Exam II Flashcards
1
Q
What controls the metabolic system?
A
-The endocrine and nervous systems
2
Q
What are some signs and symptoms of dehydration?
A
-thirst, weight loss, lack of sweating, fever, postural hypotension, dry skin, dizziness, confusion, and increase hematocrit
3
Q
What is water intoxication caused by?
A
-excessive water intake without solutes
4
Q
What are some signs and symptoms of water intoxication?
A
-confusion, sleepiness, weight gain, hyperventilation, peripheral edema, increased ICP
5
Q
What are normal blood potassium levels?
A
-3.5 to 5.0
6
Q
Potassium levels above and below what is considered an emergency?
A
-less than 2.5, greater than 7
7
Q
what is the most common cause of a potassium imbalance?
A
-Taking diuretic drugs
8
Q
What are some signs and symptoms of a potassium imbalance?
A
-weakness, vomiting, tingling thirst, irregular behavior, and arrythmias
9
Q
What should you do before exercising someone with a potassium imbalance?
A
-consult with MD
10
Q
What are normal blood calcium levels?
A
-4.5 to 5.5
11
Q
hypocalcemia occrus when blood calcium levels drop below what?
A
-4.5
12
Q
What can hypocalcemia be caused by?
A
-hypothyroidism, renal failure, alkalosis and eating disorders
13
Q
What are some signs and symptoms of hyocalcemia?
A
-bruising, general fatigue, palpitation, tingling and tetany
14
Q
Hypercalcemia is occur when blood levels rise above what?
A
-5.5
15
Q
what can cause hypercalcemia?
A
-Hyperparathyroidism, malignance, renal failure and pagets disease
16
Q
What are the symptoms of hypercalcemia?
A
- Groans (GI)
- Moans (psych)
- Bones (diffuse pain)
- Stones (kidney stones)
- Overtones (psych)
17
Q
What causes alkalosis?
A
-increase in available bases, or loss of acids
18
Q
Signs and symptoms of alkalosis include what?
A
-muscle twitching and cramping, weakness, confusion, parasthesia, irritability, confusion, agitation, slow breathing and coma
19
Q
In respiratory alklosis, what happen to pH and CO2 levels?
A
-pH increases, CO2 decrease
20
Q
In respiratory acidosis, what happens to pH and CO2?
A
-pH decreases, CO2 increases
21
Q
In metabolic acidosis, what happens to pH and HCO3 level?
A
-pH decreases, HCO3 decreased
22
Q
In metabolic alkalosis, what happens to pH and HCO3?
A
-pH increases, HCO3 increases
23
Q
What is primary gout?
A
-Inherited
24
Q
What is secondary gout?
A
-result from renal failure or idiopathic
25
What is the most commonly effected joint by gout?
-the big toe
26
What can gout return be anticipated after?
-alcohol consumption, trauma, surgury, or eating food with purine content
27
what does hemochromotosis cause?
-excess iron in the blood
28
Who is most likely to get hemochromotosis?
-men (5x > than women) over 50
29
What increases the incidence of hemachromotosis?
-alcohol use
30
What are some signs and symptoms of hemachromotosis?
-vertigo, hair loss, memory loss, arrythmias, cardiomyopathy, bronze skin, hepatomegaly, elevated liver enzymes, liver cirrhosis, DM, arthritis, and testicular atrophy
31
50% of patients with hemachromotosis develop what?
-Arthritis
32
Arthritis associated with hemachromotosis is common to manifest where?
-MCP, hips, knees and shoulders
33
How can you differentiate between RA and hemachromotosis?
- Hemochromotosis affects all joints in the hands and causes bone sclreosis
- RA affects mainly the MCPs and PIP and causes bone loss and deformities
34
What is osteomalacia?
-bone softening without bone loss
35
What can osteomalcia be caused by?
-calcium and phosphate deficiency
36
What are some risk factor associated with osteomalacia?
-Being elderly, living in cold areas, lack of vitamin d, chronic renal failure, renal defects,hyperparathyroidism
37
What types of medications can cause osteomalacia?
-tranquilizers, sedatives, anticonvulstants, muscle relaxants, diuretics, antacids with hydroxide
38
What postural deformities are associated with osteomalacia?
-kyphosis and bowed legs
39
What areas will be tender in a patient with osteomalacia?
-Ribs and proximal extremities
40
Fractures associated with osteomalacia are common where?
-The radius, femur, vertebral bodies, ribs and pubic ramus
41
What population is Paget's Disease highest in?
-People from the Great Britains, over 50
42
What cardio manifestations are associated with Paget's Disease?
-increased CO, increased blood flow to affected bone, heart failure
43
What areas are susceptible for osteoporosis?
-vertebra, calcaneus, metaphyseal area of long bones
44
What modifiable risk factors are associated with osteoporosis?
-corticosteroid use, poor nutrition and depression
45
What bone density value is associated with osteopenia?
-1.0 to 2,5 below SD
46
What bone density is associated with osteoporosis?
-2.5 or lower than SD
47
what is the bone density associated with severe osteoporosis?
-more than 2.5 below the SD and have had one or more osteoporotic fractures
48
Hyperthyroidism causes what effects on the nervous system?
-tremors, CTS, and hyperreflexia
49
Hyperthyroidism has what effect on the metabolic system?
-weight loss and bone loss
50
Hyper-adrenalism can have what effects on the nervous ststem?
-Weakness and emotional problems
51
Hypo-adrenalism can cause what problems in the metabolic system?
-bone loss and slow healing
52
Hyperparathyroidism can have what neruological effects?
-parathesia, lethargy, and fatigue
53
Hyperparathyroidism can have what effect on the metabolic system?
-MCP CPPD, Gout, bone loss
54
Decreased ADH can cause what neuro effects?
-siezures, lethargy, confusion
55
decreased ADH can cause what metabolic effects?
-weight gan
56
Endocrine disorders present how from the beginning?
-systemically
57
What immune disorders can cause CTS?
-hypocalcemia, gout, hemochromotosis
58
What endocrine disorders can cause CTS?
-acromegaly, diabetes, menopause, hyperthyroidism
59
What MSK disorders are signs and symptoms of endocrine disorders?
-periarthritis (of the 2nd PIP), and calcific tendinitis of th infraspinatus
60
Chondrocalcinosis is associated with what endocrine disorders?
-acromegaly, pseudogout, hyperthyroidism/para,
61
CPPD only affects what joints in the hand?
-MCPs only
62
What other joints does CPPD affect?
-Radiocarapal joint and patellofemoral joint, and the entire hip joint
63
what is the cluster for spondyloarthritis?
-age over 45, morning stiffness that is improved with exercise
64
Diabetes normally affects what first?
-PNS (then CNS, and ANS in advanced stages)
65
when exercising a person with diabetes, which exercises should not be included?
-those that increase HR above 75%, and those that place the legs above the head or trunk
66
If blood glucose levels are above 250 what type of exercise is allowed?
-NONE
67
what range of blood glucose levels is indicated for exercise?
-100-250
68
If a patient have blood glucose levels from 80-100 what should you do?
-give 15g of carbs and retest in 15 minutes
69
Blood glucose less than 75-80 indicated what type of exercise?
-NONE
70
Where should insulin injections not be injected?
-muscle being exercised within the next hour
71
Diabetics taking what are at a higher risk for hyperglycemia?
-Glucocorticoids
72
Blood glucose levels above what indicative of diabetic ketoacidosis?
-300
73
Cushings syndrome is caused by what?
-excess cortisol
74
What should a PT be aware of in a patient with cushing syndrome?
-the patient may have a reduced pain threshold, slow healing, and decreased heat tolerance
75
Addisons disease commonly shows muscle weakness where?
-anterior tibialis
76
What is a symptoms of addisons diease that PTs shoulde be aware of?
-orthostaic hypotension (be careful with transfers)
77
Hyperthyroidism causes muscle weakness where?
-proximally
78
Myxedema coma is associated with what?
-hypothyroidism
79
what are some signs and symptoms of myxedema coma?
-severe bradycardia, hypotension, hypothermia, slow and shallow breathing
80
Patients with hyperthermia should not use what in therapy?
-a heated pool
81
Thyroid storm (an emergency) can be precipitated by what?
-trauma, infection or surgery
82
hypoparathyroidism is cause by what?
-low calcium levels
83
hypoparathyroidism can cause spasm is what muscles?
-intercostals
84
What are the general signs and symptoms of immune disorders?
-joint of muscle involvement, poor health, nail bed and skin changes, visual and eye problems, allergies, fatigue, fever, weakness, and lymph node enlargement
85
What are the early symptoms of HIV?
-fever, night sweats, fatigue, oral sores, vaginal infections, headache, cough, SOB, and skin lesions
86
what symptoms may be the presenting symptoms of those with HIV?
-Neuro symptoms
87
what might fibromyalgia be triggered by?
-stress, viral infections or truama
88
What population is most effected by fibromyalgia?
-women more than males, most commonly between the ages of 30 and 45
89
A patient with a WPI score and SS score of what will qualify a patient to have fibromyalgia?
-WPI greater than 7, ss score greater than 5
90
If a patient has a WPI score between 3 and 6, and SS score greater than what can qualify them to have fibromyalgia?
-9
91
How else can a person be diagnosed with fibomyalgia>
-there is no other reason to explain the pain
92
88% of patient with RA test positive for what?
-Rheumatoid Factor
93
What condition most frequently tests positive for rhuematoid factor?
-Primary Sjogrens syndrome
94
What condition least frequently tests positive for rheumatoid factor?
-Reactive Arthritis
95
What population is most commonly effect by RA?
-Women 3x more likely than men, peak incidence betwwen 20 and 50 y/o
96
RA is more likely to occur with what?
-thyroid disorders
97
RA effects what joint surfaces?
-All of them
98
What population is most commonly effected by Polymyalgia Rheumatica?
-white males over 55
99
what condition is commonly associated with polymyalgia rheumatica?
-temportal arteritis
100
Muscle pain associated with polymyalgia rheumatica commonly manifest where?
-neck, shoulder and pelvis
101
What is the most commonly seen symptoms of systemic lupus?
-butterfly rash
102
What is the most common symptoms of systemic lupus?
-low grade fever, arthritis, skin rashes
103
What condition is most commonly associated with the HLA-B27 antigen?
-Anklosing Spondylitis
104
RA is associated with the HLA-B27 antigen what percent of the time?
-80%
105
AS or Marie-Stupell disease primarily effects what?
-SI joints, the lumbar spine, ribcage and proximal joimts
106
What population does AS normally affect?
-males between the ages 18-30
107
What might precede back pain in patients with AS?
-Eye irritation
108
Reiter's Disease is a triad of what?
-Arthritis. urethritis, and conjunctivitis
109
Reiters disease mainly effects who?
-Males
110
What are the systemic symptoms of Rieter's Disease?
-Low fever, anorexia, weight loss
111
What is often the first symptoms of rieters disease?
-burning urination
112
Rieters disease normally affects what joints?
-Weight bearing joints
113
Psoriatic Arthritis is commonly preceded by what?
-Skin problems
114
Psoriatic Arthritis normally effects what joints in the hand?
-The DIP
115
What is often the first sign of lyme disease?
-Red Skin rash
116
What joints are normally affected by lyme disease?
-Knee and shoulder
117
What is stage O cancer?
-Carcinoma in SItu
118
What is stage 1 cancer?
-Localized
119
What is stage 2 cancer?
-early localized advanced
120
What is stage 3 cancer?
-late localized advanced
121
What is stage 4 cancer?
-metastisized
122
What are the most common cancers in males?
-prostate, lung, and colon
123
Men are most likely to die from which cancers?
-lung, prostate, colon and pancreas
124
What cancers are most common in females?
-breast, lung and colon
125
Women are most likely to die from which cancers?
-lung, breast, colon and pancreas
126
what male population is most commonly affected by cancer?
-african americans
127
What race is least likely to be affected by cancer?
-American indian or alaskan
128
What population has the highest incidence of breast cancer?
-white females
129
What population has the lowest incidence of breast cancer?
-Native american females
130
What female population has the highest incidence of cancer?
-White females
131
What populations have the highest incidence of colon and rectum cancer?
-African american males and females
132
What male population has the lowest incidence of colon or rectal cancer?
-American Indian
133
What female population has the lowest incidence of colon or rectal cancer?
-Asian
134
What race (male and female) has the highest incidence of kindey and renal pelvic cancer?
-African americans
135
What race (male and female) have the lowest rate of kidney and renal pelic cancer?
-Asian
136
What race (male and female) has the highest rate of liver and bile duct cancer?
-asian
137
What race (male and female) has the lowest rate of liver and bile duct cancer?
-White
138
What male population has the highest incidence of lung cancer?
-African American
139
What female population has the highest incidence of lung cancer?
-White
140
What race (males and females) has the lowest incidence of lung cancer?
-Latino
141
What races have the highest incidence of stomach cancer?
-Asian and african american
142
What race has the lowest incidence of stomach cancer?
-Whites
143
What race has the highest incidence of prostate cancer?
-african american
144
What race has the lowest incidence of prostate cancer?
-american indian
145
What race has the highest incidince of uterine cancer?
-hispanic
146
What race has the lowest incidence of uterine cancer?
-American Indian
147
What race has the highest amount of cancer deaths?
-African Americans
148
What population has the highest breast cancer mortality rate?
-African American Females
149
What population has the lowest breast cancer mortality rate?
-Asian Females
150
What race has the highest colon cancer mortality rate?
-African Americans
151
What race has the lowest colon cancer mortality rate?
-Asian
152
What race has the highest kidney and renal pelvis mortality rate?
-American Indian
153
What race has the lowest kidney and renal pelvic cancer mortality rate?
-Asian
154
What race has the highest liver and bile duct cancer mortality rate?
-Asian
155
What race has the lowest liver and biles duct cancer mortality rate?
-White
156
What race has the highest prostate cancer mortality rate?
-African american
157
What race has the lowest prostate cancer mortality rate?
-Asian
158
What male population has the highest rate of lung cancer mortalities?
-African american men
159
What female population has the highest mortality rate for lung cancer?
-White Females
160
What male population has the lowest mortality rate for lung cancer?
-Hispanic
161
What male population has the highest mortality rate for stomach cancer?
-Black men
162
What female population has the highest mortality rate for stomach cancer?
-Asian women
163
What race has the lowest mortality rate for stomach cancer?
-White
164
What race has the highest mortality rate for uterine cancer?
-African American
165
What race has the lowest death rate for uterine cancer?
-White
166
What is the order of cancer related death rates per race from highest to lowest?
-African American, White, American Indian, Hispanic, Asian
167
What is the most common cancer in children?
-Leukemia (CNS is second)
168
What is the most important risk factor for cancer?
-Being over the age of 50
169
What are the 7 early warning signs of cancer?
- C: change in bladder or bowel
- A: A would that wont heal
- U: unusual bleeding of discharge
- T: Thickening or lump
- I: Indigestion or dysphagia
- O: Obvious change in mole or wort
- N: Nagging Cough or hoarseness
170
Changes in what with out a mechanical reason can be a sign of cancer?
-DTRs (can be hyper or hypo)
171
Where might you observe weakness in a patient that has cancer?
-Proximal muscles
172
What is usually the first symptom of cancer?
-pain
173
When does visceral pain usually occur with cancer?
-in advanced stages
174
Visceral pain with cancer is associated with what other symptoms?
-Hypotension, nausea, vomiting, bradycardia, and depression
175
Mild to moderate pain from cancer is associated with what other symptoms?
-Tachycardia, hypertension, tachypnea
176
Which type of cancer leads in mortality rate?
-Lung caner
177
What is the most common site of metastasis for all cancers?
-Lungs
178
What is the most site of metastasis from primary lung cancer?
-Brain (then prostate/breast and then bone)
179
What syndrome might lung cancer cause?
-Horner's
180
What spinal nerve might be affected if there is cancer in the apical lobes of the lungs?
-T1-T2
181
What is the second most common site of metastasis for all cancers?
-Hepatic
182
What is the 4th leading cause of cancer related deaths in males?
-Pancreatic
183
What is the 5th leading cause of cancer related deaths in males?
-Liver
184
Where might a patient with liver cancer be experiencing pain?
-Right upper quadrant and right shoulder
185
Where might a patient with pancreatic cancer experience pain?
-Left upper quadrant and left shoulder
186
What is the 3rd most common site of metastasis for all cancers?
-the skeleton
187
What mnemonic can be used to remember what cancer commonly metastasize to the skeleton?
- LEAD KETTLE (PBKTL)
| - Prostate, Breast, Kidney, Thyroid, Liver
188
What bones does cancer normally metastasize too?
- Spine (70%)
- 60% T-spine
- 30% Lumbar
- 10% Cerical
189
What is the most common primary cancer that effects the spine?
-Multiple Myeloma
190
What is the Clincal prediction rule for LPB related to cancer?
- Age >50
- Unexplained weight loss
- History of malignancy
- Symptoms do not improve after 4 weeks of therapy
191
What is the 4th most common site for metastasis for all cancers?
-The Brain
192
What are the most common cancers that metastasize to the brain?
-lungs, breast, skin, kidney, colon
193
Where does brain cancers normally occur?
-Cerebrum (85%)
Then Cerebellum (15%)
then brainstem
194
Headaches that are worse in the morning might be related to what?
-Brain cancer
195
What is the 5th most common site for metastasis?
-Lymph nodes
196
What might lymph cancer be precipitated by?
-A transplant
197
what accounts for 30% of cancers in children?
-Leukemia
198
Luekemia can cause what blood disorders?
-Anemia, and platelet disorders
199
What are the common places that leukemia might spread?
-spinal fluid, liver, spleen, lymph nodes, and testicles
200
Where does prostate cancer most likely metastasize?
-Bone
201
What are the early symptoms of prostate cancer?
-Changes in urination stream
202
What is the 3rd most common cancer?
-Colorectal (also 3rd in mortality rate)
203
Where does colorectal cancer most commonly metastasize?
-the liver
204
Kidney cancer is the what most common cancer in males and females?
- 7th is males
| - 8th in females
205
Where does kidney cancer most commonly metastasize?
-Bones, then brain
206
What is the 5th most common cancer in females?
-thyroid
207
Where does thyroid cancer most commonly metastasize?
-The skeleton
208
What is the condition that is signs and symptoms cause by cancer but not due to cancer cells?
-Paraneoplastic Syndrome
209
What type of cancers normally present with paraneoplastic syndromes?
-lung, breast, ovaries, or lymph
