Red Flags Flashcards

1
Q

red flag

definition

A

info obtained by hx or during exam that suggest might have serious problem OR

problem that may pose serious health issue to the pt causing paralysis or death

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2
Q

VFIRST

A

presenting as spinal pain

V=vascular
F= fracture
I=infection
R=radicular
S=spinal cord/brain
T=tumor

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3
Q

HPI/ROS red flags

A
  1. fever and/or sig weight loss
  2. pain at night/recumbent
  3. morning stiffness
  4. acute localized bone pain
  5. visceral pain
  6. radicular pain
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4
Q

symptoms not injury/activity related

A

-night pain/at rest
-temp over 100.4 for longer than 48 hours
-unexpected weight loss
-constant pain
-pain/weakness/numbness in arms/legs

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5
Q

symptoms injury/activity related

A

-recent trauma or heavy labor
-severe pain
-pain/weak/numb in arms/legs

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6
Q

fever/weight loss

A

significant if 10-15 lbs in a short time/not trying

=tumor or infection
-fever may be spondyloarthropathy

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7
Q

night pain/recumbent

A

neoplasm of the spine
-pain slowly after recumbent = arthritis
-pain at night = cancer

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8
Q

morning stiffness

A

if last for hours = inflammatory arthropathy i.e ankylosing spondylitis

if lasts 1/2 hour = osteoarthritis

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9
Q

acute/localized bone pain

A

if assoc w/ trauma = acute fracture

no trauma = fracture from bone demineralization (osteopenia) or tumor
-granulomatous processes replace bone calcium so fractures
-or bone cell death

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10
Q

visceral pain

A

look for viscero somatic reflexes or referred pain

ex- kidney stones, AAA, gall bladder disease, peptic ulcer, endometriosis

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11
Q

radicular pain

leg

A

leg pain radiate below knee w or w/o weak/numb/tingling from:
-mechanical pressure/inflamm on nerve roots
-along anatomic course of nerve
-disc or bone pathology
-nerve root compression from disc herniations (L4/5 = 5 root or L5/S1 = S1 root)

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12
Q

radicular pain

arm

A

-mechanical pressure/inflammation of cervical roots
-along anatomical course of nerve
-disc or bone pathology

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13
Q

ROS red flags

diagnoses

A

-lymphadenopathy
-dysphagia
-hemoptysis
-hematochezia/melana
-hematemesis
-hematuria
-saddle distribution numbness

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14
Q

ROS red flags

symptoms

A

-bowel/bladder aka urination retention or incontinence
-abdominal pain
-chest pain/jaw pain
-SOB
-visual changes
-headaches

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15
Q

PMH red flags

A

osteoporosis
AAA (abdominal aortic aneurysm)
cancer
prior spinal surgery
rheumatologic disease
genetic abnormalities
ETOH/drug use
under 18 or over 50

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16
Q

PSH red flags

A

AAA repair
coronary bypass/vascular sheets
cancer
organ transplant

17
Q

abnormal vital signs

A

elevated temp, pulse, BP
irregular pulse
unplanned weight loss

18
Q

abnormal physical exam

A

lymphadenopathy
organomegaly
pulsatile abdom mass
abnormal auscultations/percussions
painful palpation/rigidity
reflex/sensory changes
gait
joint instability

19
Q

structural exam

A

-actue pain w/ active or passive motion testing
-spinal crepitus w/ ROM testing
-grossly limited active/passive ROM
-neuro symptoms

20
Q

treatment red flags

A

-fail to subjective improve 2-3 treatments
-fail to objective improve 2-3 treatments
-gradually worsen w/ sound manual treat
-subject complaints not align with noted dysfunctions

21
Q

next steps

A

workup- lab or imaging
specialist
OMM