Adult Heath II -- Test 3

Question 1

Parkinson’s S/S

Answer 1

bradykinesia, resting tremor; rigidity; mental status (depression), postural instability

excess ACh – constipation, ortho HOTN, diaphoresis, flusing

Question 2

Parkinson’s Rx

Answer 2

Levodopa (dopamine precursor) and Carbidopa (inhibits peripheral conversion of levodopa = more for brain)

Question 3

Parkinson’s Rx A/E

Answer 3

dyskenisa, dystonia, on/off

Question 4

Drugs that cause PD-like Sx

Answer 4

antipsychotics (ie Haldol, lithium & others), antiemetics (ie Compazine), Reglan, antiHTN (ie reserpine, aldomet), illicit drugs (ie methamphetamines)

Question 5

Fall Precautions

Answer 5

PT for balance, low & locked bed, fall bracelet, don’t get up alone, bed alarm, non-skid footwear, no throw rugs, furniture w/ open pathways to walk

Question 6

Aspiration Precautions

Answer 6

HOB elevated before & after meal, lung sounds before & after eating, ensure not pocketing food in mouth, thickened liquids if needed, soft foods

Question 7

Paraplegia

Answer 7

injury occurring from T1 through L4 w/ paralysis of lower extremities

Question 8

Quadraplegia

Answer 8

– injury occurring from C1 through C8 w/ paralysis of all 4 extremities

Question 9

Emergency Care for SCI

Answer 9

maintain patent airway, immobilize on spinal backboard w/ head in neutral position w/ a C-collar to prevent an incomplete injury from becoming complete, prevent head flexion/rotation/extension, if severe cervical injury skeletal traction should be placed in the ER; always suspect SCI until ruled out, improper handling can cause further neurological damage/loss of function
Edema can extend up cord extending deficits, tx w/ methylprednisolone w/i 8hrs of SCI (not for penetrating injuries); enormous dosages

Question 10

Cervical traction

Answer 10

ALWAYS CONTINOUS, requires pin site care, assess for alignment, amount (lbs) will depend on level of injury, alignment & reduction obtained via x-ray, various types of tongs; in for 5 days then sx

Question 11

Halo traction

Answer 11

– high to mid cervical fractures w/o cord injury; teaching – 10-12 weeks, post op don’t raise HOB until ordered, walker, swivel chair, low heeled shoes, straws for drinking, sponge bath (no showers/baths), don’t use bars to move pt, don’t lift more than 10lbs, button up shirts

Question 12

C collar

Answer 12

post-sx: 2 collars (wear one wash the other), change collar in front of mirror, snug but not tight, should prevent nodding yes/no, complication: pressure ulcers

Question 13

Neurogenic spinal shock

Answer 13

acute SCI complication, ischemic event (lack of circulation) 30 min – 6 weeks; s/s – hypotension (tx w/ dopamine), bradycardia, warm/dry extremities, inability to regulate temp, areflexia below injury, no sensation/movement

Question 14

Hyperkalemia

Answer 14

acute SCI complication assess during first couple of weeks; loss of K from paralyzed muscle; tx w/ Kayexylate, diuretics if tolerated by hypotension, insulin

Question 15

Autonomic dysreflexia

Answer 15

potentially chronic massive sympathetic response to visceral stimulation that occurs after spinal shock resolved & reflex activity has returned, more likely w/ injuries above T5-6, disconnect b/w PNS & SNS, intact lower motor neurons sense painful stimuli below level of injury (ie full bladder); message trying to get to brain is blocked so looks for another route

Question 16

Autonomic dysreflexia S/S

Answer 16

sudden & severe HTN (250/180), pounding h/a, bradycardia, arterial dilation/flushed skin/sweating above T6, nasal congestion, cool skin/goose bumps below injury

Question 17

Autonomic dysreflexia Etiology

Answer 17

bladder/bowel distention, tight dressings, decubitus ulcers, anything that normally causes pain below lesion, PG

Question 18

Autonomic dysreflexia Tx

Answer 18

sit pt up (they are orthostatic), monitor BP, look for cause & alleviate it, vasodilators (apresoline, Procardia, nitroglycerin); teach pt to prevent

Question 19

Immobility hazards

Answer 19

pneumonia, DVT & decubitus ulcers – every system is compromised by bed rest; turn/cough/deep breathe often, meds, early mobility

Question 20

Back Tx

Answer 20

– brief bed rest (2 days – longer bedrest results in greater disability), PT including exercises (after acute pain subsides), ice/heat/massage, body mechanics, traction; meds – NSAIDs, opioids, muscle relaxants, steroids

Question 21

Myelogram – intro

Answer 21

– specialized x-ray; lumbar puncture below L3 & injection of contrast into subarachnoid space (can show bony overgrowth, spinal cord tumors/abscesses, HNP/pinched nerve)

Question 22

Myelogram – pre

Answer 22

allergies to contrast, kidney/thyroid/liver problems (inhibit excretion of contrast – BUN & creatinine), permit signed, pre-op drug, NPO at least 4-8hrs, d/c drugs that lower seizure threshold including: (phenothiazines ie Phenergan, TCA (ie Elavil), CNS stimulants, Glucophage, Demerol shouldn’t be ordered; d/c drugs that cause blood thinning ie ASA, NSAIDs, Plavix, Anticoagulants

Question 23

Myelogram – post

Answer 23

force fluids, low to semi-fowler’s, assess for voiding, assess LE movement, assess for spinal h/a, if outpatient need a driver

Question 24

Laminectomy – post

Answer 24

removal of entire lamina (sm bony plate on the back of the vertebrae) to relieve pressure on the spinal canal; post-op – always log roll, don’t ambulate or raise HOB w/o an order, always have draw sheet on bed, report any neuro deficit (ie motor loss, urinary retention, sensory loss), stool softener as ordered, assess wound, TCDB q2h, antibiotics ordered, avoid drugs that increase bleeding, pain mgmt., NSAIDs may not be ordered b/c want inflammation, don’t drive/check w/ MD, TLSO (thoracic lumbar sacral orthodesis ie brace) q3-6mos; complications – neuro deficit, retroperitoneal hemorrhage, CSF leak

Question 25

Cauda equina syndrome

Answer 25

complete/bilateral compression of lower lumbar & sacral roots (below conus medullaris) causing sensory & motor loss below level of lesion (flaccid LE, decreased DTRs, urinary & fecal incontinence or retention); sx emergency

Question 26

Five Ps

Answer 26

pain, pallor, polar, paresthesia, pulselessness, paralysis, perception, pressure

Question 27

Trigeminal neuralgia

Answer 27

unilateral facial pain d/t disease of sensory branches of trigeminal nerve (CN 5); s/s – burning, knifelike/lightninglike shock in trigeminal branches including lips, upper/ lower gums, cheek, forehead or side of nose, pain is abrupt & intense w/ unpredictable duration & recurrences; cause unknown but may be r/t trauma of jaw or ear/teeth infection; triggers – minimal stimulation by eating, brushing teeth, talking, cold blast of air

Question 28

Trigeminal neuralgia Tx

Answer 28

Meds - antiepileptic meds (ie carbamazepine, oxcarbazepine), antidepressants (ie Amitriptyline), muscle relaxants (ie baclofen) Sx – glycerol rhizotomy (chemical ablation), percutaneous rhizotomy (radiofrequency ablation), microvascular decompression, gamma knife radiosurgery (targeted radiation to site)

Question 29

Trigeminal neuralgia -- Nx

Answer 29

pain mgmt., response to drug tx, nutritional status, oral hygiene, teaching for sx prep, post-op care if residual deficits after sx (loss of sensory on that side), social isolation r/t uncertainty of pain events

Question 30

Bell's palsy

Answer 30

steroids for inflammation; antivirals if viral & doxycycline if Lyme’s disease

Question 31

Peripheral neuropathy

Answer 31

DM, vascular abnormalities, renal/liver failure, B12 deficiency, AIDS/other immune disorders, drug toxicity, infection, toxic substances (ie heavy metals), trauma

Question 32

Peripheral neuropathy S/S

Answer 32

muscle weakness w/ or w/o atrophy, pain that’s described as stabbing/cutting/ searing, paresthesia (ie tingling, burning, numbness), loss of sensation, impaired reflexes

Question 33

Peripheral neuropathy Tx

Answer 33

removal/tx underlying cause, neuropathic pain use: antiepileptic tx (ie gabapentin), antidepressants (ie nortriptyline), opioids; teaching – smoking worsens, elastic stockings to facilitate venous return, caution re extremity care (ie protect from burns/trauma/temp changes)

Question 34

Tetanus

Answer 34

severe polyradiculitis & polyneuritis affecting spinal & cranial nerves; causes – traumatic wound, dental infection, chronic OM, heroin injection, human & animal bites, open fractures; 100% fatal in severe form

Question 35

Tetanus S/S

Answer 35

stiffness in jaw (trismus) or neck, fever, tonic convulsions (opisthotonos), laryngeal & resp spasm causing apnea, overstimulation of sympathetic nervous system (diaphoresis, labile HTN, tachycardia, arrhythmias, hyperthermia);

Question 36

Tetanus Tx

Answer 36

– tetanus toxoid booster & tetanus immune globulin before onset of symptoms, control spasms w/ deep sedation (ie valium, barbituates, neuromuscular blocking agents ie vecuronium), penicillin or other antibiotics to tx infection; nursing mgmt. – prevention w/ Td booster q10yrs, immediate cleansing of wound w/ soap & H2O, acute – pain mgmt., quiet/dark room to prevent spasms/seizures, trach w/ mechanical vent, rehab; READ BOX IN BOOK ABOUT TETANUS

Question 37

Botulism

Answer 37

most serious type of food poisoning but also can be contracted through open wounds/ nasal inhalation, neurotoxin destroys/inhibits transmission of ACh leading to disturbed muscle movement;

Question 38

Botulism S/S

Answer 38

n/v, abdominal cramping, neurologic manifestations (difficulty in convergence of eyes, photophobia, ptosis, paralysis of extraocular muscles, blurred/double vision, dry mouth, sore throat, difficulty swallowing), other symptoms (paralytic ileus, muscle weakness, seizures, resp problems/resp arrest);

Question 39

Botulism Tx

Answer 39

botulism antitoxin IV, GI tract purges (non-Mg laxatives, enemas, lavage w/ charcoal); nursing mgmt. – prevention w/ proper food prep, vent support if needed, care of pt w/ altered mobility

Question 40

Functions of kidney

Answer 40

Regulatory – maintain body fluid vol & composition, filter waste products for elimination, acid-base regulation Hormonal – regulate BP (through Renin), Erythropoietin (RBC Synthesis), metabolize Vit D to active form

Question 41

Kidney terms

Answer 41

Oliguria – decreased urine output to b/w 100-400mL/24hr; 30mL/hr or 720mL/24hrs is normal Anuria – no urination (total output less than 100mL/24hr) Dysuria – painful urination Nocturia – waking from sleep d/t need to urinate Polyuria – output greater than 2000mL/24hr Uremia – full blown renal failure; collection of metabolic wastes in the bloodstream

Question 42

Urinalysis

Answer 42

ideal is 1st morning void, color/odor/turbidity, specific gravity; normal = amber yellow, pH 4-8 (average 6), specific gravity 1.003-1.030, RBC 0-4, WBC 0-5, no glucose/ ketones/bilirubin, few casts, bacteria less than 10k/mL; urinalysis doesn’t have to be sterile

Question 43

Urine culture

Answer 43

done when urinalysis is abnormal (ie WBC, leukoesterase or nitrites) or symptoms of UTI, needs to be clean catch or catheter derived specimen

Question 44

BUN

Answer 44

measures renal excretion of urea nitrogen (by-product of protein metabolism in liver); elevation may or may not indicate renal disease (other factors taken into account ie varies according to hydration, trauma can elevate); normal 6-20

Question 45

Serum creatinine

Answer 45

end product of muscle & protein metabolism filtered by kidneys & excreted in urine (muscle mass & metabolism are usually constant so this is a good indicator of kidney function); normal less than 1.3 (any elevation is important)

Question 46

KUB

Answer 46

kidneys/ureter/bladder x-ray (shows structures of urinary tract system but it’s a flat plate of whole abdomen)

Question 47

IVP

Answer 47

contrast x-ray of kidneys to look at renal system

Question 48

Bladder scan

Answer 48

portable u/s to see how much urine is in the bladder to determine if catheterization is necessary; verify empty bladder, post void residual (over 150mL after voiding will probably cath them)

Question 49

24 Hr Urine Collection

Answer 49

for Creatinine of other collections ie NaCl, Ca, other electrolytes; 24hr urine collection; throw away 1st void at 10am then collect all specimens until 10am next day & save that last urine, may need to store on ice, start over if contaminated

Question 50

Creatinine clearance

Answer 50

better indicator of kidney function (approximates GFR); normal = 70-135mL/min

Question 51

Cystoscopy

Answer 51

looks into bladder for infections, tumors, sources of bleeding, structural problems, etc; post-procedure will have pink tinged urine so increase fluids; contraindications – acute UTI, severely enlarged prostate

Question 52

Cystitis

Answer 52

inflammation or infection of bladder; s/s – frequency, urgency & dysuria are prime symptoms but can also have cloudy/foul smelling/blood tinged urine, older adults may present w/ confusion

Question 53

Cystitis Dx

Answer 53

urinalysis (100k+ organisms, positive for leukoesterase & nitrites, presence of WBC & RBC, urine culture/sensitivity confirms organism & antibiotics needed)

Question 54

Cystitis Tx

Answer 54

urinary antiseptics or antibiotics X3days (ie cipro, Bactrim), analgesics (ie pyridium which stains body fluids), antispasmodics (ie anaspaz)

Question 55

Pyelonephritis

Answer 55

acute/active infection of kidneys (often can be ascending infection); s/s – low-grade fever, chills, N&V, flank pain or CVA tenderness, cystitis symptoms

Question 56

Pyelonephritis Dx

Answer 56

urinalysis & culture, elevated WBC, blood cultures, KUB, u/s for anomalies

Question 57

Pyelonephritis Tx

Answer 57

Bactrim or Cipro usually 14-21 days, f/u culture after tx, sx repair of anomalies

Question 58

Glomerulonephritis Intro

Answer 58

immune complex deposition (antibody-antigen & complement) w/i glomeruli leads to inflammation & ineffective renal filtration ability ie SLE, post-strep infection; s/s – proteinuria, hematuria, generalized edema & other symptoms of fluid overload, elevated BP, elevated BUN & Creatinine (not infection symptoms!!!!); best way to evaluate pt’s fluid status = BP & daily weights

Question 59

Glomerulonephritis Dx

Answer 59

assess for previous often Group A Strep infection, urinalysis, BUN & creatinine, testing for immunological reactions (ie ANA, IgG, C3 complement levels), renal biopsy

Question 60

Glomerulonephritis Tx

Answer 60

symptomatic/supportive care, antibiotics if infection, mg fluid overload w/ Na & H2O restriction/diuretics, diet restriction of protein & Na, oliguria can lead to increased K which needs tx, antihypertensives, may need plasmaphoresis to remove immune complexes or short-term dialysis

Question 61

Renal cancer

Answer 61

may have no symptoms, early sign = painless hematuria, palpable mass, dull flank pain, general malignancy symptoms (weight loss, anemia, fatigue)

Question 62

Renal cancer Dx

Answer 62

urinalysis (r/o other urinary problems), CT/MRI/US, renal biopsy

Question 63

Renal cancer Tx

Answer 63

nephrectomy (remove kidneys, adrenal gland, fat & lymph nodes), radiation, chemo (if metastatic), immunotherapy (biologic response modifiers)

Question 64

Bladder cancer S/S

Answer 64

may have no symptoms, early sign = painless hematuria, palpable mass, dull flank pain, general malignancy symptoms (weight loss, anemia, fatigue)

Question 65

Bladder cancer Dx

Answer 65

urinalysis (r/o other urinary problems), CT/MRI/US, renal biopsy

Question 66

Bladder cancer Tx

Answer 66

nephrectomy (remove kidneys, adrenal gland, fat & lymph nodes), radiation, chemo (if metastatic), immunotherapy (biologic response modifiers)

Question 67

Renal / Urinary calculi

Answer 67

stones in urinary tract (a lot of stones contain Ca), strong family & personal hx

Question 68

Renal / Urinary calculi Dx

Answer 68

severe flank/abdominal pain aka renal colic, N&V, pallor, diaphoresis; dx – urinalysis usually shows hematuria & crystals, KUB/CT/US; nursing mgmt. – pain, hydration, strain urine for stones

Question 69

Renal / Urinary calculi Tx

Answer 69

different procedures for stone removal

Question 70

Causes of ARF

Answer 70

inadequate kidney perfusion ie shock, PE, anaphylaxis (prerenal failure #1 cause), damage to glomeruli/interstitial tissue or tubules ie infection/drugs/cancer (intrarenal failure), obstruction of urine flow ie ureter stone (postrenal failure)

Question 71

Phases of ARF -- Onset

Answer 71

Onset – begins w/ precipitating event (ie blood loss = hypotension from trauma) & continues until oliguria, may see elevated BUN & creatinine; can occur over several hrs-days

Question 72

Phases of ARF -- Oliguric

Answer 72

output less than 400mL/24hr that doesn’t respond to fluid challenges or diuretics; elevated BUN & creatinine, hyperkalemia, hyperphosphatemia, hypermagnesemia

Question 73

Phases of ARF -- Diuretic

Answer 73

high output phase occurs after correction of precipitating event when renal tubular function is reestablished; BUN begins to normalize; usually occurs 2-6 weeks after onset

Question 74

Phases of ARF - Recovery

Answer 74

renal function continues to improve although may never reach pre-illness levels

Question 75

ARF Dx

Answer 75

creatinine & BUN elevated & continue to increase at same pace (can get really high ie creatinine 6mg & BUN 100), K & phosphorus increased, Ca decreased, specific gravity usually decreased & fixed at 1.010 (inability of tubules to produce concentrated or dilute urine), creatinine clearance, alteration in ABGs (ie metabolic acidosis is the main thing)

Question 76

ARF Tx

Answer 76

correct cause then tx major problems of compromised fluid vol regulation & electrolyte imbalances w/ drugs (diuretics, dopamine gtt, Ca channel blockers to promote renal blood flow), diet, renal replacement tx w/ dialysis, fluid challenge w/ NS

Question 77

ARF dialysis

Answer 77

temporary hemodialysis (using temp access port in subclavian or jugular vs fistula used for CRF), peritoneal dialysis, continuous renal replacement therapies (pts are too hemodynamically unstable for HD)

Question 78

ARF and CRF diet

Answer 78

restrict protein, Na, K & fluids; admin Fe/Ca/Vit D, may need to tube feed/TPN if to ill for oral

Question 79

ARF risk factors

Answer 79

– DM, HTN, glomerulonephritis, PKD, systemic disease (ie Lupus), ARF that doesn’t resolve

Question 80

CRF risk factors

Answer 80

– DM, HTN, glomerulonephritis, PKD, systemic disease (ie Lupus), ARF that doesn’t resolve

Question 81

CRF Stages -- diminished renal reserve

Answer 81

diminished renal reserve – no accumulation of metabolic wastes b/c nephrons in overdrive to compensate but creatinine clearance may show some changes

Question 82

CRF Stages -- renal insuffiiciency

Answer 82

unaffected nephrons damaged by increased pressure leading to symptoms w/ elevated BUN & creatinine; end stage renal disease (ERSD) – no functioning nephrons = need dialysis

Question 83

ESRD -- renal insufficiency

Answer 83

BUN & Creatinine increasing, kidneys lose ability to concentrate, polyuria & nocturia, h/a, mild anemia, weakness & fatigue

Question 84

ESRD S/S

Answer 84

BUN & creatinine significantly increased, specific gravity fixed at plasma level (1.010), oliguric, dialysis necessary, sallow/yellow discoloration of skin, uremic frost, pruritus, CNS depression, peripheral neuropathy, psychological changes (withdrawal, depression, psychosis), elevated BP, CHF, pericarditis, anorexia, N&V, GI bleeding, PUD, constipation, hyperglycemia, hyperlipidemia, anemia-bleeding, hyperparathyroid, amenorrhea, infertility, impotence, gout, GFR less than 10%, renal osteodystrophy; uremia – collection of metabolic wastes in bloodstream w/ development of clinical symptoms

Question 85

ESRD -- uremic syndrome

Answer 85

hyperparathyroidism, glucose intolerance, pulmonary edema, Kussmaul’s respirations, proteinuria, hematuria, nocturia, oliguria, fixed specific gravity, anorexia, N&V, gastroenteritis, hiccups, abdominal pain, GI bleeding, PUD, osteodystrophy, bone pain, spontaneous fractures, diminished leukocyte count & increased susceptibility to infection, apathy, lethargy, h/a, impaired cognition, insomnia, restless leg syndrome, gait disturbances, paresthesias, seizures, decreased LOC, coma, HTN, CAD, dysrhythmias, pericarditis, pericardial effusion, cerebrovascular disease, CHF, anemia, impaired clotting, amenorrhea, impotence, spontaneous abortion, pallor, uremic skin color & frost (yellow green), dry skin, poor turgor, pruritus, ecchymosis, azotemia (big time uremia), edema, hyperkalemia, hyperphosphatemia, hypocalcemia, hypermagnesia, acidosis, hyperlipidemia, hyperuricemia, malnutrition

Question 86

CRF ABNORMAL LAB VALUES

Answer 86

``` creatinine < 1.3 BUN 6-20 Hgb/Hct (11-17/35-50%) Na, K, Mg (1.5-2.5) Ca (8.6-10.2) Phosphorus (2.4-4.4) Bicarb (22-26) Urine proteins (should be none) ```

Question 87

CRF Tx

Answer 87

control of HTN/anemia/electrolyte imbalances – diuretics for fluid retention & HTN early on in renal insufficiency (not ESRD), dialysis, renal transplant; anemia – colony stimulating factors (Epogen/Procrit)

Question 88

Assess AV fistula

Answer 88

(aka shunt) – auscultate bruit & palpate for thrill to ensure adequate circulation; also no BP/blood draw in fistula arm

Question 89

Peritoneal dialysis -- Nx

Answer 89

daily weight, strict aseptic technique (mask & sterile gloves), hand washing, monitor I&O; after draining: assess color (should be yellow like urine), consistency of flow (if decreasing elevate HOB/turn), if cloudy/fibrinous clots notify MD, check catheter site, assess for pain; complications

Question 90

Peritoneal dialysis -- peritonitis

Answer 90

fever, persistent abdominal pain & cramping, slow/cloudy dialysis drainage, increased WBC, swelling/tenderness around catheter

Question 91

Dialysis -- DRUGS TO AVOID

Answer 91

usually don’t give AM meds b/c will get dialyzed out, give after dialysis; avoid drugs that cause hypotension prior to dialysis

Question 92

Exclusions for Renal Transplant

Answer 92

older than 70, unresolved malignancies, active infectious process, HIV+, cirrhosis/hepatitis, substance abusers, COPD, LVEF less than 20%, BMI greater than 35, psychosocial/behavioral abnormalities

Question 93

BPH S/S

Answer 93

voiding symptoms including: difficulty initiating stream, reduced force of urinary stream, intermittency, dribbling urine, sensation of incomplete bladder emptying, frequency, urgency, nocturia; potential complications: acute urinary retention, UTI: phyleonephritis (inflammatory or infectious), sepsis, backflow leading to hydronephrosis & renal failure

Question 94

BPH Dx vs prostate cancer

Answer 94

DRE – BPH presents as uniform, elastic, non-tender enlargement vs cancer presents as stony-hard nodule PSA – elevated in both BPH & Prostate Ca; normal = 4-10ng/mL, greater the # larger the tumor Creatinine & BUN – renal complications If Abnormal DRE & PSA: KUB – to evaluate renal system; IV pyelogram – contrast x-ray of kidneys to look at renal system; Cystourethroscopy – cystoscope to view urethra, bladder neck & bladder; Bladder scan – to assess postvoid residual

Question 95

BPH conservative care Nx

Answer 95

watch & wait to see if causing urinary difficulties; dietary changes – avoid ETOH/caffeine/lg amounts of fluids in short time/drinking fluids 2-3hrs before bedtime; avoid meds that can cause urinary retention (decongestants, anticholinergics ie scopolamine, atropine)

Question 96

TURP transurethral resection of prostate

Answer 96

post op care w/ continuous bladder irrigation – tissue is removed & coagulated (to reduce pressure on urethra), irrigation solution carries out debris; bleeding is a common complication (assess clotting factors pre-op); post-op – clots normal 24-36hrs, hematuria

Question 97

CBI continuous bladder irrigation

Answer 97

NS irrigation 24hrs after TURP adjusted to maintain colorless or light pink drainage return, tape cath to leg to provide gentle traction, balloon at end of catheter is pulled down into prostatic tissue removal area to put pressure on area & maintain hemostasis; complications – potential hemorrhage, bladder spasms (tx w/ antispasmodics ie oxybutynin/Ditropan)

Question 98

Hormonal therapy for Prostrate Cancer

Answer 98

estrogens inhibit release of LH from pituitary which stops hormone stimulation to prostate (ie Megace or Depo-Provera)