USA - Differential Diagnosis - Units 9-14

Referred pain patterns associated with hepatic and biliary pathologic conditions produce musculoskeletal symptoms in the:

Clients with significant elevations in serum bilirubin levels caused by biliary obstruction will have which of the following associated signs?

Preventing falls and trauma to soft tissues would be of utmost importance in the client with liver failure. Which of the following laboratory parameters would give you the most information about potential tissue injury?

Decreased level of consciousness, impaired function of peripheral nerves, and asterixis (flapping tremor) would probably indicate an increase in the level of:

An inpatient who has had a total hip replacement with a significant history of alcohol use/abuse has a positive test for asterixis. This may signify:

A decrease in serum albumin is common with a pathologic condition of the liver because albumin is produced in the liver. The reduction in serum albumin results in some easily identifiable signs. Which of the following signs might alert the therapist to the condition of decreased albumin?

Percussion of the costovertebral angle that results in the reproduction of symptoms:

Renal pain is aggravated by:

Important functions of the kidney include all the following EXCEPT:

Match the Definition to the Term: Difficult or painful sexual intercourse in women :: [blank_start]Dyspareunia[blank_end] Painful or difficult urination :: [blank_start]Dysuria[blank_end] Blood in the urine :: [blank_start]Hematuria[blank_end] A sudden, compelling desire to urinate :: [blank_start]Urgency[blank_end]

What are the most common musculoskeletal symptoms associated with endocrine disorders?

What systemic conditions can cause carpal tunnel syndrome?

Disorders of the endocrine glands can be caused by:

3 Most common symptoms of Diabetes Mellitus

The major differentiating factor between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) is the absence of ketosis in HHS.

it is safe to administer a source of sugar to a lethargic or unconscious person with diabetes.

It is NOT safe to administer a source of sugar to a lethargic or unconscious person with diabetes?

Clients with diabetes insipidus (DI) would most likely come to the therapist with which of the following clinical symptoms?

Clients who are taking corticosteroid medications should be monitored for the onset of Cushing’s syndrome. You will need to monitor your client for which of the following problems?

Signs and symptoms of Cushing’s syndrome in an adult taking oral steroids may include:

Parathyroid hormone (PTH) secretion is particularly important in the metabolism of bone. The client with an oversecreting parathyroid gland would most likely have:

Which glycosylated hemoglobin (A1C) values are within the recommended range?

A 38-year-old man comes to the clinic for low back pain. He has a new diagnosis of Graves’ disease. When asked if there are any other symptoms of any kind, he replies “increased appetite and excessive sweating.” When you perform a neurologic screening examination, what might be present that would be associated with the Graves’ disease?

All of the following are common signs or symptoms of insulin resistance except:

Fibromyalgia syndrome is a:

Which of the following describes the pattern of rheumatic joint disease?

Which of the following symptoms are more indicative of osteoarthritis than rheumatoid arthritis?

A positive Schober’s test is a sign of:

Proximal muscle weakness may be a sign of:

Which of the following skin assessment findings in the HIV-infected client occurs with Kaposi’s sarcoma?

The most common cause of change in mental status of the HIV-infected client is related to:

Symptoms of anaphylaxis that would necessitate immediate medical treatment or referral are:

In a physical therapy practice, clients are most likely to present with signs and symptoms of metastases to:

In any individual, any neurologic sign may be the presentation of a silent lung tumor.

Complete the CAUTIONS Mnemonic for Early Warning Signs for Cancer C - [blank_start]Changes in bowel or bladder habits[blank_end] A - [blank_start]A sore that does not heal within 6-weeks[blank_end] U - [blank_start]Unusual bleeding or discharge[blank_end] T - Thickening or lump in the breast or elsewhere I - [blank_start]Indigestion or difficulty in swallowing[blank_end] O - [blank_start]Obvious change in a wart or mole[blank_end] N - [blank_start]Nagging cough or hoarsenss[blank_end] S - [blank_start]Supplemental signs and symptoms[blank_end]

Whenever a therapist observes, palpates, or receives a client report of a lump or nodule, what three questions must be asked?

When tumors produce signs and symptoms at a site distant from the tumor or its metastasized sites, these “remote effects” of malignancy are called:

A client who has recently completed chemotherapy requires immediate medical referral if he has which of the following symptoms?

A suspicious skin lesion requiring medical evaluation has:

What is the significance of Beau’s lines in a client treated with chemotherapy for leukemia?

A 16-year-old boy was hurt in a soccer game. He presents with exquisite right ankle pain on weight bearing but reports no pain at night. Upon further questioning, you find he is taking Ibuprofen at night before bed, which may be masking his pain. What other screening examination procedures are warranted?

When is it advised to take a work or military history?

A 70-year-old man came to outpatient physical therapy with a complaint of pain and weakness of his fingers and morning stiffness lasting about an hour. He presented with bilateral swelling of the metacarpophalangeal (MCP) joints of the index and ring fingers. He saw his family doctor 4 weeks ago and was given diclofenac, which has not changed his symptoms. Now he wants to try physical therapy. Since he last saw his physician, he has developed additional joint pain in the left knee and right shoulder. How can you tell if this is cancer, polyarthritis, or a paraneoplastic disorder?

A 49-year-old man was treated by you for bilateral synovitis of the proximal interphalangeal (PIP) joints in the second, third, and fourth fingers. His symptoms went away with treatment, and he was discharged. Six weeks later, he returned with the same symptoms. There was obvious soft tissue swelling with morning stiffness worse than before. He also reports problems with his bowels but isn’t able to tell you exactly what’s wrong. There are no other changes in his health. He is not taking any medications or over-the-counter drugs and does not want to see a doctor. Are there enough red flags to warrant medical evaluation before resumption of physical therapy intervention?

A client with a past medical history of kidney transplantation (10 years ago) has been referred to you for a diagnosis of rheumatoid arthritis. His medications include tacrolimus, methotrexate, Fosamax, and Wellbutrin. During the examination, you notice a painless lump under the skin in the right upper anterior chest. There is a loss of hair over the area. What other symptoms should you look for as red flag signs and symptoms in a client with this history?

A 55-year-old man with a left shoulder impingement also has palpable axillary lymph nodes on both sides. They are firm but movable, about the size of an almond. What steps should you take?

The most common sites of referred pain from systemic diseases are:

To screen for back pain caused by systemic disease:

Which statement is the most accurate?

Pain associated with pleuropulmonary disorders can radiate to:

Which of the following are clues to the possible involvement of the GI system?

Percussion of the costovertebral angle resulting in the reproduction of symptoms signifies:

A 53-year-old woman comes to physical therapy with a report of leg pain that begins in her buttocks and goes all the way down to her toes. If this pain is of a vascular origin she will most likely describe it as:

Twenty-five percent of the people with GI disease, such as Crohn’s disease (regional enteritis), irritable bowel syndrome, or bowel obstruction, have concomitant back or joint pain.

Skin pain over T9 to T12 can occur with kidney disease as a result of multisegmental innervation. Visceral and cutaneous sensory fibers enter the spinal cord close to each other and converge on the same neurons. When visceral pain fibers are stimulated, cutaneous fibers are stimulated, too. Thus visceral pain can be perceived as skin pain.

Autosplinting is the preferred mechanism of pain relief for back pain caused by kidney stones.

Back pain from pancreatic disease occurs when the body of the pancreas is enlarged, inflamed, obstructed, or otherwise impinging on the diaphragm.