Clinical Manifestations / Complications

Question 1

Benign characteristics

Answer 1

No infiltration or metastasis
Slow and local
Death and tissue damage rare

Question 2

Malignant characteristics

Answer 2

Invades and metastasizes via blood and lymph
Variable growth rate
Generalized effects
Death and tissue damage

Question 3

Warning signs of cancer

Answer 3

Change in bowel and bladder
Sore throat that doesn’t heal
Unusual bleeding or discharge
Lump
Indigestion and dysphagia
Obvious change in wart or mole
Nagging cough or hoarseness

Question 4

Radiation side effects

Answer 4

Local- dermatitis, alopecia, xerostomia

Systemic- fatigue, malaise, anorexia, dysphagia, incontinence, cognitive, sexual dysfunction

Question 5

Tissue complications with cancer

Answer 5

Stomatitis
Radiation dermatitis
Alopecia
Malignant foul smelling skin legions

Question 6

Complications with cancer

Answer 6

Stomatitis
Radiation dermatitis
Alopecia
Malignant foul smelling skin legions
Pain and fatigue
Decreased body self image
Low WBC/neutropenia/infection
Septic shock
Bleeding and hemorrhage due to thrombocytopenia due to marrow suppression

Question 7

Breast cancer

Answer 7

Upper outer quadrant
Non tender, fixed, hard
Dimples, nipple retraction, ulceration

Question 8

Osteoarthritis

Answer 8

Pain
Stiff
Functional impairment
Morning stiffness
Insidious and progressive

Question 9

Complications from total hip arthroplasty

Answer 9

Bleeding
Dislocation
VTE
Infection
Heel pressure injury
Heterotrophic ossification (abnormal bone formation)

Question 10

Osteomalacia

Answer 10

Bowing bones
Pain
Tenderness

Question 11

Paget

Answer 11

Deformed
Pain
Tender
Warmth over bones

Question 12

Osteomyelitis

Answer 12

Inflammation, necrosis, new bone formation
Infection
Pain
Edema
Erythema
Fever
Drainage
Superinfection from abx therapy

Question 13

Septic arthritis

Answer 13

Warm
Pain
Edema
Low ROM
Chills, fever, high WBC sometimes
Usually knee or hip

Question 14

Contusion

Answer 14

Pain
Swell
Ecchymosis

Question 15

Strain

Answer 15

Pain
Edema
Spasm
Ecchymosis
Lost ROM

Question 16

Sprain

Answer 16

Pain
Edema
Tender

Question 17

Major dislocation complication

Answer 17

Avascular necrosis

Question 18

Dislocation

Answer 18

Pain
Change in contour, axis, and length
Lost mobility

Question 19

Fracture

Answer 19

Pain
Loss of function
Deformity
Shortened extremity
Crepitus
Swelling
Discoloration

Question 20

Early complications of fractures

Answer 20

Shock
Fat embolism - hypoxemia, neurological compromise, petechial rash
Compartment syndrome
Rhabdomyolysis
VTE and PE

Question 21

Delayed complications of fractures

Answer 21

Delayed union
Malunion
Non union
Avascular necrosis
Complex regional pain syndrome
Heterotopic ossification

Question 22

Hip fracture complications

Answer 22

Hemorrhage
Peripheral neuro vascular dysfunction
VTE
Pulmonary complications
Skin breakdown
Loss of bladder control
Infection
Malunion
AVN

Question 23

Amputation complications

Answer 23

Hemorrhage
Infection
Skin breakdown
Phantom limb
Joint contracture

Question 24

Increased ICP - early

Answer 24

LOC
Eyes
Unilateral weakness
HA

Question 25

Increased ICP - late

Answer 25

Respiratory Cushing triad (HTN, low HR, low RR) Projectile vom Loss of brain stem reflexes

Question 26

Complications of status epilepticus

Answer 26

Brain anoxia Respiratory arrest

Question 27

Ischemic stroke

Answer 27

Numb at one side Confusion Trouble speaking or understanding Loss of balance and coordination Dizzy HA Perceptual disturbances

Question 28

Hemorrhagic stroke

Answer 28

Similar to ischemic HA LOC Vom Bleeding

Question 29

Hemorrhagic stroke complications

Answer 29

Vasospasm 7-8 days later Seizure Hydrocephalus Rebleeding Hyponatremia and SIADH Also: ICP, cerebral hypoxia, decreased cerebral perfusion

Question 30

Fat embolism syndrome

Answer 30

Dyspnea Chest pain Hypoxia Febrile Tachycardia Tachypnea Classic triad: hypoxemia, neuro compromise, petechial rash

Question 31

Chemo/cancer complications in hospital

Answer 31

Neutropenic (nadir) Thrombocytopenia Septic shock Embolism

Question 32

Altered LOC complications

Answer 32

Respiratory distress PNA Aspiration Pressure ulcer DVT Contracture Temperature and fluid Bowel and bladder

Question 33

Increased ICP complications

Answer 33

Brainstem herniation DI SIADH

Question 34

Cranial surgery complications

Answer 34

Increased ICP Bleeding and shock Fluid and electrolytes Infection CSF leak Seizures

Question 35

Avascular necrosis (AVN)

Answer 35

Death from decreased blood supply Pain

Question 36

Skull fracture

Answer 36

Bleeding from nose, pharynx, and ears Bruising behind ears (and eyes) CSF leak Localized pain

Question 37

Epidural hematoma

Answer 37

Brief LOC, lucid, then LOC

Question 38

Concussion

Answer 38

Difficulty awakening Lethargy Dizzy Confusion Irritability Anxiety Difficulty speaking and moving Vom

Question 39

Complications of SCI that lead to death

Answer 39

PNA PE Sepsis

Question 40

Meningitis

Answer 40

HA Fever Altered LOC Behavioral changes Stiff neck Kernig and Brudzinski Photophobia

Question 41

Brain abscess

Answer 41

HA that’s worse in AM Fever Vom Neuro Ss increase LOC

Question 42

Encephalitis

Answer 42

HA Fever Confusion Hallucinations Rash Flaccid paralysis Parkinson’s like movements

Question 43

MS

Answer 43

Relapsing and remitting Fatigue Weak Numb Poor coordination and balance Pain Visual

Question 44

Myasthenia gravis

Answer 44

Diplopia and ptosis Weak facial: impaired swallow and voice Generalized weakness

Question 45

GBS

Answer 45

Respiratory failure ANS and CV dysfunction Weak Paralysis Paresthesia Pain Low reflexes Starts lower and works up CN changes DVT, PE Retention

Question 46

Acoustic neuroma

Answer 46

Loss of hearing Tinnitus Vertigo

Question 47

Brain tumors

Answer 47

Increased ICP HA Vom Visual Seizure

Question 48

Parkinson’s

Answer 48

Tremor Rigidity Bradykinesia Postural instability Sweat, drool, flushing, ortho hypo, retention Dysphagia Psych changes

Question 49

ALS

Answer 49

Progressive weakness Atrophy Cramps Twitching Lack of coordination Spasticity, overactive reflexes Difficulty speaking, swallowing, breathing

Question 50

Post polio syndrome

Answer 50

Pain Weak Fatigue

Question 51

Complications with secondary bone tumor

Answer 51

Delayed wound healing, infection, hypercalcemia

Question 52

Chemo side effects

Answer 52

GI (NV and anorexia) Alopecia Stomatitis Decreased marrow (low WBC, neutropenic/nadir, RBC, and platelets) Kidney damage Cardiopulmonary damage Reproductive (infertility) Neurologic and cognitive impairment Fatigue

Question 53

Compartment syndrome

Answer 53

Pain not relieved by analgesics Numbness Tingling Edema (Assess the 5 Ps)