Other Systems Flashcards
how is metabolic syndrome diagnosed?
3 or more are abnormal: (1) Obesity: men > than 40 inches women > 35 inches (waist circumference) (2) Triglycerides >= 150 (3) HDL <40 men <50 women (4) HTN (5) Fasting glucose >= 100
what is Cushing’s Disease caused by? what are some main s/s of the disease?
(1) HIGH levels of ACTH (excess secreted by the pituitary gland) which INCREASES cortisol
(2) weight gain, BIG FACE (like a cushion), buffalo hump (cervical region), HTN, poor wound healing, easy bruising
what is Addison’s Disease caused by? what are some main s/s of the disease?
(1) adrenal insufficiency disease where the adrenal glands produce TOO LITTLE cortisol
(2) weight loss, extreme fatigue, low blood pressure
what is Hashimoto’s Disease caused by? what are some main s/s of the disease?
(1) autoimmune disease where system attacks thyroid and causes HYPOTHYROIDISM
(2) weight GAIN, cold intolerance, excessive fatigue, weakness, hyporeflexia, peripheral neuropathy, dry skin
what is Graves Disease caused by? what are some main s/s of the disease?
(1) causes HYPERTHYROIDISM
(2) weight LOSS, heat intolerance, dyspnea, hyperreflexia, possible Goiter
what does hyperparathyroidism cause? what are some main s/s of the condition?
(1) INCREASED blood calcium levels (and decreased phosphorus); this means less calcium in bones
(2) osteopenia, proximal weakness, HYPERreflexia, fatigue, glove and stocking sensory loss, gout
what does hypoparathyroidism cause? what are some main s/s of the condition?
(1) DECREASED blood calcium (and increased phosphorus)
(2) neck stiffness, muscle cramps, seizures, cardiac arrythmias, parathesia of finger tips and mouth
what causes Type 1 diabetes? what are some main s/s of the condition?
(1) pancreas produces no insulin
(2) weight loss, ketoacidosis, polyuria, polydipsia, blurred vision, dehydration
what causes Type 2 diabetes? what are some main s/s of the condition?
(1) body is resistant to insulin
2) weight loss, polyuria, polydipsia, blurred vision, dehydration (Same as Type 1 except no ketoacidosis
what blood glucose levels are considered hypoglycemic and hyperglycemia?
(1) hypoglycemia: glucose <70
(2) hyperglycemia: glucose >300``
what are some s/s of hypoglycemia?
(1) pallor / sweating
(2) shakiness
(3) unsteady gait
(4) tachycardia
(5) dizziness
(6) excessive hunger
(7) slurred speech, confusion
what are some s/s of hyperglycemia?
(1) weakness
(2) dry mouth
(3) frequent urination
(4) rapid respiration
(5) diminished reflexes, confusion
(6) excessive thirst
(7) fruity odor (breath)
what an A1C level of what indicates an immediate need for insulin therapy?
A1C >10%
what are 3 general exercise recommendations for diabetic patients?
(1) exercise in the morning (avoid hypoglycemia due to insulin fluctuation)
(2) provide carbohydrate snack initially
(3) don’t exercise in extreme heat or cold
what are the 4 types of incontinence? what are causes of each?
(1) stress: leakage during, cough, sneeze, or exertion
(2) urge: involuntary contraction of detrusor muscle with strong desire to void (typically due to infection)
(3) functional: can’t make it to bathroom and wets themselves due to mobility or cognitive deficits
(4) overflow: neurological issue causing disruption of detrusor muscle
what are the 4 types of incontinence? what are the treatments for each condition?
(1) stress: strengthen pelvic floor muscles
(2) urge: treat infections
(3) functional: clear clutter / void schedule
(4) overflow: medication and catheterization
how much weight gain is expected during pregnancy?
20-30 lbs
what positions should be avoided during the 3rd trimester of pregnancy? why?
(1) supine and right side lying
(2) these positions can cause compression of inferior vena cava which decreases CO and can cause hypotensive syndrome
what is the best position for a pregnant woman to sleep?
LEFT side lying; decreases compression of left inferior vena cava and maximizes CO
what position is best for people with GERD to sleep?
LEFT side lying
what is the difference between preeclampsia and eclampsia?
preeclampsia: DURING pregnancy
eclampsia: AFTER delivery
what is preeclampsia? how is it diagnosed? what are some s/s of the condition?
(1) pregnancy induced acute HTN after 20 weeks gestation
(2) a BP reading of greater than 140/90; second measurement is taken 4 hours later and if still elevated the dx is confirmed
(3) hyperreflexia, edema, headache, visual disturbances, sudden weight gain
what do 2cm, 3cm, and 4cm of diastasis recti indicate?
2cm or less is fine
3cm - Treatment
4cm or more needs support (protective phase; condition is severe)
what happens to HR, CO, & BMR during pregnancy?
they ALL increase
do hyperthyroidism and hypothyroidism cause diarrhea or constipation?
(1) HYPERthyroidism: causes diarrhea
(2) HYPOthyrodism: causes constipation
what quadrant is the pancreas located within?
(1) head of the pancreas: RUQ
(2) tail of the pancreas: LUQ
what structures or conditions are located in the RUQ? (3)
(1) peptic ulcers
(2) gallbladder pathology
(3) head of pancreas
what structures or conditions are located in the LUQ? (2)
(1) spleen
(2) tail of pancreas
what structures or conditions are located in the RLQ? (2)
(1) appendix
(2) Crohn’s
what structures or conditions are located in the LLQ? (3)
(1) diverticulitis
(2) ulcerative colitis
(3) IBS
what is Kehr’s sign?
pain in left shoulder referred due to blood or air in abdominal cavity
what is cholecystitis? where does pain refer to?
(1) inflammation of the gallbladder caused by blockage or impaction of gallstones in the cystic duct
(2) RUQ pain that can radiate into the right scapula
what is Murphy’s sign? how is it performed?
(1) special test for acute cholecystitis
2) palpate near the right subcostal margin; have pt. inhale deeply and if pain is present during inspiration it’s (+
what foods should be avoided for patients with GERD? what positions should be avoided?
(1) spicy, chocolate, fatty foods
2) avoid supine position and sleeping on the right side (left side prevents nocturnal reflex
what does coffee ground vomit indicate?
peptic ulcer
what do bloody diarrhea stools indicate?
ulcerative colitis
what do melena tarry (black tarry) stools indicate?
duodenal ulcer
what do white / grey / clay stools indicate?
liver, pancreas or colon disorder
what does red blood in stools indicate?
GI tract bleeding
what quadrant does Crohn’s disease present with pain?
RLQ
what quadrant does Ulcerative Colitis present with pain?
LLQ
where does Ulcerative Colitis occur? what type of lesions does this condition present with? what are some s/s?
(1) large intestine and rectum
(2) continuous lesions
(3) rectal pain, bleeding, LBP, fecal urgency, bloody diarrhea, weight loss
where does Crohn’s disease occur? what type of lesions does this condition present with? what are some s/s?
(1) anywhere in the GI tract
(2) skip lesions
(3) abdominal pain, joint arthritis, weight loss, pain RELIEVED by passing gas
what are the most common causes of IBS? which quadrant will pain be present with this condition?
(1) stress, anxiety, high fat, lactose foods
(2) LLQ
what is punch an inch test?
picking up the skin and dropping it; similar to test for rebound tenderness
where is McBurney’s point? what does it indicate when tenderness is present at this point?
(1) starting at the right ASIS, 1/3 of the distance to the umbilicus
(2) tenderness here indicates appendicitis
what is Rovsing’s sign? what does a positive test indicate?
(1) palpation of the LLQ
(2) pain in the RLQ (opposite side of the body) indicates appendicitis
how is Blumberg’s sign tested? what does it indicate?
(1) rebound tenderness in the RLQ
2) indicates peritonitis (which can occur when an appendix is perforated
should knowledge of results or knowledge of performance be an emphasis during the cognitive phase of learning?
knowledge of results
what is the difference between massed and distributed practice?
(1) Mass: more practice than rest
(2) Distributed: more rest than practice
what is the difference between blocked, serial, and random order? which is the best for improving retention?
(1) blocked: perform same task over and over to understand task (better during cognitive phase)
(2) serial: predictable order (patient knows order)
(3) random: perform various tasks randomly
- Serial and random are better for improving retention
what are continuous and summary feedback? when should each be given?
(1) Continuous: early phases; give feedback throughout task
(2) Summary: later stages; give feedback after task is completed
what is sarcoidosis? how does it present? what drugs are used to manage the condition?
(1) systemic disease of unknown cause; may by genetic, or triggered by infection or toxin
(2) restrictive lung disease, cutaenous issues (most commonly around nose and lips), erythema nodosum, pneumothorax, weight loss, fatigue
(3) corticosteriods to reduce inflammation
what is granulomatosis? how does it present? how can it be differentially diagnosed between sarcoidosis?
(1) granulomatosis affects ear, nose, throat, lungs, and kidneys; blood flow to organs may be reduced.
(2) symptoms: sinus pain, cough, fever, joint aches, blood in urine, and hearing loss
(3) more systems affected than sarcoidosis (including possible hearing loss)
what is the difference between an x-ray and CT scan?
a CT scan is clearer; it’s like a 3D x-ray
would endocarditis or pericarditis cause a possible clot within the heart? why?
(1) endocarditis; endocarditis is inflammation of the endocardium which has direct contact with blood flow; pericarditis isn’t related to blood flow and wouldn’t cause an embolism to form
what is tracheal stimulation and how is it performed?
(1) tracheal stimulation is a way to initiate cough if they can’t on their own
(2) apply quick pressure above the suprasternal notch to elicit a cough reflex
what is the obturator sign? what does it indicate?
(1) hip is flexed to 90 and IR
(2) pain on passive IR indicates appendicitis
what is psoas sign? what does it indicate?
(1) patient lays on left side and PT extended the right thigh
(2) pain with passive extension indicates appendicitis
what is a normal platelet count?
150,000 - 450,000
what are important platelet counts for exercise?
(1) <10,000 - NO THERAPY
(2) 10,000-20,000 - bike or walking (no resistance) with physician approval
(3) >20,000 bike with or without resistance
- The higher from 20,000 the less the restrictions
what are normal WBC levels?
4,800 - 10,800
what are important WBC levels for exercise?
<5,000 with fever: NO EXERCISE
<1,000 NO EXERCISE (AND MASK)
>5,000 regular exercise
what are normal hemoglobin levels for men and women?
Men: 13-18
Women: 12-16
what are important hemoglobin levels for exercise?
> 10 - regular exercise
8-10 - light exercise
<8 - NO EXERCISE
what are normal HCT (hematocrit) levels for men and women?
Men: 37-49%
Women: 36-46%
what are normal INR levels?
0.9 - 1.1
what is the highest level INR should be when on Warfarin?
3.0 max (over 3 is at an increased risk of hemarthrosis)
what are normal fasting glucose levels?
60-110 mg/dl
what are normal A1C levels?
4-6%
what are normal ESR (erythrocyte sedimentation rate) levels for men and women?
Men: 0-15
Women: 0-30
what is the difference between basal cell and squamous cell carcinoma?
squamous cell carcinomas grow much faster than basal cells
what are some contraindications for rehab with cancer patients? (4)
(1) severe nausea / vomiting / diarrhea 24-36 hours prior
(2) acute infection and fever above 100F
(3) chest pain
(4) dizziness, light headedness, confusion, blurred vision, ataxia
what blood condition may chronic kidney disease cause? why?
(1) anemia
2) the body doesn’t produce enough EPO (which stimulates RBC production
