AH2 Exam 3 all exemplars s/s

SIRS

Temp >38°C or

Sepsis

Fever or hypothermia; tachycardia; tachypnea; early hypotension; altered mental status; decreased urine output; elevated lactate; warm flushed skin (early)

Septic Shock

Persistent hypotension despite fluids; lactate >2; cold mottled skin; weak pulses; altered LOC; anuria or oliguria; metabolic acidosis

Superior Vena Cava Syndrome

Facial, neck, and upper body swelling; jugular venous distention; dyspnea; cyanosis; chest tightness; headache; stridor (late)

Tumor Lysis Syndrome

Hyperkalemia causing dysrhythmias and weakness; hypocalcemia causing tetany and seizures; hyperphosphatemia; hyperuricemia; nausea; vomiting; diarrhea; flank pain; decreased urine output

Hypercalcemia (Bone Metastasis)

Fatigue; weakness; decreased reflexes; constipation; nausea; vomiting; confusion; pathologic fractures; dysrhythmias; polyuria and dehydration

Spinal Shock

Flaccid paralysis; loss of reflexes; loss of bowel and bladder function; warm dry skin; possible hypotension and bradycardia

Neurogenic Shock

Severe hypotension; bradycardia; warm dry skin; hypothermia; inability to regulate body temperature (poikilothermia)

Autonomic Dysreflexia

Severe hypertension; bradycardia; pounding headache; flushing above injury with pallor below; diaphoresis above injury; nasal congestion; blurred vision

Mild TBI (Concussion)

Headache; dizziness; nausea; vomiting; brief loss of consciousness or none; sensitivity to light or noise; memory problems; fatigue

Moderate TBI

Loss of consciousness for minutes to hours; persistent headache; confusion; amnesia; focal deficits; behavioral changes

Severe TBI

Loss of consciousness >6 hours; abnormal posturing; seizures; unequal pupils; worsening signs of increased ICP; loss of brainstem reflexes; respiratory failure

Contusion

Altered LOC; focal neurologic deficits; seizures; personality or behavior changes

Subdural Hematoma

Gradual decline in LOC; headache; drowsiness; pupil changes; focal deficits; symptoms may be acute, subacute, or chronic

Epidural Hematoma

Loss of consciousness → lucid interval → rapid deterioration; severe headache; ipsilateral dilated pupil; nausea; vomiting; hemiparesis

Intracerebral Hematoma

Sudden neurologic decline; severe headache; vomiting; focal deficits; signs of increased ICP

Increased ICP

Decreased LOC; headache; vomiting without nausea; Cushing’s triad (hypertension with widened pulse pressure, bradycardia, irregular respirations); papilledema; pupil changes; abnormal posturing

Parkinson’s Disease

Resting tremor; rigidity; bradykinesia; shuffling gait; masklike face; soft speech; drooling; postural instability

Febrile Transfusion Reaction

Fever; chills; flushing; headache; anxiety

Circulatory Overload (TACO)

Dyspnea; crackles; hypertension; tachycardia; jugular venous distention

Bacterial Contamination Reaction

High fever; chills; hypotension; shock; vomiting; diarrhea

Graft-Versus-Host Disease

Rash; jaundice; diarrhea; bone marrow suppression

Actinic Keratoses

Rough scaly patches; pink or red lesions; tenderness or itching on sun-exposed skin

Squamous Cell Carcinoma

Firm red nodule; scaly crusted lesion; slow-growing lesion that may ulcerate or bleed

Basal Cell Carcinoma

Pearly shiny nodule; rolled edges; visible surface blood vessels; may ulcerate

Melanoma

Asymmetry; irregular borders; varied colors; diameter >6 mm; evolving lesion; possible itching or bleeding

Stevens-Johnson Syndrome

Flu-like illness followed by painful widespread rash; blistering; mucosal involvement in mouth, eyes, or genitals; skin detachment involving

Toxic Epidermal Necrolysis

Extensive skin detachment >30% of body surface; widespread blistering; severe pain; high fever; multiorgan involvement; high risk for sepsis and fluid loss