CPR/Lists

Question 1

WEEK 1

Answer 1

WEEK 1

Question 2

Fracture CPR. (4)

Answer 2

• Prolonged steroid use
• Age >70
• Significant trauma
• Female

Question 3

WEEK 2

Answer 3

WEEK 2

Question 4

Depression

• PHQ-2 Score ≥ __ should be further evaluated with PHQ-9.
• PHQ-9 Score ≥ __ indicates depression.

Answer 4

• ≥ 2

- ≥ 10

Question 5

Cook Cervical Myelopathy Cluster. (5)

Answer 5

1. ) Gait abnormality
2. ) + Hoffman
3. ) + Babinski
4. ) + Inverted supinator sign
5. ) Age >45

• > /=3/5 = Rule IN
• =1/5 = Rule OUT

Question 6

Wells CPR for DVT:

• High Probability = >__ (75%)
• Moderate Probability = __-__ (17%)
• Low Probability = __ (3%)

-What probability would warrant a referral for further screening?

Answer 6

• High Probability = >3
• Moderate Probability = 1-2
• Low Probability = 0

-High/Moderate Probability would warrant a referral.

Question 7

Wells CPR for PE:

• High Probability = >__
• Moderate Probability = __-__
• Low Probability = __-__

Answer 7

• High Probability = >6
• Moderate Probability = 3-6
• Low Probability = 0-2

Question 8

WEEK 4

Answer 8

WEEK 4

Question 9

What are (3) mechanisms to consider in regards to referred visceral pain?

Answer 9

• Embryonic Development
• Multisegmental Innervation
• Direct pressure and shared pathways

Question 10

Describe Embryologic Development mechanism for referred visceral pain. What are some examples?

Answer 10

-Pain is referred to a site where the organ was located in fetal development.

Examples

• Chest is part of gut in embryo. Thoracic disorders can refer to abdomen.
• Heart starts as cranial structure in embryo. MI or pericarditis can refer to abdomen.
• Kidney and ear come from same embryonic tissue. Kidney dysfunction can refer to ear pain.

Question 11

Describe Multi-segmental Innervation mechanism for referred visceral pain. What are some examples?

Answer 11

-Organs have multiple levels of innervation. Overlapping or same segmental projections can refer to different areas.

Examples
-Cardiac pain is not felt in the heart but referred to areas of corresponding spinal nerve. Can occur in any structure innervated by T3-T4 (jaw, neck, upper trap, shoulder, arm).

Question 12

Describe Direct Pressure and Shared Pathways mechanism for referred visceral pain. What are some examples?

Answer 12

-Organ that is inflammed/problematic and is causing organ to be larger than normal. Irritates structures and can refer pain to areas also innervated structure being irritated.

Examples

• Spleen → L shoulder
• Tail of pancreas → L shoulder
• Head of pancreas → R shoulder
• Gallbladder → R shoulder
• Liver → R shoulder

Question 13

Direct Pressure and Shared Pathways:

• Impingement on central diaphragm can refer to __________.
• Impingement on peripheral diaphragm can refer to ___________ and/or ____________

Answer 13

• central diaphragm = shoulder

- peripheral diaphragm = costal margins (ipsilateral) and/or lumbar region

Question 14

Direct Pressure and Shared Pathways:

• Spleen → __________
• Tail of pancreas → _________
• Head of pancreas → __________
• Gallbladder → _________
• Liver → ___________

Answer 14

Spleen → L shoulder
Tail of pancreas → L shoulder
Head of pancreas → R shoulder
Gallbladder → R shoulder pain
Liver → R shoulder pain

Question 15

Central Sensitization Inventory (CSI):

Cutoff score of ____ indicates possibility of predominant CS pain

Answer 15

-40 or greater

Question 16

Rhabdomyolysis biggest S/Sx?

Answer 16

Reddish-brown urine

Question 17

What are the 5 P’s that are indicative of acute arterial occlusion (ischemia)?

Answer 17

• Pain
• Pallor
• Pulselessness
• Paresthesia
• Paralysis

Question 18

Night Pain:
-Cannot lie on involved side= _____
Can stay on involved side for 30 mins to an hour before symptoms present= _______
Can lie on involved side for up to 2 hours before symptoms present= ________

Answer 18

• acute
• subacute
• chronic

Question 19

WEEK 5

Answer 19

WEEK 5

Question 20

Conditions Affecting the Heart Muscle:

• What are the MOST COMMON conditions to mimic MSK dysfunction? (4)
• Referral patterns include the _____, ____, ________, ______, and/or ____ pain.

Answer 20

• Angina, MI, Pericarditis, Dissecting Aortic Aneurysm

- jaw, neck, shoulder, chest, and/or back

Question 21

Angina:
-Pain not relieved by ____ or up to __ nitroglycerin tablets in ___-___ minutes requires sending patient to ED and notifying MD.

Answer 21

-rest or up to 3 nitroglycerin tablets in 10-15 minutes

Question 22

What are the 5 D’s and 3 N’s of VBI?

Answer 22

• Dizziness
• Drop Attacks
• Diplopia
• Dysarthria
• Dysphagia
• Nausea
• Numbness
• Nystagmus

***Can also present with vertigo, nausea, and HA.

Question 23

WEEK 6

Answer 23

WEEK 6

Question 24

• Pulmonary screening may need to be performed with patients presenting with referred pain where? (3)
• What are the (4) most common pulmonary conditions that can mimic MSK disorders?

Answer 24

• neck
• shoulder
• back
• Pneumonia
• Pleurisy
• Pneumothorax
• Pancoast’s Tumor

Question 25

What are the (5) S//Sx of pulmonary disorder? Which 2 are the most common?

Answer 25

1. ) Cough*** 2. ) Dyspnea*** 3. ) Cyanosis 4. ) Clubbing 5. ) Altered Breathing Patterns

Question 26

Lung Cancer (Pancoast's Tumor): - What is it? - Frequently involve ____ cervical and _____ thoracic nerve. - Presents in distribution of ___-___ dermatomes. (loss of hand function, Horner's syndrome) - What is the most common initial symptom? - Can mimic ___________.

Answer 26

- Tumor of the lung apex. - 8th cervical and 1st thoracic - C8-T2 dermatomes - sharp (posterior) shoulder pain - TOS

Question 27

WEEK 7

Answer 27

WEEK 7

Question 28

Abdominal Pain (Referred GI Pain Patterns): - Often more _______ and _________. - Referred pain to the MSK system can occur in the absence of visceral pain, however, _______ pain usually precedes ________ pain. - What are some areas referred pain can be perceived?

Answer 28

- intense and localized - visceral pain usually precedes referred pain - shoulder, mid-back/scapular region, pelvis, flank, low back, or sacrum

Question 29

Symptoms Affected by Food: Pain associated w/ gastric ulcers: - May occur within ___-___ after eating. - Food _________ to relieve pain. Pain associated w/ duodenal/pyloric ulcers: - May occur ___-___ after eating. - Food _______ to relieve pain. - When may these patients report pain?

Answer 29

Pain associated w/ gastric ulcers: - 30-90 minutes - not likely Pain associated w/ duodenal ulcers: - 2-4 hours - may relieve pain - Pain during night between 12-3am.

Question 30

Shoulder Pain: L Shoulder Pain: - May be result of free air following laproscopic surgery or blood in abdominal cavity (usually from ruptured _______ or _________ bleeding). - Screen for precipitating trauma/injury. - ______ Sign: Pain in shoulder w/ pressure placed on left upper abdomen. R Shoulder Pain: -Perforated _________ or __________ may refer here. L/R Shoulder Pain: -________ cancer may refer to either shoulder.

Answer 30

L Shoulder Pain: - ruptured spleen or retroperitoneal bleeding - Kehr's Sign R Shoulder Pain -duodenal or gastric ulcer L/R Shoulder Pain: -pancreatic

Question 31

Abdominal Pain MSK Clusters.

Answer 31

1. ) Does coughing, sneezing, or taking a deep breathe make your pain feel worse? (YES) 2. ) Do activities such as bending, sitting, lifting, twisting, or turning over in bed make your pain feel worse? (YES) 3. ) Has there been any change in your bowel habit since the start of your symptoms? (NO) 1. ) Does eating certain foods make your pain feel worse? (NO) 2. ) Has your weight changed since your symptoms started? (NO)

Question 32

Peptic Ulcer: - What is it? - Can cause ________ or _____ pain. - What are some things that can cause peptic ulcers? (4)

Answer 32

- Loss of tissue lining lower esophagus, stomach, and duodenum. - shoulder (usually R) or back pain - Infection w/ H.pylori, chronic NSAID use, erosions, chronic ulcers

Question 33

Crohn's Disease: - Inflammatory disease most commonly attacks terminal end of __________ and ______. - Occurs more commonly in ___________/__________. Ulcerative Colitis: - Inflammation and ulceration of lining of __________. - Cancer of ______ more common in people with UC. IBD: - UC and Crohn's disease can be accompanied by ________ component. - Joint problems usually are responsive to treatment of IBD but do on occasion require separate management.

Answer 33

Crohn's Disease: - small intestine (ileum) and colon - young adults/adolescents Ulcerative Colitis: - large intestine (colon/rectum) - colon IBD: -arthritic component

Question 34

Pancreatic Carcinoma: - ___% of pancreatic cancer arise in the head of the gland. - ___-___% occur in the body and tail. - Pain is worse with ________ and __________. - Pain is relieved by _______ and ___________.

Answer 34

- 70% - 20-30% - walking and lying supine - sitting and leaning forward

Question 35

WEEK 9

Answer 35

WEEK 9

Question 36

1

Answer 36

1

Question 37

1

Answer 37

1

Question 38

1

Answer 38

1

Question 39

1

Answer 39

1

Question 40

11

Answer 40

1

Question 41

1

Answer 41

1

Question 42

WEEK 10

Answer 42

WEEK 10

Question 43

1

Answer 43

1

Question 44

1

Answer 44

1

Question 45

1

Answer 45

1

Question 46

1

Answer 46

1

Question 47

1

Answer 47

1

Question 48

1

Answer 48

1

Question 49

1

Answer 49

1