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Block 4; Week 2-Michelle > EBM > Flashcards

Flashcards in EBM Deck (25)
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1

How many burns are treated in the US each year?

450,000 burns treated each year

2

Who is at higher risk for burns?

low income families
rural parts of the country
children & elderly

3

What is the appearance of burns?

1st degree: red w/o blistering, dry, painful (sunburn)
2nd degree: red w/ blisters, moist, painful, yellow or white
3rd degree: stiff & white/brown/black, charred, eschar, leathery, painless

4

What is eschar?

dead tissue cast off after the burn

5

What are the most dangerous things in burns?

shock
sepsis
respiratory insufficiency

6

What happens to the cardiovascular system w/ burns?

capillary permeability increases, loss of proteins, fluids
systemic hypotension
end organ hypo perfusion
**crush them with fluids

7

How do you diagnosis an infection secondary to a burn?

fever symptoms
pain, swelling, change in appearance of burn wounds
Look @ extent of burn: rule of nines
Severity: depends on % of total body surface area is burned
High risk: >20% burned
high WBC count
High fasting blood glucose
Pathogens in blood urine culture

8

What are symptoms of patients w/ sepsis or infection following a burn?

high temp
etc
etc look up

9

How do you treat burn patients?

ABCs
Fluid resuscitation: use Parkland formula
Feeding tube (high carb)
Skin Grafting (get rid of burns unlikely to heal)
Get them to a burn unit
Treat psychosocial issues

10

What is the role of inflammation in thermal injuries?

systemic capillary permeability
protein leakage into interstitial space
edema
hypovolemic shock
damaged tissue-->inflammation (helps heal, but can hurt)
SIRS can result if inflammation lasts too long-->sepsis. Bad.

11

T/F May times prostate cancer is clinically inconsequential.

True. Although sometimes it can spread.

12

When are most cases of prostate cancer diagnosed?

after the age of 65

13

How does inflammation relate to prostate cancer?

occurs in every step of prostatic malignancy
mutated cell avoids apoptotic signals & keeps dividing & releasing inflammatory mediators.
oncogenic cells escape & can cause more inflammation @ other sites.

14

How do you diagnose prostate cancer?

nocturia
dysuria
hematuria
increased urinary frequency
bone pain
high PSA
rectal exam
family hx
ethnicity
Best thing: prostate needle biopsy

15

How is prostate cancer treated?

surgery
radiotherapy
????
Alternative:
external beam radiotherapy
endocrine therapy (try to suppress testosterone, remove testicles)

16

What do inflammatory responses lead to?

removal of damaged tissue
tumorneogenesis
mutation of DNA thru ROS
???

17

What is influenza?

viral respiratory infection caused by a number of H & N antigen variants

18

How many people die from influenza & flu & pneumonia?

50K per year

19

Who is at high risk for flu-related complications?

over age 50
pregnant
chronic medical condition
less than 6 months old

20

Why are we susceptible to new flu strains?

antigenic drift
**influenza frequently mutates & surface proteins change & this makes it difficult for our immune system to adapt

21

What are the severe symptoms associated w/ influenza?

tachycardia
myalgias
high fever
exacerbation of underlying medical conditions: COPD, asthma, Diabetes
nausea
vomiting
diarrhea

22

How do you diagnose influenza?

**can't be diagnosed by symptoms alone. Could be common cold.
Rapid Diagnostic Tests: around 20 minute test
Longer tests: viral culture, PCR, immunofluorescent & serologic tests
Chest X ray in elderly

23

What is the pathogenesis of influenza?

Innate response: activated alveolar macrophages: TNF alpha & NO
Adaptive Immune Response: dendritic cells activate cytotoxic T cells & T helper cells
inflammatory cytokines are released

24

What is the treatment for influenza?

vaccine to prevent
fluids & rest
antiviral medications: neuraminidase inhibitor (tamiflu), M2 protein inhibitors

25

T/F Influenza is a viral respiratory infection that can lead to pneumonia.

TRUE