ATI sample test NOTES Flashcards

1
Q

Cranial nerves

A

01 Olfactory (smell)

02 Optic (vision)

03 Oculamotor (lift eyelid)

04 Trochlear (turns eye)

05 Trigeminal (3 branches: Opthalmic, maxillary, mandibular)

06 Abducent (turn eye laterally)

07 Facial (expressions)

08 Vestibulocochlear (balance and hearing)

09 Glossopharyngeal (temp, pressure on tongue)

10 Vagus (taste and constrict muscles after swallow)

11 Spinal accessory nerve (

12 Hypoglassal nerve

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2
Q

Where there is neuro changes, how will changes progress?

A
  1. LOC (earliest sign of change!)
  2. then posturing, VS and focal neuro signs follow
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3
Q

Diabetes Insipidus

A

Can be a result of damage to hypothalamus or pituitary gland as a resut of surgery, infecin or tumor from cranial surgery

  • there will be inadequate ADH released
    • lead to POLYURIA
    • extremely low urine specific gravity (b/c so diluted 1.001 to 1.003)
      • *note > 1.03 = hypovolemia which occurs
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4
Q

Lab signs of Meningitis

A
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5
Q

Acute angle closure glaucoma

Open angle glaucoma

Cataract

Retinal detachment

A

Acute angle closure glaucoma

  • severe pain in affected eye, blurred vision, and bulging, increased IOP may cause N/V

Open angle glaucoma

  • vision is gradually lost, peripheral. No pain.
  • dilation increases IOP, no pseudoephedrine
  • mitoics reduce the pupil, but cause impaired night vision
  • laser surgery is helpful to reestablish flow of aqueous humor

Cataract

  • clouding of the lens of eye (over black pupil), can cause blindness
  • introcular lens implant is necessary
    • after avoid lifting, bending, coughing, valsalva

Retinal detachment

  • retina at back of eye pulls away (EMERGENCY!!!)
  • Will see sudden floaters, flashes of light, and then shadow or curtain of vision field as it progresses
  • Scleral buckle needed
    • a gas bubble is injected a applies pressure to back of eye to reinforce buckle and pt s/b prone with affected eye up so that the gas bubble floats up
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6
Q

Types of Aura

(signs that seizures is imminent)

A

hearing bells

seeing lights

smelling something

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7
Q

Meniere’s disease

A

affects inner ear which controls:

balance and hearing

can cause:

  • vertigo, hearing loss, tinnitus

Tell pt to avoid:

  • sudden movements and bright lights/tv/reading

Tx: diuretics

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8
Q

ALS

A

no sensory or cognitive loss

A PROGRESSIVE NEURODEGENERATIVE DZ

attacks motor nerve cells in teh brain and spinal cord

Early symptoms: muscle weakness, especially distal arms and legs, speech, swallowing, breathing

Late stage: total paralysis b/c voluntary muscles affected

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9
Q

External otitis

A

swimmer’s ear

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10
Q

TIA

A

warning sign of adv atherosclerosis dz

a temporary interuption of O2 to brain d/t thromboembolism

common symptoms:

loss of vision in one eye | inability to speak | transient hemiparesis | tinnitus | vertigo | diplopia | dysphagia | numbness | weakness

NEURO DEFICIT DISAPPEARS W/IN 24HR

no permanent disability

  • Pt may have carotid endarterectmy to reduce freqency of TIA and danger of CVA
    • carotid arteries are scraped to remove plaque
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11
Q

Right vs Left CVA

How is pt impaired?

A

**RIGHT: impulsive, neglect left (can’t see or feel on left side)

**LEFT: cautious, speech is affected

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12
Q

Ataxia

A

uncoordinated mvmts of extremiti

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13
Q

Cheyne-Stokes respirations vs Apneustic

A

C-S

over 1 minute, there is a 10-20 sec apnea or hypopnea, then followed by respirations of increased depth and frequency, then repeats

Apneustic

slow, w/ prolonged pause b/w inspire and expire

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14
Q

Autonomic dysreflexia

A

usually sustained cervical or thoracic above T6

  • mostly assoc. w/ full bladder and distended rectum
  • at risk for HTN crisis:
    • extreme HTN, bradycardia, severe throbbing h/a, flushing of face and neck
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15
Q

VS associated w/ increase ICP

A

widening pulse pressure

decreasing HR

increasing temperature

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16
Q

Somogyi effect

A

“rebound hyperglycemia”

result of poor DM mgmt

(too much insulin or not enough snack at night)

  • blood sugar drops too low in the middle of the night, so body counters by releasing hormones to raise the sugar levels
17
Q

early manifestations of hypoglycemia

A

drowsy

headache

shaky

nausea

18
Q

manifestations of hyperglycemia

A

polyuria (urine freq)

polydipsia (thirst)

Polyphagia (hunger)

anorexia

dry mouth

19
Q

What causes agromegaly?

A

too much SOMATOTROPIN hormone from pituitary gland after closure of epiphyses

  • tissues enlarge over bones of face, jaw, hands, feet, skull
20
Q

Thyroid storm s/s

A

sudden tachycardia, fever, HTN, sweating, restlessness, tremors, abdominal pain

21
Q

Mysedema

A

severe form of hypothyroidism

22
Q

Graves disease

A

hyperthyroidism

  • diarrhea
  • heat intolerance
  • anxiety
  • difficulty sleeping
  • increased appetite, but weight loss occurs
  • exophthalmos, restlessness
23
Q

Addison’s dz

A

don’t produce enough cortisol, sometimes aldosterone

Diet: needs to be high in salt, carbs and protein, low in potassium

Skin: bronze pigmentation of exposed and unexposed skin

24
Q

when might a pt show jaundice of face and sclera

A

hepatic, biliary, or gallbladder dz

25
Cushing's disease
Can be a result of chronic corticosteroid use * complication is osteoporosis, risk of fractures skin: purple striae on chest and abdomen b/c that's where the cushion :) is and it stretched the skin
26
What should be monitored following a thyroidectomy?
for thyroid storm and hypocalcemia * Chvostek's sign: facial spasm after tapping facial nerve in front of ear (indicates low Ca) * Trousseau's sign: inflate BP cuff to pressure greater than SBP and hold for 3 minutes to occlude brachial artery. --\> if low in Ca it will cause neuromuscular irritiability and induce spasm in hand and forearm
27
When is a VMA test needed? | (vanillylmandelic acid)
this is 24hr urine test for PHEOCHROMOCYTOMA these benign tumors cause excell Epi and NE which regulate HR and BP \*\*dump first void and keep last.
28
HgbA1c Urine sugar test Glucose tolerance test 3-hr glucose testing Fasting serum glucose test
HgbA1c: tells if pt compliant Urine sugar: tells if controlled in last few hours Glucose tolerance: used to diagnose type 2 DM 3-hr: to confirm if glucose tolerance test positive Fasting: info for previous 24h
29
sign if increasing ICP
widing of pulse pressure (SBP-DBP) increased temp decreasing HR
30
Myasthenia Gravis
Causes fatigue of the muscles due to an autoimmune disease that affects the acetylcholine receptors that primarily affects the face and throat. Pt is at risk for aspiration.
31
Guillain-Barre
rapid onset of ascending weakness and paralysis but begins with weakness in lower extremities