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Physio studies > Clinical patterns > Flashcards

Clinical patterns Flashcards

1
Q

Paget’s disease epidemiological features

A

European descent, over 55 yo.

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2
Q

Paget’s disease aetiology

A

unknown

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3
Q

Paget’s disease proposed pathophysiology/pain mechanism

A

excessive osteoclastic bone resorption / increased osteoblastic bone formation - dull or aching pain or no pain

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4
Q

Paget’s disease differential diagnoses

A

osteomalacia

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5
Q

Paget’s disease symptoms

A

pain + aching of bones / pain worse after lying or sitting
hearing loss
paraethesia

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6
Q

Paget’s disease mechanism of injury

A

can have OA in surrounding joints

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7
Q

Paget’s disease contributing factors

A

suspected environmental + genetic factors

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8
Q

Paget’s disease physical exam findings

A

misshapen bones, affected bones warmer

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9
Q

Paget’s disease tests for condition

A

X ray or bone scan

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10
Q

Paget’s disease diagnostic interventions

A

alkaline phosphatase (enzyme for bone growth) present

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11
Q

Paget’s disease precautions/contraindications

A

high impact PA

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12
Q

Paget’s disease prognosis

A

excellent if diagnosed + treated early before hearing loss etc. occurs

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13
Q

Paget’s disease physiotherapy management options

A

can help maintain muscle strength, flexibility + joint ROM

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14
Q

Paget’s disease other management

A

PA
healthy diet
heat + cold packs

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15
Q

Paget’s disease medical management options

A

bisphosphonates - slow progression by controlling bone building process
pain killers
surgery

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16
Q

Osteoporosis epidemiological features

A

post menopausal women
older men

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17
Q

Osteoporosis aetiology

A

low BMD / micro-architectural deterioration of bone tissue

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18
Q

Osteoporosis pathophysiology + pain mechanisms

A

low bone mineral density
no pain unless spinal compression fracture

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19
Q

Osteoporosis differential diagnoses

A

osteomalacia
infection
osteonecrosis

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20
Q

Osteoporosis symtpoms

A

silent disease

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21
Q

Osteoporosis contributing factors

A

smoking/alcohol abuse
decreased PA
decreased calcium, vitamin D, protein intake
some drugs

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22
Q

Osteoporosis screening questions

A

early menopause?
history of smoking?

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23
Q

Osteoporosis tests for condition

A

scanning axial skeleton w/ dual energy x-ray absorptiometry (DXA)

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24
Q

Osteoporosis diagnostic investigatiosn

A

T score of 2.5 or less on DXA

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25
Q

Osteoporosis precautions/contraindications

A

some medications

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26
Q

Osteoporosis prognosis

A

15+ years after diagnosis if take medication + make lifestyle changes

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27
Q

Osteoporosis physio management options

A

measures to prevent falls, improving vision, aids for daily living, promoting exercise

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28
Q

Osteoporosis other management

A

limit alcohol/stop smoking
take vit. d + calcium
increase weight bearing + maintain optimal body weight

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29
Q

Osteoporosis other medical management

A

boniva, reclast

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30
Q

Rheumatoid arthritis epidemiological features

A

female - onset 40s + 50s
male onset 80s

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31
Q

Rheumatoid arthritis aetiology

A

genetic contribution
exposure to certain antigen

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32
Q

Rheumatoid arthritis pathophysiology + pain mechansim

A
  • synovitis + synovial hyperplasia
  • various cytokines, effector cells + signalling pathways
  • proliferation of synovial tissue, infiltration of inflammatory factors
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33
Q

Rheumatoid arthritis prognosis

A

significant disability + early mortality if left untreated

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34
Q

Rheumatoid arthritis main problem

A

inflammation of joints / polyarticular pain + swelling

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35
Q

Rheumatoid arthritis area of symptoms

A

PIP joints (fingers), MCP joints, wrists, knees, ankles, MTP joints

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36
Q

Rheumatoid arthritis characteristics of symptoms

A

ache + stiffness

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37
Q

Rheumatoid arthritis behaviour of symptoms

A
  • stiffness worse after inactivity or vigorous exercise
  • morning stiffness over 30 mins
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38
Q

Rheumatoid arthritis typical activity restriction

A

cessation of work

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39
Q

Rheumatoid arthritis typical history/mechanism of injury

A

insidious without incident
multiple joints affected

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40
Q

Rheumatoid arthritis contributing factors

A

genetic

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41
Q

Rheumatoid arthritis screening questions

A

personal/family history of autoimmune diseases

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42
Q

Rheumatoid arthritis physical examination features

A
  • swelling/redness around joint
  • atrophy
  • active/passive movements limited
  • reduced strength in hands
  • muscle length X reducing ROM
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43
Q

Rheumatoid arthritis tests for condition

A

x rays, arthocentesis

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44
Q

Rheumatoid arthritis diagnostic investigations

A

IgM antibodies present in blood tests

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45
Q

Rheumatoid arthritis precautions + contraindications

A

quit smoking
avoid certain food eg. red meat

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46
Q

Rheumatoid arthritis physio management options

A

suggest exercise program

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47
Q

Rheumatoid arthritis other management options

A

assistive devices, home mods

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48
Q

Rheumatoid arthritis medical management

A

surgery, medications eg. analgesics, NSAIDs, corticosteroids, DMARDs

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49
Q

Osteoarthritis epidemiological features

A

female
1 in 3 over 65

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50
Q

Osteoarthritis aetiology

A

obesity, inactivity, past joint injury, muscle weakness

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51
Q

Osteoarthritis pathophysiology + pain mechanisms

A
  • degradation of articular cartilage
  • thickening of subchondral bone
  • inflammation of synovium
    pain = tenderness when pressed
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52
Q

Osteoarthritis prognosis

A

joint damage X be undone - increased mortality if untreated

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53
Q

Osteoarthritis differential diagnoses

A

fibromyalgia, rheumatoid arthritis, psoriatic arthritis

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54
Q

Osteoarthritis main problem

A

joint pain

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55
Q

Osteoarthritis characteristics of symptoms

A

stiffness, aching, tenderness

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56
Q

Osteoarthritis behaviour of symptoms

A

better in warmer weather

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57
Q

Osteoarthritis contributing factors

A

past injury, sedentary, overweight, history of trauma

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58
Q

Osteoarthritis physical examination findings

A

functional movement issues
limited active/passive movement
muscle strength + length decrease in muscles around joint

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59
Q

Osteoarthritis tests

A

X rays + MRIs

60
Q

Osteoarthritis diagnostic investigation findings

A

osteophytes, loss of joint space, bone oedema, bone cysts, capsular thickening

61
Q

Osteoarthritis physio management options

A

suggest exercise program

62
Q

Osteoarthritis other management options

A

maintain healthy weight + diet etc.

63
Q

Osteoarthritis medical management options

A

corticosteroid use

64
Q

Heart failure epidemiological features

A

old age

65
Q

Heart failure aetiology

A

heart attack
coronary heart disease
chronic conditions - hypertension, arrhythmias, cardiomyopathy, myocarditis

66
Q

Heart failure pathophysiology + pain mechanisms

A

when contracting/relaxing action of heart is inadequate b/c heart muscle is weak/stiff
- chest pain/stomach pain

67
Q

Heart failure differential diagnoses

A

COPD, hypertension

68
Q

Heart failure prognosis

A

only 50% alive 5 years later

69
Q

Heart failure main problem

A

bloated stomach, chest pain, coughing, shortness of breath

70
Q

Heart failure behaviour of symptoms

A

worse when lying down

71
Q

Heart failure contributing factors

A

unhealthy lifestyle
obesity
drug + alcohol abuse
low PA

72
Q

Heart failure tests

A

ECG
chest x ray
plasma b-type natriuretic peptide
transthoracic echocardiogram

73
Q

Heart failure diagnostic intervention findings

A

high levels of BNP

74
Q

Heart failure precautions/contraindications

A

NSAIDs

75
Q

Heart failure physio management

A

education re knowing how to recognise worsening symptoms / when action is required

76
Q

Heart failure other management

A
  • treating disorder causing heart failure
  • making lifestyle changes
77
Q

Heart failure medical management

A

drugs or surgery

78
Q

Coronary heart disease epidemiological features

A
  • male / post menopausal women
  • maori or south asian descent
  • old age
79
Q

Coronary heart disease aetiology

A

unhealthy diet
inactive
overweight / diabetic
high BP + cholesterol
smoker

80
Q

Coronary heart disease pathophysiology

A

coronary arteries become less patent b/c of build up of plaque in lining
- insufficient blood to heart muscle -> pain = angina

81
Q

Coronary heart disease prognosis

A

long life if detected + managed early

82
Q

Coronary heart disease differential diagnoses

A
  • msk system -> spine, ribs, muscles
  • heartburn
  • lung issues
83
Q

Coronary heart disease main problem

A

tightness
pressure
burning
breathlessness
sweating

84
Q

Coronary heart disease area of symptoms

A

chest
chin/jaw
upper back
shoulders

85
Q

Coronary heart disease characteristics of symptoms

A

stable angina = assoc w/ exertion / worse after meal

unstable angina = unexpected, occurs at rest, X ease w/ rest or medication

86
Q

Coronary heart disease contributing factors

A

family history
lifestyle factors

87
Q

Coronary heart disease special tests

A

Coronary angiogram = catheter inserted into heart, dye injected -> shows narrowing
ECG
chest x ray

88
Q

Coronary heart disease precautions + contraindications

A

avoid certain drugs eg. NSAIDs

89
Q

Coronary heart disease physio management

A

pre + post surgery

90
Q

Coronary heart disease other management options

A

lifestyle changes
pharmacological management
surgery

91
Q

Diabetes epidemiological features

A

type 1 = before 18 yrs old
type 2 = developed after 40 b/c of obesity, poor diet + lack of exercise

92
Q

Diabetes aetiology

A

build up of glucose in bloodstream

93
Q

Diabetes pathophysiology

A

type 1 = little/no insulin production by pancreas b/c beta cells destroyed by immune system
type 2 = reduction in body’s ability to use insulin

94
Q

Diabetes prognosis

A

incurable - type 2 diabetics may not need medication if change lifestyle

95
Q

Diabetes differential diagnoses

A
  • drug induced signs + symptoms eg. corticosteroids
  • infection
  • endocrinopathies eg. hyperthyroidism
96
Q

Diabetes main problem

A

fatigue
polydipsia
polyuria
polyphagia
weight loss (type 1)

97
Q

Diabetes contributing factors

A

type 1 = genetics, viral infections, vaccines, toxins, early cessation of breast feeding

type 2 = age, ethnicity, family history, weight, PA levels, diet, smoking

98
Q

Diabetes diagnostic investigations

A
  • random blood test -> glucose above 11mmol/L
  • fasted blood test -> 7mmol/L
  • haemoglobin -> 6.5% or above
99
Q

Diabetes precautions + contraindications

A

excessive exercise
certain foods

100
Q

Diabetes physio management

A

exercise prescription

101
Q

Diabetes other management

A

diet + lifestyle

102
Q

Diabetes medical management

A

insulin replacement

103
Q

Falls + fractures aetiology

A

fall from height that shouldn’t cause fracture
osteoporosis

104
Q

Falls + fractures main problem

A

NOF + Colle’s fractures

105
Q

Falls + fractures physio management

A

exercise prescription

106
Q

Falls + fractures other management

A

home safety interventions
vision + podiatry assessment

107
Q

Stroke epidemiological features

A

> 40 yrs old
regional area

108
Q

Stroke aetiology

A

hypertension
high cholesterol
atrial fibrillation
diabetes
age, gender + fam history

109
Q

Stroke pathophysiology

A

ischaemic stroke = acute loss of blood flow to brain b/c of infarct (blockage of artery by thrombus or embolus)

haemorrhage stroke = rupture of blood vessel in brain causing brain cells to die b/c of low O2

110
Q

Stroke prognosis

A

rapid recovery in days following
long recovery in general - better outlook if rehab good

111
Q

Stroke symptoms

A

face dropped
arms X be lifted
slurred or confused speech

112
Q

Stroke contributing factors

A

poor diet
low PA
age, gender + fam history

113
Q

Stroke PT Mx

A

resistance training
things to increase cardioresp fitness
task specific practice

114
Q

Stroke other Mx

A

must be mobilised in 48hrs unless contraindicated

115
Q

Stroke med Mx

A

treated by multi D team in stroke unit -> antithrombotic surgery/therapy

116
Q

Parkinson’s epidemiological features

A

60-65 years old
male
gene-environment interactions

117
Q

Parkinson’s aetiology

A

genetically inherited or sporadic (idiopathic)

118
Q

Parkinson’s pathophysiology

A

neurological degeneration of dopamine producing neurons in substantia nigra -> basal ganglia X coordinate movement

119
Q

Parkinson’s prognosis

A

can live long + rewarding life

120
Q

Parkinson’s differential diagnosis

A

multiple system atrophy
progressive supranuclear palsy
basal degeneration
lewy body dementia

121
Q

Parkinson’s symptoms

A

postural instability
tremors
rigidity
bradykinesia

122
Q

Parkinson’s specific tests

A

none, suspected if cardinal signs present

123
Q

Parkinson’s diagnostic investigations

A

MRI + CT scan to rule out other conditions
PET scans w/ fluoro dopa - low levels in striatum
SPECT scans w/ radioisotope
L dopa challenge

124
Q

Parkinson’s physio mx

A

prevent loss of:
- flexibility
- postural control
- limb ROM

125
Q

Parkinson’s medical Mx

A

dopamine replacement via levodopa
dopamine agonists
COMT inhibitors
anticholinergics
deep brain stimulation

126
Q

COPD epidemiological features

A

1 in 7 over 40 have some form

127
Q

COPD aetiology

A

smoking
asthma
genetics
exposure to environmental irritants

128
Q

COPD pathophysiology

A

changes in large + small airways
increased normal inflammatory response

increased number of activated polymorphonuclear leukocytes -> release elastases in manner X counteracted by proteases = lung destruction

129
Q

COPD prognosis

A

quality of life can be maintained if managed properly

130
Q

COPD symtpoms

A

worsening dyspnea + exercise intolerance

chronic bronchitis = progressive card/resp failure + weight gain, productive cough + pulmonary infection

emphysema = long standing dyspnea + late onset non-productive cough, cachexia + resp. failure

131
Q

COPD objective exam

A

chronic bronchitis = obese, frequent cough, use of accessory muscles in resp, wheezing, cyanosis

emphysema = thin w/ barrel chest, breathing assisted w/ pursed lips + accessory muscles, chest hyperresonance

132
Q

COPD tests

A

spirometry before + after meds

133
Q

COPD physio Mx

A

action plan to treat exacerbation early through resp physio

134
Q

COPD med Mx

A

pharmacology or O2 therapy

135
Q

Ankylosing spondylitis epidemiological features

A

males
15-45 onset

136
Q

Ankylosing spondylitis aetiology

A

genetic contribution

137
Q

Ankylosing spondylitis pathophysiology

A

inflammatory arthritis affecting spine + large joints
ossification of ALL.s -> bamboo spine

138
Q

Ankylosing spondylitis prognosis

A

progressive flexed spinal posture -> secondary breathing difficulties

139
Q

Ankylosing spondylitis dif. diagnoses

A

rheumatoid arthritis

140
Q

Ankylosing spondylitis symptoms

A

pain + stiffness in back, buttocks + neck
tendon + lig pain in chest, heel, under foot = enthesitis

eye inflammation

141
Q

Ankylosing spondylitis behaviour of symptoms

A

inflammation improves w/ exercise
am stiffness >45 mins / improves w/ rest

142
Q

Ankylosing spondylitis tests

A

X rays
blood tests - HLA-B27, IL23R + ARTS1 genes

143
Q

Ankylosing spondylitis physio Mx

A

aquatic therapy for spine

144
Q

Ankylosing spondylitis other Mx

A

rheumatologist to learn about AS

145
Q

Ankylosing spondylitis med Mx

A

analgesics, NSAIDs, corticosteroids, DMARDs

Physio studies (7 decks)

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