Systemic (Red flag conditions) Flashcards
What is cervical artery dissection?
A tear in the tunica adventitia of the carotid and or vertebral arteries
What is the aetiology for CAD?
- History of Cx trauma (major/trivial)
- Recent trauma
- CVS risk factors
- Past or family history of migraine
- Recent URTI
What are the features of a CAD?
At least two of the following features:
- Sudden onset or “thunderclap” headache
- Unilateral pain: frontal, temporal, occipital or supraorbital region
- Unilateral neck or facial pain
- Constant and severe pain (ache/throbbing/sharp) – unlike anything ever experienced
- Neurological symptoms such as:
- Upper or lower limb deficits
- Horner’s syndrome
- Cranial nerve neuropathy
- Pulsating tinnitus
What is deep vein thrombosis (DVT)?
Thrombosis formation in a deep veins in the absence of obvious inflammation
Aetiology and risk factors for a DVT?
- Typically occurs in the lower limb vein (calf common)
- Trauma and IV drug use
- Immobility
- Obesity
- Advancing age
- Pregnancy
- Smoking
- OCP
- Malignancy
What are signs and symptoms of a DVT?
- Can be asymptomatic or unreliable
- Calf pain/ache, with tenderness
- Pitting oedema + increased warmth of affected area
- Prominent/engorged superficial veins
- Mild fever (pyrexia)
- May see colour change: dusky, cyanotic, pale
- Homan’s sign is neither sensitive or specific
What is angina?
Gradual decrease in coronary blood flow, with 50-70% of lumen compromised
What is the aetiology and risk factors for angina?
-Caused by atherosclerotic plaques building up - leading to cardiac mm ischaemia/necrosis
*First three are the main risk factors* •Hyperlipidemia •Smoking •HTN •Obesity •Physical inactivity •Advancing age •Female > Male
Signs and symptoms of angina?
- Chest pain
- Compressive/squeezing/sharp
- Central chest
- Radiation- left arm, jaw scapulae
- Aggravated by exercise and emotional stress
- Relieved by rest
Can be associated with: •Pallor •Diaphoresis - excessive sweating •Dyspnoea •Palpations •Sense of unease •Severe fatigue
What are some DD’s for angina?
GIT disorders: GORD, peptic ulcers
Musculoskeletal disorders: Costochondritis, rib pain, pectoral/intercostal strain
Pericarditis: Inflammation of the pericardium
Psychosocial: Anxiety attack
What is meningitis?
Infection of the meningeal layer (lining tissue) of the brain
What is the aetiology
-Relies on bacterial or viral meningitis as it can pass through the blood brain barrier
What are the features of meningitis?
- Focal neurological SSx
- Severe headache
- Neck pain and stiffness
- Confusion
- Severe muscle pain
- Photophobia
- Systemic signs
What is cauda equina?
Pathological compression of the cauda equina
What is the aetiology of cauda equina?
- Lumbar disc- most common
- Spinal stenosis
- Sever spondylolisthesis
- Trauma – haematoma
- Tumor
- Infection (abscess)
What are the SSx of cauda equina?
- Severe LBP
- Saddle (across pelvis area) paraesthesia or anaesthesia
- Bladder, bowel or sexual dysfunction
- Lower limb motor and sensory deficits (unilateral/bilateral)
- Hyporeflexia or areflexia
What are the typical SSx of a malignancy being present?
- Previous hx of malignancy
- Fever
- Night sweats and night pain
- Constant, unremitting pain
- Unexplained weight loss
- Feelings of fatigue and tiredness that are unexplained
- Pain at rest
- Pain with no improvement > 1 month
- Lumps at the site or in other systems
What is pelvic inflammatory disease?
- PID is not one specific disease but the outcome of any infection in the genitourinary tract which has not been adequately treated.
- Can effect the endometriosis layer, uterine tubes, ovaries and peritoneum
Risk factors for PID?
- Sexually active women with more than one partner
- Inadequately treated STI’s
- Abortion
- Dilation or curettage
- IUD insertion
- Caesarian complications
Clinical SSx and complications of PID?
Sometimes asymptomatic*
-Lower abdominal pain (worse with movement, palpation, intercourse (dyspareunia) or urination (dysuria))
- Irregular bleeding
- Mucopurulent discharge
Complications include:
-Infertility, pelvic adhesions, abscess formation, ectopic pregnancy and chronic pain
What is endometriosis?
Deposits of endometrial tissue found anywhere than the uterine mucosa
Epidemiology of endometriosis?
- 10-15% of women in their reproductive years
- Peak age is 25-35
- Can start as young as 11
- Family history increases risk
How does endometriosis occur?
1, Retrograde menstruation: opposite flow of endometrial tissue in the uterine tubes and pelvic cavity
- Embryonic cells: Remain scattered throughout the body from embryonic development
- Endometrial emboli: Travels via blood and lymphatics and seed in a new area
SSx of endometriosis?
- Pain: pelvic pain, dysmenorrhea, dyspareunia
- Bleeding: menorrhagia (heavy periods), irregular periods, spotting
- Bowel or bladder symptoms: dysuria, dyschezia, cyclical IBS syndrome
- Reduced fertility
- Systemic: fatigue, lethargy, depression
