Medical Screening questions

Original Editor - Bradley Svoboda

Top Contributors - Bradley Svoboda  

Purpose

To allow physical therapists to hypothesize about the existence of medical conditions presenting as muskuloskeletal conditions and facilitate appropriate medical evaluation and management strategies.

General Health

Fatigue, fever/chills/sweats, nausea/vommitting, weight change, paresthesia/weakness/or balance, malaise, mentation/cognition.

With a positive response to any of these factors, follow up with questions of

• duration of symptoms
• Is there a plausible explanation for these symptoms
• is the patients physician aware of the symptoms
• if the patient's physician is aware of the symptoms, has there been an appreciable change in the symptoms since the patient saw the physician last that he/she is not aware of.

Depression

Questions to ask.

During the past month have you often been bothered by feeling down, depressed, or hopeless?

During the past month have you often been bothered by little interest or pleasure in doing things?

If positive response

• is this something with which you would like help?
• Are you having thoughts about harming yourself or others?

Risk Factors for NSAID - induced GI bleed

• Increased Age, female, age>85
• History of peptic ulcer
• low serum albumen
• Concominant use of multiple antithrombotic agents, NSAIDs
• hypovolemic states, renal impairment

Predictors of abdominal pain

A positive response to any of the following questions for muskuloskelatal origin:

• Does coughing, sneezing, or taking a deep breath make your pain feel worse?
• Do activities such as bending, sitting, lifting, twisting or turning over in bed make your pain feek worse?
• Has there been a change in your bowel habit since the start of your symptoms?

A negative response to any of the following questions for muskuloskeletal origin;

• Does eating certain foods make your pain feel worse?
• Has your weight changed since your symptoms started?

Resources

Arroll B, Goodyear-Smith, F, Kerse N,   Effect of the addition of a "help"question to two screening questions on specificity for diagnosis of depression in general pracitce; diagnostic validity study. Primary Care.  BMJ, doi:10.1136/bmj.38607.464537.7C

Lichtenstein, DR, Wolfe MM.  COX-2 selective NSAIDs; new and improved?  JAMA.  2000;284;1297-1299

Sparkes V, Prevost T, Hunter J.  Derivation and identification of questions that act as predictors of abdominal pain of muskuloskeletal origin.  European Journal of Gastroenterology and Hepatology.  2003;15(9);1021-1027.

References

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