Red Flags Flashcards
progressively declining mental function at any age
degeneration and death of brain neurons
chronic or repeated dizziness occurring other than when standing up
cerebral neuronal hypofunction
increasing confusion in elderly person days, weeks, or months after minor head trauma
chronic subdural hematoma
severe dizziness immediately after standing up
severe orthostatic hypertension
adult or child w/ inattention and/or hyperactivity severely interfering w/ daily function
attention deficit hyperactivity disorder
sudden unconsciousness followed by severe drowsiness in previously healthy adult
seizure
sudden leg weakness and possible unconsciousness in elderly person when turning head
drop attack from vertebrobasilar artery insufficiency
dizziness and slow heartbeat (<60 bpm) that does not increase w/ activity in elderly person
sick sinus syndrome (SSS)
loud snoring, gasping during sleep, excessive daytime sleepiness
sleep apnea
excessive daytime drowsiness and sudden falling asleep in daytime w/o warning
narcolepsy
animal bite of finger w/ subsequent swelling and pain
serious infection of tendon and/or bone (osteomyelitis)
cough w/ bloody sputum in patient w/o obvious respiratory infection
lung cancer
painless, bloody urine in man over 50 (gross hematuria)
urinary tract cancer (usually bladder cancer)
vaginal bleeding years after last menses
uterine cancer
new nipple retraction and/or fixed breast lump in male or female
breast cancer
blueness of lips (peri-oral cyanosis) and nail beds
advanced hypoxia
sudden shortness of breath in the middle of the night, cough, bilateral ankle swelling
paroxysmal nocturnal dyspnea (PND) from congestive heart failure (CHF)
cough w/ severe episodic shortness of breath and expiratory wheezing
moderate to severe chronic asthma
unexplained or poorly explained trauma or failure to thrive in a toddler or young child
child abuse and/or neglect
non-centring of reflected light in one pupil, crossed eye
strabismus
child w/ defective language skills, self-isolating behaviour, repetitive non-useful motions
autism
child w/ sore throat, high fever (>102F), inspiratory stridor, drooling
acute epiglottitis
crying child holding flexed arm against body w/ hand pronated
nursemaid’s elbow (dislocation of elbow)
new onset of constipation and unexplained weight loss in person over 40
carcinoma of colon and rectum
acute bloody diarrhea (>6-8 loose stools/day) and fever >101.5 F
serious enteritis (gastritis if also vomiting)
chronic fatigue w/ shortness of breath and/or chest pain
significant cardiopulmonary disease
chronic fatigue w/ enlarged lymph nodes and/or abdominal mass
primary lymphatic cancer/metastatic cancer
chronic fatigue in patient w/ jaundice and/or enlarged liver
serious liver disease, liver cancer, or mets
chronic fatigue and unintended or unexplained weight loss
cancer
chronic, debilitating fatigue, weakness, muscle pain, sleep disturbance
chronic fatigue syndrome (CFS)
persistence of fever 101.5 F for over two weeks
occult infection, metabolic, or autoimmune disease
fever >103.5 F plus severe sore throat
streptococcal throat infection
fever above 105 F
possible brain damage if not brought down
progressive unilateral loss of hearing and balance
acoustic neuroma (AN)
indigestion, upper abdominal pain, feeling of fullness under diaphragm following a meal
acute gallbladder inflammation (acute cholecystitis)
amenorrhea, anorexia, and athleticism in young women
female athletic triad
pain that progressively worsens over weeks or months
ongoing tissue damage
pain that steadily increases in severity over weeks to months
threat of irreversible damage
progressively worsening pain after surgery
pain red flag post-surgery
increasingly painful area that turns numb
total sensory nerve destruction
worsening of any stable chronically recurring pain
new necrosis or injury
persistently inflamed joint
permanent joint and soft tissue damage
unexplained bone fracture caused by minimal or unidentified trauma
pathological deterioration of bone
severe immediate pain, numbness, weakness, and/or loss of function after trauma
fracture or disruption of vital structure
skin changes persisting many weeks after trauma
complex regional pain syndrome (CPS)
abdominal pain and rigidity of abdominal muscles
irritation of inner lining of abdominal peritoneum from blood and/or pus
upper abdominal (mid-epigastric) pain and vomiting of blood
upper GI hemorrhage from inner lining of stomach and/or esophagus
daily heartburn for many years
chronic esophagitis
severe abdominal pain, better w/ leaning forward, nausea and vomiting
acute pancreatitis
mid-abdominal pain followed by vomiting then pain moving to right lower abdomen
acute appendicitis
sudden lessening of appendicitis symptoms, followed by worsening of pain and fever
“honeymoon” from decreased pressure in appendix, then peritonitis
mid to lower abdominal colicky pain, vomiting, constipation, abdominal distention
bowel obstruction
low back pain w/ progressive leg numbness, tingling, and weakness
compression neuropathy from pressure on lumbar nerve roots (radiculopathy)
back pain w/ insidious onset and progressive, unintentional weight loss
cancer of spine
back pain, progressive bilateral leg weakness and erectile dysfunction in man >40 years old
cauda equina syndrome
severe, localized midline back pain w/ spinal process tenderness to percussion
vertebral compression fracture w/ possible underlying osteoporosis or tumor
chest pressure coming on reliably w/ physical exertion
angina pectoris
sharp chest pain and shortness of breath w/ unilateral or bilateral asymmetric ankle swelling
pulmonary embolus (PE)
sudden, spontaneous, sharp unilateral chest pain, and shortness of breath
pneumothorax
earache, ear drainage, fever, severe tenderness of mastoid process
acute mastoiditis
persistent elbow pain and stiffness after fall on an outstretched hand
fracture of radial head of elbow
elbow swelling and pain w/ diminished radial pulse and/or hand numbness after a fall
supracondylar fracture of the humerus
facial pain over sinuses, fever, purulent drainage from nose continuously for >3 months or recurrently for >6 months
chronic bacterial sinusitis
bunion deformity of great toe displacing adjacent toes
serious hallux valgus deformity with subluxation of adjacent joints
headache, eye pain, blurry or haloed vision, nausea, vomiting
acute closed-angle glaucoma
sudden, cataclysmic headache in a middle-aged hypertensive patient
nontraumatic subarachnoid hemorrhage (NTSAH)
traumatic, progressive, intermittent hip pain on movement and decreased hip range of motion
avascular necrosis of the hip
hip, knee, groin pain w/ limp in obese adolescent with or without trauma, with decreased hip range of motion on exam
slipped capital femoral epiphysis
knee trauma with pain and immediate and severe swelling of the knee
internal derangement of the knee
posterior calf pain reliably occurring after walking a specific distance
intermittent claudication from peripheral artery disease
late teen to early adult w/ focal, persistent shin pain after increasing running distance
stress fracture of tibia
neck pain w/ tingling, numbness, or pain radiating down one arm
cervical nerve root radiculopathy
neck pain and progressive sensory changes and weakness in both arms and legs
spinal cord injury
shoulder pain and progressive inability to abduct the arm due to shoulder stiffness
adhesive capsulitis of the shoulder (frozen shoulder)
severe sore throat, high fever, drooling, and difficulty swallowing in an adult
peritonsillar abcess
pain on urination (dysuria) w/ high fever, chills, frequent urination, pain in back and malaise
kidney infection (acute pyelonephritis)
chronic tenderness in anatomic snuffbox; pain of wrist after fall on an outstretched hand
occult fracture of the scaphoid (navicular) bone of the wrist
sudden, severe anxiety, smothering sensation, chest pain w/ complete recovery
panic disorder
non-drug induced auditory hallucination, delusions, tangential thinking
schizophrenia
patient who feels pessimistic, hopeless, and helpless
major depression
depression followed by an episode of hyper-excitation or euphoria
manic phase of bipolar disorder
personality change, social withdrawal, unstable relationships, evasiveness, and decreased academic performance in an adolescent or adult
drug abuse (partial loss of control over drug use) or addiction (loss of control over drug use)
resting heart rate >100 bpm, hypervigilance, warm skin
hyperthyroidism
irregularly irregular pulse w/ rate >100 bpm
atrial fibrillation w/ uncontrolled ventricular response
15 minute episode of unilateral tingling/numbness that resolves completely
transient ischemic attack (TIA)
slow onset of patchy numbness and weakness of >1 body areas
multiple sclerosis (MS)
growth or change in dark skin lesion
malignant melanoma
unilateral, painless lymph node swelling in the neck, arm, or groin
lymphoma
painless and hard are w/in the testicle of a young adult male
testicular cancer
one-sided ankle/distal calf swelling or asymmetric bilateral swelling (>3 cm difference)
blood clot in deep vein of the calf (deep vein thrombosis)
bilateral, pitting ankle swelling w/ shortness of breath
congestive heart failure
swelling of one arm w/ shoulder and/or armpit (axillary) pain
subclavian vein deep venous thrombosis
swelling and itching of lips following insect sting or food, herb, supplement, or drug ingestion
impending anaphylactic reaction
sudden, painless loss of vision in one eye
detached retina
transient, painless “curtain” coming down over vision of one eye then lifting
amaurosis fugax (AF)
double vision following blunt trauma to one that subsequently appears lower than the other eye
blowout fracture of the eye orbit w/ entrapment of inferior rectus muscle in the fracture
blurry vision, frequent urination, increased hunger and fatigue in an adult
adult onset diabetes mellitus (type II)
mild weight gain (5-10 pounds) w/ lethargy, dry hair, and cold extremities
hypothyroidism, overt (clinical)
weight loss and/or failure to maintain adequate body weight due to body image concerns
anorexia nervosa
