with
Hypocalcemia?
Hypercalcemia?
Hypocalcemia
muscle cramps, tetany, spasms, irritability from hyperphosphatemia, hypeoparathyroidism, vit D deficiency, alkalosis
Hypercalcemia
confusion, fatigue, increased urination from hyperparathyroidism, tumors, hyperthyroidism
What is associated with
Hypomagnesemia?
Hypermagnesemia?
Hypomagnesemia
hyperirritability, confusion from renal disease, hepatic cirrhosis, pancreitis
Hypermagnesemia
hyporeflexia, confusion, lethargy, weakness from renal fail, diabetic acidosis, hypothyroidism, Addison’s disease
