medical conditions exam 2 Flashcards
(215 cards)
1
Q
common causes of PUD
A
NSAID and h pylori
2
Q
s/s PUD
A
burning pain, bloat, heartburn, dark stool
3
Q
what s/s of a GI disease can mimic MS symptoms
A
PUD
4
Q
tx PUD
A
PPI, H2 blocker, anti/probiotic
5
Q
esophageal cancer types
A
SCC and adenocarcinoma
6
Q
esophageal cancer def
A
malignant cells in esophagus
7
Q
who is esophageal cancer more common in
A
men and older people
8
Q
additional risk factors for esophageal cancer
A
barrett esophagus and GERD
9
Q
s/s esophageal cancer
A
dysphagia, pain in sternum, indigestion
10
Q
what organ secretes digestive enzymes
A
pancreas
11
Q
what organ does most of the absorption in the GI system
A
small intestine
12
Q
hepatitis A who is most effected
A
men 30-39, white, gay, homeless
13
Q
which type of hepatitis had a big spike and outbreak in 2017
A
hep A
14
Q
is there a vax for hep a
A
yes, and if you do get the disease you can get the vax and prevent further problems
15
Q
what type of hepatitis is spread through oral-fecal contact
A
hep a
16
Q
what type of hepatitis can be spread through childbirth
A
hep b
17
Q
what is the most common cause of chronic hepatitis and liver cancer
A
hep B
18
Q
what is the term for passing on a disease during child birth
A
vertical/perinatal
19
Q
what type of hepatitis can you be an inactive carrier for
A
hep b
20
Q
what is the procedure for pancreatic cancer to treat the tumor
A
whipple
21
Q
when do s/s present for pancreatic cancer
A
after metastases
22
Q
what is the most deadly and aggressive cancer
A
pancreatis
23
Q
2 types of hep C
A
acute or chronic
24
Q
how does hep c spread
A
blood infected and spreads
25
what can hep c lead to
cancer, cirrhosis, liver disease
26
what is the most common type of pancreatic cancer
adenocarcinoma
27
achalasia def
feeling full in the esophagus
28
cachexia
weight loss due to cancer
29
constitutional symptoms
fever, malaise, chills, sweats
30
does the enterric system work with the CNAS
no, it is it's entirely own system that has its own controls within the body
31
possible reasons for n/v
chemo, tumor, motion sick, pregnancy, concussion
32
def diarhea
>3x stool/ day or abnormal volume
33
c-diff transmission
oral-fecal route
34
c-diff effects what part of the body directly
lower intestine
35
s/s c-diff
foul odor, watery diahrea, cramping, urgency
36
37
who is most likely to get nosocomial infection
immunocompromised patient
38
where is fecal impaction most common
nursing home b/c sedentary and dehydrated so constipation is common
39
causes of intestinal obstruction
strangulated hernia, IBS, colon cancer
40
def intestinal obstruction
intestine is blocked to prevent passage of food so stomach contents leak into abdominal cavity
41
s/s dehydration
poor skin turgo, sunken eyes, orthostatic hypotension
42
def malnutrition
15-20% ideal body weight
43
what can cause dysphagia
neuro conditions, obstruction, trauma, muscle damage
44
hematemesis
upper bleeding caused by gastritis, PUD, or NSAID
45
def melena
black stool
46
hematochezia def
fresh blood in stool
47
s/s GI bleeding
weakness, SOB, anemia, orthostatic hypotension, fatigue
48
contributing factors of GERD
aging, alcohol, smoking, pregnancy
49
what can GERD look like
heart attack
50
drugs for GERD
nexium, peptic acid, prilosac
51
what side could you recommend your patient with GERD sleeps on
left
52
hiatal hernia def
upper stomach bulges through diaphragm into chest cavity
53
what disease is associated w/ esophageal varices
cirrhosis
54
s/s esophageal varices
black tarry stool, pale, feel faint
55
what can gastritis lead to
ulcer
56
what are the 2 types of gastritis
acute or chronic
57
gastoenteritis def
inflammation of mucosa layer caused by virus, bacteria, parasites
58
what is the 2nd most common type of illness
gastroenteritis (normal stomach bug)
59
small intestine disorders
malabsorption: celiac
60
large intestine disorders
IBD, IBS, colorectal cancer, diverticulitis
61
what is the job of the pancreas
regulate blood sugar and digestive enzymes
62
how is IBD diagnosed
blood test, stool sample, colonoscopy
63
what part of the GI tract does chron's usually effect
ilium
64
what part of GI does ulcerative colitis impact
colon
65
s/s ulcerative colitis
cramp, arthritis, bleeding, liver disease, osteoporosis
66
how often do adults get colonoscopy
starting at 50 yo, every 10 years after
67
tx IBD
corticosteroids, sulfalazine, mesalamine, humira
68
what are some concerns with IBD
have many meds available but they all have side effects so people with IBD have decreased quality of life
69
colostomy vs colectomy
stool drains into bag at the skin layer, removal of entire colon
70
what can IBD present as MS
back, thigh, hip, knee pain
71
where is the liver located
RUQ
72
what generation are more likely to have hep c
baby boomers b/c they used to share needles
73
what is the pill for hep c
harvoni
74
what is the largest gland in the body
liver
75
where does liver get blood supply from
hepatic artery, portal vein, hepatic vein
76
functions of liver
fight infection, produce bile, detoxify, decompose RBC, store vitamins, produce urea
77
s/s liver problem
if the liver is palpable, yellow skin or eyes
78
what MS pain can indicate liver disease
R shoulder
79
will someone w/ liver disease need an increase or decrease in dose of mediciation
decrease b/c metabolizes slower and don't want to create a toxic effect
80
s/s of cirrhosis
fatigue, weakness, loss of apetite
81
steps leading up to cirhosis
fatty liver > liver fibrosis > cirrhosis
82
how to prevent further liver disease
lifestyle changes, vax, no raw shellfish, decrease stress
83
if a patient comes to us with liver disease and says they're tired today what should we do
let them rest, they need to rest
84
what liver test looks at nutrition
albumin
85
what do ALT and AST liver tests look at
liver enzymes
86
what is prothrombin time
clotting test for liver
87
what does organ donation compatibility depend on
blood type, size, age, when the person died
88
what are the options for liver transplants
recently died: use entire liver, live donor: can use any part of the liver and it will regenerate on the living person in 6 weeks
89
how many lives can 1 person save with organ transplants
8 lives
90
who is not a candidate for liver transplant
HIV, alcohol abuse, cancer, lung disease
91
endometriosis cause
unknown
92
tx endometriosis
hysterectomy, oopharectomy, surgery, NSAIDs
93
what hormone may contribute to endometriosis
estrogen
94
who's at risk for endometriosis
mother/sister/daughter has it, low BMI, heavy or early menstrual cycle
95
renal cell carcinoma
most common type of kidney cancer
96
what is a specific risk factor for renal cell carcinoma
von hippel lindau
97
are men or women more likely to get renal cell carcinoma
men 2/3
98
what is a specific symptom of renal cell carcinoma we should be aware of
constant side pain
99
what is wilms tumor
childhood tumor kidneys
100
what race is more at risk for wilms tumor
african americans
101
what is the most common type of ovarian cancer
epithelial
102
risk factors for ovarian cancer
BRCA1&2, obesity, FH, hormone therapy, endometriosis
103
why is ovarian cancer so common and not found early on
older women stop going to the gyno when they get older which is when the cancer is most likely to be found
104
functions of kidneys
regulate blood water levels, reabsorb useful substances, adjust electrolytes, excrete waste, release renin, EPO, calcitriol
105
EPO function
create RBC and bone marrow
106
renin function
regulate BP
107
calcitriol function
maintain calcium levels for bones
108
if kidneys aren't functioning well what would you expect to happen
excessive creatine in the blood
109
how should we keep BP for someone w/ kidney disease
BP <130/80
110
at what point is kidney disease a real serious problem
<25% function
111
SADH
excessive ADH that causes kidneys to retain water
112
what type of SIADH is most common
SCC
113
diabetes insipidus has how many types of kinds
4 types
114
what does diabetes insipidus cause
kidney problems, metastatic lesion, injury to hypothalamus
115
s/s diabetes insipidus
nocturia, fatigue, dehydration, polydispia
116
how common is diabetes insipidis
very rare= large amounts of dilute urine
117
how does diabetes insipdus relate to ADH
insufficient ADH
118
what does endocrine system regulate
mood, growth and development, metabolism, sexual/reproductive function
119
what type of glands are endocrine
ductless
120
how do nervous and endocrine systems work together
glands produce hormones, hormones regulate organs and cells
121
how do hormones maintain homestasis
feedback loops- keep regulating constantly
122
what organ is the "brain of the brain"
hypothalamus
123
what organ regulates body's homeostasis and is located near the optic nerve
hypothalamus
124
what organ produces hormones ADH and oxytocin that are released from pituitary gland
hypothalamus
125
how does pituitary gland secrete hormones
signal to glands to stop or start producing and releasing hormones
126
what gland controls endocrine glands
pituitary gland
127
what does the pitutary gland regulate
GH, prolactin, TSH, ACH, LH, FSH
128
which part of the pituitary gland releases ADH and oxytocin
posterior
129
what MS pain may be endocrine pathology
shoulder and carpal tunnel symptoms
130
s/s endocrine pathology PTs may notice
weakness of muscle, atrophy, OA, adhesive capsulitis, synovial fluid
131
general s/s endocrine dysfunction
changes in urine, hair changes, mental changes, vitals changes
132
def iatrogenic
HC team did something to medically cause a problem
133
acromegaly def
hypersecretion of GH in adults
134
where is GH secreted from
anterior pituitary
135
what is mostly effected by acromegaly
bones in face, jaw, feet, hands
136
s/s acromegaly
amenorrhea, DM, profuse sweating, HTN
137
what is tx for acromegaly
surgery to pituitary gland to decrease secretion of it
138
gigantism def
overproduction of GH in children that stimulates growth of long bones
139
diagnosis for pituitary tumor
blood/urine test, brain imaging, vision testing
140
what 3 hormones are produced by adrenal cortex
aldosterone, cortisol, androgens
141
what does cortisol do
help regulate body metabolism, has anti-inflammatory effects
142
what is produced by adrenal medulla
catecholamines
143
what is cushing's syndrome
hyperfunction of adrenal gland, increased secretion of ACTH and cortisol by adrenal cortex
144
2 types of cushing's syndrome
iatrogenic and ACTH
145
who is cushing's disease more common in
women 8: men 1
146
what does someone w/ cushing's disease look like
face and torso fat, easily bruising, stretch marks, back hump
147
cushing's Pt considerations
muscle weakness, potential for fracture, back pain, poor wound healing
148
addison's disease is what type of insufficiency
PRIMARY> hypofunction of adrenal gland
149
what is addison's disease
decreased production of cortisol and aldosterone, usually autoimmune
150
skin condition of addison's disease
skin darkening due to melanocytes
151
what is secondary adrenal insufficiency
dysfunction due to lack of pituitary ACTH
152
adrenal insufficency s/s
dark skin, high potassium in blood, GI problems, loss appetite w/ weight loss
153
what is a concern with corticosteroids
WBC don't turn off production and causes damage to tissue
154
thyroid cancer 4 types
papillary, follicular, medullary, anaplastic
155
most common type of thyroid cancer
papillary
156
is thyroid cancer inherited
yes, genetic influence, most common for asian women
157
s/s thyroid cancer
change in voice, difficulty swallowing, lump on neck
158
how has the rate of thyroid cancer changed
increase in number of cases but death rate stayed very low
159
osteoporosis def
bone disease that causes weakness
160
are men or women more at risk for osteoporosis
women
161
can osteoporosis be stopped
yes, if caught soon enough it can be stopped
162
what's a main concern for patients with osteoporosis
hip fracture
163
what does thyroid gland do
releases hormones to control metabolism
164
what do thyroid hormones do
respiration, HR, body weight, muscle strength, body temp, cholesterol
165
3 main thyroid hormones
thyroxine 4 and 3, calcitonin
166
too much thyroid hormone does what
speeds up metabolic functions, too little do the opposite
167
who's more likely to have thyroid dysfunction
women more likely 5-8x
168
why is thyroid disease difficult to diagnose
strong family history component and symptoms usually develop slowly over time
169
what kind of hormone is TSH
tropic so it sends message to release other hormones
170
if a patient has low TSH what does that mean about their thyroid function
likely hyperthyroidism, will be confirmed if FT3&4 are high
171
if a patient has high TSH what does that mean for thyroid function
hypothyroidism, will be confirmed if FT3 and 4 are low
172
what is the most common hyperthyroidism disease
grave's
173
what is goiter caused by around the world compared to in the US
iodine deficiency vs overproduction of thyroid hormone in glands
174
what are T3 and T4 responsible for
regulating basal metabolism and increasing metabolic rate and protein synthesis
175
what type of disease is grave's
autoimmune
176
hyperthyroid complications we may see
pain at shoulder, frozen shoulder, muscle weakness, tachycardia, bulging eyes, skin lesions
177
what is an explicit sign of graves disease
exophthalmos: bulging eyes
178
what drug is common for hyperthyroidism
tapazole and propranolol
179
is hyperthyroidism or hypothyroidism easier to treat
hypo b/c can give hormones to increase levels
180
what can radioactive iodine do for thyroid cancer
gradual shrink tumor which will destroy the thyroid gland
181
what are 2 parts of PT CI for someone w/ thyroid disease
hot pool/hot pack (be careful), strenuous exercise b/c risk for heart problems
182
what is a major risk factor for graves disease
hip fracture
183
what is the most common type of hypothyroidism
hashimoto's thyroidits
184
what happens to someone w/ hashimoto's
thyroid is inflammted, auto-immune response, progresses slowly and is chronic
185
what is myxedema
untreated hypothyroidism that can cause swelling of the face
186
primary causes of hypothyroidism
hormone insufficiency, auto-immune disease, medications, congenital or iodine deficient
187
secondary cause of hypothyroidism
pituitary gland disease
188
where may someone w/ hypothyroidism experience pain
big toe= pseudo gout
189
what does parathyroid gland regulate
calcium and phosphorus
190
how many parathyroid glands do we have
4 glands located in the thyroid
191
secondary causes of hyperparathyroidism
kidney failure, not enough calcium, vit D disorder
192
s/s hyperparathyroidism
painful bones, renal stones, psychic moans
193
primary cause of hypoparathyroidism
insufficient secretion of PTH or accidental removal of gland during surgery
194
what can hypoparapthyroidism appear as
muscle weakness and pain, muscle spasm, cardiac arrhythmias
194
treatment for hypoparathyroidsm
IV or oral calcium w/ vitamin D
195
fasting glucose test levels
pre: <126, diabetes>126, normal <100
196
not fasted glucose test results
pre=<200, <140 normal, >200 diabetes
197
what type of diabetes produces more ketoacidosis
type 1
198
what is the job of insulin in cells
gets glucose into cells and inhibits glycolysis
199
average hypoglycemia level
<70 mg/dl
200
dangerous level of hypoglycemia
<45 mg/dl
201
is feeling sleepy associated w/ hyperglycemia or hypoglycemia
hyper
202
systemic related conditions of diabetes
artherosclerosis, infection, poor wound healing, alzheimer's
203
what is a contraindication for someone w/ diabetic reinopathy
vigorous activity
204
what is a concern with charcot joint
increase weight bearing where it's not used to being
205
anatomical and neurological changes with diabetes
thicker and stiffer tissue, increase in pain at low back, shoulder, neck, extremity, change in gait, change in pressure
206
goal A1C for patients
<7%
207
what med can mask hypoglycemia symptoms
beta blockers
208
what types of drugs can help control sugar by increasing the insulin in the blood
sylfonylureas, insulin, meglitinides
209
high intensity exercise for someone with diabetes
plasma glucose rises, less likely to have hypoglycemia during exercise, recovery is more challenging
210
how often should someone w/ diabetes aerobically exercise
<2 days b/w activity
211
what type of training should be performed first to prevent hypoglycemia
resistance training of all muscle groups
212
what needs to be combined to help manage glucose of patient w/ exercise
balance of medications and carb intake
213
if a patient doesn't have ketones can they exercise
yes, they can do moderate exercise as long as they don't have ketones
214
what is a good range of pre-exercise glucose level to get started
90-250 mg/dl
