Exam 4 Flashcards
(145 cards)
1
Q
Parkinson’s Disease
A
Chronic neurodegenerative disease
Damage to dopamine production - lack of dopamine
Imbalance of dopamine and acetylcholine
Lewy bodies: Clumps of proteins
2
Q
Characteristics of Parkinson’s Disease
A
TRAP
Tremors - pill rolling
Rigidity: - cogwheel rigidity, jerky movements
Akinesia - loss of voluntary movement, bradykinesia
Postural instability - Propulsive gait
3
Q
Parkinson’s Disease tx
A
Levodopa carbidopa: Dopamine
4
Q
Dementia
A
Slower onset degenerative disease
- Infection, trauma, heart disease
5
Q
Alzheimer’s Disease patho
A
Chronic progressive neurodegenerative disease
Build up of (amyloid) plaques and neurofibrillary tangles
6
Q
Rheumatic Diseases patho
A
Inflammation from immune systems autoimmune response, mistaking own tissue as harmful stimuli
Degenerates joints, muscles, and soft tissue
7
Q
Osteoarthritis
A
Progressive deterioration of cartilage in joints
AKA Degenerative joint disease
8
Q
Labs that indicate Osteoarthritis
A
Increased ESR (Sed rate) and C-reactive protein
9
Q
Rheumatoid Arthritis
A
Systemic rheumatoid disease
Rheumatoid factors attack healthy tissue
Inflammation in synovial joints
10
Q
Gout
A
Systemic inflammatory disease
Malfunction in purine metabolism - uric acid crystals damage joints
11
Q
Labs that indicate Gout
A
Increased uric acid
Increased BUN/Creatinine
12
Q
Foods high in purine
A
Red meat/poultry
Fish
Alcohol
Soda
13
Q
Lyme Disease
A
Spirochete (tick) transmitted by deer tick
Bullseye rash 3-30 days after tick bite
14
Q
Untreated Lyme Disease s/sx
A
Heart block
Joint pain/arthritis
CNS - memory loss, numbness/tingling
Fatigue
15
Q
Lyme Disease tx
A
Oral Doxycycline
IV Rocephin
16
Q
Septic Arthritis
A
Infection in joint or joint replacement
Commonly MRSA
Transmitted through cut/incision
17
Q
Ankylosing Spondylitis
A
Chronic inflammation
- Effects joints in spine, hips, knees, shoulders
18
Q
Psoriatic Arthritis
A
Starts as Psoriasis
Destruction of joint, tendons, ligaments, nails
19
Q
Systemic Lupus Erythematosus patho
A
Autoimmune process that effects DNA/RNA
Can cause organ failure
20
Q
Systemic Lupus Erythematosus s/sx
A
Butterfly rash
Fever, malaise
Joint inflammation
Kidney failure
Reynaud’s disease
Pain
21
Q
Systemic Sclerosis
A
AKA Scleroderma
Autoimmune disease of connective tissue
- Similar to Lupus
22
Q
Polymyositis and Dermatomyositis
A
Autoimmune inflammatory disease that causes symmetrical proximal muscle weakness
23
Q
Polymyositis and Dermatomyositis s/sx
A
Butterfly rash (like Lupus)
Difficulty raising head
Difficulty going up stairs
24
Q
Sjogren’s Syndrome
A
Systemic autoimmune disorder
Effects lacrimal (eyes) and salivary glands
Goes along with other autoimmune disorders
25
Fibromyalgia patho
Chronic pain syndrome
CNS ascending and descending pathways increase pain signals
26
Polymyalgia Rheumatica and Giant Cell Arteritis
Disorders that present together
Proximal muscles of arms and legs are affected
27
Esophageal sphincters
Upper and lower/cardiac sphincters
28
Stomach sphincters
Upper = cardiac sphincter
Pyloric sphincter
29
Parietal cells
Release HCl (hydrochloric acid) which secretes Pepsin (digestive enzyme) production
Releases Intrinsic Factor - required for B12 absorption
30
Pernicious anemia
Lack of B12
31
Order of small intestines
Duodenum
Jejunum
Ileum
32
Pancreatic digestive enzymes
Amylase - carbs
Lipase - fats
Pancreas - proteins
33
Barium swallow
AKA Upper GI series
Looking for lesions, varices, tumors, obstructions
34
Barium enema
AKA lower GI series
Looking at large intestine for colorectal cancer or polyps
35
Esophagogastroduodenoscopy (EGD)
Looking at upper GI looking for inflammation
36
Video Capsule Endoscopy (VCE)
Looks at small intestine for GI bleed, IBS, celiac
37
Manometry
Tests the pressure and constriction of muscles in the esophagus as you swallow
38
Electrophysiologic studies
Looks at GI muscle motility and sphincters for peristalsis or spasms
39
Gastric analysis
Looks at gastric fluid for gastric irritation
- To see if tx is effective or to dx cause
40
Laparoscopy
Looks at abdominal organs for peritoneal disease, masses, etc.
41
Types of enteral nutrition
Short term: Nasoenteric tube (NET) or Nasogastric tube (NGT)
Long term: Percutaneous Endoscopic Gastrostomy (PEG/G tube)
Percutaneous Endoscopic Jejunostomy (J Tube)
42
Complication of enteral nutrition
Dumping syndrome: Rapid emptying of food from stomach to small intestines
- Avoid by watering down formulas
43
Parenteral nutrition reasons
If GI tract is inaccessible for more than 7-10 days
- Abd surgery, burn, trauma
44
Locations of parenteral nutrition
Peripheral (PICC)
or Central line (CVC)
45
Types of formula/solutions for parenteral nutrition
Partial Parenteral (PPN) or Peripheral Parenteral Nutrition (PPN)
Total Parenteral (TPN) or Total Nutritional Admixture (TNA)
46
Periapical abscess
Infection/pus at the apex (bottom) of tooth
- Tx with aspiration, tooth extraction, ABX, and saline rinse
47
Periodontitis
Gum inflammation leading to recession (oral thrush)
Tx: Chlorhexadine rinse
48
Candidiasis
Caused by Candida Albicans yeast
49
Parotitis
Swelling of your parotid glands (located between ear and jaw)
Caused by virus (mumps/herpes) or Epstein-Barr
50
Sialadenitis
Inflammation of salivary glands
- Can remove glands for tx
51
Salivary calculus
Calcium stone in submandibular gland
Tx: Lithotripsy
52
Erythroplasia
Red lesion
Earliest sign of CA
53
Glossectomy
Excision of tongue (partial or total)
Tx for CA
54
What is used to dx GERD
Endoscopy
Barium swallow study
pH monitoring
55
Medications commonly used for GERD
Antacids - Mylanta
Histamine blockers - Pepcid, Zantac
Proton Pump Inhibitor - Protonix, Prilosec
56
Types of Hiatial Hernias
Sliding: Stomach bulges upwards
Rolling: (Para-esophageal): Balloons out
57
Tx for hiatial hernias
Medications: Antacids, PPI (Prilosec), H2 blockers (Zantac)
Surgical: Laparoscopic repair
58
S/sx of esophageal CA
Dysphagia, pain, bad breath, hiccups, fear of choking, weight loss
59
Esophageal diverticula
Outpouching through weak area of esophagus
Dysfunctional sphincter
60
Esophageal diverticula tx
Diverticulectomy
61
Achalasia
Absent/ineffective peristalsis of distal esophagus
- Eat slowly
62
Barrett's esophagus
Damaged cells in lower esophagus caused by acid reflux
Tissue cells regrow and are cancerous
63
Reason for neck dissection
When malignant/cancerous cells travel to cervical lymph nodes they respond poorly to chemo and radiation
64
Radical neck dissection
Removal of cervical lymph nodes, sternocleidomastoid muscle, intrajugular vein, and spinal accessory muscle on one side
65
Modified radical neck dissection
Removal of cervical lymph nodes only (no muscles or IJ vein)
66
Selective neck dissection
Tries to save lymph nodes
67
Reconstructive flap (neck dissection)
Muscle and skin from other areas used at neck dissection surgical site for repair
68
What is normal JP drainage during the first 24 hours post op
80-120 mL
69
Neck dissection complication
Neck drop: Prevent with exercise and ROM in shoulder and neck
70
Most common cause of Peptic Ulcer Disease
H. pylori infection
71
Tx of PUD
Abx: Flagyl (for H. pylori infection)
PPI: omeprazole
Surgery: Remove diseased portion of stomach
72
Gastritis
Disruption of mucosal barrier that protects stomach from gastric acid causing inflammation
Pernicious anemia from lack of B12 by stomach
73
Tx for gastritis
Abx: Flagyl (for H. pylori infection)
Pepcid for acid
B12 to replace
Surgical: Gastric resection (NGT)
74
GI bleed main cause
PUD
75
Upper GI bleed s/sx
Vomiting
- Coffee ground = occult blood in stomach
- Bright red = esophageal/oral bleed
76
Lower GI bleed s/sx
Melena (dark bloody) stool
Bright red = hemorrhoid
77
Tx for GI bleed
Surgical resection of pylorus or jejunum
Gastric lavage: Withdraws clots
Embolization: Liquid clotting factor stops bleeding artery
78
IBS
Disorder of motility (increased or decreased)
Nausea, diarrhea, gas, constipation
Tx: Modify lifestyle, Metamucil (fiber) - drink with water to avoid bowel abstruction
Alosetron - med to slow motility
Rifaximin - abx
79
Appendicitis patho
Opening to appendix is obstructed, leading to infection
80
Peritonitis
Acute inflammatory bowel disorder
Inflammation of abdominal lining (peritoneum) - rigid abd
- Caused by bowel rupture
- Tx: Abx, IVF
81
Gastroenteritis
Acute inflammatory bowel disorder
Causes: Norovirus, E. coli, Campylobacter, Shigellosis
82
Ulcerative Colitis
Chronic inflammatory bowel disorder
- Mainly in rectum and sigmoid colon
Epithelial cells shed (thin) and leads to ulcers
Increased risk of colon CA
83
Crohn's disease
Chronic inflammatory bowel disorder
- Caused by hereditary, immune, or environmental factors
Bowel wall thickens - Fissures, fistulas, abscesses
Common in ileum and colon
84
Complications of Crohn's disease
Perforation, hemorrhage, obstruction, adhesions, CA, structures
85
Tx for Crohn's and Ulceratic Colitis may include
Colostomy for fecal diversion - rest bowels
86
Low residue diet
For bowel disorders
Reduce fiber, nuts, milk, whole grains, popcorn
Good foods: White bread, cooked vegetables, eggs
87
Types of bowel obstructions
Partial or total obstruction
1. Mechanical: Adhesions, strictures, fecal impaction, tumors
2. Functional/Paralytic ileus: Decreased peristalyis - possibly neuro disorder
88
Types of GI tubes
Levin tube: Single lumen, intermittent use only
Salem sump: Dual lumen with blue port for ventilation - so tube tip doesn't adhere to stomach wall
- Blue vent above waist to bring air in, prevent backflow of stomach acid
Miller Abbott: Weighted balloon (filled with mercury) travels to site of obstruction to irrigate and suction at site of obstruction
89
Polyps
Small growth protruding from a mucous membrane of the intestine
Hyperplastic = non neoplasm
Adenomatous = neoplastic -> linked to CA
90
Polyp s/sx
Usually asymptomatic
91
Polyp tx
Lysis or polypectomy
92
Colorectal cancer s/sx
Rectal bleeding
Change in stool consistency
Gas pain
Loose/bloody stool
Poor PO intake due to nausea
93
Types of colostomy (locations)
Ascending colostomy - RLQ *liquid stool
Transverse colostomy - Upper quadrants
Descending/sigmoid colostomy - LLQ *firmer stool
94
Ileostomy
Surgical opening in ileum or small intestine to redirect fecal matter into a pouch
95
Proctocolectomy with ileal pouch ( or J ) pouch
Ileum made into pouch/pseudorectum and connected to anus
96
Continent ileostomy (with Kock pouch)
No external appliance
Stool removed with catheter
High complication risk
97
Diverticulosis
Presence of pouches without inflammation
- In intestines, mostly colon
Common in older adults, asymptomatic
98
Tx for diverticulosis
Lots of fluids
High fiber diet
99
Diverticulitis
Infection/inflammation of diverticuli/pouches
Material trapped and causes infection
100
Diverticulitis dx
WBC - increased = inflammation
CT Scan
Colonoscopy
101
Types of hernias
Epigastric
Umbilical
Inguinal (groin - most common)
Femoral
102
Reducible hernia
Can be placed back with gentle pressure
103
Irreducible hernia
Requires surgery to be placed back
104
Strangulated hernia
Blood supply is cut off
- Can lead to necrosis or perforation
105
Celiac disease
Malabsorption syndrome
Autoimmune response to gluten
106
Celiac disease dx
Endoscopy with biopsy
Serum IgA (Immunoglobulin A) tests for antibodies
107
Hemorrhoid
Internal or external
Swollen vein(s) around anus
Caused by strain/pressure
108
Hemorrhoid tx
High fiber diet
Topical antiseptic
Hemorrhoidectomy
109
Anal fissure
Tear in lining of anus
Bleeding with defecation
- Stool softener
110
Anal cancer risk factors
Smokers, women with cervical cancer, HPV positive
111
Anal fistula
Tunneling from anus to rectum
May extend to outside of the body
Caused by abscess or Crohn's
112
Pilonidal cyst
Pilonidal sinus in sacrococcygeal (upper butt) area
If hair grows inward it may lead to infection, cyst, abscess
113
Tx for abcesses
I&D - incision and drainage
- Packing or surgical closure
Sitz bath
Side lying position
114
Gynecomastia
Hormonal imbalance causing excessive breast tissue in men
115
Klinefelter syndrome
Genetic disorder when male has extra X chromosome
- Less testosterone, more risk of male breast cancer
116
Tx for male breast cancer
Total mastectomy
Sentinel lymph node biospy (SLNB)
Axillary lymph node dissection (ALND)
117
Chlamydia patho
Bacterial chlamydia trachomatis
118
Dx for chlamydia
Sample cells from urethral
119
Tx for chlamydia
Abx: Zithromax or Doxycycline
120
Gonorrhea patho
Bacteria neisseria gonorrhoeae
121
Gonorrhea s/sx
Female: May be asymptomatic - untreated leads to pelvic inflammatory disease
Male: Yellow/green discharge, pain and increased urinary frequency
Both: Blisters in throat, sore throat
122
Tx for gonorrhea
Cephalosporins: Rocephin IM with PO zithromax or doxycycline
Expedited Partner Therapy (EPT)
123
Trichomoniasis patho
Parasite trichomonas vaginalis
124
Trichomoniasis s/sx
Female: Vaginal itch, burning with urination, painful intercourse
Male: Burning with ejaculation/urination
Both: May be asymptomatic
125
Tx for trichomoniasis
Abstinence
Flagyl, Tindamax
EPT
126
Genital Herpes patho
Incurable, recurrent
Virus Herpes Simplex
127
Genital herpes s/sx
Asymptomatic
Mild tingling/itching 1-2 days before outbreak
Lesions rupture and leave an erosion
128
Tx for genital herpes
Antivirals:
Zoverax
Valtrex
IV Acyclovir
129
HPV
Human papillomavirus
Cause of genital warts (condylomata acuminata)
130
HPV prevention
Gardasil
131
HPV tx
Cream or jel Condylox
Chemical ablation/cryotherapy of warts
132
Syphilis
Treponema Pallidum
Can lead to systemic diseases
133
Syphilis s/sx
Primary: Chancre
Secondary: Systemic disease
Tertiary: No longer contagious
Flu symptoms
134
Prostate function
Produces fluids for semen
135
Function of testis
Produces testosterone and sperm
136
Meatospermia
Blood in ejaculate
137
Prostate-Specific Antigen
Increased levels may indicate CA, prostatitis, or urinary retention
Less than 4 ng/mL
Beginning at age 50
138
Nocturnal penis tumescence status
Sleep study
Measures engorgement/erection
Determines erectile dysfunction cause
139
Benign Prostatic Hyperplasia
Prostate swells upwards towards bladder and constricts urethra
Caused by aging or increased estrogen or DHT (dihydrotestosterone)
140
Increased risk for BPH
Smoking, ETOH, HTN, DM, obesity
141
Tx for BPH
Transurethral Microwave Therapy (TMT): heat to prostate increase necrotic tissue slough
Transurethral Needle Ablation (TUNA): heat to prostate to increase necrotic tissue slough
Transurethral Resection of the Prostate (TURP): removal of inner portion of prostate
142
Continuous bladder irrigation (CBI)
Irrigates the surgical site after removal of prostate to removes clots/obstruction
Saline irrigates bladder through foley
Monitor for bladder spasms
143
Transurethral Resection Syndrome
NS in continuous bladder irrigation (CBI) can be absorbed into circulatory system
Leads to fluid and electrolyte imbalance - hyponatremia
144
Prostate cancer patho
BRCA 1 and 2, DHT
145
