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part 2 Flashcards

(96 cards)

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1
Q

What is multiple sclerosis?

A

Central nervous system demyelination

Demyelinated areas inflame and scarring develops

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2
Q

Cause of multiple sclerosis?

A

Genetics
Autoimmunity
Regional variation
More common in females 20-40 years

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3
Q

Signs of multiple sclerosis?

A

Loss of coordination
Tremor
Fatigue
Memory loss

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4
Q

Treatment for multiple sclerosis?

A

Treat symptoms
Reduce frequency of relapse
Prevent disability

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5
Q

What is the main extracellular cation?

A

Na

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6
Q

What does sodium do?

A

Regulates osmotic forces

Regulated acid-base balance

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7
Q

Where is sodium mainly excreted?

A

urine output

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8
Q

What is hyponatremia?

A

Deficiency in sodium in blood <135mmol/L

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9
Q

What is the cause of hyponatraemia?

A

Vomitting, diarrhoea, excessive sweating

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10
Q

What are 3 main things hyponatraemia causes?

A

Reduced extracellular circulating volume: hypotension, tachycardia, decreased urine output
Osmotic swelling of cells: muscle twitching, weakness
Altered neuronal function: nausea, vomitting, lethargy

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11
Q

What is hypernatremia?

A

Increased sodium in blood >145mmol/L. Water moves from intercellular fluid to extracellular fluid

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12
Q

Signs of hypernatraemia?

A

Thirst
Decreased LOC
hypertension or tachycardia
Oedema

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13
Q

What causes hypernatraemia?

A

Water loss or sodium gain

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14
Q

What is potassium and what does it do?

A

It is a major intercellular cation
It regulates intercellular electrical neutrality
It is maintained by the sodium potassium pump
It is essential for transmission and conduction of nerve impulses, cardiac rhythm, and skeletal smooth muscle contraction

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15
Q

What is hypokalaemia?

A

Potassium level of <3.5mmol/L

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16
Q

Cause of hypokalaemia?

A

Reduced intake of potassium

Increased output of potassium usual through GI tract or urine

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17
Q

Signs of hypokalaemia?

A

Skeletal muscle weakness and leg cramps
Cardiac arrhythmia
Nausea, anorexia, abdominal distension
Hypertension

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18
Q

What is hyperkalaemia?

A

Potassium level of >5mmol/L (rare)

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19
Q

Cause of hyperkalaemia?

A

Increased IV intake
Decreased renal excretion
Cell trauma

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20
Q

Signs of hyperkalaemia?

A

Mild: tingling of lips and fingers, restlessness, intestinal cramping and diarrhoea
Severe: muscle weakness, loss of muscle tone, flaccid paralysis, cardiac arrest

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21
Q

What is the function of the kidneys?

A

Regulates body fluid and composition
Eliminates metabolic waste
Synthesis, release, activates hormones such as erythropoietin: stimulates red bone marrow to produce RBC, renin, vitamin D
Regulates BP

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22
Q

What is a nephron?

A

It is the functional unit of the kidney that filters blood to make urine. There are 1 million per kidney

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23
Q

Components of the kidney?

A 
Glomerulus
Proximal tubule
Loops of henle
Distal tubule
Collecting duct
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24
Q

What are the consequences of altered renal function?

A

Blocking of urine flow
Dilation of structures proximal to obstruction
Injury to renal anatomy

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25
Signs of altered urinary function?
Altered volume of excretion Haematuria Pain-dull: stretching if renal capsule sharp: relates to ureters or lower urinary tract N+V
26
Diagnosis of altered renal function?
Hx + physical exam Blood bichem analysis Imaging studies
27
What are kidney stones (nephrolithiasis)?
Renal calculi in the renal system which are solid masses caused from filtrate
28
Cause of renal stones?
Urinary stasis Dehydration Elevated urinary levels of salt, protein, calcium
29
What is renal failure?
Sudden rapid decline in renal function, retention of metabolic waste, usually associated with neohrotoxicity or hypovolaemia
30
Cause of renal failure?
Prerenal (ischaemic) Intrarenal (acute tubular necrosis) Postrenal (obstructive)
31
What is chronic kidney disease?
Irreversible loss of renal function that affects nearly all organ systems
32
Causes of chronic kidney disease?
Diabetes Smoking Hypertension CVD
33
Signs of chronic renal disease?
Increased bp Increased serum urea Increase creatinine Anemia
34
What is haemodialysis?
Using special filters to remove waste that the kidneys can no longer do on their own mechanisms of diffusion, osmosis and ultrafiltration
35
What is pyelonphretitis?
Kidney infection
36
Cause of kidney infection?
When bacteria enters the urethra and travels up the bladder into the kidneys
37
What is cystitis?
infection of the bladder
38
Who is at risk for kidney infections?
Woman Children Pts with diabetes Pts with kidney stones
39
Signs of a kidney infection?
Infection Pain when urinating Nausea Lack of appetite
40
Treatment for a kidney infection?
Fluids Genital area clean ABs Pain relief
41
What is insulin produced by?
Beta cells in the pancreas
42
What is insulin?
Insulin is an anabolic hormone It is required for the uptake of glucose by many cells: liver, muscle, adipose It promotes protein synthesis and formation/storage for lipids It facilitates transport of potassium, phosphate, and magnesium into cells
43
When does insulin increase?
When blood glucose, amino acids, glucagon and gastric increase
44
When does insulin decrease?
When there is low blood glucose, high insulin levels, alpha cell stimulation
45
What is diabetes mellitus?
A disease in which the body does not produce or respond properly to insulin type 1 or 2
46
What is type 1 diabetes?
autoimmune- the body's immune system destroys cells in the pancreas that produce insulin.
47
What are the signs of type 1 diabetes?
Polydipsia Polyuria Polyphagia Fatigue
48
Diagnostic criteria for type 1 diabetes?
Hx + physical exam Blood glucose levels:fasting and random Gycosylated haemoglobin
49
Treatment for type 1 diabetes?
Carbohydrates intake Exercise Insulin replacement therapy
50
What is type 2 diabetes?
Insulin resistance and decrease mass of B cells
51
Risk factors for type 2 diabetes
``` Overweight Unhealthy diet Metabolic syndrom Ethnicity Family hx ```
52
Signs of type 2 diabetes?
``` Often symptomatic but Visual changes Nephropathy Recurrent infection Neuropathy ```
53
Diagnostic criteria for type 2 diabetes?
Blood glucose level | Presence of long term complications
54
Treatment for type 2 diabetes?
Weight control- exercise. healthy lifestyle | Oral glycaemic agents: metformin
55
What are 3 acute complications of diabetes?
``` Hypoglycaemia Diabetes ketoacidosis (only in DM type 1) Hyperglycaemia hyperosmolar nonketotic syndrome (HHNK, only in DM type 2) ```
56
What are the sympathetic effects of hypoglycaemia?
``` Neuroglycaemia Hunger Fatigue Tachycardia Increased BP Palpitations Tremor Clammy skin ```
57
What are the neurological effects of hypoglycaemia?
``` Confusion Slurred speech Headache Nightmares Sleep disturbance ```
58
What is diabetes insipidus?
Unrelated to DM type 1 and 2 A disorder of salt and water metabolism marked by intense thirst and heavy urination. Caused by a lack of the anti diuretic hormone (ADH)
59
Where is ADH (arginine vasopressin) made + what does it do?
Hypothalamus, released into blood from pituitary gland | Circulated the blood and produces concentrated urine from kidneys
60
What occurs if your body does not produce enough ADH?
The kidneys produce large amounts of dilute urine and you become thirsty
61
What is the cause of diabetes insipidus?
Almost any disease affecting the pituitary region of the brain eg Pituitary tumors Trauma
62
What is a fluid deprivation test?
Blood and urine is monitored when pt is not drinking | ADH is then given to see if kidneys can respond to the hormone
63
How is diabetes insipidus treated?
Synthetic form of ADH hormone is given called DDAVP (Minirin) by nostril spray A tablet form of DDAVP is also available but is not as absorptive
64
Is tuberculosis life threatening?
Yes. It can cause haemorrhage from the lungs, although rare
65
How is tuberculosis spread?
Aerosolized droplets expelled during coughing by an individual with active disease
66
What is latent tuberculosis?
Inactive tb infection in the body that can take many years to develop
67
What are the symptoms of tb?
``` Coughing for 3+ weeks often with thick phlegm Tiredness Night sweats Weight loss Swollen glands usually in neck ```
68
How can tuberculosis be treated?
``` Four antibiotics for 6 months and if not cured, another 2-3 months: Isoniazid Rifampin Ethambutol Purazinamide ```
69
Who is NZ is able to have the fb vaccination? (BCG-Bacille Calmette-Guerin
Babies living in a country with higher rates of tb | Babies who may likely have contact with tb
70
What is cancer and what does it do?
A disease of the bodies cells Causes damage to genes that are involved in the process of replacing worn out or damaged cells Damaged genes cause cells to behave abnormally and they may grown into a tumour at a rapid rate
71
What do malignant tumours do?
They invade into surrounding tissue and form a secondary cancer or metastasis into another part of the body
72
What is metastasis?
cancer cells leaving a tumor and invading other parts of the body
73
How is cancer treated?
``` Chemo Surgery Immunotherapy Hormone treatment Radiation ```
74
What is rheumatic fever?
A disease that follows upper respiratory infection with Group A Beta haemolytic streptococci
75
How does rheumatic fever start?
With Group A strep throat
76
How to diagnose rheumatic fever?
Carditis Arthritis Chorea (jerky movements of the shoulders hips and face) Subcut nodules (Firm, painless nodules that appear symmetrically over bony prominences) Erythema marginatum (rash) Fever Arthralgia (pain in joints)
77
How does rheumatic fever affect the brain?
Rheumatic chorea. Due to inflammation of the basal ganglia. The condition is reversible
78
How does rheumatic fever effect the skin?
Subcutaneous nodules occurs over bony prominences and their structure is similar to Aschoff bodies
79
How to manage rheumatic fever?
``` Admission to hospital Confirmation of diagnosis Treat with AB's Clinical follow up Commence long term preventative measures ```
80
What are the long term measures of rheumatic fever?
Give Bicillan every month to prevent reoccurrence until age 21
81
What are the risks following having rheumatic fever?
``` HF AF Pulmonary hypertension Ineffective endocarditis Stroke Premature death ```
82
What is angina?
chest pain due to reduced blood flow to the heart caused by Myocardial ischemia and atherosclerosis
83
Common signs and symptoms of angina?
Heaviness and tightness in the chest | Discomfort in the back, shoulders, neck and jaw
84
How does GTN work?
By quickly relaxing the blood vessels allowing blood to flow more freely to the heart
85
Adverse effects of GTN?
Headaches Flushing Dizziness soon after use Hypotension
86
What other meds are used for angina other than GTN?
Long acting nitrates (ISMN) Beta blockers Calcium channel blockers
87
What is COPD?
Chronic obstructive pulmonary disease. An umbrella term for the progressive diseases emphysema, chronic bronchitis, chronic asthma. In pts with COPD, the airway is permanently obstructed and the tissue inside the lungs is damaged making it hard to breath
88
What occurs with emphysema?
The air sacs in the lungs are gradually destroyed so pts have difficulty absorbing enough 02
89
What occurs with chronic bronchitis?
The airways become narrower and have increased mucus production and inflammation
90
Symptoms of COPD?
Coughing Increased phlegm Breathlessnes
91
What is the main cause for COPD?
smoking
92
What is strep throat caused by?
Streptococcal bacteria- commonly from the cold and flu virus
93
What are the signs of strep throat?
Chills Fever Swollen lymph nodes in neck
94
How can strep throat be treated?
Antibiotics such as penicillin or amoxicillin
95
If left untreated, what can strep throat cause?
Rheumatic fever and kidney complications
96
Is strep throat contagious?
Yes it is spread by close contact with an infected person usually by inhaling airborne droplets from an infected person

STATE EXAM PREP (4 decks)

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