Red flags Flashcards
What is the challange of diagnosis?
- majority of patients with SELF-LIMITING conditions
- identify more serious potential diagnosis
- faced with a wide range of medical problems in time-limiting encounters
What is a “red flag”?
warning symptom, sign or test result that suggests a potentially serious underlying pathology = further tests and referral
How do red flags vary?
General - direct the clinicians to recognise a serious illness even though the exact disease is not known, e.g. unexplained weight loss
Specific - signal specific illnesses and present in specific anatomical regions, e.g. ground coffee vomiting
What are the techniques for identifying red flags?
1) open qs
2) find exact reason for consultation
3) ANY SYMPTOMS
4) actively search for ‘hidden’ red flags
5) be aware of combinations of symptoms that suggest serious disease
Low back pain
This is where it all started
One of the most common presentations in primary care
1-4% is a fracture
<1% is a cancer
What are some Examples of red flags in low back pain?
Fracture
Prolonged use of corticosteroids
Older age (>70 yrs)
Hx of osteoporosis
Mild trauma > 50yrs with osteoporosis
Significant trauma at any age
Cancer
Age <20yrs or >50yrs
Previous Hx of cancer
Unexplained weight loss
Night pain not relieved by rest
Failure to improve with Tx
Lasts >4-6 weeks
Examples of red flags in low back pain
Cauda equina
Saddle anaesthesia
Bladder/bowel dysfunction
Motor weakness/sensory deficit
Infection
Systemically unwell: fever, chills
Recent bacterial infection
Recent surgery
Immunocompromised
What are yellow flags
signs and symptoms that might lead to ‘red flags’ = serious condition
Belief that pain itself is harmful
Sickness behaviours – extended rest
Social withdrawal/lack of support
Low mood/depression/anxiety
Problems/dissatisfaction at work
Compensation or benefit claims
Overprotective family
No active participation in treatment
6 cases - revise
Lecture red flags slides 11 - 16
