RED FLAGS FOR DIFFERENTIAL DIAGNOSIS (complete)

As a red flag for Pancoast tumor, a male with the history of smoking needs to be at or above what age?

50 or greater.

What is the magic age that makes almost any GI issue a red flag for colon cancer?

50! Also the age recommended to begin getting a colonoscopy every 10 years. Fun!

List the 7 red flags for peripheral artery disease in the lower extremity?

60 or older. History of smoking, diabetes type 2, and/or ischemic disease. Sedentary lifestyle. Concurrent intermittent claudication. Unilateral cool extremity. Decreased pedal pulse.

Above what age is a red flag for peripheral artery disease

60 years of age or older

A decreased pulse at what location is a red flag for peripheral arterial disease in the lower extremity

A decreased pedal pulse

What type of trauma injury is a red flag for elbow, wrist or hand fracture.

A fall on out stretched hand injury. FOOSH injury.

Ready! List the 4 red flags for a pathological fracture of the femoral head!

A female over the age of 70. History of a fall while standing. Has severe, constant pain made worse with movement. The affected leg is shorter and more externally rotated compared to the other leg.

List the 3 red flags for compartment syndrome.

A history of blunt trauma or un-accustomized exercises. Severe persistent pain, aggravated by stretching. Swelling, tenderness, paresthesia, and pulseless.

A history of what 3 things are considered when red flagging peripheral artery disease?

A history of type 2 diabetes. Ischemic disease. Smoking.

List the 3 red flags for cervical ligament instability

A major trauma, most often MVA or fall. Rheumatoid arthritis or ankylosing spondylitis. Upper motor neuron signs with dizziness, nystagmus, and vertigo.

List the red flag for meningitis listed on the slide.

A positive slump test, with headache, fever, GI signs, confusion, photophobia, sleepiness, seizure.

A person comes to you with back pain and some pain symptoms that don't seem quite right. You can tell they are not an IV drug user or abuser after you do a skin check. What other 2 red flags would you need to ask to rule out osteomyelitis?

A recent infection. Especially on the skin or of the urinary tract. Also, is their immune system compromised? Have they been taking steroids for a long time? Do they report having a disease or disorder that hinders the immune system, including autoimmune diseases, organ transplant or HIV/AIDS.

Symptoms of cholecystitis are made worse with what?

After eating fatty food.

A person comes to you with back pain after a fall cause by lifting something heavy, what age and older is a red flag for spinal fracture?

Age of 70 or greater.

A person comes to you for back pain, you notice some yellow flags, but then see their age... Above what age is a red flag for back-related tumor ?

An age greater than 50 is a red flag for back-related tumor

A person comes to you with numbness and weakness in the lower extremities. What are 4 questions you should ask them to check for cauda equina syndrome?

Are you able to pee? Are you able to hold your pee in? Do you poop your pants? Is it numb where you would ride in a saddle?

List the major red flag(s) for primary brain tumor.

Ataxia. Speech deficits. Sensory abnormality. Visual changes. GI signs. Altered mental status. Seizure.

List the 2 multi-detailed red flags for DVT.

Calf pain, edema or warmth intensified with standing or walking and relieved by rest and or elevation. A recent surgery, trauma, immobilization, pregnancy or cancer.

A person with ankle dorsi flexion and plantar flexion weakness on both sides. They have severe sensory loss bilaterally over the L4,L5,S1 dermatome and are hypo-reflexive in their both legs. It wouldn't take too many more questions to figure out if this patient is presenting with what syndrome?

Cauda equina syndrome. Red flags are: Urine retention or incontinence. Fecal incontinence. Saddle anesthesia. Global or aggressive weakness in lower extremities. Sensory deficits in L4, L5, S1. Ankle plantar and dorsi flexion weakness. Hypo reflexive in lower extremity.

Pain, skin swelling, warmth and erythema accompanied by fever, chills and malaise would be a red flag for what?

Cellulitis

3 red flags for MI

Chest pain with exertion alleviated by rest. Pallor, sweating, dyspnea, nausea, palpitation. History of CAD, hypertension, smoking, diabetes mellitus, and high cholesterol, 240 mg/dL or greater.

List the 2 red flags of pneumothorax

Chest pain, intensified with inspiration, and difficulty expanding rib cage. Decreased breathing sounds.

List the 2 red flags for pulmonary embolus.

Chest, shoulder or upper abdominal pain, dyspnea. History of DVT.

A severe persistant pain in the leg aggravated by stretching is a red flag for what?

Compartment syndrome

History of blunt trauma or un-accomtized exercises is a red flag for what?

Compartment syndrome.

Swelling, tenderness, paresthesia, and pulseless leg is a red flag for what?

Compartment syndrome.

A leg with extensive peripheral arterial disease would be rather cool or warm to the touch?

Cool

A recent pregnancy with edema in the leg can be a red flag for what issue in the lower extremity?

DVT

Calf pain, edema or warmth, intensified with standing or walking and relieved by rest or elevation, is a red flag for what?

DVT

List the 4 red flags of a peptic ulcer.

Dull or gnawing pain or burning sensation in the epigastrium, mid-back, or supraclavicular regions. Symptoms ease with food. Localized tenderness in the right epigastrium. Constipation, bleeding, vomiting, black stools.

List the 2 red flags for carpal fracture or dislocation.

FOOSH injury. Wrist swelling, localized tenderness, wrist held in neutral.

What is key description in an older lady's fall that makes you think fracture.

Falls from a standing position.

A high of high cholesterol can be a red flag for MI, what level and above is considered high cholesterol for a red flag?

Greater than 240 mg/dL

List the 2 red flags for Raynaud's disease.

Hand & feet are blanch, cyanotic, red when exposed to cold or emotional stress with pain and tingling. History of rheumatoid arthritis, occulsive vascular disease, smoking, beta-blocker user.

Sensory deficits would be present at what root levels if a person had cauda equina syndrome

L4,L5,S1

List the 6 red flags for osteonecrosis of the femoral head.

Long term corticosteriod use. Osteonecrosis in the other hip. Trauma. Antalgic gait. Pain with movement, especially hip abduction and internal rotation. A 5-8 year old boy with groin or thigh pain.

List the 4 red flags for Pancoast tumor.

Men with history of smoking over the age of 50. Nagging pain in the shoulder and vertebral border of scapula. Pain would progress to burning pain, extending down the arm and ulnar nerve distribution. May have Horner's syndrome.

With colon cancer, is their pain going to be alleviated with certain positions or movements.

Most likely not. "Pain unchanged by positions or movement."

Is COPD a red flag for cellulitis

No

What 4 items are red flags for back-related tumor

Over the age of 50. History of cancer. Unexplained weight loss. Not responding to conservative therapy.

List the 4 red flags for colon cancer.

Over the age of...50. Rectal bleeding or any other icky poo poo. Family history of colon cancer. Pain is unchanged with positioning or movement.

You have a patient reported pain that started month ago in the shoulder and vertebral border of the scapula, for it to be red flag for pancoast tumor, where would the pain most likely progress to as the tumor grew.

Pain associated with pancoast tumor would typically spread as a burning pain down the arm and along the ulnar nerve distribution; after the pain initially showed up in the shoulder.

Describe the pain associated with cholecystitis

Pain in the upper abdominal quadrant with right scapular pain.

List the 2 red flags of cholecystitis

Pain in the upper abdominal quadrant with right scapular pain. Symptoms worsen with fatty food.

List the 3 red flags for cellulitis.

Pain, skin swelling, warmth and erythema of the affected area. Fever, chills and malaise. History of recent skin ulceration, venous insufficiency, and CHF.

List the 3 red flags for peripheral entrapment neuropathy.

Paresthesia, pain at rest. Muscle tenderness with palpation. Strength and sensory deficit follow a peripheral nerve pattern.

Dull or gnawing pain or burning sensation in the epigastrium, mid-back, or supraclavicular regions is a red flag for what?

Peptic ulcer

Describe the pain associated as a red flag for pneumonia.

Pleuritic pain, referred to shoulder.

List the 2 red flags of pneumonia

Pleuritic pain, referred to shoulder. Fever, chills, malaise, nausea and productive cough.

Peluritic pain that also refers to the shoulder along with a fever is a red flag for what?

Pneumonia

History of DVT is a red flag for what else besides an undetected DVT?

Pulmonary embolus

Pain in the chest, shoulder or upper abdominal area with dyspnea is a red flag for what?

Pulmonary embolus.

A 65 year old man who smokes is complaining of nagging pain in the shoulder and vertebral boarder of the scapula. What red flag is waving?

Red flag for pancoast tumor.

Describe the pain felt with inspiration associated with pleurisy.

Severe sharp, knife pain

List the 2 red flags of pleurisy.

Severe sharp, knife pain with inspiration, dyspnea. History of respiratory disease.

With a DVT in the lower extremity, what would increase the symptoms?

Standing or walking would increase calf pain, edema, and warmth.

List the red flag(s) for subarachnoid hemorrhage.

Sudden headache. A brief loss of consciousness. Brain tumor signs. Meningeal irritation signs.

List the 4 red flags for a kidney disorder or stone. Go!

Sudden, severe back or flank pain. Chills, fever, nausea or vomiting. UTI. History of kidney stones, 50% of patients with history will have recurrence.

An 80 year old lady wheels in with pain in her hip when she moves her leg. Despite your assistance, she flops herself on the mat and won't let you move her because she's afraid it will hurt. What details of her affected leg would indicate a fracture of the femoral head?

The leg might be shortened and externally rotated compared to the other leg.

What is the age indicated as a red flag for a kidney disorder or stone?

There is not an age associated with kidney disorder or stone.

Name the 3 red flags for spinal fracture.

Think old-retired body builder who still thinks he can do barbell back squats. History of trauma. Prolonged use of steroids. Age of 70 or older.

List the 4 red flags for RSD or Complex regional pain syndrome.

Trauma or surgery. Severe stinging or boring pain, hypersensitive. Area swelling (pitting edema), warm & red. Pain does not respond like typical analgesia.

What are the 3 red flags for fracture in the elbow, wrist and hand.

Trauma, FOOSH injury. Pain tenderness, swelling and echymosis. History of osteoporosis.

Above what age does a lady need to start worrying about hip pain being a red flag for a pathological fracture of the humeral head?

When she gets to be 70 or older.

When is the pain primarily felt with pleurisy?

With inspiration

Are chills, fever nausea or vomiting considered a red flag for Kidney disorders or stones?

Yes

Is CHF a red flag for cellulitis?

Yes

Is a recent history of cancer a red flag for DVT?

Yes

Is venous insufficiency a red flag for cellulitis?

Yes

With peripheral entrapment neuropathy, will the patient experience pain at rest?

Yes, most often with accompanying paresthesia.

Is a person with cauda equina syndrome hypo-reflexive in the lower extremities?

Yes.

Describe the type of angina that is indicative of MI

angina with exertion and alleviated with rest.

Describe the pain associated with peptic ulcer

dull or gnawing pain or or burning sensation in the epigastrium, mid-back, or supraclavicular regions

What eases the symptoms of peptic ulcer?

eating food

What % of those who've had a kidney stone will have another in their lifetime?

half of them. 50% of those with prior kidney stone will develop another

What movements would be especially painful with hip osteonecrosis?

hip abduction and internal rotation

A sedentary smoker with diabetes is having leg cramps, you are thinking red flag for...?

peripheral artery disease

Localized tenderness would present where with peptic ulcer

right epigastrum

What are the 4 things listed as possible causes for sympathetic paralysis or paresis.

vertebrobasilar insufficiency. Apical lung tumor, Pancoast. Breast cancer. Dissection of carotid artery. Trauma.