1533 basics

Question 1

ECG Isoelectric line

Answer 1

baseline

Question 2

ECG P wave

Answer 2

atrial depolarization 0.12- 0.20 seconds

Question 3

QRS complex

Answer 3

ventricular depolarization (and atrial depolarization) less than 0.12 seconds

Question 4

Sodium restriction for HTN

Answer 4

less than 2.4g NA/day or less than 6g NaCl/day

Question 5

HTN drugs

Answer 5

stage 1- thiazide diuretic

Stage 2- add ACE Inhibitor, Angiotensin 2 receptor blocker, beta blocker or calcium channel blocker

Question 6

First TX for HTN

Answer 6

lifestyle changes- exercise, diet- DASH low sodium and fat, lose weight, less alcohol and less stress. then thiazide diuretic, stop smoking

Question 7

@ risk preeclampsia

Answer 7

First pregnancy, family or personal hx, obesity, age 40 y/o, multifetal gestation, poor outcome in previous pregnancy, previous HTN, Renal disease, Type 1 DM, Lupus, RA, scleroderma, clotting condition

Question 8

severe preeclampsia sxs

Answer 8

BP> 160/110, hyperreflexia, severe h/a, blurred vision, photophobia, irritability, epigastric pain, marked AST elevation, thrombocytopenia, serum creatinine elevation, decreased urinary output containing proteins. not severe- MAP over 105, but no other sxs or slight sxs, eclampsia- with seizure

Question 9

Left side CHF

Answer 9

vascular resistance and increased preload cause pulmonary edema and lowers CO- lowers peripheral perfusion. Sx: pink tinged sputum, paroxysmal nocturnal dyspnea, restless, confused, orthopnea, tachycardia, fatigue, cyanosis, lungs- crackles, wheezes cough, tachypnea. can’t lay down flat at night.

Question 10

Right side CHF

Answer 10

caused by chronic pulmonary probs or left side CHF. peripheral/ sacral/dependent edema, ascities- anorexia and GI discomfort, JVD, fatigue, enlarged spleen and liver

Question 11

MI EKG

Answer 11

T wave inversion- zone of ischemia- NSTEMI
T wave inversion with ST elevation- STEMI- zone of injury
Twave inversion with STelevation & abnormal Q (inversion)- STEMI zone of necrosis

Question 12

MVP manifestations

Answer 12

Mid systolic click and late systolic murmur, atypical chest pain, dizzy/ syncope, tachycardia, palpitations/ dysrhythmias, fatigues/weakness, hyperventilation, anxiety, depression, panic attacks.

Question 13

basic Graves

Answer 13

Hyperthyroidism

Question 14

Graves sxs

Answer 14

hyperthyroid. eye issues, anxiety/irritability, no concentration, emotional lability. fine tremor, weight loss, heat sensitivity and low grade fever- warm moist, sweaty skin. change in menstrual cycle, increase libido frequent BMs, increased appetite, increase heart and respiratory rate. goiter, decrease WBCs

Question 15

basic Cushings

Answer 15

``hypercorticolism

Question 16

Grave’s dermopathy

Answer 16

thick red skin usually on the shins or tops of feet

Question 17

exophthalmos

Answer 17

eye protrusion seen in graves. more likely if smoker

Question 18

Thyroid storm

Answer 18

risk with hyperthyroidism/ graves. increase in temp indicates onset. check temp q4h (at least). immediately report rise of 1 degree F. life threatening increase in temp and BP

Question 19

hyperthyroid tx

Answer 19

calm, stress free cool environment. meds- thionamides block thyroid hormone production by pretending iodine from binding. surgical removal (life long thyroid hormone replacement, watch for hypocalcemia from parathyroid damage!) or radioactive thyroid- destroys some of the thyroid -radiation precautions

Question 20

Thyroid storm

Answer 20

thyrotoxic crisis- hyperthyroid/ graves
sudden drastic increase in hormone from significant stress (surgery, illness, dental work)
sxs: fever (105+), sever tachycardia, restless, agitation, tremor, profuse sweating, diarrhea, vomiting, unconsciousness, coma, hypotnsn, heart failure
TX: sodium iodine solution, PTU, beta blocker, sedation, cooling measures, glucocorticoids and IV fluids

Question 21

myxedema

Answer 21

facial and periorbital edema causing puffiness mask like look to face- sx of long term hypothyroidism

Question 22

hypothyroid sxs

Answer 22

myxedema, cool dry skin, lethargy, mental impairment, reduced HR and temp, constipation, cold intolerance

Question 23

hashimoto specific

Answer 23

usually women age 30- 50. painful enlargement of gland along with dysphagia

Question 24

Akathisia

Answer 24

abnormal sensations

Question 25

Anomia

Answer 25

Loss of person or object names

Question 26

Aphasia or paraphasia

Answer 26

language impairment, receptive and expressive

Question 27

Ataxis

Answer 27

poor muscle control or movement

Question 28

Carphologia or Floccillation

Answer 28

involuntary picking at bedding or clothing

Question 29

Echolalia

Answer 29

repetition of words or sentences just spoken by another

Question 30

hypoglycemia sxs

Answer 30

polyphagia, jittery, diaphoresis- moist and clammy, palpitations-tachycardic, weakness, confusion, H/A

Question 31

hyperglycemia sxs

Answer 31

(hunger and tachycardia like hypoglycemia) poly uria, phagia, dypsia, weight loss, kussmauls, urine ketones, hot/dry skin