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75 Cards in this Set
- Front
- Back
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general red flag for ongoing tissue damage?
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pn that worsens progressively over weeks to months.
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Pain that worsens progressively over weeks to months what is the red flag for this ?
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General red flag for ongoing tissue damage.
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When pain steadily increases in severity over weeks to months what can happen?
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Pain that steadily increases in severity over weeks to months indicates a threat of IRREVERSIBLE TISSUE Damage
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What do cancer cells lack?
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Contact inhibition-bad boundary issues just like a person who has very bad boundaries.
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When someone has surgery and the pain continues to get worse after surgery what should you do as an acupuncturist?
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This is a red flag. They need to go back to their Doctor to have this checked out. They could have an infection or worst case scenario an instrument or piece of gauze got left behind.
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Suspect Autoimmune Dx ( not in book) (4)
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1. Depression'
2. Fatigue 3.Hair loss 4.Migrating Joint Pn |
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Pre diabetic what is their bld sugar like?
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It fluctuates
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What kinds of things cause inflammatory arthritis? Ex: RA , lupus arthritis, gout
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Autoimmune
Bacterial infections and crystal deposits |
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What is less urgent regarding joint pain?
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Joint pain that does not follow recent surgery
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A patient presents with joint pn following recent surgery what would you do?
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This is urgent cuz this pt cuz they could get septic and die. for ex: look for streaks that are traveling and purelent( pus ) and red joints
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What kind of joint pain is urgent and why is it?
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Acute after surgery. Sepsis can start especially if the joints are red and swollen and have pus
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These are the things that can get messed up with chronic inflammation of joints that can have acute flare-ups. (3)
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Bone
Cartilage Tendons can all break |
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Osteoarthosis vs Osteoarthitis?
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Osteoathrosis wear and tear
Osteoarthritis inflammation |
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What is not a primary causitive factor in degenerative joint disease like RA?
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Inflammation not a causative factor
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Swelling secondary to osteoarthosis is typically ?
IT corresponds to what in TCM? |
Cold and Bony
pnful, cold predominant phlem and blood stasis. |
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Why should you refer a patient with progressive severe joint pn that is unresponsive to acupuncture ?
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Not life threatening but can cause depression and weight gain( stephen) .
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This type of cancer can be primary or more commonly metasis from other parts of the body?
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Bone Cancer
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------------ Cancer can be primary( originating there) , or more commonly, metastatuic from cancers in other regions.
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Bone Cancer Can originate in the bone and or metastize to the bone
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Why is cancer of the bone so painful?
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The periosteum has a lot of nerve fibers.
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In Men what are the most common cancers that metastize to the bone?
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prostate
lung Dr Bob Bladder Dalton |
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If a patient has an unexplained fracture either caused by something minor or an unidentified trauma what do we need to do?
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This is pathological deterioration of the bone and can be caused by Cancer, osteoporosis, Paget's disease or some other bone weakening dx.
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A patient presents with Severe Pain and swelling in a joint immediately after Trauma what is the red flag?
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Ruptured arterial or arteriolar vessels
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Complex regional pain syndrome means? ss/sx( 2)
Mostly occurs where on the body? |
CRPS also known as Complex regional pn syndrome ss/sx?
Intense pain skin changes Extremities |
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what is the common falacy about fractures?
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that a person can't move the affected area.
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What can we count on with fractures so we can suspect it is a fracture?
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They always hurt like a son of a ***** cuz the periosteum is innervated with lots of nerve fibers.
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I had a patient that presented with severe abdominal pn with nausea and vomiting. She felt better if she leaned forward. What does this indicate?
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Acute pancreatitis : inflammation of the pancreas with autodigestion by pancreatic enzymes
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In the above scenario what do you do to stabilize?
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THere are no specific stabilizing steps.
I should add she walked out feeling much better after acupuncture and healing treatment . She was smiling , |
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For above condition do you need to call 911?
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No, we referred her to the nearest Emerency room
This is a potentially deadly dx. the book says people dont come in with this to the acupuncture clinic when it is acute and full blown. pt did not have insurance:( |
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What is one of the causes of pancreatitis?
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gallstones
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What is this dx? Main ss is abdominal pain in the upper left side or middle of abdomen.
worse when lying on back is persistant pt feels best when leaning forward pn may radiate to the back or below the left shoulder blade worse with eating esp fatty food Drinking alchohol may set off an attack Nausea and Vomiting Other ss can be: Anxiety Fever Mild Jaundice Sweating Mild or early cases present at "indigestion" Name it. |
acute pancreatitis
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Why is acute pancreatitis dangerous?
(3) |
pt can go into shock,
blood pressure can drop vital ss can become unstable |
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Name some other factors that cause pancreatitis( 3)
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alcohol abuse
viral and bacterial infections choletlithiasis drugs like estrogens, steroids,( she has illegal rx for the knee) thiazide diuretics and azathioprine |
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Left quadrant , tap it and the patient screams . what is this?
Nausea maybe low fever |
Appendicitis
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what are the consequences of misdiagnosing the previous illness in the previous question?(3)
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Acute appendicitis
peritonitis( infection in the abdominal peritoneal cavity sepis death No 911 unless not stable , most are |
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Why in the case of acute pancreatitis is there so much pain?
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the gallstone passes into the duodenum. pancreatic enzymes cant get past the stone so they get backed up. These enzymes "autodigest the pancreatic tissue"
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Mc Burneys test is used for what dx?
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acute appendicitis
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what are the classical ss in acute appendicitis in 50% of cases?
(3)Q |
mid upper ab pn( mid epigastric
vomiting pn moves to the RLQ |
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is there a lot of fever with acute appendicitis?
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no
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Long term ab pain near the appendix is much more likely to be?
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IBS or Intestinal volvulus , ovarian cysts or even a trigger point in psoas and not Acute appendicitis
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abdominal muscle rigidity is a general red flag for what?
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peritoneal irritation
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Mid ab pn followed by vomiting then pn moving to RLQ ?
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Acute appendicitis
Acute pancreatitis is Severe ab pn better when leaning forward with nausea and vomiting |
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Note from Dr Peterson just cuz a patient has the on the R scap , pancreas pn can be pn the left in some people.
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some people are wired differently
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Does acute appendictis smolder over years?
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no but IBS does, Cysts do and such
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Ss and sx : temp 102, abdomen is rigid with rebound tenderness in RLQ
chills and sweating skin is ashen |
ruptured appendix
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what is the key word i.e. ss/sx for appendicitis?
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Abdominal Rigidty
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sprain vs a strain?
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sprain=ligament use a brace
strain=decreased muscle do massage deep tissue |
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CRPS ( the girl who got bitten by a spider and developed severe stabbing pain all over her body. What causes it and what systems are affected?
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Idiopathic( unknown)
Endocrine Neurological Immunilogical sympathetic and ans do not fxn Sympathetic has to do with sweating ans regulates these changes |
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review many serious conditions can cause ab pn and ridgidity of ab muscles
Irritation of the inner lining of the abdominal peritoneum from blood and pus |
Hollow organs get infected and are less likely to bleed
Solid organs like Kd, Sp, liver pancreas are suseptible to being infected through dissemination of pathogenic organisms in blood |
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Do hollow organs get infected and bleed easily?
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No, solid organs do cuz they have more blood .
Hollow organs wash the infection out. |
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What organs is prone to blockage?
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Appendix-fecal matter can block and swelling causes stasis with buildup of pressure and pus that goes into the peritoneum
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What tubes can get infected?
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Fallopian tubes infected from female genital tract. Low back pn that is severe can happen .
Ab is not normally rigid PID pelvic inflammatory Dx is above |
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stones and swelling can block what organ?
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Gallbladder
can also combine with fecal matter to block The GB duct is one such orafice that can become blocked causing oozing through the GB wall. |
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Review: Upper ab ( midepigastric) pn and vomiting, blood Ulcers are an ex.
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The patient who was 30 and drank a 6 pack a day and took ibuprofden daily for HA
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What is dysplagia?
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presence of something else.
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Patient says they seem to have Bronchitis but they really have GERD that is causing food to go into their lungs .
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GERD Barretts esophageal
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To treat shock (3)
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Warm( blanket)
Hydrate Elevate feet |
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what to advise pt to take instead of baby aspirin? Aspirin messes up the muscosal lining of stomach and can cause bleeding ulcers
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Garlic pills
green tea thins blood |
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Questions to ask regarding Ulcers
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when do you get the st pn? Before or after eating.
if within 1/2 hr after eating=Upper Gi Do you skip meals? do you drink alcohol? Do you have a hx of Hep C? |
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With GI bleeding what should you check?
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Midepigastric tenderness
May have vomiting |
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What organism is assoc with incerased insidence of PUD?
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H pylori
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Review: Esophogitis, Gastritis and Upper GI upper Gi Hemmoraghe
Gastritis -beginning stage of inflammation |
bleeding into the esophagus or st causes nausea and vomiting
Erosion of blood vessels by the gastric inflam can cause rupture and fatal hemorrhage. |
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What is chronic esophagitis?
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Heart burn and if it is chronic it can cause Barrets esophogeal which is precancerous .
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Common bowel disease seen in nursing home and in elderly .
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Bowel obstruction
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What is the stabilizing thing to do First?
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DO not let them eat!!!
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What do these ss/sx indicate?
Mid to lower abdominal COLICKY pain, vomiting, constipation, abdominal distension |
Bowel Obstruction
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In previous question The order is
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Acutre , small bowel obstruction
Pain first Vomiting Distension Constipation |
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What is chronic esophagitis?
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Heart burn and if it is chronic it can cause Barrets esophogeal which is precancerous .
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What is the stabilizing thing to do First?
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DO not let them eat!!!
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What do these ss/sx indicate?
Mid to lower abdominal COLICKY pain, vomiting, constipation, abdominal distension |
Bowel Obstruction
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In previous question The order is
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Acute , small bowel obstruction
Pain first Vomiting Distension Constipation |
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Risk factors for Large Bowel Obstruction(3+)
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1. Colon Carcinoma
2. Diverticulitis or a twist in Sigmoid Colon ** dr peterson notes 3.Sigmoid Volvulus( is above condition) |
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Risk factors for Small Bowel Obstruc1.Stion(3+)
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Internal scarring ( adhesions) due to prior surgery
Cancers Neoplasm Hernias |
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Review; back pain, progressive leg weakness when getting up , erectile dysfunc in a man?
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Cauda Equina Syndrome
aka; spinal stenosis 2 types primary( congenital) and secondary 45 or older Causes Occupational trauma Arthritis Prior hx of Low back pain Very gradual onset sometimes with minimal back pain leg pn first when getting up from chairs worse with walking better with rest |
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Sob and Hypoxia is seen in
pt has bil swelling of ankles can have pitting edema |
PE Pulmonary Embolism
This is very serious and pt can die fast. often nagging symptoms can happen before the final episode |
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What are risk factors for Pulmonary Embolism (8)
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Risk factors for Pulmonary embolism
Recent airplane flight Obesity recent surgery or Trauma Smoking Being sedentary hx of prior blood clots oral contraceptives |
