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9 conditions you don't want to miss
Major depressionSuicide riskFemoral head and neck fracturesCauda equina syndromeCervical myelopathyAbdominal aortic aneurysmDeep venous thrombosisPulmonary embolismAtypical myocardial infarction TERM 2
Major depression
DEFINITION 2 patients responds yes to one or either of the following: over the past 2 wks have you felt: 1) down, depressed or hopeless 2) little interest or pleasure in doing things?then note 3-4 of following: weight change, insomnia, psychomotor agitation, fatigue, worthlessness or guilty feelings, difficulty concentrating, recurrent thoughts of suicideif above accounted for and causing impairment, then consult in order TERM 3
suicide risk
DEFINITION 3 #1 cause of death in ages 15-2450-67% of individuals will have seen a physician within previous 4 weeks"Have you attempted to or had thoughts of attempting to harm yourself ?" TERM 4
risk factors related to major depressive
disorder
DEFINITION 4 Current or previous history of major depression Women, especially during pregnancy or postpartum History of diabetes, myocardial infarction, cancer, stroke, chemical dependencySuffering from significant loss, including change in social status 90% of those committing suicide have a history of psychiatric illness, Positive family history (first-degree relative) TERM 5
femoral head and neck fractures
DEFINITION 5 Timely referralEstimated 30% of those suffering a hip fracture die within 1 year11% of stress fractures in athletes involve the femoral neck
Femoral Head fracture Manifestations
Pain and local tenderness Deformity Edema Ecchymosis Loss of general function and mobility TERM 7
Auscultory patellar pubic percussion test
DEFINITION 7 Stethoscope on pubic symphysis ( patient can hold)Stabilize patella with one hand percus with otherPositive duller and diminished sound TERM 8
Cauda Equina syndrome
DEFINITION 8 Injury below the spinal cord compressing the nerve TERM 9
presentation of cauda equina
DEFINITION 9 Urinary dysfunction (retention, incontinence) Bowel dysfunction (incontinence, loss of anal tone) Sexual dysfunction (reduced sensation during intercourse, impotence) Sensory deficits-Perineum and saddle regions Lower extremities Motor deficits-Lower limbs (multiple spinal level weakness) TERM 10
risk factors of cauda equina
DEFINITION 10 Low back injury, central disk herniationCongenital or acquired spinal stenosis (degenerative disk or facet joint disease, degenerative spondylolisthesis)Spinal fractureAnkylosing spondylitisTuberculosis
presentation of AAA
Increase with general activityNon mechanical TERM 17
how do we screen for AAA?
DEFINITION 17 ObservationPalpationAuscultation TERM 18
risk factors for DVT
DEFINITION 18 Previous history of DVT History of cancer or Receiving chemotherapy History of congestive heart failure History of systemic lupus erythematosus Major surgery or Major trauma Immobility Limb paralysis Women during pregnancy and taking oral contraceptives, hormone replacement therapy Age >60 yr TERM 19
biggest risk of DVT
DEFINITION 19 Carries a large risk for pulmonary embolism TERM 20
pulmonary embolism
DEFINITION 20 Clot becomes dislodged and travels to the lungs
risk factors of PE
Previous history of PE History of DVT Immobility History of abdominal, pelvic surgery Total hip, knee replacement Late- stage pregnancy Lower limb fractures Malignancy of pelvis or abdomen TERM 22
PE signs and
symptoms
DEFINITION 22 AsymptomaticSOBTachypneaChest Pain TERM 23
atypical MI presentation
DEFINITION 23 50% of women with an MI present with chest painUpper abdominal epigastric, neck, jaw, tooth,intrascapular pain, right arm pain,May not be associated with exersionIndigestion in which antacids dont workDyspneaFatigue TERM 24
modifiable risk factors for atypical MI
DEFINITION 24 Cigarette smoking High cholesterol levels (low-density lipoprotein and total serum cholesterol levels) Hypertension Diabetes Obesity Sedentary lifestyle Excessive alcohol consumption TERM 25
non-modifiable risk factors for atypical MI
DEFINITION 25 Age >55 female, >45 menFamily HXEthnicity
