Other Systems

What is the second highest cause of death from cancer in men?

prostate cancer

Osteoporosis: Examination 1. What should you administer to assess balance? 2. Once osteoporosis progresses in severity it can affect other areas other than weight bearing bones like what 3 regions? 3. A single fracture significantly increases the risk for what?

1. Berg 2. skull, long bones, ribs 3. subsequent fractures

Skeletal muscle as it surrounds the urethra as it extends through the pelvic floor is known as the: internal sphincter external sphincter transitional epithelium

external sphincter

What condition can be associated with hyperpigmentation of the skin? albinism chronic renal failure diabetes pernicious anemia

chronic renal failure

What are calcium alginates commonly used on?

chronic venous insufficiency ulcers or pressure wounds

What is the most common cause of ascites?

cirrhosis

Which of the following topical agents commonly used for burns has a side effect of metabolic acidosis? zinc oxide sulfamylon silvadene silver nitrate

sulfamylon NOTE: the body breaks sulfamylon down causing elevation of acidic levels in the blood for which the patient compensates with hyperventilation

Is a superficial vs. deep partial thickness burn blancheable? Is a stage 1 pressure ulcer blancheable?

superficial blanches and deep does not blanch stage 1 pressure ulcer does not blanch

A burn that blanches and exhibits brisk capillary refill would most likely be classified as: epidermal superficial partial thickness deep partial thickness full thickness

superficial partial thickness

Which of the following inflammatory mediators is responsible for causing pain in an acute wound? histamine prostaglandins phagocytes

prostaglandins NOTE: these cause vasodilation and increases the permeability of local capillaries inducing pain

What is the name of the male sex gland that surrounds the urethra and the neck of the bladder? glans penis urethra prostate scrotum

prostate

What macro is needed for tissue and organ growth?

protein

Which of the following skin disorders may also result in arthritic symptoms? cellulitis psoriasis contact dermatitis

psoriasis NOTE: this is a chronic autoimmune disease and 10% experience arthritic symptoms termed psoriatic arthritis

Which of the following S/S can mimic abdominal aortic aneurysm? renal colic nephritis uremia phimosis

renal colic NOTE: this is a type of pain caused by kidney stones (urolithiasis)

How old would the fetus be if the baby was born premature 4 weeks early?

36 weeks NOTE: full term minus four weeks

Outpatient PT should alleviate pelvic floor weakness and involuntary leakage of urine within how fast?

8-12 weeks

What is the appropriate position for a patient in shock?

supine with legs elevated

Partial Thickness Burns: Contributing Factors 1. There is a higher risk for burns in children between ________ and _____________ years of age as well as in patients over ________ years of age.

1. 1 and 5; 70

Breast Cancer: Examination 1. What is administered to patients to monitor self care and home management abilities? 2. Patients that are diagnosed with advanced breast cancer may experience: what in the lungs? what in the bones? what in the spine?

1. Barthel index (higher score is better) 2. pleural effusion, pathological fractures, spinal compression

Phases of Normal Wound Healing: Inflammatory Phase 1. How long does this phase last? 2. Repair mechanisms in this phase rapidly re-establish hemostasis through what 2 things? 3. Debris and necrotic tissue are removed and bacteria are killed by what 3 cell types? 4. Processes occurring in this phase do what to the wound bed to signal tissue restoration and permanent repair processes to begin? 5. Re-epithelialization typically starts how soon? 6. Visible signs of re-epithelialization are typically not seen until what day after injury?

1. 1-10 days after injury 2. platelet activation and clotting cascade 3. mast cells, neutrophils, and leukocytes 4. clean the wound bed 5. 24 hours after injury 6. until 3 days after injury

Scar Management Continued: Compression Garments 1. The use of sustained compression garments supplying how much pressure is believed to create an environment that facilitates the balance of collagen synthesis and lysis? 2. How long should compression garments be worn per day and for how long? 3. What can help provide sufficient pressure over small areas or concave surfaces in compression garments? 4. It is recommended that compression garment use begins when? 5. How long can compression garments be used for?

1. 15-35 mmHg 2. 22-23 hours until the scar has matured 3. silicone or foam inserts 4. 2 weeks to 2 months after wound closure 5. up to 2 years

Multiple Organ Dysfunction Syndrome: Diagnosis 1. This is the physiologic dysfunction of how many organs or organ systems? 2. The condition can be caused by what 4 things? 3. Infection and a systemic inflammatory response can lead to ______________ which eventually leads to MODS. 4. How many organ systems are considered when characterizing this condition? What are they? 5. Histologic changes to these organs include what increase in size (2), formation of what? what occurs to tissue?

1. 2 or more 2. infection, hypermetabolism, circulatory shock, or injury 3. sepsis 4. 6; respiratory, cardiovascular, renal, hepatic, neurologic, and hematologic 5. edema and inflammation, fibrosis, tissue ischemia and necrosis

Braden Scale for Pressure Injury: 1. What is the maximum score? 2. It is recommended that any patient that scores an ____________ or less be placed on a pressure injury prevention system? 3. The braden scale assesses what 7 things? How is each section scored?

1. 23 2. 18 or less 3. sensation, activity, mobility, moisture, nutrition, friction, shear; each category is graded 1-4 (lower meaning worse) except friction and shear which is graded 1-3

Physiological & Postural Changes During Pregnancy: 1. Weight gain typically varies between __________ and ________ lbs. What can occur in the blood? 2. What occurs to uterine positioning in pregnancy? 3. What occurs to the positioning of the ribs? 4. What occurs to the respiratory diaphragm position? 5. What are 3 lung volumes that increase? 6. What occurs to oxygen consumption? 7. What occurs to blood volume? 8. What occurs to cardiac output? 9. Why does hypotension occur to pregnant women that are laying in supine? 10. What can occur to joints?

1. 25 and 35 lbs; anemia 2. it moves anteriorly into the abdomen and becomes an abdominal organ 3. they elevate and expand to accommodate the uterus 4. it elevates 4 centimeters 5. respiration, tidal volume, and minute ventilation 6. increases 15-20% 7. increases 40-50% 8. increases 30-60% 9. because the fetus puts pressure on the inferior vena cava 10. hypermobility

Lifestyle Modifications to address bladder symptoms: 1. Daily fluid intake should be ____________ mL or ____________ cups to regulate excessively high or low fluid intake. 2. Reduce bladder irritants. What are 3 types of beverages that are bladder irritants? what type of food? what type of juice? what type of sweeteners? 3. When should voiding be scheduled to reduce bladder distention? 4. What should be used to assist with baseline measurements and goal setting? 5. You should avoid fluid intake for up to how long before bed? 6. What type of program may decrease occurrence of coughing and subsequent bladder leakage? 7. What type of program can be implemented to decrease pressure on the pelvic tissues and organs?

1. 2500 mL or 10 cups 2. reduce carbonated, caffeinated, or alcoholic beverages; spicy foods; citric juices; artificial sweeteners 3. every 3-4 hours 4. a bladder diary 5. 2-3 hours before bed 6. smoking cessation program 7. weight loss program

GERD Continued: 1. Typically patients with this experience symptoms how often a week? 2. Other unique symptoms that signify GERD include: what 2 feelings after eating? What taste might they have in their mouth? Can they have issues with swallowing? 3. This is characterized by a sensation of what? 4. GERD symptoms often increase with what 3 positions? 5. What time of day do GERD symptoms get worse? 6. What are 2 forms of imaging that can be performed to confirm GERD diagnosis? 7. Those at increased risk for developing GERD include: what weight status? what reproductive status? using what 2 things? what going on in the abdomen? what condition of the skin and connective tissues?

1. 2x a week minimum 2. nausea or feeling like something is stuck in the throat, sour taste in their mouth, dysphagia is common 3. sensation of a lump in the throat 4. stooping, bending, supine 5. worse at night 6. barium swallow with xray or upper GI endoscopy 7. obese, pregnant, smoking or alcohol, hiatal hernia, scleroderma (hardening and tightening of skin and connective tissues)

Phases of Normal Wound Healing: Proliferative Phase 1. When does this phase occur? 2. What signals the beginning of the proliferative phase? 3. What 2 things start to fill the wound bed creating a support structure for migration of epithelial cells? 4. What 3 cell types form the collagen matrix? 5. How does wound closure occur?

1. 3-21 days post injury 2. formation of new tissue 3. granulation tissue and capillary buds 4. keratinocytes, endothelial cells, and fibroblasts 5. contraction of the wound and epithelialization

Drug Development: 1. How many steps are involved with the development of a new drug? 2. Preclinical Testing: This involves testing on what? This phase identifies what 2 things about the drug? 3. Phase 1: This is the first stage of what? Is this tested on a large or small number of patients? This phase identifies what type of effects and what range? 4. Phase 2: This phase tests the effectiveness of the drug on a small number of patients. Researchers identify what 2 things about the drug at this phase? 5. Phase 3: this is similar to phase 2 except for what? If phase 3 is successful, what happens? 6. Phase 4: This phase is also known as what?

1. 5 step process 2. testing on animals; pharmacodynamics and pharmacokinetics 3. first stage of human testing; small number of patients; toxicity effects as well as safe dosing ranges for humans 4. effectiveness of the drug and at what dosage 5. post-marketing surveillance

Exercise & Pregnancy: 1. Guidelines permit women to remain at _______________ of their maximal heart rate for approximately ________ minutes per session. 2. What types of activities are preferred during exercise in pregnant women? 3. What type of clothing is advised to allow for adequate heat loss? 4. What does the pregnant woman make sure she needs to get adequate amounts of during exercise? 5. When should the pregnant woman stop doing any exercise in supine?

1. 50-60% of their HRmax for 30 minutes per session 2. non weight bearing activities 3. loose clothing 4. adequate amounts of fluids 5. after the first trimester

Bariatric Interventions: 1. In obese populations, a ___________________ kcal/day reduction in dietary intake is usually sufficient to produce a 1-2 pound per week loss. This rate can be maintained for ____________ months before slowing or plateauing. 2. For weight loss, what are 3 things that need to be restricted in the obese population? 3. What are 2 approved medications by the FDA that can assist in weight loss? 4. What do lipase inhibitors do? 5. Bariatric Surgery: Pre-op patients must meet a number of requirements including being of what BMI and proving what did not work? Bariatric surgeries are classified as what 2 things? The most common bariatric procedure is the invasive __________________________________ which facilitates weight loss through a combo of restriction and malabsorption. This has a high risk of complications. The most common restrictive procedure is also the least invasive and is the ___________________________ which is often referred to as a lap band and has a low risk of complications.

1. 500-1000 kcal/day reduction; 6 months 2. carbs, fat, calories 3. lipase inhibitors and appetite suppressants 4. decrease the body's ability to absorb dietary fats thereby decreasing overall calorie intake 5. BMI greater than 35-40, restrictive or malabsorptive, Roux-en-Y gastric bypass; Laparoscopic gastric banding

Phases of Normal Wound Healing: Maturation/Remodeling Phase 1. When does this phase occur? 2. When is this phase initiated? 3. Mechanisms of fiber reorganization and contraction shrink and thin the ___________ of the injury. 4. An immature scar will have what 3 characteristics? 5. A mature scar will have what 3 characteristics? 6. Scar tissue is remodeled and strengthened through the process of what? 7. Newly repaired tissues have approximately ____________ of pre-injury tensile integrity and should be protected to prevent re-injury. 8. Over time, tensile strength may increase to as much as ____________ of pre-injury strength. 9. What can significantly impact maturation phase of wound healing progression?

1. 7 days-2 years 2. when granulation tissue forms 3. scar 4. red, raised, rigid 5. pliable, pale, flat 6. collagen synthesis and lysis 7. 15% 8. 80% (never again 100%) 9. hypertrophic scarring (these SIGNIFICANTLY delay the wound healing process)

Pelvic Floor Muscle Exercises for Pregnant Women: 1. Recommendations vary from ____________ contractions per day combining what 3 types of contractions? 2. Quick contractions are important to withstand increased what? 3. The patient typically starts with __________ sets of ________ quick contractions daily, holding for ________ seconds and resting for ________ seconds. 4. Long hold contractions are for endurance training of the pelvic floor and are important for maintaining proper posture and pelvic support. The patient typically starts with ______ sets of ________ long hold contractions daily, holding for ________ seconds and resting for __________ seconds, gradually increasing the contraction time to _______ seconds.

1. 80-100 contractions per day combining quick, long, and functional contractions 2. intra-abdominal pressure changes that come quick 3. 3 sets of 10 quick contractions daily, holding for 2 seconds and resting for 4 4. 3 sets of 5 long hold contractions, holding for five seconds and resting for 10 seconds; gradually increase contraction time to 10 seconds

Breast Cancer: Outcomes 1. Overall prognosis and ten year survival rates for women are over ____________ for stage 1, ____________ for stage 2, _____________ for stage 3, and ____________ for stage 4.

1. 85% for stage 1, 66% for stage 2, 36% for stage 3, and 7% for stage 4

Rule of Nines: 1. How much is the head and neck? 2. How much is the anterior trunk? Upper vs. lower? 3. How much is the posterior trunk? Upper vs. lower? 4. How much is the anterior arm, forearm, and hand? 5. How much is the posterior arm, forearm, and hand? 6. How much is the genital region? 7. How much is the anterior leg and foot? 8. How much is the posterior leg and foot?

1. 9% (per side) 2. 18% (9% upper and 9% lower) 3. 18% (9% upper and 9% lower) 4. 4.5% 5. 4.5% 6. 1% 7. 9% 8. 9%

HIV: Confirming Your Patient Has This 1. Without treatment, HIV advances in what 3 stages? 2. Stage 1 - Acute HIV Infection: This stage occurs __________ weeks after initial transmission. Patients can range from what types of symptoms? During this stage, large amounts of the virus are being produced. ___________ cells fall rapidly, and the patient is at the highest risk of doing what? 3. Stage 2 - Clinical Latency/Asymptomatic HIV: Patients on what type of therapy can live with clinical latency for several decades because the treatment keeps the virus from replicating? Clinical latency for people not taking ART typically lasts _________ years before progressing to AIDS. 4. Stage 3 - AIDS: When the number of CD4 cells fall below ____________ cells/mm^3 and the person has other AIDS-defining illnesses, a person is considered to have progressed to AIDS. Without treatment, people can survive how long with AIDS? Once a person has an opportunistic illness, life expectancy drops to what? Manifestations of HIV may lead to other conditions including infection, what diagnosis, what 2 system dysfunctions, what decline? HIV is diagnosed through blood tests including what 2 tests?

1. Acute HIV, Clinical latency/asymptomatic, and AIDS 2. 2-4 weeks after initial transmission; asymptomatic to severe flu like symptoms; CD4 cells fall rapidly; patient is at the highest risk of transmitting this disease to others 3. antiretroviral therapy (ART); 10 years before progressing to AIDS 4. 200 cells/mm^3; 3 years with AIDS; 1 year; infection, cancer, neuro or Cardiopulm dysfunction, cognitive decline; western blot or enzyme linked immunosorbent tests

Systemic Lupus Erythematosus: Examination 1. What are 3 things that should be administered to patients to test their gait and balance? 2. SLE can cause what type of skeletal deformity to the hands? 3. Kidney involvement and what 3 cardiac involvements can occur during an exacerbation? 4. Patients that experience what 3 things have a poor prognosis? 5. Modifiable risk factors for exacerbation include high ___________, limited ______________ and _____________ support, and ____________________ distress.

1. Berg, Tinetti, and Functional Ambulation Profile 2. ulnar deviation and subluxation of the interphalangeal joints 3. pericarditis, myocarditis, endocarditis 4. nephritis, myocarditis, or neurological implications 5. high stress, limited emotional and social support, and psychological distress

Peptic Ulcer Disease: 1. This is a condition where there is disruption or erosion in what? 2. Typically what causes this is there is an imbalance between what 2 things? 3. Many ulcers are caused by what 2 things? 4. Irritants that can also cause this include: what feeling? use of what substance? particular medications, foods, and what bad habit? 5. S/S of peptic ulcer disease include: pain where? (2) what type of pain? what GI symptoms? presence of what in stools? pain that comes in waves that is relieved by what? 6. Symptoms specific to the etiology of H. pylori can include what in one's breath? what 2 things in the skin? 7. Complications of peptic ulcer disease include: what type of bleeding? what 2 direct injuries? what type of cancer? 8. Treatment is primarily what? In more severe cases what might be required?

1. GI mucosa 2. protective mechanisms of the stomach and acidic secretions 3. presence of H. pylori or chronic use of NSAIDs 4. stress, alcohol, smoking 5. epigastric pain or heartburn, burning pain, nausea, vomiting, blood in the stool, relieved by eating 6. bad breath (halitosis); rosacea and flushing of the skin 7. hemorrhage, perforations or obstructions from scarring, malignancy 8. pharmacological; surgery

Pharmacological GI Management: Proton Pump Inhibitors (PPI) 1. Proton pump inhibitors inhibit the _______________________ enzyme that blocks secretions of _________________ from _______________ cells into the stomach. 2. Proton pump inhibitors prevent erosive _________________ and may also possess ___________________ effects against H. Pylori. 3. What are 2 indications a patient should be taking proton pump inhibitors? 4. What is a side effect after discontinuing prolonged use of proton pump inhibitors? 5. Does taking proton pump inhibitors typically impact PT? 6. What is the common suffix ending to medications that are proton pump inhibitors? 7. What are 5 examples of proton pump inhibitors?

1. H+/K+ ATPase enzyme; acid from gastric cells 2. esophagitis; antibacterial 3. dyspepsia (difficulty with digestion) or GERD 4. acid rebound 5. no 6. "prazole" 7. Prevacid (iansoprazone), Nexium (esomeprazole), Prilosec (omeprazole), Protonix (pantoprazole), and AcipHex (rabeprazole)

GI Pharmacological Management: Antibiotics 1. These are prescribed to treat _________________ infection with the goal of facilitating more rapid healing of _____________________________. 2. What are 3 main side effects of taking antibiotics? 3. PTs need to keep in mind that what can occur when working with a patient taking antibiotics? 4. What are 4 main examples of antibiotics used to treat H. pylori infection in the GI tract?

1. H. pylori; gastric ulcers 2. hypersensitivity, diarrhea, nausea 3. severe skin or respiratory reaction 4. metronidazole, amoxicillin, clarithromycin, tetracycline

Ankylosing Spondylitis: Diagnosis 1. This is also known as what? 2. This is a _______________ condition that is characterized by what? 3. Chronic inflammation causes destruction of what structures? This causes subsequent ________________ and _____________________ of the area. 4. Ankylosing spondylitis primarily affects what 5 types of joints? What soft tissue does it affect?

1. Marie-Strumpell disease 2. systemic; inflammation of the spine and larger peripheral joints 3. causes destruction of ligamentous-osseous junctions causing subsequent fibrosis and ossification 4. intervertebral disks, sacroiliac joints, costovertebral joints, apophyseal joints, and larger peripheral joints (hips, knees, shoulders) 4. connective tissue

Abdominal Pain in the Right Lower Quadrant: 1. What type of diverticulitis can refer pain to right lower? 2. Inflammation in what 2 organs can refer pain to right lower?

1. Meckel diverticulitis 2. cholecystitis or appendicitis (appendix or gallbladder inflammation)

Complex Regional Pain Syndrome: Management of Symptoms 1. What are 2 medications administered to the patient in the early stages? 2. What medication might be administered for sleep? 3. What might be used for increasing peripheral circulation? 4. What might be used for long term intervention to assist motor function? 5. What is warranted in later stages to combat bone loss? 6. Surgery including what 2 procedures are used to alleviate pain? 7. PT interventions include: __________ control, patient education, ________ care, joint mobilizations, desensitization, and functional activity training. Modalities, ____________ therapy, _________________ training, and a home program will all assist with management of this disease. 8. At home patients should perform what 3 exercises? 9. At home patients should be using what 2 modalities? 10. The patient should be encouraged to use what? 11. Edema management could include what 2 things?

1. NSAIDs or corticosteroids 2. amitriptyline 3. calcium channel blockers 4. baclofen 5. bisphosphonate 6. sympathetic block or sympathectomy 7. pain control, patient education, skin care, joint mobs, desensitization, and functional activity training. Modalities, aquatic therapy, relaxation training, and a home program 8. gentle stretching, ROM, light weight bearing 9. TENS and ice/heat 10. use the affected extremity as tolerated 11. compression garments or a pump

Systemic Lupus Erythematosus: Management of Symptoms 1. Patients with mild SLE will be administered what 3 medications? 2. What are 2 other medications that may be used? 3. What type of therapy may be used for lupus? 4. What type of nutrition is recommended? 5. What should the patient try to avoid? 6. PT intervention is usually indicated after what? Interventions include _________ resumption of physical activity, __________________ techniques, _______________ endurance activities, and significant patient education regarding what 2 things?

1. NSAIDs, salicylates, or indomethacin 2. corticosteroids and antimalarial meds 3. immunosuppressive therapy 4. good nutrition 5. avoid UV exposure 6. after a period of exacerbation; slow resumption; energy conservation techniques; gradual endurance; skin care and pacing

Psychiatric Pharmacological Management: Antidepressant Agents 1. What are 3 examples of antidepressant agents? 2. Side effects of these antidepressant agents include: what level of arousal? what occurs to vision? what occurs to HR? what occurs to the mouth? what occurs to sleep? what occurs to weight? what occurs to sexual function? 3. What can occur to BP with antidepressant agents? 4. What are 2 examples of tricyclics? 5. What is an example of a MAOI? 6. What are 3 examples of SSRIs?

1. SSRIs, MAOIs, and tricyclics 2. sedation, blurred vision, tachycardia, dry mouth, insomnia, weight gain, sexual dysfunction 3. orthostatic hypotension or hypertension 4. Elavil or Pamelor 5. Nardil 6. Wellbutrin, Paxil, or Prozac

Comparing a Similar Condition to Ankylosing Spondylitis: 1. What is a very similar condition? 2. How is Sjogren's syndrome classified? 3. Sjogren's syndrome is a chronic arthritis and autoimmune disease that also can affect several organs. Lymphocytes attack healthy tissues and organs and are usually found in combination with what 2 diagnoses? 4. Sjogren's syndrome affects whom most often? 5. How is Sjogren's syndrome managed?

1. Sjogren's syndrome 2. a spondyloarthropathy 3. lupus or RA 4. postmenopausal women 5. through medication, proper diet, and exercise following RA guidelines

HIV: Examination 1. What test is administered to patients to test their balance? 2. What is the normal range for CD4 T cells?

1. Tinetti (higher score is better) 2. 500-1200 cells

Skin Graft Terminology: 1. Allograft: What is it? What is another name for allograft? 2. Autograft: What is it? 3. What is an escharotomy? This procedure reduces ________________ on a surrounding structure, relieves __________________ from interstitial edema, and subsequently enhances _______________. 4. A full thickness graft is a skin graft that contains what layers? 5. What is a heterograft? What is another name for a heterograft? 6. What is a mesh graft? 7. What is a sheet graft? 8. What is a split thickness graft? 9. What is a Z-plasty used for? How is it done?

1. a TEMPORARY skin graft taken from another human usually a cadaver; homograft 2. a PERMANENT skin graft taken from a donor site on the patient's own body 3. a surgery to remove eschar; tension; pressure; circulation 4. epidermis and dermis 5. a TEMPORARY graft taken from a different species; xenograft 6. a skin graft altered to create a mesh like pattern to cover a larger surface area 7. a skin graft transferred directly from the donor site to the recipient site 8. contains only a superficial layer of the dermis and the full epidermis 9. to eliminate scar contractures; an incision in the shape of a "z" allows the contracture to change configuration and lengthen the scar

Diverticular Disease: Diagnosis 1. What is diverticulosis? 2. Diverticulosis develops secondary to what? 3. Diverticulitis is the condition characterized by inflammation of infection of what? 4. Risk factors for diverticulitis/diverticulosis include what going on in the bowel? a diet low in what? what weight status? a lack of what? connective tissue disorders like what 2 diagnoses? what age?

1. a benign condition characterized by the presence of outpocketings of the colon wall (diverticula) 2. increased pressure in the colon 3. diverticula 4. constipation, diet low in fiber, obesity, lack of exercise, like marfan syndrome or ehlers-danlos syndrome, advanced age

Plaque Psoriasis: 1. What is this? 2. What is the most common of the 5 types of psoriasis? 3. What can cause a patient to have this? 4. Other factors that can trigger this condition include: injury to the __________, insufficient or excess _________________, what feeling, excessive _________________, _______________ infection, what bad habit, certain meds. 5. What is the primary symptom of plaque psoriasis? 6. These red raised patches can appear anywhere on the body and tend to do what? 7. Complications can include: what diagnosis? is it painful? what feeling is severe? secondary what? 8. What is typical treatment? 9. Is this a lifelong condition?

1. a chronic autoimmune disease of the skin where T cells trigger inflammation in the skin and produce an accelerated rate of skin cell growth causing skin cells to accumulate in raised red patches 2. plaque 3. genetic predisposition 4. injury to the skin, insufficient or excess sunlight, stress, excessive alcohol, HIV infection, smoking, and certain meds 5. raised red patches that present bilaterally like on both knees or elbows 6. itch and flake 7. arthritis, pain, severe itching, secondary infections 8. can range from topical to systemic medications and phototherapy 9. yes

Acute Wounds: 1. Abrasion: What causes an abrasion? What occurs when an abrasion forms? 2. Avulsion: What is another term used for avulsion? What is this? 3. Laceration: This can occur from what 3 things? 4. Penetrating: what is this?

1. a combo of friction and shear; scraping away of the skin's superficial layers 2. degloving; a serious wound resulting from tension that causes skin to become detached from underlying structures 3. shear, tension, or high force compression 4. a wound that enters the interior of an organ or cavity

Renal Failure: 1. This occurs when the kidneys experience a decrease in what rate and they fail to adequately filter toxins and waste from where? 2. This typically occurs secondary to what 2 conditions? 3. Renal failure can also occur from what 3 other things that are not diabetes or hypertension? 4. What occurs to the nephrons in renal failure? 5. Renal failure can be classified into what 3 categories? 6. What are the 5 stages of kidney disease? 7. S/S include: what 2 GI symptoms? what level of arousal? what occurs to strength? what is UNIQUE that occurs to the diaphragm? to the blood? to the GI tract? what type of neuropathy can occur? what occurs to appetite? what occurs to bones? what occurs to the lungs? what 2 neuro statuses can occur? 8. Treatment includes typically what medication? Nutritional support including avoiding what macro? making sure you get enough what each day? 9. Conservative management includes slowing the process and assisting the body in compensation. What is renal replacement therapy? 10. What is peritoneal dialysis?

1. a decrease in the glomerular filtration rate (GFR) and fail to adequately filter toxins and waste from the blood 2. diabetes or hypertension 3. genetics, poison, or trauma 4. they fail to adequately filter the blood and become damaged 5. acute, chronic, or end stage 6. stage 1 is kidney damage with normal GFR (greater than 90), stage 2 mild decrease in GFR (60-89), stage 3 moderate decrease in GFR (30-59), stage 4 severe reduction in GFR (15-29), stage 5 kidney failure (GFR less than 15) 7. nausea/vomiting, fatigue, weakness, hiccups, anemia, ulcers in the GI tract, peripheral neuropathy, anorexia, osteomalacia, pulmonary edema, seizure or coma 8. diuretics, avoiding protein, making sure you get enough water and are staying hydrated 9. hemodialysis or organ transplant 10. a form of renal replacement therapy that uses the peritoneal cavity as a semi-permeable membrane between the dialysate fluid and the blood vessels of the abdominal cavity

Wound Terminology: 1. What is a desiccated wound? 2. What is desquamation? 3. The epidermis includes what 3 cell types? 4. What does it mean if someone's skin is friable? 5. Hypergranulation means there is increased thickness of granular layers of the epidermis that look like what? 6. What does a hypertrophic scar look like? How are the collagen fibers arranged? 7. How are the collagen fibers arranged in a keloid? How does a keloid look? 8. How are the collagen fibers arranged in a normotrophic scar?

1. a dehydrated or dry wound 2. peeling of the epidermis 3. squamous cells, basal cells, and melanocytes 4. easily tears and bleeds 5. that exceed the surface height of the skin 6. it is raised, red, and firm; disorganized collagen fibers 7. irregularly distributed collagen bands; it exceeds the boundaries of the original wound appearing red, thick, raised, and firm 8. collagen fibers are arranged in a parallel fashion

Onychomycosis: 1. What is this? 2. Risk factors for developing onychomycosis include: what being done to the toes and fingers? what occurring to the nails? skin dryness or excess skin moisture? wearing what types of shoes? what going on in the immune system? 3. S/S include: what color in the nails? what occurring to nail thickness? 4. What is typical treatment?

1. a fungal infection of the toenails 2. manicure or pedicure with unsterile utensils, nail injury or deformity, excess skin moisture, wearing closed toed shoes, weakened immune system 3. yellow or brown nails, hyperkeratosis or hypertrophy of nails 4. topical antifungal medications and manual debridement of the nails

Psychological Disorders: Neuroses Disorders 1. What does neuroses refer to? 2. Do these patients have psychosis? 3. Do these patients have delusions? 4. Do these patients know they have a problem? 5. What are 3 types of neuroses disorders? 6. Anxiety Disorder: Acute anxiety attacks last for about how long? This occurs when there is excitation of what? The patient may have a fear of impending what? What are 4 symptoms common during acute anxiety attacks? What initiates this? 7. Obsessive-Compulsive Disorder: What are obsessions vs. compulsions? When does this most commonly begin? 8. Phobia Disorder: What is this?

1. a group of disorders that are characterized by individuals exhibiting fear and maladaptive strategies in dealing with stressful or everyday stimuli 2. no 3. no 4. yes 5. anxiety, OCD, and phobias 6. a few minutes; excitation of the sympathetic nervous system; death; nausea/dizziness/SOB/heart palpitations; unconscious and internal mechanisms 7. obsessions are thoughts that keep replaying in the mind and compulsions are repetitive ritual behaviors the patient cannot stop performing; young adulthood 8. excessive fear of something

Pressure Ulcers: Diagnosis 1. What is the definition of unrelieved pressure? 2. What layer of the skin is damaged in stage 1 pressure ulcers? 3. What is involved with a stage 4 pressure ulcer? 4. What are 6 of the most high risk areas for pressure ulcers?

1. greater than 32 mmHg of pressure for longer than 2 hours 2. epidermis 3. epidermis, dermis, fascia, and deeper potentially damaging muscles, ligament, tendons, and bones 4. occiput, elbows, sacrum, greater trochanters, ischium, heels

Foam Dressings: 1. What are these comprised of? 2. Where does the exudate get absorbed? 3. Semipermeable foam dressings are adhesive or no? 4. What are 2 types of wounds these can be used over? 5. These can also be used as secondary dressings over what? 6. What type of environment do these provide to the wound? 7. What do these encourage in the body? 8. How much absorption do these provide? 9. What is a disadvantage to these dressings if excessive friction is applied? 10. Can these traumatize the periwound?

1. a hydrophobic outer covering and a hydrophilic polyurethane base which contacts the wound surface 2. in the hydrophilic base 3. both 4. partial or full thickness wounds 5. amorphous hydrogels 6. moist environment 7. autolytic debridement 8. moderate absorption 9. they can roll 10. yes if they are the adhesive ones

Breast Cancer: Diagnosis 1. What is the primary symptom of breast cancer? 2. Where is the lump usually found? 3. Breast cancer either begins in what 2 areas?

1. a painless firm lump in the breast tissue 2. in males it is found right behind the areola and in females it is either behind the areola or in the outer upper quadrant of the breast 3. in the lobules which are the milk producing glands or in the ducts that bring milk to the nipples

Parenteral Administration: Injection 1. Intravenous: This is injection of a medication into what region? What is an advantage of IV injections? This can become dangerous if what happens? This is _________% bioavailable. 2. Intra-arterial: This is injection of a medication into an artery so it can travel directly to what? What is a disadvantage of this form of injection administration? This form may be necessary to perform in instances where the drug is intended to act only where? 3. Subcutaneous: This is injection of a drug directly under the _____________ into what 2 regions? This can be useful when a ___________ release of medication into the systemic circulation is required (like insulin). What are 2 factors that can slow the absorption rate of subcutaneous drugs? What are 2 factors that can increase the speed of absorption of subcutaneous drugs? 4. Intramuscular: This is injection of a drug into what? This is often used to treat what type of issues? Absorption of a drug via IM injection is slower or faster than subcutaneous injection while still allowing for a steady release of the drug? What are 2 things that tend to occur at the site of injection? 5. Intrathecal: This is injection of a drug into a sheath such as what region? This allows for introduction of a drug into what system without having to pass what?

1. a peripheral vein; the drug can reach circulation and target tissue rapidly; if the wrong dosage of a medication is given; 100% bioavailable 2. directly to the target tissue; difficult to perform; only at a specific site (like chemo) 3. skin into subcutaneous fat and connective tissue; slow release; immobility of the limb or ice; massage or heat 4. the muscle itself; muscular issues (botulinum toxin for spasticity for example), faster than subcutaneous while still allowing for a steady release; pain and localized muscle soreness 5. the subarachnoid space of the spinal meninges; into the CNS without having to pass the blood brain barrier

Deep Tissue Pressure Injury: 1. What is this? 2. What are 2 things that often precede skin color changes?

1. a persistent non-blanchable deep red, maroon, or purple discoloration 2. pain and temperature change

GI System Terminology: 1. What is barium? 2. What is a colectomy? 3. What is a colostomy? 4. What is an enema? 5. What is a fecal diversion? 6. What is a fecal occult blood test? 7. What is a fistula? 8. What is a gastrectomy? 9. What is an ileocolectomy? 10. What is an ileostomy?

1. a substance that when swallowed or given rectally as an enema enables us to see the upper GI tract better on x-ray 2. surgical removal of part or all of the colon 3. surgical creation of an opening from the colon through the abdominal wall 4. injection of fluids into the rectum and colon to induce a BM 5. surgical creation of an opening of part of the colon or small intestine to the surface of the skin to allow stool to exit the body 6. tests for blood in the stool 7. an abnormal or surgically made passage between 2 organs or 2 parts of the intestine 8. surgery where all or part of the stomach is removed 9. surgical removal of a part of the ileum and ascending colon 10. surgical creation of an opening from the ileum through the abdominal wall

Irritable Bowel Syndrome: Confirming Your Patient Has This 1. The patient will have pain and discomfort where? 2. What occurs to the size of the abdomen? 3. What occurs with gas? 4. What can occur to the bowels? 5. What are 3 main types of this condition? 6. What are 2 symptoms that often suggest the presence of IBS?

1. abdominal pain and discomfort 2. bloating 3. flatulence 4. constipation or diarrhea 5. diarrhea predominant (IBS-D), constipation predominant (IBS-C), and alternating (IBS-A) 6. abdominal pain that increases with defecation and changes in stool consistency

Malabsorption Syndrome Continued: 1. This is a group of pathologies where there is reduced intestinal ________________ and inadequate nutrition. 2. What type of pain might be present other than abdominal pain? 3. What are 3 forms of dietary support that may be given to the patient?

1. absorption 2. bone pain 3. vitamins, minerals, electrolytes

GI Pharmacological Management: Anticholinergics 1. These block the effects of ____________________ on _________________ cells in the stomach and decrease the release of _____________________. 2. What is the primary indication for anticholinergic administration to a patient? 3. Side effects of anticholinergics include what in the mouth? what feeling in the head? what in the bowels? what in the bladder? 4. PTs need to be aware of potential side effects in order to appropriately respond to changes in ___________________ or complaints of the other side effects. 5. What are 2 examples of anticholinergics?

1. acetylcholine on parietal cells; gastric acid 2. gastric ulcers 3. dry mouth, confusion, constipation, urinary retention 4. cognition 5. Gastrozepin (pirenzepine) or muscarinic cholinergic antagonists

Metabolic Acidosis: 1. This occurs when there is an accumulation of acids due to an ____________ gain or ________________ loss. 2. Metabolic acidosis causes a pH of what? 3. This commonly occurs with conditions such as: what kidney condition? a buildup of what in the body? what eating habit? diabetic or alcoholic _______________. severe _________________. poisoning by certain _______________. 4. Symptoms of metabolic acidosis include: what type of breathing? what 2 GI symptoms? pain where? what occurs to strength? what level of arousal? what occurs to potassium levels? what occurs to the heart? 5. If left untreated metabolic acidosis can result in what? 6. What are 2 things that need to be done immediately for treatment? 7. What needs to be administered to the patient for metabolic acidosis?

1. acid gain or bicarbonate loss 2. less than 7.35 3. kidney failure, lactic acidosis (lactic acid buildup), starvation, diabetic or alcoholic ketoacidosis, severe diarrhea, poisoning by certain toxins 4. hyperventilation, vomiting or diarrhea, headache, weakness, malaise, hyperkalemia, cardiac arrhythmia 5. coma and death 6. treat the cause and fix any electrolyte disturbances 7. sodium bicarbonate

Erosive Gastritis: 1. Is this considered acute or chronic? 2. Etiology of erosive gastritis includes bleeding from the gastric mucosa secondary to what feeling? what drug? use of what substance? what type of infection? what type of injury? 3. Symptoms of erosive gastritis include: what going on with digestion? what GI symptoms? throwing up what? 4. Is the patient always symptomatic? 5. Treatment includes what 2 things? 6. What type of procedure might be required if the bleeding continues?

1. acute gastritis 2. secondary to stress, NSAIDs, use of alcohol, viral infection, direct trauma 3. dyspepsia (indigestion), nausea/vomiting, vomiting blood (hematemesis) 4. no sometimes they are asymptomatic 5. removal of the stimulus of the disease process and pharmacological intervention 6. surgery

Healing By Intention: Primary Intention 1. This type of healing most commonly occurs in acute or chronic wounds with minimal or moderate-maximal tissue loss? 2. What types of edges are ideal for primary intention healing? 3. What is done to the wound edges in primary intention healing? 4. Is there a lot of scarring that occurs when wounds heal via primary intention? 5. What are 2 types of wounds that typically heal via primary intention?

1. acute wounds with minimal tissue loss 2. smooth clean edges 3. they are reapproximated and closed with sutures, staples, or adhesives 4. minimal scarring 5. superficial or partial thickness wounds

Prostate Cancer: 1. What is the most common type of prostate cancer? 2. Prostate cancer typically affects men of what age? 3. What is the prognosis? 4. There is an approximate ________% fatality from this diagnosis. 5. Risk factors include increased _________, high __________ diet, _______________ predisposition, what ethnic descent, and exposure to ________________. 6. Most times this is asymptomatic until cancer reaches the advanced stages. Symptoms include urinary ________________, pain, urgency, and decreased _________________ of urine. 6. Treatment includes surgical __________________ of the prostate, and what 2 other things? Is chemo an option? 7. This can metastasize to what 4 regions?

1. adenocarcinoma 2. over the age of 50 3. good 4. 10% 5. increased age, high fat diet, genetic predisposition, African American descent, exposure to cadmium 6. urinary obstruction, pain, urgency, and decreased flow of urine 7. MSK system, lungs, lymph nodes, bladder

Colorectal Cancer: 1. What are 2 types of cancers that account for the majority of intestinal cancers? 2. Risk factors include increasing __________, history of ______________, what type of inflammation, what GI disease, family history, diet high in _________ and low in _____________. 3. The most prominent symptom is what? 4. What from the rectum is another prominent sign of colon cancer? 5. Other symptoms include: what level of arousal? what occurs to weight, what blood condition, overt rectal ____________. 6. What is typical treatment? What might be required?

1. adenocarcinoma or primary lymphoma 2. increasing age, history of polyps, ulcerative colitis, Crohn's disease, family history, or diet high in fat and low in fiber 3. change in bowel conditions 4. bright red blood 5. fatigue, weight loss, anemia, overt rectal bleeding 6. surgical resection of the tumor and potentially a portion of the bowel; colostomy

Oncology Risk Factors: 1. What with age? 2. Use of what 2 things? 3. Exposure to what pathogen? 4. What 2 types of influences? 5. What in diet? 6. What feeling? 7. What type of behavior?

1. advanced age 2. alcohol or smoking 3. viral exposure 4. environmental or occupational hazard 5. poor diet 6. stress 7. sexual behaviors

Factors That Affect Pharmacokinetics: 1. As age increases, what happens to incidence of adverse drug reactions? 2. Dosages are typically based on a ________ lb individual. 3. Diseae of what 2 organs can result in reduced ability to metabolize or eliminate a drug and may cause toxic effects. 4. Viral infections can affect a drug's __________________ by exerting a negative effect on enzymatic activity. 5. Taking aspirin may reduce the effectiveness of what medication? (antagonistic effect) 6. Taking what type of medication while also drinking alcohol may result in excessive CNS depression? (synergistic effect) 7. The presence of what in the stomach can slow the rate of absorption of a drug? 8. What is a commonly identified drink that affects enzyme activity in the GI tract and changes the metabolism of certain drugs?

1. adverse drug reactions increase 2. 150 lb individual 3. liver or kidneys 4. half-life 5. diuretics 6. sedatives 7. food 8. grapefruit juice

Scar Management: 1. What causes hypertrophic scarring? 2. Complications of hypertrophic scarring include: what in muscles? what 3 things in the skin? what in every day life limitations? 3. What are 2 things used to quantify scar characteristics? 4. What are 7 general characteristics of scars that should be documented? 5. What intervention is used to loosen adhesions? 6. Reported benefits of friction massage include increased __________________ and decreased __________________. 7. Caution should be taken not to begin scar massage too soon or too aggressively due to the risk of causing re-injury or re-initiating what? 8. Massage techniques should be ____________ and _____________ using perpendicular, parallel, circular, and/or rolling strokes to mobilize tissue layers. 9. What can be used to reduce hypertrophic scarring? 10. Compression garments are recommended for any burn that takes how long to heal?

1. an imbalance between collagen synthesis and lysis during the healing process 2. contractures, hypersensitivity/adhesions/cosmetic issues, functional limitations 3. tonometer and rating scales 4. sensation, location, pigmentation, texture, height, pliability, vascularity 5. friction massage 6. increased pliability and decreased sensitivity 7. re-initiating the inflammatory phase of healing 8. slow and firm 9. compression garments 10. for any burn that takes longer than 14 days to heal

Ulcerative Colitis: 1. This is what type of disease? 2. This results in chronic inflammation and formation of ____________ in the GI tract. 3. Where specifically is the inflammation that makes it different than Crohn's disease? 4. What is the cause? 5. S/S may include _____________ pain and cramping, what type of BM, what in the stools, _____________ to defecate, what happens to weight, what level of arousal is common, what body temp? 6. Symptoms are often intermittent and alternate between what 2 periods? 7. Because it is considered an autoimmune disease what are 3 other common issues? 8. What are 3 other conditions that need to be ruled out?

1. an inflammatory bowel disease 2. ulcers 3. in the large intestine, usually in the sigmoid colon or rectum 4. idiopathic, but is believed to be an autoimmune disease triggered by a specific bacteria or virus and it also is believed to have a genetic component 5. abdominal pain and cramping, diarrhea, blood in the stools, urgency to defecate, weight loss, fatigue, fever 6. exacerbation and remission periods 7. vision issues, skin issues, arthritis (joint issues) 8. diverticulitis, irritable bowel syndrome, crohn's disease

Chemo Related Altered Blood Counts: 1. What are 3 conditions that are commonly found in a complete blood count after chemo? 2. Anemia refers to low levels of what 2 things in the blood? Symptoms of anemia (low H/H) include: what with breathing? what in the heart? what feeling in the head? Patients who are anemic are advised to change positions ____________, rest _______________ during activity, and allow themselves a full nights ______________. 3. Thrombocytopenia refers to platelet levels that are ________. These patients ________________ very easily. Other symptoms include: what found on the skin? what in the gums? what in the stool? what from the nose? Patients with thrombocytopenia are advised to consult with their PCP before taking any OTC meds like what 2 things? Other precautions include avoiding what type of sports? working with what type of objects? what type of clothing? 4. Neutropenia refers to a neutrophil count that is _________ placing a patient at serious risk for what? This can be classified as what 3 things? In hospitals, patients with neutropenia will get what?

1. anemia (low hematocrit and hemoglobin), thrombocytopenia (low platelets), and neutropenia (low neutrophils) 2. hematocrit and hemoglobin; dyspnea, heart palpitations, and dizziness; change positions slowly, rest frequently during activity, and allow themselves a full nights sleep 3. low; bruise very easily; petechiae (red bumps), bleeding in the gums, black or bloody stool, blood coming from the nose (epistaxis); aspirin or ibuprofen; avoiding contact sports; working with sharp objects; tight clothing 4. low; serious risk for infection; mild, moderate, or severe; their own private room and staff must wear precautions when entering to avoid giving the patient any infection

Diastasis Recti: Diagnosis 1. This is typically the result of __________________ directed sustained internal pressure which weakens and can split the linea alba which is connective tissue between the two sides of the rectus abodminus. 2. Where does the linea alba run and what is it's function?

1. anteriorly directed pressure 2. from the xiphoid process to the pubic symphysis and connects the right and left RA

Oncology Pharmacological Management: Heavy Metal Compounds 1. These are used as ____________________ agents that are also known as ______________ ________________ complexes. 2. These act as ____________________ agents that inhibit DNA translation and replication. 3. What are 4 forms of cancer that are treated with heavy metal compounds? 4. What is the ending suffix most commonly given to heavy metal compounds? 5. What are 3 examples of heavy metal compounds?

1. antineoplastic; platinum coordination complexes 2. alkylating agents 3. bladder, testicular, ovarian, and epithelial cancers 4. "tin" 5. Platinol (cisplatin), Paraplatin (carboplatin), and Eloxatin (oxaliplatin)

Psychological Disorders: Personality Disorders 1. What are 4 types of personality disorders? 2. Antisocial Behavior: Do these patients have concern for others? What do these patients often blame their actions on? Symptoms are typically seen before what age? What do these patients violate? What are 2 things these patients lack? 3. Borderline Behavior: These patients demonstrate what in all aspects of life? Can these patients identify themselves from others? What are 4 moods or behaviors they often project? What type of anger do they project? These patients feel chronic feelings of what? 4. Narcissistic Behavior: Are these patients capable of loving others? What is their personality like? What do they have an unrealistic perception of? 5. Psychopathic Personality: These patients typically have what in regards to morality? What do they have in terms of responsibility? Do they typically respect others? These patients have impulsive behavior for what? Do these patients often feel guilt or remorse for their actions? Are they able to alter their behavior? Are they good at lying?

1. antisocial, borderline, narcissistic, and psychopathic 2. typically; institutions like school; before age 16; violate the rights of others; responsibility and emotional stability 3. instability; yes; projection/denial/defensiveness/unpredictable mood; intense and uncontrolled anger; emptiness 4. no; self absorbed and obsessed with success and power; self importance 5. low morality; poor sense of responsibility; no; for immediate gratification; little; no even with punishment; expert liar

Rehab Considerations for Patients with Metabolic Bone Disease: 1. As a PT you must be aware of any signs of what? 2. PT interventions should focus on what 2 things?

1. any signs of fracture 2. endurance and strength training

GI System Anatomy: Lower GI Tract Large Intestine: 1. What are the 6 parts of the large intestine? 2. The large intestine continues to absorb what 2 things? 3. The large intestine stores undigested food as what?

1. ascending colon, transverse colon, descending colon, sigmoid colon, rectum, anus 2. water and electrolytes 3. feces

Arterial Insufficiency Ulcers: Diagnosis 1. These typically occur due to the presence of what? 2. A superficial arterial ulcer involves damage to what structure? 3. A partial-thickness ulcer involves damage to what? 4. A full thickness ulcer involves damage to what?

1. atherosclerosis (PAD) or arterial embolism 2. epidermis 3. epidermis and part of the dermis (papillary dermis) 4. epidermis, dermis, and part of the subcutaneous fat

Neuropathic Ulcer: Diagnosis 1. These typically develop due to a combination of what 3 things? 2. These occur most frequently in what population? 3. A superficial ulcer involves what layer? 4. A partial thickness ulcer involves what layers? 5. A full thickness ulcer involves what layers? 6. Damage from a subcutaneous ulcer extends through what?

1. atherosclerosis, peripheral neuropathy, and pressure 2. diabetic population 3. epidermis 4. epidermis and part of the dermis 5. epidermis, dermis, and into the subcutaneous fat 6. through all layers exposing deeper tissue layers like muscle, tendon, and bone

Metabolic Alkalosis: Diagnosis 1. This typically results from inadequate excretion of _________________, ingestion of large amounts of __________________, or excessive excretion of ____________________. 2. What is typically the cause of inadequate bicarbonate excretion? 3. Metabolic alkalosis due to excessive H+ excretion is most commonly caused by what 3 things? 4. Is this a disease in itself or a symptom of another disease?

1. bicarbonate, bicarbonate, hydrogen ions 2. renal dysfunction 3. nasogastric suctioning, vomiting, using diuretics 4. symptom of another disease

GI System Terminology Continued: 1. Jaundice is caused by increased levels of __________________ in the blood. 2. What is a laparoscopy? 3. What is the mesentery? 4. What is paracentesis? 5. What is a stoma? 6. What are varices?

1. bilirubin 2. a surgery through the abdominal wall to view the organs 3. a fold of the peritoneum that carries blood vessels and lymph glands and attaches a lot of organs 4. removal of fluid from the abdomen 5. an artificial opening of the intestine through the abdominal wall 6. large swollen veins that develop in the esophagus or stomach often causing internal bleeding

Tinea Pedis: 1. What is another name for this condition? 2. What is tinea pedis? 3. The fungus that causes this is ___________________ and will rapidly multiply in what type of environment? 4. Risk factors for developing this include: wearing what types of shoes? prolonged periods of what environment for your feet? possessing small abrasions where? 5. Is this condition contagious? How is it spread? 6. S/S include: what feeling? what color? what occurs between the toes? is this painful? does it smell? in more severe cases what can occur in the skin? 7. What is typical treatment? 8. Prevention of tinea pedis includes: doing what to your feet after bathing or swimming? wearing what type of shoes around public pools or showers? changing _____________ frequently? proper hygiene. avoiding shoe wear that creates what type of environment?

1. athlete's foot 2. a fungal infection which causes epidermal thickening and a scaly skin appearance 3. opportunistic and rapidly multiples in a moist warm environment (like between the toes) 4. wearing closed toed shoes, prolonged periods of moisture or wetness, in your feet skin or nails 5. yes, spreads through direct contact 6. itchiness, redness, peeling of skin, painful, smells, skin breaks 7. topical or oral antibiotics 8. thoroughly drying, wearing sandals, socks, moist and warm environments

Integumentary System Anatomy & Function: 1. What are the 3 layers of the integumentary system? 2. What are 3 characteristics of the dermis? 3. What are the 5 main functions of the integ system? 4. Where are free nerve endings located? 5. What makes up the hypodermis? 6. What are 2 things located on the epidermis? 7. What muscles are located in the dermis? 8. What is the innermost layer of the epidermis? 9. What functions to protect the skin? 10. What is secreted by sebaceous glands to protect the hair shaft? 11. What layer of skin holds the sebaceous glands?

1. avascular superficial epidermis and well vascularized dermis known as the true skin is in the middle, followed by the hypodermis being the bottommost layer 2. flexible, tough, elastic 3. protection, sensation, vitamin D synthesis, sweat excretion, and thermoregulation 4. in the hypodermis 5. subcutaneous fatty tissue 6. hair shafts and sweat ducts 7. arrector pili muscles 8. basal layer 9. hair 10. oil 11. dermis

Irritable Bowel Syndrome: Diagnosis 1. The exact etiology is unknown but some theories include that there is an overgrowth of _______________ in the __________ intestine and altered signaling between what 2 structures? 2. Triggers for this condition include what 3 things? 3. IBS most commonly affects what structure? 4. The walls of the intestines are lined with muscle layers which contract and relax to pass food. When the contractions are longer or stronger than normal, what 2 symptoms may occur? When the contractions are too weak, stools may become what? 5. What makes IBS different than Crohn's disease or ulcerative colitis?

1. bacteria in the small intestine; the brain and GI tract 2. food, stress, illness 3. the large intestine 4. flatulence and bloating; stools become hard and dry and constipation occurs 5. IBS does not result in structural changes to the intestines

Skin Cancer: 1. What are 2 types of skin cancer? 2. Basal Cell Carcinoma: Is this rapid or slow growing? Does this metastasize? It originates from the ________________. ______________ exposure is a common cause with risk factors including frequent sun exposure, __________ eyes, or _____________ skin. S/S can include ___________ sores that can bleed or crust and remain for __________ or more weeks, ___________ patches of skin, a _____________ bump on the skin that is often pink, or a _______-like area that has _______________ defined borders. Prognosis is good or bad? What is required to remove this? 3. Malignant Melanoma: This originates from ___________________ and can be classified as what 4 forms? Peak incidence is between what age? What is vital to a good prognosis? Does it metastasize quickly? Areas of metastasis include what 5 regions? A history of ______________ sunburns before age 20, family history, what in the immune system, __________ eyes, ____________ skin, and a previous history of __________ are all risk factors. S/S include lesions that are ________________ on the surface of the skin and appear ___________________ or ___________. Other symptoms include asymmetry, irregular borders, _______________ color, and a diameter greater than ____________ millimeters. This is 100% curable with early diagnosis and can be excited out, otherwise requires combination therapies.

1. basal cell carcinoma and malignant melanoma 2. slow growing, rarely metastasizes, originates from the epidermis; Sun, light eyes, or fair skin; open sores that can bleed or crust and remain for 3 or more weeks, red patches of skin, a shiny bump on the skin that is often pink, or a scar-like area that has poorly defined borders; prognosis is good; surgical excision 3. melanocytes; superficial spreading, nodular, lentigo maligna, or acral lentiginous melanomas; 40-60 years old; early diagnosis; metastasizes quickly; skin, lungs, liver, bone, brain; blistering sunburns, family history, immunosuppression, light eyes, fair skin, and a previous history of cancer; lesions that are raised on the surface of the skin and appear hyperkeratotic or scaly; varied color, and a diameter greater than 6 mm

Management Guidelines and Precautions for High Risk Pregnancies: 1. Medical intervention for high risk pregnancies is focused on prevention of preterm delivery through what 3 things? 2. What position is the position of choice for patients that are high risk pregnancies? This is because it reduces pressure on the _________________ _____________________ ____________________, maximizes _______________ __________________ to enhance maternal and fetal circulation, and reduces the risk of _____________________ _______________. 3. What types of exercises can stimulate uterine contractions? Should PT discontinue these? 4. You should have your patient avoid the ____________ maneuver by discontinuing activities that increase intra-abdominal pressure. 5. What are 3 things that need to be reported immediately when working with pregnant women?

1. bed rest, activity restrictions, and medications 2. left sidelying; reduces pressure on the inferior vena cava, maximizes cardiac output; and reduces risk of incompetent cervix 3. abdominal contractions; the therapist can either modify or discontinue 4. valsalva 5. bleeding, amniotic fluid loss, or uterine contractions

Pharmacological Psychiatric Management: Sedative-Hypnotic Agents 1. What are 2 forms of sedative-hypnotic agents? 2. Sedative agents produce a _______________ and ___________________ effect while hypnotic agents induce _________________. 3. Benzodiazepines have properties to promote sleep through increasing ________________ effects at the CNS synapses where ____________ is found. 4. Non-benzodiazepines include __________________ and other drugs that also provide CNS depression through the inhibitory effects of _________. 5. What are 3 indications for use of sedative-hypnotic agents? 6. Side effects of sedative-hypnotic agents include: what level of arousal? decreased ___________________ performance. what occurs to memory? can dependency form? what can occur with withdrawal? 7. What form of these agents is highly addictive and can be fatal? 8. When patients are on this type of agent what are they at an increased risk for? 9. What are 2 examples of benzodiazepines? 10. What are 3 examples of non-benzodiazepines?

1. benzodiazepines and non-benzodiazepines 2. calming and relaxing effect; sleep 3. inhibitory; GABA 4. barbiturates; GABA 5. anxiety, preoperative sedation, and insomnia 6. drowsiness, decreased motor performance, anterograde amnesia, yes dependency can form, rebound insomnia with withdrawal 7. barbiturates 8. increased risk of falls 9. halcion and dalmane 10. luminal (phenobarbital), sonata, and ambien

Urinary Stress Incontinence: Management of Symptoms 1. PT intervention for pelvic floor muscle weakness tested as 0/5-2/5 includes: what 2 modalities? what type of retraining? Pelvic floor muscle strengthening at this level includes facilitation and tapping of what muscles? Overflow exercises using what muscles? (3) You should implement what specific type of exercises? 2. PT intervention for pelvic floor muscle weakness tested as 3/5-5/5 includes continued biofeedback and bladder retraining, what is used for resistance training? implementation of pelvic floor muscle exercises during what? 3. Patients are encouraged to perform pelvic floor strengthening exercises when?

1. biofeedback and estim, bladder retraining, facilitation and tapping of pelvic floor muscles, overflow exercises using the butt/adductors/and lower abdominals, kegel exercises 2. weighted vaginal cones; during activities 3. throughout the day or when they come across a trigger that could increase intra-abdominal pressure

Psychological Disorders: Affective Disorders 1. What are 3 types of affective disorders? 2. With affective disorders, the patient goes through what types of phases? 3. Bipolar Disease: What gender is at greater risk of getting this? When does this disease typically begin? 4. Depression: This is when the patient presents with _____________ mental and physical activities. What can happen in severe cases? 5. Mania: This is when the patient is constantly ___________. What is immediately expressed? What type of activity is usually expressed? How does one feel about themselves when they are in a manic phase? If you as a PT disagree with someone in a manic state what might occur? What occurs to one's thoughts and speech in this phase?

1. bipolar, manic, and depression 2. states of extreme happiness or sadness 3. females; in their 20s 4. decreased; delusions 5. active; impulses; unrealistic activity; elated and very self confident; it can result in patient aggression; disorganized

Malabsorption Syndrome: Confirming Your Patient Has This 1. What can occur to abdominal size? 2. What occurs with gas? 3. What occurs to the bowel structure? 4. What is typically present in the bowel that is one of the most prominent factors of diagnosing this condition? 5. What occurs to weight? 6. What occurs to strength? 7. Signs of nutrient deficiency include: what in the blood? what type of swelling? what occurring in muscles? what occurring with bleeding? 8. What test is the most reliable to diagnose this? 9. The condition should be strongly considered if the patient suffers from chronic _____________, _____________________ deficiencies, and significant ______________ ______________ despite a normal diet.

1. bloating 2. flatulence 3. diarrhea 4. fat presence in the bowel called steatorrhea 5. weight loss 6. weakness 7. anemia, edema, muscle cramps, excessive bleeding 8. stool sample to test for fat content 9. chronic diarrhea, nutritional deficiencies, and significant weight loss

Diverticulitis: 1. Symptoms of this condition include: what occurs to the abdomen? what type of pain? what going on in the bowels? 2. Treatment includes an increased amount of dietary fiber to how many grams per day? 3. What is the primary symptom of diverticulitis? 4. In more severe cases of diverticulitis, insertion of what type of tube may be required to give the intestines a break? 5. Surgery is indicated for what 3 things caused by diverticulitis? 6. Complications of diverticulitis include bleeding _______________, ______________ blockage, what type of formation, what 2 things in the colon? fistulas or peritonitis.

1. bloating, mild cramping, constipation or diarrhea 2. 20-35 grams per day 3. abdominal pain in the left lower quadrant 4. NG tube 5. severe obstruction, perforation, or necrosis 6. bleeding infections, intestinal blockage, abscess, perforations or tears in the colon, fistulas, or peritonitis

Leukemia: 1. This is a cancer of the _______________ that occurs when ____________________ change into malignant cells. 2. These immature cells proliferate, accumulate in the ______________________, and ultimately cease production of normal cells. 3. This process will spread to what 3 main regions? 4. Causative factors of leukemia include: exposure to what 3 things? what predisposition? what association? 5. What are 2 of the main types of leukemia in children? 6. S/S of leukemia include: slow or sudden onset? what body temp? what abnormal blood symptom? what becomes enlarged (2)? what occurs progressively? what level of arousal? what occurs to joints? 7. Blood work will indicate what blood disease? It will also indicate a leukocyte blood count higher than _____________________ and what with thrombocytes? 8. Options for treatment include what 4 things? 9. How many patients with ALL achieve complete remission with treatment? How many patients with AML achieve complete remission with treatment?

1. blood that occurs when leukocytes 2. bone marrow 3. liver, lymph nodes, spleen 4. exposure to toxins/environment/chemicals, genetic predisposition, or viral association 5. acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML) 6. sudden onset, high fever, bleeding, enlarged lymph nodes and spleen, progressive weakness, fatigue, painful joints 7. anemia, 500,000 mm^3, and thrombocytopenia (low platelets) 8. immunotherapy, cytotoxic agents, chemo/radiation, or bone marrow transplant 9. 90% with ALL, 70-80% with AML

HIV: Contributing Factors 1. HIV is transmitted through what? 2. Risk factors for contracting HIV include _________________ sexual relations, _____________ drug use, or mother to __________ transmission. 3. The largest risk factors for HIV transmission are _________________ sex and _____________ drug use with a shared needle.

1. body fluids (parenterally) 2. unprotected sexual relations, IV drug use, or mother to fetus transmission 3. unprotected sex and IV drugs

Osteoporosis: 1. This is a metabolic condition with a decrease in ___________ ______________ that subsequently increases the risk of fracture. 2. Osteoporosis primarily affects what 2 types of bone where the rate of bone _______________ accelerates while the rate of bone _______________ declines. 3. Declining ________________ function coupled with the loss of ________________ and ___________________ will cause the bones to become brittle. 4. Primary osteoporosis can include what 3 things? 5. Secondary osteoporosis can result from another primary condition or from certain ____________________. 6. Symptoms include: compression and other bone _____________, low ________________ or _______________ pain, loss of lumbar _________________, deformities such as _______________, what does it do to height, what can form in the upper back, and postural changes. 7. Treatment of osteoporosis includes what 2 interventions?

1. bone mass 2. trabecular and cortical; resorption; formation 3. osteoblast; calcium and phosphate 4. idiopathic, post-menopausal, or senile 5. medications 6. fractures; thoracic or lumbar; lordosis; kyphosis; decreases height; dowager's hump (rounding of upper back); postural changes 7. pharmacological and vitamin supplementation

Endocrine Pharmacological Management: Bone Mineral Regulating Agents 1. What are 3 specific endocrine medications commonly administered to patients? 2. Bone Mineral Regulating Agents: What do these do for bone mass? What do these prevent in bones? Typical agents can include what 5 things? What 4 bone diseases can be an indication for bone mineral regulating agents? What 2 hormone imbalances can be an indication for bone mineral regulating agents? 3. Side effects of bone mineral regulating agents include: what going on in the GI tract? what going on with swallowing? what appetite? pain where? what in the heart? 4. Patients with bone mineral deficits are at risk for _______________ and side effects from drug therapy so PTs need to keep this in mind. What are 2 ways patients must attempt to augment drug therapy? 5. What is an example of an estrogen that is a bone mineral regulating agent? 6. What are 2 examples of forms of calcium and vitamin D that are bone mineral regulating agents? 7. What are 2 examples of bisphosphonates that are bone mineral regulating agents? 8. What is an example of a calcitonin bone mineral regulating agent?

1. bone mineral regulating agents, hormone replacing agents, and hyperfunction agents 2. enhance and maximize bone mass; these prevent bone loss; estrogen, calcium and vitamin D, bisphosphonates, calcitonin, and anabolic agents; Paget's disease, osteoporosis, rickets, osteomalacia; hypo or hyperparathyroidism 3. GI distress; dysphagia; anorexia; bone pain; cardiac arrhythmia 4. fractures; ambulation and weight bearing 5. Premarin (conjugated estrogen) 6. Tums (calcium carbonate) and Calderol (calcifediol) 7. Fosamax (alendronate sodium) and Boniva 8. Cibacalcin (human calcitonin)

Neuropathic Ulcer: Contributing Factors 1. Peripheral neuropathy impacts sensory or motor function which contributes to the development of ulcers? 2. Motor neuropathy causes weakness in what muscles that contribute to neuropathic ulcers typically? 3. What is most often the most significant contributing factor to ulcer development?

1. both sensory and motor function is impaired 2. weakness in the foot intrinsic muscles (allowing the forefoot to splay during weight bearing and alters fit of footwear) and muscles of the lower leg/ankle/foot (causing decreased coordination) 3. loss of protective sensation (impairing the patient's ability to detect discomfort)

Non-Selective Debridement: 1. Does this remove viable or non viable tissue? 2. What is a common term used for non-selective debridement? 3. What are 3 of the most common forms of non-selective debridement? 4. Wet-to-Dry: how is this applied? This is most commonly used on what type of wounds? This should be used sparingly on what type of wound? Removal of dry dressings from granulation tissue can cause _______________ and ________________. 5. Wound irrigation removes necrotic tissue from the wound bed using what? What is one of the most common wound irrigation systems used? This is most desirable for what 2 types of wounds? 6. Hydrotherapy is most commonly employed using what? What does this do? PTs must be aware of potential hydrotherapy side effects including what 3 things?

1. both viable and non viable tissue 2. mechanical debridement 3. wet-to-dry, wound irrigation, and hydrotherapy 4. apply a moistened gauze over an area of necrotic tissue then let it dry and remove it along with any necrotic tissue adhering to it; ones with moderate exudate and necrosis; use sparingly on wounds with both necrotic and viable tissue wounds because this can damage the granulation tissue; bleeding and pain 5. pressurized fluid; pulsatile lavage; infected wounds or ones with loose debris 6. whirlpool tank; softens and loosens adherent necrotic tissue; hypotension/edema from LEs being in a dependent position/maceration

Metabolic Alkalosis: Confirming Your Patient Has This 1. What breathing rate is typically observed as the body tries to regulate its acid-base balance by inducing respiratory acidosis through hypoventilation? 2. In patients with other pulmonary impairments, metabolic alkalosis can cause ______________________. 3. In severe cases, metabolic alkalosis can cause what neuro symptom? what involuntary movement in muscles? what mental status? what cardiac symptom? what potassium level? 4. What are 3 symptoms that the patient has hypokalemia from metabolic alkalosis? 5. Can this be fatal if left untreated? 6. Lab analysis of what 3 things can be used to identify abnormal alkalinity and differentiate between respiratory and metabolic alkalosis.

1. bradypnea 2. hypoxemia 3. seizure, tetany, altered mental status, arrhythmia, hypokalemia 4. weakness, myalgia, and polyuria 5. yes 6. ABG, electrolytes, and urine pH

Prostate Cancer Continued: 1. A family history of what 2 things increases one's risk? 2. It can metastasize to anywhere in the body but what are 2 regions that are especially affected? 3. Because of the prostate's position around the urethra, prostate cancer may result in difficulty urinating, what at night?, what in relation to sex?, what in the urine or semen?, pain in what 2 regions? 4. What is a blood test that is used to determine the presence of elevated levels of PSA which may indicate prostate cancer?

1. breast cancer or prostate cancer 2. lymph nodes and bones 3. nocturia, erectile dysfunction, blood in the urine or semen, low back or pelvic pain 4. prostate-specific antigen blood test

Rehab Considerations for Patients with IBS: 1. What type of techniques should you emphasize to decrease stress? 2. What type of training may be beneficial to these patients?

1. breathing techniques 2. biofeedback training

Topical Agents Used in Burn Care Continued: 1. Mafenide Acetate: What type of spectrum is this? What structure can this penetrate through? Does this require an occlusive dressing? What can occur to the metabolism? What can occur to respiratory system? What can occur to the healing process? Is this painful? 2. Gentamicin: What type of spectrum is this? Does this always need to be covered? What has this caused formation of? What can this cause in the ears? What can this cause in the kidneys? 3. Nitrofurazone: What pathogen does this kill off? What type of spectrum is this? What are 2 things this may lead to an overgrowth of? Is this painful to apply?

1. broad spectrum; can penetrate through eschar; may be used with or without an occlusive dressing; metabolic acidosis can occur; compromises respiratory function; this can inhibit epithelialization; painful application 2. broad spectrum; may be covered or left open to air; formation of resistant strains; ototoxic; nephrotoxic 3. bacteriocidal; broad spectrum; fungus and pseudomonas; painful application

Diarrhea: 1. This occurs with what 3 types of GI diseases? 2. This occurs with hyper activity of what gland? 3. This occurs with what type of imbalance? 4. This occurs with what type of disorder? 5. This occurs with what type of obstruction? 6. This occurs with intake of what? (3) 7. This occurs with what type of disease of the pelvis?

1. diverticulitis, irritable bowel syndrome, and malabsorption 2. hyperthyroidism 3. electrolyte imbalance 4. endocrine disorder 5. bowel obstruction 6. caffeine, certain medications, diet 7. pelvic inflammatory disease

Complex Regional Pain Syndrome: Confirming Your Patient Has This 1. What are 3 feelings that patient will have in the affected extremity? 2. Where do these feelings eventually spread? 3. When is the degree of pain greater than expected? 4. Symptoms in stage 1 or the acute stage of CRPS include: what change in size? what temp changes? what occurs to color? what occurs to texture? what occurs to skin hydration? 5. Progression to stage 2 CRPS is characterized by worsening and constant ___________, continued _______________, and ________________ skin changes. What is stage 2 called? X-rays reveal what 3 bone changes in the affected extremity? 6. Stage 3 is called what? This is characterized by pain that continues to _______________, ________________ edema, decreased limb _________________, and atrophic changes to the ____________________ and ________________. X-rays at this stage may reveal what 2 things in bones? 7. Motor disorders including what 3 things may be present throughout each stage of CRPS?

1. burning, intense, chronic pain 2. proximal 3. early in the syndrome 4. edema, thermal changes, discoloration, stiffness, skin dryness 5. worsening and constant pain, continued edema, and trophic skin changes (altered nail or hair growth); dystrophic stage; osteoporosis, subchondral bone erosion, and bone loss 6. atrophic stage; pain that continues to spread, hardening edema, decreased limb temperature, and atrophic changes to the fingernails and toes; demineralization and ankylosis 7. tremors, atrophy, and spasms

Osteoporosis: Contributing Factors 1. Risk factors include: inadequate dietary _____________, what bad habit, excessive intake of what 3 things?, ____________ stature, ________________ race, ________________ lifestyle, family history or history of ____________ disease. 2. Secondary osteoporosis may be caused by prolonged drug therapies of what 2 drugs? What type of disorders? what type of nutrition status? 3. Postmenopausal osteoporosis targets women approximately of what age? 4. Senile/involutional osteoporosis targets men and women of what age?

1. calcium; smoking; caffeine, alcohol, salt; small; Caucasian; sedentary; chronic 2. heparin or corticosteroids; endocrine disorders; malnutrition 3. 50-60 4. older than 70

Anatomic and Physiologic Changes Associated with Obesity: 1. What are 4 things that happen to the cardiac system? 2. What are 3 things that happen to the pulmonary system? 3. What happens to the kidneys? 4. What are 2 things that can happen to the genitourinary system? 5. What are 2 things that can happen to the integ system? 6. What are 5 things that can happen to the vasculature? 7. What diagnosis can form in the MSK system? 8. What are 2 diseases that can occur in the liver? 9. What can occur in the pancreas?

1. cardiomyopathy (heart failure), arrhythmias, atrial fibrillation, abnormal vascular hypertrophy 2. obstructive sleep apnea, hypoventilation syndrome, asthma 3. decreased perfusion 4. infertility or incontinence 5. hyperkeratosis or infection 6. vascular insufficiency, varicosities, increased total blood volume, altered stroke volume/cardiac output, hypertension 7. osteoarthritis 8. non-alcoholic fatty liver disease, non-alcoholic steatohepatitis 9. insulin resistance and type 2 diabetes

Pharmacology Effects on Other Systems Continued: 1. Adrenocorticosteroid Agents: Glucocorticoid drugs have ______________ effects that can lead to the breakdown in what 3 structures? These effects are more pronounced in patients that are of what age? of what lifestyle? of what nutrition habits? Therapists should be cautious with what interventions? What 2 things can be beneficial in decreasing the catabolic effects of these drugs? Both glucocorticoid and mineralocorticoid drugs lead to what that can contribute to hypertension? Therapists should therefore routinely monitor what? 2. Sex Hormone Replacement Therapy: These drugs lead to retention of what 2 substances? This can lead to what change in blood pressure? 3. Thyroid Agents: Patients with hypothyroidism symptoms may have decreased ________________ function and may not tolerate what? Supplementation of what may result in cardiac arrhythmias when used in excessive amounts? 4. Insulin Replacement Therapy: The therapist needs to monitor the patient for signs of what? What are 2 major signs of hypoglycemia? If the patient starts to experience this, what should the therapist do?

1. catabolic; muscle, tendon, bone; older age, inactive lifestyle, poor nutrition habits; aggressive stretching or strengthening; moderate strengthening and weight bearing activities; water retention which can cause hypertension; BP 2. salt and water retention; hypertension 3. decreased cardiac function and may not tolerate heavy workloads; calcium supplementation can cause arrhythmias 4. hypoglycemia; confusion or nausea; administer a source of glucose like orange juice

Psychological Disorders: Schizophrenia Disorders 1. What are 3 types of schizophrenia? This is typically a disorganization of thought, hallucinations, emotions, anxiety, and perception. Causative factors include trauma, genetics, biochemical imbalances, and environment. 2. Catatonic Schizophrenia: These patients experience __________ disturbances with __________ posturing. Episodes consist of uncontrolled movements, however is the patient aware during the episode? What is required to regulate episodes? 3. Disorganized Schizophrenia: Is this progressive? Is this reversible? What occurs to emotional responses? What occurs to talking? 4. Paranoid Schizophrenia: What are 2 things these patients will have delusions about? These patients may believe they have what?

1. catatonic, disorganized, and paranoid 2. motor; rigid; yes the patient is aware; medications 3. yes; no; inappropriate; mumbled talking 4. delusions of grandeur or persecution; special powers

Pharmacology Effects on Neuromuscular and Nervous Systems: 1. Antiepileptic Agents: These most commonly have what type of side effects? These can also cause specific skin conditions like what? You as a PT should be cautious when applying modalities that can possibly exacerbate what? 2. Skeletal Muscle Relaxants: Theses effects can be detrimental for patients who rely on ________________ to improve their function. What are 2 of the most common side effects? 3. Anti-Parkinson's Agents: Therapy sessions should be scheduled to coincide with maximum effectiveness of these drugs, which is when? Therapists should closely monitor what in the patient?

1. cerebellar side effects like ataxia; dermatitis; that can exacerbate skin conditions 2. spasticity; muscle weakness and sedation 3. one hour after taking levodopa; blood pressure because the patient is at risk for orthostatic hypotension

GU System Support Structures: 1. When the pelvic floor muscles are weak or have poor endurance due to pregnancy, trauma, surgery, repetitive straining or genetics, they are not able to support pelvic organs leading to prolapse. What are 5 organs that commonly prolapse? 2. Prolapse of organs can result in what 3 things?

1. cervix, uterus, bladder, intestines, and rectum 2. incontinence, urgency, or frequency

Systemic Lupus Erythematosus: Outcome 1. Overall prognosis for SLE is ___________ although in rare cases what can happen? 2. Death usually occurs due to what 2 things?

1. good although in rare cases the disease can remain acute and become fatal 2. kidney disease or secondary infection

Guidelines for Working with Oncology Patients: 1. If you are about to work with a patient has bone metastasis what should you do FIRST? 2. You should monitor a patient's blood values DAILY, especially what 2 lab values to ensure they are safe to participate in therapy activities. 3. Exercise should be conducted at a range of ________________% of peak HR, heart rate reserve, and VO2max or below the __________________ threshold. 4. During exercise, perceived exertion should remain below what level? 5. Treatment visits should be scheduled when?

1. check physician's orders and double check their weight bearing status and if they are appropriate for mobility activities 2. platelets and hematocrit 3. 40-65%; anaerobic 4. below a 12 5. when the patient feels they have the most energy

Full Thickness Burns: Contributing Factors 1. There is a higher risk for burns in children of what age as well as older individuals of what age? 2. Burns are currently the _____________ leading cause of accidental death in all age ranges. 3. Are burns more likely to occur in males or females?

1. children 1-5 years old and in those over the age of 70 2. third 3. males

Full Thickness Burns: Outcomes 1. Mortality rates are highest for children under age __________ and adults over age ___________. 2. Overall prognosis is dependent on factors such as what 4 things? 3. Without significant complication a patient should achieve independence in how long?

1. children under age 4 and adults over age 65 2. obesity, cardiovascular status, alcoholism, or peripheral vascular disease 3. a few months post injury

Non-Erosive Gastritis: 1. Is this acute or chronic gastritis? 2. This is considered type A or B gastritis? 3. This forms as a result of infection from what organism? 4. The patient is usually asymptomatic but will show symptoms if what happens? 5. H. pylori is a ________________ and must be treated aggressively. 6. Pharmacological intervention for non-erosive gastritis is the most common treatment method and includes what 2 things?

1. chronic 2. type B 3. helicobacter pylori (H. pylori) 4. if gastritis progresses 5. carcinogen 6. proton pump inhibitors and antibiotics

Hepatitis C (HCV): 1. This is one of the primary causes of what? 2. Transmission of hep c occurs through sharing of _______________, _______________________ with an infected person, exposure to an infected person's what 2 things, or what type of exposure from mom? 3. This virus accounts for ________ of post transfusion hepatitis cases. 4. Like hepatitis B, this virus is often asymptomatic and the acute infection is mild or severe? 5. Patients with hepatitis C have an increased frequency of complications or manifesting conditions including what 3 things? 6. Treatment may include the use of what to reduce inflammation and liver damage? Do all patients with hepatitis c benefit from this medication? 7. Is there any vaccine that prevents this virus? 8. Is there any immunoglobulin to fully treat the infection? 9. Chronic hepatitis occurs in 50% of cases and 20% progress to what?

1. chronic liver disease and eventual liver failure 2. sharing of needles, intercourse with an infected person, exposure to a person's body fluids, or mom-fetus exposure 3. 90% of post transfusion hepatitis cases 4. mild 5. diabetes, corneal ulcers, hashimoto's thyroiditis 6. interferon alfa-2b 7. no 8. no 9. 20% progresses to cirrhosis of the liver

Venous Insufficiency Ulcer: Contributing Factors 1. Diagnoses of what 2 things are commonly associated with venous insufficiency ulcers? 2. Patients who are _______________ are more likely to develop this type of a wound.

1. chronic venous insufficiency or venous hypertension 2. obese

Hemodialysis for Kidney Failure: 1. What does hemodialysis do for the patient? 2. A patient requires hemodialysis how often? 3. Side effects of hemodialysis include: what in the blood? what feeling? what occurs to sleep? What builds up in specific organs like the heart, kidney, and liver? what occurs to bones? 4. You need to recognize as a PT when working with these patients that they are at an increased risk for what 2 things to occur? 5. You should avoid placing the BP cuff over what area? 6. What types of activities are contraindicated during dialysis? 7. What are 2 good activities to teach patients?

1. cleanses the blood of excess salt, waste, and fluids 2. at least 3x a week for 3-5 hours each time 3. anemia, itching (pruritus), sleep disorders (restless legs), dialysis related amyloidosis (build up of protein), renal osteodystrophy (where kidneys cannot get enough calcium and phosphorous to bones) 4. hypotension and dehydration 5. over the fistula 6. mobility activities are contraindicated during dialysis 7. energy conservation and pacing

Exudate Classifications: IMPORTANT 1. Serous: what color is it? what consistency is it? is this considered normal or abnormal in a healing wound? this is observed during what 2 phases of wound healing? 2. Sanguineous: what color is it? what consistently is it? this occurs due to the presence of what? this may indicate what 2 things? 3. Serosanguineous: what color is it? what consistently is it? is this considered normal or abnormal in a healing wound? what 2 phases of wound healing is this observed? 4. Seropurulent: what color is it? what consistency is it? this may be an early warning sign of what? is this considered normal or abnormal? 5. Purulent: what color is it? what consistency is it? this is generally an indicator of what? is this normal or abnormal?

1. clear and light; thin and watery; normal; inflammatory and proliferative 2. red; thin and watery; blood which may brown if dehydrated; new blood vessel growth or blood vessel damage 3. light pink or light red; thin and watery; normal; inflammatory and proliferative phases 4. opaque and cloudy tan or yellow; thin and watery; early warning sign of infection; ALWAYS abnormal 5. yellow or green; thick and viscous; infection; ALWAYS abnormal

Abdominal Pain in the Left Lower Quadrant: 1. What going on in the colon can refer pain to left lower? 2. Inflammation in what structure can refer pain to left lower? 3. What type of diverticulitis can refer pain to left lower?

1. colon perforation 2. ileitis (inflammation of the ileum) 3. sigmoid diverticulitis

Systemic Lupus Erythematosus: Diagnosis 1. This is a ________________ tissue disorder caused by an ________________________ reaction in the body. 2. The primary manifestation of lupus is the production of destructive ___________________ that are directed at the individual's own body. The chronic inflammatory disorder produces a variety of symptoms depending on the severity and extent of involvement.

1. connective; autoimmune 2. antibodies

Oncology Pharmacological Management: Hormones 1. These are used specifically for what type of cancers? 2. What are 2 things that can occur in women as side effects? 3. What type of effects in general do these medications cause? 4. What are 3 examples of hormones used to treat oncology?

1. hormone sensitive neoplasms 2. masculinization or hot flashes 3. catabolic effects 4. Nolvadex, Lupron, and Casodex

Diastasis Recti: Management of Symptoms 1. Is typical treatment conservative or surgical? 2. Muscle support to what muscle is often necessary? 3. A gentle progression of corrective abdominal exercises can start how soon after birth? 4. Patients should be instructed to use their hands or other external assistance like a towel or bed sheet wrapped around the abdominals to facilitate what? 5. The approximation of the abdominal muscles during exercise encourages what? 6. What exercise should be avoided until healing has reduced the separation to less than 2 fingers? 7. What 2 exercises should be avoided until there is no separation? 8. While healing, the patients should avoid what functional mobility? 9. In severe cases, surgery may be warranted to prevent complications associated with what? 10. What device may be recommended to assist in maintaining approximation of the healing abdominal muscles and to provide lumbar support? 11. What types of activities at home should be limited?

1. conservative 2. muscle support to the abdominals 3. can start 24 hours after delivery 4. to facilitate abdominal muscle approximation 5. encourages proper anatomical and mechanical healing in the correct position 6. abdominal crunches 7. rotational exercises and double leg lifts 8. supine to long sit should be avoided 9. abdominal herniation 10. abdominal binder 11. heavy lifting

Partial Thickness Burns: Examination 1. What are 3 complications of these types of burns? Do these complications occur in both superficial and deep partial thickness burns?

1. contractures, infection, scarring - only in deep partial thickness burns are these an issue

Psychological Disorders: Somatoform Disorders 1. What are 3 types of somatoform disorders? 2. Conversion Disorder: What is this? What is the most common symptom? What are 3 other common symptoms? Freud believed this is what transformed into physical symptoms? Diagnosis can be made once testing is ______________ for all physical ailments. 3. Hypochondriasis Disorder: What is this? 4. Somatization Disorder: This occurs mostly in what gender? Does this have familial associations? Is this chronic and long lasting? What does the patient typically complain of? What diagnosis does this resemble?

1. conversion disorder, hypochondriasis, somatization 2. physical complaints of neuro basis with no underlying cause; paralysis; deafness, blindness, paresthesia; mental anxiety transformed into physical; negative 3. females; yes; yes; symptoms with no physiological basis; hypochondriasis

Cellulitis: Contributing Factors 1. What are 2 medications that can place the patient at high risk for cellulitis because their immune system is decreased? 2. What are 2 medical diagnoses that can place the patient at high risk for cellulitis because their immune system is compromised? 3. What are 3 examples of diagnoses that will impair blood or lymphatic flow and place the patient at higher risk for getting cellulitis?

1. corticosteroids or chemotherapy 2. HIV or leukemia 3. venous insufficiency, obesity, lymphedema

Factors Influencing Wound Healing: 1. Age: what are 2 things that occur that cause poor healing of wounds? 2. Comorbidities: What 3 diagnoses can delay wound healing? 3. Edema: increased tissue pressure from excessive edema such as with what 2 conditions can negatively impact tissue perfusion and removal of cellular waste? 4. Harsh Wound Care: The use of what 4 things can impair healing by causing further damage to peripheral and granulating tissues? 5. Wound infection negatively impacts the _______________ processes necessary for wound healing. 6. What are 2 things in every day life that can facilitate wound healing? 7. What can dramatically impede wound healing in every day life? 8. What are 5 forms of pharmacological agents that negatively impact wound healing? 9. The 5 forms of medications in #8 can cause poor or prolonged __________________ response, reduced ______________ supply, delayed ____________ synthesis, and decreased ______________ strength of repaired tissues. 10. What are 3 factors about being obese increase your risk for poor skin health?

1. decreased metabolism and epidermal thinning and flattening 2. diabetes, cardiopulmonary disease, vascular conditions 3. venous insufficiency or lymphedema 4. vigorous wound irrigation, aggressive debridement, prolonged whirlpool exposure, or use of harsh cleansing techniques 5. restorative 6. physical activity and good nutrition 7. smoking 8. anti-inflammatory, anti-coagulant, anti-neoplastics, immunosuppressive, steroids 9. inflammatory; blood; collagen; tensile 10. skin folds that cause moist and warm environments, increased skin tension, and poor periwound skin quality

Pressure Ulcers continued: 1. What is another name for pressure ulcers? 2. These result from sustained and prolonged pressure on tissues at levels greater than ______________ pressure. 3. Pressure injuries to deeper tissues may initially present as what? 4. What is a stage 2 pressure injury considered partial vs. full thickness wound? What about stage 3 pressure injury?

1. decubitus ulcers 2. capillary pressure 3. bruises or purple blisters 4. stage 2 is partial thickness; stage 3 is full thickness

Chronic Fatigue Syndrome: Management of Symptoms 1. Medical management will attempt to reestablish homeostasis for any systemic abnormalities contributing to this condition (sleep apnea, metabolic conditions, etc.). PT interventions may include relaxation techniques including what 2 things? 2. Patients with CSF have a low tolerance for what? 3. Avoidance of exercise does what to symptoms? 4. Exercise should start with ___________ level __________ duration sessions. A gradual progression of regular exercise is beneficial especially with improving tolerance for moderate daily activities. 5. Complementary therapies such as what 4 things may provide patients with alternative methods to address exercise and relaxation goals.

1. deep breathing exercises and biofeedback 2. low tolerance for exercise 3. symptoms worsen 4. low level short duration sessions 5. massage, tai chi, yoga, or acupuncture

Full Thickness Burns: Confirming Your Patient Has This 1. These are characterized by a variable appearance with what 3 potential colors? 2. What necrotic tissue forms that requires debridement? 3. What is present at the site of injury and in the surrounding tissue? 4. Does an area of full thickness burn have sensation or pain? Why? 5. During the initial stages after a full thickness burn, what occur to thermoregulation? breathing? electrolyte levels? urine excretion? level of consciousness? 6. Blood work should include what 6 things? 7. What are 2 things for the lungs that may be indicated to assess airway damage and pulmonary insufficiency? 8. What are 2 tools used to grossly approximate the percentage of the body affected by a burn?

1. deep red, white, or black 2. eschar 3. edema 4. there is no sensation or pain in a full thickness burn because free nerve endings are destroyed however adjacent areas that may have a partial thickness burn can be painful 5. impaired thermoregulation, shortness of breath, electrolyte disturbances, poor urine output, variation in level of consciousness 6. arterial blood gas, creatinine, bilirubin, blood urea nitrogen, complete blood count, and electrolytes 7. pulmonary function test and bronchoscopy 8. lund-browder charts and rule of nines

Osteomalacia: 1. This is a metabolic condition where bones become soft secondary to a deficiency in 1 of what 2 things? 2. Is there an adequate bone matrix in osteomalacia? 3. There is insufficient ____________________ of the bone matrix due to the deficiency in calcium or phosphorous. 4. Calcium is typically lost secondary to inadequate __________________ _______________________. 5. Phosphorous is lost secondary to an increase in ________________ __________________. 6. A deficiency in what vitamin will also cause osteomalacia. 7. Symptoms of osteomalacia include: what type of pain? what level of arousal? what occurs to weight? what occurs to muscles? what occurs to sensation? where does pain and tenderness occur? what type of deformity can form in the spine? what type of deformity can form in the LEs? 8. Sometimes the patient can struggle to perform transfers because it is difficult to assume what position? 9. What is recommended for treatment?

1. deficiency in calcium or phosphorous 2. yes 3. calcification 4. intestinal absorption 5. renal excretion 6. vitamin D deficiency 7. aching, fatigue, weight loss, myopathy, sensory polyneuropathy, periarticular pain and tenderness, thoracic kyphosis, bowing of the LEs 8. standing 9. increased nutrition with vitamin D or phosphate supplements

GI Pharmacological Agents: Antidiarrheal Agents 1. These are used to slow the serious debilitating effects of ___________________ associated with prolonged diarrhea. 2. What are 2 major side effects of antidiarrheal agents? 3. Does a patient taking antidiarrheal agents typically interfere with PT? 4. What are 5 examples of antidiarrheal agents?

1. dehydration 2. abdominal discomfort or constipation 3. no 4. Motofen (difenoxin), Imodium (ioperamide), Pepto Bismol (bismuth subsalicylate), Donnagel (attapulgite), and Kapectolin (kaolin)

Healing by Intention: Tertiary Intention 1. This type of healing may also be referred to as what? 2. Wounds at risk for developing ______________________ typically heal through tertiary intention. 3. What are 2 common complications in wounds that cause tertiary intention to be the technique for healing? 4. What occurs when wounds heal via tertiary intention?

1. delayed primary intention healing 2. complications 3. dehiscence or sepsis 4. they are left open until the complication is dissolved then they are closed via primary intention

Eczema: 1. What is another name for eczema? 2. What is eczema? 3. What are 3 common causes of eczema? 4. What 2 populations are at higher risk for eczema? 5. Can children outgrow eczema with age? 6. What population other than infants and children are also at an increased risk for developing this? 7. S/S of Eczema: What are 2 colors that can be seen on the skin? What feeling do these patients typically have? How is the skin described? What can exacerbate symptoms? The younger population will also frequently experience what from the patchy areas of irritation? 8. What are 3 forms of pharmaceutical agents given for eczema? 9. What modality may assist to reduce the itching? 10. What types of techniques should be practiced that can reduce eczema? 11. What should patients with eczema avoid?

1. dermatitis 2. a group of disorders that causes chronic skin inflammation 3. immune system abnormality, allergic reaction, or external irritant 4. children or infants 5. yes 6. geriatric population 7. red or brown-gray; itchiness; lichenified skin; topical agents can exacerbate symptoms; oozing and crustiness 8. topical or oral corticosteroids, antihistamines, or oral antibiotics 9. cold compresses 10. stress management techniques 11. avoid extreme temperatures

Chronic Renal Failure (CRF): 1. What condition can form that relates to blood sugar? 2. What occurs to blood pressure? 3. What type of opathy occurs? (2) 4. What occurs to the nephrons? 5. What type of kidney disease can occur?

1. diabetes 2. severe hypertension 3. glomerulopathies or obstructive uropathy 4. interstitial nephritis 5. polycystic kidney disease

Rehab Considerations for Patients with Inherited Metabolic Disorders: 1. As a PT you must be aware of the ______________ restrictions that come with each specific metabolic disorder. 2. You need to perform patient and family training to prevent ___________________ effects. 3. You need to adapt your PT treatments to facilitate what?

1. dietary 2. deleterious 3. developmental milestone acquisition

Arterial Insufficiency Ulcers: Confirming Your Patient Has This 1. Where do these typically develop? 2. What are 3 common sites these form? 3. What do the edges look like? 4. What color is the wound bed typically? 5. What occurs to the appearance of the nails? nail beds? surrounding skin? 6. Intact surrounding skin may have what 4 characteristics? 7. What occurs to distal pulses? 8. What can be observed sometimes in advanced cases? 9. Is pain significant in this condition? 10. Limb related pain with arterial insufficiency ulcers occurs when?

1. distal 1/3 of the leg 2. dorsum of the foot, lateral malleoli, toes 3. smooth and rounded 4. pink with a gray tint 5. yellow nails, cyanotic nail beds, and pale surrounding skin 6. shiny, hairless, thin, cool to the touch 7. diminished or absent 8. muscle wasting 9. yes 10. when the limb is in non-dependent positions (elevated) or with activity (intermittent claudication)

Pharmacological Genitourinary Agents: 1. What are 4 examples of GU medications used to treat bladder symptoms like urgency, frequency, infection, and pain? 2. Overactive Bladder Agents: These relieve symptoms of an overactive bladder meaning there are involuntary contractions of what? What are 4 indications for taking overactive bladder agents? Side effects of overactive bladder agents include What 2 GI symptoms? what feeling in the head (2)? sensitivity to what? what in the bowels? what in the lungs? A therapist should communicate any signs of _________________ impairment to the physician. What are 2 examples of overactive bladder agents? 3. Urinary Anti-Infective Agents: These treat what? These are not traditional _________________ or __________________ agents. Indications for urinary anti-infective agents include: inflammation where? what feeling in the bladder? what feeling when urinating? what type of infection? what occurs at night? Side effects of urinary anti-infective agents include what 2 GI symptoms? what 2 feelings in the head? sensitivity to what? what in the bowels? what on the skin? What are 2 examples of urinary anti-infective agents?

1. diuretics, hormones, overactive bladder agents, or urinary anti-infective agents 2. the bladder (detrusor muscle); urinary urgency/urinary frequency/urge incontinence/nocturia; GI distress, nausea, dizziness, headache, photosensitivity, constipation, pulmonary impairment; pulmonary; Ditropan (oxybutynin chloride) or Detrol (tolterodine tartrate) 3. urinary tract infections; antibiotics or sulfonamide agents; cystitis, urinary urgency, burning when urinating, UTI, nocturia; GI distress/nausea/dizziness/headache/photosensitivity/constipation/rash; Cinobac (cinoxacin) and Furadantin (nitrofurantoin)

Malignant Melanoma: 1. Factors that increase the risk of developing melanoma include: living where? excessive number of what?

1. living at high altitudes close to the equator; excessive number of moles

Electrolyte Imbalances: Confirming Your Patient Has This 1. General symptoms that may occur include: what feeling in the head? what level of arousal? what 3 GI symptoms? what occurs to urine output? what occurs to color of the urine? what occurs to the mouth? what occurs to perspiration? what occurs to strength? what 2 sensations occur in the muscles? what occurs to heart rhythm? pain where? 2. Signs and symptoms that require immediate medical care because the patient is dehydrated include: what in regards to mental status/behavior? what occurs to skin? what occurs to HR? what occurs to the eyes?

1. dizziness; fatigue; nausea/diarrhea/constipation; decreased urine output; dark urine; dry mouth; decreased perspiration; weakness; cramping or spasms; irregular heartbeat; headache 2. change in behavior; decreased skin elasticity; fast HR; sunken eyes

Pharmacology Terminology: 1. Dose Response Curve: This is a graphic representation between _________________ and body ___________________. As the dosage of a drug increases, what occurs to the body's receptors? Will the body's response to a drug ever plateau? 2. What is pharmacodynamics? 3. What is pharmacotherapeutics? 4. What is pharmacokinetics? 5. Therapeutic Index: This is a measurement of what? This is calculated as a _______________ and compares effectiveness of a drug against what? A drug with a low TI indicates what about the drug? 6. What is toxicology?

1. dosage and body's response; more body receptors are activated and body response increases; yes 2. the study of how a drug exerts its therapeutic effect at the cellular and organ level 3. the study of using drugs to prevent, treat, and diagnose disease 4. the study of how drugs are absorbed, distributed, metabolized, and eliminated from the body 5. safety of a drug; ratio and compares effectiveness of a drug against its lethal effects; low TI indicates the drug is less safe 6. the study of adverse effects of drugs

Pharmacology Effects on Other Systems: 1. Sedative-Hypnotic and Antianxiety Agents: When these drugs reach their peak effectiveness, the patient may experience an extreme level of ______________________ that makes it difficult for the patient to participate in PT. Scheduling patients when for PT should be avoided since the therapy session will be less effective. The patient is also at an increased risk for what? 2. Antidepressant Agents: Some antidepressants such as what 2 things produce sedation and muscle weakness making it more difficult for a patient to actively participate in therapy. These patients are at an increased risk for what in their BP? Therapists should do what in response to this? 3. Antipsychotic Agents: Patients on these experience what type of symptoms? Therapists should be alert for changes in the patient's what 3 things and notify personnel immediately if they are spotted. 4. Gastrointestinal Agents: These cause minor side effects including what 2 feelings in the head? What in the GI tract?

1. drowsiness; avoid scheduling patients a few hours after taking these medications; falls 2. lithium and tricyclic agents; orthostatic hypotension OR hypertension; monitor BP 3. extrapyramidal symptoms (abnormal movement patterns like dyskinesia or dystonia); posture, balance, or movement patterns 4. fatigue or confusion, GI distress

GI System Anatomy: Lower GI Tract Small Intestine 1. What are the 3 parts of the small intestine? 2. The duodenum does what to food in the stomach? 3. The jejunum absorbs what 3 things? 4. The ileum absorbs what 2 things?

1. duodenum, jejunum, ileum 2. neutralizes acid in food and mixes biliary and pancreatic secretions into the food 3. water, electrolytes, and nutrients 4. bile and intrinsic factors to be recycled

Arterial Insufficiency Ulcers: Confirming Your Patient Has This 1. What is the least invasive method of assessing arterial blood flow? 2. What ABI value indicates moderate arterial blockage and increases the likelihood of ulcer development and symptoms of intermittent claudication with activity?

1. duplex ultrasonography 2. less than 0.79 ABI

HIV: Management of Symptoms 1. What is important so that pharmacological intervention can be initiated and slow the progression of the virus? 2. Is there any cure for HIV? 3. With proper medical treatment, what is the life expectancy of someone living with HIV? 4. Current guidelines for treatment include: what type of therapy? When does this start? How does it work? 5. Other medications that may be administered include what 3 things? 6. PT goals and interventions include promotion of optimal fitness, flexibility, energy conservation, stress management, ADL equipment, relaxation, what type of therapy?, modalities, positioning, pain management, what type of exercises?, and what type of rehab?

1. early detection 2. no 3. equal to someone without HIV 4. antiretroviral therapy; once CD4 T cell levels drop below 500; it prevents the virus from replicating 5. nucleoside analogs, protease inhibitors, and non-nucleoside reverse transcriptase inhibitors 6. aquatic therapy, breathing exercises, neuro rehab

Neuroblastoma: 1. This is a tumor that initiates from primitive _________________ cells of the ______________ ______________ and is found within the sympathetic nervous system, primarily in what 2 structures? 2. Etiology remains unknown, but causative factors include _________________ predisposition, _____________ incidence, _______________ influence, exposure to _________________ or __________________, and ______________ association. 3. S/S of neuroblastoma include: what in the abdomen? what changes? what blood condition? what GI symptom? sweating and pain also occur. 4. What is typical treatment? 5. Prognosis is best for which children? 6. Can neuoblastomas spontaneously regress?

1. ectodermal; neural plate; adrenal glands or paraspinal ganglia 2. genetic predisposition, familial incidence, environmental influence, exposure to radiation or toxins, viral association 3. abdominal mass, personality changes, anemia, diarrhea, sweating, pain 4. resection chemo and radiation 5. those diagnosed under the age of 1 6. yes

Wilms' Tumor: 1. This is an _________________ ______________________ found in the ___________________. 2. Most cases are diagnosed at what age? 3. Causes include genetic inheritance as an autosomal _________________ disease or a non inherited form with an ________________ etiology. 4. S/S include abdominal ____________, pain, what in the urine, what 2 GI symptoms, what body temp? 5. Treatment includes resection of what? What follows resection? What is administered due to the drug's antitumor properties? 6. The five year cure rate is approximately _______%.

1. embryonic nephroblastoma found in the kidneys 2. 1-4 3. autosomal dominant; unknown 4. abdominal mass, pain, hematuria, nausea/vomiting, fever 5. resection of the kidney; chemo/radiation; Dactinomycin 6. 75%

Endocrine Pharmacology: Hormone Replacement Agents 1. These restore normal endocrine function when _________________ production of a particular hormone is deficient or absent. 2. What is a major indication for hormone replacement agents?

1. endogenous 2. decrease in endogenous hormone secretion

Uterine Cancer: Diagnosis 1. What is another name for uterine cancer? 2. This is the malignant growth of any cells that comprise the tissue of the uterus. What is the cause? 3. Risk factors for the disease include: elevated levels of what hormone without similar levels of what hormone? what with age? what with weight? what diagnosis? family history of what? what type of therapy to the pelvis? what 2 medications? early onset of what? late onset of what? Having how many children? 4. The most common type of uterine cancer affects what structure? 5. The endometrium is where in the uterus? 6. When there is an imbalance of estrogen and progesterone, what occurs to the endometrium that can increase one's risk for uterine cancer? 7. If these cancer cells metastasize, they can spread to what 5 structures?

1. endometrial cancer 2. unknown 3. elevated levels of estrogen without similar levels of progesterone, advanced age, obesity, diabetes, family history of uterine cancer, radiation therapy to the pelvis, estrogen or tamoxifen medications, early onset of menstruation, late onset of menopause, having no children called nulliparity 4. the endometrium 5. the inner lining of the uterus 6. the endometrium thickens over time and cancer cells can start to develop 7. liver, lung, lymph nodes, bone, brain

Methods of Drug Administration: 1. What are the 2 basic methods for drug administration? 2. Enteral Administration involves use of the ______________________ for administration of the drug. 3. Parenteral Administration involves any form of drug administration that does not involve the _________________.

1. enteral and parenteral 2. GI tract 3. GI tract

Osteogenic Sarcoma: 1. This is a cancer that forms at the ________________ of ____________ bones. 2. This has a peak incidence in what age range? 3. Exact etiology is unknown, however there is correlation between immunoincompetence and what? 4. Does osteogenic sarcoma metastasize quickly? 5. There will likely be a presence of what? 6. Treatment includes what 2 options? 7. Is chemo and radiation beneficial?

1. epiphyses of long bones 2. 10-20 years old 3. tumor growth rate 4. yes 5. a mass 6. amputation with proximal resection to ensure proper removal of affected tissue or surgical procedures to try to salvage the limb 7. chemo is beneficial but radiation has no affect on this type of tumor

Lung Cancer: 1. This is a cancer of the ________________ within the respiratory tract. 2. Why is lung cancer the most frequently lethal cancer? 3. What are 5 regions that the cancer typically metastasizes to first? 4. Risk factors for lung cancer include: what bad habit? environment. geography. occupational hazards. age. family history 5. S/S include what 3 respiratory symptoms? Progression may include symptoms of _____________________ breath sounds, ___________ pain, and coughing up what? 6. Is there a good or poor prognosis?

1. epithelium in the respiratory tract 2. because it rapidly metastasizes and is often asymptomatic until it is too late 3. adrenal cortex, pulmonary vascular system, brain, bone, and liver 4. smoking 5. dyspnea, cough, sputum; adventitious breath sounds, chest pain, and coughing up blood (hemoptysis) 6. poor prognosis with 5 year survival rate less than 14%

Breast Cancer: Contributing Factors 1. What hormone is believed to have some relationship to this disease process? 2. Risk factors include gender, age, late ____________________, family history, high ________________ intake, high ______________ diet, ___________________ exposure, and past history of cancer.

1. estrogen 2. late menopause; high alcohol intake, high fat diet, radiation exposure

Systemic Lupus Erythematosus: Confirming Your Patient Has This 1. Symptoms will appear and then go away with what? 2. Symptoms such as: what in joints? what level of arousal? what on the skin? what body temp? what in the head? what with weight? 3. Common clinical presentation throughout the course of SLE includes what across the cheeks and nose? What over light exposed areas? What with hair? What in the lungs? What neuro symptom? What mental state? What condition in muscles? Involvement in what system? 4. Patients can have CNS involvement that can lead to _____________________ manifestations that present with what 4 symptoms? 5. Microscopic fluorescent techniques are indicated to detect the presence of what in the blood? A positive ANA test warrants additional test for what in the blood? 6. A patient requires at least _________ of 14 characteristics that occur during the same period of time to be diagnosed with lupus.

1. exacerbations and remissions 2. arthralgias, malaise, rash, fever, headache, weight loss 3. butterfly rash across the cheeks and nose; red rash over light exposed areas, alopecia, pleurisy, seizures, depression, fibromyalgia, cardiac involvement 4. neuropsychiatric manifestations; depression, irritability, emotional instability, and seizures 5. antinuclear antibody (ANA); antideoxyribonucleic acid antibodies 6. 4/14 characteristics

Partial Thickness Burn: Diagnosis 1. Is a superficial partial burn painful? Why? 2. Is a deep partial burn painful? Why? 3. Irreversible epithelial damage occurs in DEEP partial thickness burns resulting in what 2 types of scarring?

1. extremely painful because free nerve endings are exposed 2. less painful because there is damage to nerve endings 3. hypertrophic or keloid scarring

Complex Regional Pain Syndrome (CRPS): Diagnosis 1. This is usually found in an _______________ that has experienced some form of _________________. 2. Symptoms result from a disturbance in the function of what system? 3. The increase in sympathetic activity causes a release of ______________________________ in the periphery and subsequent __________________________ of blood vessels. 4. The vasoconstriction of blood vessels results in pain and an increase in sensitivity to what? 5. This results from injured ______________ nerve fibers at one somatic level that initiates sympathetic _________________ activity that affects many segmental levels. 6. What area sustains injury?

1. extremity; trauma 2. sympathetic nervous system 3. norepinephrine; vasoconstriction 4. increase in sensitivity to peripheral stimulation 5. afferent; efferent 6. the extremity of origin and the areas adjacent to that extremity

Laxative Agents: 1. These are used to do what? 2. Side effects of laxatives include: what 3 feelings in the stomach? what type of imbalance? what side effect regarding fluids? what can occur with prolonged use? 3. What are 6 examples of laxatives?

1. facilitate bowel evacuation 2. nausea, cramping, discomfort; electrolyte imbalance; dehydration; dependence 3. Citrucel (methylcellulose), Metamucil (psyllium), Colace (docusate), Fleet Glycerin Suppository (glycerin), Phillips' Milk of Magnesia (magnesium hydroxide), Correctol (Bisacodyl), or Senokot (senna)

GU System Terminology: 1. What is anuria? 2. What is a cystocele? 3. What is the glomerulus? 4. What is hematuria? 5. What is the myometrium? 6. What is the term for development of kidney stones? 7. What is oliguria? 8. What is polyuria? 9. What is the perimetrium? 10. What is a rectocele? 11. What are the seminiferous tubules in males?

1. failure to produce urine in a 24 hour period that is less than 100 mL 2. bulging of the bladder into the vagina 3. specialized tufts of capillaries that are needed for filtration of fluid 4. blood in the urine 5. the muscular outer layer of the uterus 6. nephrolithiasis 7. inadequate urine output in a 24 hour period less than 400 mL 8. large volume of urine excreted at one time 9. the serous peritoneal coat of the uterus 10. the bulging of the anterior wall of the rectum into the vagina 11. found in each lobe of the testes where spermatogenesis takes place

Cellulitis: 1. What is cellulitis? 2. What region is typically affected most often by cellulitis? 3. What causes cellulitis? 4. Predisposing factors to cellulitis include what about age? what about the immune system? what type of injury? what going on in the veins? the presence of what? 5. S/S of cellulitis include: what coloring? skin that is what temp? skin that has the presence of what 2 potential things? tenderness with what? what body temp? what level of consciousness? 6. What should you do as a PT if you find a patient that you suspect has cellulitis? 7. How is cellulitis treated? 8. What 2 things are differential diagnoses that need to be ruled out? 9. PT may be warranted for those with cellulitis for what purpose? 10. Cellulitis can lead to what 2 things if not treated properly?

1. fast spreading inflammation of the skin and connective tissues caused by a bacterial infection 2. extremities 3. bacteria like streptococcus or staphylococci 4. advanced age, immunosuppression, trauma, venous insufficiency, presence of wounds 5. redness that spreads quickly, skin that is warm or hot to the touch, skin with ulcers or an abscess, tenderness to palpation, chills/fever, malaise 6. refer them to a physician immediately 7. systemic antibiotics 8. DVT and contact dermatitis 9. for wound care 10. gangrene or sepsis

Urinary Tract Infection (UTI): 1. There is a higher incidence in what gender? 2. There is a higher incidence in what age range? 3. What are 4 classifications of UTIs? 4. UTI occur when bacteria infiltrate the urethra which is called what? or when they infiltrate the bladder itself which is called what? 5. Untreated, this type of infection can spread and cause what to the kidneys? 6. Diagnosis is typically confirmed with what? 7. Symptoms of UTI include: increased ___________________ of urination, what 2 feelings with urination, what look to the urine, pressure above what region in women, what involuntary movement, what body temp, pain where, what level of arousal? 8. What medication is typically necessary? 9. Patients are encouraged to do what in excess?

1. females 2. geriatric 3. recurrent, chronic, complicated, uncomplicated 4. urethritis; cystitis 5. kidney infection (pyelonephritis) 6. urinalysis 7. increased frequency of urination, pain and burning with urination, pressure above the pubic symphysis in women, shaking, fever, low back pain, fatigue 8. bacteria specific antibiotics 9. drink excess fluids

Multiple Organ Dysfunction Syndrome: Confirming Your Patient Has This 1. Symptoms of sepsis can include: what 3 things in relation to body temp? what function is altered? what occurs to ventilation? 2. Other symptoms of MODS are dictated by the systems affected and can include: pain in what structure? (4) what occurs to breathing? what 3 GI symptoms? what occurs from the vagina or urethra? what 2 things can occur in relation to urination?

1. fever/chills/sweating, mental function is altered, hyperventilation 2. earache, abdominal pain, flank/back pain, sore throat; dyspnea; nausea, vomiting, diarrhea; discharge; frequency and urgency

Comparing a Similar Condition to Breast Cancer: 1. What is a similar condition that forms in both breasts and is characterized by nodular lumps in the breast tissue? 2. Are the cysts benign or malignant in fibrocystic breast disease? 3. When do symptoms worsen and the lumps become tender in fibrocystic breast disease? 4. What are 2 feelings patients commonly get in the breast? 5. When do symptoms normally disappear? 6. Fibrocystic breast disease increases a patient's risk for what?

1. fibrocystic breast disease 2. benign 3. they worsen before menstruation 4. aching and burning 5. after menstruation ends 6. breast cancer

Anticipates Deformities Based on Burn Location: 1. Anterior Neck Burn: What is the anticipated deformity? What are 3 splinting types that can be used? 2. Anterior Chest and Axilla: What is the anticipated deformity in the shoulder (3)? What are 2 splinting types that can be used? 3. Elbow: What is the anticipated deformity in the elbow (2)? What are 4 splinting types that can be used? 4. Hand and Wrist: What is the anticipated deformity in the MCP joints? What is the anticipated deformity in the IP joints? What is the anticipated deformity in the thumb? (2) What is the anticipated deformity in the wrist? What are 3 splinting types that can be used? 5. Hip: What is the anticipated deformity in the hip (2)? What are 2 splinting types that can be used? 6. Knee: What is the anticipated deformity in the knee? What are 3 splinting types that can be used? 7. Ankle: What is the anticipated deformity in the ankle? What are 3 splinting types that can be used?

1. flexion with potential side bending; soft collar, molded collar, Philadelphia collar 2. extension/medial rotation/adduction; axillary/airplane splint or shoulder abduction brace 3. flexion and pronation; air splint/confirming splint/three point splint/gutter splint 4. extension or hyperextension of the MCPs; flexion; flexion and adduction; flexion; thumb spica splint/wrist splint/palmar or dorsal extension splint 5. flexion and adduction; anterior hip spica or abduction splint 6. flexion; conforming splint/air splint/three point splint 7. plantar flexion; posterior foot drop splint/posterior ankle conforming splint/anterior ankle conforming splint

GI System Anatomy: Gland Organs 1. What are 3 glands that assist the GI system in digestion? 2. Gall Bladder: This organ stores and releases _____________ into the ________________ to assist with digestion. 3. Liver: What does it produce? Bile is necessary for absorption of ______________ soluble substances. The liver also assists with production of what 2 other things? It regulates serum levels of what? 4. Pancreas: How does it function as an exocrine organ? How does it function as an endocrine organ?

1. gall bladder, liver, and pancreas 2. bile into the duodenum 3. produces bile; lipid soluble; vitamin K and red blood cell production; regulates serum levels of macros 4. releases bicarbonate and digestive enzymes into the duodenum; releases insulin, glucagon, and other hormones into the blood to regulate serum glucose levels

Cholecystitis and Cholelithiasis: 1. This condition is inflammation of the _____________________. 2. What is the most common etiology? 3. Gallstones develop from ___________________ of the gallbladder, supersaturation of the ______________ with cholesterol, or crystal formation from __________________ _____________. 4. Gallstones can cause _____________ which will exacerbate symptoms. 5. What is the most common symptom? 6. If the gallstone becomes lodged in the cystic duct, then the patient can experience many problems including severe right upper quadrant pain with muscle guarding, tenderness, and rebound pain. These symptoms can radiate to what region? 7. Other symptoms that are more unique include: what coloration of the skin? What GI symptoms? what body temp? what change in appetite? what does the abdomen feel like? 8. Treatment is not recommended for the patient with asymptomatic gallstones but what type of diet can decrease mild symptoms? 9. If patients are symptomatic, what procedure can be used in an attempt to break up and dissolve the gallstones? 10. Primary treatment is a laparoscopic __________________ to remove the gallbladder and the lodged stones from the dugs. 11. Acute cholecystitis should resolve itself how soon with analgesics, antibiotics, and IV alimentary feedings? 12. What are 3 exercises and patient education activities PT should perform with patients post-surgical after laparoscopic cholecystectomy?

1. gallbladder 2. gallstones (cholelithiasis) that has impacted the cystic duct 3. hypomobility of the gallbladder, supersaturation of the bile with cholesterol, or crystal formation from bilirubin salts 4. infection 5. right upper quadrant pain 6. interscapular region 7. jaundice (yellow), nausea/vomiting, fever, anorexia, rigid 8. low fat diet 9. lithotripsy 10. cholecystectomy 11. within 1 week 12. splinting exercises while coughing, breathing exercises, and mobility training

Necrotic Tissue Types: 1. What are the 4 types of necrotic tissue? 2. Eschar: what texture is it? what color? this is dehydrated tissue that is firmly or loosely attached to the wound bed? 3. Hyperkeratosis: this is also referred to as what? what color? what is the texture? 4. Slough: what texture is this? what color? is this loosely or firmly attached?

1. gangrene, hyperkeratosis, eschar, slough 2. hard/leathery; black/brown; firmly attached 3. callus; white/grey; varies from firm to soggy depending on the moisture content in the wound 4. stringy and moist; white/yellow; loosely attached

Arterial Insufficiency Ulcers: Examination 1. What are 3 major complications that can occur from arterial ulcers?

1. gangrene, sepsis, osteomyelitis

Gastrointestinal Pharmacological Management: Antacid Agents 1. Pharmacological intervention is normally related to GI disorders that are caused by what 2 things? 2. These are used to do what to gastric acid? 3. What do these do to intragastric pH? 4. Primary antacids are classified as what 4 things? 5. Indications to use antacids include minor gastric ___________________ or _________________, what type of ulcer? what disease in the esophagus? 6. Side effects of antacids include: what type of phenomenon? what occurs to the bowels? what occurs with other medications? what occurs to electrolytes? 7. How does a patient taking antacids affect PT? 8. What is an example of an aluminum containing antacid? 9. What is an example of a calcium containing antacid? 10. What is an example of a magnesium containing antacid? 11. What is an example of a sodium bicarbonate containing antacid?

1. gastric acid secretion or abnormal food movement through the GI tract 2. neutralize gastric acid 3. increase the intragastric pH 4. aluminum containing, calcium carbonate containing, magnesium containing, or sodium bicarbonate containing 5. minor gastric indigestion or heartburn; peptic ulcer; gastroesophageal reflux disease (GERD) 6. acid rebound phenomenon, constipation or diarrhea, may affect metabolism of other medications, can cause electrolyte imbalances 7. it doesn't because there typically are no side effects 8. Basalijel (aluminum carbonate gel) 9. Tums (calcium carbonate) 10. Milk of Magnesia (magnesium hydroxide) 11. Bromo Seltzer (sodium bicarbonate)

Peptic Ulcer Disease Continued: 1. This disease encompasses what 2 types of ulcers? 2. What are 3 types of comorbidities that can cause peptic ulcer disease? 3. What might the patient be throwing up? 4. Patients with a bleeding ulcer may have what blood condition? 5. A patient with a gastric ulcer will typically report pain shortly after what? 6. A patient with a duodenal ulcer will typically report pain when? 7. Patients who present with sudden or more severe symptoms may have developed what? Is this an emergent condition? 8. Symptoms of a perforated ulcer include: what type of tone? tenderness with what? what type of abdominal pain? pain that worsens with what? 9. What are 3 signs of a perforated ulcer and the patient has gone into septic shock?

1. gastric and duodenal ulcers 2. crohn's, celiac's, COPD 3. blood (hematemesis) 4. anemia 5. shortly after eating 6. 2-3 hours after eating and will often wake at night with pain 7. perforated ulcer; this is an emergency 8. rigidity, rebound tenderness to palpation, more generalized but sharp abdominal pain, pain that worsens with movement 9. anuria (absence of urine), tachycardia, hypotension

Abdominal Pain Left Upper Quadrant: 1. What type of ulcer refers pain to the left upper? 2. What going on in the colon can cause pain to left upper? 3. What lung disease can cause pain to left upper? 4. Injury or rupture of what organ can cause pain to left upper? 5. What going on in the aorta can cause pain to the left upper quadrant?

1. gastric ulcer 2. perforated colon 3. pneumonia 4. injury or rupture of the spleen 5. aortic aneurysm

Hydrocolloids: 1. What do these consist of? 2. Where do these attach to the wound? 3. How do these absorb exudate? 4. What are 2 types of wounds these are used on? 5. Can these be used for granular or necrotic wounds? 6. What type of environment do these provide to the wound? 7. What do these trigger in the body? 8. How much absorption do these provide? 9. Do these require a secondary dressing? 10. Are these waterproof? 11. What is a downfall to these with excessive friction? 12. Can these be used on infected wounds?

1. gel forming polymers (carboxymethylcellulose, gelatin, or pectin) backed by a strong film or foam adhesive 2. anchors to the intact surrounding skin 3. they swell into gel like masses 4. partial or full thickness wounds 5. yes 6. moist 7. autolytic debridement 8. moderate 9. yes 10. yes on the outside 11. they can roll 12. these CANNOT be used on infected wounds

Hydrogels: 1. These consist of varying amounts of water and gel forming materials like __________________. 2. Are these moisture retentive? 3. What are 2 types of wounds these are commonly used on? 4. What type of environment do these promote in the wound? 5. What do these trigger in the body? 6. Can these reduce pressure and diminish pain? 7. What is this commonly used as a coupling agent for? 8. Does this adhere to the wound? 9. Do these typically require a secondary bandage?

1. glycerin 2. yes 3. superficial or partial thickness (abrasions, blisters, pressure ulcers) 4. moist 5. autolytic debridement 6. yes 7. ultrasound 8. minimally 9. usually yes

Neuropathic Ulcer: Confirming Your Patient Has This 1. At risk areas include those that are routinely subjected to pressure during normal weight bearing including what 6 areas? 2. The wound typically presents with what types of edges? 3. What type of rim typically surrounds the wound? 4. What does the wound bed typically present with? 5. How much exudate is commonly produced with these types of ulcers? 6. Are pain complaints common? 7. Surrounding intact skin around neuropathic ulcers have what 3 characteristics? 8. What occurs to distal pulse? 9. Is ABI readings accurate in these patients?

1. heel, tips of toes, tips of hammer toes, plantar surface of met heads, dorsal surface of hammer toes, bunions 2. oval shaped well defined edges 3. a rim of hypertrophic callus 4. granular tissue and not typically any necrotic tissue (no eschar or slough) 5. minimal exudate 6. no 7. shiny, inelastic, and dry 8. diminished or absent 9. no because the blood vessels tend to become rigid

Wilson's Disease: 1. What type of metabolic disorder is this? 2. This is a rare inherited disorder that is most common in what 3 cultures? 3. This typically appears in people under age ________ and symptoms can develop in children between _______________ years of age. 4. Is this condition autosomal recessive or dominant? 5. Wilson's disease produces a defect in the body's ability to metabolize ________________. This leads to copper accumulation in what 4 major regions? 6. Symptoms typically include: what forming around the iris of the eyes secondary to copper deposits? degenerative changes in the brain especially in what structure? what occurs to the liver? what types of involuntary movements can occur? what type of gait pattern is possible? what are 2 personality changes that can occur? there can be deformities in the ___________ system including what 2 things in bones? what 2 things in muscles? 7. Treatment includes continual pharmacological intervention using what 2 things because both promote the excretion of excess copper from the body? 8. What also needs to be prevented or else the patient can die from it?

1. hepatolenticular degermation disorder 2. southern Italians, Sicilians, and Europeans 3. 40; 4-6 years old 4. autosomal recessive 5. copper; kidneys, liver, cornea, and brain 6. Kayser-Fleischer rings, basal ganglia, cirrhosis or hepatitis, athetoid movements, ataxic gait, emotional or behavioral changes, MSK, pathologic fracture or osteomalacia, muscle atrophy or contracture 7. vitamin B6 and D-penicillamine 8. hepatic disease

Abdominal Pain Right Upper Quadrant: 1. What going on in the liver can refer pain to right upper? 2. What type of ulcer can refer pain to right upper? 3. Inflammation in what 2 organs can refer pain to right upper? 4. What lung disease can refer pain to right upper? 5. What type of stones can refer pain to the right upper quadrant?

1. hepatomegaly 2. duodenal ulcers 3. hepatitis or cholecystitis (liver or gallbladder inflammation) 4. pneumonia 5. biliary stones

Pancreatic Cancer: 1. This is a prominent type of cancer with an extremely ______________ mortality rate. 2. Cancer of the _________________ cells in the ___________ is the most common form of pancreatic cancer. 3. It will metastasize to what 6 regions? 4. Risk factors for pancreatic cancer include: _______________ use, gender, increasing ______________, and what procedure? 5. Why is prognosis so poor and mortality rate so high? 6. Common symptoms as it is highly progressed include: what in weight? what coloring of the skin? pain in what region? 7. Advanced cancer may present with severe pain that may indicate what? 8. Pancreatic cancer has a very poor survival rate with a mortality rate of _____________%. 9. What are 3 things that relieve symptoms?

1. high mortality rate 2. exocrine cells in the ducts 3. spleen, stomach, colon, pleura, liver, lungs 4. tobacco use, gender, increasing age, and a cholecystectomy procedure 5. because initial symptoms are asymptomatic 6. weight loss, jaundice, epigastric pain 7. metastasis 8. 100% mortality rate 9. surgical resection, chemo, radiation

Drug Classification: 1. Schedule 1 Drugs: These have a high or low potential for abuse and high or low rate for addiction? These are only used for ____________ purposes and not for medical treatment. What are 2 examples of schedule 1 drugs? 2. Schedule 2 Drugs: These drugs have a high or low potential for abuse and high or low risk for addiction? Are these approved for medical use? Are automatic prescription refills allowed? What are 3 examples of schedule 2 drugs? 3. Schedule 3 Drugs: These have a high or low potential for abuse than schedule 2 drugs? These have a _______________ risk for physical dependence and a ___________ risk for psychological dependence. Are automatic prescription refills allowed? What are 2 examples of schedule 3 drugs? 4. Schedule 4 Drugs: These drugs have a higher or lower potential for abuse than schedule 3 drugs and only a ____________ risk for physical or psychological dependence. What are 2 examples of schedule 4 drugs? 5. Schedule 5 Drugs: These have the lowest potential for abuse and addiction. What are 2 examples of these?

1. high potential for abuse; high rate for addiction; research purposes only; heroin and LSD 2. high potential for abuse and high risk of addiction; these are approved for medical use; no automatic prescriptions are not allowed; opioids, amphetamines, and barbiturates 3. lower potential for abuse than schedule 2 drugs; moderate risk for physical dependence and high risk for psychological dependence; yes but there are limitations; opioids combined with non-opioids (narcotic mixed with acetaminophen) and anabolic steroids 4. lower; mild; antianxiety drugs and certain barbiturates like phenobarbital 5. cough and cold medicines with low doses of opioids

GI Pharmacological Agents: H2 Receptor Blockers 1. These bind specifically to ____________________ receptors to prevent the histamine activated release of _________________________ normally stimulated during food intake. 2. What are 3 indications for a patient taking H2 receptor blockers? 3. Side effects of taking H2 receptor blockers include: pain in what 2 regions? what feeling in the head? what in joints? what can occur with discontinuation of the agent? 4. Does a patient taking H2 receptor blockers typically interfere with PT? 5. What are 3 examples of H2 receptor blockers?

1. histamine receptors; gastric acid 2. dyspepsia (impaired digestion), peptic ulcer, GERD 3. headache or GI discomfort, dizziness, arthralgia, acid rebound 4. no side effects 5. Zantac (ranitidine), Tagamet (cimetidine), or Pepcid (famotidine)

Osteoporosis: Management of Symptoms 1. What is recommended for post menopausal patients? 2. What are 4 supplements recommended? 3. What does Fosamax do? 4. What activities should be emphasized? 5. What 2 things can be given to patients if the patient is at risk for vertebral fracture? 6. Patients should be educated to avoid what activities? (3) 7. Can light resistance such as small dumbbells or TheraBand be used?

1. hormone replacement therapy 2. calcium and vitamin D supplements along with Fosamax and Raloxifene 3. prevents bone resorption 4. weight bearing activities like walking 5. corset or lumbar support 6. avoid heavy resistive exercise, ballistic movements, and excessive flexion during exercise or household activity 7. if cleared by the PCP

Metabolic Acidosis: Diagnosis 1. This can result from overproduction or inadequate excretion of ____________________ or excessive excretion of _____________________. 2. What are 2 conditions that are common forms of metabolic acidosis related to H+ overproduction? 3. What is most often associated with metabolic acidosis due to inadequate H+ excretion? 4. What is most often the etiology for excessive HCO3- excretion? 5. Is this an independent disease or a symptom of some other disease?

1. hydrogen ions (H+); bicarbonate (HCO3-) 2. lactic acidosis or ketoacidosis 3. impaired kidney function 4. severe diarrhea 5. a symptom of another disease

Venous Insufficiency Ulcer: Diagnosis 1. This typically results from venous ___________________________ which may present from what 3 things? 2. The resultant distention of capillary beds from venous hypertension impedes exchange of oxygen and nutrients at the capillary level and results in relative stasis of interstitial fluid and resultant significant _________________. 3. Over time, with increased edema there is increased _______________ and ________________________ content in the interstitium facilitating __________________ changes that further impede capillary exchange. 4. The formation of an ulcer results from a combo of increased tissue _______________________ that decreases skin ____________________ and ____________________ damage that allows enzyme and free radical leakage into tissues. 5. A superficial ulcer involves what layer? 6. A partial thickness ulcer involves what layers? 7. A full thickness ulcer extends through what? 8. Damage from a subcutaneous ulcer extends through what?

1. hypertension; idiopathic, valve incompetence (damaged from a DVT), or peripheral impedence (from obesity) 2. edema 3. protein and fibrinogen content; fibrotic 4. pressure that decreases skin elasticity and endothelial 5. epidermis 6. epidermis and part of the dermis 7. epidermis, dermis, and into the subcutaneous fat layer 8. extends through all integ layers exposing tendon, muscle or bone

Risk Factors For Developing Obesity: 1. What going on with the thyroid can increase your risk? 2. What going on with the ovaries can increase your risk? 3. What going on with the adrenal cortex can increase your risk? 4. What genetic disease can increase your risk?

1. hypothyroidism 2. polycystic ovary syndrome 3. production of too much cortisol called Cushing's Syndrome 4. Prader-Willi syndrome

Childhood Overweight vs. Obesity: 1. What BMI deems a child is overweight? 2. What BMI deems a child is obese?

1. if their age appropriate BMI is between the 85th and 94th percentile 2. if their age appropriate BMI is greater than or equal to the 95th percentile

Rehab Considerations for Patients with Hepatitis: 1. If you are exposed to blood or body fluids of an infected person you must receive what type of therapy immediately? 2. What type of precautions are used for those with hepatitis? 3. What type of precautions should be used for hepatitis A and E? 4. What might be a common symptom in patients with hepatitis especially in the older patients? 5. What are 2 things that should be incorporated into activity for those that fatigue easily? 6. What types of functional mobility activity is important to incorporate into therapy? 7. What should the patient with hepatitis avoid? 8. The therapist should provide patient education regarding signs of what?

1. immediate immunoglobulin therapy 2. standard (PPE with body fluid exposure potential) 3. enteric (gown and gloves) 4. arthralgias 5. energy conservation techniques and pacing skills 6. balance activities 7. prolonged bed rest 8. relapse of chronic hepatitis

Systemic Lupus Erythematosus: Contributing Factors 1. This is described as an _____________________ disturbance from what 4 contributing factors? 2. Environmental factors associated with SLE include ______________ exposure, infection, antibiotics especially what 2 drugs? extreme _____________. what medical procedure? and what reproductive status? 3. This is most common to occur in what age group? 4. This is how much more likely to occur in women over men?

1. immunoregulatory disturbance from genetic, environmental, viral, and hormonal contributing factors 2. UV light exposure, infection, antibiotics especially penicillin and sulfa drugs, extreme stress, immunization, and pregnancy 3. 15-40 years old 4. 10-15x more likely to occur in women

Oncology Pharmacological Management: Antimetabolite Agents 1. What do these do to fight cancer? 2. These agents create an imposter to the endogenous metabolites in the body to form what? 3. What is the main indication for use of antimetabolite agents? 4. What are 4 examples of antimetabolite agents?

1. impair biosynthesis of genetic material and interrupt synthesis of DNA an RNA 2. a nonfunctional genetic product that is incapable of reproduction 3. rapidly dividing neoplastic cells 4. Leustatin, Adrucil, Fludara, and Trexall

Pressure Ulcers: Contributing Factors 1. What type of cognition is at risk? 2. What type of nutrition status is at risk? 3. What type of sensation status is at risk? 4. What type of continence status is at risk? 5. What type of body mass is at risk? 6. What type of systemic condition is at risk?

1. impaired cognition 2. poor nutrition status 3. altered sensation 4. incontinence 5. decreased lean body mass 6. infection

Erectile Dysfunction (ED): 1. What is another name for this? 2. What is the primary cause of ED and can result in this forming 10-15 years than if the patient did not have this? 3. Other causes include: what type of heart disease? what going on in blood pressure? what in the thyroid? what in the pituitary? what progressive neuro disease? what type of mental state disorder? excessive consumption of what? what bad habit? what going on in the kidneys? side effects of what? what going on in hormones? 4. Treatment includes what 3 things? What can a PT do for treatment?

1. impotence 2. diabetes 3. coronary heart disease, hypertension, hypothyroidism, hypopituitarism, MS, psychiatric disorders, excessive alcohol consumption, smoking, kidney disease, side effects from meds, hormonal imbalance 4. meds, surgery, direct injections to the penis - Kegel exercises

Venous Insufficiency Ulcers: Management of Symptoms 1. What are 2 examples of modifiable risk factors to treat these? 2. What is a procedure that chemically redirects blood return to better functioning vessels? 3. What is a procedure that thermally redirects blood return to better functioning vessels? 4. What are 3 pharmaceutical agents that treat venous insufficiency ulcers? 5. What are 5 examples of surgeries commonly performed for venous insufficiency ulcers? 6. What might be indicated if the wound bed is unable to support normal healing? 7. What are 3 forms of graded compression used? 8. What should be done to the surrounding skin around venous ulcers? 9. How much exudate is typically produced by venous ulcers?

1. lose weight and edema management 2. sclerotherapy 3. ablation 4. antimicrobials, antibiotics, and diuretics 5. stent, bypass, valve repair, angioplasty, vein stripping 6. graft 7. bandages, unna boots, garments 8. kept well moisturized 9. moderate to heavy amounts

Lymphoma: 1. This is a cancer found where? 2. What are 2 types of lymphoma? 3. Risk factors for Hodgkins lymphoma include: association with ______________________ virus, _____________ abuse, ___________________________ use, what weight, what type of diseases? 4. Risk factors for Non-Hodgkin lymphoma include exposure to _______________, what type of emissions, and what in the air? 5. What is typically the first sign of lymphoma? 6. General symptoms of lymphoma can include: what 2 things with body temp? what level of arousal? 7. Hodgkin disease is distinguished by the presence of what? 8. Can both Hodgkin and Non-Hodgkin lymphoma metastasize? 9. What type is one of the most curable cancers? 10. Treatment options include what 4 things?

1. in the lymphatic system 2. Hodgkin and Non-Hodgkin 3. association with Epstein-Barr virus, drug abuse, immunosuppressant use, obesity, chronic or autoimmune disease 4. exposure to benzene (cigarette smoke), auto emissions, pollution 5. a painless lump 6. fever, chills, fatigue 7. Reed-Sternburg cancer cells 8. yes 9. Hodgkin 10. chemo, radiation, stem cell transplant, and highly active antiretroviral therapy

Metabolic Alkalosis: 1. This is a condition that occurs when there is an increase in __________________ or a loss of ___________. 2. As a result what happens to the pH? 3. Metabolic alkalosis commonly occurs when there has been continuous ___________, ingestion of __________________, or _________________ therapy. It can also be associated with what potassium levels? suctioning in what region? 4. Symptoms include: what 3 GI symptoms? what mental status? what 2 things in muscles? what neuromuscular symptom (3)? what breathing rate? 5. If metabolic alkalosis is left untreated what can occur (3)? 6. What are 2 of the most important things to do right away for treatment? 7. What needs to be administered to the patient immediately?

1. increase in bicarbonate or loss of acid 2. pH rises above 7.45 3. continuous vomiting, ingestion of antacids, or diuretic therapy 4. prolonged vomiting, diarrhea, nausea; confusion; muscle cramps or fasciculations; neuromuscular hyperexcitability, convulsions, paresthesias; hypoventilation 5. respiratory paralysis, seizures, or coma 6. treat electrolyte imbalances and fix underlying cause 7. potassium chloride

Fibromyalgia Syndrome: Examination 1. What are 3 reasons these patients typically lose functional independence?

1. increased pain 2. decreased ROM 3. severe fatigue

Pressure Ulcers: Examination 1. Complications of pressure ulcers include: what 2 types of systemic conditions? what going on in bones? what feeling? what going on in muscles? what going on with nutrition? what going on with bowel/bladder? what mental status?

1. infection or sepsis; osteomyelitis; pain; spasticity; malnutrition; incontinence; depression

Gastritis: 1. This is when there is inflammation in what region? 2. Symptoms of gastritis are similar to ______________ however they tend to have a higher intensity. 3. Gastritis can be classified as what 2 things? 4. The classification of gastritis is based on what 2 things?

1. inflammation in the gastric mucosa or inner layer of the stomach 2. GERD 3. erosive or non-erosive 4. the level and zone of injury

Prostatitis: 1. This occurs when there is ___________________ of the prostate. 2. The most common etiologies include _________________ infection or the backup of prostate _________________ in the gland. 3. Classification of prostatitis includes type 1 which is? type 2? type 3? type 4? 4. S/S include: what type of discharge? what 2 things about feeling the need to go? discomfort with what? pain with what? 5. Chronic pelvic pain syndrome manifests as pain in what 6 regions? 6. Asymptomatic inflammatory prostatitis is characterized by prostate inflammation in the absence of what symptoms? 7. Management includes lifestyle modifications, _________________ training, stretching, __________________ techniques, and ______________ retraining. 8. What are 3 forms of medications that might be helpful in treating prostatitis?

1. inflammation of the prostate 2. bacterial infection or the backup of prostate secretions in the gland 3. acute bacterial prostatitis (1), chronic bacterial prostatitis (2), chronic pelvic pain syndrome (III), and asymptomatic inflammatory prostatitis (IV) 4. watery urethral discharge, urgency/frequency, discomfort with urination, pain with ejaculation 5. perineum, rectum, prostate, penis, testicles, and abdomen 6. without GU symptoms 7. biofeedback training, stretching, myofascial techniques, and bladder retraining 8. antibiotics, NSAIDs, alpha blockers

Crohn's Disease: Diagnosis 1. This is a specific form of what? 2. This is where inflammation occurs where? 3. What is the etiology? 4. Structural injury typically starts with what 3 things in the GI tract's superficial mucosal lining. 5. The inflammatory process may cause what 3 things? The inflammation can also spread to deeper mucosal layers forming what 2 things?

1. inflammatory bowel disease 2. in the lining of the GI system (can present anywhere in the GI system but typically is in the lower structures i.e. the small bowel or colon) 3. idiopathic, but is estimated to be an imbalance between anti-inflammatory and pro-inflammatory mediators in the GI tract 4. edema, hyperemia (excess of blood in the vessels supplying the GI tract), and ulcers 5. adhesions, fibrosis, or thickening; granulomas or abscesses

Autonomic Dysreflexia: 1. What going on with the toes can trigger this if it occurs below the level of SCI? 2. What going on with the skin (3) can trigger autonomic dysreflexia if occurs below the level of SCI?

1. ingrown toenails 2. blisters, burns, or pressure ulcers

Endocrine Pharmacology: Hyperfunction Agents 1. These agents manage hyperactive endocrine function to allow for ____________________ of hormone function. 2. This is accomplished through what 2 things? 3. What is the indication that hyperfunction agents can assist the patient?

1. inhibition 2. negative feedback loops or through hormone antagonists 3. excessive or hyperactive function/hormone levels

Appendicitis: Diagnosis 1. This is inflammation of the _____________ lining of the appendix. 2. Can this inflammation spread to other areas? 3. What 2 things of the appendiceal lumen are the most commonly reported causes? 4. Increased pressure as bacteria multiply and fluids stagnate in the appendix cause the walls to become ________________. This can lead to what 4 things? 5. The appendix extends off what structure? 6. This is most commonly located in a ____________________ position in the ____________ lower quadrant.

1. inner 2. yes 3. obstruction or infection 4. ischemic; perforation, peritonitis, abscess, or gangrene 5. the cecum 6. dorsomedial position in the right lower quadrant

GI System Anatomy: Upper GI Tract 1. What are 3 structures that make up the upper GI tract? 2. The stomach secretes hormones that cause the release of digestive enzymes from what 3 structures to assist with digestion?

1. mouth, esophagus, stomach 2. liver, pancreas, gall bladder

Ankylosing Spondylitis: Confirming Your Patient Has This 1. A patient with early AS will present with what type of low back pain? 2. When will they feel stiff? 3. What motion will be impaired? 4. They will have decreased ROM in the affected joints for how long? 5. As the disease progresses, what occurs to pain? 6. What will occur to the lumbar curve? 7. Other manifestations include: fixed flexion at the ____________, what spinal deformity, what level of arousal, what occurs to weight, what types of joints become involved? 8. If the costovertebral joints are affected, a patient will present with impaired ______________ mobility, compromised ____________________, and what lung volume is decreased? 9. X-ray of the spine may be negative in the initial stages of AS. With progression x-ray reveals what 4 things? What is syndesmophyte formation? 10. In later stages of the disease, x-ray will reveal what of the SI joint, what in the apophyseal joints and spinal ligaments, and what type of appearance of the spine? 11. Physical examination may reveal joint tenderness, pain, and limitation of what 2 regions?

1. insidious and recurrent 2. morning stiffness 3. spinal extension 4. over 3 months 5. it becomes severe, consistent, and extends to the midback or neck 6. it flattens due to muscle spasms 7. fixed flexion at the hips, spinal kyphosis, fatigue, weight loss, peripheral joints become involved 8. impaired chest mobility, compromised breathing, and decreased vital capacity 9. demineralization, erosion, calcification, and syndesmophyte formation; ossification of the outside of the intervertebral disks) 10. fusion of the SI joint, calcification of the apophyseal joints and spinal ligaments, and bamboo like appearance in the spine 11. limitations in the SI joint and spine

Fibromyalgia Syndrome: Contributing Factors 1. Factors include intake of what? What type of disorders? Infections from what pathogens? What type of distress? What 2 factors? What in the thyroid? What type of injury? Is this hereditary?

1. intake of a specific diet, sleep disorders, environmental and occupational factors, hypothyroidism, trauma, can be hereditary

Oncology Pharmacological Management: Biologic Response Modifier Agents 1. These include what 3 things that are responsible for enhancing the body's own ability to respond to neoplastic growth? 2. Are the agents listed in #1 cytotoxic? 3. What are 4 main indications for using biologic response modifiers? 4. What are 3 examples of biologic response modifier agents?

1. interferons, interleukin-2, and monoclonal antibodies 2. no but they enhance the body's own ability to respond to neoplastic growth 3. leukemias, lymphomas, Kaposi sarcomas, and organ/tissue malignancies 4. Proleukin, Avastin, and Intron-A

Oncology Treatment Options: Radiation 1. This is administered as either ________________ radiation or __________________ radiation. 2. What are 3 ways radiation can be administered? 3. How does radiation work? 4. What are 3 reasons for radiation use? 5. Radiation is most useful with localized or widespread malignancy? 6. Common side effects include: pain in what region? suppression in what structure? reactions in what? what can occur to nerves? what can occur to vision? What 3 GI symptoms? What can occur to urination? What can occur to wounds? (2)

1. ionizing or particle 2. teletherapy (external beam), brachytherapy (implanted), or system therapy (unsealed) 3. it breaks hydrogen bonds between DNA strands of malignant cells 4. palliative, curative, or adjuvant 5. localized malignancy 6. headache, bone marrow suppression, skin reactions, neuropathy, visual disturbances, diarrhea/nausea/vomiting, urinary frequency, delayed wound healing or infection

Ankylosing Spondylitis: Examination 1. What can occur to the irises? 2. What can occur to the uveas? 3. What occurs in the bones? (2) 4. What joint can subluxate? 5. What can occur in the spine completely? 6. What type of inflammation can occur in the heart? 7. What can occur in the lungs? 8. What can occur to the rhythm of the heart? 9. What can occur to proteins? 10. What can occur to the aorta?

1. irisitis 2. uveitis 3. osteoporosis or fracture 4. AA subluxation 5. complete spinal fusion 6. pericarditis 7. pulmonary fibrosis 8. arrhythmias 9. amyloidosis (protein aggregation) 10. aortic insufficiency

Symphysis Pubis Pain: 1. To prepare for delivering a baby, what occurs to the pubic symphysis? 2. Other causes other than birth include: what type of adaptations? what type of laxity? 3. S/S include: severe pain in what 2 regions? What might be present in the urine? 4. Treatment includes drugs for pain and surgery based on the degree of separation. PT treatment can include: what 2 modalities if acute? manual techniques for correcting _______________ or _______________ alignment such as muscle energy techniques, self correction techniques. What type of positioning education does the patient need? What type of training? what type of stabilization exercises? what device might they use?

1. it becomes mobile and separates slightly 2. postural adaptations, ligamentous laxity 3. severe pain in the SI joints or symphysis pubis, blood in the urine 4. heat or ice if acute, manual techniques for correcting pelvic or sacral alignment, positioning and postural education, gait training, pelvic and lumbar stabilization exercises, lumbo-pelvic brace or binder

Pain in both lower quadrants: 1. Stones in what 2 regions can refer pain to the entire lower quadrant? 2. What going on in the intestines can refer pain to the entire lower quadrant?

1. kidney stone or ureteral stone 2. intestinal obstruction

Urinary Stress Incontinence: Confirming Your Patient Has This 1. The amount of urine that leaks is typically less than _____________ mL with coughing, sneezing, or straining. 2. What test is used to evaluate bladder capacity, control, contractility, and strength? 3. What test observes the stability of the bladder? 4. What test observes bladder contractions? 5. What is used for differential diagnosis to rule out infection, diabetes, and other conditions? What test uses finger elevation of the paraurethral vaginal tissues at the neck of the bladder in order to stop leakage of urine? 6. Baseline exam should include what 3 things?

1. less than 50 mL 2. cystometry 3. urodynamic testing 4. electromyography 5. urinalysis 6. amount of time the patient can hold urine in, reps performed of holding a contraction, and amount of pelvic floor contraction

Muscles of the Pelvic Floor: 1. What makes up the pelvic diaphragm? (4) 2. What are 2 structures that make up the urogenital diaphragm? 3. What are 3 structures that make up the female urogenital triangle? 4. What are 3 structures that make up the male urogenital triangle? 5. What are 2 sphincters that control the anal triangle?

1. levator ani (made up of the pubococcygeus, iliococcygeus, coccygeus, and puborectalis 2. deep transverse perineal and urethrae sphincter 3. bulbocavernosus, ischiocavernosus, and superficial transverse perineal 4. bulbospongiosus, ischiocavernosus, and superficial transverse perineal 5. external and internal anal sphincters

Osteoporosis: Confirming Your Patient Has This 1. A patient diagnosed with osteoporosis may complain of pain where? What might the patient experience in the vertebrae? 2. What 2 types of fractures may occur with little to no trauma? 3. Pain is acute and increases with what 2 things? 4. What test accounts for 70% of bone strength and is the easiest way to determine osteoporosis? 5. What is used to measure bone mass particularly in the vertebrae, hips, and extremities? 6. What may be used to aid diagnosis by examining bone density of the spine?

1. low thoracic or lumbar spine; compression fractures 2. vertebral fractures or crush fractures 3. weight bearing and palpation 4. bone mineral density test 5. photon absorptiometry 6. quantitative CT scan

LE Ulcers: 1. Location: Arterial Insufficiency Ulcers? (3) Venous Insufficiency Ulcers? Neuropathic ulcers? 2. Appearance: Arterial? (3) venous (2) Neuropathic (4)? 3. Exudate: Arterial? Venous? Neuropathic? 4. Pain: Arterial? Venous? Neuropathic? 5. Pedal Pulses: Arterial? Venous? Neuropathic? 6. Edema: Arterial? Venous? Neuropathic? 7. Skin Temperature: Arterial? Venous? Neuropathic? 8. Tissue Changes: Arterial? (3) Venous? (2) Neuropathic? (4) 9. Does LE elevation increase or decrease pain for: arterial? venous? neuropathic?

1. lower 1/3 of leg, toes, web spaces; proximal to medial malleolus; areas of foot susceptible to pressure or shear forces during weight bearing 2. smooth well defined edges, lack granulation tissue, tend to be deep; irregular shape, shallow; well defined oval or circle edges, callused rim, cracked periwound, little to no wound bed necrosis with good granulation 3. minimal; moderate/heavy; low/moderate 4. severe; mild to moderate; none however dysesthesia may be present 5. diminished or absent; normal; diminished or absent with unreliable ABI 6. none; increased edema; none 7. decreased; normal; decreased 8. thin and shiny, hair loss, yellow nails; flaking dry skin, brown discoloration; dry, inelastic, shiny, decreased or absent sweat and oil production 9. increase pain; decrease pain; loss of protective sensation occurs so neither

Gastroesophageal Reflux Disease (GERD): 1. This most commonly occurs from what area that is incompetent? 2. Causes of incompetent lower esophageal sphincter include: weakness, intermittent ________________, or direct damage through what medication? intake of what 2 things? intake of what type of agent? 3. Symptoms of GERD include: chest pain called what? what with the gastric contents? gas that presents as what? what does their voice sound like? what are they doing a lot? there is inflammation of what? what are they vomiting up? 4. If GERD is left untreated the patient may develop narrowing of what? inflammation of what? what type of pneumonia? what condition in the lungs? what type of cancer? 5. How is this treated typically?

1. lower esophageal sphincter (LES) 2. intermittent relaxation; direct damage through NSAIDs, smoking, alcohol, infectious agents 3. heartburn, regurgitation of the gastric contents, burping, hoarse voice, coughing, esophagitis, blood (hematemesis) 4. narrowing of the esophagus (esophageal strictures), esophagitis, aspiration pneumonia, asthma, esophageal adenocarcinoma 5. medications

Breast Cancer: Management of Symptoms 1. Surgery may range from what? 2. What are 3 therapies that might be used in isolation or after surgery? 3. PT interventions include: management of what system? post surgery ______________ exercises. positioning. pain management. what 2 types of activities? range of motion exercises. what modality? (2)

1. lump resection (lumpectomy) or total radical mastectomy with axillary dissection 2. chemo, radiation, or hormone replacement 3. lymphedema management, post surgery breathing exercises, positioning, pain management, strengthening and endurance activities, range of motion exercises, intermittent compression and massage

Full Thickness Burns: Examination 1. What should you always assess? 2. What are 3 of the most common complications post full thickness burn? 3. Other secondary damage from a full thickness burn includes impairments in what 5 systems? 4. Damage to these 5 systems can result in what 4 things?

1. lung auscultation 2. contractures, hypertrophic scarring, and infection 3. cardiovascular, respiratory, immune, gastrointestinal, and renal systems 4. metabolic disorders, acidosis, sepsis, and dehydration

Venous Insufficiency Ulcer: Examination 1. With chronic venous insufficiency, the same conditions that impede capillary exchange are also likely to locally overwhelm the _____________________ system. 2. With impaired lymphatic function, the patient is at increased risk for developing what 3 significant infections?

1. lymphatic system 2. cellulitis, osteomyelitis, and wound infection

Moisture and Occlusion: 1. In an appropriately moist wound environment, what cells appear earlier to the wound site to reduce risk of infection? What 2 rates are enhanced facilitating for more rapid wound closure? 2. What is occlusion? 3. What does it mean if something is fully occlusive vs. non-occlusive? 4. What is the order of dressings from most occlusive to non-occlusive? (out of hydrogels, traditional gauze, alginates, impregnated gauze, semipermeable film, hydrocolloids, and semipermeable foam) what is the order of dressings from most to least moisture retentive or absorptive out of alginates, hydrogels, semipermeable film, semipermeable foam, and hydrocolloids?

1. macrophages; epithelialization rate and collagen synthesis rate 2. the ability of a dressing to transmit moisture, vapor, or gas between a wound bed and the atmosphere 3. fully occlusive means nothing gets in or out (latex gloves) vs. non-occlusive means anything can get in and out almost (like gauze) 4. hydrocolloid, hydrogel, semipermeable foam, semipermeable film, impregnated gauze, alginates, traditional gauze) - alginates, semipermeable foam, hydrocolloids, hydrogels, semipermeable film

Malabsorption Syndrome: Diagnosis 1. This is a condition in which the GI tract fails to properly absorb nutrients from ingested food resulting in what? 2. What are 2 infectious agents that cause this? 3. What are 2 structural defects that cause this? 4. What mucosal abnormality causes this? 5. What enzyme deficiency causes this? 6. What 2 digestive insufficiencies cause this? 7. What systemic disease causes this? 8. This occurs when what sequence is disrupted in the intestines?

1. malabsorption 2. HIV or giardia 3. Crohn's disease or diverticula 4. celiacs disease 5. lactose intolerance 6. cystic fibrosis or pancreatitis 7. diabetes 8. digestion-absorption-transport sequence

Psychological Disorders: Dissociative 1. What are 2 types of dissociative disorders? 2. Dissociative disorders develop when a person unconsciously does what? 3. Multiple Personality: This includes how many personalities? Does each personality know about the other? This diagnosis is believed to allow a patient to engage in behaviors that are against the patient's _______________. 4. Psychogenic Amnesia: This is produced by what? What occurs?

1. multiple personality and psychogenic amnesia 2. dissociates one part of the mind from the rest 3. 2 or more; they may or may not; morality 4. the mind with no physical cause; the patient forgets all aspects of the past

Neuropathic Ulcers: Management Of Symptoms 1. Medical management typically emphasizes management of contributing factors. What are examples of this? 2. What medication is commonly given to those with neuropathic ulcers? What if there is an infection? 3. What might be used to protect the extremity as the wound heals (3)? 4. Surgical management includes __________________ for wounds with heavy necrosis, ____________________ for non-healing wounds, and ______________________ of bony structures to reduce pressure points and restore vascular integrity. 5. What 2 types of wounds may specifically benefit from debridement with pulsatile lavage and packing? 6. What should be ruled out if a neuropathic ulcer starts to produce a lot of exudate? 7. For more severe wounds, healing interventions include what 2 things? 8. What type of documentation is recommended?

1. managing blood glucose, hypertension, hyperlipidemia, obesity, etc. with lifestyle changes 2. platelet derived growth factors (PDGF); antibiotics 3. total contact casting, special footwear, or activity restrictions 4. debridement; grafts; restoration 5. deep wounds or those with significant tunneling 6. infection 7. hyperbaric oxygen chamber or vacuum assisted closure 8. photo documentation

Pharmacological Psychiatric Management: Bipolar Disorder Agents 1. These focus on prevention of ____________ episodes in order to avoid the extreme mood swings that follow. 2. What is the primary agent used in this treatment? 3. Certain __________________ and _________________ medications may assist as mood stabilizers with bipolar disorder. 4. Side effects of bipolar agents include: distress in what system? what type of dyskinesia? what level of arousal? what mental status? what in gait? what in the eyes? what involuntary movement? what Parkinson like symptom? what neuro symptoms (2)? what diagnosis? There is a risk of what? 5. Long term use of lithium can result in __________________ and should be noted by the PT. 6. What is the brand name for lithium? 7. What are 2 forms of antipsychotics that can be used to treat bipolar disorder? 8. What are 2 forms of antiseizure meds that can be used to treat bipolar disorder?

1. manic episodes 2. lithium 3. antiseizure and antipsychotic 4. GI distress, tardive dyskinesia, lethargy/fatigue, confusion, ataxic gait, nystagmus, tremors, parkinsonism, seizures or coma, diabetes insipidus, death 5. osteoporosis 6. lithobid 7. Clozaril or Risperdal (risperidone) 8. tegretol or Neurontin (gabapentin)

Venous Insufficiency Ulcers: Confirming Your Patient has This 1. Where do patients commonly develop venous insufficiency ulcers? 2. Are these typically larger or smaller in area and more shallow or deep than arterial and neuropathic ulcers? 3. What are wound borders of venous ulcers usually like? 4. What is the wound bed typically like in venous ulcers? 5. Venous ulcers may initially be obscured by a moist layer of what? 6. Both the wound borders and wound bed will typically ______________ easily with disruption due to distended and fragile superficial capillaries. 7. What 2 types of exudate are typically moderate to heavy with venous ulcers? 8. Signs of what condition may be observed in surrounding skin including a dry, flaky appearance and ruddy, brownish skin discoloration termed hemosiderin staining. 9. What occurs to distal lower extremity pulses in venous ulcers? 10. Pain complaints with venous ulcers are typically relieved by what 2 things? 11. What is the least invasive method of assessing venous blood flow? 12. What should be obtained before applying compression?

1. medial lower leg between the mid calf and malleoli (gaiter zone) 2. larger in area and more shallow 3. irregular wound borders 4. red granulation tissue and moist 5. white yellow slough that requires debridement 6. bleed 7. serous or serosanguineous 8. stasis dermatitis 9. normal 10. elevation or compression 11. duplex ultrasonography 12. ABI (contraindicated if arterial insufficiency is indicated by ABI)

Electrolyte Imbalances: Diagnosis 1. There are several causes for electrolyte imbalances including medications, what 2 GI symptoms, inadequate __________ or malabsorption, what 2 types of injuries, what diagnosis, disorders in what organ, what 2 general disorders, disease in what 2 organs, what type of heart failure, excessive intake of what, eating disorders. 2. Electrolyte imbalances commonly involve what 6 electrolytes? 3. Skeletal muscles may be affected if there are abnormal concentrations of what 4 electrolytes?

1. medications, nausea/vomiting, inadequate diet or malabsorption, trauma or burns, cancer, thyroid disorders, metabolic or endocrine disorders, liver or renal disease, congestive heart failure, excessive intake of alcohol, or eating disorders 2. calcium, chloride, magnesium, potassium, phosphate, and sodium 3. sodium, potassium, magnesium, calcium

Brain Cancer: 1. This occurs as a primary tumor arising from what 4 structures in the brain? 2. Metastatic brain cancer stems from what? 3. Symptoms of brain cancer include: pain in what region? what neuro symptom? what can happen to ICP? what are 2 behavioral/mental impairments that can occur? What are 2 functions that are decreased? 4. What is typical treatment?

1. meninges, nerves, astrocytes, or brain tissue 2. stems from progressed primary cancer 3. headache, seizures, increased ICP, cognitive and emotional impairment, decreased motor and sensory function 4. resection and radiation typically

Partial Thickness Burns: Management of Symptoms 1. A superficial partial thickness burn will typically re-epithelialize with __________________ to ______ scarring how fast? 2. Management primarily involves what 2 things for superficial partial thickness burns? 3. Is PT necessary for superficial partial thickness burns? 4. A deep partial thickness burn will typically heal through formation of a ___________ and in some cases may require a _____________. 5. A deep partial thickness burn if there is uncomplicated healing will typically heal how fast?

1. minimal to no scarring; 5-21 days 2. maintenance of a moist environment and protection of the damaged area through dressings 3. no 4. scar; graft 5. 21-35 days

Oncology Pharmacological Management: Plant Alkaloid Agents 1. What is another name for plant alkaloid agents? 2. These are _______________ based and largely derived from plants. 3. These directly target the __________________ process before and during mitosis to inhibit cell division. 4. What are 3 forms of plant alkaloid agents used to fight cancer?

1. mitotic inhibitors 2. nitrogen based 3. replication process 4. Taxol, Taxotere, and Oncovin

Female Genital System: 1. What are 8 external genitalia of the female? 2. What are 2 functions of the female external genitalia? 3. Ovaries are suspended in what ligament? What are 2 hormones they release?

1. mons pubis, labia majora, labia minora, clitoris, vestibule of vagina, bulbs of vestibule, greater vestibular glands, Skene's gland 2. to protect and hydrate the vagina and urethra 3. suspended in the broad ligament; releases estrogen and progesterone

Diastasis Recti: Contributing Factors 1. The risk of developing or exacerbating the condition increases with what in regards to pregnancy? 2. Diastasis recti is often observed in what population? 3. What other population other than pregnant women or premature infants is at risk for developing diastasis recti?

1. multiple pregnancies 2. premature infants - this is considered normal for this population 3. those that are obese

Constipation: 1. This occurs in what 2 progressive neuromuscular diseases? 2. This occurs in what 2 CNS injuries? 3. This occurs in what 2 GI diseases? 4. This occurs in what type of disorder? 5. This occurs with low amounts of _________________. 6. This occurs with what type of obstruction? 7. This occurs with what type of reproductive status? 8. This occurs with what that you intake?

1. multiple sclerosis or Duchenne muscular dystrophy 2. SCI or CVA 3. diverticulitis or irritable bowel syndrome 4. endocrine disorder 5. low amounts of activity 6. bowel obstruction 7. pregnancy 8. intake of certain medications

GI Pharmacological Agents: Antiemetic Agents 1. These are used to decrease what symptoms? 2. Indications for antiemetic agents include nausea associated with what 4 things? 3. What are 3 side effects of antiemetic agents? 4. What type of antiemetic agent frequently causes sedative effects which can be limiting to PT? 5. What is an anticholinergic antiemetic agent? 6. What is an antihistamine antiemetic agent? 7. What is a 5-HT3 receptor antagonist antiemetic agent? 8. What is a promethazine hydrochloride antiemetic agent?

1. nausea and vomiting 2. pain, anesthesia, motion sickness, oncology 3. sedation, dysrhythmias, pain 4. antihistamine antiemetic agents (Meclizine) 5. Scopolamine 6. Meclizine 7. Dolasetron 8. Phenergan

Psychiatric Pharmacological Management: Antipsychotic Agents 1. What is another name for antipsychotic agents? 2. These agents block ________________ receptors and reduce the overactivity of _______________ typically transmitted in areas such as the __________________ system. 3. The agents will bind to dopamine receptors, and do they activate them? 4. What are 3 indications for use of antipsychotic agents? 5. Side effects of traditional agents include: increased ____________________ symptoms, ______________ dyskinesia, what Parkinson like symptom, what inability to sit still, what level of arousal, what in the bowels, what in the mouth? 6. Side effects of atypical agents include what to weight? what diagnosis? what happens to cholesterol? 7. What is the largest barrier to therapy when patients are taking antipsychotic agents? 8. What are 2 examples of traditional antipsychotic agents? 9. What are 2 examples of atypical antipsychotic agents?

1. neuroleptic agents 2. dopamine; dopamine; limbic 3. they block activation and do not activate them themselves 4. schizophrenia, various psychotic disorders, Alzheimer's in certain cases 5. increased extrapyramidal symptoms, tardive dyskinesia, pseudoparkinsonism, akathisia, sedation, constipation, dry mouth 6. weight gain, diabetes, hyperlipidemia 7. extrapyramidal symptoms 8. Haldol or Thorazine 9. Risperidone or Abilify

Chronic Fatigue Syndrome: Outcomes 1. Is there a cure? 2. Patients may experience complete symptom resolution in how long? 3. Can patients experience symptoms the rest of their life?

1. no 2. as little as 6 months 3. yes

Diverticular Disease: Confirming Your Patient Has This 1. Do patients with diverticulosis always have symptoms? 2. Those with diverticulosis may experience pain in what region? what body temp? what GI symptoms? (4) 3. More serious complications of this condition include bleeding where? what type of obstruction? infection of what region? 4. What imaging device is used to best diagnose diverticular disease?

1. no they are typically asymptomatic 2. abdominal pain especially in the left lower quadrant), fever, nausea, vomiting, constipation, diarrhea 3. bleeding in the rectum, colon obstruction, abdominal cavity infection 4. CT scan

MSK Pain and Oncology: 1. Should MSK complaints in oncology patients be taken lightly? 2. New back pain complaints of unclear origin should be evaluated immediately because the pain can be indicative of what?

1. no this can be very serious and may indicate metastasis to a new location 2. spinal metastasis and can result in neuro symptoms

Cellulitis: Diagnosis 1. Is this contagious? 2. This is a bacterial skin infection occurring in what 2 layers of the skin? 3. What are 3 other microbes that can cause cellulitis other than staphylococci and streptococci? 4. What are 3 examples of when this can occur from the protective barrier being compromised? 5. Repeated cellulitis infections and the associated edema can cause permanent damage to what?

1. non-contagious 2. dermal and subcutaneous layers 3. pseudomonas, pneumococcus, and clostridium 4. bug bite, surgical incision, abrasions 5. to the lymphatic system

Bacterial Terminology of Wounds: 1. Contamination: There is presence of replicating or non-replicating bacteria? Does this cause additional tissue injury? Does this stimulate an inflammatory immune response? 2. Colonization: There is presence of replicating or non-replicating bacteria? Does this cause additional tissue injury? Does this stimulate an inflammatory immune response? 3. Infection: There is presence of replicating or non-replicating bacteria? Does this cause an inflammatory immune response? Does this delay wound healing? This can progress to what 3 conditions?

1. non-replicating bacteria; no; no 2. replicating; no; no but can delay wound healing 3. replicating that invades tissue beyond the wound surface; yes; significantly yes; osteomyelitis/gangrene/sepsis

Pressure Ulcers: Confirming Your Patient Has This 1. What is the definition of a stage 1 pressure ulcer? 2. What is the definition of a stage 2 pressure ulcer? 3. What is the definition of a stage 3 pressure ulcer? 4. What is the definition of a stage 4 pressure ulcer? 5. Why would urine or stool samples be indicated? 6. What are 3 staging techniques to stage pressure ulcers?

1. nonblanchable erythema of intact skin with warmth 2. a partial thickness wound that extends through the epidermis and part of the dermis 3. extends into subcutaneous tissue but NOT through the fascia 4. extends through the fascia and deeper potentially to muscles, bones, ligaments, and tendons 5. to determine contributing factors 6. Norton, Gosnell, or Braden scales

Red-Yellow-Black System: 1. Red: what is the description of the wound? what is the goal for this wound to manage it? (2) 2. Yellow: what is the description of the wound? what is the goal for this wound to manage it? (2) 3. Black: what is the description of the wound? what is the goal for this wound to manage it?

1. pink granulation tissue; keep a moist environment and protect it 2. moist yellow slough; remove exudate and debris and absorb drainage 3. black thick eschar; debride necrotic tissue (UNLESS on heel)

Selective Debridement: 1. This involves the removal of viable or nonviable tissue from the wound? 2. What are 3 of the most commonly performed forms of selective debridement? 3. Sharp debridement: This is most often used for what wounds? This can also be used in the presence of what 2 systemic conditions? 4. Enzymatic debridement: This is _______________ application of an enzyme to necrotic tissue. Can this be used on infections? This can also be used for wounds that have not responded to ____________________ debridement or in conjunction with other debridement techniques. How quick is this to take an effect? 5. Autolytic debridement uses what 4 things to trigger the body to digest it's own nonviable tissue? What type of wound environment does this produce? Is this invasive? Is this painful? Can this be done on infected wounds? How quick is this to take effect?

1. nonviable tissue removal ONLY 2. sharp debridement, enzymatic debridement, and autolytic debridement 3. used for wounds with large amounts of thick, adherent, necrotic tissue; sepsis or cellulitis 4. topical; can be used on infections; autolytic; this is slow to clean a wound bed 5. hydrocolloids, hydrogels, alginates, or transparent film; moist wound environment; non-invasive; painless; this cannot be done on infected wounds; this is a slow process

Chronic Fatigue Syndrome: Contributing Factors 1. The patient could potentially have what type of deficiency causing this? 2. The patient could have what type of imbalance? 3. The patient could be in what mental state? 4. The patient could have what blood condition? 5. The patient could have what going on with their blood pressure?

1. nutritional deficiency 2. hormonal imbalance 3. depression 4. anemia 5. hypotension

Hepatitis: 1. This is an inflammatory process of what organ? 2. Hepatitis from what pathogen is most common? 3. What 3 types of hepatitis are most common? 4. Other than viral origin, other etiologies of hepatitis include a _______________ reaction, __________ reaction, or _____________ abuse. Other viruses that can cause hepatitis include what 4 viruses? 5. S/S include: what body temp? what type of symptoms? abrupt onset of what? what with appetite? pain where? what discoloration of the skin? what color of urine? what color of stool? what occurs to the spleen and liver? what feeling occurs intermittently? 6. Acute viral hepatitis usually resolves with medical treatment. Chronic hepatitis may result in the need for what?

1. of the liver 2. viruses 3. hepatitis A, B, and C 4. chemical reaction, drug reaction, or alcohol abuse; Epstein-barr virus, herpes 1 and 2, varicella zoster, or measles 5. fever, flu symptoms, abrupt onset of fatigue, anorexia, headache, jaundice, darkened urine, lighter stool, enlarged spleen and liver, intermittent pruritus (itching) 6. liver transplant

Healing By Intention: Secondary Intention 1. This permits wounds to close how? 2. Wounds with characteristics such as __________________ tissue loss, _______________ tissue present, _________________________ wound margins, ______________________________ contamination are all ideal for secondary intention healing. 3. A layer of _______________________ tissue will gradually fill the wound bed to the level of the surrounding skin with closure occurring by what 2 things? 4. Are scars that form from secondary intention larger or smaller than those from primary intention? 5. What are 5 forms of wounds that typically are left to heal via secondary intention?

1. on their own without superficial closure 2. significant tissue loss, necrotic tissue present, irregular wound margins, infection or debris contamination 3. granulation; contraction of the wound and scar formation 4. larger in secondary than in primary 5. neuropathic/venous/arterial/pressure ulcers and full thickness wounds

HIV: Outcomes 1. What is the leading cause of death that is AIDS related? 2. What are 3 of the leading causes of death in non-AIDS progressed patients?

1. opportunistic infection 2. cardiopulmonary disease, cancers, or liver disease

Enteral Administration: 1. What are 3 forms of enteral administration? 2. Oral administration: This involves absorption by the GI tract that allows for a _______________ increase in drug levels in the body. A disadvantage to oral administration is that the compound must be _____________ soluble so that the intestinal tract can absorb it. This can be achieved by placing a _________________ soluble medication inside a lipid soluble _____________. Other disadvantages include ____________ irritation, metabolism and degradation by the ______________ before it reaches its target, and factors that affect intestinal absorption making ______________________ unpredictable. 3. Sublingual Administration: This involves passage of a drug through what 2 ways? What is sublingual mucosa verses buccal mucosa? After being absorbed, the drug travels through the venous system directly to the what? After it goes through the heart, where does it go next? This form of administration allows for faster or slower intro of the drug in cases of acute pain (angina) and allows for the drug to bypass what organ so it is not overly metabolized? 4. Rectal Administration: This means insertion of a ____________________________ into the rectum and absorption of the drug in the rectal cavity. This is advantageous for patients who cannot take drugs orally due to what 2 things? As with sublingual medication, these drugs also bypass what organ? Are drugs absorbed well through the rectum?

1. oral, sublingual, or rectal 2. gradual increase; lipid soluble; nonlipid soluble; capsule; gastric irritation; liver; bioavailability 3. sublingual mucosa or buccal mucosa; sublingual means under the tongue and buccal means between the cheek and gums; directly to the heart; into the arterial system; faster; bypasses the liver 4. suppository; vomiting or unconscious; the liver; not as well absorbed through the rectum

Cellulitis: Management of Symptoms 1. How are antibiotics typically administered to these patients? 2. How are antibiotics administered to patients with severe cases? 3. With antibiotic intervention symptoms should begin to resolve how fast? 4. Until symptoms have dissipated, what should the patient do?

1. orally 2. intravenously 3. within a few days 4. rest and elevate the extremity that is affected to reduce swelling

Astrocytoma: 1. This accounts for approximately 50% of what? 2. Etiology of astrocytomas include ______________ predisposition, ___________________ influence, ___________________ and ______________ exposure, and association with certain childhood disorders. 3. What are 2 types of astrocytomas? 4. Cerebellar Astrocytoma Symptoms: What is seen in gait? 5. Supratentorial Astrocytoma Symptoms: What neuro symptom can occur? What sensory impairment is often seen? 6. What are 3 common symptoms in both types of astrocytomas? 7. What is typical treatment for these type of brain tumors? 8. Surgical resection of cerebellar tumors are how successful? 9. Supratentorial tumors require surgery to resect the tumor but with what?

1. pediatric brain tumors 2. genetic predisposition, environmental influence, radiation and toxin exposure, and association with childhood disorders 3. cerebellar or supratentorial 4. ataxic and clumsy gait 5. seizures; visual impairments 6. vomiting, personality changes, headache 7. surgical resection 8. 80-90% 9. radiation/chemo

Pharmacology Effects of Cardiovascular and Pulmonary Systems: 1. Antihypertensive Agents: These increase the risk of what occurring to the patient? Interventions that could cause widespread vasodilation including what type of modality should be avoided in patients taking vasodilating drugs. Patients taking beta blockers may have diminished HR response therefore what should be used to assess HR? 2. Antianginal Agents: Other patients, especially those taking what 2 things, will have diminished HR response to exercise. These patients may not be able to tolerate what? These patients are at an increased risk for what? 3. Antiarrhythmic Agents: These can sometimes lead to an increase in _______________________ or a change in the type of arrhythmia the patient is experiencing. If beta blockers or calcium channel blockers are used to treat cardiac arrhythmia, therapists should be aware of the risk of what? 4. Congestive Heart Failure Agents: Patients taking diuretics may experience fatigue and muscle weakness due to what 2 things? 5. Anticoagulant Agents: This causes patients to be at an increased risk for what? PT interventions that increase the risk for tissue trauma such as what 2 things should be performed with caution. What type of interventions for wound care should be performed extra cautiously to avoid excessive bleeding? 6. Respiratory Agents: Patients who use bronchodilators may experience what in the heart? what mental state? what neuromuscular symptom? All of these are signs of what? Mucolytics and expectorants should be taken how long before chest PT to maximize effective treatment?

1. orthostatic hypotension; whirlpool; RPE 2. beta blockers or calcium channel blockers; high loads of activity; orthostatic hypotension 3. arrhythmias; orthostatic hypotension 4. fluid loss and electrolyte imbalances 5. excessive bleeding; soft tissue massage and chest percussion; dressing changes 6. cardiac arrhythmia; confusion; tremors; toxicity; 30-60 minutes before chest PT

Paget's Disease: 1. This is a metabolic condition characterized by heightened ___________________ activity. 2. this process of excessive bone ___________________ lacks true structural integrity because the bone appears enlarged but lacks strength due to the high turnover of bone secondary to abnormal osteoclastic proliferation. 3. This disease has a __________________ component as well as _____________________ incidence. 4. Paget's disease most commonly affects patients of what age? 5. Symptoms include: what type of pain? what bony deformity can occur in the spine (2)? what bony deformity can occur in the long bones? what bony deformity can occur in the hips? 6. What are 6 common sites that exhibit bony changes in Paget's disease? 7. Other symptoms include: pain where? what feeling in the head? what sense could be lost? what occurs to mental acuity? what level of arousal can occur? what occurs to the heart? 8. Treatment for Paget's disease relies heavily on pharmacological intervention using what to inhibit bone resorption and improve quality of involved bone? 9. What 3 things are all key components in a program to maintain strength and motion in Paget's disease?

1. osteoclast 2. formation 3. genetic; geographical 4. patients over the age of 50 5. MSK pain, thoracic kyphosis or vertebral compression, bowing of the long bones, coxa vara 6. pelvis, skull, clavicle, femur, spine, tibia 7. headache, vertigo, hearing loss, mental deterioration, fatigue, increased cardiac output that can lead to heart failure 8. bisphosphonates 9. improved cardio fitness, exercise, and weight loss

Osteoporosis: Diagnosis 1. Out of osteoblasts and osteoclasts which activity exceeds the other? 2. Osteoporosis primarily affects trabecular or cortical bone in a postmenopausal patient? What about in the general geriatric population? 3. Fractures of what 3 regions are the most common?

1. osteoclast activity exceeds osteoblast activity 2. trabecular bone in postmenopausal patients; both trabecular and cortical in senile osteoporosis 3. distal radius/ulna, vertebrae, and femoral neck

Rehab Considerations for those with Malabsorption Syndrome: 1. You as a therapist need to recognize the risk for what 2 bone conditions? 2. You need to monitor ___________ levels, ____________ pain, and ____________ tolerance in these patients. 3. You need to recognize the patient is at an increased risk for what due to electrolyte imbalances. 4. You need to recognize the patient is at an increased risk for generalized ________________ due to protein depletion.

1. osteoporosis or fractures 2. fatigue levels, bone pain, and activity tolerance 3. for muscle spasms 4. swelling

Mitochondrial Disorders: 1. How many forms of mitochondrial disease are there? 2. These typically result from what 2 causes that lead to impaired functions of _________________ found in the mitochondria. 3. Signs and symptoms vary but can include loss of muscle __________________, muscle _______________, what 2 sensory issues, what type of disability, what 3 types of organ disease, what 3 types of system disorder, and what cognitive diagnosis? 4. These diagnoses are relatively new and so treatment is focused on treating _________________ and slowing ____________________.

1. over 100 2. genetically inherited or spontaneous mutation of DNA that lead to impaired functions of proteins in mitochondria 3. coordination; weakness; visual and hearing issues; cognitive disability; liver, heart, kidney disease; GI, neuro, and respiratory system disorders; dementia 4. symptoms and slowing progression

Breast Cancer: Confirming Your Patient Has This 1. Approximately 70% of all breast cancers occur in women of what age? 2. As the disease progresses the breast may become ________________, change _____________, _____________ from the nipple, and ______________ over the area of the mass. 3. Symptoms associated with metastases include ____________ pain, edema in what region, what happens to weight? 4. What is used to detect the location and growth of the mass? 5. Diagnosis of breast cancer is only made after what? 6. What is used to identify exact lymph node involvement?

1. over the age of 50 2. painful, change shape, bleed from the nipple, and dimple over the mass 3. bone pain, UE edema, and weight loss 4. mammography 5. after tissue biopsy 6. sentinel lymph node mapping

Rehab Considerations for Patients with Peptic Ulcer Disease: 1. What 3 things must be monitored for signs of bleeding? 2. What type of change in HR would signal bleeding? 3. What type of change in BP would signal bleeding? 4. Pain in what region is a sign of a perforated ulcer located on the posterior wall of the stomach and duodenum. 5. Pain that radiates from the __________________ area to what quadrant and shoulder may signify blood and acid in the peritoneal cavity secondary to a perforated and bleeding ulcer.

1. pallor, exercise tolerance, fatigue levels 2. increased HR 3. decreased BP 4. pain in the back 5. pain that radiates from the midthoracic area to the right upper quadrant and right shoulder

Endometriosis: Confirming Your Patient Has This 1. What is the primary symptom associated with this condition? 2. What can worsen the pelvic pain? 3. What is the only test that can definitively diagnose this? 4. Ultrasound may be used to aid in the diagnosis but is only effective in identifying what? 5. Other conditions need to be ruled out including what 2 things?

1. pelvic pain 2. menstruation 3. laparoscopy 4. large cysts 5. irritable bowel syndrome or pelvic inflammatory disease

Arterial Insufficiency Ulcers: Contributing Factors 1. What diagnosis is typically linked to the development of arterial insufficiency ulcers?

1. peripheral arterial disease (PAD)

Urinary Stress Incontinence: Contributing Factors 1. What reproductive status? 2. What type of birth? 3. What type of surgical incision during delivery births? 4. What 2 types of surgeries? 5. What natural process? 6. What diagnosis? 7. Dysfunction in what 2 nervous systems? 8. What type of recurrent infection? 9. A prolapse in what 3 structures may contribute to leakage? 10. This is seen in women who have had what in regards to number of pregnancies? 11. What is a risk factor in regards to weight that is believed to increase intra-abdominal pressure?

1. pregnancy 2. vaginal birth 3. episiotomy 4. pelvic or prostate surgery 5. aging 6. diabetes 7. dysfunction in the PNS or CNS 8. recurrent UTIs 9. prolapsed bladder, uterus, or bowel 10. multiple pregnancies 11. obesity

Recommendations for Exercise in Pregnancy and Postpartum: 1. Women should avoid supine after their first trimester. What other position should they avoid prolonged? 2. Women should be aware of the decreased ______________ available for aerobic exercise during pregnancy. 3. What are 2 examples of great NWB exercises for pregnant women? 4. Pregnancy requires an additional _________ kcal/day in order to maintain metabolic homeostasis. Thus women who exercise during pregnancy should be particularly careful to ensure an adequate diet. 5. Pregnant women who exercise in the first trimester should augment heat dissipation by ensuring adequate _______________, ________________ clothing, and optimal __________________ surroundings. 6. Many of the physiological and morphological changes of pregnancy persist for how long postpartum?

1. prolonged standing still 2. oxygen 3. swimming or biking 4. 300 kcal/day 5. adequate fluids, loose clothing, and optimal environmental surroundings 6. 4-6 weeks

Types of Burns: 1. What are 4 types of burns? 2. Thermal burns are caused by ______________________ or _____________________. Thermal burns result from contact with what 3 things? 3. Electrical burns are caused by passage of ________________ _________________ through the body. Typically there is what type of wound? Complications can include what with the heart? What with the lungs? What with the kidneys? What with the nervous system? What with the bones? 4. Chemical burns occur when certain chemical compounds come in contact with the body. When do these stop? Compounds that cause chemical burns include what 4 things? 5. Radiation burns occur most commonly with exposure to what type of radiation therapy? What occurs to DNA when radiation is given to a patient? Complications from radiation can include what on the skin? what in the tissues? what color on the skin? what types of cancers?

1. radiation, chemical, thermal, or electrical 2. convection or conduction; hot water/steam/fire 3. electrical current; entrance and exit wound; cardiac arrhythmias/respiratory arrest/renal failure/neurological damage/fracture 4. when the area of the skin the chemicals came in contact with is diluted; hydrochloric acid/gasoline/lye/sulfuric acid 5. external beam radiation therapy; DNA is altered in exposed tissues and irreversible ischemic injury occurs; severe blistering/desquamation/non-healing wounds; tissue fibrosis; skin discoloration that is permanent; new malignancies

Partial Thickness Burns: Confirming Your Patient Has This 1. A superficial partial thickness burn is characterized by a ___________ color that will or will not blanch when touched? 2. Blanching indicates what? 3. What 2 things are typically present in a superficial partial thickness burn? 4. Do hair follicles remain intact in superficial partial thickness burns? 5. The preservation of deeper dermal tissues will allow for ______________________ regeneration during healing in superficial partial thickness burns. 6. A deep partial thickness burn is also characterized by _________ discoloration however when touched does it or does it not blanch? 7. What does the absence of blanching in deep partial thickness burns mean? 8. Does edema accumulate between the epidermal and dermal layers for both superficial and deep partial thickness burns? 9. Cellular necrosis is typical with deep partial thickness burns, especially in what layer? 10. Healing occurs in deep partial thickness burns from what 2 things?

1. red color that will blanch 2. capillary refill and no damage to the deeper blood vessels 3. superficial moisture and blisters 4. yes 5. epithelial regeneration 6. red discoloration however it does not blanch 7. there was damage to the deeper blood vessels 8. yes 9. the upper dermal layer 10. scarring or grafting

Stage 2 Pressure Injury: partial thickness skin loss with exposed dermis 1. The wound bed is viable, and of what 2 colors? what is the wound environment? 2. This can present as what? 3. Is adipose and deeper tissues visible? 4. Is granulation tissue, eschar, or slough present in stage 2 pressure injuries?

1. red or pink; moist 2. serum filled blisters 3. no 4. no

Cellulitis: Confirming Your Patient Has This 1. What can be spotted leading away from the primary site of infection that is a primary sign of cellulitis? 2. What type of drainage will be seen coming from the area with cellulitis? 3. What occurs to lymph nodes when cellulitis occurs? 4. What may be used to evaluate the patient's white blood cell count? If it is elevated, what does this suggest? Is this test conclusive by itself? 5. What can assist in identifying the specific infectious microbe present so that antibiotics can be more specific?

1. red streaks 2. serous (typically pale yellow) weeping drainage 3. tender and swollen 4. blood sample analysis 5. wound culture

Ankylosing Spondylitis: Management of Symptoms 1. Main 3 goals of medical management include reduce ___________________, maintain ___________________ __________________, and relieve _________________. 2. What are 4 drugs used to treat ankylosing spondylitis? Which one is specifically used for pain relief? 3. PT should focus on what type of exercises? Emphasizing what spinal direction? General what? What type of management? What type of techniques? What type of cardio is appropriate? 4. What 2 types of exercises are CONTRAINDICATED for ankylosing spondylitis? 5. What should you educate your patients about for night time? 6. What types of workout techniques should you educate your patient about? 7. What should be avoided as it can increase the inflammatory response and injury? 8. What cardio exercise is highly recommended for ankylosing spondylitis? 9. What type of sleeping surface does the patient require?

1. reduce inflammation, maintain functional mobility, and relieve pain 2. NSAIDs, analgesics, methotrexate, and Indomethacin; INDOMETHACIN** 3. postural exercises, emphasizing spinal extension, general range of motion, pain management, energy conservation techniques, low impact and aerobic exercise is appropriate with emphasis on extension and rotation 4. flexion exercises or high impact exercises are contraindicated** 5. sleeping position 6. proper lifting 7. too much exercise 8. swimming 9. firm surface

Fibromyalgia Syndrome: Management of Symptoms 1. PT interventions include ______________________ and _______________ ______________________ techniques, ____________ stretching, what 3 modalities, what types of body mechanic education, and tolerance to what? 2. What is recommended to improve a patient's fitness level? 3. What type of evaluation should be performed? 4. This population should not work through what? 5. These patients with fibromyalgia require _____________ exercise sessions that are initially how long? These patients have a ________ tolerance to exertion. ** 6. What is the key to success? 7. What types of exercises should be avoided?

1. relaxation and energy conservation techniques, gentle stretching, moist heat, ultrasound, biofeedback, postural education, and tolerance to exercise 2. aquatic therapy 3. ergonomic evaluation 4. pain 5. short exercise sessions initially 3-5 minutes long; low tolerance to exertion ** 6. patient education 7. exercises that strain muscles like lifting **

Endometriosis: Diagnosis 1. What is the most widely accepted theory of what causes this? 2. Structures most commonly affected include what 6 structures?

1. retrograde menstruation theory - where menstrual blood flows backwards in the fallopian tubes and into the pelvic cavity 2. ovaries, fallopian tubes, uterine ligaments, urinary bladder, ureters, and intestines

Human Immunodeficiency Virus (HIV): Diagnosis 1. This is a ______________________ that initially invades and destroys cells in the immune system. 2. What specific immune cells does HIV invade and destroy? 3. This virus also affects what 3 other cell types? 4. When do patients typically start to exhibit symptoms? 5. HIV uses and destroys cells that possess the ____________ _____________ on their surface in order to replicate HIV, and as a result the immune system becomes weaker and unable to function.

1. retrovirus 2. CD4+ T-lymphocytes (T cells) 3. monocytes, B cells, and macrophages 4. once the number of T cells drops below a specific number 5. CD4 antigen

Fibromyalgia Syndrome: Diagnosis 1. This is classified as a ______________ syndrome or a nonarticular rheumatic condition. 2. What is the primary symptom? 3. What causes the pain?

1. rheumatic syndrome 2. pain 3. tender points (NOT TRIGGER POINTS**) in muscles, tendons, and ligaments

Systemic Sclerosis: 1. What is another name for systemic sclerosis? 2. This is a __________________ tissue disease characterized by excessive ________________ production which leads to changes in the skin and internal organs. 3. This is typically caused by an abnormal _____________ response. 4. What are 2 types of systemic sclerosis? 5. Limited scleroderma is characterized by thickening of the skin without involvement of what? This form tends to affect what regions of the body? 6. Diffuse scleroderma affects the skin on all areas of the body and also affects what? What are 4 organs commonly affected? 7. S/S of scleroderma include: what feeling on the skin? skin that appears ______________, what color or texture of skin, what phenomenon, what occurs in muscles, what occurs in joints, what occurs to lung function, what occurs to blood pressure in the lungs, what occurs in the GI tract (3), what occurs to the kidneys? 8. Involvement of what 3 organs generally leads to poor prognosis?

1. scleroderma 2. connective tissue; collagen 3. immune 4. limited or diffuse 5. without involvement of internal organs; distal to the elbows and knees 6. internal organs; GI tract, lungs, kidneys, heart 7. itchy, tight, red or scaly skin, Raynaud's phenomenon, muscle weakness, joint pain, decreased lung function, pulmonary hypertension, GERD/decreased gastric or intestinal motility/intestinal malabsorption, renal failure 8. kidneys, lungs, heart

Alginate Dressings: 1. These are derived from _________________ extractions, specifically what component of alginic acid? 2. Are these absorptive? permeable? occlusive? 3. Do these require a secondary dressing? 4. What are 2 things these dressings do? 5. What are 2 types of wounds alginates are used on? 6. Can these be used on infected wounds? 7. What do these trigger in the body? 8. Do these adhere to the wound? 9. What is a disadvantage in regards to the amount of care it requires to apply an alginate dressing to a patient? 10. Can these be used on wounds with exposed tendons, joint capsule, or bone?

1. seaweed; calcium salt 2. highly absorptive, highly permeable, non-occlusive 3. yes 4. act as a hemostat and create a hydrophilic gel through the interaction of calcium ions in the dressing and sodium ions in the wound exudate 5. partial or full thickness wounds like in venous insufficiency ulcers or pressure ulcers 6. yes 7. autolytic debridement 8. no 9. frequent dressing changes 10. no

Pharmacology Effects on Musculoskeletal Systems: 1. General Anesthesia: This can last how long in some patients? What are 2 of the most common side effects associated with anesthesia? Since anesthesia can result in retained pulmonary ___________________, the PT may need to initiate what after this is administered? 2. Local Anesthesia: How is this typically administered? What are 2 things that will be diminished after surgery? Exercise should be performed ________________ since the patient may not fully feel pain. What might be needed during ambulation if the patient is lacking motor control? Local anesthesia may also be administered in the form of transdermal patches called lidocaine to help control pain. What should therapists NEVER** apply to this area when there is a patch on? 3. Opioid Analgesic Agents: What do these do? Therapy sessions should be scheduled to coincide with what? Side effects that the PT needs to look out for include what 2 things? 4. NSAIDs: These provide analgesia while avoiding the side effects of other pain meds however, these are not as effective. What is the primary side effect of taking NSAIDs? 5. Antiarthritic Agents: ___________________ drugs tend to have catabolic effects and can lead to the breakdown of tendon, bone, or skin. Therapists should be cautions with what interventions to avoid soft tissue injury or fracture? Care must be taken when applying what to the patient to prevent skin breakdown? The use of some antirheumatic drugs can result in an increase in what in the joints? what in size?

1. several days; muscle weakness and confusion; secretions 2. local or spinal nerve block; sensory and motor function; cautiously; a brace; therapists should NEVER** apply heat over a lidocaine patch 3. significantly reduce pain; peak incidence of the drug; sedation and respiratory depression 4. GI distress 5. glucocorticoid; aggressive stretching or strengthening; when applying orthotics; increased joint pain and edema

Urinary Incontinence: 1. This typically occurs when bladder pressure exceeds what? 2. 3 good PT interventions to perform with these patients include what type of release? what type of mobilization? strengthening of what musculature? 3. What can be injected? 4. Stress Urinary Incontinence (SUI): This is loss of urine dur to activities that do what? 5. Urge Urinary Incontinence (UUI): This is loss of urine after what? The most common causes are _____________ muscle overactivity, overactive bladder also known as what syndrome, changes in smooth muscle of the _______________, increased _________________ activity, increased sensitivity of the detrusor to ___________________. There is also association with what 4 neuro diseases? Two of the most common triggers are what? What is the primary goal of treatment? What modality is commonly used? Strengthening of what is done? What type of bladder retraining is recommended? 6. Overflow Urinary Incontinence (OUI): This is when there is a loss of urine when the intra bladder pressure exceeds what? This is caused by outflow obstruction secondary to a narrowed or obstructed ______________ which results from what 5 things? The patient may have difficulty with initiating what? Treatment likely includes surgery to do what? If there is weakness of the detrusor muscles, what is recommended for these patients? Failed intervention can result in what? 7. Functional Urinary Incontinence (FUI): This is loss of urine due to the inability or unwillingness to do what? What is the main causes (2)? What is treatment typical for this type of incontinence?

1. sphincter resistance 2. myofascial release, visceral mobilization, abdominal strengthening 3. a bulking agent to the urine 4. due to activities that increase intra abdominal pressure like coughing, sneezing, laughing, running, or jumping 5. loss of urine after the detrusor muscle of the bladder involuntarily contracts during bladder filling; detrusor muscle overactivity, overactive bladder known as urgency-frequency syndrome, changes in smooth muscle of the bladder, increased afferent activity, increased sensitivity of the detrusor to acetylcholine; Parkinson's, MS, SCI, or CVA; "key in the lock" when arriving home or running water; behavior modification; biofeedback; pelvic floor strengthening; scheduled voiding 6. when intra bladder pressure exceeds the urethra's capacity to remain closed due to urinary retention; urethra from prolapsed organ, stricture, enlarged prostate, chronic constipation, or neuro disease; initiating a stream; surgery to remove the obstruction; double voiding is recommended; intermittent catheterization 7. due to the inability or unwillingness to use the bathroom; decreased mental awareness or decreased mobility; improve mobility, remove tight clothing, increase independence

Contraindications to Exercise During Pregnancy: 1. Relative Contraindications include: what blood disease? what going on with heart rhythm? what going on in the lungs? what that is poorly controlled (4) What going on with weight? (2) What if the mom has a history of it? What going on with growth in the uterus? What type of limitations? What bad habit? 2. Absolute Contraindications include: What type of heart disease? What type of lung disease? What going on with the cervix? What going on with the number of fetuses? What occurring persistently? What going on with the placenta? What type of labor? What going on with the membranes? What going on with hypertension?

1. severe anemia, unevaluated maternal cardiac dysrhythmia, chronic bronchitis, poorly controlled type 1 diabetes, poorly controlled hypertension, poorly controlled seizure disorder, poorly controlled hyperthyroidism, extreme morbid obesity, extreme underweight (BMI less than 12), history of extremely sedentary lifestyle, intrauterine growth restriction in current pregnancy, orthopedic limitations, heavy smoking 2. hemodynamically significant heart disease, restrictive lung disease, incompetent cervix, multiple gestation at risk for premature labor, persistent second or third trimester bleeding, placenta previa after 26 weeks gestation (where the placenta covers the opening of the cervix), premature labor, membrane rupture, preeclampsia/pregnancy-induced hypertension

Hepatitis B (HBV): 1. Transmission of this virus occurs through sharing of ______________, _______________ with an infected person, exposure to an infected person's what 2 things, or what type of exposure through moms? 2. Approximately how many cases of hep B progress to chronic hepatitis since the body cannot always get rid itself of HBV? 3. Treatment includes hep B _____________________ for the unvaccinated patient within ____________ hours of exposure. 4. The patient should then receive vaccination series at __________ and ______________ months after immunoglobulin is administered. 5. If the patient is already vaccinated, they may require another dose of what? 6. Chronic hepatitis is now being treated with what that is providing remission for some patients?

1. sharing of needles, intercourse with an infected person, exposure to a person's blood or semen, maternal-fetal exposure 2. 10% progress to chronic 3. hep B immunoglobulin; 24 hours of exposure 4. 1 and 6 months 5. another dose of the HBV vaccine 6. interferon alfa-2b

Topical Agents Used in Burn Care: 1. What are the 6 topical agents commonly used for burns? 2. Silver Sulfadizine: Can these be used without a dressing? Is this painful? Can you apply to the wound directly? What type of spectrum is this? This is effective against what compound? What structure does this not penetrate through? 3. Silver Nitrate: What type of spectrum is this? Can this cause an allergic reaction? Is this painful? Does this penetrate easily through structures? What occurs that makes assessment difficult when this is applied? What type of imbalance can this cause? When is this dressing painful the most? 4. Povidone-Iodine: What type of spectrum is this? What pathogen does this fight? How is this easily removed? This is not effective against what pathogen? What organ may this impair function of? Is this painful to apply?

1. silver sulfadiazine, silver nitrate, povidone-iodine, gentamicin, nitrofurazone 2. can be used with or without a dressing; painless; can be applied to the wound directly; broad spectrum; effective against yeast; does not penetrate through eschar 3. broad spectrum; non-allergenic; dressing application is painless; does not penetrate easily; discoloration makes assessment difficult; severe electrolyte imbalances; painful dressing removal 4. broad spectrum; antifungal; easily removed with water; not effective against pseudomonas; impairs thyroid function; painful application

Diastasis Recti: Confirming Your Patient Has This 1. A visible separation can be visible when? 2. S/S include: weakness in what muscles? decreased stability in what region? pain in what region? 3. When is abdominal pain typically present? 4. To test if a patient has this, what position should the patient be in? What should you ask them to do? While in this position, a separation greater than how much is considered to be positive for this condition?

1. sitting, standing, supine 2. abdominal weakness, decreased stability in the lumbar region, pain in the lower back 3. if there has been excessive stretching that has caused muscle tearing in the rectus abdominis 4. hooklying, ask the patient to lift their head and shoulders off the treatment table, a separation greater than 2 finger widths is considered to be positive

Metabolic Bone Disease: 1. These are disruptions in normal metabolism in the ______________ system. 2. The skeletal system houses _______________ and ________________. It also continuously balances the remodeling of _________________ and ________________ bone in order to optimize the structure of the skeleton.

1. skeletal 2. calcium and phosphorous; cortical and trabecular bone

Pharmacological Effects of Other Systems Continued: 1. Antibacterial Agents: These may cause hypersensitivity in what 2 regions? Therapists should be cautious when using what modality as part of therapy? 2. Chemotherapy Agents: What is the most significant side effect? These drugs may also cause toxic effects on what systems? Therapists should be aware of any nervous system abnormalities including what 2 things? 3. Immunomodulating Agents: These have what type of effects on muscles, tendons, and bones? These also can have ______________ effects which may affect a patient's ability to participate in balance or gait activities secondary to what 2 things?

1. skin or respiratory tract; UV light 2. significant fatigue; central and peripheral nervous systems; peripheral neuropathy or ataxia 3. catabolic effects; neurotoxic effects; peripheral neuropathy or CNS damage

Ankylosing Spondylitis: Outcomes 1. This condition progresses quickly or slowly? 2. How long does ankylosing spondylitis progress for? 3. What are the 2 most common long term effects? 4. How many patients experience complete remission? 5. What is a marker for a severe form of ankylosing spondylitis? This is more likely to occur in what patients?**

1. slowly 2. over 15-25 years 3. joint limitations and stiffness 4. 1% 5. hip disease; in those diagnosed at a younger age **

Lung Cancer Continued: 1. What is the leading cause of lung cancer? 2. Other causes of lung cancer include ____________ factors or exposure to _________________ gas, ___________________, or air ________________. 3. Lung cancer arises when carcinogens damage epithelial cells of the lungs. Initially, the body is able to repair the cell damage, but cumulative damage causes what? 4. What occurs to weight that is a symptom? 5. What body temp can be a symptom? 6. What can occur to the fingernails that can be a symptom?

1. smoking or exposure to smoke 2. genetic factors; radon gas, asbestos, or air pollution 3. mutation of the DNA and tumor formation 4. weight loss 5. fever 6. clubbing of the fingernails

Cervical Cancer: 1. This typically starts in the cells on the surface of the cervix typically __________________ cells. This precancerous condition is called ________________ and is easily treatable. 2. Diagnosis of cervical cancer is made through what? 3. How is prognosis for dysplasia? 4. If dysplasia goes undetected, changes can develop into cervical cancer and metastasize to what 4 regions? 5. What is the primary cause of cervical cancer? 6. Risk factors for cervical cancer development include what bad habit? maternal use of what? what ethnicity? what medication? what types of diseases? 7. Symptoms can include abnormal _______________, pain in what 2 regions, impairment with what 2 functions? 8. Treatment can include what 4 things with adjunct chemo or radiation?

1. squamous cells; dysplasia 2. pap 3. good 4. intestines, bladder, liver, lungs 5. human papilloma virus (HPV) 6. smoking, maternal use of diethylstilbestrol (DES), African American ethnicity, oral contraception use, STDs 7. abnormal bleeding, low back or pelvic pain, impairment with bowel/bladder 8. laser, cryotherapy, excision, or hysterectomy

Complex Regional pain Syndrome: Outcomes 1. Overall prognosis is better for patients that what? 2. CRPS can go away in what different ways? 3. A patient's long term outcome is dependent on what? 4. Research indicates a better prognosis if treatment is initiated within the first ______________ months of the disease.

1. start treatment early in the disease process cycle 2. it can go away spontaneously or come and go for years 3. how early they get treatment 4. within the first 6 months of the disease onset

Appendicitis: Confirming Your Patient Has This 1. What is the most commonly reported symptom? 2. Patients will often try to stay in what position? 3. What 3 things are also common symptoms reported? 4. The duration of symptoms is often less than how long in adults? 5. What are 2 instances where duration of symptoms might be longer? 6. Examination findings include abdominal rebound tenderness, pain with _______________, guarding, and what tone? 7. What type of history is commonly needed to be retrieved in female patients?

1. stomach pain that starts as umbilical or gastric and migrates to the right lower quadrant 2. they will try to not move and lay down with their hips flexed 3. nausea, vomiting, and anorexia 4. less than 48 hours 5. if a perforation occurred or in the elderly 6. pain with percussion, rigidity 7. gynecological history

Rehab Considerations for Patients Undergoing Chemo/Radiation: 1. What should initially be avoided following implantation of radioactive seeds used for brachytherapy radiation? 2. What are used to guide beam alignment with external beam radiation? PTs must be cautions not to do what? 3. What are 2 things contraindicated over irradiated (radiation) areas for a minimum of how long?

1. strenuous activity 2. skin tattoos; PTs must be sure they don't do anything to move them like taping, soft tissue massage, or myofascial mobs) 3. massage and heat for a minimum of 12 months

Urinary Stress Incontinence: Diagnosis 1. What are the 5 classifications of urinary incontinence? 2. This usually occurs from loss of strength and integrity of the contractile and noncontractile tissues that maintain what? 3. What musculature is typically weak in the pelvic floor (2)? 4. There can be damage to what nerve that can cause this? 5. What can be malpositioned that can cause this?

1. stress, urge, mixed, functional, and overflow 2. that maintain bladder control 3. levator ani and urogenital diaphragm 4. pudendal nerve 5. urethra malpositioning

Full Thickness Burn: Diagnosis 1. A full thickness burn causes complete destruction of the epidermis, dermis, hair follicles, and nerve endings in the dermis. What layer is also affected? 2. What specifically gets destroyed with full thickness burns?

1. subcutaneous fat layer and muscle 2. red blood cells

Acute Renal Failure (ARF): 1. This occurs when there is a sudden or slow decrease in renal function? 2. What are 2 lab values that are increased? 3. What electrolyte is increased in the blood? 4. What amount of urine can typically be excreted and what is this called? 5. What occurs to sodium levels? 6. Prerenal etiology is secondary to a decrease in what? This can occur from what 4 things? 7. Postrenal etiology is secondary to what? What are 3 things that can cause this? 8. Intrarenal etiology is secondary to what? What are 3 things that can cause this?

1. sudden decrease in renal function 2. BUN and creatinine are increased 3. potassium (hyperkalemia) 4. small amounts of urine (oliguria) 5. sodium hypertension 6. secondary to a decrease in blood flow; shock, hemorrhage, burn, or pulmonary embolism 7. secondary to an obstruction distal to the kidney; neoplasm, kidney stone, or prostate hypertrophy 8. secondary to primary damage of renal tissue; toxins, intrarenal ischemia, or vascular disorders

Contact Dermatitis: 1. What is contact dermatitis? 2. Is this common? 3. This typically occurs with exposure to mechanical, chemical, environmental, or biological agents. What are 4 examples of irritants? 4. S/S of contact dermatitis include what 2 feelings? what color of the skin? Does edema occur? 5. What is the treatment for contact dermatitis?

1. superficial skin irritation 2. very common in all ages 3. rubber, latex, nickel, or topical antibiotics 4. itching or burning, redness, yes 5. removal of the irritant and topical steroids to calm down the itching

Burn Classification: 1. What are the 5 different types of burns? 2. Superficial burns only involve the ___________________. The involved area may be ____________ with slight ___________________. Healing occurs without peeling or evidence of scarring how fast? 3. Superficial Partial-Thickness Burns involve what 2 regions? Is this painful? What might this burn have? Healing occurs how quickly? Is there scarring? 4. Deep Partial-Thickness Burns involve what 2 areas? What will the involved area look like? What specific area is damaged that results in only moderate pain levels? What are 2 types of scarring that might occur? In the absence of infection how quickly do these heal? 5. Full Thickness Burns involve what areas? What necrotic tissue will form? How much pain will the patient be in? What do these typically require for treatment? What is the healing period like for these type of burns? 6. Subdermal Burns involve what areas? What do these require for healing?

1. superficial, superficial partial thickness, deep partial thickness, full thickness, subdermal burns 2. epidermis; red with slight edema; 2-5 days 3. epidermis and the papillary dermis; extremely painful; blisters; 5-21 days; minimal to no scarring 4. epidermis and majority of dermis; discolored with broken blisters and edema; damage to nerve endings; hypertrophic or keloid scarring; 21-25 days 5. epidermis and dermis along with partial damage to subcutaneous layer; eschar; minimal pain; skin grafts; they can vary - if small may not require a graft and will take weeks or if large will require a graft and takes months 6. epidermis, dermis, subcutaneous tissue, and sometimes even muscle or bone; extensive healing time and multiple surgeries

Arterial Insufficiency Ulcers: Management of Symptoms 1. What can convert a chronic ulcer to an acute would thereby reactivating normal healing process? 2. In cases with more significant arterial occlusion, what is typically performed? 3. For larger wounds, what might be indicated once normal circulation has been restored? 4. What occurs if vascular integrity cannot be restored? 5. Do arterial ulcers produce a lot of exudate? 6. It is important to select dressings that do what 2 things?

1. surgical debridement 2. surgical revascularization (femoral-popliteal bypass) 3. grafts 4. amputation 5. minimal exudate 6. ones that create a moist environment and protect the wound

Metabolic Acidosis: Confirming Your Patient Has This 1. What type of respiratory rate is often observed as the body tries to regulate its acid-base balance by inducing respiratory ________________ through hyperventilation. 2. What 2 mental states are likely to occur as acid levels increase? 3. Symptoms also include: what in the ears? what 2 things in the heart? what in the head? what in vision? what 2 GI symptoms? what happens to strength? what occurs to breathing? 4. Can this be fatal if left untreated? 5. Lab analysis of what 3 things are used to identify abnormal acidity and differentiate between respiratory and metabolic acidosis. 6. What 3 things can contribute to systemic H+ increases? 7. What can contribute to inadequate H+ excretion? 8. What 2 things can contribute to excessive HCO3- loss?

1. tachypnea; alkalosis 2. confusion or lethargy 3. tinnitus, chest pain or cardiac arrhythmia, headache, vision changes, abdominal pain or vomiting, generalized weakness, hyperventilation 4. yes 5. ABG, serum electrolytes, and urine pH 6. uncontrolled diabetes, alcoholism, salicylate poisoning 7. renal failure 8. severe diarrhea or intestinal fistula

Male Genital System: 1. The scrotum is a cutaneous fibromuscular external sac that carries what 5 structures? 2. What does the ductus/vas deferens do? 3. The epididymis is encased in what? What does it do? 4. What are seminal vesicles? 5. Where is the prostate located? What does it do?

1. testes, ductus deferens, epididymis, nerves, blood vessels 2. carries sperm from the testes to the seminal vesicle to form the ejaculatory duct 3. encased in the scrotum; stores sperm 4. internal tubes that secrete thick fluid to combine with sperm in the ejaculatory duct 5. inferior to the bladder; produces and secretes fluid to contribute to sperm formation

Oncology Treatment Options: Antiangiogenic Therapy 1. This focuses on the use of what to suppress blood supply formation? 2. This has had initial success in treating what cancer?

1. thalidomide 2. multiple myeloma

Oncology Treatment Options: Biotherapy/Immunotherapy 1. These are techniques used to change the relationship between what 2 things? 2. What is commonly used for biotherapy and strengthens the biological response to malignant cells? 3. Common side effects include: what 2 body temp symptoms? what 3 GI symptoms? impairment in what system? what type of reaction? what blood count is abnormal? what level of arousal?

1. the body and the malignancy 2. biological response modifiers (interferons, interleukin-2, bone marrow transplant, stem cell transplant, monoclonal antibodies, hormone therapy) 3. fever/chills, nausea/vomiting/anorexia, impaired CNS, inflammatory reaction, leukopenia (low leukocytes), fatigue

Staging of Cancer: 1. Stage 0? What is this referred to as? 2. Stage 1? 3. Stage 2? 4. Stage 3? 5. Stage 4? 6. What is another way to classify the stage of cancer?

1. the cancer is only a mass of cells; cancer in situ 2. cancer cells have invaded the organ it grows on with no lymph node involvement or metastasis 3. malignancy spread into adjacent tissues and there is micrometastases in the lymph nodes but not enough to be seen on imaging 4. malignancy has spread to adjacent tissue and metastatic lymph node likelihood is high 5. malignancy has metastasized beyond the primary site 6. TNM system - size of primary tumor, lymph node involvement, metastasis

Metabolic System Terminology: 1. What is anabolism? 2. What is catabolism? 3. What is osteopenia? 4. What is osteopetrosis?

1. the creation of simple molecules into complex molecules 2. the breakdown of complex molecules into simple ones 3. low bone mass that is not severe enough to be called osteoporosis - there may not be actual bone loss but a naturally lower bone density than the norm 4. a group of conditions characterized by impaired osteoclast function which causes bones to become thick but fragile

Full Thickness Burns: Management of Symptoms 1. What is the emergent stage and how long does it last? 2. What type of procedure is usually required for full thickness burns? 3. PT begins immediately following what? 4. PT involves immobilization for how long after the wound occurs? 5. What should be incorporated as soon as possible in order to decrease complications such as atelectasis, pneumonia, and contracture?

1. the phase where stabilizing the patient is the main goal trying to regain capillary permeability and hemodynamic stability - 48-72 hours 2. autograft procedure 3. immediately following skin grafting 4. 3-5 days after the initial burn 5. early mobility and ambulation

IBS Continued: 1. This consists of recurrent symptoms of what structures that interfere with normal functioning of the colon. 2. Some theories hypothesize that what system can cause this? 3. Some theories also state what neurotransmitter can cause this? 4. IBS typically occurs in as many as 20% of adults, more commonly in what gender and starts in what age in 50% of patients? 5. Triggers can include: what 2 feelings? intake of what? substance abuse of what 2 things? High dietary _________ intake. 6. Symptoms can include pain in what region? What can happen to the size of the abdomen? What GI symptoms? What can occur to appetite? What occurs to stool frequency and form? Passing of ____________ in the stool can be a determining factor. 7. Change in lifestyle and nutrition, decrease in stress, pharmacological intervention, adequate sleep and exercise, and psychotherapy can improve symptoms. Patients with IBS should avoid what sized meals? They should also avoid what 4 foods? They should avoid what 2 liquids? 8. Does IBS lead to serious disease?

1. the upper and lower GI system 2. immune system 3. serotonin 4. more commonly in females and starts in ages before 30 in 50% of the patient population 5. stress or anxiety, intake of caffeine, smoking or alcohol, high dietary fat intake 6. abdominal pain, distention and bloating, nausea/vomiting, anorexia, changes, passing of mucus in the stool 7. large sized meals,wheat/rye/barley/milk, alcohol and caffeine 8. no

Pharmacological Oncology Management: Alkylating Agents 1. What do these do to fight cancer? 2. How do alkylating agents initiate cell death? 3. What are 4 of the most common side effects seen in patients when taking any form of oncology medication? 4. What are 3 examples of alkylating agents?

1. they bind the DNA strands together to prevent replication 2. by disrupting DNA function and releasing enzymes that destroy the cell 3. blood disorders, extreme fatigue, cancer pain, and GI distress 4. Mustargen (mechlorethamine), Buxulfex (busulfan), and Leukeran (chlorambucil)

Pharmacological Psychiatric Management: Antianxiety Agents 1. How do these work to decrease anxiety? 2. What are 3 main forms of antianxiety agents? 3. What are 5 indications for antianxiety medications? 4. Side effects of anti anxiety medications include: what level of arousal? what type of withdrawal symptoms? 5. Implications for PT are very similar to when you are treating a patient taking what similar type of medication? What 4 things can PTs do to try to decrease the patient's anxiety? 6. What are 3 examples of benzodiazepines commonly given? 7. What is an example of a commonly given azapirone? 8. What are 2 examples of commonly given SSRIs?

1. they target the CNS through facilitation of GABA, serotonin, or dopamine 2. benzodiazepines, azapirones, and selective serotonin reuptake inhibitors (SSRIs) 3. PTSD, OCD, general anxiety, social anxiety, panic disorder 4. drowsiness/sedation; rebound anxiety 5. sedative-hypnotic agents; exercise, massage, stress education, relaxation techniques 6. Valium, Xanax, Ativan 7. BuSpar 8. Paxil or Effexor

Neurogenic Bladder: 1. Is this an issue that the patient is incontinent and cannot keep the urine in or can they not get urine out? 2. This occurs when there is damage to the cerebral control of the bladder. If the urine cannot be properly released what are 2 things the patient is at an increased risk for? 3. Causes can include: what disease? diminished bladder _______________. a hyperactive ____________________ muscle. what neuro condition? what systemic condition? what going on in the nerves? 4. S/S include what type of frequent infection? leakage of _____________. inability to empty the bladder. loss of the _________________ to urinate when the bladder is full. 5. Treatment includes setting a goal to prevent bladder _____________________, what type of infection, what type of damage? 6. Treatment for neurogenic bladder includes: patient education, what type of techniques, massage along what? temporary use of what? meds. a timed _________________ program.

1. this is an issue that the patient cannot empty urine out of the bladder 2. UTIs and kidney damage 3. diabetes, diminished bladder capacity, hyperactive detrusor muscle, CVA, infection, nerve damage 4. frequent UTIs, leakage of urine, inability to empty the bladder, loss of the urge to urinate when the bladder is full 5. overdistention, UTIs, or renal damage 6. bladder techniques, lower abdominal massage, temporary catheterization, meds, a timed urination program

Cellulitis: Outcomes 1. Recurrence of cellulitis is common among whom?

1. those at high risk of infection from their comorbidities

Crohn's Disease: Confirming Your Patient Has This 1. Signs and symptoms can range from mild to what? 2. Do signs and symptoms develop gradually or rapidly? 3. Symptoms typically include _______________ pain, what type of pain, what type of BM? 4. Other symptoms can include what in the stool? GI tract _______________. Diminished ______________. What can happen to weight? 5. Over time, complications can occur including what 4 things? 6. Chronic inflammation can cause symptoms like what in the gall bladder? What in the kidneys? What 2 things in the joints and bones? 7. If this occurs in children they typically experience delays in what? 8. What are 3 forms of imaging to identify Crohn's disease? 9. What are 3 other diagnoses that need to be ruled out? 10. Patients with a family history of Crohn's, who have what bad habit, or who maintain a diet high in ___________ are at greater risk for developing this.

1. to life threatening 2. either 3. abdominal pain, cramping, diarrhea 4. blood in the stool, GI tract ulcers, diminished appetite, weight loss 5. bowel obstruction, malnutrition, intestinal fistula, or anal fissure 6. gall stones, kidney stones, arthritis or osteoporosis 7. delays in growth and development 8. MRI/CT/xray, fecal occult blood test, colonoscopy 9. irritable bowel syndrome, diverticulitis, or colon cancer 10. family history of crohn's, who smoke, or who maintain a diet high in fat are at greater risk

Parenteral Administration: 1. What are 4 forms of parenteral administration? 2. Inhalation: These drugs can be inhaled if they are in what 2 forms? Inhalation is advantageous since the lungs have a large ________________ ________________ for absorption and therefore the drug can enter the systemic circulation _________________. This is often used when treating what type of pathology? What region can become irritated? 3. Topical: These drugs are absorbed through the skin into the systemic circulation and this method is reserved for treating what 4 localized disorders? Mucous membranes have a larger or smaller capacity for drug absorption and thus drugs applied to the mucous membranes can be used to treat ________________ conditions. 4. Transdermal: This involves application of a drug directly to the ____________. Unlike topical administration, the intent is that the drug will absorb through the skin and enter what? Transdermal allows for rapid or slow release of the drug? This form of administration occurs with the use of what commonly seen medication that is transdermal or through what 2 modalities that are transdermal? Drugs that cannot penetrate the skin or that are degraded by ______________ ___________________ cannot be administered with this method. 5. Injection: What are 5 forms of injection? What is a disadvantage to injection?

1. topical, transdermal, inhalation, injection 2. aerosol or gas; large surface area; rapidly; pulmonary pathologies; respiratory tract 3. localized eye, ear, nose, skin disorders; larger capacity for drug absorption; systemic conditions 4. skin; enter systemic circulation; slow controlled release of the drug (different than topical); patches or iontophoresis/phonophoresis; dermal enzymes 5. intravenous, intra-arterial, intramuscular, intrathecal, subcutaneous; can cause infection

Oncology Pharmacological Management: Antibiotics 1. Certain antibiotics are used with treating cancer because of their high ________________ and ability to interfere with DNA and RNA what 2 things? 2. Side effects of antibiotics can include: what with breathing? what in the heart? what type of disorder? edema where? what occurs to bone marrow? 3. What are 3 examples of antibiotics commonly used in oncology?

1. toxicity; synthesis and cell division 2. dyspnea, dysrhythmias, blood disorders, pedal edema (in the feet), myelosuppression (decreases bone marrow production) 3. Adriamycin, Mithracin, and Cosmegen

Transparent Film: 1. These are thin membranes made from what? 2. These are permeable to what 2 things? 3. These are largely impermeable to what 2 things? 4. Are these elastic? 5. What are 2 types of wounds these are useful on? 6. What type of environment do these provide to wounds? 7. What do these trigger in the body? 8. What are 2 forces these are resistant to? 9. What can occur if there is excessive exudate? 10. Can these be used on infected wounds?

1. transparent polyurethane and waterproof adhesives 2. oxygen and vapor 3. bacteria and water 4. highly elastic, conforming to a variety of body contours 5. superficial or partial thickness wounds with minimal drainage (scalds, abrasions, lacerations) 6. moist 7. autolytic debridement 8. shear or friction 9. maceration 10. no

Complex Regional Pain Syndrome: Contributing Factors 1. Predisposing factors include: what type of injury? what procedure? what 2 neuro diagnoses? disorders that occur from what? what type of nerve injury? 2. This condition is most likely found in the age group of ________________ years with which gender having 3x more likely to be affected.

1. trauma, surgery, CVA, TBI, repetitive motion disorders, lower motor neuron/peripheral nerve injury 2. 35-60 years with females being 3x more affected

Fibromyalgia vs. Myofascial Pain Syndrome: 1. Myofascial pain syndrome is characterized by what rather than tender points? 2. Myofascial pain syndrome is associated with pain in what region? 3. Myofascial pain syndrome is a ______________________ condition whereas fibromyalgia is a _______________ condition.

1. trigger points 2. pain in one muscle or a few muscles (not four quadrants of the body like fibromyalgia) 3. musculoskeletal; rheumatic

Uterine Cancer: Confirming Your Patient Has This 1. What is the most common symptom? 2. Other signs and symptoms include what in premenopausal women only? what in postmenopausal women only? pain in what 2 regions? pain with what 2 things? 3. What is the only method to confirm the diagnosis of uterine cancer? 4. What condition should be ruled out?

1. unexpected vaginal bleeding 2. abnormal menstrual cycle, abnormal vaginal discharge, pain in the pelvis or lower abdomen, pain with urinating or having sex 3. tissue biopsy via dilation and curettage 4. endometriosis

Chronic Fatigue Syndrome: Confirming Your Patient Has This 1. A patient has to meet several criteria to be able to be diagnosed with this. The criteria include a history of at least 6 months of what? This must be accompanied by at least ___________ of 8 additional symptoms including: self-reported __________________ or _____________ deficits severe enough to interfere with daily activities, persistent or recurrent sore ______________, painful or enlarged __________________ or ________________ lymph nodes, unexplained _____________ pain, migrating ________________ pain without visible signs of inflammation, complaints of malaise lasting more than ____________ hours after physical or mental exertion, and ______________ that exhibits changes in pattern or severity. 2. Other conditions need to be ruled out including: what going on with the thyroid? what progressive neuromuscular disease? what systemic condition? what diagnosis? 3. Other conditions that can mimic CFS include _________________________ disorders, what occurring at night, what type of appetite disorder, abuse of what, what going on with weight?

1. unexplained prolonged severe fatigue; 4 of 8 additional symptoms including self-reported memory or concentration deficits, persistent or recurrent sore throat, painful or enlarged axillary or cervical lymph nodes, unexplained muscle pain, migrating joint pain, complaints of malaise lasting more than 24 hours, and headache 2. hypothyroidism, multiple sclerosis, cancer, mononucleosis 3. psychological disorders, sleep apnea, anorexia, substance abuse, morbid obesity

Herpes Zoster: Confirming Your Patient Has This 1. This condition typically begins with what symptoms? 2. Initial symptoms of this condition are followed by a _______________ __________________ rash. 3. General symptoms may also include: what body temp? what type of pain? what feeling? 4. As the infection progresses, blisters will do what? 5. VZV transmission occurs through what? 6. When is the patient no longer contagious? 7. What is the most common herpes zoster complication? 8. What are 3 other complications that can occur with herpes zoster other than post-herpetic neuralgia? 9. What can show the presence of VZV antibodies and an increased white blood cell count?

1. unilateral painful burning and itching 2. painful blistered rash 3. fever, body aches, fatigue 4. blisters will split open and drain the VZV 5. direct contact when the blisters are split open 6. when the blisters have scabbed over 7. post-herpetic neuralgia (scarring or destruction of nerve tissue) 8. vision issues, balance issues, or facial paralysis 9. blood samples

Urinary Stress Incontinence: Examination 1. What scale is often administered to patients? 2. The patient may be at an increased risk for what type of infection? Weakness where? Prolapse of what organ? 3. A patient that has poor _________________, what BM status, inadequate __________________, and urinary _________________ will further worsen incontinence.

1. urge impact scale 2. UTI, weak pelvic floor, uterine prolapse 3. poor nutrition, constipation, inadequate hydration, and urinary frequency

Herpes Zoster: Diagnosis 1. What virus causes this? 2. The varicella-zoster virus is responsible for causing what in children and what in adults? 3. Once exposed, the virus can remain dormant for how long? 4. Is herpes zoster contagious? 5. After exposure, VZV typically lies dormant within _______________ tissue where it may never reactivate. 6. Reactivation and a resultant herpes zoster outbreak commonly occurs when? 7. As the reactivated herpes zoster virus reproduces, the infection attacks and damages what structures? 8. Once the virus reaches the surface of the skin, what does it cause? 9. What are 3 other typical structures that can get blisters but are unseen?

1. varicella zoster virus (VZV) 2. chickenpox in children and shingles (herpes zoster) in adults 3. years 4. highly contagious especially to those with a weak immune system 5. neural tissue 6. when the immune system has been weakened 7. nerve fibers 8. blistered rashes 9. inside the mouth, in the inner eye, or on surfaces of organs

Hepatitis A (HAV): 1. Transmission of hep A occurs via what? 2. What type of symptoms represent acute infection by hep A? 3. Does hep A typically progress to chronic disease or cirrhosis of the liver? 4. Patients typically recover from hep A how quickly?

1. via close personal contact or the fecal-oral route (contaminated food or water) 2. flu like symptoms 3. no 4. 6-10 weeks

Desensitization Techniques for Burns: 1. Using these techniques for those that have developed hypersensitivity from a burn can improve the patient's tolerance to what 4 things? 2. Desensitization techniques include variable texture, pressure, and vibration sensations applied to the affected area by what 3 motions? 3. The use of _____________ contact with use of dry beans, popcorn kernels, or fluidotherapy can be beneficial in desensitizing distal extremities. 4. What are 2 things that have also been shown to help with desensitization other than these techniques? 5. How long are these interventions performed for? 6. How often are these interventions performed? 7. How should each session progress?

1. vibration, pressure, temperature, touch 2. rolling, rubbing, or tapping motions 3. particle contact 4. compression and TENS 5. 5-10 minutes 6. 3-4x daily 7. progress with texture starting with something noxious but tolerable

Chronic Fatigue Syndrome: Diagnosis 1. Potential etiologies include: origin from what pathogen? an immune response to inflammation where? it could also be from a combo of lifestyle factors like what 2 things mixed with nonmodifiable factors like what 2 things and comorbidities.

1. viral origin; inflammation in the nervous system; stress and environment mixed with age and genetics mixed with comorbidities

GI Pharmacological Agents: Emetic Agents 1. These are used to induce __________________. 2. These are indicated usually after ingestion of what? 3. What are 3 side effects of emetic agents? 4. Do emetic agents impact PT? 5. What are 2 examples of emetic agents?

1. vomiting 2. a toxin 3. dehydration, electrolyte imbalance, and upper GI erosion 4. yes because if the patient is vomiting PT should be deferred 5. Apomorphine or Ipecac

Neuropathic Ulcers: Examination 1. What type of integ assessment do you need to grade the neuropathic ulcer on? 2. What type of sensory assessment do you need to perform? 3. What type of circulation assessment do you need to perform even though it may not be super accurate? 4. Neuropathic ulcers that extend to bony surfaces are associated with a high risk of what? 5. Neuropathic ulcers are slow or fast to heal and why?

1. wagner ulcer classifcaiton system 2. semmes-weinstein monofilament testing 3. ABI 4. osteomyelitis 5. slow to heal due to systemic impact associated with underlying conditions

Renal System: 1. What are 3 things kidneys remove from the blood through excretion of urine?

1. water, salt, metabolic waste

Pool Therapy: 1. Advantages of pool therapy include: decreased ____________ ________________ due to buoyancy, improved therapist _________________, enhanced control over the amount of ___________________ during exercise, and diminished risk of __________ with activity. 2. Recommended populations for pool therapy include patients with what bone condition? what type of injury? what type of deficits? what type of injury in the spine? what brain injury? what progressive neurological disease? and selected _____________________ diagnoses.

1. weight bearing; handling; resistance; falls 2. arthritis, MSK injuries, neuromuscular deficits, spinal cord injury, CVA, multiple sclerosis, cardiopulmonary diagnoses

Pressure Ulcers: Management of Symptoms 1. Nonocclusive dressings include what 4 things? 2. Occlusive dressings include what 5 things? 3. Patients should avoid the use of what 2 things? 4. The therapist should promote proper positioning techniques including what position in bed? 5. What should the patient make sure they are getting enough of in their diet?

1. wet to wet, wet to dry, dry to dry, or composite 2. alginates, hydrocolloids, hydrogels, foams, semipermeable films 3. hot water or massage 4. making the head of the bed stay at less than a 45 degree angle to reduce friction and shear 5. enough protein

Coccydnia: 1. What is this? 2. Causes include ________________ during delivery or adherence to ______________ or ______________________ scar. 3. S/S include: difficulty being in what position? referred pain to what 6 areas? pain with what type of ADL? what occurs during sex? what can form? 4. Treatment can include: ice or heat? what type of joint mobs? what 2 types of muscle techniques? biofeedback for what muscles? what type of training? what type of strengthening? stretching for what muscles? what device might be nice for the patient to have?

1. when after childbirth the joint between the coccyx and the sacrum can become hypermobile and cause soft tissue surrounding the coccyx to become painful 2. subluxation during delivery or adherence to tear or epislotomy scar 3. difficulty sitting, referred pain to the low back/SI joint/hip/butt/groin/rectum, pain with bowel movements, pain with sex (dyspareunia), formation of hemorrhoids 4. heat, external joint mobs, myofascial release or muscle energy techniques, biofeedback for pelvic floor muscle relaxation, postural training, abdominal strengthening, stretching for surrounding muscles, a cushion to sit on

Iontophoresis Burns: 1. When do these occur? 2. pH levels below _________ or above ____________ can result in acidic or alkaline reactions. 3. Chemical burns from iontophoresis are typically more severe under the positive or negative electrode? 4. With skin resistance reduced, what happens to electrical current delivery? 5. Factors contributing to chemical burns from ionto include treatment delivered with excessive _______________, prolonged _____________, and electrode placement over ________________ skin areas with _______________ resistance.

1. when skin pH increases or decreases beyond normal tolerance 2. 3; 5 3. under the negative electrode causing alkaline mediums to pool 4. electrical current delivery increases 5. treatment delivered with excessive current, prolonged duration, and electrode placement over defective skin areas with lower resistance

Uterine Prolapse: 1. What is this? 2. What is the most widespread classification of prolapse using a five point grading system ranging from no prolapse to max descend of vaginal tissue outside the body? 3. What are 3 causes? 4. S/S of uterine prolapse include: what feeling in the pelvis that increases with exertion? what 2 feelings? are they continent? can they fully empty their bladder? what occurs to the vagina? what occurs during sex? pain that is in what region that is relieved when laying down? 5. PT treatment may include muscle training of what muscle using biofeedback, what type of exercises, what type of strengthening exercises, education on proper body mechanics and symptom dependent lifestyle modifications. 6. In more severe cases, an intravaginal mechanical support device called a ________________ may be indicated. 7. If conservative treatment fails, what are 2 types of surgery they might require?

1. when the uterus and cervix descend out of the vagina 2. Baden-Walker System 3. genetics, denervation, direct muscle trauma (usually during labor and delivery) 4. pelvic pressure that increases with exertion, frequency/urgency, urinary incontinence, cannot fully empty the bladder, vaginal dryness and irritation, dyspareunia, pain that is in the lower back relieved when laying down 5. muscle training of the pelvic floor using biofeedback, kegel exercises, core strengthening, body mechanics and symptom dependent lifestyle changes 6. pessary 7. reconstructive or obliterative surgery

Wet Gangrene: 1. When is gangrene referred to as wet? 2. Swelling resulting from the infection causes what to blood flow? 3. Wet gangrene can typically develop after what 3 things? 4. How quickly does it spread? 5. Does this require immediate medical attention? 6. Is this painful? 7. What occurs to the skin color? 8. What forms at the site of infection? (2) 9. What occurs to body temp? 10. What occurs to level of consciousness? 11. What should be done for treatment?

1. when there is an associated bacterial infection 2. stops blood flow 3. severe burn, frost bite, or injury 4. spreads quickly and can be fatal 5. yes 6. yes 7. turns from red to brown to black 8. blisters with pus and swelling 9. fever 10. malaise 11. IV antibiotics and surgical debridement to the gangrene

Dry Gangrene: 1. When is gangrene referred to as dry? 2. What are 3 regions most often affected? 3. Is dry gangrene typically painful? 4. Does dry gangrene develop slow or fast? 5. In some cases, dry gangrene can result in what? 6. Dry gangrene occurs most commonly in what type of disease? 7. Is infection typically present in dry gangrene? 8. Can dry gangrene progress to wet gangrene? 9. What color will the skin typically change to with dry gangrene? 10. What occurs to the skin tissue with dry gangrene? 11. The patient may complain of what with dry gangrene? 12. Does this require immediate medical attention? 13. What are 3 options for treatment?

1. when there is loss of vascular supply resulting in local tissue death 2. fingers, toes, and limbs 3. no 4. develops slowly 5. auto amputation 6. blood vessel diseases including atherosclerosis or diabetes 7. no 8. yes if infection occurs 9. brown or black 10. it turns into a hardened mass (mummified) 11. cold or numb skin 12. yes 13. pharmacological agents, surgery, or hyperbaric oxygen therapy

Diagnostic Tools: 1. What is peripheral fat distribution? What is this also referred to as? This is more common in what gender? Is this more or less associated with obesity related risk factors? 2. What is central fat distribution? What is this also referred to as? Is this more or less associated with obesity related risk factors? 3. Research suggests that what might be more predictive of diabetes and cardiovascular risk than BMI alone? 4. Waist measurements greater than ___________ inches for males and greater than _________ inches for females is considered to be indicative of central obesity. 5. A waist to hip ratio of ___________ for males and greater than ____________ in females is suggestive of central obesity.

1. when there is more fat distributed *********** and legs; pear shaped or gluteofemoral obesity; women; less 2. when more fat is distributed in the abdominal area; apple shape or abdominal obesity; more 3. waist circumference measurements 4. 40 inches for men and 36 inches for women are considered to be centrally obese 5. wait to hip ratio of greater than 1 for males and greater than 0.85 for females is indicative of central obesity

Endometriosis: 1. What is this? 2. What is the most common location of extrauterine endometrial growths? 3. Exact etiology is unknown but during each menstrual cycle the endometrial tissue bleeds causing what 2 things subsequently? 4. S/S include: moderate to severe pain in what 3 regions before or during menstruation? what type of menstrual cycle? what going on before the menstrual cycle that is abnormal? pain with what 2 things? can this cause infertility? 5. Treatment from PT includes: manual techniques like what? mobilization of what? soft and deep tissue massage to do what? Mobility exercises are performed why? Relaxation exercises such as what 2 things are used to regulate the pain cycle? What modality is indicated? Pharmacological intervention is indicated to alter hormone balances using what 2 things? Surgery to remove extrauterine endometrial tissue, scarring, and adhesions might be performed but what might be recommended when pregnancy is no longer desired?

1. when uterine tissue grows outside of the uterus 2. the uterosacral ligaments 3. scarring and adhesions 4. abdominal region, pelvis, or low back; abnormal menstrual cycles; spotting; pain with sex (dyspareunia) or having a BM; this can cause infertility 5. manual techniques like myofascial release, visceral mobilization, soft and deep tissue massage to break up scar tissue, mobility exercises to sustain elongation of tissue, breathing techniques and restorative poses are used to regulate the pain cycle, TENS is indicated, oral contraceptives and antigonadotropins might be prescribed, total hysterectomy

Oncology Treatment Options: Chemotherapy 1. Chemo is most useful with localized or widespread malignancies? 2. Common side effects include: what 2 GI symptoms? what occurs to electrolytes? what occurs to sex? what occurs to hair? what 3 blood cell counts are abnormal?

1. widespread 2. nausea/vomiting, electrolyte imbalance, sexual dysfunction, hair loss, RBC/WBC/platelet count

Cirrhosis of the Liver: 1. This is a condition where the healthy tissue of the liver is replaced with what? 2. What are 2 of the most common causes of this condition? 3. What does alcohol do that can cause cirrhosis of the liver? 4. If cirrhosis of the liver occurs from alcohol, the patient has likely been heavily drinking for how long? 5. Inflammation of the liver secondary to hepatitis C causes persistent inflammation and slow damage to the liver after how long of an infection? 6. Other causes of cirrhosis can include: what 2 other types of hepatitis? certain drugs. infections. toxins. what type of diseases? nonalcoholic _______________hepatitis. What structure that could be blocked? 7. Symptoms include: what level of arousal? what level of appetite? what GI symptom? what occurs to strength? pain in what region? what found on the skin? what occurs to weight? 8. Common complications from cirrhosis include what in the abdomen? Edema in what region? What coloration of the skin due to liver failure? Stones in what organ? What increased sensation? What found under the skin? An increase in sensitivity to what? An accumulation of toxins in what structure? Hypertension where? Development of what in the stomach and esophagus? Dysfunction in what system? Cancer in what organ? What brain condition? 9. Treatment: does this stop the condition? What might be necessary to sustain life?

1. with scar tissue that blocks blood flow to the liver and prevents it from functioning properly 2. alcoholism or hepatitis C 3. blocks normal metabolism of proteins, fats, and carbs 4. a decade 5. several decades 6. hepatitis B or D, certain drugs, infections, toxins, genetic diseases, nonalcoholic steatohepatitis, and blocked bile ducts 7. fatigue, decreased appetite, nausea, weakness, abdominal pain, spider angiomas (a spot on the skin that is red and spreads out in thin legs), weight loss 8. ascites (water accumulation in the abdomen secondary to decreased production of albumin by the liver), edema in the lower extremities, jaundice, gallstones, increased itching, ecchymosis under the skin, increased sensitivity to medications, accumulated of toxins in the brain, portal vein hypertension, development of varices (enlarged blood vessels in the stomach and esophagus), dysfunction in the immune system, liver cancer, encephalopathy 9. this does not stop it but will slow the condition; a liver transplant

Fibromyalgia Syndrome: Confirming Your Patient Has This 1. Fibromyalgia syndrome (FMS) is more common in women or men? 2. What age is most commonly diagnosed? 3. To be diagnosed, you must present with widespread pain that is located where? 4. To be diagnosed, there also must be pain in at least __________ of 18 standardized tender point sites. 5. Tender point sites include where on the head? where in the C spine? what 2 back muscles? what rib? what region on the elbow or knee? what LE muscle? what region on the femur? what joint in the LE? 6. The patient might also complain of: what level of arousal? what cognitive impairment? what sensory impairment? what disturbances? what complaint in the GI tract? what going on in the head? what 2 mental conditions? 7. This is commonly misdiagnosed as what 4 things? 8. What is the only positive finding in imaging and lab results? What is this substance involved with? 9. What is used for reliability when testing tender points by providing a consistent pressure (4 kg/cm^2)? 10. If the patient meets the criteria and has experienced symptoms for greater than _______________ months, then the patient is diagnosed with FMS. 11. What are 2 diagnostic written tools that can assist with diagnosing fibromyalgia?

1. women 2. 14-68 3. in all four quadrants of the body (above and below the waist) and with axial pain 4. 11 of 18 standardized tender point sites 5. occiput, lower C spine, trapezius or supraspinatus back muscles, 2nd rib, lateral epicondyle on the elbow or knee, glutes, greater trochanter, knee 6. fatigue, memory impairment, visual impairment, sleep disturbances, irritable bowel syndrome, headache, depression/anxiety 7. chronic fatigue syndrome, myofascial pain, systemic lupus, fibrositis 8. abnormal substance P levels; chemical involved with pain transmission 9. a dolorimeter 10. 3 months 11. Beck Depression Inventory (higher scores indicate depression more) and Fibromyalgia Impact Questionnaire (those with fibromyalgia will score in the 40s and 50s - severe disease may be higher)

Gauze: 1. These are typically manufactured from what 2 things and are the most readily available dressing in inpatient settings? 2. Impregnated gauze is a variation of woven gauze in which various materials such as what 3 things are added? 3. Can these be used on infected wounds? 4. What are 3 types of debridement these can be used for? 5. What is a disadvantage of these that can happen to the wound bed? 6. Are these permeable? 7. What is a downfall to these in regards to taking care of a patient that has one of these on? 8. How well do these keep out infection?

1. yarn and thread 2. petrolatum, zinc, or antimicrobials 3. yes 4. wet to wet, wet to moist, or wet to dry 5. these can adhere to the wound bed and pull off viable tissue like granulation tissue 6. highly permeable 7. frequent dressing changes 8. these cause the patient to be at increased risk for infection

Stage 3 pressure injury: full thickness skin loss 1. Is adipose and granulation tissue visible? 2. What often happens to the edges of these wounds? 3. Is slough and eschar present? 4. What may occur deep in the wound?

1. yes 2. epibole (rolled edges) 3. yes 4. undermining or tunneling

Ankylosing Spondylitis: Contributing Factors 1. Is this a progressive systemic disorder? 2. What is the cause? 3. There is a possibility of a _____________ influence combined with ________________________ influence. 4. A person born with what has a high risk for developing ankylosing spondylitis? 5. HLA-B27 is found most often in what race? 6. Which gender is 2-3x more likely to get this? 7. When is onset?

1. yes 2. unknown 3. genetic influence combined with environmental 4. with histocompatibility antigen HLA-B27 5. males 6. 20-40 years of age

Complex Regional Pain Syndrome: Examination 1. Has malingering ever been an issue with this diagnosis?

1. yes, you need to monitor for any signs of this

Zones of Burn Injury: 1. What are the zones of injury that surround burns? 2. What is the zone of coagulation? 3. What is the zone of stasis? 4. What is the zone of hyperemia?

1. zone of coagulation, zone of stasis, and zone of hyperemia 2. the area of the burn that received the most IRREVERSIBLE cell damage 3. the area surrounding the zone of coagulation with less severe injury that possesses REVERSIBLE damage 4. the area surrounding the zone of stasis that has inflammation but will fully recover without any intervention or permanent damage

Which of the following would be considered an appropriate compression pressure for use with a patient with a venous wound? 10 mmHg 20 mmHg 30 mmHg 40 mmHg

40 mmHg

Which of the following pathologies is not associated with left upper quadrant pain? gastric ulcer pneumonia kidney stone spleen injury

kidney stone NOTE: the kidneys usually refer pain to the LOWER right and left quadrants

What is the acronym used for general S/S of cancer?

Change in bowel/bladder A lesion that does not heal Unusual bleeding or discharge Thickening or lump Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness

Wagner Ulcer Grade Classification System for Neuropathic Ulcers: Grade 0 Grade 1 Grade 2 Grade 3 Grade 4 Grade 5

Grade 0: intact skin Grade 1: superficial ulcer Grade 2: ulcer extends into tendon, bone, or capsule Grade 3: deep ulcer with osteomyelitis or abscess Grade 4: partial foot gangrene Grade 5: whole foot gangrene

What is another way to calculate extent of body surface area burned other than the rule of 9s? **IMPORTANT**

Lund and Browder method

What is the most common cause of intestinal blockage?

adhesions

What is the difference in the RULE OF NINES for CHILDREN? **IMPORTANT**

a child under 1 year has 9% taken from the LEs and added to the head and neck - each year of life 1% is distributed back to the LEs until age 9

Does a keloid scar extend beyond the boundaries of the wound bed or stay within the boundaries?

a keloid extends BEYOND the boundaries of the original wound

What are the 5 things that are risk factors for metabolic syndrome?

abdominal obesity, decreased HDL, increased triglycerides, increased BP, increased blood glucose

Testing for diastasis recti should be performed on whom?

all pregnant women if you are going to recommend abdominal exercises in PT

What type of medication commonly causes diarrhea or constipation in patients?

antacids

LE pain that wakes the patient up at night is most usually caused by what type of insufficiency?

arterial

Rubor of dependency is used to assess venous or arterial insufficiency?

arterial insufficiency

Which personality disorder is characterized by social inhibition and hypersensitivity to negative evaluation? paranoid avoidant borderline schizoid

avoidant NOTE: this is characterized by persistent feelings of inadequacy and preoccupation by being negatively evaluated by others

What is the most common form of skin cancer?

basal cell carcinoma

When is the most effective time for a patient to take pain meds post-op? before the pain starts before the pain gets severe after the pain gets severe at predetermined intervals

before the pain gets severe NOTE: if the patient waits for the pain to get too high it may be harder to control and bring back down

Which of the following medications is not commonly used to treat ADHD? stimulants depressants antihypertensive agents antidepressants

depressants NOTE: stimulants are often the first line of defense because they help to focus thought

What clinical term describes a group of conditions that causes continuous weeping of the skin and pruritis (itching)?

eczema

Which of the following is a common side effect of Vicodin? urinary retention emesis constipation delirium

emesis NOTE: emesis means vomiting - Vicodin is a pain killer and common side effects include dizziness, drowsiness, sedation, nausea, and emesis

What layer of the skin contains melanocytes?

epidermis

A pink and shiny appearance in a wound bed is most often indicative of granulation tissue or epithelial tissue?

epithelial tissue

What is another term for a scratch on the surface of the skin?

excoriation

Which side effects of chemo are the most likely to impact participation in PT? dehydration and electrolyte imbalance fatigue and GI distress dysrhythmias and pain dyspepsia and bone pain

fatigue and GI distress

What is the most common breast disorder in women?

fibrocystic breast disease

What is the most common MSK disorder in the United States?

fibromyalgia syndrome

What position is used to promote max chest expansion and oxygenation?

fowlers

Allopurinol is commonly prescribed to treat what diagnosis?

gout

What is a similarly presenting condition to HIV?

hepatitis B - transmitted parenterally and is diagnosed via blood tests but 95% with this fully recover

What is the most occlusive dressing?

hydrocolloids NOTE: occlusive means blocking

Which of the following is an example of catabolism? carbohydrate storage dehydration synthesis hydrolysis biosynthesis

hydrolysis NOTE: this is the process of breaking down water molecules

Which term best describes necrotic tissue representing a callus? eschar hyperkeratosis slough

hyperkeratosis

Which of the following is considered a common adverse reaction that a patient with diabetes is likely to experience from an insulin injection? hyperglycemia hypoglycemia hyperthyroidism hypothyroidism

hypoglycemia

Chemical burns most often occur through what 2 things?

ingestion or inhalation

What is a term used when there is a lack of sensation placing a patient at an increased risk for wounds?

insensate

Patient controlled analgesia delivers analgesics through all of the following routes except: intravenous intramuscular epidural subcutaneous

intramuscular

What is the process called when epithelial cells die and produce a protective outer layer?

keratinization NOTE: keratinocytes are located in the epidermal layer and produce keratin which is a strong protein that makes up the rigid structure of the skin

What is a complication in AIDS due to extended drug therapies?

kidney failure

Sigmoid diverticulitis is often associated with lower abdominal pain in the right or left lower quadrant?

left lower quadrant

Which lab result would be the most consistent with the presence of leukemia? thrombocytosis leukocytosis erythrocytosis monocytosis

leukocytosis NOTE: leukemia is a caner of the white blood cells causing abnormal proliferation and high numbers so there would be a high number of white blood cells

What type of cancer is the most frequent cause of death?

lung cancer

What is the most common malignant tumor found in children?

neuroblastoma

Does silver sulfadiazine penetrate into eschar?

no

What is the most common form of bone cancer in children?

osteogenic sarcoma

A lack of or inability to use vitamin D is often associated with: osteoporosis osteopenia osteomalacia

osteomalacia NOTE: this is a softening of the bones often from vitamin D deficiency or an inability to use vitamin D

What condition is caused by urinary obstruction?

overflow urinary incontinence

What are the 2 layers of the dermis?

papillary dermis is the superficial layer and reticular dermis is the deep layer

What enzyme central to digestion is produced by the gastric glands? trypsin chymotrypsin pepsinogen lipase

pepsinogen NOTE: pepsinogen along with hydrochloric acid are produced by the gastric glands

What is the term used to describe an infant in prone with the head and trunk extended with scapular retraction?

pivot prone

More likely to involve muscle and bone: full thickness subdermal burn

subdermal burn NOTE: full thickness is complete destruction of all muscle

What topical agent can impair thyroid function?

povidone-iodine

What disease is characterized by extreme bowing of bones, especially in the legs in children? Paget's disease osteoporosis osteopenia rickets

rickets NOTE: softening of bones usually due to an extreme deficiency in vitamin D

Is the gall bladder on the left or ride side of the body?

right

What is a similarly presenting condition to systemic lupus erythematosus?

scleroderma (systemic sclerosis)

What is the most appropriate dressing to place over an IV?

semipermeable film

What type of dressing would be the least moisture retentive? alginates semipermeable foam semipermeable film hydrocolloids

semipermeable film NOTE: moisture retentive means not letting liquid pass through

Does a long stretch or short stretch bandage work better for those with venous wounds?

short stretch with high working pressure and low resting pressure work best to facilitate the calf muscle pump

The medial and lateral condyles of the tibia are most likely to develop pressure injuries in what position?

sidelying

What topical agent can cause severe electrolyte imbalances?

silver nitrate

Which topical ointment, typically used for burns, is effective against pseudomonas infections? silver sulfadiazine silver nitrate bacitracin collagenase

silver sulfadiazine NOTE: this is the most commonly used antibacterial agent

The use of which 2 topical agents is typically not painful? silver sulfadiazine nitrofurazone gentamicin povideone-iodine mafenide acetate

silver sulfadiazine and gentamicin

In what position places the patient at greatest risk to get a pressure ulcer on the vertebral spinous process?

sitting in a chair

An enterostomy is a surgical procedure that creates an artificial stoma into which organ?

small intestine

A complaint of pain under the ribs during palpation of the upper left quadrant would most likely involve the: stomach liver spleen gallbladder

spleen NOTE: the spleen is on the left under the ribs and can be palpated and actually felt when it is inflamed - this organ controls amount of red blood cells and fights infection

What structure in the epidermis serves as a barrier against fluid, electrolytes, and chemical loss? basal cells Langerhans cells keratinocytes stratum corneum

stratum corneum NOTE: the primary function of Langerhans cells, keratinocytes, and basal cells is epidermal reproduction, immunity, and keratin synthesis

What is a similar condition that presents like complex regional pain syndrome?

sympathetically maintained pain (SMP)

Whirlpool is contraindicated for what scenario?

those with chronic venous insufficiency because it can encourage venous pooling

What would be the most appropriate dressing to apply to a stage 1 or 2 pressure ulcer?

transparent film

What is the most common incontinence in the geriatric population and among residents in long term care facilities?

urge urinary incontinence (UUI)

When treating a patient with bulimia nervosa, what would be the most important for a therapist to discern? previous exercise experience how often the patient binges and purges use of vomit-inducing agents presence of body dysmorphia

use of vomit-inducing agents NOTE: this especially includes an agent called ipecac which can produce toxic body levels that can cause myopathy

What are 3 of the most common cardiac arrhythmias produced by electrical burns?

ventricular systole sinus tachycardia ventricular fibrillation

What reflex stimulates the impending need to urinate when the bladder is filling? bulbocavernosus reflex internal sphincter reflex vesicle reflex bladder tonic reflex

vesicle reflex NOTE: this reflex refers to the sensation of the need to urinate