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System review and screening
10 questions on test
51
Other
Graduate
12/09/2013

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Term
Reasons for medical screening
Definition
Direct access
quicker/sicker at baseline
Signed prescription
Info told to PT and not to Dr
Flags present (yellow or red)
Term
screening
Definition
detecting disease or body dysfunction before the person would normally seek care
Term
example of screening
Definition
Older women - getting mammogram or bone density check
teens - scoliosis, eating disorders
Term
Surveillance
Definition
-Requires targeted prevention
-Analysis of health information to look for problems occurring in general population, specific groups, or workplace.
Term
Functional reach test
Definition
Reach as far forward as you can without taking a step
-Score < 6/7 limited functional balance
-Most healthy individuals reach 10+ in.
Term
Functional reach test - normal score for 70-87 yrs old
Definition
10.5 +/- 3.5 (25.4 cm)
Term
Functional reach test - stop when
Definition
feet lift off floor or fall forward
-Guard from front
Term
Timed up and go test - what used for
Definition
Use to identify/screen elderly prone to falls
-Longer than 14 seconds - have a high risk of falls
Term
What is the difference between TUG, TUG Cognitive, and TUG Manual
TUG=Timed up and go
Definition
TUG alone - stand from seated position in chair, walk 3 meters, turn around, walk back and sit down.
TUG Cognitive - Do TUG while counting backwards
TUG Manual - Do TUG while carrying full cup of water
Term
Neurological screening includes
Definition
-mental/emotional status
-Cranial nerves
-Deep tendon reflexes
-Motor function (gait, posture, balance, etc)
-Sensory function
-Superficial (pin prick)
-Temperature
-Vibration (tuning fork)
Term
Balance screening test
Definition
-Romberg: feet together (30 sec) with eyes open and closed
-Sharpened Romberg: Heel/toe eyes open and closed
-Single leg stance: 30 sec, eyes open and closed
-TUG
-Functional Reach
Term
Functional tests
Definition
Gait assessment (observe)
Sit to Stand
Stairs climbing
Term
Musculoskeletal Screening
Definition
-Observe for deformities, abnormalities, disabilities, asymmetries
-Assess from all angles (front, back, right, left)
-May include upper or lower quarter screen
-ROM
-Joint mobility
-Strength
Term
Integumentary screening - very important for PTs
Definition
-Hands, arms, feet, and legs
-Look for changes in
- texture
- color
- temperature
- clubbing
- circulation
- edema
Term
Clinical signs of mild dehydration
Definition
Thirst
Mouth/lips dry
Term
Clinical signs of moderate dehydration
Definition
-very dry mouth/cracked lips
-Sunken eyes - infants(fontanel)
-Poor skin turgor
-postural hypotension
-Headache
Term
Clinical signs for severe dehydration
Definition
-all signs moderate
-Rapid/weak pulse (>100bpm)
-Rapid breathing
-Confusion, lethargy, irritability
-Cold hands/feet
-unable to cry or urinate
Term
When would you use the Karnofsky Performance Scale?
Definition
-For patients with HIV
-Rates in order of %
-0% death ------ 100% normal/no signs of disease
Term
What kinds of questions does the mini mental status scale ask? How many questions?
Definition
- 10 questions
-date/orientation/age/president/
subtract 3 from 100 and keep going
Term
Classify mini mental state scale
Definition
Max - 30
Impaired < 24
Mildly impaired 21-23
Moderate 16-20
Severely <16
Term
Body temperature testing
Definition
Average oral temp 98.6F / 37C
Hypothermia: < 95 F / 35 C
Realize: temp varies thru day/lifespan
Term
When monitoring pulse - easiest thing to do is..
Definition
Compare it to your own pulse
-weak
-strong
-mixed
-irregular
Term
Define bradycardia and tachycardia
Definition
Bradycardia < 60bpm
Tachycardia > 100bpm
Term
Things to have in a mobile screening kit
Definition
-stethoscope
-sphygmomanometer
-thermometer
-pulse oximeter
-reflex hammer
-penlight
-cotton swab/ 2 test tubes (sensation)
-Familiar objects
-tuning fork
-watch
-gloves
-tape measure
-goniometer
-safety pin (dermatome)
Term
Body / breath odors
Definition
-Fruity - diabetic ketoacidosis (acetone)
-Scent of alcohol
-Halitosis - dental decay, pulmonary infections, throat/sinus infection, liver failure, uremia
Term
Vital signs that should be taken on all people
Definition
Pulse, BP, temp
Term
Vital signs in general
Definition
pulse, bp, temp
RR
Pulse oximetry
skin temp
pain
Term
Signs/symptoms of malnutrition
Definition
-muscle wasting
-hair loss/thinning (alopecia)
-Dermatitis - dry/flaking skin
-Chapped lips/lesions mouth corners
-Brittle nails
-Abdominal distension
-decreased activity, fatigue, lethargy
Term
RED FLAGS - past medical history
Definition
-personal/family history of cancer
-Recent infection (6wks)followed by neurological symptoms like memory, headache, blurred vision
-Recurrent colds/flu
-Recent history of trauma
-History of immunosuppression
-IV drug use
Term
Pt clinical red flag
Definition
-no known cause for problem
-symptoms not relieved/worsened by PT
-symptoms better w/PT but return
Term
Significant weight gain without effort can be a red flag for ..(10% gain w/in 3 weeks)
Definition
Heart failure
Term
Significant weight loss can be a red flag for ....(10% weight w/in 3 weeks)
Definition
Cancer etc
Term
Clinical symptoms can be red flags if...
Definition
-gradual, progressive or cyclical
-unrelieved by rest/position change
-Out of proportion to injury
-Longer than expected time
-cannot alter during an exam
-does not fit neuromuscular/ musculoskeletal pattern
-no pattern of symptoms
Term
A growing mass is always to be assumed..
Definition
A tumor
- until proven otherwise
- a hematoma will decrease over time
Term
If a woman over the age of 55 (postmenopausal) complains of bleeding
Definition
RED FLAG
Term
Red flags that may show up bilaterally
Definition
-Edema
-Numbness/tingling
-clubbing
-nail bed changes
-skin-pigmentation changes
-skin rash
Term
what can be a red flag in people with neurological conditions?
Definition
-Change in muscle tone
-Change in ROM
Term
Pain pattern red-flags
Definition
-back/shoulder referred pain
-Night pain (constant/intense)
-Worse w/activity, better w/rest
-intermittent claudication, angina
-Description:throbbing/boring/deep aching
-Pain hard to localize
-pain associated w/viscera
Term
Constitutional symptoms/red flags
- more common
- whole body
Definition
-diaphoresis (unexplained sweating)
-night sweats
-nausea, vomiting, diarrhea
-pallor, dizziness, syncope
-fatigue, malaise
-weight loss (unexplained)
-fever
-decreased appetite
Term
What do we always ask during interview?
Definition
Are there any symptoms your are experiencing that may not seem related to your current problem?
Term
If we see any constitutional symptoms, what should we do?
Definition
- Examine further b/c these are symptoms of many diseases
Term
What is the PTs role in disease prevention?
Definition
-Primary prevention
prevent development w/education etc
-Secondary prevention
early detection w/screening
-Tertiary prevention
limit degree of disability/
improve function
Health promotion and wellness
help to make good choices w/health
Term
Systems to reveiw
Definition
-Cardiovascular
-pulmonary
-integumentary
-musculoskeletal
-Neuromuscular
-GI/GU
-Psychosocial
Term
Getting ready for health history interview
Definition
-time to reflect
-review chart
-set goals for interview
-review behavior/appearance
-adjusting to environment
-taking notes
Term
Interview sequence
Definition
-greet/establish rapport
-invite pt story
-establish agenda
-expand/clarify pt story
-generate/test diagnostic hypothesis
-create shared understanding
-negotiate a plan
-plan for follow up and close
(they need to take responsibility for health and know what to do)
Term
Name some things
Definition
Term
Name some things that help build a therapeutic relationship
Definition
-active listening
-guided questioning
-nonverbal
-empathy
-validation
-reassurance
-partnering
-summarization
-transitions
-empowering patient
Term
Example: patient interview for falls

OPEN QUESTIONs
Definition
History of fall: when happened, what else was going on, what were you doing at the time, what caused the fall, has this happened before ....
Effects of the fall: who helped you after, did you lose consciousness, injuries, get up on own or require help, what do after.
Term
Name some risk factors
Definition
Substance abuse, age, BMI, gender, alcohol abuse, occupation, domestic violence, hysterectomy, race, tobacco, overseas travel, sedentary lifestyle, radiation exposure, multiple sex partners
Term
Past medical history can include things like ...
Definition
cardiovascular, diabetes, cancer, infection, trauma, surgeries, pulmonary disease, TB, pregnancy, births, miscarriage, medications, occupational/environmental exposures, oversees travel, psychosocial screen
Term
Risk factors for nutritional deficiency
Definition
-economic status, LIVING ALONE,older age, depression, anxiety, eating disorders, lactose intolerance, nausea, GI impairments, chronic diarrhea, addiction, liver disease, dialysis, medications, burns, difficulty swallowing/chewing (like after a stroke)
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