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Flashcards in Medical Issues Final Deck (137):
1

holistic patient care

care for the whole patient, not just their problem

2

clinical presentation vs. diagnosis

presentation
-overall "picture" of signs, symptoms, medical history, and clinical exam
diagnosis
-determination of the problem using the clinical presentation

3

pathology vs. pathogenesis vs. etiology

pathology
-science concerned with disease including structural and functional changes
pathogenesis
-the underlying cause of a disease
etiology
-study of pathogenesis

4

clinical decision making

similar to diagnostic reasoning
determines the best course of action
not a final diagnosis

5

three stages of prevention

primary
-analyzing risk factors
secondary
-early detection
teriatry
-disease management

6

six components of a medical history

patient's age and gender
patient's chief complaint
past medical history
current health status
family history
review of systems

7

diagnostic imaging and testing

x-ray
radionuclide bone scan
fluoroscopy
-live-image x-ray
computed tomography
position emession tomography
magnetic resonancy imaging
diagnostic ultrasound

8

pharmacology

LECTURE

9

plaque psoriasis
-common location
-treatment

inflammatory condition where the skin cells overproduce
-common
-elbows
-knees
-knuckles
common S/S
-silvery scales
treatment
-topical and oral

10

bacterial skin infections types

impetigo
staph infections

11

impetigo
-treatment
-RTP

causes blisters
leads to a honey colored crust
treatment
-antibiotic
RTP
-no new skin lesions for at least 48 hours
-completion of a 72-hour course of directed antibiotic therapy
-no further drainage or exudate from the wound
-active infections cannot be covered for competition

12

MRSA
-S/S

methicillin-resistant Staphylococcus aureus
S/S
-abscess with red streaks - emergency room
-size
-redness extends out from the injury

13

CA-MRSA

community acquired
-contagious
-common among sports teams

14

RTP for MRSA

no new lesions for at least 72 hours
completion of a 72-hour course of directed antibiotic therapy
no further drainage or exudate from wound
active infections may not be covered for competition

15

tinea (fungal infections)
-RTP

tinea pedis (athlete's foot)
tinea cruris (jock itch)
tinea corporis (ringworm)
timea capitis (on head)
tinea versicolor (change in skin color)
RTP
-72 hours
-cover lesions

16

Tinea Capitis RTP

two weeks of anti fungal biotics

17

Tinea Corporis

circular plaque with clear center
can be covered if in small enough area

18

Tinea Pedis
-treatment

most common fungal and skin infection
treatment
-common sense prevention
--dry feet after shower
--change out of socks after exercise

19

Tinea Cruris

scaly plaques

20

viral infections

herpes simplex

21

herpes simplex
-S/S

very contagious
S/S
-blisters
-fatigue and fever
treatment
-antiviral

22

herpes simplex RTP

athlete must be free of systemic symptoms
no new blisters for 72 hours
all lesions must be surmounted by a firm adherent crust
have completed 5 days of antivirals

23

molluscum contagiosum

lesion with a hard center
main treatment is having them removed
-must be removed for competition

24

warts

caused by HPV
categorized by location and appearance
treatment
-removal

25

plantar warts

grow into skin instead of out

26

parasitic infections

scabies
pediculosis

27

scabies

itches
most common between fingers
mites that lay eggs and burrow beneath the skin
treated with prescription strength cream

28

pediculosis

lice
-head, body, and genital lice
cannot compete until treatment is complete

29

NATA position statement on prevention of skin disease

evidence-based recommendations
-clean environment
-hand hygiene
-overall hygiene
-no sharing
-whirlpools
-report all open wounds and lesions to an ATC

30

S/S of neurological pathology

syncope
coma
paresthesia
abnormal motor control, coordination, or tone
headache
changes in senses
changes in mental status

31

ALS
-cause
-S/S
Tx

fatal, progressive neurological disease that slowly attacks neurons responsible for voluntary muscle actions
S/S
-tired or clumsy, often begin in one limb, difficulty with swallowing and speech
-may be spasticity or hyperflexia
-weight loss
Tx
-can be treated with drugs but is not curable

32

Bell's Palsy

disease typically affects CN 7
S/S
-bilateral or unilateral facial weakness
Tx
-corticoseroids

33

epilepsy

>2 seizures in lifetime
caused by abnormal activity in brain
Tx
-combo of medicine or surgery

34

multiple sclerosis

neurodegerative lifelong chronic disease
-can lead to permanent disability in affected nerves
S/S
-problems w/ balance and coordination
-spasticity and fatigue, visual problems, dizziness, pain, numbness, bladder + bowel dysfunction
-cognitive and emotional changes
Tx
-relapsing + progressing symptom management w/ medication

35

vascular headache

caused by spasms of the vellels surrounding the brain
include migraines
S/S: rapid onset, unilateral throbbing pain in frontal or temporal area
-start in morning and peak 2 hrs later (migraine)
-begins with aura and accompanied w/ increased sensitivity to light/sound (migraine)

36

migraine

type of vascular headache that may present w/ or w/o neurological symptoms

37

stroke (CVA)

lack of oxygen to the brain - may lead to reversible or irreversible paralysis and other damage
S/S
-numbness or weakness on one side of the body
-confusion, trouble speaking or understanding
-headache, dizziness
Tx
-acute: designed to reverse or lessened the amount of tissue death
-rehab to improve function so that the stroke survivor can continue an independent lifestyle

38

GBS (Guillain-Barre)

acute demyelinating disorder of the spinal roots and peripheral nerves
S/S
-progressive weakness distal to proximal pain in movement of the affected area and nocturnal muscle cramps
Tx
-no cure
-rehab to make things better and lessen severity of symptoms

39

bacterial and viral miningitis

inflammation of the meninges by bacteria or viruses

40

docorticate rigidity

indication of cerebral cortex damage
arms in flexion, legs in extension

41

decerebrate rigidity

indication of cerebellum damage
arms and legs in extension

42

meningeal irritation tests

kernig test
-patient in supine
-passively raising one leg at a time
-keep knee fully extended
-raise leg until symptoms are felt
-flex knee to relieve symptoms
-dorsiflex foot
-if dorsiflexion recreates symptoms, meningeal irritation is present
Brudzinski Test
-perform the above test with neck passively or actively flexed

43

ocular palpation areas

orbital margin
frontal bone
nasal bones
zygomatic bones

44

pupillary reaction to light
-PEARL

pupils equal and reactive to light

45

red flags for eye referral

blurred vision
diplopia - double
foreign object protruding into the eye
restricted eye movement
distorted pupil
hyphema
unilateral pupil dilation or constriction
large lacerations of the eyelids
lacerations that involve the margins of the eyelids
persistent floaters

46

refractive errors
--cause
-types

caused by length of eye and shape or curvature of cornea
types
-myopia - hard to see distance
-hyperopia - hard to see close up

47

conjunctivitis
-contagious?
-other S/S

can be contagious
-viral or bacterial
other respiratory problems

48

conjunctivitis RTP

48-72 hours after starting antibiotic eyedrops

49

stye
-S/S

inflammation of duct or hair follicle on the eyelid
S/S
-pain
-swelling
-redness

50

glaucoma

increased intraocular pressure
-build up of aqueous humor
-can lead to damage to the optic nerve

51

eyelid laceration
-question to ask

bleed profusely
can you approximate the wound?
-harder to do over the eyelid

52

periorbital contusions
-DDx
-RTP

black eye
test the eye early before swelling develops
DDx
-orbital fracture
-concussion
RTP
-as soon as possible if there are not major problems

53

orbital fracture
-S/S

blow to the eye or the bones around the eye
blowout fracture
-fracture to the walls or floor of the orbit
S/S
-pain with eye movement
-possible inability to look up if bottom is fractured
-pain when blowing nose
-diplopia
refer

54

dislocated contact lens

evert eyelid
wash with sterile saline solution
locate lens
replace once the lens is clean or with a new one

55

corneal and conjunctival foreign bodies

may need to evert the upper eyelid to visualize the foreign bodies

56

corneal abrasions

feels with something in the eye
can lead to decreased to vision, pain, tearing

57

how to diagnose a corneal abrasion

fluorescein - dye
shine pen light with attachment
abrasion will be visible
will resolve within a few days to a week

58

corneal laceration

puncture wound to the eye
"open globe"
automatic referral
can use an eye shield

59

subconjunctival hemorrhage

benign
can occur from trauma (straining, high BP)

60

hyphema

bleeding in the anterior chamber of the eye
not benign
shows up over the iris and pupil
S/S
pain, blurred vision
911
-keep them upright
Tx
-bedrest in an elevated position
resolve in about a week
will require eye protection

61

detached retina

high chance of disrupting optic nerve
S/S
-"curtain" over their field of vision
-floaters
-blurred vision
can be caused by a severe jarring force
immediate referral

62

retinal tears

similar S/S to detached retina
immediately refer

63

chemical burns

flush continuously
refer

64

traumatic iritis

blunt trauma
S/S
-photophobia
-sluggish pupil reaction
refer

65

proptosis

direct trauma
bulging of the eye caused by swelling
swelling can damage the optic nerve
S/S
-bulging
-decreased motility
-diplopia
-can't close eyelids fully
-pain
-nausea
immediate referral

66

ruptured globe

blunt trauma directly to the glove
rupture of the cornea or the sclera resulting in the inner contents spilling out
S/S
-pain
-eyeball may look out of place
-marked edema
-hyphema possibly
shield and refer

67

examination of the ear

patient history
general observation
palpate pinna and mastoid process
conduct a hearing test if necessary
-determine difference between sensorineural loss and conductive hearing loss using the Weber test
Otoscope evaluation

68

auricular hematoma

buildup of fluid between the skin and the certilage of the pinna
MOI
-repeated trauma to the site
S/S
-buildup of fluid
-sometimes painful
Tx
-ice and compression
-referral if they have a visible buildup of fluid
RTP
-clear to play
-drain and cover

69

ruptured tympanic membrane

MOI
-change in pressure
-puncture wound
-direct blow to the head
S/S
-painful
-tinnitus
-hearing loss
Tx
-will heal on it's own
refer out
RTP
-depends on the sport
-self-limiting in most sports

70

otitis externa

inflammation and/or infection of the external auditory canal
swimmer's ear, or cleaning the ear too much
cerumen dries out - dries the ear out
S/S
-pain
-itching
-burning
-possible swelling of pinna
Tx
-antibiotics
RTP
-usually within 24 hours of beginning antibiotics

71

otitis media

presence of fluid in the middle ear
accompanied by S/S of infection
S/S
-earache
-fullness in the ear
-fever
-ringing in the ears
-dizziness
-hearing loss
-tympanic membrane is red when looking with an otoscope
Tx
RTP
-24 hours after starting antibiotics

72

impacted cerumen

build of earwax in the external canal
S/S
-hearing loss
-ear's "plugged up"
Dx
-use otoscope
Tx
-referral to have it removed
-manual removal

73

nose exam

ask questions
look for drainage
examine the nose
palpate the nose
palpate the facial bones and sinuses

74

allergic rhinitis

hypersensitivity to inhaled allergens
S/S
-clear mucus
-sneezing
-runny nose
-congestion
-itchy, watery eyes
Tx
-send in if they have a fever
-antihistamines
-avoid allergens
-humidifier, air filter

75

non-allergic rhinitis

caused by virus, bacteria or vasomotor-related inflammation or infection of the nasal passages
S/S
-same as allergic but won't react to same Tx

76

sinusitis

inflammation of mucus membranes lining the paranasal sinuses
S/S
-sinus pain
Tx
-referral
-antibiotics
RTP
-can play without fever

77

exam of the mouth and throat

inspect the face, head and neck
palpate the lymph nodes
examine the lips both open and closed
inspect the tongue and mucosal lining of the mouth, gingivae, and back of throat

78

gingivitis

Bacterial infection of the gums
S/S
-swollen and red gums
-possible bleeding
-pain
-haltosis: bad breath
Tx
-referral
-oral hygiene is important for oral health

79

oral candidiasis

"thrush"
fungal infection of the mucous membranes in the mouth
S/S
-white/yellow tongue
-can turn into red lesions of the gums
Tx
-referral

80

oral cancer

direct link between tobacco use and oral cancer
individuals who use tobacco products and alcohol are at 15x more risk
S/S
-hoarseness
-pain or difficulty swallowing or chewing
-masses in the mouth or neck
Tx
-chemo
-radiation

81

phayngitis and tonsillitis

inflammation of either/or
can be caused by bacteria or viruses
streptococcus is the main culprit
-strep throat
S/S
-white spots in the back of the throat
-sore throat
-painful swallowing
-fever/chills depending on infection type
Tx
-bacterial: refer
--strep test, antibiotics
-viral: rest
RTP
-depends on if they have a fever
-no fever for 24 hours

82

laryngitis

inflammation of the larynx
-direct blow to the throat
-can accompany upper respiratory infection
-common in smokers
S/S
-loss of voice
-tickling in back of throat
Tx
-humid environment
-cough drops
RTP
-self-limiting in absence of fever

83

lymphatic system

olymphics

84

what is athlete's heart

the concept that the heart of athletes enlarges as a result of cardiovascular training

85

normal physiological response to exercise
-acute
-chronic

acute
-increased HR and SV
-increased systolic BP
-increased breathing
chronic
-decreased HR
-decreased breathing
-decreased BP

86

SCD common causes

HCM - hypertrophic cardiomyopathy
sickle cell trait/anemia
commotio cordis
coronary artery abnormalities

87

cardiac pathology S/S

chest pain
dyspnea
fatigue
palpitations
syncope
claudication
skin and nail temperature, color and appearance
edema

88

what creates the "lub dub" sounds you hear when ausculating

heart sounds 1 and 2
S1
-closure of mitral and tricuspid valves
S2
-closure of aortic and pulmonic valves

89

heart failure

decrease in cardiac output
-heart has developed an insufficient heart pump
hear failure can be
-left
-right
-acute
-chronic
acute is immediately life threatening
chronic heart failure displays gradual but systemic failure

90

heart failure S/S

cyanosis
shortness of breath
low BP

91

myocardial ischemia
-S/S
-may be cause by

decreased blood supply to the myocardium
S/S
-angina
-dyspnea
-snycope
coronary artery disease can cause this
-the myocardium can become ischemic and necrotic causing a myocardial infarction

92

myocardial infarction
-S/S

most MI's happen during moderate to heavy activity
S/S
-angina
-fatigue
-dizziness
-syncope
quick response and referral is necessary

93

hypertrophic cardiomyopathy

enlargement of the heart
-general
-left ventricle
leads to
-heart failure
-ischemic damage
-fatal arrhythmia
pathological
-LV wall thickness > 15mm
leading cause of SCD

94

hypertrophic cardiomyopathy S/S

syncope
angina
dyspnea
murmur that increases with Valsalva Maneuver
family history

95

valve disorders
-stenosis or prolapse
-sports participation

stenosis or prolapse
-stenosis: narrowing of the valve; restricts blood flow
-prolapse: allows backflow of blood
often allowed to participate in sports
may result in arrhythmias
-withheld from sports

96

MVP

mitral valve prolapse
most common valve abnormality

97

Marfan's Syndrome

genetic defect that leads to abnormalities in the body's connective tissue
signs
-tall stature and long extremities
-pectus deformity
-scoliosis
-spontaneous pneumothorax
-myopic (nearsighted)
80-90% will develop fatal artery abnormalities

98

Marfan's Syndrome complications

Mitral Valve Prolapse (MVP)
Aortic Valve Disease
Aortic Rupture
-vessel walls weaken and dilate

99

Marfan's diagnosis

hard
complete family hx is important

100

commotio cordis

sudden blow to the chest
during repolarization
15% resuscitation rate without immediate AED application

101

congenital abnormalities of coronary arteries

abnormal origin of the left main coronary artery
-may cause a "kinking" of the artery or force it to pass through the aorta and pulmonary artery
--blood flow is restricted to the heart tissue
S/S
-Chest pain
-arrhythmias
-syncope

102

congenital abnormalities of coronary arteries

Hypoplasia (underdevelopment) of the R and L circumflex coronary arteries
absence of the left coronary artery
myocardial bridging
-artery goes through tissue instead of over the top
testing
-ECG
-treadmill stress test (if both are +, further investigate)
coronary angiography

103

deep vein thrombosis (DVT)

blood clot lodged in a vein
results in venous blockage
most common in the lower leg
S/S
-limb pain and swelling
Dx
-ultrasound
Tx
-anticoagulants
may lead to a pulmonary embolism

104

disorders of the blood

anemia
sickle cell anemia
sickle cell trait

105

anemia

defines as a decreased # of RBC's or a decreased hemoglobin concentration in the blood
3 general categories
-microcytic: iron deficiency
-normocytic: normal sized RBC (blood loss)
-macrocytic: enlarged; don't function properly

106

S/S and hx of anemia

vague symptoms
-weakness, fatigue, dizziness and headache
-decreased performance
-craving ice or crunchy raw veggies
signs
-tachycardia, orthostatic hypotension, dyspnea, tachypnea and pallor
-bruises easily
hx
-dietary habits
-menstrual cycle and amount of flow
-NSAID use and antibiotic use

107

treatment for anemia

refer to doctor for CBC to determine type of anemia first
identify and correct any sources of blood loss
look at diet and ensure athlete is getting good sources of iron
take 325mg 3x per day of ferrous sulfate
-2 week response is good
-after 3-6 weeks hemoglobin is back to normal

108

sickle cell anemia

occurs as a recessive genetic trait, producing abnormally shaped RBC's that inhibit binding of O2
creates a decreased O2 carrying capacity of the blood

109

sickle cell trait

20-40% of the hemoglobin is HbS; the rest of the hemoglobin is normal
1 in every 400-600 African Americans have anemia
1 in every 10 AA have the trait
the risk of SD is 27x higher in AA that have the SCT
SCT is a risk factor for
-exertional rhabdomyolysis
-splenic infarction
-cardiac arrhythmias
-kidney failure

110

SCT S/S

tachycardia
hypotension
hyperventilation
LOC

111

athletes with SCT are advised to...

avoid dehydration and acclimatize gradually to heat and humidity
condition gradually for several weeks before engaging in exhaustive exercise regimens
acclimate to altitude over an appropriate amount of time
refrain from extreme exercise during acute illness, especially if fever is involved

112

effects of exercise on respiratory system

increased blood to the lungs
increased oxygen demand to muscles
increased carbon dioxide produced by muscles
increase in ventilation

113

S/S of pulmonary disease

dyspnea
cough
cyanosis
abnormal breathing patterns
thorax pain

114

peak flow meter

establish a baseline for your patient
test patient upon suspicion of bronchospasm
-green zone: 80-100% of baseline
-yellow zone: 50-80% of personal best
--medication is necessary
-red zone: below 50%
--call 911

115

pulmonary pathology disease classification

obstructive
-limits airflow
restrictive
-limits lung expansion

116

pulmonary pathology sources

environmental influences
trauma
genetic factors
immune response

117

flail chest injury

multiple fractures that result in displacement of the ribs
can also sprain the joint between the rib and cartilage

118

pneumothorax

collaped lung (air in the pleural space)
commonly caused by trauma
S/S
-pain
-trouble breathing
-would hear hyper-resonance during percussion
Tx
-referral

119

hemothorax

blood in the pleural space
S/S
-similar to pneumothorax
-coughing up blood (frothy)
-percussion and auscultation differences
Tx
-referral

120

asthma

produces
-bronchial spasms
-chronic bronchial inflammation
-bronchial edema
symptoms
-chest constriction
-fatigue
-anxiety
clinical signs: symptoms worsen at night

121

asthma cont.

onset
-begins early, genetic predisposition to severe allergic responses
causes
-allergens
-infection
-cold/dry air
-emotional states
-exercise
Tx
-patient education is important
-limit inflammation (corticostaroids)
-treat bronchospasms (short and long acting beta-2 agonist)
-control symptoms
-prevent exacerbation by controlling known triggers

122

management of an acute asthma attack

seated position
take deep breaths
exhale through pursed lips (whistle)
tell them to remain calm
administer inhaler
ER is all else fails

123

exercise induced bronchospasm

exercise-induced asthma
more common than asthma
-15% of the population
-90% of people with asthma
-35-40% of people with allergies
occurs 5-10 minutes into exercise, worsens with activity
spontaneous recovery occurs 30-60 minutes after stopping exercise

124

exercise induced bronchospasm
-triggers
-S/S

triggers
-cold, dry air
-allergens
-pollutions
-infection
S/S
-unusual dyspnea
-central chest pain during exercise
-coughing

125

Acute EIB management

similar to an asthma attack
remove from exercise
reassure
assess and monitor

126

when to refer w/ EIB

cyanosis
syncope
symptoms >60 minutes

127

exercise induced anaphylaxis

breathing disorder + chronic use of NSAIDs
produces an abnormal immune response
S/S
-flushing
-urticaria
-cough, croup (deep "honking" cough)
-stridor
--harsh wheezing sound
-hypotension & tachycardia (shock)

128

EIA treatment

administer Epipen
call 911

129

acute bronchitis

caused by infection or irritant that produces an inflammatory response
-most commonly viral
early S/S
-fever
-nonproductive cough
-sore throat
-chest pain
progresses to
-productive cough
-wheezing
treatment
-cough suppressants
-rest
-hydration

130

chronic bronchitis

caused by prolonged or repeated exposure to irritants
inflammation of the bronchial mucous membranes
S/S
-wheezing
-dyspnea
-cough that is more productive in the mornings and evenings
symptoms present from 3 months - 2 years
treatment
-avoid irritants

131

pneumonia

every year more than 60,000 Americans die of pneumonia
infection and inflammation in the lungs
recognition and early treatment is the best option

132

pleurisy

inflammation of the pleura
may develop secondary to other infections
fluid can accumulate at the site of the inflammation
can cause coughing, dyspnea, tachypnea, cyanosis, and retractions
diagnosis
-auscultation
-pain at one site with laughing, coughing

133

influenza

the "Flu"
viral
S/S
-high fever
-headache/body aches
-cough
-chest pain
-shortness of breath
-fatigue
-loss of appetite
-nasal congestion
-sore throat
refer when
-close contact with other person's diagnosed influenza
-symptomatic
diagnosis
-clinincal grounds mainly
-antigen testing
-CBC's
-sputum cultures
-fever is generally the hallmark

134

upper respiratory infections

rhinovirus
very easily spread through cough or sneeze
mild symptoms very similar to influenza but don't last as long
secondary bacterial infection can happen
7-10 day duration

135

tuberculosis

highly contagious bacterial infection
-mycobacterium tuberculosis
airborne droplets cause infection
immunocompromised people are more likely to get active TB
S/S
-fatigue
-fever
-weight loss
-cough
-hemoptysis
-shortness of breath/wheezing
diagnosis
-skin test
-symptomatic
-positive radiograph

136

pulmonary obstructive disorders (COPD)

Chronic obstructive pulmonary disease is a classification of diseases involving partially blocked airways
-asthma
-bronchitis
-emphysema
-cystic fibrosis
decreased vital capacity, increased CO2, decreased O2, thus disrupting the diffusion gradient across the alveoli

137

emphysema

complication of chronic pulmonary disease + prolonged smoking
causes destruction of alveolar walls, capillaries, and lung elasticity
S/S
-SOB
-increased exhalation effort
-infection
-Cor pulmonale (right sided heart failure)
irreversible, poor prognosis