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Differential > Exam 3 > Flashcards

Exam 3 Flashcards

(51 cards)

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1
Q

What are early manifestations of thyroid or parathyroid disease?

A
  • muscle weakness, myalgia, cramps and fatigue - proximal upper/lower limb symmetrically
  • bilateral carpal tunnel syndrome
  • periarthritis and calcific tendinitis
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2
Q

What often occurs in the shoulders of people with endocrine disease?

A

periarthritis and calcific tendinitis

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3
Q

acromegaly S&S

A
  • bony enlargement
  • amenorrhea
  • DM
  • diaphoresis - excessive sweating
  • HTN
  • Carpal tunnel
  • hand pain and stiffness
  • back pain
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4
Q

What is Addison’s disease and what are S&S

A

hyposecretion by adrenal glands
- dark pigmentation of skin, especially mouth and scars
- hypotension
- progressive fatigue
- hyperkalemia
- GI issues

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5
Q

What is Cushing’s syndrome pathophys

A

increased secretion of cortisol by adrenal cortex
- cortisol suppresses the inflammatory response and an increase causes poor wound healing

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6
Q

What is a warning sign of cushing’s disease?

A

unexplained fever w/o other symptoms
- medical referral

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7
Q

Cushing’s disease S&S

A
  • moonface
  • buffalo hump
  • kyphosis and back pain
  • easy bruising
  • slow wound healing
  • masculinizing effects
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8
Q

What is Graves’ disease? What are some signs?

A

hyperthyroidism
- goiter leading to a swollen neck
- protruding eyes

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9
Q

S&S of hyperthyroidism in older adults

A
  • tremors
  • anxiety
  • palpitation
  • weight loss
  • heat intolerance
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10
Q

S&S of hyperthyroidism in younger patients

A
  • cold intolerance
  • weight gain
  • dry skin
  • constipation
  • mental and physical slowing
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11
Q

S&S of hyperthyroidism

A
  • severe tachycardia
  • hyperthermia
  • restlessness
  • chest pain
  • abdominal pain
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12
Q

risk factors for hypothyroidism

A

Depression of body metabolism
- women > 65 and increases with age

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13
Q

S&S of hypothyroidism

A
  • cold intolerance
  • excessive fatigue and drowsiness
  • HA
  • weight gain
  • irregular menstrual bleeding
  • skin dryness
  • brittle hair and nails
  • palpable nodules of thyroid
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14
Q

What is Woltman’s sign? What does this occur with?

A

Woltman’s sign - delayed relaxation phase of an elicited deep tendon reflex; more observable in the achilles

occurs with hypothyroidism

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15
Q

blood glucose levels needed to diagnosis DM

A

fasting blood glucose >/= 126 mg/dl on 2 different days
- risk factor if >/= 100 mg/dl

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16
Q

At what glucose level should exercise be postponed?

A

> 250 mg/dl

eat snack if < 100 mg/dl

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17
Q

S&S of hyperglycemia

A
  • thirst
  • hyperventilation
  • fruity breath
  • lethargy/confusion
  • cramps
  • poluria/dehydration
  • flushed face
  • elevated temp
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18
Q

S&S of hypoglycemia

A
  • pallor
  • perspiration
  • irritability/nervousness
  • weakness
  • shakiness
  • blurred vision
  • HA
  • fatigue
  • slurred speech
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19
Q

What is tophi? What is it a sign of?

A

tophi - lumps under the skin, or actual eruptions through the skin of chalky urate crystals

  • sign of gout
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20
Q

Osteoporosis T scores

A

normal - -1 or above
osteopenia - -1 - -2.5
osteoporosis - < -2.5
severe osteoporosis - < -2.5 or less with 1 or more fragility fractures

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21
Q

What is Paget’s disease?

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A

localized excessive osteoclastic bone resorption f/b compensatory increased osteoblastic activity

22
Q

risk factors for paget’s disease

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A
  • > 40 years old
  • Europe or Australia
  • anglo-saxon descent
  • genetic factors
23
Q

What is anisocytosis and hypochomia?

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A

anisocytosis - abnormal variations in size of erythrocytes

hypochromia - erythrocytes deficient in hemoglobin

24
Q

anemia is a ___________, not a __________

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A

is a symptom, not a disease

25
S&S of anemia
too few erythrocytes - skin pallor or yellow-tinged skin - fatigue or listlessness (lack of energy) - dyspnea on exertion with heart palpitation and rapid pulse - chest pain with minimal exertion - decreased diastolic BP - nervous system manifestations
26
thrombocytosis vs thrombocytopenia
cytosis - abnormally high cytopenia - abnormall low
27
S&S of hemophilia
- progressive loss of motion - muscle atrophy - flexion contractures
28
What are the most common symptoms of polycythemia? Other S&S
- general malaise and fatigue - SOB Other - headache - dizziness - irritability - blurred vision - decreased mental acuity - easy bruising - cyanosis and digital clubbing - HTN
29
monocytes
- largest circulating blood cells - travel to the tissues and form macrophages
30
granulocytes
contain lysing agents (digest various foreign materials)
31
S&S of leukocytosis
- fever - symptoms of localized or systemic infection
32
If a patient is leukopenia, what would require a medical referral?
leukopenia - decreased leukocytes - greater risk for infection S&S for medical referral - fever - chills - diaphoresis
33
S&S of leukopenia
- sore throat, cough - high fever, chills, sweating - ulceration of mucous membranes - frequent or painful urination - persistent infections
34
Thrombocytosis vs Thrombocytopenia
thrombocytosis - abnormally high platelets thrombocytopenia - abnormally low platelets
35
_____________ boosts the production of chemical activators that destroy unwanted clots. ___________ promotes coagulation
Exercise Vitamin K
36
S&S of thrombocytosis
- thrombosis - splenomegaly - easy bruising
37
S&S of thrombocytopenia
- bleeding after minor trauma - spontaneous bleeding - excessive bleeding - gums and menorrhagia - melena (black, tarry stools)
38
common sites of bleeding with hemophilia
- large muscles of the LE - flexor surface of the forearm
39
HIV results in what
destruction of CD4 white blood cells
40
Criteria for referral of a person with early inflammatory symptoms like RA
- significant discomfort on the compression of the MCP and MTP joints - the presence of 3 or more swollen joints - a report of morning stiffness lasting longer than 60 min
41
S&S of RA
- swelling in 1 or more joints, typically symmetrical and bilateral - morning stiffness lasting several hours - recurring pain or tenderness in any joint - redness and warmth in joint 0 unexplained weight loss, fever, or weakness with joint pain - symptoms last > 2 weeks
42
What is the most common inflammatory rheumatic disease in elderly?
polymyalgia rheumatica
43
polymyalgia rheumatica S&S
- bilateral muscle pain in proximal muscles - morning stiffness > 30 min - fatigue, malaise, anorexia - low-grade fever - headaches - vision loss
44
Lupus characteristic
malar (butterfly rash across cheeks and nose)
45
Lupus S&S
- skin changes - MSK changes - joint pain and arthritis - neuro - seizures, depression, confusion, psychosis - peripheral neuropathy
46
What is scleroderma?
- chronic, multi-system disease - inflammation and fibrosis of many parts of the body
47
Scleroderma S&S
- circumscribed plaques w/ ivory-colored center - widespread skin involvement - muscle atrophy - sclerodactyly - telangiectasis - dilated blood vessels
48
Who is at higher risk for reactive arthritis?
- adults - women after enteric infection - men after venereal infection
49
S&S of psoriatic arthritis
- skin lesions - nail lesions - arthritis - morning stiffness > 30 min - ankylosis of the spine - dactylitis (sausage fingers) - mouth ulcers
50
Lyme disease S&S
- red rash - flu-like symptoms - migratory MSK pain - neuro symptoms - headaches, numbness/pain, poor motor control, cog dysfunction
51
What is gel phenomenon?
stiffness in the morning 1 hour after waking, symptoms relieved with activity, recurrence of symptoms after sitting/ inactivity and then attempting to resume activity

Differential (5 decks)

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