DDx Exam 1
Reasons for screening - ANS 1. Direct access
2. Quicker and sicker client base
3. Signed prescription without being examined by physician
4. Specialist fail to recognize systemic disease
5. Disease progression might be hard to recognize
6. Client discloses more info
7. Client does not report symptoms
8. Red and yellow flags
Goodman screening for refferal - ANS - past medical history
- personal and family history
-current medical history
-risk assessment
-clinical presentation
- signs and symptoms
-ROS
Active listening - ANS 1. Paraphrasing
2. Ask questions
3. Positive body language
4. Show empathy
5. Avoid judgement
6. Dont give advice too quickly
7. Evaluate convo
,8. Listening may be enough
Subjective key - ANS 1. Ask open ended questions
2. Leave close ended questions to clarify
3. Confidential
4. Active listening
5. Encourage questions
6. Assessing their understanding of current problem
7. Signs and symptoms
8. Descriptive responses
Constitutional signs and symptoms - ANS -fever
-diaphoresis
-sweats
-nausea
-vomiting
-pain at night
-pain worsening
-idiopathic origin
-pallor
-dizziness/syncope
-unexplained changes in bowel
-unexplained fatigue/weakness
-unexplained weight loss/gain
-unremitting pain
,-lack of pattern
-bowel or bladder incontinence
-assessing health?
Review findings - ANS Be clear and honest and sum it up.
Things to consider for refferal - ANS -med list
-comorbidities
- rule out msk vs not
-does patient improve with pt
-problem progresses despite efforts
-constitutional symptoms
- are they in care of physician- get med records
- treat what you can only
What requires urgency? - ANS -angina with vomiting/diaphoresis/LOC
-angina not relieved with rest and nitroglycerine
-bowel/bladder incontinence
-signs of anaphylaxis/shock
-sudden or worsening SOB
-changes in cognition
-diabetes with lethargy or confusion
-positive McBurney's
-pulsating abdominal mass
- changes in size, shape, tenderness of lymph nodes
, -sudden worsening of intermittent claudication
-patients expression/demeanor
ER - ANS 1. Life, limb, function, or eyesight
- acute MI, CVA, diabetic shock, LOC, anaphylaxis, SOB, DVT
Urgent care - ANS UTI, infections, cellulitis, sick
Physician - ANS Skin stuff, suspected cancer, lots of GI stuff, suspected endocrine dysfunction
Pain sources - ANS 1. Systemic
2. Somatic
3. Emotional/psychological
4. Vascular
5. Visceral
6. Neuropathic
Superficial somatic - ANS Cutaneous- skin and superficial fascia
Deep somatic - ANS Bone/tendon/ligaments/joint
Characteristics of deep msk pain - ANS - can be poorly localized
-dull/diffuse/achy
-usually above or below a single joint
-intensity is variable depending on MOI
Reasons for screening - ANS 1. Direct access
2. Quicker and sicker client base
3. Signed prescription without being examined by physician
4. Specialist fail to recognize systemic disease
5. Disease progression might be hard to recognize
6. Client discloses more info
7. Client does not report symptoms
8. Red and yellow flags
Goodman screening for refferal - ANS - past medical history
- personal and family history
-current medical history
-risk assessment
-clinical presentation
- signs and symptoms
-ROS
Active listening - ANS 1. Paraphrasing
2. Ask questions
3. Positive body language
4. Show empathy
5. Avoid judgement
6. Dont give advice too quickly
7. Evaluate convo
,8. Listening may be enough
Subjective key - ANS 1. Ask open ended questions
2. Leave close ended questions to clarify
3. Confidential
4. Active listening
5. Encourage questions
6. Assessing their understanding of current problem
7. Signs and symptoms
8. Descriptive responses
Constitutional signs and symptoms - ANS -fever
-diaphoresis
-sweats
-nausea
-vomiting
-pain at night
-pain worsening
-idiopathic origin
-pallor
-dizziness/syncope
-unexplained changes in bowel
-unexplained fatigue/weakness
-unexplained weight loss/gain
-unremitting pain
,-lack of pattern
-bowel or bladder incontinence
-assessing health?
Review findings - ANS Be clear and honest and sum it up.
Things to consider for refferal - ANS -med list
-comorbidities
- rule out msk vs not
-does patient improve with pt
-problem progresses despite efforts
-constitutional symptoms
- are they in care of physician- get med records
- treat what you can only
What requires urgency? - ANS -angina with vomiting/diaphoresis/LOC
-angina not relieved with rest and nitroglycerine
-bowel/bladder incontinence
-signs of anaphylaxis/shock
-sudden or worsening SOB
-changes in cognition
-diabetes with lethargy or confusion
-positive McBurney's
-pulsating abdominal mass
- changes in size, shape, tenderness of lymph nodes
, -sudden worsening of intermittent claudication
-patients expression/demeanor
ER - ANS 1. Life, limb, function, or eyesight
- acute MI, CVA, diabetic shock, LOC, anaphylaxis, SOB, DVT
Urgent care - ANS UTI, infections, cellulitis, sick
Physician - ANS Skin stuff, suspected cancer, lots of GI stuff, suspected endocrine dysfunction
Pain sources - ANS 1. Systemic
2. Somatic
3. Emotional/psychological
4. Vascular
5. Visceral
6. Neuropathic
Superficial somatic - ANS Cutaneous- skin and superficial fascia
Deep somatic - ANS Bone/tendon/ligaments/joint
Characteristics of deep msk pain - ANS - can be poorly localized
-dull/diffuse/achy
-usually above or below a single joint
-intensity is variable depending on MOI
