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130 Cards in this Set
- Front
- Back
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Lack of Pigmentation d/t melanocyte destruction
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Vitiligo
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Associated with hyperthyroidism, stomach cancer, diabetes, p. anemia, and autoimmunte diseases
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Vitiligo
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Assoc: Virus, lupus, parasites, metals/chemicals
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Skin Rash
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Required Immediate medical attention and is a rupture of small vessels in the skin
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Hemorrhagic Rash (Will not blanch)
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Assoc: Stress, allergy, infection, and environment irritants
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Dermatitis
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Chronic facial skin disorder and can be linked to GI disorders
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Rosacea
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Immediate medical attention that are benign fatty nodules found around tendons.
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Xanthomas (assoc:biliary disease, diabetes, lipid metabolism)
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Large skin areas of bruising d/t of using topical ointment
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Steroid Skin
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Bullseye Rash
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Erythema Chronicum Migrans (Lyme disease)
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Low or high pigmentation of the skin depending on the dose
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Radiation
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A relapse of skin changes after chemotherapy or other radiation event.
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Radiation Recall Reaction
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Can effect the nail bed or skin and can result in joint pain
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STDs
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HSV1 ganglion and area of effect
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Trigeminal; mouth/face
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HSV2 ganglion and area of effect
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Sacral, genitals
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Intermittent painful infections of the finger phalanx with a history of malaise prior to symptoms
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Herpetic Whitlow
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Thoracic root ganglion, painful chest blisters
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Herpes Zoster/shingles
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Atypical bruising of the mid-arm or abdomen
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Abuse
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Spots of the skin that are not from abuse
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Mongolian spots/birth marks
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Purplish/red/brown discolorization of the skin
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Pinch Purpura (cancer)
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Opportunistic cancer
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Kaposi Sarcoma
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Round patches of red/brown skin with hair loss
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Lymphomas (hodgkins or non-hodgkins)
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Lifting up of nail bed
Assoc: |
Onycholysis
myeloma, neoplasm, graves disease, anemia, arthritis |
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1. Upward tilted edges with depressed nail beds
2. Assoc: |
1. Koilonychia (spoon nails)
2. Anemia, diabetes, thyroid issues, rheumatic fever |
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1. Grooves in nail plate
2. Assoc: |
1. Beau's lines
2. chemotherapy, eating disorder, liver cirrhosis, acute illness, poor peripheral circulation |
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1. Lines of blood in nail bed
2. Assoc: |
1. Splinter Hemorrhage
2. Silent MI, bacterial endocarditis, vasculitis, renal failure |
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1. Dots or white lines in the nail bed
2. Assoc: |
1. Leukonychia
2. Hypocalciumia, anemia, hodgkins, renal failure, MI, malnutrition, cirrhosis, leprosy |
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Infection of the skin fold on the margin of the nail from working in wet conditions
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Paronychia
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Changes in the nail bed d/t chronic O2 deprivation
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Clubbing
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Poor nail development and associated joint pain
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Nail patella syndrome
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What is the ABI formula and the normal values
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sys ankle/sys arm
1-1.3 normal <1 poor flow >1.3 calc |
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Reason for:
Crackles, Wheezing, Girgles, and plural friction rub |
Crackles-fluid filled airway
Wheezing-narrow cavity Girgles-thick secretion PFR-high pitches/scratchy |
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Reasons for Anemia
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Iron deficiency
Chronic Diseases Neuro Conditions (P Anemia) Infectious disease (Cancer/AIDs) |
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Symptoms of Anemia
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Dyspnea, palpitations, severe weakness, pallor, easy bruising, bleeding gums, blood in stool or emesis
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Signs of Anemia
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1/2 hemocrit, fatigue, increased resting pulse, decreased diastolic, skin is lemon yellow (p anemia), white (hemorrhage), gray-green (chronic blood loss), brittle nail beds
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Increased RBC, blood hemoglobin, clotting, and thickness
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Erythrocytosis/Polyerythemia
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Causes for Erythrocytosis
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High Altitude, smoking, radiation, chronic heart/lung condition
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Symptoms of Erthrocytosis/Polyerythemia
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Shortness of breath, fatigue, stroke, thrombus, gout like symptoms
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What is sickle cell crisis
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Acute severe pain in the bone or joint, CVA, chronic leg ulcer
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An autosomal recessive disorder with abnormal hemoglobin, chronic anemia, and vasoocclusion
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Sickle Cell Anemia
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Greater than 10,000 white blood cells
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Leukocytosis
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Less than 10,000 WBC
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Leukopenia
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Causes for Leukocytosis
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Infection, necrosis, neoplasm, acute hemorrhage
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Symptoms of Leukocytosis
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Fever, Infection, inflammation, trauma
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S/S of leukopenia
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Sore throat, fever chills, ulceration of mucus membrane, frequent/painful urination, persistent infection
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Increased platelet count, thrombosis and easy bruising/splenomegally
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Thrombocytosis
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Decreased platelet, sever bruising, joint swelling, superficial hemotoma, multiple peticia
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Thrombocytopenia
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Secondary to bone marrow failure and radiation, leukemia, cancer, cytotoxic agents
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Thrombocytopenia
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5 S
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Site, Size, Shape, Surface, and Spider Angiomas
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5 T
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Tenderness, Turgor, Texture, Temperature, and Trans-illumination
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CAMP
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Consistency
Appearance of Client Mobility of Lesion Pulsation |
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FIRE
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Fluctuation
Irreducibility Regional Lymph Nodes Edges |
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Common intra-abdominal disease that refers to the MS system
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Ulceration/Infection of the mucosal lining
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Signs/Symptoms of GI disorders
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Dysphagia, GI Bleeding, Epigastric pain that radiates to the back, sympts affected by food, arthralgia, shouder pain, poas abcess, McBernies point
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Site of GI pain
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Dermatome in which the organ is innervated
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Epigastric pain
1. Level of innervation 2. Organs |
T3-T5
Heart, esophagus, stomach, deudunum, gall bladder, liver |
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Umbilical pain
1. Level of innervation 2. Organs 3. Referral site |
T9-T11
Small intestine, pancreas, appendix Low Back |
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Low Abdominal pain
1. Level of innervation 2. Organs |
T10-T12
Large Intestine |
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What does the abdominal visera detect?
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1. Rapid Stretch
2. Inflammation/metabolities from ischemia |
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What does the visceral peritoneum detect
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No pain except for infection/inflam
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Types of GI pain that pts report
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Deep, Gnawing, Burning, Vage, Achy
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Esophagus Referral
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Mid Back
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Liver, Diagphagm, pericardium referral pain
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Shoulders
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Gallbladder, small intestine, stomach referral pain
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Mid Back/Shoulder blades
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Sigmoid colon, rectum referral pain
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Pelvis, lumbar, sacrum
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4 signs of internal bleeding
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1. Pain in mid thoracic/RUQ
2. Blood in vomit/stool 3. Coffee grounds in stool/vomit 4. Bloody diarrhea (ulcerative colitis) |
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Anal fissures/bright red blood
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rectum/anal pathology
colorectal cancer, hemorrhoids, anal intercourse |
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Red/Mahogany Stool
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Certain foods/Lower GI, Rectal, colon bleeding
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S/S of epigastric pain/radiation
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Sharp pain behind breast bone
long standing ulcers Food effects |
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Foods 2 effects on epigastric pain and their diseases
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1. Decrease pain (duodenum)
2. Increase pain (gastric ulcers) |
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Eating very little and feeling full
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Vertebral column compression
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Questions to ask a pt who you suspect of GI disorder
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Change in bowel habits, medications (narcotics, antacids), diet, GI disorders
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GI Red flags
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Unexplained constipation, sudden change in bowel habits, blood in stool
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Causes of diarrhea
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Neoplasm, inflam bowel disease, antibiotics, laxative use
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Causes of fecal incontinence
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Cancer, colitis, post-radiation therapy, anal distortion post pregnancy, hemorrhoids
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Causes of arthralgia linked GI disorders
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Rheumalogical disorders, spondilitis/sacralitis, reactive arthritis from (virus, bacteria)
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How does the arthrlagia from GI disorders present?
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Bilateral and at bony inserts of tendons (Enthritis)
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GI causes of left shoulder pain
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Air in abdominal cavity, ruptured spleen, ectopic pregnancy, pancreatic disease
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Associated conditions with obturator/psoas abcess
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Chrones disease, divicultis, staph infection, antalgic gait, tender mass
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S/S of GERD
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Heart burn, regurgitation, belching
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Causes of Peptic Ulcers
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H-Pylori bacteria, Chronic NSAID use
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Red Flags and Dangers of Peptic Ulcers
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1. Sudden shoulder or back pain with no mechanism
2. Internal bleeding, perforation, infection |
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S/S of gastric ulcers
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1. Epigastric pain/heart burn, pain comes on in waves in the back to right shoulder, increases with food
2. Nausea, vomiting, weight loss |
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S/S of chronic NSAID use
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GI pain, CNS changes, renal involvement, muscle weakness, fatigue
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Diviticulosis
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Ballooning of part of the colon through a weakened muscle wall
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Diviticulitis
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Infection/inflammation accompanying a micro perforation (diviticula)
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S/S of Diviticular Disease
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Left abdominal pain and tenderness, left pelvic pain, and blood in the stool
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S/S of pancreatic cancer
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Anorexia, weight loss, epigastric pain, pain that radiates to the back
Jaundice of secondary to bile duct obstruction |
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Ulcerative Colitis
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Inflam/ulceration of the inner lining of the large intestine
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Crones Disease
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Inflam of the terminal end of the small intestine but can occur everywhere; autoimmune disease
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S/S of Inflammatory bowel disease
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diarrhea, constipation, fever, abdominal pain, bleeding, night sweats, decreased appetite, arthralgia
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Petechia is associated with what condition?
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Thrombocytopenia
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Role of the Liver
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Convert Billirubin into bile
Sole source of Albumin Clotting Factors Metabolize toxins/carbs/fats/proteins/exc |
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The pancreas metabolized what?
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Carbs, Fats, Proteins with exocrine juices
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What stimulates the Gall Bladder
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Cholecystokinin
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Signs and Symptoms of Liver disease
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Dark Urine, light colored stool, Jaundice, pallor, spider anginomas, neuro changes d/t amonia
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What are Asterixis?
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Flapping tremor of hand with arm flexion
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How does amonia react in the brain and what does it cause?
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Amonia-->glutamate-->glutamide
Impairs neurotransmitters |
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Liver pain pattern
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Right shoulder/Trap/Subscap/Scapula
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Hepatic Osteodystrophy
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Abnormal osteoblasts and bone development
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Issues that could arise in therapy with pts with liver disease
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exercise, pts need rest d/t decreased clotting
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Aging effects of hepatic system
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Decrease size and blood flow
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Two causes of Jaundice
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1. Billiary obstruction d/t cancer with risks that increase with age
2. Hep B/C |
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Pre-Hepatic Dysfunction
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Billirubin increases before reaching liver d/t hemolysis or blood incompatatbility
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Hepatic Dysfunction
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Pathology in the liver cells effecting the livers ability to metabolize billirubin
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Post-Hepatic Dysfunction
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Obstruction in the bile duct (gall stones, cancer)
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Abnormal Billirubin Process
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Billirubin binds albumin to become unconjugated and is deposited in the brain/fatty tissues/skin/sclera
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Normal Billirubin removal
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billirubin with glucagonic acid-->congegated billirubin-->urobillirubin-->Urine
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1.Hyperbilirubemia (Un-Conjugated)
2. Assoc |
1. Bilirubin cannot be excreted with increased serum levels
2. Weakness, abdominal/back pain, acute hemolytic crisis |
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1. Hyperbilirubemia (Conjugated)
2. Assoc |
1. Can be excreted in the urine
2.weakness, pale stool, pruritus |
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Pruritis
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Itching from build up of bile salts in the skin
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Hepatocelluar Disease S/S
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Malaise, anorexia, low grade fever, RUQ pain, jaundice, dark urine, spider anginomas, white nails, yellow eye lids, loss of sexual hair
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Biliary Obstruction S/S
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RUQ pain, weight loss, jaundice, dark urine, light stool
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Pre-Icteric phase of hepatitis
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3-4 weeks; dark urine and light stool
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Icteric phase of hepatitis
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Jaundice stage peaking for 1-2 weeks for 6-8 weeks
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Recovery phase of hepatitis
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3-4 months; pt feels fine but fatigues quickly
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Fulminant Hepatitis
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Sever hepatitis that leads to hepatic failure with a 3-4 stage encephalopathy (stupor/necrosis) d/t sever hepatic necrosis
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Causes of Fulminant Hepatitis
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Tylenol, mushrooms, carbon-tetrachloride (20% survival rate without transplant)
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Odynaphagia
Assoc. |
Pain with swallowing
Esophagitis/Gerd/Eso spasm Vertical=better; supine=worse |
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Irritable Bowel Syndrome S/S
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Linked with psych issues
Painful abdominal cramps. constipation, diarrhea, nausea, vomiting, bad breath, flatulence |
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Colo-Rectal Cancer S/S
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Rectal bleeding, hemorrhoids, abdominal/sacral/pelvic pain, change in bowel pattern, back pain that radiates into legs
-Constipation-->Obstipation |
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Toxic Hepatitis
S/S |
Necrosis starts 2-3 days post toxin
Anorexia, nausea, fatigue, jaundice, dark urine, clay stool, fever, dizziness, RUG epigastric pain, arthalgias |
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Chronic Active Hepatitis
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Serous and destructive leading to cirrhosis of the liver. Treated with steroids and interferon
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Chronic Persistent Hepatitis
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Similar to viral hepatitis and is not as massive a breakdown
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Autoimmune Hepatitis
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Destruction of liver by body, females under 40, treat with steroids and other anti-immune drugs
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Alcohol Hepatitis
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Fat build up around liver d/t destruction my EtOH
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Cirrhosis
Assoc |
Chronic end stage of disease d/t inflammation.
Portal Hypertention, scar tissue |
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Ascities
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Accumulation of serous fluid in abdominal cavity often caused by cirrhosis or heart failure or kidney disease.
Leads to respiratory distress, bacterial inflection, or renal failure |
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Ascities mechanism
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Increase lymphatic hydrostatic pressure (d/t portal vein blockage), decreased albumin, increased aldosterone
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Ascities Treatment
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Diuretics, shunt for hepatic portal vein
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Hepatic Encephalopy
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Caused by inability to metabolize ammonia d/t chronic liver failure.
Dizziness, drowsiness, flapping tremor |
