Medical Terminology #3

Medical Terminology 3 A.Backache 1. Diagnosis and Comments -Acute lumbosacral sprain: Sudden, initiated by lifting a load or a Twisting motion. Aggravated by straining coughing, etc Relieved by recumbency. Neurologically normal -Spinal cord tumor -Metatastic deposits: multiple myeloma, carcinoma prostate/breast -Prolapsed intervertebral disc: sudden onsett, radiculopathy, abnormal tendon Reflexes -Degenerative lumbosacral arthritis: Gradual onset, initiated by activity. Limited Mobility of LS spine. Pain worse in morning, Nonradiating. Normal neurologic exam -Spinal canal: stenosis Gradual onset. Like Claudication But confined to gluteal and thigh region. Worse on walking) no Pain when cycling due to flexion. May have neurologic deficits -Vaginal discharge: Pain relived by recumbency. Worse during men Struation. No neurological deficts, nonradiating -Depression: Severity of pain varies with mood 2. Test and Reason -X-ray lumbosacral spine: Spondylitis/deposits/narrow intervetebral/space/spondylolisthesis, Spinal stenosis -CT/MRI: Disc prolapse/tumor -HLA B27: Ankylosing spondylitis -Rectal examination: Prostatitis -Prostatic fluid: WBC present in prostatitis B.Joint pain 1. Diagnosis and Comments -Down syndrome -Marfan syndrome -Osteogenesis imperfecta -Ehlers-Danlos syndrome -Ligamentous injury -Fracture -Traumatic hemarthrosis -Meniscus injury (knee) -Chondrosarcoma -Osteoid osteoma -Hypertrophic pulmonary osteopathy -Metastatic malignant disease -Multiple myeloma -Lymphoma -Paget sarcoma -Influenza -Mycoplasma pneumonia -Parvovirus B 19 -Meningococcal infection -Hepatitis B and C -Histoplasmosis -Coccidioidomycosis -Cryptococcosis -Rheumatic fever -Erysipelas -Cat scratch fever -Anthrax -Avascular necrosis -Malingering -Medication: Anticoagulants, barbiturates, corticosteroids, oral contraceptives, hydralazine, quinidine -Migratory arthralgia: Found in rheumatic fever, influenza, acute and chronic hepatitis B and C, hyperthyrordism, and acute leukemia 2. Test and Reason -CBC and differential: Hb/HCT: infective process, leukemia -Blood urea and electrolytes: Renal failure -ESR: Elevated in polymyalgia rheumatica, ankylosing spondylitis, temporal arteritis Peripheral smear (Siclde cells, Howell Jolly bodies): Sickle cell disease AST/ALT/yGT/alkaline Phosphatase: Liver disease—alcoholic hepatitis AST>ALT, vira Hepatitis—ALT>AST -CPK enzymes : Dermatomyositis -T3, T 4: Hyperthyroidism -Free T4 and TSH level: Hypothyroidism -Blood cultures: Septic arthritis -Viral titers: Viral pneumomas -Serum uric: acid Gout -HLA 827: Ankylosing spondylitis -Rheumatoid factor: Rheumatoid arthritis -Antinuclear: antibody (ANA), -Anti-d5 DNA -Anti-Smith antibody: Systemic lupus erythematosus -X-ray of joint: Evidence of arthropathy/erosion, malignant deposits/coccidiodomycosis -Fluid Cytology: Histoplasmosis, cocceidiodomycosis Kweim test Sarcoidosis B.Shoulder pain 1. Diagnosis and Comments -Rotator cuff tear: Sudden pain deltoid area, increases after 12 hours Tender over greater tuberosity. Decreased AP movement, especially overhand, painful at this point.Wakes up patient at night, worse on lying on ghoulder. Relieved by allowing arm to hang limP. May lead to calcific tendonitis, in which case pain on movement in any direction -Dislocation of the shoulder -Fracture surgical neck humerus/ clavicle -Septic arthritis: Fever, swelling, pain, redness, limitation or movement -Supraspinatus: tendonitis Pain referred to lower deltoid area. Pain on abdation/overhand movement. Awakens patient at night Painful lying on shoulder -Subacromial bursitis: Pain over shoulder, radiates to arm/forearm. Increases on lifting object/overhand movement. AC Joint swelling, increased warmth, tender -Bicipital tendonitis: Pain over anterior belly of biceps. Pain increases on resistance to supination of forearm, worse at night -Metastatic deposits. -Gout -Cervical spondm prolapse -Pancoast tumor -Poor posture/myofascial pain -Esophagitis -Diaphragmaticirritation—subdiaphragmatic abscess, cholecystitis -Myocardial ischemia 2. Test and Reason -CBC and differential: Hb/HCT, infective process -X-ray Showder joint: Osteo/rheumatoid arthritis, fracture, metastati deposits, calcification in supraspinatus tendon -X-ray my acromio clavicular joint: Acromio clavicular joint pathology -X.ray cervical spine: Cervical spondylitis/ disk prolapse -X-ray thoracic outlet: cervical rib/thoracic outlet syndrome -Rheumatoid factor: Rheumatoid arthritis -Nerve conduction studies: Brachial plexus neuropathy -Abdominal ultrasound: Subdiaphragmatic abscess.cholecystitis EKG: Myocardial ischemia/pericarditis