Systems Review LQ Flashcards

1
Q

Purpose of systems review?

A

identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional

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2
Q

________are the best tools to raise suspicion of pathology

A

RED flags

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3
Q

What are the constitutional symptoms or general health components requiring system(s) review when present?

A

Fever, chills, sweats- MOST often associated with systemic illness
Prolonged (≥2 wks.)
> 102° may require hospitalization
Weight changes, particularly loss of ≥ 5% and if unexplained
Nausea and Vomiting (N&V)
Dizziness and lt. headedness
Fatigue- prolonged (≥ 2 wks.) and limiting
Weakness- limiting
Paresthesia/Numbness
Malaise or ill feeling- “I feel like I’m coming down with something”
Mentation or cognitive changes

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4
Q

Kidneys, ureters, bladder, and urethra belong to what system?

A

Urinary

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5
Q

The function of the Urinary System:

A

Filter fluid from renal blood flow
Remove waste
Retain essential substances for fluid and contents balance i.e., electrolytes, acid-base balance, etc.

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6
Q

The urinary system stimulates _______ production
BP _________
Converts _______ to its active form

A

RBC
regulation
vitamin D

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7
Q

Urinary S&S

A

P! in trunk, flank, and/or pelvic regions
Discoloration
-Urinary changes
Frequency
Urgency
Bleeding
Pus
-Dysfunction
Flow
Initiation
Control
-Nocturia- awake to urinate

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8
Q

Urinary Review

A

MOST from Hx
Observation of urine is unlikely
P! w/kidney percussion
P! with bladder palpation/percussion during abdominal assessment

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9
Q

Function of the reproductive system

A

Producing sex cells i.e., eggs/sperm, and creating sex hormones with the Endocrine system
Maintaining fertilized eggs for development

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10
Q

Reproductive S&S

A

P! in pelvis, LB, abdominal regions and/or sexual organs

Dysfunction
Sexual
Bowel and bladder due to proximity

Abnormal
Discharge from sex organs
Menstruation

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11
Q

Early and possibly UNKNOWN pregnancy indications are ________ S&S

A

reproductive

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12
Q

What is polyuria?

A

excessive or an abnormally large production or passage of urine

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13
Q

Breast tenderness
Fatigue
N&V with possible wt. loss
Heartburn
Constipation
Abnormal vaginal discharge

These are ___________ S&S?

A

reproductive

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14
Q

Reproductive review

A

MOST from Hx
Observation unlikely
NO other specific assessment

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15
Q

The metabolic system compose of what structures?

A

gut, liver adipose tissue, pancreas, kidney, and mm

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16
Q

Functions of the metabolic system?

A

Conversion of foods and liquids into:
Energy for all cellular processes
Building blocks for proteins, fats, and carbohydrates
Eliminate waste
Fluid and electrolyte balance is KEY for cellular metabolism

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17
Q

Metabolic S&S:

A

Due to imbalance of fluid, electrolytes, and/or pH

If the S&S don’t match to a specific system and seem widespread, it is possibly a metabolic condition because altered metabolism can affect MULTIPLE systems

18
Q

What are two of the MOST common reasons you get fluid and electrolyte imbalances?

A

polyuria and/or dehydration

19
Q

What are things that contribute to polyuria and/or dehydration:

A

Diabetes (rid excess sugars)
Kidney dysfunction- regulates MOST electrolytes followed by intestines, bone, and parathyroid gland
Malignancy
Alcoholism/liver disease
Medication side affects e.g., diuretic for HTN
Burns
Diarrhea
N&V

20
Q

What are the 3 common electrolytes?

A

sodium, potassium , calcium

21
Q

What are other electrolytes? (4)

A

Phosphorus, bicarbonate, magnesium, chloride

22
Q

Fluid and Electrolyte imbalance S&S

A

Skin
-Loss of skin elasticity
-Temperature
Warm and flushed due to vasodilation from impaired circulation and thermoregulation with metabolic acidosis or Diabetes
Pale and cool due to vasoconstriction with hypovolemia or dehydration
-Neuromuscular irritability
Fatigue
Twitching
Cramping
Tetany

23
Q

CNS involvement regarding fluid and electrolyte imbalance S&S (4)

A

Memory impairment
Depression
Delusions/Hallucinations
Seizures

24
Q

Cardiovascular changes regarding fluid and electrolyte imbalance S&S (3)

A

Tachycardia
Postural hypotension
Altered respirations

25
Q

pH is ideally between ____ and ______
Kidney removes ____ and keep _____
Lungs balance the ________

A

7.35 and 7.45
acids; bases
acidic C02

26
Q

Four classes of pH imbalance

A

Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis

27
Q

T or F: Confusion and fatigue S&S may occur with ALL classes listed below

Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis

A

True

28
Q

respiratory acidosis (lowered pH)

A

Hypoventilation and an accumulation of acidic CO2 may occur with:
-numerous disorders affecting respiration
-drugs that suppress respiration like -opioids/muscle relaxers
-sleep apnea

29
Q

S&S of Respiratory Acidosis (lowered pH)

A

Headache
Anxiety
May progress to:
-memory loss/personality changes
-sleep disturbances
-incoordination/tremors

30
Q

Respiratory Alkalosis (higher pH)

A

Hyperventilation leading to a loss of acidic CO2 may occur with:
-pulmonary conditions
-anxiety
-anemia with less oxygenation

31
Q

S&S of Respiratory Alkalosis (higher pH)

A

Shortness of breath (SOB) is often the ONLY sign
Lightheadedness
Otherwise highly variable

32
Q

Metabolic Acidosis (lowered pH)

A

MOST common acid-base abnormality
Accumulation of acidic H+ ions may occur with:
MOST commonly due to diabetes with build-up of ketone bodies or acids
Diarrhea/dehydration leading to greater acid concentration
Kidney diseases that hold onto too many acids

33
Q

S&S of Metabolic Acidosis (lowered pH)

A

Long deep breaths with a fruity smell due to ketoacidosis
Think Diabetes cardinal S&S
-frequent urination (polyuria)
–dry mouth
–extreme thirst (polydipsia)
–decreased skin turgor
Blurry vision
Weakness/fatigue

34
Q

Metabolic Alkalosis (higher pH)

A

Accumulation of bicarbonate base may occur with:
-vomiting by loss of stomach acids
-kidney disorders or medications that keep too many bases
-excessive antacid, laxative, or diuretic medications
-diarrhea

35
Q

S&S of metabolic Alkalosis

A

Headache
Neuromuscular excitability
-paresthesia/Numbness
-twitching and cramping, particularly in feet and hands (Trousseau sign)
-seizures
Muscle alterations due to associated lowering of Ca2+
-skeletal weakness
-cardiac arrhythmias- irregular heart beating

36
Q

What is the MOST common metabolic condition?

A

Metabolic Acidosis (lowered pH)

37
Q

What are the review components for metabolic system?

A

Hx
Observation
resisted and or mmt -weakness
neuro test- possibly altered sensations
abdominal assessment
standard vitals
palpation

38
Q

Observation: Metabolic Review (6)

A

muscle twitching/tetany
altered respiration
memory loss
dry mouth
fruity breath**

39
Q

Metabolic Review: (+) abdominal assessment P! with palpation and percussion of (3)

A

liver
kidney
pancreases

40
Q

Metabolic Review: standard vital signs – what are they?

A

tachycardia or irregular heartbeat
postural hypotension
altered respiratory rate

41
Q

Metabolic Review: what should a PT expect to see w/palpation? (2)

A

loss of skin mobility
extreme skin temperatures