DD Exam 2 Review: Focused Questions and Answers
What are some MSK S/S of hepatic and/or biliary dysfunction? - correct answer ✔✔-R shoulder
-R upper trap
-R subscapular area
What is asterixis and in what type of disease may you see it present? - correct answer ✔✔Asterixis is an
outward sign of liver dysfunction; cause by impaired inflow of joint and other afferent info that causes
movement dysfunction.
ex: Hand Flap (extend the shoulder, elbow, and wrist --> hand should flap up/down like a tremor)
If a patient presents with any BIL S/S, what should you do? - correct answer ✔✔REFER OUT!
Anytime a pt presents w/ BIL S/S , it is a HUGE RED FLAG
What do you do if a patient presents with BIL Carpel Tunnel syndrome? - correct answer ✔✔-Of course,
refer out
-More importantly ask about personal hx of liver or hepatic disease
What are the referred pain patterns in someone with hepatic or biliary disease? - correct answer ✔✔-
Thoracic p! (b/w scapula, R shoulder, R upper trap, and R subscap areas)
What is Kehr's sign, and what might it signify? - correct answer ✔✔P! that refers to the L shoulder, and
can signify a RUPTURED SPLEEN
What are ascites? - correct answer ✔✔- abnormal accumulation of serous (edematous) fluid in the
peritoneal cavity
What may ascites indicate? - correct answer ✔✔-Liver impairment
, What are two tests that can be used to test for ascites? - correct answer ✔✔--> Dullness Test (tympany
to dullness)
--> Wave Test (have pt hold hands on both sides and tap on one side to create impulse)
What is a guideline for an immediate physician referral? - correct answer ✔✔- NEW ONSET OF
MYOPATHY (older adult with use of statin)
- Color change in newborns
What are some clues to screening for hepatic disease? - correct answer ✔✔--> R shoulder and upper
mid back of unknown cause
What are the major Constitutional S/S of genitourinary disease? - correct answer ✔✔--> Fever, fatigue
--> Weight Loss
What are the major MSK S/S of genitourinary disease? - correct answer ✔✔--> Unliateral costovertebral
tenderness
--> Ipsilateral shoulder p!
How would you assess for pseudorenal pain? - correct answer ✔✔--> Hx of: straining, lifting, accident
--> Back pain occur at the same level as kidney
--> Lying on the invovolved side increases p!
--> Prolonged sitting increases p!
What are the clinical S/S of infection of the upper and lower urinary tract? - correct answer ✔✔--
>Ipsilateral shoulder p!
-->Low back p!
-->Pelvic/lower abdominal p!
What are some systemic manifestations of chronic kidney disease? - correct answer ✔✔-->Carpal Tunnel
syndrome, burning feet syndrome
-->Raynaud's phenomenon
What are some MSK S/S of hepatic and/or biliary dysfunction? - correct answer ✔✔-R shoulder
-R upper trap
-R subscapular area
What is asterixis and in what type of disease may you see it present? - correct answer ✔✔Asterixis is an
outward sign of liver dysfunction; cause by impaired inflow of joint and other afferent info that causes
movement dysfunction.
ex: Hand Flap (extend the shoulder, elbow, and wrist --> hand should flap up/down like a tremor)
If a patient presents with any BIL S/S, what should you do? - correct answer ✔✔REFER OUT!
Anytime a pt presents w/ BIL S/S , it is a HUGE RED FLAG
What do you do if a patient presents with BIL Carpel Tunnel syndrome? - correct answer ✔✔-Of course,
refer out
-More importantly ask about personal hx of liver or hepatic disease
What are the referred pain patterns in someone with hepatic or biliary disease? - correct answer ✔✔-
Thoracic p! (b/w scapula, R shoulder, R upper trap, and R subscap areas)
What is Kehr's sign, and what might it signify? - correct answer ✔✔P! that refers to the L shoulder, and
can signify a RUPTURED SPLEEN
What are ascites? - correct answer ✔✔- abnormal accumulation of serous (edematous) fluid in the
peritoneal cavity
What may ascites indicate? - correct answer ✔✔-Liver impairment
, What are two tests that can be used to test for ascites? - correct answer ✔✔--> Dullness Test (tympany
to dullness)
--> Wave Test (have pt hold hands on both sides and tap on one side to create impulse)
What is a guideline for an immediate physician referral? - correct answer ✔✔- NEW ONSET OF
MYOPATHY (older adult with use of statin)
- Color change in newborns
What are some clues to screening for hepatic disease? - correct answer ✔✔--> R shoulder and upper
mid back of unknown cause
What are the major Constitutional S/S of genitourinary disease? - correct answer ✔✔--> Fever, fatigue
--> Weight Loss
What are the major MSK S/S of genitourinary disease? - correct answer ✔✔--> Unliateral costovertebral
tenderness
--> Ipsilateral shoulder p!
How would you assess for pseudorenal pain? - correct answer ✔✔--> Hx of: straining, lifting, accident
--> Back pain occur at the same level as kidney
--> Lying on the invovolved side increases p!
--> Prolonged sitting increases p!
What are the clinical S/S of infection of the upper and lower urinary tract? - correct answer ✔✔--
>Ipsilateral shoulder p!
-->Low back p!
-->Pelvic/lower abdominal p!
What are some systemic manifestations of chronic kidney disease? - correct answer ✔✔-->Carpal Tunnel
syndrome, burning feet syndrome
-->Raynaud's phenomenon
