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Other Systems Flashcards

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1
Q

Metabolic Syndrome criteria

A

3 or more of:
1. Waist Circumference >40 (M) or >35 (F).
2. HDL <40 (M) or <50 (F).
3. Triglyceride >150.
4. SBP >130 and/or DBP >85.
5. Glucose >100.

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2
Q

The anterior & posterior Pituitary Glands are controlled by…

A

Hypothalamus

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3
Q

Anterior Pituitary secretes what hormones? (Just list them)

A
  1. ACTH
  2. TSH
  3. FSH & LH
  4. GH
  5. Prolactin
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4
Q

Posterior Pituitary secretes what hormones? (Just list them)

A
  1. ADH & Vasopressin
  2. Oxytocin
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5
Q

ACTH stimulates…

A

Adrenal cortex to secrete Cortisol & Aldosterone

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6
Q

TSH stimulates…

A

Thyroid to secrete T3 & T4

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7
Q

FSH & LH stimulate…

A

Ovaries/Testes to secrete Estrogen, Progesterone, Testosterone.

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8
Q

GH stimulates…

A

Bone/tissue growth & metabolism

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9
Q

Prolactin stimulates…

A

Breasts to produce milk

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10
Q

ADH & Vasopressin stimulate…

A

Kidneys to retain water & manage water/mineral balance.

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11
Q

Oxytocin stimulates…

A

Uterine contractions & breast milk ejection

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12
Q

Cortisol functions

A

Glucose production
Regulates BP
Decrease stress
Decrease inflammation

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13
Q

Aldosterone functions

A

Retains Na & water
Kicks out K

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14
Q

Addison’s Disease definition

A

Adrenal insufficiency (not enough cortisol & aldosterone).

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15
Q

Cushing’s Disease definition

A

Elevated cortisol & aldosterone.

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16
Q

Addison’s Disease is caused by…

A

Infections
Tumors
Autoimmune

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17
Q

Cushing’s Disease is caused by…

A

Pituitary tumor = increased ACTH production

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18
Q

Addison’s Disease symptoms

A

Decreased glucose
Decreased BP
Weight loss
Poor tolerance to cold & stress
Bronze skin tone
Generalized weakness

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19
Q

Cushing’s Disease symptoms

A

Increased glucose
Increased BP
Weight gain
Infections, poor wound healing
Red skin
Moon face
Proximal muscle weakness
Osteoporosis

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20
Q

How do adrenal conditions affect potassium levels?

A

Addisons = hyperkalemia
Cushings = hypokalemia

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21
Q

Difference between Cushing’s Syndrome & Cushing’s Disease

A

Syndrome = problem at the adrenal gland. Only cortisol is elevated.
Disease = problem at the pituitary gland. Both cortisol and ATCH elevated.
Symptoms are the same.

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22
Q

Examples of HYPER-Thyroid conditions

A

Grave’s
Exophthalmos

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23
Q

Examples of HYPO-thyroid conditions

A

Hashimoto’s
Myxedema

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24
Q

HYPER-Thyroidisim: hormone levels

A

High T3 & T4
Low TSH

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25
HYPO-thyroidisim: hormone levels
Low T3 & T4 High TSH
26
HYPER-Thyroidisim: BMR
High
27
HYPO-thyroidisim: BMR
Low
28
HYPER-thyroidisim: HR & BP
HR high BP low
29
HYPO-thyroidisim: HR & BP
HR low BP high
30
HYPER-thyroidisim: glucose
Increased absorption Lower blood glucose levels
31
HYPO-thyroidisim: glucose
Decreased absorption Higher blood glucose levels
32
HYPER-thyroidisim: DTRs
Hyperreflexia
33
HYPO-thyroidisim: DTRs
Delayed/prolonged
34
HYPER-thyroidisim: symptoms
Diarrhea Silky hair Moist palms Increased sweating Restlessness, insomnia Heat intolerance
35
HYPO-thyroidisim: symptoms
Constipation Brittle, dry skin/hair Decreased sweating Proximal mm weakness Cold intolerance
36
HYPER-thyroidism increases risk of...
Osteoporosis Adhesive capsulitis
37
HYPO-thyroidism increases risk of...
Diabetes Adhesive capsulitis
38
Parathyroid function
Calcium & phosphate metabolism
39
HYPER-Parathyroid Conditions: serum calcium & phosphate levels
Calcium high Phosphate low
40
HYPO-Parathyroid Conditions: serum calcium & phosphate levels
Calcium low Phosphate high
41
HYPER-Parathyroid Conditions: symptoms
Osteopenia, gout, arthralgia. Kidney stones, renal insufficiency. GI ulcers. Fatigue, confusion. Weakness.
42
HYPO-Parathyroid Conditions: symptoms
Convulsions. Arrhythmias. Mm twitching/tetany. Mm spasms.
43
HYPER-Parathyroid Conditions: sensory changes
Glove & stocking loss
44
HYPO-Parathyroid Conditions: sensory changes
Fingers & mouth paresthesias.
45
Type 1 vs Type 2 Diabetes: definitions
Type 1: insulin dependent (pancreas does not PRODUCE insulin). Type 2: insulin resistant (body does not RESPOND to insulin).
46
Common symptoms of diabetes (both Type 1 and 2)
3 P's: Polyphagia (hunger), Polydipsia (thirst), Polyuria. Weight loss. Blurred vision. Dehydration. Ketoacidosis (rare with Type 2).
47
Diabetes diagnosis (lab values)
Fasting glucose >126 Random glucose >200 HbA1c elevated (normal = 4-6%).
48
When is immediate insulin therapy indicated?
HbA1c >10%
49
Hypoglycemia glucose level
<70
50
Hyperglycemia glucose level
>300
51
Hypoglycemia sxs
Early: tachycardia, irritable, restless, excessive hunger, dizzy. Late: slurred speech, confusion, loss of consciousness, coma. Mnemonic = cold and clammy, give them a candy.
52
Hyperglycemia sxs
Early: more exaggerated 3 P's, deep rapid breathing, diminished reflexes. Late: fruity odor breath, coma. Mnemonic = hot & dry means sugar high.
53
Exercise considerations w/ diabetes & insulin injections
-Avoid exercise during peak insulin hours (2-4hrs after dose). -OK to exercise 1hr after dose or 5hrs after dose. -Following exercise, next insulin dose should be decreased. -Injections in abdomen or non-active extremity.
54
Safest pre-exercise glucose levels
100-250
55
Avoid exercise if pre-exercise glucose levels are...
<70 or >300
56
What to do if pre-exercise glucose level is 70-99
Give 15g carb snack, re-check glucose after 10-15mins. Continue to give snacks every 20mins.
57
What to do if pre-exercise glucose level is 250-300
Exercise with caution, as long as not in ketoacidosis. No exercise if ketoacidosis.
58
Diabetes FITT
F: 3-7 days/wk. I: Moderate, RPE 11-13 (progress to 17). T: >150min/wk (progress to 300min/wk). T: Aerobic & large mm groups.
59
Diabetes foot care considerations
-Wash daily, but do NOT soak (bc risk of maceration). -Soft sole shoes. -Shoe shopping later in the day to ensure snug fit w/ swelling.
60
Stress Incontinence: definition, causes, & treatment
Definition: leakage when stress on pelvic floor (cough, sneeze, exertion). Cause: weak pelvic mm, typically d/t pregnancy. Treat: pelvic floor strengthening.
61
Urge Incontinence: definition, causes, & treatment
Definition: bladder contracts too much. Cause: infections, PD, UMN lesion. Treat: voiding schedule.
62
Overflow Incontinence: definition, causes, & treatment
Definition: underactive bladder (not contracting enough). Bladder fills too much & does not completely empty. Cause: diabetes, prostate enlargement. Treat: behavioral modificiation (e.g., double voiding).
63
Functional Incontinence: definition, causes, & treatment
Definition: unable to get to bathroom in time and/or can't remember to go. Cause: mobility, dexterity, or cognitive deficits. Treat: clear clutter, improve access, prompted voiding (e.g., alarms).
64
MSK changes with pregnancy
Weight gain 25-35lb. Forward head, kyphosis, lordosis, anterior pelvic tilt (continues postpartum w/ lifting/carrying baby). COM shifts upward & anterior. Relaxin.
65
Cardiopulmonary changes with pregnancy
Increased CO & blood volume. Decreased BP in 1st & 2nd trimester. Increased BP in 3rd trimester. HRrest increases 10-20bpm. Increased O2 consumption.
66
Positioning concerns w/ pregnancy
NO SUPINE after 1st trimester - risk of Supine Hypotensive Syndrome (compression of IVC = decreased CO). LEFT sidelying ideal - maximizes CO, limits IVC compression, decreases GERD.
67
Gestational Diabetes definition
DM during pregnancy. Same dx criteria as regular DM. Resolves post-partum.
68
Preeclampsia definition
Acute HTN during pregnancy in 3rd trimester (BP>140/90). EMERGENCY.
69
Eclampsia definition
Seizures after giving birth in patient with preeclampsia. EMERGENCY.
70
Sxs of preeclampsia
Increased protein in urine. Hyperreflexia. Headaches. Sudden weight gain. Edema.
71
How is a preeclampsia diagnosis confirmed?
After first abnormal BP reading, must have a second reading 4hrs later.
72
Key difference between preeclampsia & eclampsia
Eclampsia ALWAYS characterized by seizures. Preeclampsia MAY have seizures.
73
Pregnancy: contraindications to exercise
Medical History: -Hemodynamically significant heart disease. -Restrictive lung disease. -Severe anemia. -Uncontrolled Type 1 DM. Pregnancy-Related: -Incompetent cervix. -Vaginal bleeding. -Placenta previa. -Preeclampsia. -Premature labor (before 37wks).
74
Diastasis Rectus: how to measure
Do a curl-up (clear the scapula). Palpate the gap. (+) if >2cm.
75
Diastasis Rectus: treatment for 2-4cm
Stabilization & bracing. Start w/ head lifts. Progress to head lift + posterior pelvic tilts.
76
Diastasis Rectus: treatment for >4cm
Abdominal bracing & breathing exercises ONLY.
77
Diastasis Rectus: treatment for >6cm
Refer to MD
78
Diastasis Rectus: key consideration with exercise
NO VALSALVA Always exhale during ab contractions.
79
GERD: definition
Gastric contents reflux up into esophagus. Due to weak lower esophageal sphincter.
80
GERD: symptoms
-Heartburn (especially 30min after eating & when lying supine). -Dysphagia. -Sour taste. -Hoarseness. -Head/neck P!
81
GERD: how to differentiate from cardiac issue?
GERD pain relief with movement & exercise. GERD pain worsened by lying down. Cardiac symptoms would be opposite.
82
GERD: treatment
-Maintain upright as much as possible. -Sleep on L side. -Eat 3-4hrs before sleep. -Exercise 2-3hrs after eating. -Avoid: spicy, fatty, peppermint, chocolate.
83
Pancoast Tumor: definition & presentation
Upper lung tumor. Mimics TOS: pain refers to C8-T2 distribution & top of ipsilateral shoulder. Dyspnea. Coughing. Weight loss. Night pain.
84
Kehr's Sign
Procedure: supine, raise leg. (+) = pain with elevating leg. Indicates blood in abdomen, typically spleen rupture.
85
Hiatal Hernia: presentation
Diaphram weakness L shoulder P! Similar sxs to GERD
86
Hiatal Hernia: considerations post-surgical repair
NO VALSALVA. Avoid abdominal strengthening for 6-8wks.
87
Femoral Hernia: pain location
Lateral pelvic wall Groin
88
Inguinal Hernia: pain location
Groin
89
Umbilical Hernia: pain location
Mid-low abdomen
90
Cholecystitis (gall stones) symptoms & test
Pain: RUQ & R scapula. Agg: fatty foods. Nausea, vomiting, fever. Murphy's Sign: palpate subcostal angle while pt takes deep breath. (+) = pain/tenderness during inspiration.
91
Peptic Ulcers (gastric & duodenal) symptoms
R shoulder P! Burning/cramping in epigastric region. Coffee ground emesis. Dark tarry stool.
92
Gastric Peptic Ulcers: causes
-Chronic NSAID use. -Stress/anxiety. -H. Pylori.
93
Aggs of Gastric vs. Duodenal Peptic Ulcers
Gastric: presence of food (after eating). Duodenal: absence of food (in the morning, btwn meals).
94
Duodenal Peptic Ulcers: causes
H. Pylori
95
Treatment of Peptic Ulcers
Gastric: antacids Duodenal: medical treatment of H. Pylori infection
96
UC vs. Crohn's: inflammation characteristics
UC: large intestine & rectum, continuous. Crohn's: anywhere in GI tract, discontinuous.
97
UC vs. Crohn's: pain location
UC: LLQ Crohn's: RLQ
98
UC symptoms
-Bloody diarrhea -Mucous/pus -LBP -Weight loss -Fecal urgency
99
Crohn's symptoms
-Abdominal pain -Weight loss -Reactive arthritis -Passing gas = pain relief
100
Reactive Arthritis involves...
-Conjunctivitis -Urethritis -OA of LEs Mnemonic: can't see, can't pee, can't climb a tree
101
IBS: definition, causes, & presentation
Definition: spastic, nervous, irritable colon. Causes: stress/anxiety, high fat, lactose. Pain: LLQ. Ribbon-like stool. Relief w/ defecation.
102
Appendicitis presentation
RLQ pain Nausea, fever Elevated WBC
103
Tests for Appendicitis
All (+) if pain in RLQ. -McBurney's Point: pain when palpating RLQ. -Rosving's Sign: pain in RLQ when palpating LLQ. -Blumberg's Sign: pain when pressure released. -Psoas Sign: resisted R hip flex or passive ext. -Obturator Sign: resisted R hip ER or passive IR. -Hop Sign: hop on R leg. -Markle's Sign: stand on toes & drop suddenly. -Pinch an Inch: pinch skin & release.
104
Pinch an Inch Test
Pinch skin & release. For appendicitis: RLQ. For diverticulitis: LLQ. (+) = pain.
105
Signs of liver or pancreas issue
Dark colored urine Clay colored stool

NPTE (28 decks)

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