Clinical Reasoning Final Review

50-59, females, athletes, anterior knee pain, over-pronation, increased pain with running, stairs, kneeling

What type of cartilage is in the facet?

<20, male, spinal stiffness, pain for longer than 5 months, hyperkyphosis, genetic, inflammatory arthritide

younger, female, large curves, right side more common, un-level hips/shoulders

a signal that’s felt it noticed by the person who has it

30-50 y/o, women, hard to grasp, holding a baby, overuse, injury

male, inflammation of SI joint, caused by injury or bacterial infection, buttock and LBP

What is considered normal blood pressure?

older, viral infection, pain, burning, itching, sensitive to touch, sometimes fluid filled blisters

45-60 y/o, female, tingling/numbness/weakness/pain in anterior thumb and index fingers

>40, female, dominant arm, pain/burning/weakness, can be medial or lateral

male=female, athletes, can’t lay on involved side, pain with stairs, lateral thigh/knee pain, + Obers

What type of history is a longer visit, the initial visit, for a new patient, and gathers baseline information?

>50 y/o, males, palmar fascia thickening, 4th and 5th fingers, slow progression

What is the normal pulse for toddlers?

leaning on forearm, keeping elbow bent for long time, pain, weakness, numbness, tingling

What type of history is with an established patient and focused on a specific body system?

What is unrelenting nocturnal pain a sign of?

65, male, African American, deep bone pain, prone to fracture/bleeding/bruising, fatigue

women, reproductive years, lumbar pain, pelvic/hip/groin pain, headaches, hereditary

> females, middle age, runners/cyclists, deep buttock pain down to knee or calf, walking alleviates, wakes up at night

8-10 y/o girls, 10-12 y/o boys, heel pain, inflamed growth plate

plumbers, air technicians, develops over several months, pain, redness, swelling

What is elevated blood pressure?

women, pain between 3rd and 4th digit, feels like standing on a pebble, numbness/tingling/shooting pain

4-10 y/o, male, painless limp progresses to hip/knee pain, unilateral, avascular necrosis of hip

Clinical finding is absent and the patient does not have the disease

What is the normal pulse for infants?

30-50 y/o, LBP, forced over-rotation, sitting increases pain, + or - valsalva, - SLR, + seated kemps

What does HEENT stand for?

What is Stage 1 Hypertension?

Clinical finding is present but the patient does not have the disease

baseball, swimmers, associated with SLAP injuries, tendon impingement, anterior shoulder pain, full ROM

What does the N in VINDICATE represent?

> female, pain with prolonged seated, stairs, walking, fall on buttocks, pain at PSIS, - valsava, + nachlas, +ely

What is the normal pulse for adults?

30-50 y/o, bend twist lift, LBP and LP, sitting increases pain, + valsava, + or - SLR, + bechterews

What does the D in VINDICATE stand for?

30-50 y/o, females, repetitive overuse, walking/running, pain following activity, heel/foot pain

40-60 y/o, 2 million/year, partial or full tears, supraspinatus tendon common, achy, weak, FOOSH

What does “ecchymosis” mean?

What is swelling caused by excess fluid trapped in the body’s tissues?

Proportion of people with the disease that have a clinical finding/positive test

Which of the following is NOT an inflammatory arthritide?

What is Stage 2 Hypertension?

What is the least common region to experience a disc lesion?

Musculoskeletal diseases have the 2nd greatest impact on overall health.

No position of relief, bilateral, pain doesn’t change with position, rest doesn’t help, deep boring pain

30-50 y/o, male, feels like joints in hand/foot on fire, diet high in meat and seafood, alcohol, uric acid formations

>50, males>females, ossification of ALL, pain/stiffness in thoracic spine, NOT an inflammatory arthritide

What kind of data is what the patient tells you?

What does the T in VINDICATE stand for?

What type of pain is caused by trigger points, muscles, tendons, ligaments, and organs?

40-50 y/o, male=female, affects spine and extremities, joint sx. appear 10 yrs after skin sx, inflammatory arthritide

mid 40s, male, runners, repeated overuse, posterior foot/ankle pain, swelling

Pain improves or worsens with position, unilateral, sharp, dull, achy, burning

What does the first I in VINDICATE stand for?

doctor squires specific information, provides information about other possible diseases, used to achieve a diagnosis

40-60 y/o, throwing sports, weak rotator cuff muscles, poor posture, pain in abduction, achy, pain @ night

>65, male, smoking, hypertension, tearing/ripping pain, back pain, low BP, increased pulse, SOB

>50, bacterial infection, lumbar, IV drug use, unrelenting pain worse with activity

10-30, male=female, inversion most common, poor landing, high arches, partial or full ligament tear

What does the second I in VINDICATE stand for?

What does the A in VINDICATE stand for?

30-50 y/o, male, bend lift twist, LP, standing increases pain, + SLR, - valsalva

Males>females, 20-30 y/o, athletes, medial knee pain, unable to extend knee, joint may lock

whiplash, repetitive overuse, achy neck pain, +PROM, -RROM, - valsalva, + compression tests

40+, >females, achy neck pain, + or - valsalva, - distraction, + bakody

How much spine pain is mechanical?

What does the E in VINDICATE stand for?

50-60 y/o, women, feels a catch or click, finger gets stuck, farmers/musicians/smokers

Clinical finding is absent and the patient has the disease

<40 y/o acute, >40 y/o chronic, popping/grinding/catching in shoulder joint, MVA, FOOSH,

What type of pain is from a nerve root? (pins and needles, burning)

4-6 million/yr, middle back pain, burning, stomach pain, bacterial, overuse or aspirin or alcohol or smoking

>70, women, increased kyphosis, prednisone use, sudden onset, post menopausal, pain with movement

Which of the following is NOT an inflammatory arthritide?

Musculoskeletal diseases are the #2 cause of disability

Proportion of people without the disease that do not have a clinical finding or they have a negative test

What kind of data is what you observe, palpate, and test for?

What does the C in VINDICATE stand for?

Clinical finding is present and the patient has the disease

Which is NOT a component of the HPI?

15-30 y/o, athletes, misstep or collision, trauma from outside to inside, feeling of instability, swelling

>50, pinching, comes from breast, prostate, or lung, history of cancer, unexplained weight loss

>60 y/o, women, inflammatory, causes muscle pain and stiffness, worse in morning, bilateral, bad sleep

Patient expresses what’s most important to them, doctor facilitates narration; rarely complete

a signal that can be seen by someone else

40-60 y/o, females, non dominant side more common, sedentary, immobilized shoulder joint

50+, cartilage and capsule injured in hyperextension, no pain seated/supine, + standing kemps, - valsalva

What does the V in vindicate stand for?

13-17 y/o, male, endplate trauma, hyperkyphosis, thoracic pain and stiffness

What % of body weight is on the facet?