Diagnostic testing for DVT?
Ascending venogram, D-Dimer, Compression
USG, MRI, Wells Score,
Peripheral Vascular Disease Differentials:
arterial-
5P’s (pain, pallor, pulseless, paralysis, paresthesia, shiny
ski, hair thinning, thick toenails (Keep legs down for blood flow)
venous
- venous pooling, edema, discoloration, pain (Keep legs up
for blood return)
DVT
- warm, erythema, pain, red streaking
Varicosities
- engorged vessels, visible veins, “spider veins”
Obstructive Vs Restrictive Pulm Diseases
FVC < than 80%-restrictive
disease;
FVC < 70% obstructive-COPD, emphysema, Bronchitis, asthma
ASTHMA:
FEV1 Classification:
Normal FEV1/FVC
: 8-19 yr 85%
20-39 yr 80%
40-59 yr 75%
60-80 yr 70%
Intermittent
- pulmonary function may be normal, symptoms less
than 2 days per week
Mild
- wake up few times/month and use rescue inhaler 3-4x per
week, minor limits on activity
Mod persistent
- wake up once/week use rescue inhaler daily, some
limitation of activity
Severe persistent
- wake up from sleep often use rescue inhaler
multiple times/day, 7x per week usage of inhaler and extremely
limiting their activities
Signs and Symptoms:
Emphysema
- cough, hemoptysis, smoker, hyperventilation
Bronchitis-
cough, sputum, dyspnea
Pneumonia
- fevers, chills, sputum production, myalgias, chest
pain, possible crackles
Asthma
- I/E wheezing, accessory muscle use, stridor, tachypnea,
tachycardia, SOB
COPD-
dyspnea, cough, barrel chest, crackles, JVD, fatigue distant
Breath Sounds, wheezing
CURB65
-confusion, BUN >19, RR >30, BP: sys<90, dys <60, age >65 0.1
home, 0-2 short Outpatient, 3-5 inpatient, possible ICU admittance
Common organism associated with CAP
-
S pneumoniae, Hemophilus
Influenzae, Mycoplasma Pneumoniae, Chlamydophilia Pneumoniae, Viral
Infections.
Stages of COPD
-1. mild FEV>80%, 2. Mod FEV50-79% 3. Severe FEV1 30-
39% 4. Very severe <30%(pg362)
Contributing factors to obstructive sleep apnea, PT EDUCATION-
