Med surg exam

Question 0

Doctyl sodium sulfosuccinate ( colace)

Answer 0

Is a fecal softner

Question 1

Polyethylene glycol and electrolytes

Answer 1

Is an osmotic agent.

Question 2

Bisacodyl sodium (dulcolax)

Answer 2

Is a stimulant relaxant

Question 3

Magnesium hydroxide ( milk of magnesia)

Answer 3

Is a Saline agent

Question 4

What is MS, amyotrophic sclerosis ( ALS) and myasthenia gravis (MG)

Answer 4

They are neurological diseases that typically result in impaired and worsening function of voluntary muscles.
MS & ALS affect nerve cells in the brain and spinal cord.
MG affects the neuromuscular junction.

Question 5

What is MS

Answer 5

It is an autoimmune disorder characterized by development of plague in the white matter of the CNS. This plague damages the myelin sheath and interferes with impulse transmission between the CNS and the body.

Question 6

ALS

Answer 6

Is a disease of the upper and lower motor neurons characterized by muscle weakness progressing to muscle atrophy and eventually paralysis and death.
ALS does not Involve autonomic changes, sensory alterations, or cognitive changes.

Question 7

What is MG

Answer 7

It is an autoimmune disorder characterized by antibody- mediated loss of acetylcholine receptors at the neuromuscular junction, interfering with communication between motor neurons and innervated muscles.

Question 8

Crede manuever

Answer 8

Placing manual pressure on abdomen over the bladder to expel urine

Question 9

What are medications used to treat MS

Answer 9

Azathioprine ( Imuran) and cyclosporine ( sandimmune)
Immunosuppressive agents are used to reduce the frequency of relapses.
Prednisone- corticosteroids are used to reduce inflammation in acute exacerbations.
Dantrolene ( Dantrium), tizanidine ( zanaflex) baclofen ( lioresal) and diazepam ( Valium)- antispasmodics are used to treat muscle spasticity

Question 10

What med can be used in severe cases of MS

Answer 10

INTRATHECAL baclofen

Question 11

Interferon beta ( Betaseron)

Answer 11

Immunomodulators are used to prevent or treat relapses

Question 12

Carbamazepine ( tegretol)

Answer 12

Anticonvulsants are used for paresthesia

Question 13

Docusate sodium ( colace)

Answer 13

Stool softener used for constipation

Question 14

Propantheline

Answer 14

Anticholinergics used for bladder dysfunction

Question 15

What exactly is ALS

Answer 15

It is a degenerative neurological disorder of the upper and lower motor neurons that results in deterioration and death of the motor neurons.this results in progressive paralysis and muscle wasting that eventually causes respiratory paralysis and death. Cognitive function is usually not affected.

Question 16

What is the other name for ALS

Answer 16

Lou Gehrig’s disease… After the baseball player who died of this in 1941.
Death usually occurs due to respiratory failure within 3-5 yrs of the initial manifestations.
There is no cure

Question 17

Risk factors for MS

Answer 17

20-40 years of age
Woman
Genetic
Environmental factors include smoking, lack of vitamin D exposure, and exposure to Epstein Barr virus.

Question 18

Because MS, is an autoimmune disease, what factors triggers relapse

Answer 18

Viruses and infectious agents
Cold climates
Physical injury
Emotional stress
Pregnancy
Fatigue
Extreme temps
Hot shower or bath

Question 19

What are the risk factors for developing ALS

Answer 19

Men

40-70 years of age

Question 20

What are objective findings of a person with ALS

Answer 20

Muscle weakness, usually begins in one part of the body
Muscle atrophy 
Dysphagia 
Dysarthria 
Hyperreflexia of deep tendon reflexes

Question 21

What are lab test to diagnose ALS

Answer 21

Increased creatine kinase ( CK-BB) level

Question 22

What are diagnostic procedures to diagnosis ALS

Answer 22

Electromyogram ( EMG)- reduction in number of functioning motor units of peripheral nerves.

Muscle biopsy- reduction in number of motor units of peripheral nerves and atrophic muscle fibers.

Question 23

What are medications used to treat ALS

Answer 23

Rilozole ( Rilutek) is a glutamate antagonist that can slow the deterioration of motor neurons by decreasing the release of glutamic acid. It must be taken early in the disease process and will add approx. 2-3 months of life to the clients lifespan.

Baclofen ( Lioresal), dantrolene sodium ( Dantrium), diazepam ( Valium)
Are antispasmodics used to decrease muscle spasticity

Question 24

What are complications of ALS

Answer 24

Pneumonia can be caused by respiratory muscle weakness and paralysis ncontributing to ineffective airway exchange Respiratory failure may necessitate mechanical ventilation.

Question 25

What is MG

Answer 25

Myasthenia gravis is a Progressive autoimmune disease that produces severe muscular weakness. It is characterized by periods of exacerbations and remission. Muscle weakness improves with rest and worsens with increased activity

Question 26

What are risk factors of MG

Answer 26

Coexisting autoimmune disorder | Frequently assoc with hyperplasia of the thymus gland

Question 27

What are subjective symptoms of MG

Answer 27

``` Progressive muscle weakness Diplopia Difficulty chewing and swallowing Respiratory dysfunction Bowel and bladder dysfunction Poor posture Fatigue after exertion ```

Question 28

What are objective physical findings of a person with MG

Answer 28

``` Impaired respiratory status Decreased swallowing ability Decreased muscle strength Incontinence Droopy eyelids ```

Question 29

What are diagnostic tests performed to diagnose MG

Answer 29

Tensilon testing- baseline assessment of cranial muscle strength is done Electromyography- shows the neuromuscular transmission characteristics of MG.

Question 30

What is atropine the antidote for

Answer 30

Atropine is the antidote for edrophonium ( bradycardia, sweating, and abdominal cramps.)

Question 31

What are medications used to treat MG

Answer 31

Anticholinesterase is the 1st line in therapy. Pyridostigmine ( Mestinon) and neostigmine ( Prostigmin) are used to increase muscle strength. It inhibits the breakdown of acetylcholine and prolongs its effects. Immunosuppressants- because MG is an autoimmune disease, immunosuppressants decrease the production of antibodies.

Question 32

What is bile

Answer 32

Bile is used for the digestion of fats | It is produced in the liver and stored in the gallbladder

Question 33

What are risk factors of SLE

Answer 33

Nephritis Oral ulcers Very fragile skin Ulcers on skin

Question 34

What are tests to determine SLE

Answer 34

Blood tests

Question 35

S&s of cholecystitis

Answer 35

``` Feeling of fullness Cholesterol Pigment stones Dark urine Pale stool Jaundice Itchiness, warmth on skin RUQ PAIN RUQ PAIN. RUQ PAIN ```

Question 36

What are risk factors of cholecystitis

Answer 36

``` Woman Oral contraceptives Estrogens or clofibrate Meds known to ^ biliary levels Cholesterol saturation Increased age GI DISEASE Diabetes Obesity/rapid wt. loss ```

Question 37

What is treatment of cholecystitis

Answer 37

Decrease intake of fatty foods

Question 38

What are diagnostics to diagnose cholecystitis

Answer 38

``` ERCP ABDOMINAL X RAY CHOLECYSTOGRAPHY BILIRUBIN LEVELS ULTRA SOUND ^ WBC ^ CHOLESTEROL LEVELS ```

Question 39

What are s&s of crohns

Answer 39

``` Diarrhea Abdominal pain Anorexia Wt.loss Nutritional deficiencies ```

Question 40

What is treatment for crohns

Answer 40

``` Sedatives Anti diarrheal Anti peristaltic meds Amino salicylates ( sulfalazine) Corticosteroids Immunosuppressants ```

Question 41

What tests determines whether a person has crohns

Answer 41

``` Proctosigmoidoscopy Stool examination Barium study ^ WBC ^ ESR ^ CRP ⬇️ HCT ⬇️ HGB ⬇️ albumin ```

Question 42

What are s&s of ulcerative colitis

Answer 42

``` 10-20 stools LLQ PAIN LLQ PAIN LLQ PAIN Fever Vomiting Abdominal distention Hyperactive bowel sounds Hypocalcemia Rectal bleeding ```

Question 43

What is treatment of ulcerative colitis

Answer 43

``` Steroids Immunosuppressants Anti inflammatory Surgical interventions Colon resection Colostomy/ illeostomy ```

Question 44

What tests determine ulcerative colitis

Answer 44

Endoscopy Colonoscopy Barium enema ⬆️ WBC ⬆️ ESR ⬆️ CRP ⬇️ albumin ⬇️ HCT ⬇️ HGB

Question 45

Where does the genetic predisposition of MS come from

Answer 45

It is indicated by the presence of a specific cluster ( halo type) of human leukocyte antigens on the cell wall.mits presence may increase susceptibility to factors such as viruses,mthat teigger that autoimmune response activated in MS.

Question 46

What does the RR course of MS involve

Answer 46

Relapsing remitting...with each relapse recovery is usually complete; however, residual deficits may occur and accumulate mover time.

Question 47

What does the primary progressive course of MS involve

Answer 47

Disabling symptoms steadily increase, with rare plateaus and temporary minor improvement.

Question 48

What are signs and symptoms of MS

Answer 48

PAIN, most ppl with MS also take opioids. Paresthesia, dysesthesias, and proprioception loss. Muscle Spasticity- usually occurs in in the lower extremities and can include loss of abdominal reflexes. Ataxia ( impaired coordination of movements) and tremor Bladder, bowel and sexual dysfunction

Question 49

What do secondary complications of MS include

Answer 49

``` Urinary tract infections Constipation Pressure ulcers Contracture deformities Dependent pedal edema Pneumonia Reactive depression And osteoporosis. ```

Question 50

What is treatment for MS

Answer 50

Analgesics Antiimmune therapy Interferon beta 1a ( rebif) and interferon 1b ( Betaseron) are administered SC every other day. Another preparation of interferon : avonex, is administered IM once a week

Question 51

What are side effects of all interferon beta meds

Answer 51

Flulike symptoms that can be managed with acetaminophen and ibuprofen and resolve after a few months Additional side effects include; potential liver damage Fetal abnormalities and depression

Question 52

What med is the key agent in treating acute relapse in the RR course of MS

Answer 52

IV methylprednisolone, they key agent in treating acute relapse in the RR course shortens the duration of relapse.it eceprts anti inflammatory effects by acting on T cells and cytokines, it is administered 1g IV daily for 3-5 days followed by an oral taper of prednisone. Side effects include mood swings, wt. gain, and electrolyte imbalances.

Question 53

Mitoxantrone ( Novantrone)

Answer 53

Is used for MS. It is administered by IV infusion every 3 months. It can reduce the frequency of clinical relapses in patients with secondary progressive or worsening RR MS. patients must be very closely monitored for side effects and there is a maximum life time dosage that can be used.

Question 54

What are medications used for the specific symptoms of MS

Answer 54

Baclofen ( lioresal) {GABA agonist}- is used to treat muscle spasticity Benzodiazepines- diazepam, tizanidine ( Zanaflex), and dantrolene ( Dantrium) may also be used to treat muscle spasticity Meds used to treat ataxia include; beta blockers ( propranolol) The anti seizure gabapentin ( Neurontin) and benzodiazepines ( clonazepam)

Question 55

What may be used to acidify the urine making bacterial growth less likely

Answer 55

Vitamin C ( ascorbic acid)