last pathopharm test ever!!!!! Flashcards by Jane Daum

DKA sx

-ketones
-fruity breath
-polyuria / polydipsia
-N/v
-dec skin turgor
-dry mucus membranes
-tachycardia
-hypotension
-metabolic acidosis
-decreased K+
-weight loss

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BG for DKA

350-500

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HHS sx

-decreased K+
-polyuira & polydipsia
-weight loss
-lethargy / obtunded
-coma
-volume depletion
-electrolyte imbalance
-hyperosmolarity

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thyroid storm

-fever
-tachycardia
-afib/aflutter
-n/v
-agitation
-tremor
-psychosis
-stupor/coma
-hypotension

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myxedema (10)

-hypothyroidism
-hard non pitting swelling
-coma
-hypothermia
-hypotension
-hypoglycemia
-hypoventilation
-slowing of functions of other organs
-bradycardia
-hypoNa

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addisonian crisis

-hypotension
-salt craving
-hypocortisolism
-hypoglycemia
-weakness
-hyperpigmentation
-N/V/D
-hyperK+

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DKA & HHS treatment

-fluid replacement
-electrolyte corrections
-IV insulin
-sodium bicard (if pH <7.2)
-dextrose (<200 and anion is still open)

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thyroid storm drugs

-beta blocker (sx control)
-thionamide (propylthiouracil/PTU): suppresses conversion of T4 & T3
-iodine solution: to block the release of thyroid hormone
-glucocorticoids: reduce T4 to T3, promote vasomotor stability & treat adrenal insufficiency
-bile acid sequestrates: recycling of thyroid hormones

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myxedema drugs

-levothyroxine & liothyronine
-glucocorticoids
-IV fluid
-lytes
-glucose

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addisonian crisis drugs

-IV hydrocortisone
-NS
-dextrose

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primary HTN

direct dysfunction of the thyroid gland itself
-low levels of T3 & T4
-high levels TSH
-causes: thyroiditis, cogenital hypothyroidism, surgical removal of thyroid or radiation to thyroid

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secondary hypothyroidism

dysfunction of the pituitary gland
-low T3, T4, & TSH
-causes: pituitary tumors, radiation, therapy or pituitary surgery

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tertiary hypothyroidism

dysfunction of the hypothalamus

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complications of uncontrolled DM

-infection
-wound healing
-DKA/HHS
-micro & macro vascular

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microvascular comps of uncontrolled DM

-damage to capillaires
-retinopathies
-nephropathies
-neuropathies

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macrovascular comps of uncontrolled DM

-damage to large vessels
-coronary artery
-peripheral vascular
-cerebral vascular

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patho of T1DM

activation of cellular immunity (macrophages & T cells) & humoral immunity towards beta cells-> beta cells in the pancreas are destroyed

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alpha cells secrete

glucagon

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beta cells secrete

insulin

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patho of T2DM

insulin resistance d/t receptor fatigue and decrease insulin secretion

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main cause of left sided heart failure

HTN

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main cause of right sided heart failure

COPD

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assessment finding w/ left sided heart

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-pulmonary congestion
-LV increases in size
-back flow into pulmonary veins
-cough, crackles, wheezes
-frothy sputum, may be blood tinged
-paroxysmal nocturnal dyspnea
-orthopnea

assessment finding w/ right sided heart

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-COPD w/ cor pulmonale
-RV increases in size
-back flow into vena cava, decrease to the lung
-congestion in JV, liver & lower extremities
-dependent edema
-weight gain
-hepatosplenomegaly
-fatigue
-ascites
-GI distress/fullness

medications for HF

-BB (carvedilol) -CCB (idipine) -Digitallis -nitrates -dapaglifozin -HTN drugs -spironolactone -ranolazine

ACE, ARBs, ARNI holds

hyper K & hypotension

beta block holds

less than 100, less than 60

dapaglifozin holds

low BG

digitalis holds

-hold if pulse <60 -low K+

S/s of OA

->40 -osteophytes -deep, aching pain w/ exertion & relieved by rest -worsens w/ cold -crepitus -joint swelling -altered gait -bowed leg -limited ROM -B&H nodes -wear & tear on unilateral joints -localized -no biomarker

S/s of RA

-young to middle age -positive RF & ANCP -systemic affects to start -joint swell soft, warm & tender -stiffness -deformities & joint subluxation -sjorgren's syndrome -rheumatoid nodules -autoimmune

Cimetidine & Famotidine (H2 receptor antagonists) MOA

-blocks H2 receptors in the stomach -reduces gastric acid secretion by 60-70% -increases stomach pH

omeprazole, pantoprazole, esomeprazole (PPIs) MOA

binds to proton pump and inhibits the hydrogen potassium ATPase (proton pump) + irreversibly inhibits the section of HCl

antacids (aluminum, calcium, magnesium, Al+MG)

neutralizes acid by approximately 50%

complications of acute viral gastroenteritis

fluid volume deficit / electrolyte imbalance caused by watery diarrhea, abdominal pain, N/v, fever & malaise

HIV patho

**retrovirus that destroys CD4 Tcells** targets CD4 cells on T lymphs, monocytes & macrophages -> enters cells -> reverses transcriptase -> HIV integrase -> HIV protease **CD4 drops, Viral load will increase**

expected findings for IDA

-microcytic, hypochromic -pallor -glossitis, cheilitis -brittle hair & nails -koilonchia -pica & pagophagia

sucralfate (mucosal protectant)

alters when exposed to gastric acid and turned into a sticky, thick gel to make a protective barrier

carcinogens: known

smoking, asbestos, estrogen, alcohol, HPV or HIV

proto oncogenes

genes that stimulate and regulate a cell's movement through the cell cycle, resulting in cellular growth and proliferation -> when mutated, proto oncogenes becomes oncogenes that stimulate constant, unrelenting cellular proliferation and cell cycling

main causes of CKD

DM HTN

Beta Blocker SE

hypotension, mask hypogly, fatigue & lethargy

ACE SE

cough, first dose hypotension, angioedema, renal insufficiency

ARBs SE

angioedema, renal insufficiency

CCB SE

orthostatic hypotension and peripheral edema

IV heparin things to know

-labs: PTT & anti Xa -discoloring of fingers and toes -black patches on hands & feet -black tarry stools -common signs of bleeding -anemia -antidote: protamine sulfate

rapid acting insulin

**lispro & aspart** -onset: 15 mins -peak: 1 hr -duration: 2-4 hr

short acting insulin

**regular** -onset: 30-60 mins -peak: 2-6 hr -duration: 3-8 hrs

intermediate insulin

**NPH** -onset: 2-4 hrs -peak: 4-10 -duration: 10-20

long acting insulin

**glargine** -onset: 70 mins -peak: none -duration: 24 hrs

SE of chemo

**do not give chemo at nadir** -decreased WBC, RBC, platelets (pancytopenia) -GI effects -alopecia -stomatitis -toxic to fetus -hyperuremia -organ damage -extravasation

inhaled steroids

beclomethasone dipropionate budesonide fluticasone

systemic steroids

prednisone hydrocortisone dexamethasone

which type of steroid has more side effects

**systemic** because inhaled are limited to the lungs -hypotension -weight gain -glaucoma -hypergly -GI upset -osteoporosis -adrenal problem (cushings)

Asthma CM

bronchoconstriction / vasoconstriction wheezing dyspnea / SOA inflammation cough chest tightness accessory muscle use diaphoresis respiratory failure

chronic bronchitis CM

-persistent productive cough -SOA -congestion -pulmonary htn (late)

emphysema CM

-gradual inc in breathlessness (**esp w/ exertion**) -SOA at rest -wheeze -malnourished -barrel cheset -pursed lip breathing -**decreased breath sounds**

last pathopharm test ever!!!!! Flashcards

(57 cards)