Symptom Investigation by Body Region

Question 1

Words of Concern

Answer 1

Cramping, Colicky, throbbing/aching, pressure, tightness, heaviness, weakness, severe/disabling, worst pain I have ever had

Question 2

Cancer Red Flags

Answer 2

Persistent pain at night, constant pain anywhere in body, unexplained weight loss, loss of appetite, unusual lumps/growths, unwarranted fatigue

Question 3

Cardiovascular Red Flags

Answer 3

SOB, dizziness, pain/heaviness in chest, pulsating pain anywhere in body,constant/severe pain in lower leg/arm, discolored or painful feet, swelling (no history of injury), bilateral LE edema

Question 4

GI/Genitourinary Red Flags

Answer 4

Frequent/severe abdominal pain, frequent heartburn or indigestion, frequent nausea or vomiting, changes/problems with bladder function (UTI etc.), Unusual menstrual irregularities

Question 5

Neurological Red Flags

Answer 5

Changes in hearing, frequent or severe headaches with no history of injury, difficulty with swallowing/speech, changes in vision, problems in vision, problems with balance, fainting spells (drop attacks), sudden weakness

Question 6

Miscellaneous Red Flags

Answer 6

Fever or night sweats (possible infection), recent sever emotional disturbances, swelling/redness in any joint with no history of injury, pregnancy (treatments to avoid)

Question 7

Low Back Region: Back related tumor

Answer 7

Age over 50, hx of cancer, weight loss, failure of conservative care

Question 8

Low Back region: Abdominal anuerysm

Answer 8

PVD, symptoms not related to movement

Question 9

Low Back region: Back related infection

Answer 9

Recent infection (UTI/skin), IV drugs, immunosuppressive disorder, recent injections in to any joint

Question 10

Low back region: Cauda Equina Syndrome

Answer 10

B&B, saddle paresthesia, weakness, myotomes/dermatomes

Question 11

Low back region: Spinal fracture

Answer 11

Trauma, age over 70, prolonged use of steriods (ie: pts with RA or lupus)

Question 12

Pelvis, Hip, Thigh Region: Colon Cancer

Answer 12

Age over 50, rectal bleeding/black stool, weight loss, pain unchanged by position

Question 13

Pelvis, Hip, Thigh Region: Pathological fx of femoral neck

Answer 13

Age over 70, fall, severe/constant pain, ER LE

Question 14

Pelvis, hip, thigh region: Avascular necrosis

Answer 14

Long term corticosteriod use, trauma

Question 15

LE Red Flags: Peripheral arterial occlusive disease

Answer 15

Age over 60, Type II DM, Heart disease, smoker, sedentary, intermittent claudicaiton, cool extremity, decreased pedal pulses, prolonged venous filling time

Question 16

LE red flags: DVT

Answer 16

Recently immobilized, pain worse with moving, less with elevation, TTP, warm, swollen

Question 17

LE Red Flags: Compartment Syndrome

Answer 17

Recent trauma/unaccustomed exercise, paresthesias, decreased pulses

Question 18

LE red flags: Septic Arthritis

Answer 18

Recent infection/surgery/infection, constant aching/throbbing pain, tenderness, warmth, immunosuppressive disorder

Question 19

5 P’s of compartment syndrome

Answer 19

Pain, pressure, pulselessness, paresthesia, palpable tenderness

Question 20

Red Flags for Head, Face, TMJ: Vertebrobasilar Insufficiency

Answer 20

Dizziness/Vertigo, visual disturbances, headaches/nausea, loss of Consciousness, apprehension with CAROM

Question 21

Red Flags for Head, Face, TMJ: Meningitis

Answer 21

Positive slump sign, headache/Fever, GI distress, photophobia, confusion/seizures

Question 22

Red Flags for Head, Face, TMJ: Primary brain tumor

Answer 22

Ataxia, speech deficits, headache/visual changes, GI distress, altered mental status, seizures

Question 23

Red flags for Head, Face, and TMJ: Subarachnoid Hemorrhage

Answer 23

Severe headache - sudden onset, brief loss of consciousness, brain tumor signs, meningeal irritation

Question 24

Red Flags for CSpine, Shoulder: MI

Answer 24

Chest pain, pallor, nausea or palpitations, presence of risk factors, men age over 40, women age over 50, Symptoms more than 30 min - not relieved by nitroglycerin

Question 25

Red Flags for CSpine, Shoulder: Pancoast Tumor

Answer 25

Men over 50 with history of smoking, nagging pain - shoulder and vertebral edge of scapula, progresses to burning pain in ulnar nerve distribution

Question 26

Red Flags for Elbow, Wrist, Hand: Raynaud Phenomenon/disease

Answer 26

Hands/feet blanch, go cyanotic then red with cold or emotional distress, pain in hands/feet with redness, PMH of RA, occlusive vascular disease, smoking, or use of beta-blockers

Question 27

Red Flags for Elbow, Wrist, Hand: Complex Regional Pain Syndrome

Answer 27

Trauma, Severe aching/stinging pain not typical of injury, pitting edema, erythema, warm pain doesn’t respond to analgesics

Question 28

Red Flags for TSpine, Ribs: MI

Answer 28

Chest Pain, pallor, nausea or palpitations, presence of risk factors, men age over 40, women age over 50, symptoms more than 30 min not relieved by nitroglycerin

Question 29

Red Flags for TSpine, Ribs: Stable Angina Pectoris

Answer 29

Chest pain with predictable level of exertion, relieved by nitroglycerin

Question 30

Red Flags for TSpine, Ribs: Unstable Angina Pectoris

Answer 30

Chest pain outside of predicable pattern, not responsive to nitroglycerin

Question 31

Red Flags for TSpine, Ribs: Pericarditis

Answer 31

Sharp Stabbing pain referred to lateral neck or shoulder, increased pain with L sidelying, relieved with forward leaning posture

Question 32

Red Flags for TSpine, Ribs: Pleurisy

Answer 32

Sharp, stabbing pain with inspiration, dyspnea, history of respiratory disorder

Question 33

Red Flags for TSpine, Ribs: Pulmonary Embolus

Answer 33

Chest, Shoulder, or upper abdominal pain, dyspnea, history of DVT risk factors

Question 34

Red Flags for TSpine, Ribs: Pneumonia

Answer 34

Pleuritic pain may be referred to shoulder, fever, chills, HA, malaise, or nausea, productive cough

Question 35

Red Flags for TSpine, Ribs: Pneumothorax

Answer 35

Chest pain increased with inspiration, difficult to expand rib cage, recent coughing, strenuous exercise, trauma, hyperresonance upon precussion, decreased breath sounds

Question 36

Red Flags for TSpine, Ribs: Cholecystitis

Answer 36

Colicky pain in RUQ with R scapular pain, worsen with ingestion of fatty foods, no change with activity/rest

Question 37

Red Flags for TSpine, Ribs: Peptic Ulcer

Answer 37

Dull gnawing pain/burning in epigastrium, back, or supraclavicular region, TTP in R epigastrium, symptoms relieved with food, constipation, bleeding, vomiting

Question 38

Red Flags for TSpine, Ribs: Pyelonephritis

Answer 38

UTI, enlarged prostate, history of kidney stones

Question 39

Red Flags for TSpine, Ribs: Nephrolithiasis (Kidney Stones)

Answer 39

Sudden, severe back or flank pain, chills, fever, nausea, renal colic, symptoms of UTI, history of kidney stones