Exam 4 Flashcards

Question

Diabetes Diagnostics

Answer 1

* FBS >126 * post-prandial BS >200 * HbA1C >6.5

Answer 2

hormone produced in the pancreas which regulated the amount of glucose in the blood, allows glucose to enter the cells to provide energy

Answer 3

* Released from alpha cells into islets of Langerhans in response to low blood glucose * Causes immediate mobilization of glycogen stored in lover and raises blood glucose levels

Answer 4

need 3 or more criteria to be diagnosed * hyperglycemia: over 100 fasting * abdominal obesity: 35 for females, 45 for males * increased triglycerides * decreased HDL: high cholesterol * increased BP * systemic inflammation

Answer 5

Patho * thyroid hormone deficiency * high TSH, low T3 and T4 * Hashimoto's disease Causes * absence of thyroid or tumor in pituitary * lack of iodine needed to produce needed levels of thyroid hormone * Lack of sufficient functioning thyroid tissue due to tumor or autoimmune disorder S/S: everything low * low RR/HR/BP * low temp, energy, metabolism * low mental staus, libido, depression * hair loss * constipation, dry skin * weight/water gain Complications: Myxedema coma * Low RR – respiratory failure * Priority: place tracheostomy kit by bedside * Low BP and HR * Low temp * Can be caused by thyroidectomy or abrupt stop of levothyroxine Treatment * Gradual thyroid hormone replacement with synthetic hormone levothyroxine * Diet of low calories, low cholesterol, salts, and fats * Frequent rest periods * levothyroxine (synthroid)

Answer 6

* Lifelong drug * Long slow onset for 3-4 weeks * Early morning and empty stomach daily * 1 hr before breakfast * Very hyper: report symptoms of hyperthyroidism like agitation and confusion * Pregnancy safe

Answer 7

Patho * Metabolic imbalance caused when thyroid hormone is overproduced: high energy * Excessive amounts of thyroid hormones are produced and released into circulation - high T3 and 4 * Grave's disease Cause * excessive iodine intake and stress * Thyroid stimulating hormone secreting pituitary tumor * Subacute thyroiditis * Too many hypothyroid meds – levothyroxine S/S: high and hot * grape eye and goiter * high HR, BP, RR * heart palp * intolerance to heat * weight loss * diarrhea * thin skin Complications * thyrotoxic crisis: thyroid storm * Onset is almost always abrupt and evoked by stressful event * Agitation, confusion, restlessness, extreme temp, high hr and bp Treatment: Meds * Methimazole * PTU * SSKI * Beta Blockers * Radioactive Iodine Uptake: destroys thyroid Other Treatments * Grape eyes: tape eyelids down or use eye patch * High diet in calories (4-5k per day), high protein and carbs, frequent meals and snacks * No fiber, caffeine, spicy food

Answer 8

* ingest food * digest through mechamical chewing * chemical digestion in stomach * reabsorption in the intestine * excretion to form stool

Answer 9

Patho: Inflammation of the vermiform appendix * Inflammation accompanies the ulceration and temporarily obstructs the appendix * Obstruction, if present, is usually caused by stool * Mucus outflow is blocked, which distends the organs * Pressure within appendix increases and appendix contracts * Bacteria multiply and inflammation and pressure continue to increase, affecting blood flow to the organ and causing severe abdominal pain S/S * Periumbilical pain with progression and radiation to **RLQ ** * With rebound tenderness * Pain between right hip area and belly button * Low-grade fever Complication * Rupture is life threatening, appendectomy is only treatment * Perforation: peritonitis * High fever * Tachycardia and pnea * Rigid board like abdomen Treatment * Watch and wait * Antibiotics * Surgery * No heating pads * No laxatives and enemas: no added pressure to bowels Need CT scan for diagnosis

Answer 10

Patho * Inflammation of the gallbladder caused by gallstones * Block ducts, creates backup of bile and inflammation Risk Factors * Obesity and high calorie, high cholesterol diet * Increased estrogen levels * Use of clofibrate * Age over 40 * Diabetes mellitus, ileal disease, blood disorders, liver disease, or pancreatitis S/S * **RUQ** pain that radiates to right shoulder * N/V * high WBC * Fevers with chills * Tachycardia * High bilirubin: jaundice, dark urine, light colored stools * Lack of enzymes from pancreas can make steatorrhea Treatment * Dietary modification * Lifestyle modifications * NPO, IVF, antibiotics * Surgical removal * Gallbladder removal * Choledochotomy * Exploration of common bile duct

Answer 11

gallstones in the gallbladder, made of cholesterol * RUQ pain

Answer 12

Patho * Infrequent bowel moments * Less than 3 stools per week * Lumpy, hard stools * Straining to have a bowel movement Causes * stress * low fluid and fiber * lack of exercise Treatment * high fluid and fiber * ambulation * laxatives Complications * Fecal incontinence (encopresis): leakage of stool * laxative overdose: NVD, abdominal cramping from dehydration and electrolyte

Answer 13

Patho * loose, watery and possibly more-frequent bowel movements * may be an indicator of IBS, IBD, celiac, C-diff Causes * viruses, bacteria, parasites * meds * lactose intolerance * digestive disorders S/S * abdominal cramping and bloating * NV * vomiting * fever * blood or mucus in stool Treatment * IV fluids * check electrolytes * add antidiarrheals when no infections are present

Answer 14

Patho * Infection in colon caused by imbalance in normal flora of the gut causing profuse diarrhea Causes * overuse of antibiotics * hospital acquired infection - most common S/S * three or more liquid stools per day for more than 2 days Complication * GI bleed Treatment * oral or IV antibiotics: vancomycin, fidaxomicin, metronidazole

Answer 15

Patho * small, bulging pouches (diverticula) develop in your digestive tract and become inflammed Causes * constipation, withholding stool S/S * diarrhea * abdominal pain * feeling need to defecate and cannot Complication * perforation Treatment * diet modifications, exercise * fluid replacement * meds: antibiotics, analgesics, antispasmodics * colon resection, temporary colostomy

Answer 16

Patho: * abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus) * commonly occurs with people with serious liver diseases * normal blood flow to liver is blocked by clot or scar tissue in liver

Answer 17

Patho * Backflow of gastric or duodenal contents into esophagus and past lower esophageal sphincter * Heartburn * Can lead to inflammation and even cancer Causes * Weakened lower esophageal sphincter * Increased abdominal pressure * Hiatal hernia: upper part of the stomach bulges, and acid gets stuck * Medications * Food or alcohol ingestion or cigarette smoking * Nasogastric intubation for more than 4 days S/S * NV * Burning sensation in throat, chest * Epigastric pain following a meal * Radiating pain to the arm and chest Treatment * diet therapy: small meals * positioning: lie down 3 hours after a meal * increased fluid intake * stop smoking * surgery: tighten LES * Upper gastrointestinal endoscopy: see if the lower esophageal sphincter is closing properly * Meds: antacids, H2 blockers, PPI

Answer 18

Causes * Upper: gastritis, GERD, peptic ulcer, esophageal varcies from cirrhosis * Lower: hemorrhoids, colorectal cancer, diverticulosis, UC S/S * Upper: vomiting "coffee ground emesis" - blood that has been digested * Melena stool: blood from upper and made it through digestion Complications * Hypovolemic shock - hemorrhagic shock * Low CBC: H&H

Answer 19

Patho * most common infection that leads to liver failure Cause * Post viral infection * Alcohol * Autoimmune diseases * Unprotected sex * Sharing blood and body fluids S/S * Three or more liquid stool/day for more than 2 days * Flu like symptoms * NV * Elevated liver enzymes: ALT and AST, bili: jaundice * Pruritus: itching * Dark colored urine * Clay colored stools * Elevated PT and aPTT: bruising * Low albumin: edema, cannot attact water Treatment * New drugs vs interferon alpha * Post-viral infection commonly resolves within a few weeks * Apply moisturizer and use cold compresses, stay out of sun

Answer 20

* Avoiding risky behaviors, such as sharing needles, having unprotected sex and drinking large amounts of alcohol * Avoid sharing personal items, such as razors or toothbrushes * Avoid contact with body fluids

Answer 21

A & B B is for healthcare

Answer 22

an infection that causes liver inflammation and damage from a virus

Answer 23

* fecal-oral route from food * can spread up to 3 months * obtaining antibodies = immunity

Answer 24

* blood and body fluids * can lead to Hep if not treated

Answer 25

* blood and body fluids * treatment: direct-acting antiviral (DAA) tablets

Answer 26

bacteria that can cause an infection in the stomach or duodenum * risk for duodenal ulcers and gastric ulcers * found via serum antibody test * treatment: PPI, antibiotics

Answer 27

a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon) * Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain medications; or strictures from an inflamed intestine caused by certain conditions, such as Crohn's disease or diverticulitis.

Answer 28

Patho: * Inflammation of the pancreas * Autodigestion of own enzymes: protease, lipase, amylase Cause * Biliary tract disease * Alcoholism * Gallbladder disease * CF * Surgery that causes trauma: ERCP procedure, clears gallstones Diagnostics * Elevated enzymes - amylase, lipase * Elevated glucose, lack of insulin * Elevated WBC over 10k: fever * Elevated coagulation time: PT and aPTT * Elevated bili S/S * LUQ pain, may have epigastric pain or pain radiating to the back * Bruising: Turner's sign - on side of body, Cullen's - on abdomen near bellybutton * Liver disease symptoms: jaundice, HTN Treatment * maintain circulation, fluid volume, and pain relief * NPO because eating stim more enzymes * IV pain meds: hydromorphone * meds: antacids, PPI, H2 blockers * diet low in fat and sugars, enzymes with meals

Answer 29

* occurs during cirrosis * elevated pressure in your portal venous system: over 10mm Hg in vein * spleen will enlarge with enlarged esophagus * forces pressure into the esophagus: esophageal varcies * fluid will spill over into the abdomen: ascites * if the esophagus pops, will throw up blood, turn patient on side

Answer 30

Patho * Open sores in mucosal membrane of upper GI tract - stomach * Erosions in lining of stomach and adjacent areas of the GI tract from the gastric acid Types * duodenal * gastric * stress: from traumatic event Cause: Gastric * gastric pain * Gnawing, dyspepsia: burning pain to the back, often occurring after meals * weight loss * vomiting blood Duodenal * Pain decreased with food, 2-3 hours after meals * Worst at night * Weight gain * Blood in stool “melena” dark tarry stool Complication * GI bleed Treatment * drugs and surgery

Answer 31

Patho * Parts of the skin become itchy, red, patchy, rough, can have serous exudate * Autoimmune disease * Tends to flare up periodically when exposed to allergens

Answer 32

Patho * A skin condition that causes scaly patches and red skin, mainly on the scalp. * It can also occur on oily areas of the body, such as the face, upper chest, and back. * Can cause stubborn dandruff

Answer 33

* A small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. The muscles, tendoms, and tissues are then exposed. * Examples: tearing off an ear or finger, normally occurs in hips, elbows, and ankles

Answer 34

Patho * Deep skin infection of the dermis and subq tissue from Staphylococcus entering the body through a break in the skin * Found near lower limb of the tibia * Can spread by direct contact Risk Factors * trauma * diabetes * lymphedema * obesity * venous insuffcuency * history of cellulitis or athletes foot S/S * Fever * Red, swollen, painful tenderness on skin * Erythema * If untreated, leads to an abscess -> sepsis -> edema

Answer 35

Patho * Increased pressure from a cast that compromises muscle and nerve perfusion, causing ischemia and potential tissue death S/S * Pain: Unrelieved with morphine or other meds, Extreme pain with passive movement: suffocation * Parensthesia: Tingling, burning, numbness (24-48hrs), Problem moving or extending fingers or toes, great difficulty Treatment * Fasciotomy: incision through skin and fascia to reduce swelling and pressure

Answer 36

Patho * a separation of two bones where they meet at a joint * occurs in knee, hip, ankle, shoulder, usually larger joints * from trauma

Answer 37

Patho * partial dislocation of joints * occurs commonly in shoulders, fingers, kneecaps, ribs, wrists, ankles, and hips

Answer 38

Patho * Uric acid build-up causes pain and inflammation in the joints, either from limited excretion or overproduction * Causes destruction inside the joints and crystals in connective tissue * Can lead to arthritis S/S * red skin, tender joint, hot * usually seen in great toe Causes * Genetic predisposition to overproduction of uric acid * High purine food: meat, alcohol, seafood * Obese, diabetes, stress on the body, dehydration Treatments * achieve healthy weight * avoid high purine foods (meat, seafood, alcohol, and some vegetables) * increase fluid intake * monitor I and O * meds: allopurinol, colchicine

Answer 39

Patho * closed: does not break the skin * open: surface of skin is broken and bone is shown * any way the bone breaks Treatment * immobilize, reduce pressure, preserve function Delayed Bone Healing * age * meds * disease * poor circulation * disordered coagulation * malnourishment

Answer 40

* Inflammatory Stage: body sends out signals for inflammatory response * Reparative Stage: starts within a week of injury, callus (soft bone) replaces blood clot formed by inflammatory stage, becomes harder and stronge * Remodeling Stage: regular bone replaces callus

Answer 41

Patho * Often results from injury to musculoskeletal system * Caused by flood of sensory impulses coming to spinal cord from injured area * from overuse of muscles, electrolyte imbalance, CNS damage, sustained injury, permanent if occurs at birth Treatment * meds: direct or centrally acting skeletal muscle repaxants

Answer 42

Patho * Protective cartilage cushion at the end of bones wears out over time – creates bone on bone friction Causes * old age, women * obese * smoking * repetitive stress on joints S/S * joint pain and stiffnesss * crepitus * **more pain with activity and relief with rest** * node formation: joint swelling in hands * Osteophytes and bone spurs: bony lumps that grow around the spine and in the joints * Subchondral cysts * Loss of range of motion * Pain with weight bearing Treament * exercise, weight loss * NSAIDS, steroids * surgery: total knee replacements

Answer 43

Patho * inflammation or swelling that occurs in the bone * usually from infection - staph * can spread to blood stream: sepsis Treatment * antibiotics * surgery

Answer 44

Patho * loss of bone mineral density that weakens bones * common in older women * no S/S - need screening test * lifestyles changes to preserve bone density

Answer 45

Patho * Fragile, porous bones * Low bone density * Increased rate of bone reabsorption, or body makes too little bone – Ca leaves bone and goes into the blood stream * osteopenia and osteomalacia: decrease vit D Causes * female, older, white & asian * Excessive caffeine intake * Smoking or alcohol abuse * Medications: anticonvulsants, steroids Complications * fractures in hip, spine, waist Treatment * Ca/Vit D, bisphosphonates, SERMs

Answer 46

Patho * Breakdown of skeletal muscle that causes release of intracellular components * Myocytes: high in K, P, myoglobin, creatinine kinase for energy and metabolism * can cause acute renal failure with CK levels greater than 15k S/S * Malaise * Myalgia * Weakness * Hyperkalemia: can make cardiac problems * Hyperphos: can create HypoCa - spasms, parensthesia, anxiety, seizures * High myoglobin: AKI - low urine output, brown urine Treatment * maintain adequate fluid resuscitation and prevent acute kidney injury * watch I and O * watch electrolytes * may need dialysis

Answer 47

Patho * Body attacks own joints – causes systemic inflammation * Autoimmune disorder * More common in women Diagnostics * Synovial fluid aspiration to test * Arthoscopy * Blood Tests: RF (rheumatoid factor), ESR (erythrocyte sedimentation rate) general inflammation, CRP (c-reactive protein) general inflammation S/S * Fatigue, anorexia, weight loss * **Morning joint stiffness ** * Symmetrical pain and swelling in the small joints of the hands * **Joint pain that has relief with activity and more pain at rest** * Pannus: hard tissue around the joints – scar tissue * Ankylosis: stiffness and immobility * Iron deficiency anemia Treatment * Meds: DMARDs, NSAIDs, Steroids

Answer 48

Patho * Deadly skin disorder that can result in toxic necrolysis * usually 10% of body S/S * From meds * Flu-like symptoms * Painful rash: widespread erythema, skin peeling and blistering * Leads to denuded skin and mucosa: top layer of skin dies and falls off, very vulnerable to infections and sepsis Interventions * Everything must be sterile to prevent infection * Wound care: sterile, moist dressings * Warm room – prevent hypothermia * Eye care: cool compresses and eye lubricants * Fluids, food, pain management

Answer 49

Patho * a life-threatening skin disorder characterized by a blistering and peeling of the skin * large areas of peeling skin (30% of body)

Answer 50

Patho * Inflammatory response form S. aureus or Strep. Pyogenes * Large amounts of inflammatory cytokines are released from toxic exoproteins from infection * Causes capillary leakage and tissue damage – shock then multiorgan dysfunction * Staph toxin – most common S/S * Erythroderma: arms and legs * Fever * Low BP * NVD * Dizziness * Disorientation * Peripheral edema * Oliguria

Answer 51

* stretching or tearing of ligaments * occurs in ankles "rolling" * caused when a joint is forced to move into an unnatural position

Answer 52

* A stretched or torn muscle or tendon * Often occur in the lower back and in the muscle in the back of the thigh

Answer 53

* A stretched or torn muscle or tendon * Often occur in the lower back and in the muscle in the back of the thigh

Answer 54

Patho * an autoimmune disorder where the body attacks itself, causing major inflammation in the skin, joints, kidneys, & heart resulting in organ failure over time, most often in the kidneys Causes * unknown * mostly in pre-menopausal women S/S * Butterfly-shaped rash * Fever higher than 100 * Joints: painful and swollen Triggers * Sun * Smoking * Stress * Sepsis Treatment * steroids * immunosupporessants

Answer 55

* necessary for strong bones and muscles * needed to absorb Ca

Answer 56

* two peptide hormones that play important roles in calcium homeostasis through their actions on osteoblasts (bone forming cells) and osteoclasts (bone resorbing cells) * PTH is responsible for stimulating the enzyme that transforms vitamin D your skin makes from sun exposure into calcitriol * Calcitonin decreases calcium levels by blocking the breakdown of bone calcium and by preventing your kidneys from reabsorbing calcium

Exam 4 Flashcards

(81 cards)