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Med Con II Kelly > Quiz 1/Exam 1 > Flashcards

Quiz 1/Exam 1 Flashcards

1
Q

what happens to the subcutaneous layer as we age

A

As we age we lose the subcut layer, vascular supply is less and there is less nerve endings (skin thins – bc of less nerve endings and elderly person may not feel a wound)
Less protection from cold bc of subcut layer dim as we age

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2
Q

what % of our body is skin

A

15-20

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3
Q

functions of skin

A

Protection from injury or invasion
Insulation
Maintenance of homeostasis (sweating)
Assist in metabolism (Vit D production, aids in waste removal of urea and other waste products)
Attachment of muscles (ex. erector pili and frontalis)
Cutaneous sensation

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4
Q

a flat, circumscribed area that is a change in the color of skin, less than 1 cm in diameter

Examples: freckles, mole/moles (nevus/nevi), measles

A

macule

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5
Q

a flat macule that is greater than 1cm

A

patch

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6
Q

port wine stain is a

A

patch

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7
Q

an elevated mole or a wart is a

A

papule

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8
Q

an elevated, firm, area less than 1 cm in diameter

A

papule

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9
Q

an elevated, firm, rough lesion with a flat top surface greater than 1 cm in diameter

A

plaque

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10
Q

elevated, irregular-shaped area of cutaneous edema; solid, transient; variable diameter
Examples: insect bite, allergic reaction

A

wheal

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11
Q

elevated, firm, circumscribed lesion, deeper in dermis than papule; 1-2 cm
Example: lipoma

A

nodule

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12
Q

elevated, circumscribed, superficial, not into dermis, filled with serous fluid; less than 1 cm in diameter (varicella - chicken pox)

A

vessicle

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13
Q

vesicle greater than 1 cm in diameter (blister),

A

bulla

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14
Q

bursting of a bulla

A

erosion

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15
Q

elevated, superficial lesion; similar to a vesicle but filled with purulent fluid
Example: acne

A

pustule

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16
Q

elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material

A

cyst

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17
Q

Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of the extremity
Example: chronic dermatitis (skin inflammation)

A

lichenefication (atopic dermatitis also is on flexor surfaces)

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18
Q

spider veins are aka

A

Telangiectasi

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19
Q

spider veins can be indicative of

A

liver disease

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20
Q

enlarging scar; grows beyond the boundaries of the wound, usually elevated; caused by excessive collagen formation

A

keloid

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21
Q

elevated, solid lesion; may be clearly demarcated; deeper in dermis; greater than 2 cm in diameter

A

tumor

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22
Q

nevi/nevus is associated with what term

A

macule

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23
Q

Cspine, Tspine, or shoulder px could be

A

cardio, pulmonary or GI condition

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24
Q

inconsistant px sx could be

A

Psychological, Endocrine, Neurologic, Rheumatic disorders, Adverse Drug Reactions

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25
Q

a pt who is having spine px and has a hx of Ca, what should you do

A pt who has px in spine when WB (and has hx of Ca)

A

refer, need to rule out Ca in the spine

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26
Q

age frame for Ca in spine or bone

A

Over 50, Ca is more likely to go to spine

30-50 they are more likely to have px/sx/Ca in long bones

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27
Q

what are main compentencies a primary care PT needs to be able to do

A

Know when to refer- know red flags, know how to rule in or rule out, know drug interactions, ability to read imaging

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28
Q

gallbladder px

A

right upper quadrant

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29
Q

where is visceral px for heart, lung, and diaphragm

A

o Heart- Cervical anterior, jaw, teeth, upper thorax, epigastric, L upper extremity, R shoulder and upper extremity

o Lungs and Bronchi- Ipsilateral thoracic spine, chest wall, cervical (when diaphragm involved)

o Diaphragm (central portion)- Cervical spine

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30
Q

in regards to cspine, which imaging has higher sensitivity and specificity

A

CT scan

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31
Q

skin plaques have a ___ top

A

flat (they are large papules)

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32
Q

most common skin Ca is

A

basal cell carcinoma (softer in appearance)

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33
Q

which type of skin Ca is hyperkeratotic - crusty

A

squamous cell

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34
Q

prognosis for melanoma is based on

A

depth

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35
Q

prognosis for what skin Ca’s are good

A

basal cell

squamous cell

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36
Q

are men or women more likely to have melanoma

A

men

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37
Q

melanoma travels where first

A

lymph and blood

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38
Q

distinguishing from malignant to benign lesions (what are char. of malignant)

A
  • Malignancy: > 6 mm in size
  • Multiple shades, varied pigmentation
  • Irregular, blurred borders
  • Asymmetric
  • Often bleed or ulcerate
  • Firm to hard consistency
  • Slow or rapid rate of growth or change
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39
Q

where are basal and squamous cells typically located

A

back of hands, neck, face, ears

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40
Q

risk factors melanoma for men (# of moles)

A

17 or more moles increases risk for men they have 4.6 x risk for melanoma, 50% of melanoma dev in existing moles

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41
Q

risk factors melanoma for women (# of moles)

A

12 or more moles , risk is 5.2 x greater

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42
Q

overall risk factors for skin Ca

A 
History ******
Age >50
Regular dermatologist absent
M-mole changing
M-male gender
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43
Q

itching is aka

A

pruritis

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44
Q

visceral px for lungs can be referred to

A

Lungs and Bronchi- Ipsilateral thoracic spine, chest wall, cervical (when diaphragm involved)

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45
Q

the D in the ABCDEs of skin checks is for what specifically

A

diameter over 6 mm

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46
Q

What does the E stand for in the ABCDE’s of skin check

A

elevation or evolution

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47
Q

acne is a

A

pustule

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48
Q

a wart is a

A

papule

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49
Q

elevated, irregular-shaped area of cutaneous edema; solid, variable diameter

A

wheal

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50
Q

bulla can be due to

A

sunburn

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51
Q

heaped up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size

A

scale

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52
Q

chronic inflammation or chronic dermatitis

A

lichenification

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53
Q

scaly itchy rashes associated with family hx of hayfever or allergies

A

atopic dermatitis-exzema

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54
Q

what would you not use on pts with atopic dermatitis

A

alcohol wipes or gels/lotions

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55
Q

A chronic, relapsing, proliferative skin disorder with an unknown cause (possibly genetic and/or immunological), flare ups asst. with winter and no sunlight

A

psoriasis (immune disorder= genetic)

psoriasis is aggravated by stress or change in homeostasis

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56
Q

Assymetrical pxful joint with noticeable skin lesion = (often the DIP of fingers, toes, and SI jts)

A

psoriatic arthritis (usually unilateral)

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57
Q

how is psoriasis often DX

A

uric acid hematology

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58
Q

pustules that rupture easily and drain a straw-colored fluid that dries to a golden honey-colored crust.

A

impetigo

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59
Q

raynauds is usually 1st sign of

A

sclerederma (tightening -thickened skin causing contractures)

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60
Q

non msk (visceral px) descriptoin

A

Visceral pain is vague and not well localized and is usually described as pressure-like, deep squeezing, dull or diffuse.

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61
Q

vascular px description

A

heaviness
cramping
throbbing
numb

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62
Q

areas of referred pain for heart

A

Cervical anterior, jaw, teeth, upper thorax, epigastric, L upper extremity, R shoulder and upper extremity

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63
Q

of the 3 main types of skin cancer, list in order from superficial to deep the layers they go to

A

squamous - epi
basal cell-half way through dermis
melanoma - all way through dermis into blood and lymph

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64
Q

main blood/nerve location layer of skin

A

dermis (subcu has blood supply also epidermis has no blood supply on it’s own)

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65
Q

size of vessicles

A

less than 1cm

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66
Q

elevated, superficial, not into dermis, filled with serous fluid; less than 1 cm in diameter

A

vessicle

elevated, superficial, serous, small

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67
Q

skin issue that creates an elevated, hard, 1-2 cm deep bump

A

nodule

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68
Q

size of bullas

A

bullas are big

greater than 1cm

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69
Q

3 triage categories of pt condition

A

minimal
serious - (broken into urgent, immediate and delayed)
expectant

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70
Q

typically, if motion causes the px you can expect the issue to be related to

A

MSK

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71
Q

which type of triage is “requiring additional treatment before other needs or categories of patients attended to”

A

serious

medical trumps PT services

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72
Q

which type of triage is “can attend to other needs as well as treat primary condition (can attend to them later – maybe see PCP within a month or so)”

A

minimal

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73
Q

which type of triage is, “efforts are futile to tx”

A

expectant

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74
Q

PA’s have prescription authority but practice under

A

physicians

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75
Q

what are some key competencies she mentioned for a direct access PT to have

A 
Know when to refer (diff dx)
know red flags, know how to rule in or rule out
know drug interactions
ability to read imaging
prevention care
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76
Q

if a pt has hx of Ca and px in spine that is difficult to determine a cause…you

A

refer out

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77
Q

px in upper right quadrant is

A

gallbladder

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78
Q

px in LOWER right quadrant is

A

appendix

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79
Q

what is sensitivity

A

if it has high sensitivity it means it is ruling out the condition (if the sensitive test was neg you rule out)

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80
Q

what is specificity

A

if it has high specificity it means you are ruling in the condition (if specific test is pos you rule in)

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81
Q

bone scans are highly sensitive, what does this mean

A

if the test is neg, it rules out the condition

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82
Q

if something has very low sensitivity it means

A

if the test is neg, it doesn’t do a very good job at ruling out the condition

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83
Q

if something has high specificity it means

A

if the test is pos, it does a good job at ruling IN the condition

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84
Q

if something has LOW specificity it means

A

if the test is pos, it DOESNT do a good job at ruling IN

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85
Q

what is likelyhood ratio

A

Combines sensitivity and specificity
Gives probability before and after test result
Positive LR = increase in odds for the condition to be present
Negative LR = decreases odds for the condition to be present

LR of 1 = test neither proves nor disproves the condition

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86
Q

glucose below ___ you don’t touch them

A

60

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87
Q

what is macrocytic anemia

A

it when their red blood cell distribution is high (they have very large RBC, but there isn’t enough of them)
often associated with alcoholism

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88
Q

BBS ratings that indicate high risk of falls

A

BBS scores of 31 to 45 correlated with significantly higher rates of falls.

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89
Q

symbiosis vs pathogenic infection

A

symbiosis is good (microflora in gut)

pathogenic is bad - like strep

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90
Q

differentiate Ca sx and infection sx in regards to lymph nodes

A

in Ca pts, they get swollen but don’t hurt

in an infection they are swollen and pxful

91
Q

Confusion
Tachycardia
Hypotension

where do these infection sx come in to play

A

typically immunosuppressed or elderly pts

92
Q

chain of infection transmission

A 
existing pathogen
reservoir (anything)
portal of exit
transmission type
host
portal of entry
93
Q

bacteriocidal vs bacteriostatic

A

Bacteriocidal: will kill invading organisms (everything dies)
Bacteriostatic: will inhibit bacterial growth without killing organisms (ex: soaps)

94
Q

chemotherapeautic aka

A

antibiotic

95
Q

leading cause of infective endocarditis

A

staph

96
Q

most common pathogen causing infection of any age

A

strep

97
Q

what is pseudomonas

A

common infection in hospitals, nursing homes

leads to pneumonia or sepsis in immunocompromised

98
Q

Clostridial Myonecrosis is aka

A

gangrene

needs anaerobic env to thrive

99
Q 
Sudden  sharp pleuritic pain aggravated by movement
Hacking & productive cough 
Rust- or green-colored sputum 
Decreased chest excursion  
Cyanosis
Headache 
Fatigue, fever & chills
Generalized aches
Myalgia of the thighs and calf muscles

all sx of

A

pneumonia

100
Q

sx of walking pneumonia

A

more than 2 weeks

low grade fever

101
Q

long courses of antibiotic
immunocompromised pt
smelly, loose stools

all sx of

A

cdiff

102
Q

how to prevent spread of cdiff

A

only soap and water

hand sanitizer does not prevent

103
Q

types of herpes

A

HSV-1 & 2: Simplex causes lesions on mouth and genitals

HSV-3: Zoster is associated with chickenpox and shingles

HSV-4: Mononucleosis (“kissing disease”)

HSV-5: Cytomegalovirus

104
Q

2 manifestations of varicella zoster

A

primary is chicken pox

secondary is shingles

105
Q

what precautions do you use for someone with chickenpox

A

airborne and contact
Spread by coughing and sneezing-airborn- (highly contagious), by direct contact, and by aerosolization of virus from skin lesions

106
Q

what precautions do you use for someone with shingles

A

contact only

107
Q

if you have shingles and you pass on the virus to someone who has not had chicken pox will they get shingles or cp

A

chicken pox

108
Q

pt has a joint replacement surgery, but px is not getting any better since it was done, but rather it is getting worse….what might you think of

A

infection in the joint

refer out

109
Q

strange neuro sx with a target like rash could be

A

lymes disease

110
Q

precautions for tb, measles and chicken pox

A

airborne

111
Q 
Productive cough > 3 wks
Weight loss
Fever
Night sweats
Fatigue
Malaise
Anorexia
Rales in the lungs

these are all sx of

A

TB

112
Q

In CNS
It will manifest like neural tension stress
They will have swollen pxful lymph nodes, fever, and malaise. Stiff neck

A

bacterial meningitis

113
Q

staph can be prevented by

A

handwashing or sanitizing

114
Q

staph is spread by

A

contact (skin to skin)

115
Q

staph is tx by

A

antibiotics

116
Q

staph appears as a supprative wound, this means

A

pus

117
Q

strep appears both ___ and ___

A

supprative and non supprative

118
Q

Most common type of eczema

A

atopic dermatitis

presents with scaling and itchy rashes

119
Q

Atopic dermatitis is Most common

A

in infants and usually clears by age 36, but is chronic in adults

120
Q

risk factors for atopic dermatitis include

A

○ Family or personal history of allergies, asthma or hay fever

121
Q

irritants for atopic dermatitis

A

cold weather
dry skin
certain foods and products
wool

122
Q

where does atopic dermatitis often present

A

flexor surfaces or face

123
Q

psoriatic arthritis often presents where

A

affecting the fingers, toes, and sacroiliac joints

124
Q

skin turnover is decreased from the normal 26-30 days to 3-4 days with increased T cell lymphocytes, so immature skin cells are building on top of eachother

dermis and epidermis are thick with hyperproliferation

A

psoriasis

125
Q

where does psoriasis usually show up

A

primarily on the scalp, the chest, the elbows, the knees, the groin, skin folds, lower back, and buttocks.

126
Q

psoriasis is chronic, how is it tx

A 
Treatment includes: 
Topical preparations – corticosteroids, synthetic vitamin D, vitamin A analogs (retinol), ointments (petroleum jelly, etc), oatmeal baths, emollients, and open wet dressings to prevent pruritis, tar preparations (for their anti-mitotic effects)
UV light (or sunlight)
Anti-metabolic medication
Immunosuppressants
127
Q

PT implications for herpes

A

not heat or US

128
Q

impetigo is caused by __ or ___

A

strep or staph

found on exposed areas (face, extremeties, neck)

129
Q

tx for impetigo

A

Treatment usually involves systemic or topical antibiotics and gentle debridement of crusts with warm water soaks.

130
Q

phases, not stages, of wound healing

A

Phase 1: Hemostasis - immediate
Phase 2: Inflammatory - should last 3- 7 days (NORMAL)
Phase 3: Proliferation- granulation (wound bed)
Phase 4: Remodeling

131
Q

during remodeling, if there is an imbalance in collagen synthesis and lysis at the cellular level (whether it be overproduction of collagen, too much or too little mvmt, lack of blood flow) what can occur

A

dehisience

without the balance then keloids or holes occur

132
Q

why don’t PTA’s do wound care

A

you have to re-assess every time you tx

133
Q

SWHT

A

sussman wound healing tool (assessment for wounds)

134
Q

PUSH

A

pressure ulcer scale of healing

135
Q

4 main components of an OE for wounds

A

Measurement

Classification

Peri-wound

Wound Bed Assessment

136
Q

when measuring a wound, what is L and W

A

L 12-6 (head to foot)

W 3-9 side to side

137
Q

ways to STAGE/classify tissue loss for NON PRESSURE ULCER wounds

A

partial or full thickness

138
Q

what is partial thickness

A

loss of epidermis and down into but not through the dermis

139
Q

what is full thickness

A

all way through dermis to subq, muscle may be exposed

140
Q

capillary refill Longer than 2-3 seconds can indicate

A

arterial occlusion

141
Q

ABI under ___ indicates arterial disease

A

.9
1 is normal
never compress if .7 or lower

142
Q

what is hypergranulation

A

the tissue overfills the boundaries of the wound

143
Q

what is slough

A

necrotic, non healthy tissue that should be granulated

144
Q

when doing wound bed assessment you look at % escar, % yellow necrotic, what do these mean

A

escar-black

yellow necrotic - any non tendon yellow

145
Q

characteristics of arterial wounds

A

Toes, Dorsal aspect of foot
Lateral malleolus
Tibia

Thin dry skin, absence of hair, shiny, smooth, cool to touch

Pulses: Absent or diminished

146
Q

if px decreases with dependent/dangled legs it’s prob a(n) ____ wound

A

arterial (px increases when blood drained from LE -elevated)

147
Q

if px increases withdependent/dangled legs it’s prob a(n) ___ wound

A

venous

148
Q

dry

“punched out” smooth edges – punched with a circle stamper

erythematous halo – red halo surrounding wound
black/gray necrotic tissue

type of wound

A

arterial

149
Q

locations of venous wounds

A

MEDIAL

medial malleoli

150
Q

characteristics of venous wounds

A

WET
Eschar or slough, yellow fibrous
Moderate to heavy exudate
Irregular wound edges

Surrounding skin is dry and scaly

Pulses present

151
Q

what is usually present with venous wounds

A

Hemosiderin staining – dark stain around the wound – hemoglobin stains the skin

152
Q

4 main contributing factors for decubs

A
  • Pressure
    • Shear
    • Friction
    • Moisture
153
Q

risk factors for decubs

A 
Advanced Age: ability of soft tissue to distribute mechanical load is impaired
Nutrition
Smoking
Low blood pressure
Poor oxygen perfusion
154
Q

explain stages of decubs

A

1 - skin intact but red (does not blanch)
2- (partial thickness loss) shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.
3 - (full thickness loss) Subcutaneous fat may be visible but bone, tendon or muscle are not exposed.
4- bone exposed

unstagable - full thickness in which the base is totally covered by necrosis

155
Q

explain neuropathic pressure ulcers

A

they lack sensation so WB areas are taking on pressure without the pt knowing

callous forms around edges of wound

foot deformities can occur (hammer toe, claw toe, charcot foot)

156
Q

pts should be turned at least ___

A

q 2 hrs

157
Q

Sloughing of skin
Phagocytosis of bacteria
Destruction of pathogens by acid secretions
Digestive enzymes in the gastrointestinal tract
Sneezing or coughing

these are examples of ___ immunity

A

innate

occur every time same way (no memory)

158
Q

which type of immunity is the 1st line of defense

A

innate

159
Q

2 types of acquired immunity

A

active
passive

both develop after invasion by a foreign agent

160
Q

what is active acquired immunity

A

you had direct contact with the antigen and you create antibodies and they have memory of that antigen

161
Q

what is passive acquired immunity

A

mom to baby (temporary)

or injection of antibodies via innoculation

162
Q

List the specific leukocytes responsible aquired immunity

A

2 TYPES OF LYMPHOCYTES

Tcells- Cell-mediated response
Recognizes one antigen
Attacks the antigen directly
Produces: Memory cells, T-cytotoxic (killer) cells,T-helper cells, T-suppressor cells, Lymphokine-producing cells

Bcells-Humoral response
Recognizes one antigen
Produces and secretes ANTIBODIES that attack antigen
Produces memory cells for future responses

163
Q

effect of aging on immunity

A 
decreased acidity in GI tract
shallower breathing =junk stays in lungs
less acidity in urine = UTIs
thymus gets smaller 
decreased responsiveness of Tcell
decreased antibody responsiveness
increased antibody responsiveness to self-cells= autoimmune

poor diet = malformation of WBC

164
Q

where T cells go to mature

A

thymus

165
Q

issue with BP and chronic fatigue syndrome or (SEID)

A

they have ortho HTN and their BPs dont respond to exercise

166
Q

what scale to use with SEID

A

RPE

167
Q

tx for SEID

A

don’t let them do a lot of bed rest
work on gradual endurance/graded exercise and fatigue management

Low to moderate level of intensity (RPE 9-12/20),
3-5 times a week with 5 minute sessions progressing to 40-60 minutes

168
Q

an antigen is anything that

A

TRIGGERS IMMUNE RESPONSE

169
Q

TYPE OF WBCS ASSOCIATED WITH INNATE IMMUNITY

A

Granulocytes: Basophils, Eosinophils, Neutrophils

Monocytes:Macrophages

170
Q

apoptosis ____ with age

A

decreases (ability to self destruct if unable to complete it’s normal job)

but EXERCISE increases healthy apoptosis

171
Q

other aging responses in regards to immunity

A

they don’t run fevers as much to fight off infections

number of lymphocytes does not change, but the configuration of lymphocytes and their reaction to infection does.

duration of antibody response is shorter

after age 70, are more likely to produce autoantibodies, which attack parts of the body itself instead of infections.

172
Q

exercise and immunity

A

strenuous ex =bad

moderate ex =good (decreases stress)

173
Q

in general, what does AIDS do to immunity

A

attaches itself to the T4/CDF cells (the ones that call other cells to initiate the immune response and destroys them)

destructs Tcells
changes Bcells

174
Q

sx of HIV

A 
-Arthralgia
‐ Myalgia
‐ Night sweats
‐ Gastrointestinal problems
‐ Aseptic meningitis
‐ Oral or genital ulcers
175
Q

stages of HIV

A

if CD4 cells are still over 500 it’s asymptomatic

200-500 early sx (infections can make them sick here)

under 200 late sx (more advanced illness) = AIDS no longer HIV

176
Q

pts with HIV are at high risk for what illnesses

A 
pneumonia
thrush
TB
kaposi sarcoma
wasting syndrome
lipodystrophy
177
Q

explain wasting syndrome

A

2 or more loose stools per day
fevers for 30 days
10% loss of body wt

178
Q

explain tx focus for HIV

A

medical -antiretroviral drugs (which have many side effects)

increase CD4 count

179
Q

exercise guidelines for HIV

A

No exercise testing during acute infections

Frequency: 3-4 times a week at 40-60% of VO2

Moderate level of resistance training 8-10 reps.

Time 30-60 minutes per day.

Avoid exhaustive exercise with symptomatic individuals.

180
Q

explain the 3 sub levels of the serious category of triage

A

urgent- have to go now (life threatening)
immediate - need to go soon (hours to a day)
delayed - can be seen by PCP within a week or so

181
Q

high pressure irrigation for wound care starts at ___ PSI

A

8 and over

182
Q

PSI you would never use for wound care

A

over 15 is not good

183
Q

types of debridment

A 
non selective
selective
auto
bio
sharp
enzymatic
184
Q

type of estim best for wound care

A

HVPC

185
Q

contraindications for estim

A

malignancy
electronic implants
osteomyelitis

186
Q

contraindications for US

A

Pregnancy
Over gonads, heart, or eyes
DVT
Malignancies

187
Q

overall, foam pad dressings are used for

A

draining wounds

188
Q

what are standard universal precautions

A

put a barrier btwn yourself and pt fluids at all times for any point of contact

wash/sanitize after every contact always

assume all pts are infectious

189
Q

2 types contact precation type illness most prevelant in acute care

A

cdiff

staph/mrsa

190
Q

contact precautions require

A

gloves, gown, any type of protection from you touching the source

191
Q

droplet precautions require

A

Maintain at least 3 feet between you and patient
Room door may remain open
Wear a mask when working within 3 feet of patient
gloves when working with patient or environment

192
Q

airborne precautions require

A 
door shut
private room
pressure regulation
resp protection
(TB, measles, chicken pox)
193
Q

drug to help tx mrsa

A

vancomyacin

194
Q

what is VRE

A

vanco resistant enterococcus

bad GI issue that immunosuppressed/ill get in hospitals

195
Q

pitting edema scale

A 
1+  = Barely perceptible depression
2+ = Easily identified depression; depression takes up to 15 seconds for tissue to rebound
3+ = Depression takes 15-30 seconds to rebound
4+ = Depression lasts for 30 seconds or more
196
Q

explain how to do ABI

A

The highest ankle SBP divided by the highest brachial SBP

197
Q

never compress if ABI is

A

under .7 (arterial disease present)

never compress arterial insufficiency (venous only)

198
Q

ABI over 1.2 means

A

venous disease, you need to compress (high pressure)

199
Q

which type of heart failure would you NOT use compression with

A

left

200
Q

would you use compression pumps for lymphedema

A

no

201
Q

what must you always do before applying a compression pump

A

take BP

202
Q

Red flags we may need to refer out for

A 
*Fatigue
• Malaise
• Fever, Chills, Sweats (99.5 or higher for 2+ weeks)
• Weight loss, gain (5‐10% body weight)
• Nausea, vomiting
• Dizziness, lightheadedness
• Paresthesia, numbness
• Weakness
• Change in mentation, cognitive abilities
203
Q

some differences btwn MSK and non MSK px

A

MSK -can usually be reproduced, typically has an MOI

non MSK -reproduction usually doesn’t occur, sx are vague and accompany other general complaints. Also, non MSK px will not respond to PT tx.

204
Q

ringworm is aka

A

tinea corporis

they will need to get topical cream

205
Q

narrow vs broad spectrum antibiotic and why would you use one over the other or visa versa

A

narrow- only txs against certain bacteria
broad -effective against many types of bacteria

cultures often take 72 hours, so rather than wait to see specific bacteria you can prescribe broad

however, using broad spectrum too much attributes to our “super bugs” like MRSA bc then only the strong survive

206
Q

what is rule of 9s

A

way to determine extent of burn surface area

use pts palm (which is 1%) and determine % of involvment

207
Q

explain 1st degree burn

A 
superficial
no blister
just red
pxful
good healing on own
208
Q

explain 2nd degree burn

A

superficial partial thickness OR deep partial thickness, erythema, blister, painful, wet, edema, re-epithelializes in 14-20 days

(typically second degree doesn’t have to get grafted, they typically heal on their own)

209
Q

explain 3rd degree burn

A 
will need grafting
full thickness always
brown-leathered
no blisters
no px
210
Q

explain 4th degree burn

A

goes to muscle/tendon/bone

often has to amputate, but if good wound bed they can graft

211
Q

which is more pxful, donor or graft site

A

donor site

212
Q

sheet vs mesh graft

A

sheet is for skin that is exposed (face, hands)

mesh is for large surfaces not exposed

213
Q

with any graft pt has to be immobile for at least

A

5 days

214
Q

donor site area heals by

A

7-10days

215
Q

PT role in acute setting for burn pt

A

Restorative Care (until wound closure)

i) infection control
ii) wound care
iii) skin grafts
iv) pain management/positioning
v) optimize functional recovery and cosmetic outcome

216
Q

PT role in rehab setting burn pt

A

movement!! get that scar moving to full range to prevent contracture

positioning, splinting, ADLs

217
Q

when to proceed with caution or not proceed with ROM for burn pts

A
  • Cellulitis- don’t range with cellulitis
  • Heterotopic ossifications – only perform AROM until surgically removed – don’t be aggressive
  • Escharotomy – continue ROM but without dressings to view any signs of wound stress, no ambulation if on legs
  • Fasciotomy – an incision with a scalpel through eschar down to the fascia, seen in deep injuries such as electrical contact, minimal to NO ROM depending on Dr recommendation
218
Q

what is heterotopic ossifications

A

presence of bone in soft tissue
will have a block in ROM and no improvement
has to be surgically removed
due to repetetive trauma

219
Q

when would you start resistance with burn pts

A

when they are in compression bc they will bleed

220
Q

your saying to understand sens/spec
If the test has ____high/low ____sens/spec

if the test is ____(pos/neg) then it does a ____(good/bad) job of ruling the condition____ (in/out)

A

sens (highly sens if neg it rules out)

spec

221
Q

sx of SEID

A

-Impairment of memory or concentration
‐ Sore throat
‐ Tender lymph nodes
‐ Muscle pain
‐ Multiple arthralgias without swelling or redness
‐ Headaches ‐ new tape, pattern, or severity
‐ Unrefreshing sleep (key component)

222
Q

response will increase in intensity and speed each time pathogen appears

this describes what kind of immunity

A

aquired

223
Q

what RPE do we use for SEID pts

A

9-12/20

224
Q

full thickness always
brown-leathered
no blisters
no px

which degree burn

A

3rd

Med Con II Kelly (2 decks)

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