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Med Screening > Intake Overview > Flashcards

Intake Overview Flashcards

1
Q

where does 80% of the initial exam info come from

A

the interview

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2
Q

where does the other 20% of initial exam info come from

A

systems review and tests/measures

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3
Q

what is the initial goal of a hx

A

is the primary c/o NMS or medical?
- risk and sx screening can r/o or r/i medical vs NMS

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4
Q

what are the methods for info gathering

A

chart review
interdisciplinary discussion
patient interview
questionnaire/survey

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5
Q

what info might a questionnaire be best for (5)

A

risk factors
general health - review of systems
meds
surgical hx
medical tests - XR, MRI, EMG, blood work

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6
Q

what settings are questionnaires really common in

A

outpatient
- direct access setting

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7
Q

what info is better gathered verbally

A

HPI
- ask follow up questions

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8
Q

why might hobbies included on an intake form

A

help find out normal activity level and helps w goal writing

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9
Q

what are general risk factors (7)

A

age
sex at birth
BMI
smoking
occupation/hobbies
ethnicity
substance abuse

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10
Q

what age ranges are risk factors

A

> 65yo “aging adult”
- for dz and comorbidity, med interactions
0-3 - inc risk for peds problems
13-20 teens

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11
Q

what about the female sex at birth might be risk factors for

A

if of childbearing age
gynecological issues

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12
Q

BMI, smoking, alcohol, and drugs are inc health risk; what type of prevention is this an opportunity for you to implement

A

health promotion education

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13
Q

what is construction work a risk factor for

A

asbestos exposure&raquo_space; pulm issues

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14
Q

what is some health care professions a risk factor for

A

radiation exposure

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15
Q

what is a dentist occupation a risk factor for

A

higher risk for depression

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16
Q

what is sedentary lifestyle a risk factor for

A

CV risk

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17
Q

how is a Native American ethnicity a risk factor for health outcomes

A

higher prevalence of DM2

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18
Q

what does being an African American man inc the risk of

A

heart dz (essential HTN)

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19
Q

what does being an African American woman inc the risk of vs. a white woman

A

2.5x higher incidence
2x mortality

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20
Q

what does an African American ethnicity inc the likelihood of dying from

A

pneumonia
influenza
DM
liver dz

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21
Q

what are the social determinants of health (SDH)

A

education (access and quality)
health care (access and quality)
economic stability
neighborhood/built environment
social/community context

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22
Q

if screening for SDH, what is an important thing to have ready

A

the resources to help them

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23
Q

what is important in the process of implementing SDH

A

to implement it across the board w everyone
- can’t pick and choose

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24
Q

what substance use/abuse are risk factors

A

caffeine
tobacco (all forms)
alcohol

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25
Q

what does the use and abuse of tobacco and caffeine specifically inc the risk of

A

inc bp of HTN adults by ~15/33 mmHg for up to 2hrs after ingestion
- can be dangerous if pt is HTN

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26
Q

what are the PT implications for someone who uses/abuses tobacco and/or caffeine and has HTN

A

careful monitoring of VS during exercise
important to know when last consumed

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27
Q

what conditions do you see teens and adults self medicating for with alcohol

A

ADD/ADHD
PTSD

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28
Q

alcohol or drug abuse is a very common cause of what condition

A

TBIs

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29
Q

what is the alcoholism criteria

A

men: >14 drinks per week
women: >7 drinks per week

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30
Q

what body systems which alcohol affects is of particular interest to PTs

A

neurologic
musculoskeletal

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31
Q

what are 5 common neurologic/MS system issues d/t alcohol that PTs may treat

A

alcoholic polyneuropathy
alcoholic myopathy
alcoholic ataxia (cerebellar)
nontraumatic hip osteonecrosis
injuries from falls

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32
Q

how does alcoholic polyneuropathy present

A

bilateral numbness/tingling in sock/glove distribution

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33
Q

how could alcoholic ataxia be a cerebellar issue

A

d/t cerebellar deterioration from chronic alcohol use

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34
Q

why is nontraumatic hip osteonecrosis seen in cases of alcohol abuse

A

osteonecrosis caused by a loss of blood supply due to the alcohol abuse

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35
Q

4 alcohol screening questions
how do you interpret the responses

A
  1. have you had any fx or dislocations to your bones or joints?
  2. have you been injured in road traffic accident?
  3. have you ever injured your head?
  4. have you been in a fight or been hit/punched in the last 6mo?

if yes to 2 or more, red flag for alcohol abuse

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36
Q

what are the 4 intake form categories

A

general health screening
medical screening
current sx
functional outcome measures & screening

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37
Q

what are the top 6 common dx found in medical screening

A

cancer
spinal infection
cauda equina
AAA (abdominal aortic aneurysm)
vertebral fx
depression/suicide risk

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38
Q

what body systems are evaluated in medical screen (8)

A

cardio
pulm
GI
hepatic
biliary
renal
urinary
reproductive

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39
Q

what 2 tools are frequently utilized to measure current sx

A

body chart - where does it hurt
NPRS (numeral pain rating scale)

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40
Q

when going through questionnaires of sx what are you looking for for effective med screening that might lead to a dx

A

system clusters

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41
Q

why is it important to ask about if the pt has ever been dx with any conditions in the past

A

previous conditions:
- can inc susceptibility
- could be coming back
- could be presenting in a different way

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42
Q

when are we a mandated reporter of physical abuse

A

children (0-18yo)
aging adult / elder abuse

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43
Q

when are mandated to report physical abuse in children

A

“reasonable suspicion of a problem”

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44
Q

what can we do for physical abuse in adults since we aren’t mandated to report?

A

health promotion and safety
ethically bound to inquire and refer

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45
Q

what is a good question to start w to screen for physical abuse / assault

A

do you feel safe at home?

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46
Q

what do you often see clustered w pts experiencing chronic pain

A

> 50% report physical and/or sexual abuse hx (both men and women)

daily HA associated

hx of many injuries and accidents
- including multiple MVAs

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47
Q

what are the PT implications for a pt w a hx of abuse

A

PT has a lot of hands on techniques that might be triggering
- INFORMED CONSENT

watch for non verbal responses
- ms guarding

frequent check ins

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48
Q

what are the most common SE for meds

A

constipation/diarrhea
nausea
abdominal pain
sedation

49
Q

what are 4 general things to screen for if pt is on medications

A

ADE - unpredictable, dangerous
drug to drug interaction
drug to dz interaction
SE - predictable, undesirable

50
Q

what are you watching for w common OTCs (ie NSAIDs) used for pain control

A

4 D’s

Dizziness
Drowsiness
Depression
visual Disturbance

51
Q

what is s/sx of antibiotics

A

skin reactions (ie rashes)
joint pain

52
Q

what is a s/sx of diuretics

A

ms weakness/cramping

53
Q

what is a s/sx of caffeine

A

ms hyperactivity

54
Q

what is a s/sx of corticosteroids

A

hip pain d/t femoral head necrosis

55
Q

what is a common s/sx of thorazine/tranquilizers and antipsychotics

A

gait disturbances

56
Q

what is the acceptable dosage for OTC NSAIDs

A

1200mg max
- prescribed doses for something like RA might be higher than this

57
Q

what pt population might be taking NSAIDs

A

back, shoulder, scap pain

58
Q

for pts taking NSAIDs what should you look for and how do you use this info

A

look for GI complications
- correlate inc sx after taking meds, food intake

59
Q

what pt population is at special risk with NSAIDs

A

post-surgical

60
Q

what are post-surgical pts on NSAIDs at risk for

A

hypotension
GI bleed
dec bone and tendon healing

61
Q

what is a pain management med you could recommend to post-surgical patients

A

tylenol

62
Q

what do sx do you report if noticed in a pt taking NSAIDs

A

inc bp
ankle/foot edema

63
Q

what would inc bp in a pt taking NSAIDs indicate

A

renal vasoconstriction

64
Q

what are risk factors for GI complications in pts taking NSAIDs

A

> 65yo - confusion/memory loss
hx of peptic ulcer dz
smoking, alcohol use

65
Q

what is a pro to the use of acetaminophen when managing pain

A

less GI issues

66
Q

what is the max dosage for acetaminophen

A

4000mg for every 24hrs

67
Q

what is a name brand for acetaminophen

A

tylenol

68
Q

what is a potential side effect of acetaminophen usage

A

liver toxicity

69
Q

what inc the risk of liver toxicity in pts taking acetaminophen

A

alcohol and vitamin C intake

70
Q

what are the 3 types of corticosteroids

A

anabolic
mineralocorticoid
glucocorticoid

71
Q

what types of corticosteroids are most commonly seen

A

mineralocorticoid
glucocorticoid

72
Q

what are examples of anabolic corticosteroids

A

testosterone
estrogen
progesterone

73
Q

what is a potential side effect of anabolic corticosteroid usage

A

roid rage
- usually seen in illegal usage

74
Q

what are mineralocorticoids taken for

A

electrolyte balance

75
Q

what are glucocorticoids taken for

A

anti-inflammatory

76
Q

what are potential side effects of glucocorticoids (4)

A

GI issues
AVN of the hip
immunosuppression
psychological issues

77
Q

what is the dosage like for corticosteroids

A

start at higher dose and then have tapering off dose

78
Q

why is the dosage of corticosteroids an important pt education piece

A

pt shouldn’t stop suddenly taking them
- can have withdrawal bc body needs time to start producing its natural corticosteroids again

79
Q

what are s/sx of corticosteroid withdrawal (7)

A

severe fatigue
weakness
body aches
joint pain
nausea
loss of appetite
light headedness

80
Q

what does hormone therapy put pts at an inc risk for

A

HTN
clotting issues (ie DVTs)

81
Q

what are risk factors for DVTS in pts receiving hormone therapy (6)

A

> 35yo
smoker
HTN
obesity
DM
recent surgery

82
Q

what does injectable hormone therapy (depro-provera) put pt at inc risk for

A

bone loss

83
Q

what are 4 common examples of opioids

A

codeine
morphine
oxycodone
hydrocodone

84
Q

what are side effects of opioids (6)

A

nausea
constipation
dry mouth
itchy skin
DROWSINESS
DIZZINESS

85
Q

what is an important side effect of opioids w direct PT implications

A

dec central respiratory drive and rate
- inc airway resistance
- dec ventilation

86
Q

what are risk factors for opioid abuse

A

<65yo
previous hx of abuse
depression and psychotropic med use

87
Q

what is an important thing to follow up if pt is on opioids

A

how long has pt been on them

88
Q

why might pt experience joint pain while on antibiotics

A

noninflammatory

89
Q

how long can SE of antibiotics last? what is the PT implication of this?

A

SE can occur 2 hrs to 60 days after taking meds

implication - hx of taking antibiotics is important bc SE can last up to 60 days

90
Q

what are fluoroquinolones (cipro, levaquin) typically used to treat

A

antibiotics
UTI and URI treatment

91
Q

what do fluoroquinolones put pt at inc risk for

A

possible tendonitis and/or tendon rupture

92
Q

what risk factors inc the risk of toxicity while taking fluoroquinolones

A

if taken w corticosteroids and >60yo

93
Q

what are some examples of natraceuticals (8)

A

herbs
vitamins
minerals
antioxidants
supplements
fish oil
melatonin
fat vs water soluble vitamins

94
Q

what is an important consideration regarding natraceuticals when getting a med hx

A

need to ask specifically
- patients prob won’t consider these meds

95
Q

what patient population is at special risk for SE from natraceuticals

A

post op

96
Q

what is a characteristic of natraceuticals to be wary of when reviewing meds

A

can see significant interactions w other meds

97
Q

what SE of natraceuticals can you see in post op patients (5)

A

anticoagulation
HTN
CV function changes
sedation
diuresis

98
Q

what should be included in your questions when getting a surgical hx (3)

A

comprehensive list of surgeries/procedures
dates
scars

99
Q

what can a list of medical tests provide insight into

A

medical direction of the case

100
Q

what are 5 ex of medical tests

A

XR
MRI
CT
EMG
blood work

101
Q

what does a body chart vs NPRS tell you

A

body chart - location and type of pain
nprs - how high is the pain

102
Q

what is an important follow up question to a patient reporting a hx of pain

A

what has worked
what hasn’t worked

103
Q

what are the 6 patterns of pain

A

vascular
neurogenic
musculoskeletal (somatic)
neuropathic
emotional
visceral

104
Q

descriptors of vascular pain

A

cramping
temp changes (hot or cold)
throbbing

105
Q

descriptors of neurogenic pain

A

shooting
lancinating/stabbing
superficial in a dermatomal pattern

106
Q

descriptors of musculoskeletal (somatic) pain

A

deep
sharp
ache

107
Q

descriptors of neuropathic pain

A

hyperalgesia
allodynia
central sensitization

108
Q

hyperalgesia vs allodynia

A

hyperalgesia = inc sensitivity to pain
allodynia = pain from stimulus that normally doesn’t cause pain

109
Q

what is the etiology of neuropathic pain

A

change in central processing of pain and how brain is interpretting it
- can have emotional impact on better or worse pain

110
Q

what is the definition of an emotional pattern of pain

A

SYMPTOM MAGNIFICATION

self-destructive, socially reinforced behavioral response pattern consisting of reports or displays of sx which control the life of the sufferer

111
Q

how does a pt talk ab their pain that would tip you off to being possibly an emotional pattern

A

sx rather than physiologic phenomenon of injury determine the outcome/function
- ex: my back won’t let me ….

112
Q

what are characteristics of a visceral pain pattern

A

constant
intense (won’t change much)
unrelieved by rest or position change
doesn’t fit expected mechanical or NM pattern

113
Q

what are the 3 types of visceral pain patterns

A

gradual
progressive
cyclical

114
Q

pt descriptors of visceral pain

A

colicky
knifelike
boring
deep aching

115
Q

what are visceral pain indicators that PTs could identify through tests

A

can’t alter, provoke, alleviate, eliminate, aggravate sx

doesn’t fit expected pattern

PT intervention doesn’t change clinical picture or pt gets worse

116
Q

what are red flags in general (4)

A

sx out of proportion to injury
sx persist beyond expected time frame
no position is comfortable
unable to mechanical provoke or relieve

117
Q

what is a medical history (in the most general of terms) and where in the intake do you get this

A

what they told you
- in hx duh

118
Q

where do you get associated s/sx and where is this categorized in the intake

A

what you asked ab
- hx

119
Q

how do you determine the clinical presentation and where does this go in an intake

A

what you saw
- tests and measures

Med Screening (17 decks)

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