Week 2: Review of Systems Flashcards
What are the components of a general health screen?
Fatigue
Malaise
Fever, chills, sweats
Weight loss, gain
Nausea, vomiting
Dizziness, lightheadedness
Parasthesia, weakness, numbness
Change in mentation, cognitive abilities
What does black, tarry, shiny, sticky stool indicate?
Upper GI bleed
What does black, but not sticky stool?
Ingestion of iron & bismuh salts, black licorice, some commercial CC cookies
What does light gray, pale stool indicate?
Obstructive jaundice
What does bright, blood red stool indicate?
Lower GI bleed
what does dark, coke-like urine indicate?
rhabdomyolysis
hepatic or biliary obstructive disease
which system is affected? bone pain, increased bruising, increased thirst, parasthesia
endocrine
_____ _____ checklist is the starting point for assessing the psychologic system
general health
pain that fluctuates over a 24 hr period indicates an issue with which system?
MSK
how do most (~80%) adverse drug reactions present?
as a magnification of what the drug was meant to do therapeutically
what is the most common cause of joint pain?
OA
PTs should be primary care providers for what condition?
OA
if a person is experiencing a headache that wraps around the entire circumference of the middle of the head, what type of headache are they having?
tension
if a person is experiencing a headache that is around the eyes and forehead, what type of headache are they having?
migraine
if a person is experiencing a headache in the orbital region, what type of headache are they having?
cluster
if a person is experiencing a headache behind the eyes and radiating to the neck, what type of headache are they having?
cervicogenic
which type of headache is a second degree?
cervicogenic
which spinal levels refer pain up to the head?
C1-C3
what is one of the most common disabling conditions in the world?
headache
what’s the most likely condition?
pain improves with exercise
morning stiffness for >30 mins
pain at night
onset <40 yo
uveitis, IBS
ankylosing spondylitis
what’s the most likely condition?
onset 33-55 yo
pain improves with exercise
no non-joint conditions
potential pain referral to hip
non-specific LBP
classification criteria for RA must be present for ____ to have a diagnosis
6 weeks or more
what’s the most likely condition?
morning stiffness >1 hr
sx increase with rest & intense exercise
sx decrease with short rest & mild mvmt
onset 20-50 yo
autoimmune thyroid disorders
RA
what is the most common area to see RA?
MCP joint
classification criteria for RA
morning stiffness >60 mins
arthritis of 3+ joints
arthritis of hand joints
systemic arthritis
rheumatoid nodules
serum rheumatoid factor
radiologic changes
what’s the most likely condition?
sx increase with rest & intense activity
sx decrease with short rest & mild mvmt
onset 15-40 yo
infection, sunlight, meds
SLE
what’s the most likely condition?
onset 40s-50s
males more likely to have
increased uric acid levels
sx increase with WB and joint use
sx decrease with rest but unrelenting
night pain
no morning stiffness
rapid progression
gout
what’s the most likely condition?
onset teens-20s
psoriasis with arthritis following
morning stiffness >60 mins
no night pain
sx increase with rest & intense activity
sx decrease with short rest & mild mvmt
psoriatic arthritis
what’s the most likely condition?
onset 3rd decade (20s)
acute onset
venereal disease or dysenteric disease
reactive arthritis (Reiter’s Syndrome)
what’s the most likely condition?
abrupt onset
trauma or illness occurred
systemic corticosteroid use
DM, infection
sx increase with WB & joint use
sx decrease with rest but unrelenting
septic arthritis
what’s the most likely condition?
review of systems findings:
uveitis
fatigue, weight loss, fever, malaise
cardiac & pulmonary complications
ankylosing spondylitis
what’s the most likely condition?
review of systems findings:
skin rash
fever, fatigue, malaise
photosensitivity
dyspnea, cough
peripheral neuropathies
SLE
what’s the most likely condition?
review of systems findings:
fever, malaise
tachycardia
gout
what’s the most likely condition?
review of systems findings:
fever, fatigue, malaise
psoriasis
psoriatic arthritis
what’s the most likely condition?
review of systems findings:
urethritis
conjunctivitis
nausea, vomiting, diarrhea
weight loss
reactive arthritis (Reiter’s Syndrome)
what’s the most likely condition?
review of systems findings:
fever, chills, malaise
septic arthritis
what are some conditions that are associated with limb pain that PTs do not treat?
hypothyroidism
Lyme disease
polymyalgia rheumatica
statin-induced myopathy
dizziness vs vertigo
dizziness - spatial perception
vertigo - spinning sensation
T/F: dizziness and vertigo is common in children
F
could indicate a tumor
what should be considered when evaluating dizziness?
serious pathologic neck conditions
what are the 5 Ds of vertebral artery insufficiency?
drop attacks
dizziness related to neck movement
dysphagia
dysarthria
diplopia
what are the 3 Ns of vertebral artery insufficiency?
nausea
numbness
nystagmus
vertebral artery insufficiency will have positive ______ signs
cranial nerve
CVA - FAST stands for?
facial droop
arm numbness/weakness
speech difficulty
time
symptoms of cervical ligamentous instability
occipital HA and numbness
severely limited neck AROM all directions
signs of cervical myelopathy
what are the 4 categories of dizziness?
vertigo
disequilibrium
presyncope
non-specific (psychogenic)
what is vertigo?
sensation of spinning
vertigo is caused by
asymmetrical involvement of the vestibular system
which type of vertigo is more common?
peripheral (rather than central)
what is disequilibrium?
dizziness, imbalance, unsteadiness
W/O VERTIGO
degenerative changes in brain & body
what causes presyncope?
vascular compromise to cerebellum
CV disease
hypoglycemia
certain meds
what causes non-specific (psychogenic) dizziness?
panic/anxiety
cervicogenic
what is the most common type of HA?
tension
____% of HA are cervicogenic
15-20%
____% of HA are migraine
10-15%
____% of HA are cluster
<1%
____% of HA are tension
40%+
symptoms of cervicogenic HA
non-throbbing, non-pulsating
unilateral sx
provoked by neck mvmt &/or sustained posture
sx mild to moderate
symptoms of migraine HA
unilateral sx but shifts sides
severe sx
1+: nausea, vomiting, photophobia, phonophobia
symptoms of cluster HA
comes every other day for 8 days
sx are severe or very severe
lacrimation, nasal congestion &/or rhinorrhea, eyelid edema, forehead & facial sweating, ptosis, sense of restlessness or agitation
symptoms of tension HA
caused by stress, anxiety, or depression
bilateral symptoms
sx mild to moderate
red flags for TBI
double vision
severe or worsening HA
seizure or convulsion
LOC
deteriorating consciousness
vomiting
agitation &/or combativeness
what are the high-risk sites for stress fracture?
femoral neck
anterior cortex of tibia
medial malleolus
tarsal navicular
base of 2nd and 5th metatarsal
talus
patella
