Red flags Flashcards by Jenna Mowatt

name some red flag pathologies

myelopathy
cervical artery dysfunction (CAD)
malignancy
systemic inflammatory disorders e.g. RA
DVT
infections
Fractures
Cauda equina syndrome

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What is myelopathy?

a term used to describe any neurologic deficit related to the spinal cord

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What is myelopathy usually due to?

compression of the spinal cord

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Where does myelopathy occur?

It is most commonly localised in the cervical spine but it can also occur in the thoracic and lumbar spine

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Name some common symptoms of myelopathy

muscle weakness
altered muscle tones
sensory loss (in trunks and legs) and spasticity
impaired coordination
gait disturbances
spinal pain
urinary disturbances

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What is cervical artery dysfunction?

an umbrella term used to cover a range of vascular pathologies which may lead to cervico-cranial ischaemia

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How does CAD present?

presentations range from pain, through to cranial nerve dysfunctions, blindness, stroke or at worst death

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Name some risk factors of CAD

previous trauma to Cx spine
migraine type headaches
HTN
High cholesterol
cardiac disease/vascular disease
diabetes
blood clotting disorders
anti-coagulant therapy
long term use of steroids
history of smoking
recent infection
immediately post-partum
absence of plausible mechanical explanation of symptoms

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When does cancer occur?

when normal cells change such that they divide and grow in an uncontrolled way, forming malignant tumours

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What is local spread?

When cancer cells spread to nearby area by pushing their way into healthy parts of the body and potentially damaging them

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what are secondary tumours also known as?

metastases

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What happens if metastatic spinal cord compression is not caught early?

It can lead to permanent paralysis from the level of the compression

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What patients does MSCC most commonly occur in?

Patients with lung, breast or prostate cancer, lymphoma and multiple myeloma

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Where is the most common site of MSCC?

thoracic spine followed by lumbosacral spine

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What are the general signs and symptoms of MSCC?

Non mechanical pain
constant night pain
unexplained weight loss
general fatigue or feeling unwell
previous history of cancer
night sweats
unusual lumps/bumps/swelling

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What does DVT stand for?

deep vein thrombosis

What is DVT?

a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis

Name some symptoms of DVT

pain
swelling
redness
enlarged veins in the affected area

What is inflammation?

a biological response to stimuli interpreted by the body to have a potentially harmful affect

What is an inflammatory disorder?

where the immune system mistakenly attacks your bodys own cells or tissues

What can inflammatory disorders result in?

chronic pain
redness
swelling
stiffness
damage to otherwise healthy body tissues

What is rheumatoid arthritis?

Systemic autoimmune disease characterised by inflammatory arthritis with extra-articular involvement

What happens with RA?

synovium is infiltrated by immune cells
fibroblasts and inflammatory cells lead to osteoclast generation resulting in bone erosion and loss of joint integrity

Name some risk factors of RA

genetic factors
smoking
air pollution
obesity
low vitamin D

Name some commonly affected joints for RA

elbow shoulder hip knee ankle MTP

How can RA be managed?

Goal of treatment is symptom management pharmacological management - disease modifying anti-rheumatic drugs Nutrition physiotherpay

When does an infection occur?

an infection occurs when a foreign organism enters the body or multiplies in a harmful way

What are some risk factors for infections?

taking steroids or other medications that supress your immune system, such as anti-rejection drugs for a transplanted organ HIV or AIDS having a certain type of cancer or other disorders that affect your immune system open surgery poor nutrition stress lack of sleep

What do the signs and symptoms of an infection depend on?

the type of disease

Name some signs of infection

fatigue loss of appetite weight loss fevers night sweats chills aches and pains swelling pus formation increased temperature

Name some risk factors for fractures

age and gender smoking diabetes alcohol RA Trauma steroid use other systemic diseases

What is RED-S?

Relative energy deficiency in sport is a syndrome in which disordered eating (or low energy availability) and decreased bone mineral density (osteoporosis and osteopenia) are present

What is RED-S caused by?

eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competition when they have an extremely lean body type

Name some signs and symptoms of RED-S

dull pain along the bone which can increase with activity potential mild swelling around the affected area tenderness around the affected area

How can RED-S be managed?

treatment is often multidisciplinary requiring a general practitioner, a dietician and a physiotherapist for stress fracture in addition there is a potential for a sports psychologist to be required if RED-S syndrome is the primary factor for the stress fracture

What is the cauda equina?

the spinal cord usually terminates terminates between the L1 and L2 vertebra forming the conus medullas, emerging from this bundle of lumbar and sacral roots called the cauda equina

What does the nerves of the cauda equina serve?

sphincter muscle sexual function perineal sensation sensation motor functions throughout the lower limbs

What are some red flag signs and symptoms for cauda equina?

saddle anaesthesia back pain bladder dysfunctions bowel dysfunction

What are the causes of cauda equina syndrome?

herniated lumbar intervertebral disc epidural abscess spinal epidural hematoma diskitis tumor trauma