Review of Systems Flashcards
General Health Screen Components
-Fatigue
-Malaise: uneasiness, feeling hat something isn’r right
-Fever, chills, sweats
-Weight loss/gain: 5% BMI, depression/cancer/GI
-Nausea/vom: metabolic, CV, liver, pregnancy
-Dizziness/lightheadedness: neuro, CV, DM, anxiety
-Paresthesia, numbness, weakness: renal, neuro, endocrine, drugs
-Change in Mentation: dementia, head injury, drugs, infection
CV System Review
-Syncope
-palpitations
-Sweats
-edema
-skin discoloration
Pulmonary System Review
-dyspnea
-cough
-clubbing of nails
-wheezing
-stridor (gasping)
Hematologic System Review
-exertional dyspnea
-palpitations
-angina
-fatigue
-pallor
-clubbing finger/toes
-lightheadness
-syncope
Looking for:
-blood cell conditions
-bleeding disorders
GI System Review
-swallowing difficulties
-indegestion
-intolerance
-bowl dysfunction
Stool Color Meanings
Black, Tarry, Shiny, Sticky: upper Gi bleeding
Black, not sticky: ingestion of iron, licorice
Lack Grey, pale: obstructive jaundice
Bright red: lower GI bleeding
Reproductive System Review
- urethral/vagina dysfunction
-sexual dysfunction
-pain with intercourse
-menstruation
-Hx pregnancy
-menopause
Urinary System Review
-color
-flow
-force
-difficulty initiation/incontinence
Nervous System Review
-numbness/tingling
-weakness
-tremors/seizures
-vision
-sexual difficulties
-hearing
-incontinence
-vom w/o nausea
-balance problems
Endocrine System Review
-general health
-psychological: personality, memory loss
-GI: n/v, anorexia, dysphagia, diarrhea, constipation
-Uro-genital
-MSK
-Sensory
-dermatologic
-Misc.: temp intolerance, visual issues, orthostatic hypo, bruising, thirst
Integumentary System Review
-changes of nails/skin/nails
-itching
-changes in sweating and dryness
Psychologic System Review
-general health screen
-major clinical depression
-chemical dependence
-abuse
MSK System Review
-location
-description of pain
-onset of symptoms
-changes in pain
-mmts ass with pain
DDx: Joint Pain
-OA MC
-PTs are primary care
-RA
-OA
-SLE
-Gout
-Psoriatic arthritis
-Reactive Arthritis
-Septic Arthritis
Criteria for Inflammatory Back Pain
-morning stiffness
-improces with exercise, not with rest
-pain at night (specifically 2nd half)
-alternating butt pain
-age of onset <50 or younger, insidious, 3m of LBP
Ankylosing Spondylitis
-rare
-<40yrs
-3:1 male to female
-autoimmune arthritis
-pain at rest that decreases with activity
-pain at night
Non joint involvement:
-IBS, uveitis (eye)
-weightt loss
-cardiopulm complications
Non-Specific LBP
-common
-35-55yrs
-1:1 male to female
-degenerative arthritis
-potential hip referral
Non-joint involvement:
-N/A
Classification for RA
-morning stiffness
-arthritis of >3 joints
-arthritis of hand joints
-symmetric arthritis
-nodules
-serum rheumatoid factor
-radiographic changes
4+ Sensitivity 85%, Specificity 90%
Rheumatoid Arthritis
-20-50y
-Females more likely
-family hx
-autoimmune
-Sx increase with rest and intense activity, decrease with short rest, mild activity
-severe stiffness
Systemic Lupus Erythematosus
-15-40ys
-Black females more likely
-family Hx
-Infection, sunlight, uv, meds
Sx: increase with rest, intense activity, decrease with short rest, mild activity
-moderate stiffness
Exam:
-skin rash, fever, photosensitivity, dyspnea, peripheral neuropathies
Gout
-40s men, 50s women
-males more often
-nutrition, renal disorders, increased uric acid, cancer/treatment, HTN, diuretics
Sx: inc WB activity, joint use, dec w/ rest, but still there
-excruciating pain
-stiffness
-night pain
-rapid progression
Exam:
-fever, tachycardia
Psoriatic Arthritis
-Psoriasis in teens-20s, arthritis follows 20ys later
-family Hx
Sx: inc w/ rest, intense activity, dec w/ short rest, mild activity
-tenderness in joints
-moderate stiffness
Exam:
-psoriasis, fever, fatigue
Reactive Arthritis (Reiter’s Syndrome)
-peak onset in 20s
-males
-vejeral or dysenteric disease
Sx: inc w/ rest, intense activity, dec w/ short rest, mild activity
-tenderness in joints
-moderate to severe stiffness
Exam:
-urethitis, conjuctivitis, n/v, weight loss
Septic Arthritis
-abrupt onset
-corticosteroid use, DM, infect, joint trauma
Sx: inc WB activity, joint use, dec w/ rest, but still there
-excruciating pain
- less stiffness
-night pain
-rapid progression
-severe Sx
Exam:
-fever, chills
Limb Pain
-calf/thigh pain
-gait issues
-not typically managed by PTs
Dizziness
-impariment in spatial percepttion and sability
-consider neck conditions
-very common 17-20%
-rare in children, concerns for tumor, concussions, nutrition
-4 types
Vertigo
-sensation of spinning
-asym of vestib sys (peripheral 40%, central 25%)
-2-10% incidence
Vertebra Artery Insufficiency
-usually basilar
-drop attacks, dizziness, dysphagia, dysarthria, diplopia (4 Ds)
-nausea, numbness, nystagmus (3 Ns)
-CN signs
-markers for CVA
Upper Cervical Ligamentous Instability
-occipital HA and numbness
-limited AROM
-signs of myelopathy
Serious Patthologic Neck Conditions
-Vertebral Artery Indufficiency
-Upper cervical ligamentous instability
-Cervical Myelopathy
-Neoplastic Conditions
-Inflammatory of Systemic Disease
Dysequilibrium
-dizziness, imbalance, unsteadiness w/o vertigoo
-changes in brain or body
Presyncope
-vascular comprimise
-CV disease
-hypoglycemia or meds
Non-Specific Dizziness
-panic/anxiety
-cervicogenic
Cervicogenic Headache
-non throbbing, secodary to other coonditions
-15-20%
-cervical spine dysfunction
-unilateral
-provoked by neck mmts
-mild to moderate
Migraine Headache
-pounding, pulsating
-10-15%
-unilateral but can shift sides
- >1 sign of: n, v, photophobia, phonophobia
Cluster Headache
-Crushing
-<1%
-clusters every other day for 8 days
-other S/s: congestion, edema, sweating, ptosis, restlessness
Tension Headache
-band, tightening
->40%
-stress, anxiety, depression
-bilateral
-mild to moderate
Concussion Physical S/S
-HA
-N/V
-balance
-dizziness
-visual issues
-sensitivity to light/noise
-numbness and tingling
-dazed
Concussion Emotional S/S
-irritable
-sadness
-nervousness
Concussion Cognitive S/S
-mental fog
-feeling slow
-concentration issues
-remembering issues
-forgetful
-confusion
-slow responses
Concussion Sleep S/S
-drowsiness
-Sleep (more or less)
-difficulty falling asleep
Trauma
Major: Fx, instabiltiy, imaging
Minor: pathological (osteoporosis), tumors
Repetitive Overuse: bony stress
Fx Screening: ascultation w/ bony precussion, tuning fork
Head Injury: TBI, Concussion (functional not anatomic disturbance)
TBI Red Flags
-double vision, severe HA, sezizure, LOC, consciouness issues
High Risk Sites of Overuse Injury
-femoral neck
-anterior cortex of tibia
-med malleolus
-navicular
-base of 2nd and 5th met head
-talus
-patella
