sx 2 Flashcards
episodes of cramping or aching abdominal pain relieved by defecation, change in bowel habits w/predominant diarrhea or constipation or alternation, bloating, abdominal distention, tenesmus, gastroesophageal reflux, nausea, feeling of lump in throat
irritable bowel syndrome
abdominal pain, nausea, vomiting, weakness, profuse sweating, fever, distention, abdominal tenderness, septicemia, shock, death
peritonitis
painless, rectal pain, itching, protrusion, bleeding after defecation, mucous discharge from rectum, feeling of incomplete defecation, difficulty cleaning anal area, painful anal lump
hemorrhoids
loss of appetite, weight loss, nausea, vomiting, indigestion, abdominal distention, edema, bleed and bruise easily, frequent nosebleeds, jaundice, skin dry and pruritus, small red spidery marks on face and body, testicular atrophy, gynecomastia, loss of chest hair, impaired memory, confusion, drowsiness, hepatic failure, death
cirrhosis of liver
asymptomatic, abnormal findings on blood and urine tests, abrupt onset of headache, anorexia, malaise, fever, nausea, dark urine, clay-colored stools, jaundice, yellowing of sclera of eyes, abdominal discomfort, myalgia, liver enlargement
viral hepatitis
asymptomatic, sx of liver disease, upper abdominal pain, weight loss, early satiety, palpable abdominal mass, hepatomegaly, splenomegaly, jaundice, thrombocytopenia, elevated bilirubin, low albumin, electrolyte abnormalities, elevated serum alpha-fetoprotein
cancer of liver (HCC)
asymptomatic, colicky pain/biliary colic, pain in RUQ radiation to right upper back scapula, nausea, vomiting, severe pain, flatulence, clay-colored stools, jaundice, transient elevations of bilirubin/line phosphate/AST/ALT
cholelithiasis (gallstones)
acute colicky pain, pain in URQ and radiates to right lower scapular region, nausea, vomiting, guarding of URQ muscles, shallow respirations, fever, jaundice, clay-colored stools, dark urine, pruritus, peritonitis, resolve spontaneously
cholecystitis
sudden onset of severe abdominal pain radiating to back, nausea, vomiting, epigastric pain worsened by waking or lying supine but better sitting and leaning forward, diaphoretic, tachycardic, shallow rapid respirations, low BP, increased body temp, tender abdomen gen in upper quadrants, no guarding and rigidity, reduced bowel sounds, mild jaundice
acute and chronic pancreatitis
abdominal pain, weight loss, jaundice, nausea, vomiting, acholic stools, steatorrhea, ascites, abdominal tenderness, palpable gallbladder, glucose intolerance, weakness, fatigue, diarrhea, elevated bilirubin and alkaline phosphatase concentrations
pancreatic cancer
emaciation, obestiy, loss of energy, diarrhea, drastic weight change, skin lesions, loss of hair, poor nails, generalized edema, delayed healing, greasy stools, muscle wasting, enlarged glands, hepatomegaly, abnormal blood and urine tests
malnutrition
irritability, loss of hair, anorexia, enlargement of liver and spleen, jaundice, skin changes, psychiatric disorder, increased pressure in brain, tinnitus, pruritus, swelling of optic nerve, abnormal bone growth
vitamin a toxicity
calcificatino of soft tissue, poor appetite, weakness, kidney damage, excessive thirst and urination, mental changes
vitamin D toxicity
dyspnea, flushing, cardiovascular complications, RBC hemolysis, jaundice, brain damage
vitamin K toxicity
nausea, diarrhea, acidification of urine,, flushing, hyperglycemia, liver damage, photosensitivity, peripheral nerve dmage
vitamin C toxicity
abdominal discomfort, bloating with gas, abnormal bowel movements, chronic diarrhea, yellowish gray greasy looking stools, weight loss, anemia, SOB, sx of vitamin and mineral deficiency
malabsorption syndrome
weight loss, anorexia, abdominal cramping, diarrhea, flatulence, abdominal distention, intestinal bleeding, weakness, muscle wasting, dermatitis herpetiformis, large pale greasy foul-smelling stool, malnutrition and malabsorption
celiac disease (gluten enteropathy)
rumbling stomach, nausea, vomiting, diarrhea with abdominal pain, cramps, malaise, fever, dehydration
food poisoning
thinning hair, poor wound healing, dental changes, amenorrhea, cold intolerance, constipation, bloating, abdominal distress, hyperactivity, hypotensive, bradycardia, hypothermia, feelings of sadness, insomnia, purging
anorexia nervosa
compulsive exercise, swollen salivary glands, broken blood vessels in eye
bulimia
nasal congestion and discharge, sore throat, hoarseness, sneezing, watery eyes, coughing, headache, slight fever, chills, discharge is greenish yellow and thick
common cold (upper respiratory tract infection)
headache over one or both eyes especially after waking up, pain and tenderness above eyes intensifies when bending down, pain in cheeks and upper teeth, drainage thick greenish yellow mucopurulent liquid
sinusitis
sore throat w/dryness, burning sensation, sensation of lump in throat, chills, fever, dysphonia, dysphagia, cervical lymphadenopathy, red and swollen mucosa of pharynx with or w/o tonsillar exudate
pharyngitis
neck mass, nasal obstruction w/epistaxis, serous otitis media, headache, hearing loss, tinnitus pain, impaired function of cranial nerves
nasopharyngeal carcinoma
hoarseness, aphonia, fever, malaise, painful throat, dysphagia
laryngitis
dysphonia, stridor
laryngeal tumor
persistent hoarseness, dysphagia, hemoptysis, chronic cough, referred pain to ear, stridor, airway obstruction
laryngeal cancer
substernal retraction, cyanosis, physical exam, diminished breath sounds, mediastinal shift toward side of collapse
atelectasis
sudden onset of dyspnea and chest pain, tachycardia, apprehension
pulmonary embolism
cough, fever, SOB, chills, sweating, chest pains, cyanosis, blood in sputum, shallow and rapid respiration
pneumonia
malaise, headache, cough, fever, chest pain, nausea, vomiting, chills, myalgia, diarrhea, anorexia
legionellosis (legionnaires disease and pontiac fever)
coldlike sx, nasal congestion, otitis media, coughing in mild upper respiratory tract, fever, malaise, lethargy, coughing, wheezing, and dyspnea
respiratory syncytial virus pneomina
asymptomatic, dyspnea, febrile, loss of energy, spleen and lymph nesdo enlarged
histplasmosis
inflammation of upper and lower membranes, severe protracted cough, fever, headache, sore throat, generalized malaise, fever, chills, weakness, sweating
influenza
fever, cough, sore throat, body ache, headache, chills, fatigue, diarrhea, vomiting, pneumonia, death
H1N1 (swine flu)
deep persistent productive cough, thick yellow to gray sputum, SOB, wheezing, slightly elevated temperature, pain in upper chest aggravated by cough, scattered or occasional rales
acute bronchitis
slight cough in mornings, obstructive and asthmatic sx, wheezing, flares, soughing, SOB, wheezing
chronic bronchitis
chronic cough with large quantities of purulent foul smelling sputum, hemoptysis, dyspnea, wheezing, fever, malaise, chronic halitosis
bronchiectasis
wheezing, productive cough, difficulty breathing, airway closure, severe anxiety
asthma
enlarged alveoli, dyspnea, increasing difficulty breathing, tachypnea, wheezing, cough, barrel chest from using accessory muscles to force out air, SOB, purses list to assist exhaling, circumoral cyanosis, sx of right ventricular heart failure, digital clubbing
pulmonary emphysema
dyspnea on exertion, dry cough becoming productive and similar to chronic bronchitis, increasing effort for inspiration, pulmonary hypertension, tachypnea, general malaise, recurrent respiratory tract infection, regular exposure to dust
pneumoconiosis
unilateral sharp needlelike pain increasing with inspiration and coughing, cough, fever, chills, shallow rapid and restricted inspirations, pain radiating to shoulder or abdomen
pleuritis
severe SOB, sudden and sharp chest pain, falling blood pressure, rapid weak pulse, shallow and weak respirations, cyanotic, anxious, mediastinal shift to unaffected side
pneumothorax
pale and clammy skin, weak and thready pulse, falling BP, chest pain, labored and shallow respiration, gasping, similar sx to pneumothorax
hemothorax
severe pain, dyspnea, cyanotic, extremely anxious, segment of chest moves inward during inspiration and outward during expiration (paradoxical breathing)
flail chest
asymptomatic, weight loss, reduced appetite, listlessness, vague chest pain, dry cough, loss of energy, fever, productive cough with purulent sputum, blood streaking, hemoptysis, fever, night sweats
pulmonary tuberculosis
lymphadenopathy, fever peaking in afternoon, general malaise, anorexia, chills, sore throat, fever, headache, fatigue, cervical and generalized lymphadenopathy, tonsils coated w/debris, mild transient hepatitis, atypical lymphocytosis
infectious mononucleosis (glandular fever)
sudden onset of severe hypoxemia, progressive hypercapnia, acidosis, atelectasis, sudden and severe dyspnea with rapid and shallow respirations, inspiratory intercostal and suprasternal retractions, cyanosis, mottled skin, no improvement with supplemental oxygen, rales, rhonchi, wheeze, history of trauma/septicemia/shock/insult to lungs or body
adult respiratory distress syndrome
dry cough, SOB, mild chest pain, fatigue, fever, weight loss, swollen ankles, joint pain, organ specific sx, granulomas in lungs
sarcoidosis
cough with or w/o sputum, changes in character of cough, dyspnea, hemoptysis, chest pain gen dull intermittent on side of tumor, weight loss, headache, weakness, change in mental status, seizures, asymptomatic
lung cancer
asymptomatic, pain of angina pectoris,l burning squeezing crushing and radiating pain to arm neck or jaw, nausea, vomiting, weakness, changesor no changes in ECG
coronary artery disease
sudden onset of left-sided chest pain during or shortly after exertion, pain radiating to left arm or back, dyspnea, pain stopped by stopping activity or nitroglycerin, blood pressure increase, arrhythmia
angina pectoris
sudden severe substernal or left-sided chest pain, pain crushing/burning/vague discomfort, feeling of massive constriction of chest, pain radiate to left or right arm/back/jaw, pain not relieved by rest or nitroglycerin, irregular heartbeat, dyspnea, diaphoresis, denial, severe anxiety, feeling of impending doom, nausea, asymptomatic
myocardial infarction
unresponsive with no respiratory effort and no palpable pulse
cardiac arrest
chest pain and SOB after stressful or exciting event
broken heart syndrome (takotsubo cardiomyopathy)
headache, epistaxis, lightheadedness, syncope, asymptomatic
essential/primary hypertension
severe headache, blurred vision, dyspnea, sudden onset of sx
malignant hypertension
insidious onset, gradually increasing dyspnea, cardiac and respiratory rate increase, anxious, neck veins distend, edema in ankles, liver and spleen enlargement, peripheral edema, pulmonary congestion, more pronounced respiratory difficulties
congestive heart failure
dyspnea, distended neck veins, edema of extremities, liver enlarged and tender
cor pulmonale
dyspnea, coughing, orthopnea, increased cardiac and respiratory rate, blood frothy sputum, blood pressure falls, skin cold and clammy, sx gen at night after pt lies down
pulmonary edema
sx of CHF, dyspnea, fatigue, tachycardia, palpitations, chest pain, peripheral edema, hepatic congestion, syncope, cardiac murmurs
cardiomyopathy
fever, malaise, chest pain fluctuating with inspiration/heartbeat, dyspnea, chills, anxiety, pounding heart sensation, detectable friction rub or grating sound heard on auscultation, tachycardia
pericarditis
palpitations, fatigue, dyspnea, fever, arrhythmia, tenderness in chest
myocarditis
fever, chills, night sweats, weakness, anorexia, fatigue, vegetative growths on cardiac valves, ischemia, cardiac murmur
endocarditis
fever, polyarthritis, joint pain, edema, redness, limited range of motion, carditis, cardiac murmurs, cardiomegaly, CHF, weakness, malaise, anorexia, weight loss, rash on trunk, abdominal pain, small nodules on tendon sheaths in knees/knuckles/elbows, sx 1-5 weeks after URI
rheumatic fever
dyspnea, tachycardia, edema, nonproductive cough, cardiac murmurs
rheumatic heart disease
exertional dyspnea, fatigue, cough, palpitations, hemoptysis, cyanotic
mitral stenosis
dyspnea, fatigue, heart murmur
mitral insufficiency
asymptomatic, chest pain, dyspnea, dizziness, fatigue, syncope, severe anxiety
mitral valve prolapse
palpitations, tachycardia, skipped heartbeat, bradycardia, syncope, fatigue
arrythmia
> 100 bpm, regular, P wave uniform
sinus tachycardia
< 60 bpm, regular, P wave uniform
sinus bradycardia
rate depends on underlying rhythm, normal P wave, different morphology from other P waves
premature atrial contraction
150-250 bpm, rhythm normal, sudden onset
atrial tachycardia
atrial rate > 350 bpm, ventricular rate < 100 bpm controlled or > 100 bpm rapid ventricular response
atrial fibrillation
rate depends on rate of underlying rhythm, P-R interval > 0.2 seconds
first degree heart block
intermittent block w/progressive longer delay in conduction until one beat is blocked, atrial rate normal, ventricular rate slower than normal, rhythm irregular
second degree heart block (wenckebach heart block)
ventricular rate slow (1/2 or 1/4 atrial rate), rhythm regular, P waves normal QRS complex dropped every second third or fourth beat
classic second degree heart block
atrial rate normal, ventricular rate 20-40 or 40-60 bpm, no relationship between P wave and QRS complex
third degree heart block
single ectopic beat arising from ventricle followed by compensatory pause
premature ventricular contraction (single focus)
rate dependent on underlying rhythm, rhythm either irregular or regular, P wave absent before ectopic beat
multifocal arrhythmia
150-250 bpm, rhythm usually regular, focus of pacemaker normally single, palpitations, dyspnea, anxiety, chest pain
ventricular tachycardia
unconscious, no peripheral pulse palpable, no heart sounds, no BP
Ventricular fibrillation
pale cold and clammy skin, rapid weak and thready pulse, rapid breathing, altered level of consciousness, BP drops, anxiety, irritable, restless, feeling of impending doom, dizziness, extreme thirst, profuse sweating, pupils dilate, eyes dull and lusterless, shaking, trembling
shock
sx of shock after MI/severe heart failure/certain arrhythmias/acute valve failure
cardiogenic shock
sudden severe dyspnea, rapidly falling BP, pulse weak thready and rapid, shock, cyanotic above nipple line, falling level of consciousness
cardiac tamponade
severe pain in area of embolus, area becomes pale numb and cold to touch, arterial pulse below occulsion absent if arterial, nausea, vomiting, fainting, shock
emboli
angina pectoris, dizziness, SOB, elevated BP, asymptomatic
atherosclerosis
asymptomatic, abdominal or back pain, pulsating mass in abdomen, sx of hemorrhagic shock, sx of CVA
aneuryusm
pain and tenderness in area becoming more severe, swelling, redness, warmth, tender cordlike mass under skin, clots
phlebitis
pain, area swelling heaviness and warmth chills, fever, area tender to palpation
thrombophlebitis
fatigue in legs, continuous dull ache, leg cramps, swelling ankles, veins thicken and hard to touch, pain worsens, dull or stabbing pain
varicose veins
intense pain in effected area aggravated by exercise and relieved by rest, atrophy, ulcers, gangrene
thromboangiitis obliterans (Buerger disease)
white discoloration (blanching), blue discoloration, red or purple discoloration, digits ulcerate and become painful
raynaud disease
pale, dyspnea, tachycardia, pounding of heart, pallor on the palmar surface of hands/nail beds/conjunctiva/mucous membranes of mouth, fatigue, headache, loss of appetite, heartburn, edema, numbness and tingling sensation, syncope
anemia
severe fatigue, weakness, sore throat, ulcerations on oral mucosa, dysphagia, elevated body temperature, weak and rapid pulse, chills
agranulocytosis
increased RBC mass, headache, dyspnea, irritability, mental sluggishness, dizziness, syncope, night sweats, weight loss, circulatory stagnation, thrombosis, increased blood viscosity, splenomegaly, clubbing of fingers, cyanosis
polycythemia
pale, bone pain, weight loss, sore throat, fatigue, fever, night sweats, weakness, increased bruising and bleeding, lymphadenopathy, splenomegaly, headache, blurred vision, nausea, vomiting, cranial nerve palsies, mediastinal mass
acute lymphocytic leukemia
asymptomatic, weight loss, fever, night sweats, extreme fatigue, splenomegaly, hepatomegaly, painless swelling of cervical/supraclavicular/axillary lymph nodes spontaneously waxes and wanes, susceptibility to viral and fungal infections
chronic lymphocytic leukemia
sx of anemia, easy bleeding and bruising, increased risk of infection, gingival bleeding, epistaxis, menorrhagia, weight loss, pallor, fatigue, lymphadenopathy, organomegaly
acute myelogenous leukemia
asymptomatic, splenomegaly, bone pain, fever, night sweats, systemic sx, chromosomal abnormalities, abnormal proliferation of WBCs, increase of leukocytosis, neutrophil differentiation impaired
chronic myelogenous leukemia
swelling of extremities, gen no pain, pain and limited movement, extremity grossly distended
lymphedema
red streak at site of entry of infective organism, redness extend to regional lymph node, swollen and tender regional lymph node, cellulitis, fever, chills, malaise
lymphangitis
asymptomatic, unexplained weight loss > 10% body weight in past 6 months, persistent or recurrent fevers > 38C previous month, recurrent drenching night sweats previous month
lymphoma
painless, enlargement of lymph nodes in neck/mediastinum, fatigue, pruritus, fever, night sweats, weight loss, reed-sternberg cell
hodgkin lymphoma
painless lymphadenopathy, fatigue, pruritus, bone pain, GI sx, enlargement of tonsils/adenoids, fever, night sweats, weight loss
Non-hodgkin lymphoma
chills, fever, tachycardia, severe back pain, vomiting, diarrhea, hives, rash, substernal tightness, dyspnea, hypotensive, circulatory collapse, bleeding from puncture site, blood in urine, renal, failure
transfusion incompatibility reaction
unusually prolonged bleeding episode, easy bruising, hematomas, excessive nosebleeds, ecchymosis at birth, bleeding from circumcision, joint swelling and pain, male
hemophilia
oozing of blood from needle puncture sites/mucous membrane/incisions, purpura, wound hematomas, petechiae, hematemesis, hematuria, blood stools, weak, headaches, air hunger, tachycardia, sx after major event like obstetric complications/septicemia/burns/trauma/hypothermia/extensive tissue destruction
disseminated intravascular coagulation
proteinuria, edema, decreased urine volume, hematuria, dark or coffee-colored urine, sx 1-2 weeks after streptococcal infection, hypertension, fluid retention, headache, visual disturbances, malaise, anorexia, low-grade fever, flank or back pain
acute glomerulonephritis
asymptomatic, hematuria, hypertension, proteinuria, oliguria, edema, renal failure, hypertension, azotemia, tiny urea crystals on skin (uremic frost), fatigue, malaise, nausea, vomiting, pruritus, dyspnea
chronic glomerulonephritis
proteinuria, hypoalbuminemia, glomerular filtration diminishes, edema, hypertension, microscopic or gross hematuria, plasma lipid levels elevate, sloughed-off fat bodies in urine, susceptible to infection, lethargic, depressed, loss of appetite, pale, puffiness around eyes, swollen ankles, weight gain, skin irritation
nephrotic syndrome (nephrosis)
oliguria, gastrointestinal disturbances, headache, drowsiness, alterations in levels of consciousness, sx dependent on cause/impairment/BUN levels
acute renal failure
weak, tired, lethargic, hypertension, edema, arrhythmia, muscle weakness, dyspnea, metabolic acidosis, ulceration of gastrointestinal mucosa, hair and skin changes
chronic kidney disease
pus in renal pelvic, abscess, rapid onset sx, fever, chills, nausea, vomiting, flank pain, condition after UTI, foul odor to urine bc of hematuria and pyuria, tenderness in suprapubic region, rigid abdomen, tender enlarged kidney, abnormal constituents in urinalysis
pyelonephritis
asymptomatic, vague backache, diminished urine output, no palpable conditions, incidental detection on imaging/ultrasound, fever/chills/hematuria/pyuria if infection occurs
hydronephrosis
sudden severe pain in flank area, nausea, vomiting, hematuria, fever, chills, abdominal distention
renal calculi
urinary urgency and frequency, dysuria, incontinence, pressure in pelvis, pain in pelvic region and low back, bladder spasms, fever, chills, burning sensation with urination, urine dark yellow/pink/red
infectious cystitis and urethritis
urinary retention, hypertension, nausea, protein in urine, UTI, pyelonephritis
diabetic nephropathy
kidneys palpable, lumbar pain, abdominal pain and tenderness, hematuria, systemic hypertension, prone to renal infections and renal calculi, chronic high blood pressure, kidney infection
polycystic kidney disease
hematuria, abdominal mass, flank pain, weight loss, anemia, fever, hepatic dysfunction, hypercalcemia, asymptomatic
renal cell carcinoma
asy,ptomatic, dysuria, odorless yellow vaginal discharge with burning sensation, itching, abdominal pain, dyspareunia, thin, watery discharge from penis burning iwth urination, urethritis, swollen scrotum, urethritis, inguinal lymph nodes enlarged, small transient lesion, skin irritation
chlamydia
purulent dischargefe from renitourinary tract, dysuria, asymptomatic
gonorrhea
asymptomatic, urethritis with dysuria and itching, profuse frothy greenish yellow odorous discharge from vagina, vulvar irritation, strawberry cervix, thin whitish discharge from penis, discharge subsiding w/o tx
trichomoniasis
blisterlike lesions on genitals/around anus, blisters occur 2-30 days after infected person, systemic influenza sx, swollen glands, fever, headache, painful urination, asymptomatic
genital herpes
warts on genitals, itching, burning, no pain
genital warts (condylomata acuminata)
painless highly contagious local lesion (chancre), fever, headache, aching joint, mouth sores, rashes on palms and soles, latent stage
syphilis
shallow painless lesion on skin or mucous membrane 7 to 10 days after sexual contact w/infected person, tender superlative inguinal adenopathy, ulcer deeps and becomes purulent
chancroid
scrotal pain, discomfort radiating into groin, pain w/ejaculation, epididymis enlarged tender and firm, groin and scrotal tenderness with severe pain in testes, difficulty walking
epididymitis
inflammation of testes, tenderness/swelling/acute pain in testes, chills, fever, vomiting, nausea, malaise
orchitis
sudden severe pain in one testicle, nausea, vomiting, constant pain, swollen red and tender scrotum
torsion of testicle
more uncomfortable than painful, more discomfort in hot weather or after exercise, discomfort relieved by lying down, lower sperm count, discomfort on left testicle
varicocele
enlarged and tender prostate, pus at tip of penis, asymptomatic, pain, burning sensation when urinating, low back pain, perineal pain, fever, muscular pain/tenderness, urinary frequency with urgency, blood in urine
prostatitis
difficulty starting urination, weak urine stream, inability to empty bladder completely, urinary frequency, nocturia, inflammation and sx of renal disease
benign prostatic hyperplasia
asymptomatic, abnormality on digital rectal exam, high concentration of PSA in serum, asymmetrical areas of induration and nodules felt on DRE
prostate cancer
nodule/painless swelling of one testicle, dull ache, heavy sensation in abdomen/perineal area/scrotum, acute pain, gynecomastia, enlarged lymph nodes in neck, dyspnea, cough, anorexia, bone pain, lower extremity swelling
testicular cancer
changes in mood/sexual desire/energy, anxiety, anger, sadness, bloating, food cravings, breast pain, irritability, fatigue, bloating, abdominal pain
premenstrual syndrome
secondary dysmenorrhea, painful intercourse, painful defecation, infertility
endometriosis
low abdominal pain, fever, chills, malaise, foul-smelling vaginal discharge, backache, painful tender abdomen, walking painful, walking with shuffling gait, soft tender pelvic mass, WBC and ESR elevated
pelvic inflammatory disease
asymptomatic, pelvic pain, pressure, constipation, urinary frequency, abnormal bleeding, heavy/prolonged periods
uterine leiomyomas (fibroids)
vaginal discharge, local itching, burning, odor, discharge is white/gray/green, discharge is almost absent to copious, discharge is odorless or malodorous, irritation and soreness of vulva, fever
vaginitis
high fever, headache, sore throat, rash, hypotension, shock, diarrhea, neuromuscular disturbances, abnormal kidney function, elevation of liver enzymes
toxic shock syndrome
hot flashes, night sweats, vaginal dryness, skin changes, depression, poor memory, anxiety, sleep disorders, loss of interest in sex
menopause
pelvic pressure, urinary leakage, urinary urgency, discomfort during intercourse, bladder can’t be emptied completely, nerve or muscle damage
cystocele
bearing down feeling, fullness in vagina, back pain, pelvic pressure, difficulty evacuating rectum
rectocele
watery bloody or purulent vaginal discharge that may be heavy and foul smelling, bleeding between menstrual periods/after sex/after menopause, abnormal Pap smear, low back/pelvic pain, hematuria, dysuria, rectal bleeding
cervical cancer
vaginal bleeding gen postcoital/postmenopausal, constipation, malodorous or watery vaginal discharge, dysuria, urinary frequency, melena, vaginal mass
vaginal cancer
lower abdominal discomfort, bloating, constipation, lower back pain, irregular menstrual cycles, urinary frequency, dyspareunia, enlargement of abdomen
ovarian cancer
abnormal perimenopausal or postmenopausal uterine bleeding, pain, systemic sx, atypical endometrial cells
endometrial cancer
positive pregnancy test and pelvic pain, negative pregnancy urine test, pain gen unilateral, cramping of uterus w/or w/o bleeding, diffuse pelvic pain, hypotension, shock
ectopic pregnancy
weight gain, peripheral swelling/edema, BP > 140/9o0, > 300 mg of protein in urine over 24 hrs, persistent headache, visual disturbances, epigastric pain, clonus present, more exaggerated deep tendon reflexes
preeclampsia
painless bright vaginal bleeding in first/2nd trimester of pregnancy, abdomen normal, vital signs align with shock, fetal heart rate compromised
abruptio placentae
placenta covers opening to service
placenta previa
nausea, vomiting, vaginal bleeding, hCG elevated
Hydatidifiurm fubction
uncomfortable feeling in breasts, lumps/cysts, tenderness, breasts tender on palpitation and shooting pains down preast, gen this is less of a problem with no clockwise
fibrocystic breast condition
sx of erythematous, xema, focus scaly, alternated
psychological concerns
erythematous eczema scaly ulcerated lesion, unilateral generally, heal spontaneously,
paget disease of breast
sudden severe headache, sudden aphasia, dysphasia, difficulty understanding language, sudden weakness/numbness/paralysis of face, one sided drooping mouth and eyelid, sudden confusion, impaired consciousness, sudden loss of vision, blurred vision, unequal pupils, diplopia, sudden onset of dizziness, loss of balance, loss of coordination
cerebrovascular accident
generalized/region specific headache, worst headache of their life nausea, vomiting, stiff neck, confusion, lethargy, generalized weakness, muscle weakness & paralysis of face, ringing in ears, dizziness, cyncope, loss of consciousness, impaired speech, visual problems, irritability
arteriovenous malformations
sudden weakness and numbness down one side of body, dizziness, dysphagia, confusion, difficulty seeing with one eye, loss of balance, sudden onset headache,
transient ischemic attack
sudden headache, dilated pupils, nausea, vomiting, increased drowsiness, hemiparesis, unconsciousness, coma, death
epidural or subdural hematomas
loss of consciousness, periods of amnesia, shallow respirations, pulse drops, muscle tone flaccid, headache, nausea, vomiting, diplopia, blurred vision, photophobia, irritability, decreased levels of concentration
cerebral concussion
severe headache, hemiparesis, drowsiness, lethargy, hostile, combative, impaired intellect, dysphagia, paralysis, epilepsy, impaired gait, continuing stupor
cerebral contusion
bleeding from wounds/ears/nose/around eyes, changes in pupils, bruising behind ears/around and under the eyes, clear/bloody drainage around ears or nose, headache, stiff neck, nuchal rigidity, nausea, vomiting, visual disturbances, slurred speech, confusion, restlessness, irritability, difficulty balancing, drowsiness, seizures, loss of consciousness
depressed skull fracture
pain radiating down nerve path, burning pain, tractable, constant back pain, severe pain down one or both legs, loss of some motor functions in legs, numbness/tingling associated with weakness, bowel or bladder issues
degenerative disk disease
severe back pain, disability, sudden sharp pain worsening with movement/certain position, pain radiates from back to butt/thighs/legs fown path of impinged nerve, paresthesia, muscle weakness in leg, pain/sx in dermatomal pattern, pain and weakness in arms and neck
herniated and bulging disk
severe sharp pain radiating from sciatic nerve down leg and to foot, pain continuous or intermittent, numbness, low back pain, disability
sciatic nerve injury
pain in back/radiating down leg/butt/thighs/calves, pain increases w/standing/walking/exercise, numbness becomes worse with standing/activity, reflexes in lower extremities asymmetric, sensation decreases, weakness in legs
spinal stenosis
visual auras, photophobia, abnormal fatigue, irritable, numbness/tingling in one arm/side of body, dizziness, temporary mental confusion
migraine
convulsions, disturbances in consciousness and sensory phenomena, motor signs in hands or face, behavioral/psychic/sensory manifestations, amnesia of attack, blank stare
epilepsy
tremor in hands/arms/jaws/face/legs, rigidity/stiffness of limbs and trunk, stooped posture, move slowly, shuffling gait, head bowed and body flexed forward, knees slightly bent, impaired balance and coordination, expressionless face, muffled speech, dysphagia, gradual changes in behavior/mental activity
Parkinson’s disease
loss of musculoskeletal control, dysphagia, mild fidgeting, tongue smacking, dementia, speech difficulty, emotional state deteriorates, disruption of personality, untidy and careless appearance, apathetic moody behavior, onset of paranoia
huntington chorea
fasciculations, atrophy, weakness, difficulties in speech/chewing/swallowing/breathing
amyotrophic lateral sclerosis
itchy/burning/jittery/creepy crawly/pulling/tugging/painful sensation in legs, sensations in arms/hips/face, walking/moving helps relive ex, periodic limb movement disorder in sleep
restless legs syndrome
sudden onset memory loss, memory returns within 6-12 hours, period of amnesia unable to be recalled, headache
transient global amnesia
severe headache after sneezing/coughing/strain, lack of fine skill coordination, difficulty balancing, neck pain, tingling of feet and hands, numbness, dizziness, difficulty swallowing, other neurologic sx
chiari malformation
clumsiness, loss of sensation in hands and feet, flaccid paralysis, wasting of muscle, deep tendon reflexes diminish, tenderness in atrophied muscles, glossy red skin, decreased sweating, foot drop, pain in affected regions
peripheral neuritis/neuropathy
transient excruciating pain radiating along diff CN V branches, unilateral pain, undernourished, dehydrated, pain from chewing/swallowing/touching area
trigeminal neuralgia (Tic Douloureux)
pain/drawing sensation behind ear, inability to close/open eye, drooping of mouth, drooling of saliva, cannot smile/whistle/grimace, distorted facial expression, taste diminishes, unilateral, loss of appetite
bell palsy
vomiting, headache increasing in intensity w/movement of head, nuchal rigidity, positive Kernig sign, positive Brudzinskin sign, deep tendon reflex increase, irritability, photophobia, hypersensitivity of skin, seizures, drowsiness, stupor, coma
meningitis
headache, elevated temp, stiffness of neck and back, muscle weakness, restlessness, visual disturbances, lethargy, mental confusion, disorientation, coma
encephalitis
numbness and tingling of feet and hands, increasing muscle pain and tenderness, progressive muscle weakness, paralysis, sx gen begin in lower extremities and move up body or vice versa, respiratory insufficiency, dysphagia
Guillain-Barre syndrome
headache, nausea, vomiting, visual disturbances, unequal pupil size, seizures, eyes looking toward area of insult, nuchal rigidity
brain abscess
low-grade fever, profuse discharge from nose, malaise, progressive muscle weakness, stiff neck, nausea, vomiting, flaccid paralysis of muscles, atrophy, decreased tendon reflexes, muscle and joint deterioration
poliomyelitis and post-polio syndrome
neurological deficits, cerebral edema, increased intracranial pressure, herniation, headache gen dull constant and worse at night, focal or generalized seizures, nausea, vomiting, syncope, cognitive dysfunction, memory problems, personality changes, muscle weakness, sensory loss, aphasia, visual dysfunction
intracranial tumors
[tumor], seizures, nausea, vomiting, headache
glioblastoma
[tumor] gait disturbance, nystagmus, lethargy, dysarthric speech pattern, balance difficulty
cerebellar tumor
difficulty acquiring skill in specific learning area, lower level of achievement despite normal or above normal intelligence and adequate teaching, deficit in social skills, problems listening/paying attention, speaking
learning disorder
frequent repetition/prolongation of sounds/syllables, inappropriate disturbance of pattern and fluency of speech for age, broken words, filled/unfilled pauses, word substitutions, word repetitions, in absence of neurologic cause
stutter
impairment in socialization/communication/activities/interests, impairment in nonverbal behaviors, fail to establish normal peer relationships, do not initiate in age-appropriate play, repetitive natural motions, inflexibility toward change, compulsion for sameness, persistent preoccupation w/objects, memory for certain lists/facts, social isolation, cognitive impairment, language deficits, aversion to physical tough, resistant to change
autism
failure to pay attention to detail, careless mistakes, messy work performed carelessly, difficulty sustaining attention and completing tasks, inability to sit quietly w/o fidgeting, inappropriate running and climbing, difficulty playing, excessive talking, impatience, frequent interruptions, failure to listen to directions, inability to organize activities and set goals
attention-deficit/hyperactivity disorder
lose language and social skills, lose control of body functions, long period of normal development before regression
childhood disintegrative disorder
sx of pervasive development disorder, problems w/physical development, loss of motor skills, poor coordination
rett syndrome
loss of temper, arguing with adults, defying/refusing to comply w/adult’s requests/rules, deliberately annoying others, blaming others for mistakes and behaviors, irritable, easily annoyed, angry, resentful, spiteful, vindictive, negative, defiant, involvement in theft/vandalism/bullying
oppositional defiant disroder
loss of short-term memory, inability to concentrate, incapacity to learn new info, impairment of reasoning, subtle changes in personality, communication skills decline, increasing dependence on caregiver, deterioration of intellectual and physical ability, restlessness, sleep disturbances, disorientation, hostility, combativeness
Alzheimer’s disease
general loss of intellectual abilities in pt, changes in memory/judgment/abstract thinking/personality, disregard for personal hygiene, apathy, disorientation, inappropriate response, depression, anxiety, irritability, restlessness, sleeplessness, hallucinations, psychotic tendencies, stupor, coma
vascular dementia
reduced mental status, inability to perform cognitive tasks, reduced intelligence test results, sx begin after head trauma
dementia caused by head trauma
anxiety, depression, insomnia, impotence, behavioral disorders, amnesia, slow motor skills, impaired judgment/concentration, unable to think clearly, frequent infection, hypertension, GI problems, confusion, abdominal pain, nausea, vomiting, unexplained seizures, cirrhosis of liver, pancreatitis, peripheral neuropathy, muscle weakness, paresthesia, cancer of GI, aggressive/violent behaviors, denial of inability to control/discontinue alcohol
alcohol abuse
delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, affective flattening, alogia, avolition, difficulty maintaining education/employment/relationships, withdrawal, odd behavior, disheveled appearance, loss of interest, disorganized thinking
schizophrenia
fever, muscle rigidity, altered mental status, autonomic dysfunction
neuroleptic malignant syndrome
deep and persistent sadness, despair, hopelessness, anxious or brooding appearance, empty/heavy feeling inside accompanied by vague sense of loss, self-blame, remorse, guilt, loss of self-esteem, sleep disturbance, physical sluggishness, fatigue, loss of concentration, inability to experience pleasure, appetite disturbances, social withdrawal, suicidal behavior/thoughts
major depressive disorder
tightness in throat, SOB, sighing, “mental pain”, exhaustion, food tasts like sand, things feel unreal, pain/discomfort identical to sx experienced by dead person, sx normally brief
somatic distress
lack of energy, excessive sleeping, overeating, craving for carbohydrates, weight gain
seasonal affective disorder
fatigue, changes in normal appetite and sleep patterns, feelings of worthlessness and despair, crying episodes, poor personal hygiene, despair about ability as a mother, anger, recurrent thoughts of suicide, sad, flat affect, excessively angry, lack interest in normal events, difficulty concentrating/decisions, desire to run away, fear of being alone, concern about potentially harming baby, thoughts of homicide
postpartum depression
sense of impending doom, feeling they are going crazy/losing control/dying, derealization, depersonalization, palpitations, rapid pulse, pounding heart, sweating, trembling, SOB, chest pain, nausea, paresthesia, dizziness, chills, hot flashes
panic attack
abrupt emotional personality change in 3 yr olds to prepubertal kids, severe mood swings, separation anxiety, abrupt obsessive unusual behavior, detachment to parents/caregiver, hyperactivity, uncontrollable ADHD sx, sleep disturbances, motor or vocal tics, nighttime fears
pediatric autoimmune neuropsychiatric disorders associated w/streptococcal infections (PANDAS)
inability to respond to affection, insomnia, irritability, strong physiologic responses to reminders of event
posttraumatic stress disorder
pain related to at least 4 areas/functions of body, GI sx other than pain, sx related to reproductive sx, neurologic sx w/o clinical basis
somatization disorder
deficits in voluntary motor or sensory functions that are unintentional and preceded by conflicts/other stressors, clinically significantly social and occupational functioning, anesthesia, hyperesthesia, analgesia, paresthesia, paralysis, tremors, tics, contractures, ambulation disturbances, aphonia, mutism, headache, coughing, choking, nausea, vomiting, belching, cold and clammy extremities, weight loss, pseudocyesis, blindness, seizures, dysphagia, dyspnea
conversion disorder
physical and mental tiredness, groggy, tense, irritable, anxous on awakening, extremely early morning awakening, sleep not restorative
insomnia
snorting and gasping during sleep, snoring, choking episodes
sleep apnea
chronic ingrained maladaptive behavior, disordered patterns of relating/thinking/perceiving, impaired social and occupational performance, project negative feelings, blame others, distinguishing characteristics, painful shyness, arrogance, reject responsibility
personality disorders
