patho midterm Flashcards
(116 cards)
1
Q
respiratory acidosis
A
cause: shallow breaths/respiratory congestion
effect: increase CO2
compensation: kidneys->more H+ ions and reabsorb more bicarbonate
2
Q
metabolic acidosis
A
cause: shock, renal failure, diarrhea, diabetic ketoacidosis
effect: decreased bicarbonate
compensation: rapid breaths
3
Q
respiratory alkalosis
A
cause: hyperventilation
effect: decreased CO2
compensation: kidneys-> less H+ ions and reabsorb less bicarbonate
4
Q
metabolic alkalosis
A
cause: vomiting
effect: increased bicarbonate ion
compensation: slow, shallow breaths
5
Q
decompensation
A
compensation mechanisms fail, additional problems, or problems become more severe
LIFE THREATENING
6
Q
to treat imbalances…
A
treat underlying issue
7
Q
what role do OTs play in joint injuries
A
-ergonomics
-joint protection
-splinting
-massage
-various modalities
8
Q
what are the weight bearing precautions
A
NWB: non weight bearing
TTWB: toe touch weight bearing
FFWB: foot flat weight bearing
WBAT: weight bearing as tolerated (no extra weight)
FWB: full weight bearing
9
Q
what is compartment syndrome
A
-edema of the limb btwn. fascia
-ischemia/infarction may occur b/c of compression of arterial blood supply
-gangrene possible->amputation
-tight cast can cause this
10
Q
what is osteomyelitis
A
bone infection caused by bacteria or fungi
11
Q
s/s of osteomyelitis
A
-local inflammation and bone pain
-fever/excessive sweating
-chills
-general malaise
12
Q
treatment for osteo myelitis
A
-antibiotics
-possibly surgery
-WB precautions
13
Q
Dislocation
A
-separation of two bones at a joint
-significant soft tissue damage
-joint distortion
-may req. surgery
-trauma
14
Q
what is heterotopic ossicifcation (HO)
A
hardening/ calcification of bone in tissue where it does not normally exist
-post traumatic
-neurogenic
15
Q
what are treatments for HO
A
-passive ROM
-radiation
-surgery (staged)
16
Q
subluxation
A
-joint unaligned, not completely disconnected like dislocation
-common after stroke
-common with RA in multiple joints
17
Q
characteristics of bone tumors
A
-common site of secondary tumors from breast, lung or prostate
-most primary tumors, “sarcomas” are malignant
18
Q
what is osteosarcoma
A
-most common primary neoplasm of bone
-occurs in shaft of long bones of leg
-more common in children, adolescence and young adults
-warning sign: bone pain at rest
19
Q
what is Ewing Sarcoma
A
-malignant neoplasm
-common in adolescence
-occurs in diaphysis of long bones
20
Q
what is muscular dystrophy
A
degeneration of skeletal muscle over time
-group of inherited disorders (autosomal recessive, X-linked recessive/Duchennes)
21
Q
how can OT assist w/ MD
A
maximize function and adaptation
22
Q
what is diffusion
A
solutes from high -> low concentration
23
Q
what is osmosis
A
H2O from low -> high solute concentration
24
Q
what is filtration
A
H2O and solutes move across a membrane
high->low pressure (hydrostatic-“push”)
25
active transport
requires carrier molecules
26
causes of edema
- increased capillary hydrostatic pressure (increased BP), pulmonary edema
- loss of plasma proteins (albumin), decreased osmotic pressure
- obstruction of lymphatic circulation, localized
-increased capillary permeability
27
effects of edema
restricts ROM
reduced vital capacity
impaired diastole
impaired arterial circulation
dental complication
28
interventions for edema
address source: kidney, CHF, albumin
elevation
compression
mobilization of joints
massage
thermal modalities
kines. tape
29
purpose of lymphatic system
transport fluid
absorb proteins, fats, vitamins
recognize foreign cells, microbes, cancer cells
30
What is the difference between Hodgkin and non-Hodgkin lymphoma
Hodgkin: one lymph node that spreads to other parts of body
non-Hodgkin: multiple nodes, unorganized, wide spread
31
edema s/s
rapid onset
bilat./ symmetrical
clear fluid/blistery
deep pitting
shiny skin
(-) stemmer sign (will lift)
32
lymphedema s/s
slow onset
unilat./bilat. not symmetrical
non-pitting
thick skin
(+) stemmer sign (wont lift)
33
organs of lymphatic system
spleen, thymus, tonsils
34
what are common areas of lymphedema
extremities, head/neck, intestinal, genitals
35
what is complete decongestive therapy (CDT)
treatment for lymphedema.
includes:
manual lymphatic drainage
compression
skin care/education
exercise/mobility
36
what is lymphoma
-lymphatic tumors that are often malignant
-first signs: anemia, weight loss, weakness, fever
- painless enlargements of lymph nodes
37
what is phlebolymphedema
when lymphatic load exceeds the maximum transport capacity
38
what is myasthenia gravis
-an autoimmune disorder that affects the neuromuscular junction
-the immune system attacks and damages receptors in the muscle cells
39
symptoms of myasthenia gravis
-muscle weakness in face/eyes
-impaired vision
-head drops, arms weaker
-upper respiratory infections common
-can cause difficulty speaking, chewing and swallowing
40
Raynaud's Phenomenon
-sudden decreases in circulation in the digits
-usually in response to stress or temp. change
41
Characteristics of a first degree burn
-superficial (epidermis)
-dry, red, NO blisters
-3-7 days to heal
-example: sunburn
42
Characteristics of a second degree burn (SPT)
-epidermis and 1/3 dermis
-wet, blisters, red
-<2wks to heal
-example: hot metal
43
iatrogenic
relating to illness caused by medical examination or treatment
44
idiopathic
disease of unknown cause
45
Hypersensitivity reactions
type I: RAPID, allergies, can be genetic
type II: RAPID, cytotoxic (transfusion reactions, HOLD THERAPY)
type III: DELAYED, autoimmune conditions (SLE, AIDS)
type IV: DELAYED, cell-mediated (tissue matches, organ transplants, rash where contracted)
46
causes of cancer
abnormal cell division
genetics
carcinogens
age
environment
viruses
47
benign tumor characteristics
slow growing, encapsulated, expands but doesnt spread, similar to normal tissue, low mortality rate
48
malignant tumor characteristics
rapid growing, non-encapsulated, metastasizing, undifferentiated, high mortality if untreated
49
most common secondary cites for malignant tumors
liver, lungs, bone, brain
50
precautions during cancer treatment
treatment-related and neutropenic: to protect ourselves and from chemo and to protect pt who is immune compromised
51
what are the stages of lymphedema
0: latency
1: mild
2: moderate
3: severe
52
infection chain
agent: microbe causing infection
reservoir: environmental source, infected person/animal
portal of exit: leaves reservoir
mode of transportation: air, water, direct contact, food
portal of entry: access to new host
53
what are signs and symptoms of infection
local inflammation: pain, swelling, red, warm
systemic inflammation: fever, fatigue/weakness, headache
54
what is inflammation?
process that attempts to minimize injury to tissue, thus maintaining homeostasis
55
what is the process of inflammation
1. start with stimuli (trauma, toxins, virus, irritants, cell damage)
2. cell damage occurs
3. inflammation mediators are released
56
what are signs and symptoms of blood clotting disorders
-hematemesis: throwing up blood (coffee grounds)
-Hemoptysis: spitting up blood (usually from lungs)
-epistaxis: a bloody nose
-melena: dark stool (from higher up)
-anemia
-ecchymosis: black and blue (internal bleeding)
-hemarthrosis: blood in joints
-persistent bleeding
-low BP/faint/anxious (shock)
-rapid pulse
57
what are some causes of excessive bleeding
-thrombocytopenia (low platelets or defective function)
-low vit. K
-liver disease
-anticoag. meds
- hemorrhagic fever
-inherited defects
58
Characteristic of thrombocytopenia
-clotting disorder: bleeding from many small vessels
59
What are the OT implications for blood clotting?
-critically high INR/PT: high risk of hemorrhage w/functional mobility (especially with fall risk pt.)
-critically low INR/PT: high risk of thrombus formation (DVT/VTE)
*get clearance before mobilizing pt w/ critical values*
60
Characteristics of Hemophilia A
-most common inherited clotting disorder (mother->son)
-factor VIII: clotting factor needed to form prothrombin activator
-signs: bruising, deep muscle hemorrhage, nosebleeds, hematuria, brain bleed, joint bleeding, pain/joint deformity
-rx: prevent injury, avoid clot altering meds, factor VIII, DDVAP
61
define thrombus, thrombosis, embolus
-thrombus: stationary blood clot
-thrombosis: formation of a blood clot in blood vessel
-embolus: clot dislodges and circulates through the blood stream (pulmonary embolism)
62
what is cardiogenic shock
any type of heart failure where it cant pump blood effectivly
63
what is anaphylactic shock
acute allergic reaction (also blood vessel dilation)
64
what is septic shock
infectious agents release toxins into the blood (also blood vessel dilation)
65
what is not an appropriate intervention for a pt w/ an unruptured aneurysm
restrict to sedentary occupations (causes high BP)
66
what is claudication
-symptom of PVD
-pain caused by too little blood flow to muscles during exercise
67
what is an HLA
-antibodies in our tissues to recognize/differentiate btwn. self and non self
-impact on transfusions
68
what is neurogenic shock
widespread dilation of the blood vessels due to an imbalance in autonomic stimulation of smooth muscle
69
what is hypovolemic shock
-loss of blood volume in blood vessels
- hemorrhage
-loss of interstitial fluid
70
what is the therapeutic range for PT, PTT, INR
has to do with what anticoagulant meds the pt. is on
71
Characteristics of a second degree burn (Deep)
-epidermis and 2/3 dermis, hair follicles, sweat glands
->2wks to heal
-red/white, ruptured blisters
-most painful
-high infection risk
-example: flames/intense heat
72
Characteristics of a third degree burn
-full thickness including nerve endings
-surgery required
-no pain (only peripheral)
-dry, pale
-months to heal
-example: chemical
73
Characteristics of a fourth degree burn
-full thickness and underlying tissue
-surgery required, sometime amputation
-charring, no pain, peripheral nerve damage
-example: electrical
74
OT and burns:
avoid position of comfort, promote stretch of skin, mobility work
75
symptoms of Raynaud's Phenomenon
-pale in affected fingers, numbness, cyanosis
-when blood returns to digits they are dark, red, painful, swollen
76
what is circulatory shock
-failure of the circulatory system to adequately deliver O2 to the tissue
-caused by: reduced blood flow throughout vessels
77
what is arteriosclerosis
thickening of arterial walls, progress to hardening as calcium deposits form
-reduces blood flow to tissues
78
effects of arteriosclerosis
blocks arteries, weakens arterial walls, lumen narrows, loss of elasticity, increased BP
79
Causes of arteriosclerosis
diabetes, high fat and cholesterol diets, HTN, smoking, old age
80
what is atherosclerosis
most common type of arteriosclerosis
-blockage by lipids, fatty deposits become fibrous and calcified
81
What is treatment for arteriosclerosis or atherosclerosis
vasodilators, angioplasty, stents, surgically bypassed or replaced
82
What is the difference between MI and cardiac arrect
-MI (heart attack): occurs from heart block from blood clot, stops blood flow to heart
-cardiac arrest: sudden loss of heart function, stops blood flow to body, can be caused by MI, arrhythmia, drug overdoes, trauma
83
What is vitamin K's role in blood clotting
Vitamin K stimulates liver cells to increase the synthesis of prothrombin
84
What should OT do if pt. is getting transfussion
Hold treatment, patients nurses and doctors are looking for reactions in patient to transfusion
85
What are the components of the blood
plasma, buffy coat, formed elements
formed elements: RBC, WBC, platelets
86
what is hematopoiesis
generation of blood
87
what is scleroderma
-disease from overproduction of collagen
-hard, shiny, tight skin
-facial expression become hard
-unknown primary cause
88
what is septic shock
infectious agents release toxins into the blood (also blood vessel dilation)
89
what signs and symptoms would you see with someone with hypoalbumenia
fatigue, mental confusion, weakness
90
what are signs and symptoms of dehydration? over hydration?
-dehydration: decreased skin turgor
-overhydration: confusion/lethargy, seizures/coma (severe)
91
what are 3 common mechanisms causing edema
-obstruction of lymphatic circulation (retention of sodium in ecf)
-increased capillary blood pressure (hydrostatic pressure)
-decrease in concentration of plasma proteins
-increased capillary permeability
92
what are the bodies 3 lines of defense?
1st: non-specific, mechanical, skin/mucous membranes, tears and gastric juice
2nd: non-specific, phagocytosis, inflammation
3rd: specific, antibodies/cell-mediated immunity
93
characteristic of HIV
-RNA retrovirus
-attacks immune system and destroys WBC
-leads to AIDS if not treated
-transmitted through blood, sexual contact, , needles, breast feeding
94
what are the areas most affected by HTN
kidneys, heart, brain, retina
95
treatments of HTN
-lifestyle changes
-lower sodium intake
-weight reduction
-reduces stress
-drugs
96
what are initial signs of HTN
-fatigue
-malaise
-sometimes occipital HA
97
What can atherosclerosis cause in the heart
-Angina pectoris (ischemic heart attack->partial occlussion)
-MI (complete occlussion)
98
What can atherosclerosis cause in the brain
-TIA (partial occlusion)
-cerebrovascular attack (total occlusion)
99
what is an aneurysm
-can be caused by damage from arteriosclerosis
-section of artery abnormally widened due to weakened wall
-tend to burst which can cause hemorrhage or death
100
causes of a stroke?
-brain aneurysm: ischemia of brain tissue from a ruptured aneurysm
-severity is determined by location and amount of tissue
101
what is the route of circulation (systemic and pulmonary)
LV->blood into aorta->arteries->tissues/organ capillaries->veins->inferior (lower half) or superior (upper half) vena cava->RA->RV->pulmonary artery->capillaries (gas exhange)->venules (4 primary veins)->LA->LV
102
what is neurocytosarcosis
parasitic infection caused by larval cysts of the pork tapeworm
-epilepsy
-requires vector
103
What can atherosclerosis cause in the aorta
aneurysm (occlusion, rupture, hemorrhage)
104
What can atherosclerosis cause in the legs
PVD-> gangrene and amputation (iliac arteries)
105
what are the most common sites of PVD
-abdominal aorta
-carotid aorta
-femoral and iliac arteries
106
what is the process of gangrene from PVD
ischemia->infarction->necrosis->gangrene
107
what are factors for thrombus development
-stasis of blood or sluggish blood flow
-endothelial injury
-increased coag.
108
what is a DVT
deep vein thrombosis
-usually in femoral or popliteal veins
-can cause pulm. embolism, or stroke
109
what is a VTE
venous thromboembolus: a blood clot that is moving
110
what is orthostatic hypotension
-decreased BP, increased HR against gravity when getting up too quickly
-vessels do not constrict how theyre supposed to
111
what is a Homan's sign
pain in the calf during ankle dorsiflexion-may indicate a DVT
112
what is the treatment for DVT
-preventative measures (exercise/leg elevation)
-anticoag. therapy
-surgery (clot retrieval or inferior vena cava filter)
113
s/s of a DVT
-often unnoticed
-aching, sharpness, burning, tender in affected leg
-systemic: fever, malaise, leukocytosis
-*notify nurse or doctor if you notice signs*
114
what are the precautions with a DVT
initial bedrest
115
what is cellulitis
-most common lymphedema related infection
-caused by bacteria
-hot, red, tender. skin
-can lead to sepsis or death if untreated
-treatment: antibiotics
-trackable by drawing lines where it started
116
what is anigina pectoris and treatment
severe chest pain when myocardium is deprived of O2
rx: aspirin, coronary bypass/ angioplasty
