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Christina-Summer 25 > PC: Lecture 2 > Flashcards

PC: Lecture 2 Flashcards

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1
Q

Low Back: Tumor (Hx)

A

age > 50
Hx of cancer
Unexplained WL
Failure of conservative treatment

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2
Q

Low Back: Tumor (exam)

A

constant pain not affected by position or activity

worse at night

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3
Q

Low Back: Back related infection (Hx)

A

recent infection

IV drug user

immunosuppressive disorder

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4
Q

Low Back: Back related infection: Exam

A

deep constant pain, increases with WB

fever, malaise, swelling

spine rigidity, accessory mobility may be limited

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5
Q

Low Back: Cauda Equina (Hx)

A

Hx of spinal stenosis
Hx of DD

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6
Q

Low Back: Cauda Equina (exam)

A

urinary retention or incontinence

fecal incontinence

saddle anesthesia

global or progressive weakness in LE

sensory deficits (dermatomal)

ankle DF, toe ext & ankle PF weakness

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7
Q

Low Back: Spinal fx (Hx)

A

trauma Hx (falls or heavy lifts for older pts)

long term steroids

> 70

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8
Q

Low Back: Spinal fx (Exam)

A

tender with palpation over fx site

inc pain with WB

edema

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9
Q

Low Back: AAA (Hx)

A

back abdominal or groin pain

PVD, CAD, smoker, HTN, DM

> 50

symptoms not related to movement

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10
Q

Low Back AAA (Exam)

A

abnormal width of aortic or iliac arterial pulses

presence of bruit

exertion makes it worse

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11
Q

Head/Face/TMJ: Meningitis (Hx)

A

recent bacterial or viral infection

hx of skull fx

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12
Q

Head/Face/TMJ: Meningitis (Exam)

A

*(+) slump sign

HA, *fever

GI signs: nausea & vomiting

*photophobia

confusion

seizures

sleepiness

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13
Q

Head/Face/TMJ: Brian Tumor (Hx)

A

20-64

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14
Q

Head/Face/TMJ: Brian Tumor (Exam)

A

HA

*altered mental status

*ataxia

speech deficits

sensory abnormalities

GI signs

vision changes

*seizures

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15
Q

Head, Face, TMJ: Subarachnoid hemorrhage (Hx)

A

hx of smoking, HTN, ETOH abuse

WORST HA OF LIFE SUDDENLY

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16
Q

Head/Face/TMJ: SUBARACHNOID hemorrhage (Exam)

A

*brief loss of consciousness

brain tumor signs: neuro dysfxn, nausea vomiting

meningeal irritation signs: nuchal rigidity, fever, photophobia, nausea

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17
Q

Pelvis, Hip, Thigh Regions - Colon Cancer (hx)

A

> 50
bowel disturbances
WL
hx of colon cancer
pain unchanged by movement

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18
Q

Pelvis, Hip, Thigh Regions - Colon Cancer (exam)

A

hypo/hyper active bowel sounds

TTP of abdomen in area of cancer

ascites

1st sign may be metastases to liver, lug, bone or brain

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19
Q

Pelvis, Hip, Thigh Regions - femoral neck fx (Hx)

A

older women > 70 w/ hip, groin, thigh pain

hx of a fall from standing position

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20
Q

Pelvis, Hip, Thigh Regions - femoral neck fx (exam)

A

severe, constant pain worse w movement

shortened & ER leg (trying to lengthen to compensate)

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21
Q

Pelvis, Hip, Thigh Regions - osteonecrosis of femoral head (hx)

A

hx of long term coriticosteroids

hx of osteonecrosis of other hip

trauma

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22
Q

Pelvis, Hip, Thigh Regions - osteonecrosis (exam)

A

gradual onset of pain that worsens with WB (may refer to groin, thigh, medial knee)

stiff hip joint (restricted 1 degree in IR and flex)

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23
Q

Pelvis, Hip, Thigh Regions - Legg-Calve-Perthes disease (hx)

A

5-8 year old boy with groin/thigh pain

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24
Q

Pelvis, Hip, Thigh Regions - Legg-Calve_perthes (exam)

A

antalgic gait

pain complaints aggravated w hip movement, especially hip ABD & IR

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25
Pelvis, Hip, Thigh Regions - SCFE (hx)
*overweight adolescent (13+) hx of a recent growth spurt or trauma
26
Pelvis, Hip, Thigh Regions - SCFE (exam)
aching in groin exacerbated w WB *involved leg held in ER ROM limitation in hip IR
27
Knee Leg Ankle Foot: Peripheral arterial occlusive disease (Hx)
> 60 Hx D2M, ischemic heart disease somking sedentary lifestyle concurrent intermittent claudication (all thinks that decrease BF distally, think stoking glove)
28
Knee Leg Ankle Foot: PAD Exam
unilateral cool extremity (bilateral if aorta) prolonged cap refull time dec pulses prolonged vascular filling time ankle-brachial index (ABI) < .9
29
Knee Leg Ankle Foot: DVT Hx
recent surgery, malignancy, pregnancy, trauma or leg immobilization
30
Knee Leg Ankle Foot: DVT Exam
calf pain, edema, tenderness, warmth calm pain worse with walking and standing and relieved by rest possible pallor or loos of dorsalis pedius pulse
31
Knee Leg Ankle Foot: Compartment Syndrome Hx
hx of blunt trauma, crush injury, or unaccustomed exercise
32
Knee Leg Ankle Foot: Compartment Syndrome Exam
severe persistent leg pain that is intensifies w stretch* swelling, tenderness and palpable tension/hardness *paresthesia (diff from DVT), paresis, pallor, pulselessness
33
Knee Leg Ankle Foot: Septic Arthritis Hx
hx of recent infection, surgery or injection coexisting immunosuppressive disorder
34
Knee Leg Ankle Foot: Septic arthritis Exam
constant aching or throbbing pain, *joint swelling, tenderness, warmth *may have elevated body temp
35
Knee Leg Ankle Foot: Cellulitis Hx
hx of recent skin ulceration or abrasion, venous insufficiency CHF or cirrhosis
36
Knee Leg Ankle Foot: Cellulitis Exam
pain, skin swelling, warmth, adv irregular margin of erythema/red streaks fever, chills, malaise, weakness
37
Thoracic Spine & Rib cage regions: Myocardial infarction Hx
presence of risk factors - previous MI, hx of CAD, HTN, smoking, DM, cholesterol > 240 men > 40, women > 50
38
Thoracic Spine & Rib cage regions: MI Exam
chest pain pallor, sweating, dyspnea, nausea, palpitation symptoms > 30 min and not relieved with sublingual nitroglycerin
39
Thoracic Spine & Rib cage regions: Unstable angina pectoris Hx
Hx of CAD
40
Thoracic Spine & Rib cage regions: Unstable angina pectoris Exam
chest pain that occurs *outside of predictable pattern not responsive to nitroglycerin
41
Thoracic Spine & Rib cage regions: Stable angina pectoris Hx
Common in people ? 65 men Hx of CAD
42
Thoracic Spine & Rib cage regions: Stable angina pectoris exam
chest pain pressure that occurs w predictable levels of exertion symptoms predictably alleviated w rest or nitroglycerin
43
Thoracic Spine & Rib cage regions: Pericarditis Hx
associated with autoimmune diseases hx of MI hx of renal failure, open heart surgery, or radiation therpay
44
Thoracic Spine & Rib cage regions: Pericarditis Exam
sharp stabbing chest pain that may be referred to lateral neck or wither shoulder inc pain w L sideling relieved with froward leaning while sitting (arms on knees or table)
45
Thoracic Spine & Rib cage regions: PE Hx
hx of risk factors, developing DVT immobility trauma cancer
46
Thoracic Spine & Rib cage regions: PE Exam
chest, shoulder or upper abdominal pain dyspnea tachypnea tachycarida
47
Thoracic Spine & Rib cage regions: Pleurisy Hx
hx of recent ot concurrent respiratory disorder, infection, pneumonia, tumor, TB
48
Thoracic Spine & Rib cage regions: Pleurisy Exam
severe sharp knife like pain w inspiration dyspnea, dec chest wall excursion
49
Pneumothorax Hx
recent bout of coughing or strenuous exercise or trauma
50
Pneumothorax Exam
chest pain, intensifies w inspiration, difficulty ventilating and expanding rib cage hyperresonance on percussion and dec breathe sounds**
51
Pneumonia Hx
hx of bacterial, viral or fungal infection
52
Pneumonia Exam
pleuritic pain (may refer to shoulder) fever, chills, HAS, malaise, nausea
53
Cholecystitis (gallbladder inflammation) Hx
middle aged women WBC elevated
54
Cholecystitis (gallbladder inflammation) Exam
colicky pain in R upper abdominal quadrant w right scap pain worse pain with ingestion of fatty foots symptoms not inc by activity or relieved by rest
55
Peptic Ulcer Hx
dull or gnawing pain or burning sensation in *epigastrium, mid back or supraclavicular relieved w food hx of infection hx of multiple stressors
56
Peptic Ulcer Exam
tenderness at R *epigastrium constipation, bleeding, vomiting, tarry colored stools, coffee ground emesis
57
Pyelonephritis (kidney infection) Hx
women recent UTI kidney stone hx or current
58
Pyelonephritis (kidney infection) Exam
fever, chills, malaise, HA, flank pain enlarged prostate tenderness over costovertebral angle Murphy sign
59
Nephrolithiasis (kidney stones) Hx
live in hot humid climates past kidney stones (common)
60
kidney stones exam
sudden severe or flank pain chills, fever, nausea vomiting renal colic UTI symptoms
61
Spinal fx Hx
hx of fall or MVA, osteoporosis ling term steroid use > 70 years loss of function or mobility
62
Spinal fx Exam
midline tenderness at level of fx T11-L1 most common bruising LE neurological deficits evidence of inv thoracic kyphosis
63
Cervical ligamentous instability/possible cord compromise Hx
major trauma (MVA, fall) RA SA oral contraseptive use
64
cervical ligamentous instability/possible cord compromise exam
UMN signs - dizziness, nystagmus, vertigo w head neck movements, + Babinski
65
cervical and shoulder girdle peripheral entrapment neuropathies Hx
parethesthesias pain present at rest and possibly with a retrograde distribution
66
cervical and shoulder girdle peripheral entrapment neuropathies Exam
muscle innervated by the nerve can be tender muscles and sensory distribution follow specific nerve pattern
67
spinal acessory nerve hx
hx of penatrating injury direct blow or stretching during trauma surgical hx of radial neck dissection hx of blow from a hockey stick or lacrosse stick
68
spinal accessory exam
asymmetry of neck line an drooping of shoulder inability to shrug shoulders lack of scapular stabilization weakness of shoulder abduction
69
axillary nerve hx
> 40 w/ shoulder dislocation hx of traction force or blunt trauma to shoulder hx of brachial neuritis or quadrilateral space syndrome
70
axillary nerve exam
weakness of shoulder abduction and flexion lack of sensation of lateral aspect of upper arm
71
long thoracic nerve
many sports scapular winging loss of scapulohumeral ryhtm
72
suprascapular nerve hx
deep, poorly localized pain hx of scapula fx w involvement of the notch traction injury compression of scapular notch
73
suprascapular nerve exam
simialr to RC tear bc wasting of supraspinatus and infraspinatus loss of shoulder ABD and ER
74
pancoast tumor (superior sulcus lung tumor at lung apices)
men > 50 smoking nagging pain in shoulder along vertebral border of scap pain that has progressed from nagging to burning in nature, often down the arm into ulnar distribution
75
scaphoid fx
FOOSH (hx) wrist swelling wrist held in neutral position pain in snuffbox
76
lunate fx for dislocation
FOOSH, diffuse symptoms general wrist swelling and pain dec motion and grip strength*
77
TFCC tear
FOOSH pronated associated with colles fx ulnar sided wrist pain tenderness and clicking weak grip ulnar head sublux
78
space infection of the hand hx
recent punction, bug bite, presence of abscess purulent tenosynovitis of tendons
79
space infection of the hand exam
typically signs of inflammation long standing inflammation - fever chills weakness etc
80
radial head fx
FOOSH supinated anterolateral tenderness at elbow inability to supinate or pronate elbow held at 70 degrees flexion and slightly supinated
81
colles fx (distal radius)
FOOSH w *forceful wrist extension women > 40 hx of osteoporosis wrist held in neutral resting position, swelling, wrist ext painful
82

Christina-Summer 25 (23 decks)

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