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Fall > 311 Final > Flashcards

311 Final Flashcards

1
Q

What are the 4 basic steps in Hemostasis

A

Vessel injury
Vessel spasm
Platelets adhere to form plug
Insoluble Fibrin strands form and coagulate

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2
Q

Damaged cells initiating a series of complex reactions is called what

A

Coagulation cascade

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3
Q

What is the intrinsic pathway of a coagulation cascade

A

The activated response to injury

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4
Q

What is the extrinsic pathway in the coagulation cascade

A

Blood leaking out of vessels

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5
Q

What clotting factors are made by the liver

A

Prothrombi—-> thrombin
Fibrinogen

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6
Q

What vitamin is required for the liver to make clotting factors

A

Vitamin K

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7
Q

Patients with hepatic impairment usually have coagulation issues. T/f

A

T

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8
Q

How are coagulation disorders diagnosed

A

Prothrombin time (PT)
Activated partial thromboplastin time (aPTT)
Platelets.

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9
Q

What do anticoagulants and antiplatelets modify

A

They prevent clot formation

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10
Q

What do thrombolytics do

A

Removal of an existing clot by
Dissolving the clot

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11
Q

What are hemostatic and clotting factor concentrates used for ?

A

Promotion of clot formation.
Hemostatics = inhibition of fibrin destruction
Clotting factor concentrates= administration of missing clotting factors

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12
Q

Drugs that are used to prolong bleeding time and prevent thrombi are called what

A

Anticoagulants

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13
Q

Thumb therapy is usually initiated with what route

A

IV; then transitioned to PO

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14
Q

What are 4 primary anticoagulant drug classes?

A

Heparin
vitamin k antagonists
Direct thrombin inhibitors
Factor Xa inhibitors

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15
Q

What drugs are associated with DVT

A

Estrogens, hormaonal contraceptive, raloxifene (evista).

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16
Q

What lab value would you expect to monitor in someone who is receiving Heparin

A

aPTT

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17
Q

What is heparin overdose tx

A

Protamine sulfate

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18
Q

Can heparin be self administered?

A

Yes

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19
Q

Warfarin indications

A

MI, DVT, mechanical valves, strike prevention

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20
Q

What food should you avoid if taking warfarin?

A

Foods high in K: spinach, kale, turnip, broccoli

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21
Q

Where does hematopoiesis occur

A

Red bone marrow

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22
Q

What vitamins/ minerals are required for hematopoiesis?

A

Vitamin B, vitamin C, copper, iron.

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23
Q

What drugs are used for blood cell formation disorders?

A

Epoetin
Ferrous sulfate
Vitamin B

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24
Q

What is the black box warning for Epoetin (Epogen)

A

Increased risk of thromboembolis causing: TIA, MI, Stroke

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25
Q

What condition makes RBCs have a decreased capacity to deliver oxygen to tissues?

A

Anemia

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26
Q

What are three categories of anemia

A

Blood loss due to hemorrhage
Increased erythrocyte destruction
Decreased erythrocyte production

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27
Q

What is the classification of anemia generally based on

A

The description of the erythrocytes size and color

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28
Q

What are example of anemia classified as microcytic-hypochromic morphology with the description of small, abnormally shaped erythrocytes with decreased hemoglobin concentration

A

Iron deficiency anemia and thalassemia

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29
Q

What anemia is classified as macro-normochromic in morphology and described as large abnormally shaped erythrocytes with normal hemoglobin concentration?

A

Pernicious anemia and folic acid deficiency anemia

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30
Q

Signs and symptoms of anemia

A

Pallor
Fatigue
Lethargy
Dizziness/fainting
Chronic disease can result in HF

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31
Q

What is cyanocobalim (nascobal) used for and the side effects

A

To treat anemia.
It is IM or SQ
Side effects: hypokalemia, arthralgia, dizziness.
Pregnancy cat A

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32
Q

What disease manifests as lesions located in the stomach or small intestine

A

Peptic ulcer disease

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33
Q

Risk factors for peptic ulcer disease

A

Blood type O
Family hx
Smoking tobacco
Caffeine use
Drugs: aspirin, nsaids, corticosteroids, platelet inhibitors
Stress
Helicobacter pylori.

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34
Q

What pharmacotherapy is used for Peptic Ulcer disease

A

Proton pump inhibitor
H2- receptor antagonist
Antacids
Antibiotics
Miscellaneous drugs

35
Q

What drugs block enzyme responsible for secreting hydrochloric acid in the stomach

A

Proton pump inhibitors

36
Q

What drugs suppress the volume and acidity of parietal cell secretion

A

H2-receptor antagonists

37
Q

Should antacids be taken at the same time as H2 receptor antagonist?

A

No because absorption of the H2- receptor antagonist will be diminished

38
Q

Zantac (ranitidine) is what kind of drug. has what side effects, what should be monitored, and when should it be taken

A

H2- receptor antagonist
Headache
Monitor liver and renal fx
Take after meals.

39
Q

Side effects of proton pump inhibitors

A

Headache
Abdominal pain
Diarrhea
Nausea and vomiting
Long term therapy increases risk of osteoporosis (can interfere with ca absorption)

40
Q

When Do you want to take proton pump inhibitors

A

20-30 min before meals

41
Q

Will a patient feel immediate relief from proton pump inhibitors

A

No. It can take several days of therapy before patients gain relief from ulcers pain

42
Q

Which peptic ulcer drug decreases acid secretion the most

A

Proton pump inhibitors

43
Q

A patient with peptic ulcer disease associated with H. Pylori infection has what increased risk

A

Gastric cancer.

44
Q

What is the main administration guideline for antacids

A

Administer at least 2 hours before or after other drugs to decrease affecting other drugs absorption

45
Q

What is Lomotil used for

A

Anti diarrhea. It is an opioid one and most effective.

46
Q

Side effects of Imodium

A

Constipation, nausea, dizziness

47
Q

Alternating constipatation and diarrhea often occurs with what condition

A

IBS

48
Q

Examples of inflammatory bowel disease (IBD)

A

Crohns : ulcers in distal portion of small intestine.
Ulcerative Colitis: mucosal erosions in large intestine
Hyperactive immune response resulting in chronic intestinal inflammation.

49
Q

Is crohns a condition that affects the large or small intestine

A

Small

50
Q

Ondansetron (zofran) is what kind of drug, used for what, with what adverse effects

A

Serotonin receptor antagonist used for nausea
Adverse effects: it prolongs QT intervals leading to Dysrrhythmias,
Use cautiously with other QT prolonging drugs (haldol, Amiodarone)

51
Q

What condition occurs when digestive enzymes are not released into the duodenum and cause inflammation in surrounding tissues

A

Pancreatitis

52
Q

Causes for pancreatitis

A

Gallstones for women
EtOH for men

53
Q

Pancrelipase(creon) is used for what and what are administered guidelines

A

For patients that have insufficient pancreatic enzymes.
Give 1-2 hours before meals
Do not crush

54
Q

Vitamin D levels can be affected by what kind of drugs

A

Certain anticonvulsants

55
Q

What vitamin is given to promote clotting

A

Vitamin K

56
Q

When administering TPN what do you monitor and how long do you take the TPN out of fridge prior to using

A

Monitor glucose levels and 30 minutes prior to

57
Q

What hormone acts on the collecting ducts of kidneys to increase water reabsorption

A

ADH

58
Q

When water increases in the body what happens to the serum osmolality

A

It is reduced

59
Q

What hormones have receptors on nearly every cell in the body

A

Thyroid and insulin

60
Q

What is synthetic adh known as

A

Vasopressin (Vasostrict)

61
Q

A deficiency in adh results in what condition

A

Diabetes insipidus

62
Q

What condition is characterized by the production of large volumes of very dilute urine, accompanied by increased thirst and polyuria.

A

Diabetes insipidus

63
Q

What is desmopressin (DDAVP)

A

Synthetic form of adh for diabetes insipidus and nocturia

64
Q

What labs do you want to monitor when administering desmopressin

A

Sodium labs.

65
Q

What hormone increases BMR

A

Thyroid

66
Q

What systems does the thyroid gland affect

A

Cardio, respiratory, GI and neuromuscular

67
Q

What is the negative feedback system

A

Thyroid hormone low- hypothalamus secretes TRH- TRH stimulates anterior pituitary to secrete TSH- TSH stimulates thyroid to produce and secrete T3 &T4- blood levels of thyroid hormone increase and negative feedback suppresses secretion of TSH and TRH

68
Q

What does the adrenal cortex secrete

A

Glucocorticoids: cortisol
Mineralocorticoids: aldosterone
Gonadocorticoids: male androgens and small amount of estrogen

69
Q

What is used as replacement therapy for patients with adrenocortical insufficiency

A

Corticosteroids (glucocorticoids)

70
Q

What is important to monitor with corticosteroids

A

Blood glucose as it increases with this drug.

71
Q

What is administration guidelines for corticosteroids

A

Educate on the importance of taking this med at same time every day
Administer with food

72
Q

What is the difference between Cushings disease and Cushing’s syndrome

A

Disease- prolonged high level of corticosteroids present in body (from pituitary gland tumor producing excess amounts of ACTH)
Syndrome- high level of corticosteroids present in body. (From long term therapy with high doses of systemic corticosteroids)

73
Q

Symptoms of cushings

A

-Adrenal atrophy
-Moon face
-Osteoporosis
-Htn
-Acne
-Obesity in upper body
-Increased risk of infections and delayed round healing.

74
Q

Tests for diagnosing diabetes mellitis

A

Hemoglobin A1C at 6.5% or higher
Fasting plasma glucose of at least 8 hrs at 126 mg/dL or higher
Oral glucose test results of 200 mg/dL or higher.

75
Q

DKA primarily occurs in what type of patients

A

Type 1 diabetes

76
Q

Which diabetes occurs due to an autoimmune destruction of pancreatic beta cells resulting in a lack of insulin secretion

A

Type 1 diabetes

77
Q

What kind of syringes should you use for insulin admin

A

Only calibrated syringes

78
Q

What kind of insulin is humalog

A

Rapid
Sq
5-10 min prior to meals
Monitor electrolytes (maybe cause decreased serum k+, ca+, and mg

79
Q

What kind of insulin is Lantus

A

Long acting
Sq
Once daily same time every day

80
Q

Symptoms of hypoglycemia

A

Nausea, paleness, sweating, diaphoresis, tremors, irritability, headache, lightheaded, anxiety, decreased LOC

81
Q

Signs of hyperglycemia

A

Flushed, dry skin, polyuria, polyphagia, polydipsia, drowsiness, glycosuria, ketonuria, acetone breath and infection

82
Q

What is Metformin used for, mechanism of action.

A

For diabetes mellitis type 2; it decreases the production of glucose and reduces insulin resistance

83
Q

Can glargine be mixed with other insulins

A

No

Fall (13 decks)

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