Goodman & Snyder: Differential Diagnosis for Physical Therapists,

5th Edition
Appendix
APPEND! D"5
#e$ie% of Systems&
When conducting a general review of systems, ask the client about the presence of any
other problems anywhere else in the body. Depending on the clients answer you may
want to prompt him or her about any of the following common signs and symptoms
associated with each system:
General '(estions
___ Fever, chills, sweating constitutional symptoms!
___ "ppetite loss, nausea, vomiting constitutional symptoms!
___ Fatigue, malaise, weakness constitutional symptoms!
___ #$cessive, une$plained weight gain or loss
___ %ital signs: blood pressure, temperature, pulse, respirations
___ &nsomnia
___ &rritability
___ 'oarseness or change in voice, fre(uent or prolonged sore throat
___ Di))iness, falls
nteg(mentary )ncl(de S*in, +air, and Nails,
___ *ecent rashes, nodules, or other skin changes
___ +nusual hair loss or breakage
___ &ncreased hair growth hirsutism!
___ ,ail bed changes
___ &tching pruritus!
-(sc(los*eletal.Ne(rologic
___ -oint pain, redness, warmth, swelling, stiffness, deformity
___ Fre(uent or severe headaches
___ %ision or hearing changes
___ %ertigo
___ .aresthesias numbness, tingling, /pins and needles0 sensation!
___ 1hange in muscle tone
___ Weakness2 atrophy
___ "bnormal deep tendon or other! refle$es
___ .roblems with coordination or balance2 falling
___ &nvoluntary movements2 tremors
___ *adicular pain
___ 3ei)ures or loss of consciousness
___ 4emory loss
___ .aralysis
___ 4ood swings2 hallucinations
1opyright 5 6789, 677:, 6777, 8;;<, 8;;7 by 3aunders, an imprint of #lsevier &nc.
"ppendi$
#he(matologic
___ .resence=location of >oint swelling
___ 4uscle pain, weakness
___ 3kin rashes
___ *eaction to sunlight
___ *aynauds phenomenon
___ ,ail bed changes
/ardio$asc(lar
___ 1hest pain or sense of heaviness or discomfort
___ .alpitations
___ ?imb pain during activity claudication2 cramps, limping!
___ Discolored or painful feet2 swelling of hands and feet
___ .ulsating or throbbing pain anywhere, but especially in the back or abdomen
___ .eripheral edema2 nocturia
___ 3udden weight gain2 unable to fasten waist band or belt, unable to wear regular shoes
___ .ersistent cough
___ Fatigue, dyspnea, orthopnea, syncope
___ 'igh or low blood pressure, unusual pulses
___ Differences in blood pressure from side to side with position change
87 mm 'g or more2 increase or decrease=diastolic or systolic2 associated symptoms:
di))iness, headache, nausea, vomiting, diaphoresis, heart palpitations, increased
primary pain or symptoms!
___ .ositive findings on auscultation
P(lmonary
___ 1ough, hoarseness
___ 3putum, hemoptysis
___ 3hortness of breath dyspnea, orthopnea!2 altered breathing e.g., whee)ing, pursed@
lip breathing!
___ ,ight sweats2 sweats anytime
___ .leural pain
___ 1yanosis, clubbing
___ .ositive findings on auscultation e.g., friction rub, une$pected breath sounds!
Psychologic
___ 3leep disturbance
___ 3tress levels
___ Fatigue, psychomotor agitation
___ 1hanges in personal habits, appetite
___ Depression, confusion, an$iety
___ &rritability, mood changes
Gastrointestinal
___ "bdominal pain
___ &ndigestion2 heartburn
___ Difficulty in swallowing
___ ,ausea=vomiting2 loss of appetite
___ Diarrhea or constipation
___ 1hange in stools2 change in bowel habits
1opyright 5 6789, 677:, 6777, 8;;<, 8;;7 by 3aunders, an imprint of #lsevier &nc.
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"ppendi$
___ Fecal incontinence
___ *ectal bleeding2 blood in stool2 blood in vomit
___ 3kin rash followed by >oint pain 1rohns disease!
+epatic.0iliary
___ 1hange in taste=smell
___ "nore$ia
___ Feeling of abdominal fullness, ascites
___ "steri$is muscle tremors!
___ 1hange in urine color dark, cola@colored!
___ ?ight@colored stools
___ 1hange in skin color yellow, green!
___ 3kin changes rash, itching, purpura, spider angiomas, palmar erythema!
+ematologic
___ 3kin color or nail bed changes
___ Aleeding: nose, gums, easy bruising, melena
___ 'emarthrosis, muscle hemorrhage, hematoma
___ Fatigue, dyspnea, weakness
___ *apid pulse, palpitations
___ 1onfusion, irritability
___ 'eadache
Genito(rinary
___ *educed stream, decreased output
___ Aurning or bleeding during urination2 change in urine color
___ +rinary incontinence, dribbling
___ &mpotence, pain with intercourse
___ 'esitation, urgency
___ ,octuria, fre(uency
___ Dysuria painful or difficult urination!
___ Besticular pain or swelling
___ Cenital lesions
___ .enile or vaginal discharge
___ &mpotence males! or other se$ual difficulty males or females!
___ &nfertility males or females!
___ Flank pain
Gynecologic
___ &rregular menses, amenorrhea, menopause
___ .ain with menses or intercourse
___ %aginal discharge, vaginal itching
___ 3urgical procedures
___ .regnancy, birth, miscarriage, and abortion histories
___ 3potting, bleeding@especially for the postmenopausal woman 86 months after last
period without hormone replacement therapy!
Endocrine
___ 'air and nail changes
___ 1hange in appetite, une$plained weight change
___ Fruity breath odor
1opyright 5 6789, 677:, 6777, 8;;<, 8;;7 by 3aunders, an imprint of #lsevier &nc.
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"ppendi$
___ Bemperature intolerance, hot flashes, diaphoresis une$plained perspiration!
___ 'eart palpitations, tachycardia
___ 'eadaches
___ ?ow urine output, absence of perspiration
___ 1ramps
___ #dema, polyuria, polydipsia, polyphagia
___ +ne$plained weakness, fatigue, paresthesia
___ 1arpal=tarsal tunnel syndrome
___ .eriarthritis, adhesive capsulitis
___ -oint or muscle pain arthralgia, myalgia!, trigger points
___ .rolonged deep tendon refle$es
___ 3leep disturbance
/ancer
___ 1onstant, intense pain, especially bone pain at night
___ +ne$plained weight loss 87D of body weight in 87@8E days!2 most clients in pain are
inactive and gain weight
___ ?oss of appetite
___ #$cessive fatigue
___ +nusual lumps!, thickening, change in a lump or mole, sore that does not heal2 other
unusual skin lesions or rash
___ +nusual or prolonged bleeding or discharge anywhere
___ 1hange in bowel or bladder habits
___ 1hronic cough or hoarseness, change in voice
___ *apid onset of digital clubbing 87 to 8E days!
___ .ro$imal! muscle weakness, especially when accompanied by change in one or more
deep tendon refle$es
mm(nologic
___ 3kin or nail bed changes
___ Fever or other constitutional symptoms especially recurrent or cyclical symptoms!
___ ?ymph node changes tenderness, enlargement!
___ "naphylactic reaction
___ 3ymptoms of muscle or >oint involvement pain, swelling, stiffness, weakness!
___ 3leep disturbance
F1luster of three to four or more lasting longer than 8 month.
1opyright 5 6789, 677:, 6777, 8;;<, 8;;7 by 3aunders, an imprint of #lsevier &nc.
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