Exam I Flashcards
1
Q
What is a diagnosis most commonly based on?
A
-A cluster of clinical findings from the history and physical exam
2
Q
What is the biggest factor in making an incorrect diagnosis?
A
-Bias
3
Q
What is the advantage of the Heuristic appraoch to diagnosis?
A
-It is quick
4
Q
What is the disadvantage of the heuristic approach to a diagnosis?
A
-it might ignore serious health conditions
5
Q
What is the advantage of the hypothetic approach?
A
-all symptoms are investigated
6
Q
What is a disadvantage of the hypothetic approach
A
-It is slow, may delay intervention
7
Q
When a PT refers a patient out based on a single clinical finding, what approach is that an example of?
A
-Naturalistic or Event Driven
8
Q
Many clinicians are experienced and use what approach?
A
-Hueristic
9
Q
Less experience clinicians use what approach?
A
-Hypothetic Deductive
10
Q
What approach is recommend to make diagnosis?
A
-Mixed Approach
11
Q
How much information is gained from the history and interview that is needed to make a diagnosis?
A
-70-80%
12
Q
What is the purpose of the review of systems?
A
- To identify health problems that may have been over looked during the medical history
13
Q
In the cardiovascular, genital/urinary, and hepatic systems, conditions usually begin as what?
A
-Non-systemic and turn Systemic when they become chronic
14
Q
What is an example of a systemic condition involving the cardiovascular system?
A
-Congestive Heart Failure
15
Q
What systems normally present as non-system conditions only?
A
-GI, Billiary, Pulmonary, Nonmechanical musculoskeletal
16
Q
What systems usually present as systemic conditions only?
A
-Endocrine, Hematologic, Immune, Metabolic, Nuero, Cancer with metastasis. and drug reaction
17
Q
If a person has systemic sysmptoms, it is important to give a checklist involving what systems?
A
-Psychological, Endocinre, Hematoligcal, Neurological, Immune, Metabolic and Drug
18
Q
If a person is presenting with non-systemic symptoms, what should the screen incluce?
A
-Hepatic, Billiary, GI, Urogenital, Cardio and pulmonary
19
Q
If a patient has a systemic symptom it is important to refer them if what?
A
-It has not be investigated by the physician
20
Q
If a person has pain in the C-spine/shoulders, what systems should be checked?
A
-GI, GU, Cardio and pulmonary
21
Q
If a person has pain in the T-spine, what systems should be checked?
A
-Cardio, GI, GU(if a t/l spine junction)
22
Q
If a person has pain in the lumbar spine and SI joints, what systems should be checked?
A
-GI, GU, Perivascular
23
Q
If a person has pain in either UE or LE, what systems should be checked?
A
-Perivascular
24
Q
Is night pain a constitutional symptom?
A
-NO
25
How many people have a skin disorder that report for a consult?
-1 of 4
26
What is the primary lesion of a skin disorder?
-The 1st lesion to appear
27
What is the most common manifestation of dermatological disease?
-Pruritis (itching)
28
What is a vascular reaction that is marked by skin patched that appear smooth and slightly elevated?
-Uticaria (Hives)
29
Where to rashes normally present?
-Face, Trunk, Axilla and Groin
30
Changing of the skin and nail beds can be the first sign of what types of disease?
-Inflammatory, infection, hepatic, metabolic, and immunilogical
31
In what type of patients should skin be examined in?
-outpatient and bed bound
32
Palor skin can mean what?
-Anemia (Iron def)
33
Yellow skin can mean what?
-Liver disease, carotonemia, hemolysis
34
Red skin can mean what?
-Can be an exacerbation of other skin disorders
35
Color finding indicate what types of conditions?
-Systemic
36
Generalized skin malpigmentation can be the result of what type of disease?
-Tryoid, liver, or renal disease
37
Soft skin can be caused by what?
-thyrotoxicosis
38
Tight skin can be caused by what?
-Scleroderma
39
Rough skin can be caused by what?
-Hyperthyroidism
40
Dry skin can be caused by what?
-Vitamin A Def
41
Where should Turgor be tested?
-forhead, under clavicle, extensoer side of arm or hand
42
A turgor test is positive is skin remains raised for how long?
-5 or more seconds
43
What can a positive turgor test mean?
-Dehydration
44
Generalized warmth can be caused by what?
-Fever or hyperthyroidism
45
Coolness of the skin can be caused by what?
-Hypothryroidism, frostbite, hypothermia, shock or low C.O
46
Pitting Edema is a claasic sign of what?
-cardiac failure
47
Skin patches larger than what should raise suspicion of a pathology?
-1.5 cm
48
What is often the first sign of rhuemati disease?
-Skin lesions
49
Butterfly rash over the nose and cheeks is associated with what?
-Lupus in the cute stage
50
Chronic Cutaneous lupus is marked by what?
-chronic skin eruptions on sun exposed skin
51
Acute cutaneous lupus occurs in what percentage of clients who have systemic lupus?
-30-50%
52
Acute cutaneous lupus is marked by what?
-malar and widespread erythema (redness) and bolus lesions
53
Lesions from lupus are expected to present where?
-face, scalp, ears, neck and arms (sun exposed)
54
What else besides skin can be ea sign of lupus?
-brittle hair, bald pathes
55
Skin lesions with lupus are usually accompanied by what other symptoms?
-malaise, fatigue, arthritis, anemia, hair loss, white nails, uroligic symptoms
56
What diease is characterized by red patches, covered by think, dry silvery, scales?
-Psoriasis
57
Where are psoriasis lesions normally located?
-extensor surfaces, bony prominences, scalp, ears, and genitals
58
Psoriasis is ofter accompanied by what?
-Arthritis of small joints (fingers/hands)
59
What is the average onset of psoriasis?
-27 years
60
what tends to aggravate psoriasis?
-cold whether, sever anxiety, or emotional distress
61
What is the most common complaint of psoriasis?
-itching and sometimes pains for dry, cracked lesions
62
Psoriasis can cause what in nails?
-small indentations and yellow or brown discoloration
63
What is systemic scelerosis?
-A diffuse CT disease that cuases fibrosis of skin, joints, blood vessles, and internal organs
64
How is systemic sclerosis classified?
-the degrees and extent of skin thickening
65
Other symptoms of sclerosis include what?
-pain, stiffness, and swelling in the fingers and joints
66
How can systemic sclerosis cause muscle atrophy?
-by limited ROM secondary to skin, joint or tendon involvement
67
CI motility dusfuction cause by systemic sclerosis can affect what?
-esophagus, anorectal region, and can cause reful, heartburn, dysphagia and bloating after meals
68
Systemic Sclerosis targets what nerve in early stages?
-Median NEerve, CTS is common
69
What are the signs and symptoms of Lyme disease?
-Red rash (1st), and flu like symptoms
70
Lyme disease often presents with pain in what joints?
-Shoulder and knee
71
Maculopapular rash is associated with what?
-secondary syphilis
72
How does a maculupapular rash appear?
-"copper penny spots"
73
Where do maculopapular rashes normally occur?
-palms, bottom of feet, and maybe the face
74
In its second stage, maculopapular rash may present with what symptoms?
-flu symptoms, patchy hairloss and joint pain
75
Where do shingles normally appear?
-unilaterally along the path of a spinal nerve
76
What may shingles mimic?
-T-spine radiculopathy
77
Peak incidence of shingles occurs between what ages?
-50-70
78
By 80, what percent of people have experienced shingles?
-15%
79
What are the early symptoms of shingles?
-pain and tingling along spinal nerve or CN dermatome
80
How does HPV manifest?
-warts on hands, feet and mouth
81
Rosacea may be associated with what?
-Helicobacter Pylori
82
Where is rosacea normally seen?
-Cheeks, nose and chin
83
Where does Tinea Corporis normally appear?
-chest, abdomen, back of arms, face and dorsum of the feet
84
Steroids can cause what side effects on the skin?
-ecchymosis and cutaneous atrophy
85
Hypersensitity of the skin is common in what medications?
-Antibiotics (esp penecillin), sulfonamids (antiinfectives) and phenobarbital
86
Thrombocytopenia is a medical emergency that can be a result of what?
-radiation and chemotherapy, blood disorders and anticoagulants
87
Spider Angioma is usually present where?
-upper half of the body; usually the face, neck and chest
88
Spider angioma is accosiated with what?
-pregnancy, chronic liver disease, or estrogen therapy
89
Palmar Erythema can be cause by what?
-liver problems
90
How does palmar erythema present?
-warmth and redness in palm of hand and soles of feet
91
What should you look for when a patient presents with palmar erythema?
-other signs of hepatic disease; such as nail bed changes, spider angiomas, liver flap, and bilateral CTS/TTS
92
What are xanthelasmas?
-soft, raised, yellow plaques
93
Xanthelasmsas may be a result from what?
-high cholesterol
94
Where do xanthelasmas normally occur?
-eyes, and extensor tendons of hands, elbows, and knees
95
If a xanthelasma looks like ant bites, what does that mean?
-could be poorly managed diabetes; patient needs immediate medical attention
96
What should nails be screened for?
-color, shape, thickness, texture and presense of lesions
97
Clubbing is accosiated with what?
-cardiopulmonary conditions (80%) of the time
98
Splinter Hemorrhages (dark spots) under nails may be a sign of what?
-endocarditis
99
White spots under the nails may be caused by what?
-Alcohol use, nutitional deficits or MI
100
Koilonychia (spoon nails) may be a result of what?
-anemia, thryroid problems, or syphilis
101
Beau's lines on the nails may be caused by what?
-Alcohol use, nutritional deficits, or MI
102
Nail pitting may be a sign of what?
-psoriasis
103
Nail thickening may be caused by what?
-poor circulation issues
104
A capillary refil test is positive if it takes longer than?
-2 seconds
105
What does the capillary refill test assess?
-arterial circulation, dehydration or shock
106
Any skin lesion that hasnt healed in how long should be referred for consultation?
-4 weeks
107
a new skin lesion in a patient with a history of what should be referred for consultation?
-malignancy
108
A new skin rash with what should be referred for consultation?
-constitutional symptoms
109
Poor capillary refill along with signs of what should call for immediate medical referral?
-Shock
110
A rash where should be referred for immediate medical attention?
-on the trunk along the spincal nerve
111
A new skin lesion in a patient with history of malignancy and what else should be referred for immediate attention?
-constitutional symptoms
112
What is the description of Type I skin?
-always burns, never tans
113
What is the description of Type II skin?
-usually burns, tans minimally
114
What is the description of Type III skin?
-sometimes burns, tans uniformly
115
What is the description of Type IV skin?
-Burns minimally, always tans
116
What is the description of Type V skin?
-Very Rarely Burns, Tans easily
117
What is the description of Type VI skin?
-Never burns, always tans
118
Skin cancer is most common where on males?
-Trunk
119
Skin is most common where on females?
-Trunk and legs
120
Skin cancer is most common in what race?
-Whites
121
Skin cancer is least common in what race?
-Blacks
122
What is the most common cause of basal cell carcinoma?
-prolonged sun exposure
123
Does basal cell carcinoma usually spread?
-no
124
What is the appearance of basal cell carcinoma?
-pearly or ivory appearance, rolled slightly elevated edges,may ulcerate in center
125
What is the 2nd most common skin cancer in whites?
-squamous cell carcinoma
126
Where does squamous cell carcinoma usually appear?
-ears, face, lips, mouth and dorsum of the hand
127
80% of sqaumous cell carcinomas occur where?
-head and neck
128
How can the borders of a squamous cell carcinoma be described?
-poorly defined
129
How does a squamous cell carcinoma appear
-has an ulcer, flat red area, cutaneous hord, indurated plaque of nodule; may be flesh colored surrounded by scaly tissue
130
Superficial Spreading Meanoma accounts for what percent of cutaneous melanomas?
-75%
131
Malignamt melanomas usually arise from what?
-preexisting moles
132
When screening for medical referral for a possible skin cancer lesion, what point scale is used?
-7
133
On the 7 point skin cancer scale, what items are worth 2 points?
-CHANGES- color, size and shape
134
On the 7 point skin cancer scale, what items are worth 1 point?
7mm or more diameter, inflammation, oozing or bleeding
135
If a person scores 3 or higher on the 7 point skin cancer scale how soon should the see a dermatologist?
-within 2 weeks
136
If a person score a 1 or a two on the 7 point skin cancer scale, how soon soon the see a dermatologist?
-3-4 weeks
137
A person with possible skin cancer should be reffered immediately if they also have what?
-abnormal vitals or constitutional signs of metastasis
138
What gender is depression most common in?
-Females (2x)
139
What types of patients is depression common in?
-stroke, MI, Cancer and PD
140
How does the onset of Depression compare to that of dementia?
-More abrupt
141
What tends to have a longer duration, depression or dementia?
-Dementia
142
A person with dementia will answer questions how?
-near-misses
143
A person with depression with complain of memory loss, a person will dementia will do what with memory loss?
-deny it
144
Scoreing higher than what on the GDS scale will indicate depression?
-6
145
Anxiety is 2 times more likely for who?
-females
146
75% of those with anxiety have their first onset before what age?
-21
147
When anxiety begins later in life, what should be suspected?
-alcohol or durg use, or recent trauma
148
Scoring what on the DASS screening will call for medial referral?
-7 or above
149
A person with somatic symptom disorder usually seeks what?
-attention
150
dysmorphic disorder is described as what?
-distorted view of body
151
Dysmophic disorder is commonly due to what?
-Burn, Scare or amputation
152
A person with an eccentric personality disorder may present as what clinically?
-Claim to have no pain, and no exaggerated symptoms' may become hostile when stressed
153
A person with a dramatic personality disorder will do what with symptoms?
-exaggerate them; like compliments; palliative intervention helpful
154
An anxious personality disorder will present what challenges?
-wont complete HEP, has excuses, usualy pain as scapegoat
155
A patient rarely shows up for appointments and doesn't complete interventions would be considered what type of personality disorder?
-self defeating
156
Females attempt suicide how many more times more likely than men?
-3
157
Males are how much more likely to complete suicide than women?
-4x
158
suicide is the what ranked cause of death in white males?
-8th
159
73% of suicides are completed by who?
-White males
160
80% of fire arm suicides are performed by who?
-white males
161
Suicide is highest in what populations?
-white and native american males
162
A patient scoring higher than what percent on stress screening should be referred?
-30%
163
A person planning suicide with the means to do it should receive what type of referral?
-immediate
164
What is Type I non-hemolytic anemia?
-Iron deficient
165
What is Type Ii non-hemolytic anemia?
-caused by inflammatory response
166
What is Type III non-hemolytic anemia?
Aplastic
167
What is Type IV non-hemolytic anemia?
-Renal insufficiency (lack of erythropoetin)
168
What is Type I non-hemolytic anemia?
-Megaloblastic
169
Mild or slow onset anemia will have what symptoms?
-post exercise fatigue,SOB, and palpitations
170
Severe or rapid developing anemia will have what symptoms?
-SOB, palpittions, bounding pulse, increased HR, feeling fain all at rest
171
What signs in the GI tract can be observed with megaloblastic anemia?
-smooth, red tongue, diarrhea, and B12 deficient neuro sings
172
A b12 deficiencys will cause what symptoms?-
-numbeness in extermities, poor coordiation, motor weakness, dementia
173
Aplastic anmemia is common in what population?
-ashkenazi jews and leukemia patients
174
What is often the first sign of aplastic anemia?
-bleeding
175
Hemolytic Anemias are cause by what>
-Increased rate of RBC desctruction
176
Sickle cell is considered what type of hemolytic anemia?
-A)synthesis of abnormal Hgb
177
Thalassemias are considered what type of hemolytic anemias?
-b)decreased synthesis of normal Hgb
178
What is the occurance rate of homosygote sickle cell in AAs?
-1/400
179
What percent of AAs have heterozygote sickle cell?
-8-10%
180
What is the most painful step in sickle cell?
-II)
181
People with what decent is thalassemia prevelent in?
-Mediterranean (Greece, cyrus, italy), SE asian (Thailand, india, laos), and N African
182
Minor or Alpha Thalassemia will cause what?
-Very small RBCs with minimal or mild decrease in Hgb
183
Major or Beta Thalassemia will cause what?
-less Hbg: 4-6g/dl
184
What is normal Hgb densitiy in mean?
-13-17 g/dl
185
What is normal Hgb density in women?
-12-17 g/dl
186
What is normal Hct percentage in men?
-39-49%
187
What is normal Hct percentage in females?
-36-48%
188
Hct is approx how much more the Hgb in blood?
-3x
189
A person with <25% Hct levels can perform what level of exercise?
-NONE
190
A person with >25% Hct levels can perform what level of exercise?
-Light
191
A person with 30-32% Hct levels can perform what level of exercise?
-Resistance exercise as tolerated
192
A person with <8 g/dl Hgb can perform what type of exercise?
-NONE
193
A person with 8-10 g/dl Hgb can perform what type of exercise?
-Light
194
A person with >10 g/dl Hgb can perform what type of exercise?
-Resistance exercise as tolerated
195
What is Polycythemia?
-increased Hgb and Hct
196
Primary polycythemia is what?
-Vera-bone marrow disorder causing excessive RBC production- increases blood viscosity
197
Secondary polycythemia is cause by what?
-Increased erythropoietin
198
What are the symptoms of polycythemia?
-fatigue, BOD, pressure on left side of abdomen, itching, blurred vision, weight loss, swelling common in big toe
199
What are some physical finding for polycythemia?
-large spleen, fullness/redness of face, High BP
200
What are the complications of polycythemia?
-clot formation, hemorrage of upper GI tract
201
What is thrombostopenia?
-decreased platelet number
202
What can thrombocytopenia be caused by?
-Bone marrow (aplastic anemia), immune disorders, platelet sequestartion within enlarged spleen, pregnancy
203
What is a type B platelet disorder?
-Abnormal Platelet function (aquired or hereditary)
204
What is a sign of thrombocytosis?
-Fish net veins
205
What is NADIR?
-the lowest point WBC counts reach; usually occurs 7-14 days after chemo
206
Signs of unknown bleeding require what?
-immediate medical care
207
A patient with thrombocytopenia and a platelet count of 150,000-450,000 can perform what type of activity?
-Normal
208
A patient with thrombocytopenia and a platelet count of <150,000 can perform what type of activity?
-progressive resistance exercise as tolerated, swimming, biking on flat ground
209
A patient with thrombocytopenia and a platelet count of <50,000 can perform what type of activity?
-AROM, Moderate exercise
210
A patient with thrombocytopenia and a platelet count of <30,000 can perform what type of activity?
-light exercise, AROM only
211
A patient with thrombocytopenia and a platelet count of <20,000 can perform what type of activity?
-None or AROM, restricted ADLS with MD approval
212
Physical therapy is contraindicated with PT less than or equal to what?
-25 seconds
213
What is normal PT?
-10-15 seconds
214
Patients with a platelet count <50,000 what its there risk of bleeding?
-may bleed excessivly when challendged with mild or moderate trauma as well as surgury, bruises easily
215
Patients with a platelet count <20,000 what its there risk of bleeding?
- may have spintaneous bleeding, has petechiae or purpura
216
Patients with a platelet count <10,000 what its there risk of bleeding?
-risk for life threatening bleeding
217
What are the two types of hemophelia?
-hereditary and aquired
218
Where does bleeding occur with platelet disorders?
-superficial cites
219
Where does bleeding occur with clotting factor disorders?
-deep tissue, muscle, joints, body cavities
220
Hemophillia is suspected in a patient with PTT times, PT times and platelet counts of what?-
-PTT >36 sec; PT 10-15 sec (normal), and platelet count 150,000-450,000 (normal)
221
80% of hemophilia cases are caused by a deficiency of what clotting factor?
-Clotting facotr VIII (type a)
222
What is the most common musculoskeletal finding of hemophilia?
-hemerthrosis
223
What is the 2nd most common site for hemophiliac bleeding?
-Muscle
224
What symptoms are related to GI bleeding with hemophilia?
-abdominal pain, melena (tarry stools), Hematemesis (bloody vommit), groin pain, hip and trunk contracture
225
How does Illiopsoas pain present?
-More pain with active trunk flexion, and passive hip extension than with passive hip IR
226
What are the complications of hemophilia?
-Crippling arthritis, life threatining bleeding
227
What is the medical emergency in which the organs and tissues are not receiving an adequate flow of blood or the blood is not carrying enough oxygen?
-Shock
228
What is the shock index a ratio of?
-HR to systolic blood presuure
229
What is the normal shock index of males aged 20-24
-0.63 (0.46-0.86)
230
What is the normal shock index of males aged 30-34?
-0.60 (0.43-0.82)
231
What is the normal shock index of males aged 40-44?
-0.57 (0.40-0.79)
232
What is the normal shock index of males aged 50-54?
-0.55 (0.38-0.77)
233
What is the normal shock index of males aged 60-64?
-0.61 (0.36-0.75)
234
What should you refer a patient for with a history of easy bleeding and acute joint bleeding?
-Medical Referral
235
A patient with an INR above what calls for a medical referral?
-3
236
Patients with a history of hemophilia presenting CNS symptoms or acute joint bleeding should be referred to what?-
- Emergency care
237
Patients with a shock index greater than what should be referred to emergency care?
-0.08
238
What are the cardinal signs of CVD?
-Chest neck or Arm pain, palpitations, dyspnea, nocturnal dyspnea, syncope, fatigue, coughing and cyanosis
239
What is the most common symptoms of the vascular component of CVD?
-Edema and Leg pain
240
Where might chest pain radiate to in a patient with Cardiovasular Disease?
-Neck, Jaw, Upper Trap, Upper back, shoulder, or arm
241
Where is the most common site of pain from CVD to radiate?
-Left arm
242
What can chest pain in CVD be caused by?
-MI, Ischemia, pericarditis, endocarditis, mitral valve prolapse, and aortic dissection
243
What other signs and symptoms accompany chest pain in those with CVD?
-Nausea, vomiting, diaphoresis, dyspnea, fatigue, pallor and syncope
244
in females, where can pain from microvascular disease radiate?
-sternum, above left breast and left cheek
245
In males, where can pain from coronary artery disease radiate?
-left neck, shoulder, and ulnar border of arm and hand
246
Some people may confuse the pain from angina as what?
-indigestion
247
What is orthopnea?
-breathlessness relived by standing up
248
What is cardiac syncope caused by?
-lack of oxygen to the brain
249
What is vasovagal syncope caused by?
-intense parasympathetic response that causes global vasodilation
250
What should you use to dose exercise for a person that is on medication that lowers their HR?
-RPE
251
What is the most notable symptoms of MI?
-sudden sensation of pressure, described as crushing chest pain
252
Where does pain from an MI radiate?
-arms, throat, neck and back
253
What other symptoms accompany pain with an MI?
-Pallor, SOB, and sweating
254
What is the most common myotoxic event cause by statins?
-Myalgia
255
What symptom is common with statins?
-Joint pain
256
if a patient on statin medication has symptoms such as pains, unexplained fever, nausea, vomiting and dark urine?
-refer immediately
257
What are signs of liver impairment?
-Dark Urine, Asterixis, Bilateral CTS, Palmar Erythema, Spider Angioma, Ascitis
258
Hypertension is commonly asymptomatic, but what is a common symptoms?
-Headache
259
What is the most powerful risk factor of stroke and is strongly linked to heart attack?
-Systolic Hypertension
260
What are some other signs of hypertension?
-Anxiety, Brain Damage, breathlessness, fear, hemorrhages, hyperventilation, nose bleeds and palpitations
261
What is the most common symptoms of Congestive Heart Failure?
-Shortness of Breath
262
What are the signs of Left sided CHF?
-(FORCED): Fatigue, Orthopnea, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended neck veins
263
What are the signs of Right sided CHF?
-(BACONED) Bloating, Anorexia, Cyanosis/Cool legs, Oliguria, Nausea, Edema, Distended NeckVeins
264
Orthostatic Hypotension is a cardinal feature of what?
-Autonomic Dysfunction
265
What is the main presentation of orthostatic hypotension in older adults?
-Falls, acute mental confusion, cardiac symptoms
266
What are the ischemic symptoms of orthostatic hypotension?
-lethargy, weakness, low back ache, calf claudication, angina
267
What is infective endocarditis caused by?
-Bacteria (strep or Staph)
268
What is the most common musculoskeletal symptoms of endocarditis?
-Artlralgia
269
What is the most common site of arthralgia with endocarditic?
-Shoulder
>>> knee, hip, wrist, ankle, MTP, MCP, AC
(most to least)
270
1/3 of endocarditic patients report what?
-Low back pain
271
What are the symptoms of pericarditis?
-chest pain, dyspnea, high pulse, high temp, malaise, and myalgia
272
Chest pain from endocarditic may mimic the pain of what?
-MI
273
How does pain from pericarditis differ from MI pain?
-it can be releive by learning over or holding breath, MI pain doesnt change
274
What is the most common site of an aneurysm?
-The Aorta
275
95% of anueryms occur where?
-Just below the renal arteries (can cause back pain)
276
Chest pain associated with an thoracic aneurysm can radiate where?
-Neck, between the scapulas, shoulders, low back and abdomen
277
What are the early warning signs of an impending rupture of an abdominal aneurysm
-Abdominal heart beat when laying down, dull ache in left flank or lower back
278
What is the most common symptoms of an abdominal aneurysm?
-pulsating mass in abdomen
279
What are the risk factors for aneuryism?
-Males>females, age, being active, smoking, congenital heart disease, CAD, Marfan Syndrome, LD syndrome, Turner syndrome, EDS, Anticoagulant therapy
280
What are the primary symptoms of PAD?
- Sense of weakness or tiredness, pain, faigue
| - May be aleviated by rest
281
What are the symptoms of claudication?
-cramping and pain with exercise; rest releives symptoms
282
Lower extremilty cluadication often occurs with what?
-PAD and CAD
283
What symptoms can occur with LE claudication?
-Angina, Dyspnea
284
What skin changes will you see with LE claudication?
-disocloration, coolness, trophic changes, and shemic pain
285
What is the normal ABI value?
-0.91-1.3
286
What ABI value represents a mild to moderate claudication?
-0.41-0.9
287
What ABI value a severe claudication?
-0-0.4
288
Varicose veins and chronic venous insuffeciency is known as what?
-chronic venous disease
289
What are the signs and symptoms of a DVT?
-leg or calf sweeling, pain and tenderness, dilation of superficial veins, and pitting edema
290
50% of individuals who get a DVT also have what?
-pulmonary embolism
291
A rise in diastolic BP higher than what calls for the stop of exercise?
-20
292
A fall in systoilc blood pressure of what calls for stopping exercise?
-10
293
What visual changes can you see that would cause for exercise to be stopped?
-increased peripheral edema and juggular distension
294
What are the signs and symptoms of hypoxemia?
-pale/blue skin, confusion, couhging, SOB, sweating, wheezing, rapid breathing
295
75-85% of clubbing is due to what?
-Pulmonary disease cause by hypoxia
296
persistent dry cough may be caused by what?
-Tumor, congestion, hypersensitive airways
297
Cough with sputum may signify what?
-Infection
298
Hemoptysis (coughing blood) may be the result of what?
-infection, inflammation, abscess, or tumor
299
Dyspnea usually indicates what?
-Hypoxemia
300
Pumonary pattersn of chest pain usually result where?
-substernal, or over the affected lung
301
Where can pulmonary chest pain radiate?
-neck, upper trap, costal margins, t-spine, scapula and shoulder
302
Any client with chest pain should be evaluated for what?
-Trigger points and intercostal muscle tear
303
What is the most common change in breathing patterns?
-Hypoventilation
304
What is hypercapnia?
-excessive retention of CO2
305
What are the mild symptoms of Hypercapnia?
-flushed skin, inability to focus, mild headache, disorientation, abnormally tired, or exhaustion
306
What are the severe symptoms of hyercapnia?
-confusion, paranoia, depression, abnormal muscle twitching, irregular heart beat, hyperventilation, seizures, panic attack, syncope
307
Generalized myalgias from pneumonia may extend to where?
-Thighs and calves
308
what are the signs and symptoms of tuberculosis?
-progressive fatigue, malaise, anorexia, weight loss, crhonic cough, hemoptosis
309
What are the suggestive symptoms of TB?
-cough lasting longer than 3 week, especially when accompanied by weight loss, fever, night sweats, fatigue, anorexia
310
What are the symptoms of chronic bronchitis?
-persistent cough, sputum production that is worse in the mornig and at night
311
what are most cases of pulmonary edema caused by?
-left ventricular cardiac failure, acute hypertension, mitral valve disease
312
What non cardiopulmonary condition can cause pulmonary edema?
-kidney and liver dysfunction
313
How will sputum appear with pulmonary edema?
-frothy and tinged with blood
314
What is the first a primary symptom of pnuemothorax?
-dyspenia
