Update ) Differential
Diagnosis in Acute Care Practicum |
Study Guide Questions & Answers |
Grade A | 100% Correct –
Chamberlain
Question:
Shoulder Disorders TX
Answer:
Although specific measures may be indicated based on the mechanism of
injury, possible treatment of shoulder disorders include several options.
Rest
NSAIDS
Ice or Heat
Steroid Injection
Physical Therapy
,Question:
Impingement syndrome
Answer:
Space between acromion and rotator cuff narrows, compresses bursa tendon.
Inflammation, gradual onset pain worse with overhead activity. Described as
"catching" sensation, may radiate to elbow.
The most reliable sign of an impingement syndrome is that the pain is
reproduced when the arm is flexed forward forcibly against resistance with
the elbow extended
Question:
de Quervain's disease
Answer:
Pain at the base of the thumb aggravated by movement of the wrist or thumb
and reproducible by flexion of the thumb, which is tenosynovitis of the
thumb abductors and extensors.
Question:
carpal tunnel syndrome
Answer:
most common cause of nocturnal hand pain and often occurs in the later
stages of pregnancy and rheumatoid arthritis.
Pain in wrist radiating to the forearm.
,The Phalen maneuver and Tinel's sign have been used to observe for
reproduction of the patient's symptoms when the wrist is placed in flexion or
when it is percussed on the volar surface.
A history by the patient of shaking the hand or flicking the wrist in an
attempt to alleviate nighttime discomfort (called the "flick sign") predicts
electrodiagnostic abnormalities of the median nerve 93% of the time.
, Question:
Phalen's test
Answer:
Patient maximally flexes both wrist holding them against each other for 1
minute.
(+) TEST: Reproduces tingling and/or paresthesia into hand following median
nerve distribution
Question:
Tinel's sign
Answer:
A distal tingling sensation on percussion of median nerve of the inner wrist;
characteristic of carpal tunnel syndrome
Question:
Rheumatoid arthritis
Answer:
Involves the elbow and wrist; it seldom involves the shoulder. Patients with
active rheumatoid arthritis usually have joint stiffness as well as warmth,
swelling, and tenderness.
The pain is usually polyarticular and migratory rather than monoarticular.