Week 2.1 Do Not Want to Miss List Flashcards Preview

Advanced Clinical Practice Complex Patient > Week 2.1 Do Not Want to Miss List > Flashcards

Flashcards in Week 2.1 Do Not Want to Miss List Deck (27)
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what percent of men and women are depressed

10-25% women
5-12% men


what do you follow these two questions with if yes?
-felt down, depressed or hopeless in the last two weeks
-little interest or pleasure

you note 3-4 of the following symptoms
-weight change
-psychomotor agitation
-feelings of worthlessness guilt
-difficulty concentrating
- recurrent thoughts of suicide


what do you do if the symptoms are not accounted for by bereavement, substances and the symptoms are causing significant impairment socially, occupationally, or function



who has the highest suicide risk

middle aged women


who has a higher suicide contemplation, and who has a higher risk of attempts

higher contemplation is men, attempts is women


what are some risk factors for suicide

widowed, divorced, living alone, psychiatric illness, suicide attempts, chronic progressive illnesses, significant loss, unemployed, hopelessness, family history suicide


what are some phrases that are concerning

I don't know how much longer I can take this, stopping therapy, stopping other treatments


what is the sensitivity of people expressing thoughts about death? what about wishing they were dead?



what are some of the issues to consider with suicidal patients

own a gun? have a plan? medications? who do we need to contact?


why is it so important to diagnose and image a femoral head and neck fracture

to prevent non-displaced going to a displaced fracture, which could require surgery.


where do osteoporotic fractures usually occur?

femur and lumbar spine


what are some manifestations of a femoral head or neck fracture

pain and local tenderness,
loss of function and mobility
pain in the anterolateral thigh, knee and even the groin or the butt


_% of those suffering from a hip fracture die within the first year



what is the MOI of a hip fracture

trauma, slip and fall, sneeze, lifting things in and out of the car, trying to open a window (decreased bone density)


what are some disorders associated with compromised bone density

renal failure, GI issues, RA, ankylosing spondy, hyperparathyroidism, hyperthyroidism, T2DM, MS, alcoholic, Cushing's


what are some meds associated with fracture

aluminum, anticonvulsants, steroids, cytotoxic drugs, thyroxine, heparin and warfarin, methotrexate, caffeine, more that 3 cups coffee per day, soft drinks, tobacco


what are some risk factors for fatigue fractures

female, hormone imbalances, running, jumping and marching, new activity, increase intensity, changes surface or footwear, nutritional, leg length discrepancy, decreased strength


what is the patellar pubic percussion test

lateral to the symphysis, on the pubic tubercle, you put the stethoscope, and you tap the patella


what is a negative or normal PPPercussion test

sharp and distinct sound


what is a positive (fracture) PPP Test

not a sharp and distinct sound


what is the fulcrum test

put your arm under the femur, where you think the stress fracture is, and push down on the distal femur, until they have pain (which would be a stress fx)


What are the risk factors for caudal equina syndrome

low back injury, central disc herniation, stenosis, spinal fracture, ankylosing spongy, tuberculosis, Pott's disease


what are some of the clinical manifestations of cauna equina syndrome

urinary dysfunction, bowel dysfunction, incontinence, retention, sexual dysfunction like lack of sensation or impedance, sensory issues, saddle region things, LE motor deficits, and lower limbs weak


what is the most common cauna equina manifestation

retention of urine


what is the manifestation for cervical myelopathy based on the history

impaired hand dexterity
gait and balance issues (slow and stiff)
numbness and paresthesias of the extremities
neck stiff
urinary dysfunction (retention and urgency and frequency)


what are some of the physical exam findings of a cervical myelopathy

hand (intrinsics atrophy)
muscle weakness, esp. in the triceps
muscles weak in the LE
UMN signs of the DTR hyperactive) and babinski and Hoffman positive


what are the risk factors for a cervical myelopathy

-cervical spine spondylitis changes
-age 50-60
-history of neck trauma like a MVA or sports injury