NR 511 Final exam with complete solutions.

Population most commonly affected by Bacterial Prostatis Sexually active men BETWEEN THE AGES OF 30 AND 50 YEARS OLD Physical Exam Characteristics of Acute Bacterial Prostatitis Abdominal examination to detect a distended bladder and costovertebral angle tenderness. Genital examination A digital rectal examination should be performed gently because vigorous prostatic massage can induce bacteremia and, subsequently, sepsis. DRE results for the three conditions, we can expect to see the following. Acute bacterial Warm, tense, swollen, boggy, and very tender prostate Chronic bacterial Normal (may be a little boggy or focally indurated) Nonbacterial Normal or tender prostate Phren Sign - Torsion or Epididymitis The most common finding on clinical exam is the absence of the cremasteric reflex and unlike in epididymitis elevation of the affected testis does not relieve the pain BPH Symtpms Fever Chills Hematuria Dysuria Foul-smelling urine Difficulty starting to urinate or emptying the bladder Dribbling Weak urine stream Hallmark Characteristics of Varicocele Sensation that the testes feel like a "bag of worms." Population affected by Testicular Cancer American males between the ages of 15 and 35. Explain Spinal Stenosis Most Common source of lower back pain Caused by a narrowing of the spinal canal as a result of degeneration of the bony facet joints and the intervertebral disks Common Characteristics of lumbar spinal stenosis Leg pain is commonly greater than back pain and pain is characteristically worse with prolonged standing or walking and improved by rest. In more advanced cases, leg pain with weakness or numbness and tingling can be present. Pt will lean or stoop for short term relief Chronic Pain Greater than 3 months in duration Pain symptoms become more generalized topographically and less localized to the site of injury or initial complaint Pain referral patterns that shift in location as well as intensity, frequency, and quality Pain that does not change with movement, rest, or over time Patients usually report pain as constant or continuous (less like to be intermittent). Mood or current psychological status tends to affect or worsen the pain complaints. Number of Joints Involved in Polyarticular Disorder Four or more joints Four Cardinal Signs of Joint Inflammation Erythema Warmth Pain Swelling DeQuervian's Tensynovitis Inflammation of tendons on the side of the wrist at the base of the thumb. Like CTS(carpul tunnel), it may be caused by repetitive movements but is also associated with pregnancy and rheumatoid disease. Most common in middle-aged women. The main symptom is pain felt over the thumb side of the wrist that may travel up the forearm. The pain is worse when forcefully grasping objects or twisting the wrist. A catching or snapping sensation may be felt when moving the thumb. Carpal Tunnel Syndrome (CTS) Occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes constricted. Repetitive activity with the hands that cause irritated tendons, causing compression of the median nerve. Symptoms may include burning, tingling, or itching numbness of the hand and fingers, especially the thumb, middle, and index fingers. Medial Epcondylitis Golfer's Elbow Pain is often sharp in the medial epicondyle and radiates down the arm from the inside of the elbow. Pain occurs upon extension of the wrist or supination of the forearm such as when gripping, twisting, or flexing at the wrist. There may be weakness in the hand or wrist as well or numbness and tingling in the ring and little fingers. Lateral Epicondylitis Tennis Elbow Pain is often sharp in the lateral epicondyle and radiates from the outside of the elbow and down the forearm. Pain occurs upon extension of the wrist or supination of the forearm such as when gripping and twisting. There may be weakness in the forearm or a weak grip. Difference between lateral and medial epicondylitis & treatment location of the pain Imaging is unnecessary but it may be useful if needed to rule out alternative diagnoses. Treatment: The patient should be educated to avoid or alter activities responsible for symptoms. PT may speed improvement or recovery, and braces may reduce pain and improve function. Treat with topical NSAIDs. Steroid injections for lateral epicondylitis may provide short-term pain relief (up to 12 weeks) but result in increased pain and recurrence at 1 year. Thus, work/home restriction is key to improvement and recovery.