Systems Review LQ

Question 1

Purpose of systems review?

Answer 1

identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional

Question 2

________are the best tools to raise suspicion of pathology

Answer 2

RED flags

Question 3

What are the constitutional symptoms or general health components requiring system(s) review when present?

Answer 3

Fever, chills, sweats- MOST often associated with systemic illness
Prolonged (≥2 wks.)
> 102° may require hospitalization
Weight changes, particularly loss of ≥ 5% and if unexplained
Nausea and Vomiting (N&V)
Dizziness and lt. headedness
Fatigue- prolonged (≥ 2 wks.) and limiting
Weakness- limiting
Paresthesia/Numbness
Malaise or ill feeling- “I feel like I’m coming down with something”
Mentation or cognitive changes

Question 4

Kidneys, ureters, bladder, and urethra belong to what system?

Answer 4

Urinary

Question 5

The function of the Urinary System:

Answer 5

Filter fluid from renal blood flow
Remove waste
Retain essential substances for fluid and contents balance i.e., electrolytes, acid-base balance, etc.

Question 6

The urinary system stimulates _______ production
BP _________
Converts _______ to its active form

Answer 6

RBC
regulation
vitamin D

Question 7

Urinary S&S

Answer 7

P! in trunk, flank, and/or pelvic regions
Discoloration
-Urinary changes
Frequency
Urgency
Bleeding
Pus
-Dysfunction
Flow
Initiation
Control
-Nocturia- awake to urinate

Question 8

Urinary Review

Answer 8

MOST from Hx
Observation of urine is unlikely
P! w/kidney percussion
P! with bladder palpation/percussion during abdominal assessment

Question 9

Function of the reproductive system

Answer 9

Producing sex cells i.e., eggs/sperm, and creating sex hormones with the Endocrine system
Maintaining fertilized eggs for development

Question 10

Reproductive S&S

Answer 10

P! in pelvis, LB, abdominal regions and/or sexual organs

Dysfunction
Sexual
Bowel and bladder due to proximity

Abnormal
Discharge from sex organs
Menstruation

Question 11

Early and possibly UNKNOWN pregnancy indications are ________ S&S

Answer 11

reproductive

Question 12

What is polyuria?

Answer 12

excessive or an abnormally large production or passage of urine

Question 13

Breast tenderness
Fatigue
N&V with possible wt. loss
Heartburn
Constipation
Abnormal vaginal discharge

These are ___________ S&S?

Answer 13

reproductive

Question 14

Reproductive review

Answer 14

MOST from Hx
Observation unlikely
NO other specific assessment

Question 15

The metabolic system compose of what structures?

Answer 15

gut, liver adipose tissue, pancreas, kidney, and mm

Question 16

Functions of the metabolic system?

Answer 16

Conversion of foods and liquids into:
Energy for all cellular processes
Building blocks for proteins, fats, and carbohydrates
Eliminate waste
Fluid and electrolyte balance is KEY for cellular metabolism

Question 17

Metabolic S&S:

Answer 17

Due to imbalance of fluid, electrolytes, and/or pH

If the S&S don’t match to a specific system and seem widespread, it is possibly a metabolic condition because altered metabolism can affect MULTIPLE systems

Question 18

What are two of the MOST common reasons you get fluid and electrolyte imbalances?

Answer 18

polyuria and/or dehydration

Question 19

What are things that contribute to polyuria and/or dehydration:

Answer 19

Diabetes (rid excess sugars)
Kidney dysfunction- regulates MOST electrolytes followed by intestines, bone, and parathyroid gland
Malignancy
Alcoholism/liver disease
Medication side affects e.g., diuretic for HTN
Burns
Diarrhea
N&V

Question 20

What are the 3 common electrolytes?

Answer 20

sodium, potassium , calcium

Question 21

What are other electrolytes? (4)

Answer 21

Phosphorus, bicarbonate, magnesium, chloride

Question 22

Fluid and Electrolyte imbalance S&S

Answer 22

Skin
-Loss of skin elasticity
-Temperature
Warm and flushed due to vasodilation from impaired circulation and thermoregulation with metabolic acidosis or Diabetes
Pale and cool due to vasoconstriction with hypovolemia or dehydration
-Neuromuscular irritability
Fatigue
Twitching
Cramping
Tetany

Question 23

CNS involvement regarding fluid and electrolyte imbalance S&S (4)

Answer 23

Memory impairment
Depression
Delusions/Hallucinations
Seizures

Question 24

Cardiovascular changes regarding fluid and electrolyte imbalance S&S (3)

Answer 24

Tachycardia
Postural hypotension
Altered respirations

Question 25

pH is ideally between ____ and ______ Kidney removes ____ and keep _____ Lungs balance the ________

Answer 25

7.35 and 7.45 acids; bases acidic C02

Question 26

Four classes of pH imbalance

Answer 26

Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis

Question 27

T or F: Confusion and fatigue S&S may occur with ALL classes listed below Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis

Answer 27

True

Question 28

respiratory acidosis (lowered pH)

Answer 28

Hypoventilation and an accumulation of acidic CO2 may occur with: -numerous disorders affecting respiration -drugs that suppress respiration like -opioids/muscle relaxers -sleep apnea

Question 29

S&S of Respiratory Acidosis (lowered pH)

Answer 29

Headache Anxiety May progress to: -memory loss/personality changes -sleep disturbances -incoordination/tremors

Question 30

Respiratory Alkalosis (higher pH)

Answer 30

Hyperventilation leading to a loss of acidic CO2 may occur with: -pulmonary conditions -anxiety -anemia with less oxygenation

Question 31

S&S of Respiratory Alkalosis (higher pH)

Answer 31

Shortness of breath (SOB) is often the ONLY sign Lightheadedness Otherwise highly variable

Question 32

Metabolic Acidosis (lowered pH)

Answer 32

MOST common acid-base abnormality Accumulation of acidic H+ ions may occur with: MOST commonly due to diabetes with build-up of ketone bodies or acids Diarrhea/dehydration leading to greater acid concentration Kidney diseases that hold onto too many acids

Question 33

S&S of Metabolic Acidosis (lowered pH)

Answer 33

Long deep breaths with a fruity smell due to ketoacidosis Think Diabetes cardinal S&S -frequent urination (polyuria) --dry mouth --extreme thirst (polydipsia) --decreased skin turgor Blurry vision Weakness/fatigue

Question 34

Metabolic Alkalosis (higher pH)

Answer 34

Accumulation of bicarbonate base may occur with: -vomiting by loss of stomach acids -kidney disorders or medications that keep too many bases -excessive antacid, laxative, or diuretic medications -diarrhea

Question 35

S&S of metabolic Alkalosis

Answer 35

Headache Neuromuscular excitability -paresthesia/Numbness -twitching and cramping, particularly in feet and hands (Trousseau sign) -seizures Muscle alterations due to associated lowering of Ca2+ -skeletal weakness -cardiac arrhythmias- irregular heart beating

Question 36

What is the MOST common metabolic condition?

Answer 36

Metabolic Acidosis (lowered pH)

Question 37

What are the review components for metabolic system?

Answer 37

Hx Observation resisted and or mmt -weakness neuro test- possibly altered sensations abdominal assessment standard vitals palpation

Question 38

Observation: Metabolic Review (6)

Answer 38

muscle twitching/tetany altered respiration memory loss dry mouth fruity breath**

Question 39

Metabolic Review: (+) abdominal assessment P! with palpation and percussion of (3)

Answer 39

liver kidney pancreases

Question 40

Metabolic Review: standard vital signs -- what are they?

Answer 40

tachycardia or irregular heartbeat postural hypotension altered respiratory rate

Question 41

Metabolic Review: what should a PT expect to see w/palpation? (2)

Answer 41

loss of skin mobility extreme skin temperatures