Powerpoint notes Exam 3

Question 1

The PPE (Pre-participation physical eval) should be completed _ weeks prior of planned sports so if need specialist evals, rehab, or therapy time to go

Answer 1

6

Question 2

Collegiate athletes should have a PPE and a comprehensive health assessment upon entry to athletic program with __ follow up exam based on injury/illness

Answer 2

annual

Question 3

Middle school/Highschool athletes a comprehensive PPI should occur every _to _ years followed by annual questionnaire assessments and exams for problem areas.

Answer 3

2-3

Question 4

atlantoaxial instability is related to injury to someone with _ _

Important to talk about spinal cord injury risk to parents who have children that will be involved in soccer, gymnastics, football.

Symptoms to look out for are (5)

Answer 4

down syndrome

change in gait, ankle clonus, positive babinski, change in tone strength or gait (OBTAIN CERVICAL SPINE RAGIOGRAPHY).

Question 5

Musculoskeletal start with _ and palpation then _

Answer 5

inspection, ROM and muscle tone and strength.

Question 6

muscle tone is assessed using a scale from 0-5… 5 being

Answer 6

normal Complete ROM full resistance

Question 7

compare everything from _ to _

first _
then _

Answer 7

right to left

inspect
palpate

Question 8

superficial pain sensation is not typically performed in _

Answer 8

children

Question 9

Remember a red flag is when the patient states, “This is the worst headache I have ever had.” this can mean_ _

Answer 9

brain hemorrhage

Question 10

When assessing for seizures, find out if this is the first time experiencing a seizure or if they were they previously diagnosed. Review _ taking

ask about _ of events if has an _

Answer 10

medications

sequence, aura

Question 11

Tremors can be related to what medications?

Associated problems are:

Answer 11

neuroleptics, valproate, phenytoin, albuterol, pseudoephedrine, anti-arrhythmics, corticosteroids or caffeine.

hyperthyroidism, familial tremor, liver or kidney disorder, consumption of alcohol, or multiple sclerosis?

Question 12

type of weakness are:

assess for:

Answer 12

general, focal, proximal, or distal.

assess for onset, the character such as generalized or specific body area, associated symptoms, any co-morbid conditions such as
- HIV, nutritional or vitamin deficiency, and any
medications such as Zidovudine or Amphotericin B

Question 13

(Muscle tone) If patient is only able to move against gravity and not resistance, assign the tone as grade _

Answer 13

Grade 3.

Question 14

Only perform _ and deep pressure if superficial pain sensation not intact

Answer 14

temperature

Question 15

Vibratory response- Set tuning fork to then place on _ joint of finger and the big toe

Answer 15

128 Hz

DIP (tell when buzz stops).

Question 16

evaluate proprioperception by

Answer 16

grabbing big toe with thumb and index finger and moving up and down with eyes closed and have them tell you which way it is moving.

Question 17

steriognosis

Graphesthisia

Answer 17

placing a paper clip or object in hand and asking them to describe what it is with eyes closed.

single digit drawn in palm of hand patient says what it is with eyes closed

Question 18

protective sensation is good to assess for _

Using a monofilament 5.07 or

Answer 18

diabetics
ability to detect sensation in order to prevent harm or injury.

Waardenburg wheel

Question 19

instead of a reflex hammer for tendon reflex on pediatric patients you can use

Answer 19

index finger.

Question 20

tests for meningitis are: (3)

meningeal irrigation can be seen with which test?

This test is when you flex the hip and knee in supine and try to straighten it… if pain in lower back or resistance it is a positive_ _ means _ _

Answer 20

Nuchal rigidity, Brudsinski, Kernig

Nuchal rigidity is when the neck is lifted and there is resistance or pain. This can mean two things: Meningitis or intracranial hemorrhage.

Brudzinski (neck flexed and then involuntary flexion of knee and hip.)

Kernig test, meningeal irritation.

Question 21

Dementia is an acquired syndrome of decline in memory and at least one other cognitive
domain (language, visuospatial or executive function).

Symptoms:

Answer 21

Subtle behavioral changes
• Difficulty taking medications properly
• Problems attending to household chores or paying bills
• Loss of interest in usual activities
• Behave strangely after surgery or an acute illness

Question 22

Cognitive Decline:

Answer 22

Age related cognitive decline presents with mild forgetfulness, difficulty remembering names
and mildly reduced concentration. The presenting symptoms are sporadic and do affect function

Question 23

Cognitive Impairment:

Answer 23

Mild cognitive impairment is the memory impairment without cognitive deficits or functional
decline. There is a higher frequency for progression to Alzheimer’s Disease for those
patients suffering from cognitive impairment

Question 24

Alzheimer’s Disease presents as normal alertness but progressive global deterioration of
cognitive abilities in multiple domains.
Major issues are:

Answer 24

• Short-term memory, but sparing remote events
• Subtle language errors
• Visuospatial perceptual difficulties
• Changes in executive function
• Ability to perform sequential tasks such as ADLs

Question 25

MMSE stands for ____ and consists of _ questions

Answer 25

mini mental state exam, 8- 11 questions

Cognitive function, recall and short term memory assessed here

score less than 23 means cognitive impairment max score is 30.

relies heavenly on reading writing and verbal response which can be negative because of literacy issues instead if cognitive.

Question 26

The Montreal Cognitive Assessment or MoCA is designed to detect_cognitive impairment better than the Mini Mental State Exam (MMSE).

MoCA is specific to assessing

Answer 26

mild

Most elderly with early signs of cognitive impairment would score within the normal range on the MMSE. MoCA requires more training

working memory

Question 27

Some rationales for this is their less likely to complain of a
depressed mood but usually have _ complaints.

Other tendencies that lead to this
missed diagnosis are

Risk factors for suicide are:
The elderly population, which is greater than 65 years of age equals about 13% of the population, but commit 25% of suicides.

Answer 27

somatic

• Feelings of worthlessness, rather than guilt
• Demonstrate hypochondriasis
• Have psychomotor retardation or agitation
• Manifest psychotic delusions
• Living alone
• Male
• Alcoholism
• Comorbid physical illnesses

Question 28

Depression screening is done by using:

SIG E CAPS

PHQ9 is assessed next to detect severity of depression

Answer 28

S- sleep changes
I- interest lost 
G- guilt or worthless feeling 
E- Energy or lack of 
C- cognition- reduced concentration 
A- Appetite- decreased 
P- psychomotor symptoms like agitation
S- suicide or death ideation.

Question 29

_ is one of the most prevalent psychiatric diagnosis in the US. _ is usually generalized without a precipitating event that causes excessive worrying and is hard to
control. For diagnosis, the client needs 3 of these 6 symptoms:

Questionnaire to assess for is called

Answer 29

Anxiety, Anxiety

GAD-7

Question 30

anxiety is 3 out 6 of these:

Answer 30

• Restless, keyed up or on the edge
  • Easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Difficulty falling or staying asleep, restless or unsatisfied with sleep

Question 31

CAGE is used to assess for _ positives= alcohol misuse

Answer 31

alcohol misuse , 2

C- Cut down
A- Annoyed
G- Guilty
E- Eye opener (drink first thing in the morning).