Review Flashcards
(151 cards)
1
Q
SPECT scan
A
extent of brain damage post stroke
2
Q
PET scan
A
parkinson’s, epilepsy, mental illness, heart attack
3
Q
laproscopy
A
abdomen & pelvis
4
Q
What two things effect metabolism of a pharmaceutical
A
age, immunity
5
Q
Pregnancy Categories A- B C D E
A
A- no risk B- no risk in humans C- indeterminate risk, benefits may outweigh risk D- high risk, benefits may outweigh risk E- contraindicated
6
Q
Controlled Substance Schedule I II III IV V
A
I- high abuse, no medical necessity
II- high abuse and dependency (opoids, amphetamines)
III- low abuse may cause dependence (steroids, analgesics, barbiturates, antidiarreal)
IV- low abuse, limited dependence (benzos)
V- low abuse, limited dependence (antitussive, anti diarrheal)
7
Q
Anthelmintic
A
kills parasites and their eggs
8
Q
anticholinergic
A
blocks parasympathetic nerve impulses
9
Q
Antidepressants (tricyclic, MAOI, SSRI, SNRI)
A
end in -ine
- fluoxetine (prozac)
- sertaline (zoloft)
10
Q
Common Anticoagulants
A
aspirin, heparin, warfarin (coumadin)
11
Q
Ma huang shouldn’t use used with MAOI because…
A
it intensifies the effect of medication and side effects (stomachache, headache, tremors, hypertension)
12
Q
Ren shen shouldn’t be used with antihyperglycemics, asprin, corticosteroids, digoxin, estrogen, MAOIs, opoids, warfarin
A
Increases hypoglycemia, increases bleeding, increases adverse effects of anti inflammatories, increases digoxin levels, intensify adverse effects of estrogen, can cause headaches, tremors, and manic episodes (MAOIs), reduces the effects of opoids, and increases bleeding
13
Q
Green Tea (lu cha) should be avoided with which medication
A
warfarin- increases thromboembolism
14
Q
Gan cao should be avoided with digoxin and diuretics because
A
with digoxin it decreases K+, and increases digoxin toxicity
- with diuretics it increases K+, wasting effects and interferes with effectiveness
15
Q
St Johns Wort should be avoided with digoxin, iron supplements, MAOIs, OCPs, protease inhibitors, SSRIs, Tricyclic antidepressants, and warfarin
A
Digoxin- increases toxicity
iron- reduces iron absorption
MAOIs- augments maois, can cause traumatic hypertension
OCPs- increases metabolism of drugs, reduces effectiveness
Protease inhibitors- reduces blood level and efficacy
SSRIs- augments effects of drugs
Tricyclics- augments effects
Warfarin- increases risk of thromboembolism
16
Q
Food-drug interactions- grapefruit
A
inhibits or slows metabolism of drugs
17
Q
Food-drug interactions- tyramine
A
can cause hypertensive crisis if taking MAOI
18
Q
Food-drug interactions- black tea
A
inhibits iron absorption
19
Q
Food-drug interactions- alcohol
A
impairs thiamin, niacin, pyridoxin
20
Q
Drug-mineral interactions: opoids, anticholinergics
A
decreases GI motility, constipation
21
Q
Drug-mineral interactions: diuretics (thiazides, corticosteroids)
A
depletes K+ (can lead to arrhythmia)
22
Q
Drug-mineral interactions: cortisol, aldosterone
A
increases sodium and water retention
23
Q
Drug-mineral interactions: birth control
A
impairs zinc and increases copper levels (can lead to dementia)
24
Q
Drug-mineral interactions: phenytoin, primidone
A
creates Vitamin B9 (folate) deficiency
25
Aminosalicyclic acid, slow release K+ iodide, colchicine, ethanol, OC
creates B12 (cobalamin) deficiency
26
High progestin dose
can cause depression by reducing tryptophan
27
Orlistat
prevents fat absorption
28
chloramphenicol, tetracycline
decreases protein
29
adrenal corticosteroids, ethanol
increases lipids
30
aspirin, colchicine, glucagon
decreases lipids
31
antibiotics, fiber, digoxin
decreases appetite
32
Hypernatremia (elevated Sodium levels)
Causes:
Sx:
Usually due to dehydration; excess diuretics w/ salt intake; N/V with high salt intake
Sx: confusion, neuromuscular excitability, hyperflexia, seizures, cerebrovascular damage with subcortical or subarachnoid hemorrhage
33
Hyponatremia (decreased sodium levels)
Causes:
Sx:
extrarenal fluid loss; renal fluid loss; diuretics; pancreatitis; rhabdomylosis; opioids, NSAIDS, Addisons disease, hypothyroidism
Sx: lethargy, confusion, altered mental status, stupor, hyperexcitability, hyperreflexia
RED FLAG- refer to ER immediately- saline drip, fluid restriction, removal of diuretics
34
Hyperkalemia (K+) (for muscle and cell contraction)
Causes:
Sx:
EKG
rhabdomylosis, GI bleed, bleeding ulcers
SX: flaccid paralysis, cardiac tonicity with weakness or paralysis (mostly asymptomatic)
Caution: ACE inhibitors, potassium sparing diuretics, urinary obstruciton, renal failure, heart failure
EKG: short QT wave which will be tall, peaked T wave
35
Hypokalemia (K+)
Causes:
Sx:
EKG
clay (betonite) ingestion, vomiting, heavy gan cao, chewing tabacco, CUSHINGS,
Sx: muscle weakness, cramping, paralytic ileus, hypoventilation, hypotension, rhabdomylosis
EKG: depression of T wave, elevated U wave
36
Hypercalcemia (calcium) (note: important for hormone release, blood coagulation, muscle and nerve contraction
Causes:
Sx:
Causes: pagets, osteoporosis, Vit A & D toxicity, Myxedema, Cushings, Addisons
Sx: constipation, polyuria, polydipsia, pancreatitis
37
Hypocalcemia (calcium)
Causes:
Sx:
Causes: hypoparathyroidism, Vit D xu, renal disease, acute pancreatitis, hypoproteinemia
Sx: carpopedal spasm, parasthesia of lips, fingers and feet, general muscle aching, facial spasms, dry scaly skin, brittle nails
38
Hyperphosphatemia (phosphorus)
Causes:
Sx:
Causes: hypoparathyroidism; rhabdomylosis
Sx: hypocalcemia, tetany, soft tissue calcemia
39
Hypophosphatemia (phosphorus)
Causes:
Sx:
Acute alcoholism, undernutrition, hyperparathyroidism, cushings, hypothyroidism, diuretic use, chronic fasting
Sx: anorexia, muscle weakness, osteomalacia, hemolytic anemia
40
Hypermagnesemia (Magnesium)
Causes:
Sx:
usually uncommon and/or asymptomatic
- respiratory depression, excess antacid use, excess laxative use
Sx: hyporeflexia, hypotension, cardiac arrest
41
Hypomagnesemia (magnesium)
Causes:
Sx:
alcoholism, steatorrhea, preeclampsia, lactation, thyroid hormone sue, ADH use, polyurea
Sx: anorexia, N/V, lethargy, weakness, personality change, tetany, carpopedal spasm
*caffeine can reduce Mg levels when using in excess
42
what can cause right upper quadrant pain
cholecystitis and billiary colic; hepatitis, retrocecal appendicitis (rare)
43
what can cause right lower quadrant pain
appendicitis, cecal diverticulitis, Meckel's diverticulitis (Crohns)
44
what can can cause left lower quadrant pain
sigmoid diverticulitis (ulcerative colitis)
45
What BMI is considered overweight
25-30%
46
What is a normal pH for saliva and what is it's function
6.5-7.5 - it moistens and lubricates
47
what is the pH for bile and what is it's function
digestion of lipids; 7.5-8.8
48
A patient comes to you complaining of shoulder issues with limited ROM. They also have extreme thirst, frequent urination, hunger, fatigue, numbness and tingling in the feet and candida. What is your diagnosis?
type 1 diabetes
49
What is the standard treatment for type 1 diabetes?
| What lab tests are done?
Tx: insulin (humalog)
Lab: HbA1C
50
Patient has dry flushed skin, ketonic breath, nausea and vomiting, cramping, polyuria, blurred vision and foggy head. What is your diagnosis
Type 2 Diabetes
51
What is the tx for type 2 diabetes?
| what is the lab test?
tx: insulin replacement- * Metformin
lab: HbA1C
52
a patient is sweating, nauseous, warm, has anxiety, palpitations, hunger, and a headache? what is their likely diagnosis?
Hypoglycemia
53
What is the treatment for hypoglycemia
glucagon
54
What disease is common in hispanic and african americans and is due to H. Pylori weakening the stomach lining
Peptic Ulcer
55
NSAIDS and Ethanol can cause pain, nausea, fullness, and bleeding -- what disease is this
gastritis
56
long term asprin use can lead to bleeding ulcers and need to be refered to a physician ASAP- what kind of ulcer is this
Gastric Ulcer
57
This disorder is caused by H Pylori (mostly) and causes consistent pain which usually awakens a patient at night
Duodenal ulcer
58
what does melena stand for
black tarry stools due to long term stomach or duodenum bleeding
59
Amoxil, Cipro, and Levaquin are what kind of common medication?
Antibiotics
60
what disease is a bacterial diarrhea due to undercooked poultry, milk, eggs or contact with reptiles
Salmonella
61
what disease is the 3rd most common bacterial diarrhea in the US transmitted person to person
Shigella
62
What disease has bloody diarrhea from undercooked beef, unpasteurized milk, juices; can also have watery diarrea, found commonly in nurseries
E. Coli
63
which bacterial disease is from undercooked seafood
Vibrio
64
Which bacteria disease is food born and usually found in cheese
listeria
65
What disease has sx of upper abdominal distention with postprandial fullness that is gnawing or burning; epigastric pain with nausea and vomiting.
What is the treatment?
Dyspepsia
| Tx: H2 blockers; PPIs
66
what is the route of transmission for Hep A
fecal-oral
67
what is the route of transmission for Hep B
blood
68
what is the route of transmission for Hep C
blood
69
what is the route of transmission for Hep D
needle
70
what is the route of transmission for Hep E
water (seen in africa)
71
What is the most common type of hepatitis in the medical field?
Hep B
72
What is the most common hepatitis in the world?
Hep A
73
What is the deadliest type of hepatitis
Hep C
74
What is your diagnosis for a patient with fever, fatigue, loss of appetite, nausea and vomiting, dark urine, CLAY COLORED STOOLS, joint pain, jaundice
Hep B
75
Crohn's
- area involved
- sx location
- S/S
- Imaging
Area: SI (in 80%)
Location: usually right sided
S/S: 75-85% can have rectal bleeding; fistula; 25-35% have perianal lesions
Imaging: asymmetrical and segmental (skip areas) on X Ray/ Barium Swallow
76
Ulcerative Colitis- area involved
- area involved
- sx location
- S/S
- Imaging
area: LI- descending section
Location: left sided
S/S: rectal bleeding; no fistulas, no perianal lesions
Imaging: symmetrical and uninterrupted bowel wall
77
What physical assessment test would you use to rule in/out appendicitis
McBurney's Point/Roving's sign
78
this disorder is usually due to stress however etiology unknown; gas bloating, cramping, bowel changes, constipation and diarrhea- seen most in females
IBS
79
This virus is most common causes of diarrhea in children and day care workers in america
Rotavirus
80
This disorder is very common in day care centers, international travelers, hikers and can be from consumption from unfiltered/treated water; spreads community wide. Its a parasite
Giardia
81
this parasite is water borne and resistant to chlorine (pool water)
Cryptosporidium
82
this type of worm/parasite is highly common in the US and causes loss of appetite, loss of weight, abdominal distention, anemia and intestinal bleeding
Hookworm
83
This worm/parasite is common in schools and day cares and can cause an itchy perineum
pinworms
84
this worm/parasite causes weight loss, abdominal distention, pain, diarrhea, and malnutrition
Tapeworm
85
this worm/parasite causes stomach pain, extreme fatigue, N/V, diarrhea, fever, headache, chills, swelling of eyes, cough, muscle aches, may have constipation, heart palpitations, dyspnea. Can mimic tertiary syphillis
Trichinosis
86
What are your water soluble vitamins
B1, B2, B3, B6, B12, Folate, Vit C
87
Vitamin B1 name
Thiamin
88
Vitamin B2 name
Riboflavin
89
Vitamin B3 name
niacin
90
Vitamin B6 name
pyridoxine
91
Vitamin B12 name
cobalamin
92
What does B1 deficiency result in
beriberi, wernicke-korsakoff syndrome
93
what does B2 deficiency result in
angular stomatitis (will have red tongue)
94
what does B3 deficiency result in
Pellagra (dermatitis, glossitis, GI and CNS dysfunction), will have red edges of tongue
Toxicity: flushing
95
what does Folate deficiency result in
megaloblastic anemia; neural tube defects
96
what does B6 deficiency result in
seizures, anemia, neuropathies, seborrheic dermatitis- looks like eczema
97
what does vit C deficiency result in
scurvy (bone defects, gingivitis, loose teeth, hemorrhages); will have a mapped tongue, and possible bone pain
98
What are your fat Soluble vitamins
ADEK
99
what does Vit A Deficiency result in
night blindness, xerophthalmia, keratomalacia; goose flesh skin, cataracts
100
What does Vit D deficiency result in
rickets (weakness and softening of the bones, Heberden nodules), osteomalacia
toxicity: anorexia, renal failure
101
What does Vit E deficiency results in
red blood cell hemolysis, neurologic deficits, dry scaly skin, follicular hyperkeratosis, alopecia
102
What does Vitamin K deficiency result in
bleeding, osteopenia
103
Diarrhea is usually caused by what deficiencies
protein, Vitamin B3, Folic Acid, Vitamin B12, K+
104
Alcoholism can lead to what deficiencies
magnesium, zinc, thiamin
105
Which leukocyte deals with bacteria (and some viruses)
Neutrophils
106
which leukocyte deals with allergic reactions (and worms)
Eosinophils
107
which leukocyte deals with histamine and heparin reactions
basophils
108
which agranulocyte (mononucleus WBC) becomes macrophages to ingest bacteria and also secrete lysine
monocytes
109
which agranulocyte (mononucleus WBC) is produced in the bone marrow and moves to lymph tissues- has two types: B & T Cells
lymphocytes
110
which agranulocyte (mononucleus WBC) produce immunoglobulins due to bacteria and toxins
B-Cells
111
which agranulocyte (mononucleus WBC) attach to antigen bearing cells like bacteria and kill toxins
T- Cells
112
this type of anemia has s/s like chronic bleeding, hx of aspirin/painkiller use, heavy menstruation, poor diet, trauma/surgery, IBD, peptic ulcer
Which lab tests would you order?
Iron deficiency anemia(microcytic)
Labs: H&H, TIBC, Iron (ferritin)
113
this type of anemia is d/t B12 deficiency, may have a beefy red, smooth red tongue w/o taste
pernicious anemia (macrocytic)
114
this type of anemia is the excessive destruction of RBCs due to: SLE (lupus)
What lab tests would you order?
Hemolytic
ANA, H&H, ABO-Rh
115
this type of anemia is when the bone marrow is unable to produce sufficient new cells
What labs would you order?
Aplastic
CBC, Bone Biopsy
116
How long can RBCs live for:
100-120 days
117
What is the function of RBCs:
transport oxygen, carbon dioxide, and nitric oxide
118
How long do WBCs live for
13 days
119
this type of anemia is primarily found in african americans and hispanics. S/S include: chest pain, numbness in hands and legs, syncope, fatigue, swollen hands or feet, jaundice, frequent infections, sore on the skin, delayed growth, stroke, seizure, breathing difficulty, spleen, liver, and lung damage
Sickle Cell
| its a form of hemolytic anemia
120
this type of anemia effects mostly mediterranean (and asian) heredity, is evident in infancy, will have freckled or bronzed skin with iron deposits, and slow growth
Thalassemia (a type of microcytic anemia- low MCV hypochromic)
121
this WBC disease has S/S such as: fatigue, dyspnea with exertion, splenomegaly, hepatomegaly, swollen lymph nodes, epistaxis, bleeding hums, chronic fever, unexplained weight loss, and bone pain.
leukemia
122
What is the universal blood recipient
AB
123
what is the universal blood donor
0
124
RBCs can be elevated due to
Polycythemia, renal disease
125
RBCs can be low due to
anemia, hodgkins lymphoma, sickle cell
126
HCT/HGB can be high due to
dehydration, shock, COPD, polycythemia
127
HCT/HGB can be high due to
dehydration, shock, COPD, polycythemia
128
HCT/HGB can be low due to
anemia, hyperthyroidism, trauma
129
WBC can be high due to
acute infection, leukemia
130
WBC can be low due to
bone marrow problems, immunodeficiency, AIDS, chemo
131
Iron levels could be low due to
acute hepatitis, nephrosis
132
iron levels could be low due to
anemia, RA, hypothyroidism, pregnancy (3rd tri)
133
BUN is high due to
renal pathology, GI bleeding, heart failure, high protein diet,
134
BUN is low due to
pregnancy, liver pathology
135
creatinine is high due to
renal pathology, hyperthyroidism
136
creatinine is low due to
muscle atrophy
137
uric acid is high due to
gout, arthritis, renal stones
138
uric acid is low due to
hypothyroid, ethanol
139
LDLs should be under what number
<100
140
High T4 is elevated in and low in...
high in hyperthyroid and low in hypo
141
MCH is elevated/low in ...
high in macrocytic anemia, low in microcytic anemia
142
Mean copruscular hemoglobin concentration is low in
iron deficiency anemia
143
ALT is very specific for testing/diagnosing what disease
Liver disease
144
what are some S/S for ordering an ALT test
hepatitis viral exposure, alcoholics, history of liver disease, obesity, PALE STOOL
Note: chronic hep may have low values; will have a greater than 1 in alcoholic hep and viral hep in acute stages
145
AST is a less specific test for hepatic disease but will be elevated in..
acute injury or acute skeletal or cardiac injury (MI)
146
AST S/S for ordering would include
long term medication use, obesity, diabetes. Pregnant women who have had muscle strain or medication injections may also have elevated AST
147
ALP (alkaline phosphatase) is high in
Bone disorders, liver disease
148
S/S for ordering ALP lab
osteomalacia, hepatitis, Pagets disease, rickets, sarcoidosis, blood type O or B= fatty foods
149
When AST/ALT are high and ALP are high it indicates
LV disease
150
When ALT/AST are low and ALP is high it indicates
bone disease or bone cancer
Note: if GGT is high with elevated ALP then bone disease is usually not the problem
151
GGT is indicative of
congestive heart failure, pancreatitis, liver disease, hepatitis, cirrhosis
Alcohol and smoking are most noted at causing elevated GGT for up to 24hrs
