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Spring 2022 classes > medical conditions exam 1 > Flashcards

medical conditions exam 1 Flashcards

1
Q

what is a PT’s job in relation to drugs

A

we can’t prescribe or administer in general, we can only administer for modality use like iontophoresis and phonophoresis

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2
Q

what type of drug is aspirin

A

anti-platelet

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3
Q

if a patient says they are having a lot of inflammation, can you recommend the use of an NSAID

A

NO. but you can educate them on different types of OTCs so they can make the best choice but we can’t recommend use of drugs

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4
Q

are drugs removed from the body as active or inactive

A

can be either one depending on the type of drug and how the body responds

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5
Q

example of ace inhibitor

A

lisionopril

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6
Q

example of calcium channel blocker

A

norvasc

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7
Q

what do PTs use drug screenings for

A

precautions and contraindications for PT intervention

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8
Q
A
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9
Q

what does the FDA do

A

direct drug development, give approval for drug marketing, approve new use for older drugs, monitor use of existing drugs, determine if drugs are safe for humans and if they are effective

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10
Q

why are some drugs banned in the US but able to get in other countries

A

FDA determines if they are safe, most other countries just care if they are effective

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11
Q

what determines if a drug is rx or OTC

A

OTC have higher theraputic index so side effects are less

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12
Q

give examples of classifications of drugs

A

traditional vs generic, biologic vs biosimilar

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13
Q

what type of drug must be bioequivalent to the original

A

generic

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14
Q

what does bioequivalent mean

A

same dose, strength, ingredients and has the same effect in the blood

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15
Q

which type of drug can be analyzed for its components

A

traditional

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16
Q

what type of drug comes from living systems like yeast, plants, animals and can’t be replicated

A

biologic

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17
Q

what kind of drugs aren’t identical to the original but are usually at a lower cost, but we don’t know how therapeutic they are

A

biosimilar

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18
Q

what are examples of natural alternative therapies

A

minerals, fish oil, vitamins, etc

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19
Q

what does integrative medicine focus on

A

health vs disease

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20
Q

how many stages in drug testing does the FDA have and what is stage 4

A

4 stages, when they continue monitoring for adverse effects even after it’s approved

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21
Q

4 steps in pharmacotheraputics

A

AADME

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22
Q

what are some things drugs may be used for

A

maintenance, treatment, replacement, prevention

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23
Q

chemical name drug

A

long and complicated name, specific compound and structure

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24
Q

generic name

A

official name usually used in journals

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25
Q

trade name

A

copyrighted name, assigned by the drug company

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26
Q

how many schedules of drugs are there based on the comprehensive drug abuse prevention and control act

A

5

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27
Q

what schedule is marijuana in

A

used to be 1, but now it’s 3

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28
Q

what schedule are cocaine, morphine and adderall in

A

1

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29
Q

what schedule is testosterone in

A

3

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30
Q

what schedule are xanax, valium in

A

4

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31
Q

what schedule is robitussin in

A

5

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32
Q

risk factors for THC

A

stroke, fall, MI

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33
Q

what trimester should a pregnant woman make sure she does not consume drugs in

A

1st trimester

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34
Q

def dose

A

amt drug reach target site

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35
Q

def potency

A

amt needed to produce effect

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36
Q

def low dose

A

no observable effect b/c dose is too low

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37
Q

ceiling effect

A

dose is high so there is no increase in the response

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38
Q

which type of drug is immunogenic

A

biological, NOT chemical

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39
Q

which type of drug is stable and has a well-defined structure

A

chemical

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40
Q

what are some pros and cons of biologics

A

very expensive but better for the body and can be very specific in what they target

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41
Q

what is the most important thing for us as PTs to know about drugs out patients are taking

A

why they are taking the drug

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42
Q

what does bioavailability depend on

A

administrative route and ability to cross membrane barriers

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43
Q

2 types of drug administration

A

enteric and parenteral

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44
Q

enteric is also known as

A

alimentary (through GI)

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45
Q

what step of pharmokinetics determines bioavailability

A

absorption

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46
Q

what is drug absorption affected by

A

dosage, solubility, blood flow, acidity, concentration, diffusion

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47
Q

what is distribution of drugs affected by

A

blood flow, plasma protein, binding, anatomic blood barrier

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48
Q

what stage of pharmacokinetics includes the liver breaking it down

A

metabolism

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49
Q

what happens in the metabolism stage

A

liver changes drug to inactive form which also impacts how quickly it is excreted from the body

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50
Q

what organ is involved with elimination stage

A

kidney

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51
Q

what stage of pharmacokinetics is related to clearance or half life

A

excretion

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52
Q

what methods of taking drugs are parental

A

sublingual/buccal, IV, IM

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53
Q

what is a disadvantage about rectal administration and PEG tube

A

unpredictable where the drug will go in the body

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54
Q

example of drug administered via sublingual or buccal

A

nitroglycerine

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55
Q

what type of drug administration is 100% bioavailable

A

IV and IA

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56
Q

what type of administration are phonophoresis and iontophoresis

A

transdermal

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57
Q

what is intrathecal baclofen therapy

A

uses baclofen to decrease abnormal tone and deliver drug into CSF to manage severe spasticity

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58
Q

volume of distribution

A

ratio of drug administered to the concentration of drug in plasma

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59
Q

where are most drugs stored in the body

A

adipose tissue b/c lipid soluble

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60
Q

what are prodrugs

A

required to be active, liver breaks it down to create a stronger response

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61
Q

what should you not take if you are taking tetracycline

A

antacid b/c decreases antibiotic effects

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62
Q

risk of long term NSAID use

A

stomach ulcer, high BP, increase risk of heart attack

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63
Q

def drug selectivity

A

how the drug knows where to go

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64
Q

def affinity

A

attraction b/w drug and receptor

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65
Q

clearance (CL)

A

volume plasma cleared per unit time, predicts elimination in relation to blood serum concentration

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66
Q

what effect of drugs tells us when the next dose should be taken

A

clearance

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67
Q

what does half life ensure

A

maximum dose is administered at each time

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68
Q

what does a higher half life mean

A

longer time it takes for the drug to leave the system

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69
Q

what does a lower half life mean

A

the dose needs to be taken more often b/c doesn’t stay in the body for as long

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70
Q

does chemo have a high or low therapeutic index

A

low b/c it is very dangerous

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71
Q

how many of the most prescribed drugs that are prescribed for Americans are for hypertension

A

6/15

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72
Q

what are some conditions that have very costly drugs associated with them

A

diabetes, hep C, cholesterol

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73
Q

what are some of the most commonly prescribed drugs in the US

A

asthma, diabetes, cholesterol, GERD

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74
Q

vyvanse

A

ADHD

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75
Q

lyrica

A

seizure

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76
Q

lantus

A

DM

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77
Q

ventolin

A

COPD

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78
Q

crestor

A

cholesterol

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79
Q

advair

A

COPD

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80
Q

spiriva

A

COPD

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81
Q

januvia

A

DM

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82
Q

2018 GA prescription drug monitoring program

A

requires MDs to check database before rx opioids or cocaine

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83
Q

are analgesics an opioid

A

yes they are

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84
Q

do analgesics relive pain

A

no, they just alter the perception of pain

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85
Q

examples of non-opiods

A

NSAID, anti-inflammatory, glucocorticoids

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86
Q

examples of opiods

A

codeine, morphine, fetanyl, hydrocodone, heroin

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87
Q

what are some effects of opioids

A

sedation, mood change, constipation, depression, orthostatic hypotension

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88
Q

what does a PCA do

A

allows pt to control amount of opioid given to them via pump, shown to decrease addiction rates and side effects b/c constant supply instead of running out and asking for more

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89
Q

what is a benefit of cox 1 and 2 drugs

A

causes less GI upset

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90
Q

functions of acetaminophen

A

analgesic and antipyretic NOT anti-inflammatory

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91
Q

why would a dr combine acetaminophen and opiods

A

both used for pain relief but when used together the dose of opioid can be less

92
Q

what does NSAID inhibit in the body

A

prostaglandis

93
Q

what does a steroid do

A

anti-inflammatory and supresses immune system

94
Q

what negative effects do NSAIDS have

A

liver damage, distrupt bone and cartilage healing

95
Q

why are steroid packs given as packs instead of just a few doses

A

want to prevent adrenal suppression from removing it too fast from the body

96
Q

what does a statin do

A

lower cholesterol in the body by slowing down the production of it

97
Q

examples of statins

A

crestor, zocor, ezallor, lipitor

98
Q

PPI treats what

A

GERD

99
Q

example of PPI

A

nexium

100
Q

what was amoxicillin used to treat for a while until drs realized they were becoming resistant to it

A

ear infections in kids

101
Q

what does glucophage treat

A

type 2 diabetes

102
Q

example of glucophage

A

metformin: leads to an increased response to insulin

103
Q

example of diuretic

A

hydrocholorathiazide

104
Q

what do diuretics treat

A

high BP or edema

105
Q

what do ambien or zolpidem treat

A

insomnia

106
Q

are there different types of drugs for insomnia

A

yes, some are oral, spray, sublingual depending on the purpose and how quick they would act

107
Q

examples of SSRIs

A

prozac, zoloft, paxil, celexa, laxapro

108
Q

bupropion and wellbutrin

A

works on dopamine to increase effectiveness on other drugs instead of increases the dosage of the more intense drug

109
Q

benzodiazepines examples

A

xanax, valium

110
Q

benzodiazepine purpose

A

promote sleep, decrease muscle spasm, alcohol withdrawl, anxiety and agitation

111
Q

examples of stimulants

A

adderall, ritalin, concerta

112
Q

angina

A

chest pain

113
Q

nitroglyerin

A

tx angina, is sublingual administration

114
Q

perocet combination of

A

opioid and acetamenophen

115
Q

what type of drug is hydrocholorothalazide

A

diuretic, treats HTN and CHF

116
Q

what does hemodynamic stability mean

A

considered stable based on the lab values available

117
Q

if hematocrit levels are 25% what does that mean for the HCP

A

decide if they can continue on w/ tx, may or may not depending on clinical judgement

118
Q

what are normal hematocrit levels

A

37-52 ish

119
Q

how is anemia related to hematocrit and hemoglobin

A

decreased levels of both, hemoglobin is a better predictor

120
Q

ESR def

A

rate of RBC settle out of unclotted plasma in 1 hour

121
Q

what does ESR measure

A

inflammation in the body

122
Q

leukocytosis def

A

increase in WBC that may be associated w/ malaise, lethargy, fever, bruising

123
Q

what does basic metabolic panel include

A

electrolyte level, acid-base balance, blood sugar, kidney status

124
Q

when pt is in the hospital is blood sugar expected to be higher or lower than normal

A

higher

125
Q

what is HBA1c of someone w/ diabetes

A

> 6.5%

126
Q

leukopenia def

A

decrease in WBC that may be associated w/ anemia, weakness, fatigue

127
Q

what does a liver enzyme test for

A

billirubin and other enzymes to see what the quantity of them is like

128
Q

what may lead to hypoalbuminum

A

poor nutrition b/c not getting adequate protein

129
Q

what area of the body would liver problems cause pain

A

RUQ

130
Q

what do pts w/ DVT usually complain of

A

dull pain the calf that doesn’t go away

131
Q

3 things that together cause cancer

A

carciongen causes irreversible changes, endogenous + exogenous factors, non-carcinogen agent that promotes growth of cancer

132
Q

what type of cells are platelets

A

thrombocytes= initiate clotting

133
Q

what is good blood glucose level

A

140-180 mg/dL

134
Q

what is an increased blood glucose level

A

200 mg/dL

135
Q

what HBA1c levels are important to know

A

<5.7% is normal
>5.7 is pre-diabetes

136
Q

what electrolyte is very important for controlling heart muscle function

A

potassium

137
Q

what are blood urea nitrogen

A

waste elimated from kidneys

138
Q

what is waste from liver called

A

bilirubin, recycled into RBC

139
Q

what protein is made by the liver and can lead to poor wound healing

A

albumin

140
Q

PT

A

prothrombin time

141
Q

PTT

A

partial thromboplastin time

142
Q

INR

A

international normalized ratio

143
Q

normal INR

A

0.8-1.2

144
Q

what level of INR requires MD consult

A

> 4.6

145
Q

what level of INR increases risk of hemarthrosis during exercise

A

> 3.6

146
Q

what is the leading cause of preventable death in the hospital

A

DVT

147
Q

why is DVT risky

A

increase viscosity which decreases blood flow and makes it easier to clot and travel

148
Q

is homan’s sign a valid test for DVT

A

no, don’t use it. refer to MD for ultrasound if DVT is suspected

149
Q

tx for DVT

A

eliquis, pradaxa, xarelto

150
Q

types of cholesterol

A

HCL- good
LDL- bad

151
Q

5 common places for cancer to spread to

A

bone, brain, lung, lymph, liver

152
Q

what is most leading cause of death in people under 85 yo

A

cancer

153
Q

what is the second leading cause of death in children

A

cancer

154
Q

what is the most fatal type of cancer

A

lung

155
Q

what is the most aggressive type of cancer

A

pancreatic

156
Q

what’s an example of chemoprevention

A

preventative mastectomy, taking tomoxiphan; both will prevent breast cancer

157
Q

main risk factors of cancer

A

> 50, ethnicity, environment, family history, obesity, age of menstration, skin color, etc

158
Q

what is a very good screening tool to prevent a specific type of cancer

A

colorectal screen= 90%

159
Q

screen for pancreatic cancer

A

none exists currently

160
Q

who should be screened for ovarian cancer

A

if have BCRA 1 or 2 mutations

161
Q

difference b/w malignant and benign cells

A

don’t invade, differentiated, encapsulated
compress and invade, undifferentiated, invasive

162
Q

what is a word to describe malignant cells

A

anaplastic: DNA loses ability to make codes that allow for mature cell function

163
Q

what cancer is associated w/ BCRA 1 and 2 mutaiton

A

mostly breast cancer but also increase risk for ovarian

164
Q

what is the #1 cause of preventable disease death in the US

A

smoking

165
Q

what cancers can exercise lead to a decrease in risk

A

breast and colon

166
Q

what cells are ideal to target in early detection screenings

A

mataplasia b/c they are reversible

167
Q

are dyslasia cells cancerous or not

A

no they are not cancerus, they are abnormal and they may progress to be cancerous but at their current state they aren’t

168
Q

what is the most advanced type of metaplasia cells

A

anaplasia, have metastacized

169
Q

what is the most common type of cancer cell

A

carcinoma, begins in epithelial and moves internal towards the lymph and organs

170
Q

who are carcinoma cells common in

A

kids like lymphoma and leukemia

171
Q

if a tumor is benign what will its suffix be

A

-oma

172
Q

what cancers are most associated w/ age

A

lekemia, breast, GI, prostate, urinary

173
Q

how many grades of cancer are there

A

4

174
Q

what does grade 1 of cancer mean

A

best prognosis, least threatening, most differentiated

175
Q

TNM system includes what 3 factors

A

size/area of tumor, # lymph, metastases presence

176
Q

what are tumor markers

A

biomarkers made by a tumor that is found in high levels for people with cancer

177
Q

what viruses are associated w/ cancer

A

EBV, HIV, leukemia, Hep B&C

178
Q

why are metastasis especially concerning

A

even after they are killed w/ chemo or radiation they can come back in 15-20 years

179
Q

what are some yellow flags in patients who could have cancer

A

24 hour pain, unexpected pain, weight loss/gain

180
Q

what is the goal of neoadjuvant therapy

A

shrink the cancer before typical treatment begins

181
Q

what are examples of neoadjuvant therapy

A

chemo, radiation, hormone

182
Q

who is adjuvant therapy given to

A

lower cancer reoccurance risk because it may be undetectable

183
Q

what does cancer surgery do

A

take out some tissue for pain relief, to relieve obstruction or debulk (take out entire thing)

184
Q

fulguration tx

A

uses electrical current to destroy the cancer

185
Q

excisional vs incisional biopsy

A

remove tumor and normal tissue vs use for diagnostic purposes and only take out tumor

186
Q

what is radiofrequency ablation therapy

A

high energy radio waves that use needles to kill cancer

187
Q

what is a thoroscopic treatment for cancer

A

use a tube with a video camera to create an incision in the chest

188
Q

what are some benefits of robotic cancer treatment

A

decrease in blood loss, more accurate

189
Q

what is en bloc resection

A

removing the entire tumor without taking part of the capsule

190
Q

pros of cryosurgery

A

limited side effects, less money and less recovery time

191
Q

what types of cancers can be treated with cryosurgery

A

liver, prostate, cervical, bone

192
Q

what is an advantage of radiation therapy

A

increase the dose to the tumor and use the other tissues much less

193
Q

what are some side effects of radiation therapy

A

red skin, looks burned, peeling after, xerostomia, mycositis, alopecia

194
Q

what is the goal of radiation therapy

A

break down the chemical bonds to shrink the tumor

195
Q

what do about half of patients use for cancer treatment

A

radiation therapy

196
Q

what is the difference b/w adjuvant and prophylactic radiation

A

near the original site, gets to it before the cells spread

197
Q

side effects of radiation

A

aloplecia and erythema may be long lasting

198
Q

example of systemic treatment

A

iodine injected to kill thyroid cancer

199
Q

what does chemotherapy do

A

mutates the DNA of cells to do apoptosis or be self-destructive

200
Q

types of chemotherapy

A

oral, topical, IV, IA, injection

201
Q

what type of cancer treatment may be used after surgery

A

chemo

202
Q

what are some side effects of chemotherapy

A

anemia, increased infection risk, nausea, decrease dual task stability, increase fall risk, decrease vision and executive function

203
Q

most common and effective chemo administration

A

IV

204
Q

when are cancer patients immunocompromised

A

only during treatment itself, not after the treatment

205
Q

what are some benefits of target therapy

A

stimulate immune system to destroy cells in specific areas, protect healthy cells

206
Q

what does hormone therapy do

A

stop the production of some hormones in the uterus, prostate, breast, etc

207
Q

what are the stages of a clinical trial

A
  1. determine safe dose, 2. investigate efficacy, 3. considered safe
208
Q

what are most lung cancer cells

A

non-small cell carcinoma (80-85%)

209
Q

what type of lung cancer spreads faster and is more fatal

A

small cell carcinoma

210
Q

what PT tx is related to lung cancer

A

dry needling of levator scapula, train posture and rib cage

211
Q

who’s most likely to get lung cancer

A

smokers who are >65 yo

212
Q

cause of prostate cancer

A

no known cause

213
Q

risk factors for prostate cancer

A

STI, vasectomy, smoking, obesity

214
Q

where does prostate cancer rank in most common for men

A

2nd most common, behind lung cancer

215
Q

who is most likely to get prostate cancer

A

african american males over 50 yo

216
Q

s/s of prostate cancer

A

polyuria, urinary hesitation, blood in urine, irritation

217
Q

what’s the survival rate for prostate cancer

A

very high, especially in the long term

218
Q

what test should be done for prostate cancer

A

PSA, biopsy, DRE (feel for bumps)

219
Q

breast cancer def

A

abnormal cells that accumulate in milk ducts

220
Q

what genes are associated w/ breast cancer

A

BRCA 1 and BRCA 2 mutation

221
Q

what tests can be done to screen for breast cancer

A

breast exam, ultrasound, mamogram

222
Q

if breast cancer is caught early what’s the treatment and survival rate like

A

very good prognosis if caught early

223
Q

where is breast cancer metastasis most likely found in

A

bone after breast tissue

224
Q

is breast cancer common

A

yes, 1/8 women in the US have it

225
Q

how has the death rate of melanoma changed over time

A

increased prevalence but great decreas in death rate b/c it is treatable

226
Q

who’s most at risk for melanoma

A

less than 50 yo females and greater than 50 yo males

227
Q

warning signs of melanoma

A

abnormal shape, asymmetrical, large, multicolor

Spring 2022 classes (21 decks)

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