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Clin Med > systems review - Exam 1 > Flashcards

systems review - Exam 1 Flashcards

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1
Q

What is the purpose of a systems review?

A

Identify suspicious non-MSK or Red flag S&S that require referral to another healthcare professional

  • NOT a diagnosis of non-MSK S&S
  • look for combinations of S&S
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2
Q

what is the best tools to raise suspicion of pathology?

A

RED flags

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3
Q

How is a systems review determined?

A

from the initial history and observation of the patient

ex: symptoms w/ aerobic exertion indicate cardiovascular and respiratory systems

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4
Q

What two factors weigh in when determining level of concern?

A
  1. evidence (red flags)

2. clinical profile (urgency, progression, co-morbidities, etc)

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5
Q

what are some constitutional symptoms requiring systems review?

A 
fever, chills, sweats
weight changes
N&V
dizziness
fatigue
weakness
paresthesias
malaise
cognitive changes
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6
Q

How do you get referred pain?

A

some muscles share innervations which then share symptoms

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7
Q

what are S&S of infections?

A 
malaise (most common early symptom)
fever, chills, sweats
N&V
enlarged/tender lymph nodes
redness, heat, swelling
specific system S&S
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8
Q

what are systemic S&S in older adults?

A

more subtle & atypical

mentation changes
subnormal body temp
bradycardia
tachypnea
fatigue
lethargy
decreased appetite
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9
Q

what are you palpating for in infections?

A

lymph nodes - > 2 cm diameter, firm, immobile, tender
heat
swelling
abdominal quadrant assessment

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10
Q

what are standard vital signs?

A

temperature
heart rate
blood pressure
respiratory rate

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11
Q

what is the function of the immune system?

A

defends the body against harmful substances, pathogens, and cells or non-selfs from internal and external threats

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12
Q

common S&S to most auto-immune conditions but not exhaustive

A 
GI p!
inflammation - local or systemic
myalgia
skin and weight changes
swollen lymph nodes - tender with acuity, non tender if chronic 
fatigue
fever - immune system kicks in 
typically affect >1 part of body
emotional changes
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13
Q

Cancer S&S

A

Hx of cancer
P! - local and referred - especially at night
N&V
loss of appetite
unexplained weight loss
fever, chills, sweats - even in absence of infection
swollen and non-tender lymph nodes - hard & immobile due to fibrosis
unusual malaise and fatigue
secondary infections due to lowered immunity

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14
Q

describe abnormal lymph nodes of someone with cancer

A

> 2 cm
firm
immobile
non-tender due to limited inflammation with typical slow growth of most cancer

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15
Q

What are the functions of the integumentary system?

A 
protects underlying structures
insulator
regulates temperature
assists with fluid balance
synthesis of vitamin D
sensory detection of stimuli
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16
Q

Integumentary system S&S

A 
itchy/dry/rough texture
- impaired circulation/oxygenation
- associated with many conditions
hives/rash
callus - excessive friction
blisters - increased friction
edema
- local: in one area
- generalized: all over
change in nail appearance - yellow
skin markings
discoloration
ulceration/wound
limited mobility - scar adhesion or inflammation
scars - past injury/surgery
varicose veins - venous congestion
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17
Q

what are the ABCDE of melanoma skin cancer?

A 
Asymmetry
border - not well defined or irregular
color - multiple shades
diameter - larger than pencil eraser
evolution - change over time
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18
Q

what is Cafe au Lait?

A

aka coffee stain

indicate underlying genetic problem
mostly benign but a concern if multiple spots

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19
Q

what are hair skin marks like?

A

patch, especially on spine - underlying genetic problem

loss may indicate impaired circulation

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20
Q

what are the discolorations as an integumentary S&S?

A

cyanosis - possible impaired circulation/oxygenation
redness/red streaks - may indicate acute inflammation, stage I pressure ulcer, infection or allergic reaction
bruising - recent injury

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21
Q

what are the two types of hot S&S in integumentary system?

A

localized - acute or local inflammation

generalized - fever, chills, sweats with infection or cancer

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22
Q

what are you looking for in an integumentary review?

A 
Hx and observation S&S
palpation
- swelling
- heat
- skin mobility
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23
Q

what are you looking for in an infection review?

A

hx and obsercation S&S
palpation
standard vital signs

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24
Q

what are you looking for in an immune review?

A

hx and observation S&S
temperature
palpation of lymph nodes

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25
what are you looking for in a cancer review?
hx and observation S&S palpation of lymph nodes temperature
26
what is the function of the endocrine system?
sends messages throughout the body by hormones
27
where does the endocrine system meet the nervous system?
hypothalamus-pituitary interface
28
what is the hypothalamus?
main integrative center of endocrine and autonomic nervous system functions by hormonal and neural pathways
29
endocrine S&S
depends on affected gland - hyper or hypoactive, creating hormonal changes may affect multiple symptoms
30
why could you mistake an endocrine S&S as MSK problem?
can initially present as msk problem that regresses in response to hormonal changes or is not progressing
31
neuromusculoskeletal endocrine system S&S
``` presence of some MSK conditions (RA, OA, CTS, osteoporosis) persistent muscle weakness, atrophy, P! fatigue stiffness joint P! ```
32
what are some systemic endocrine S&S?
``` growth alterations polydipsia/polyuria changes in mentation, hair, skin, body fat, elevated vitals heart palpitations increased perspiration deep rapid breathing fluid imbalance ```
33
what are you looking for in an endocrine review?
hx and observation S&S selective tension testing and/or MMT standard vital signs
34
what is the function of the cardiovascular system?
coordination with respiratory and nervous system oxygenated blood through arterial system deoxygenated blood carried by venous system
35
what is the primary reason for cardiovascular S&S?
insufficiency of heart and vessels
36
cardiovascular S&S
``` family hx of heart attack before 60 P! in chest heart palpitations nausea sweating SOB/wheezing dizziness fatigue w/ minimal exertion cough cyanosis with coldness ```
37
describe P! in chest symptom for cardiovascular
P! can be with or without upper thorax, neck, UE and/or face due to shared C4-T4 innervation L UE more common UE pain - ulnar n. distribution medially into little finger especially on exertion
38
peripheral vascular S&S
LE edema including weight gain indicates impaired R ventricle P! in LE due to claudication, w/ activity and area may lose color or become cold diminished pulses
39
what are you looking for in a cardiovascular review?
``` hx and observation S&S vitals ankle-brachial index - LE systolic BP/UE systolic BP - > .9 can be used for prediction ```
40
what is the function of the lymphatic system?
develops embryologically from venous system
41
primary reason for lymphatic S&S
fluid build up and pressure
42
lymphatic S&S
``` P! in local area full, heavy, tight sensation impaired ROM paresthesias increased extremity size weight gain swollen lymph nodes ```
43
what are additional S&S in advanced lymphatic cases?
skin breakdown/wounds infections --> infection S&S head and neck edema interferes with speech, swallowing, breathing
44
what are you looking for in a lymphatic review?
``` hx and observation S&S ROM girth measures palpation of lymph nodes temperature ```
45
what is the function of the respiratory system?
coordination with cardiovascular, nervous and immune systems to facilitate gas exchange nutrients and O2 to tissues, CO2 and waste from tissues
46
respiratory S&S
``` P! in neck, thoracic regions Thorax P! - T2-4 shared innervation cyanosis digital clubbing - circulatory issues SOB, wheezing, altered breathing patterns cough decreased breath sounds hyper resonance with percussion ```
47
what are you looking for in a respiratory review?
hx and observation S&S vitals breath sounds with stethoscope percussions
48
function of GI system
``` digestion - stomach and SI absorption - stomach & SI excretion - LI, colon, rectum protection - 70-80% immune cells in gut assisted by hepatic system emotional physiological connection for gut health ```
49
GI S&S
P! in neck, trunk, pelvic, shoulder regions - shared innervation dysphagia N&V food aversion/intolerances indigestion or heartburn full feeling bowel dysfunction - color, shape, constipation, incontinence
50
what are you looking for in GI review?
hx and observation S&S | abdominal quadrant assessment
51
function of hepatic system
filter and remove things plays a role in nearly every bodily system houses immune system cells - largest number of phagocytic cells
52
what are most hepatic S&S due to?
increased bilirubin
53
hepatic S&S
P! in R upper abdominal and/or thoracic quadrant and/or R upper shoulder GI S&S skin changes - jaundice, bruising, palmar erythema, spider angioma dark urine discolored stools neurological involvement due to increased neurotoxin build up of ammonia/bile - confusion, sleep disturbances, asterixis hepatic osteohystrophy - metabolic bone disease due to suppression of bile flow
54
what is asterixis?
paresthesia's from ammonia build up and inability to maintain wrist ext with shd flx
55
what are you looking for in a hepatic review?
hx and observation S&S abdominal quadrant assessment neurological tests
56
what is the function of the nervous system?
sensory processing involuntary and voluntary responses controlling, regulatory and communicating bodily system
57
LMN parts
cranial nerves anterior gray column of spinal cord cauda equina spinal nerves and distal to terminal nerves
58
UMN parts
above anterior horn of spinal cord | brain and most of spinal cord
59
neurological S&S - superficial abdominal reflex
light strokes in each abdominal quandrant WNL = umbilicus moves in direction of stroke hypoactive = decreased or lack of umbilical movement
60
neurological S&S
N&V dizziness visual or auditory dysfunction
61
what are you looking for in a neurological review?
hx and observation | neurological tests specific to region (dermatomes, DTR, myotomes, etc)

Clin Med (7 decks)

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