BIO TCM Flashcards
1
Q
the right side of the heart pumps blood to the…
A
lungs
2
Q
2
menstrual bleeding occurs when..
A
estrogen increases and progesterone decreases
3
Q
3
the chain of blood pressure regulating hormones is
A
renin-angiotensin-aldosterone
4
Q
4
what is indicative of right sided heart failure
A
distended jugular vein
5
Q
5
LH is secreted by..
A
the anterior pituitary
6
Q
6
in a urinalysis what is present in a possible bacterial infection
A
nitrites
7
Q
7
the mechanism of vasotec, an ACE inhibitor, is to..
A
inhibits the production of angiotensin II
8
Q
8
Which cranial nerve is involved in sensing taste
A
CN 9
9
Q
9
what innervates the palmer aspect of the middle and index finger and distal thumb
A
median nerve
10
Q
10
a 64 year old female has bells palsy all of the following can confirm diagnosis except:
- EMG
- physical exam of facial ptosis
- MRI with contrast agent of 7th CN
- facial biopsy of 7th CN
A
- physical exam
11
Q
11
What tests can confirm hashimoto’s thyroiditis?
A
TSH, T3, T4
12
Q
12
Normal shoulder flexion ROM
A
170-180
13
Q
13
what are the most common side effects of antiarrythmic drus
A
bradycardia and dizziness
14
Q
14
using a microcentrifuge, Hct measures the precentage of blood volume that is composed of
A
RBCs
15
Q
15
Schedule 2 drugs are..
A
high risk potential resulting in severe physical and psychological dependence
16
Q
16
Mxyedema refers to under active
A
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thyroid
17
Q
17
a blood tests the shows elevated creatinine indicates a disorder of
A
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the kidneys
18
Q
18
symptoms of Osteoporosis
A
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back pain, fractures in hips, spine, or femur, loss of height, kyphosis
19
Q
19
what is the medication for Hashimotos
A
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levothyroxine
20
Q
20
reduced bile production will result in what in the feces
A
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fat
21
Q
21
which hormone raises body temperature during the luteal phase
A
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progesterone
22
Q
22
Personnel with HBV vaccine …
- need to receive a new vaccine every 3 years
- develop immunity with no risk
- can still transmit the infection through sex
- also develop immunity to HIV
A
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2
23
Q
23
which of the following is not a tx for Benign Prostatic Hyperplasia
- Suprax
- Flomax
- Avodart
- Proscar
A
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2
24
Q
24
which dermatome innervates the anterior ankle and foot
A
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L5
25
25
| KUB x ray assesses the Kidneys, Bladder, and
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| Ureters
26
26
| which form of Hepatitis is the most significant infectious occupational risk int he US
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| Hep C
27
27
which of the following is a primary responsibility a health care worker has for his their patients?
1. Assess for colon cancer
2. Assess for TB
3. Assess for Hep C
4. Assess for alcohol and substance abuse
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| 4
28
28
| What is the CD4 count on a HIV infected person to acquire AIDS
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| <200
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29
| What as the s/s for Stage 1 endometrial cancer
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| abdominal bloating, pelvic pain, back pain, cachexia
30
30
| a myelogram provides radiographic visualization of the
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| spinal cord
31
31
| bouchards nodes occur in the ..
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| PIP
32
chloramphenicol, tetracycline
decreases protein
33
2
| PET scan
parkinson's, epilepsy, mental illness, heart attack
34
laproscopy
abdomen & pelvis
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4
| What two things effect metabolism of a pharmaceutical
age, immunity
36
```
Pregnancy Categories
A-
B
C
D
E
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A- no risk
B- no risk in humans
C- indeterminate risk, benefits may outweigh risk
D- high risk, benefits may outweigh risk
E- contraindicated
37
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Controlled Substance Schedule
I
II
III
IV V
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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)
38
Anthelmintic
kills parasites and their eggs
39
anticholinergic
blocks parasympathetic nerve impulses
40
9
| Antidepressants (tricyclic, MAOI, SSRI, SNRI)
end in -ine
- fluoxetine (prozac)
- sertaline (zoloft)
41
Common Anticoagulants
aspirin, heparin, warfarin (coumadin)
42
11
| Ma huang shouldn't use used with MAOI because...
it intensifies the effect of medication and side effects (stomachache, headache, tremors, hypertension)
43
12
| Ren shen shouldn't be used with antihyperglycemics, asprin, corticosteroids, digoxin, estrogen, MAOIs, opoids, warfarin
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
44
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13
Green Tea (lu cha) should be avoided with which medication
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warfarin- increases thromboembolism
45
14
| Gan cao should be avoided with digoxin and diuretics because
with digoxin it decreases K+, and increases digoxin toxicity
| - with diuretics it increases K+, wasting effects and interferes with effectiveness
46
15
St Johns Wort should be avoided with digoxin, iron supplements, MAOIs, OCPs, protease inhibitors, SSRIs, Tricyclic antidepressants, and warfarin
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
47
16
| Food-drug interactions- grapefruit
inhibits or slows metabolism of drugs
48
17
| Food-drug interactions- tyramine
can cause hypertensive crisis if taking MAOI
49
18
| Food-drug interactions- black tea
inhibits iron absorption
50
19
| Food-drug interactions- alcohol
impairs thiamin, niacin, pyridoxin
51
20
| Drug-mineral interactions: opoids, anticholinergics
decreases GI motility, constipation
52
21
| Drug-mineral interactions: diuretics (thiazides, corticosteroids)
depletes K+ (can lead to arrhythmia)
53
22
| Drug-mineral interactions: cortisol, aldosterone
increases sodium and water retention
54
23
| Drug-mineral interactions: birth control
impairs zinc and increases copper levels (can lead to dementia)
55
24
| Drug-mineral interactions: phenytoin, primidone
creates Vitamin B9 (folate) deficiency
56
25
| Aminosalicyclic acid, slow release K+ iodide, colchicine, ethanol, OC
creates B12 (cobalamin) deficiency
57
26
| High progestin dose
can cause depression by reducing tryptophan
58
27
| Orlistat
prevents fat absorption
59
29
| adrenal corticosteroids, ethanol
increases lipids
60
30
| aspirin, colchicine, glucagon
decreases lipids
61
31
| antibiotics, fiber, digoxin
decreases appetite
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32
Sodium (NA-)
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
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33
Sodium (NA-)
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
64
34
Potassium (K+)
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
Red Flag: Lithium, NSAIDS, trimethoprim, Heparin, cyclosporine, ace inhibitors, digoxin, beta blocker, adrenal insufficiency, IV insulin or glucose
65
Potassium (K+)
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
66
Calcium (Ca+)
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
67
Calcium (Ca+)
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
68
38
Hyperphosphatemia (phosphorus = Ph+)
Causes:
Sx:Causes: hypoparathyroidism; rhabdomylosis
Sx: hypocalcemia, tetany, soft tissue calcemia
69
39
Hypophosphatemia (phosphorus = Ph+)
Causes:
Sx: Acute alcoholism, undernutrition, hyperparathyroidism, cushings, hypothyroidism, diuretic use, chronic fasting
Sx: anorexia, muscle weakness, osteomalacia, *hemolytic anemia = phosphorus leads to
70
40
Hypermagnesemia (Magnesium = Mg+)
Causes:
Sx: usually uncommon and/or asymptomatic
- respiratory depression, excess antacid use, excess laxative use
Sx: hyporeflexia, hypotension, cardiac arrest = too much Mg+
71
41
Hypomagnesemia (magnesium)
Causes:
Sx: alcoholism (reduces Mg+0, 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
72
42
| what can cause right upper quadrant pain
cholecystitis and billiary colic; hepatitis, retrocecal appendicitis (rare)
73
43
| what can cause right lower quadrant pain
appendicitis, cecal diverticulitis, Meckel's diverticulitis (Crohns)
74
44
| what can cause left lower quadrant pain
sigmoid diverticulitis (ulcerative colitis)
75
45
| What BMI is considered overweight
25-30%
76
46
| What is a normal pH for saliva and what is it's function
6.5-7.5 - it moistens and lubricates
77
47
| what is the pH for bile and what is it's function
digestion of lipids; 7.5-8.8
78
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
79
49
What is the standard treatment for type 1 diabetes?
What lab tests are done?
Tx: insulin (humalog)
Lab: HbA1C
80
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
81
51
What is the tx for type 2 diabetes?
what is the lab test?
tx: insulin replacement- * Metformin
lab: HbA1C
82
52
a patient is sweating, nauseous, warm, has anxiety, palpitations, hunger, and a headache? what is their likely diagnosis?
Hypoglycemia
83
53
| What is the treatment for hypoglycemia
glucagon
84
54
| What disease is common in hispanic and african americans and is due to H. Pylori weakening the stomach lining
Peptic Ulcer
85
55
| NSAIDS and Ethanol can cause pain, nausea, fullness, and bleeding -- what disease is this
gastritis
86
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
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57
| This disorder is caused by H Pylori (mostly) and causes consistent pain which usually awakens a patient at night
Duodenal ulcer
88
58
| what does melena stand for
black tarry stools due to long term stomach or duodenum bleeding
89
59
| Amoxil, Cipro, and Levaquin are what kind of common medication?
Antibiotics
90
60
| what disease is a bacterial diarrhea due to undercooked poultry, milk, eggs or contact with reptiles
Salmonella
91
61
| what disease is the 3rd most common bacterial diarrhea in the US transmitted person to person
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| Shigella
92
62
What disease has bloody diarrhea from undercooked beef, unpasteurized milk, juices; can also have watery diarrea, found commonly in nurseries
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| E. Coli
93
63
| which bacterial disease is from undercooked seafood
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| Vibrio
94
64
| Which bacteria disease is food born and usually found in cheese
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| listeria
95
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?
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Dyspepsia
Tx: H2 blockers; PPIs
96
66
| what is the route of transmission for Hep A
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| fecal-oral
97
67
| what is the route of transmission for Hep B
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| blood
98
68
| what is the route of transmission for Hep C
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| blood
99
69
| what is the route of transmission for Hep D
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| needle
100
70
| what is the route of transmission for Hep E
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| water (seen in africa)
101
71
| What is the most common type of hepatitis in the medical field?
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| Hep B
102
72
| What is the most common hepatitis in the world?
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| Hep A
103
73
| What is the deadliest type of hepatitis
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| Hep C
104
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
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| Hep B
105
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75
Crohn's
- area involved
- sx location
- S/S
- Imaging
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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
106
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76
Ulcerative Colitis- area involved
- area involved
- sx location
- S/S
- Imaging
```
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area: LI- descending section
Location: left sided
S/S: rectal bleeding; no fistulas, no perianal lesions
Imaging: symmetrical and uninterrupted bowel wall
107
77
| What physical assessment test would you use to rule in/out appendicitis
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| McBurney's Point/Roving's sign
108
78
this disorder is usually due to stress however etiology unknown; gas bloating, cramping, bowel changes, constipation and diarrhea- seen most in females
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| IBS
109
79
| This virus is most common causes of diarrhea in children and day care workers in america
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| Rotavirus
110
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
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| Giardia
111
81
| this parasite is water borne and resistant to chlorine (pool water)
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| Cryptosporidium
112
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
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| Hookworm
113
83
| This worm/parasite is common in schools and day cares and can cause an itchy perineum
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| pinworms
114
84
| this worm/parasite causes weight loss, abdominal distention, pain, diarrhea, and malnutrition
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| Tapeworm
115
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
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| Trichinosis
116
86
| What are your water soluble vitamins
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| B1, B2, B3, B6, B12, Folate, Vit C
117
87
| Vitamin B1 name
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| Thiamin
118
88
| Vitamin B2 name
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| Riboflavin
119
89
| Vitamin B3 name
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| niacin
120
90
| Vitamin B6 name
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| pyridoxine
121
91
| Vitamin B12 name
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| cobalamin
122
92
| What does B1 deficiency result in
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| beriberi, wernicke-korsakoff syndrome
123
93
| what does B2 deficiency result in
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angular stomatitis (will have red tongue)
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124
94
| what does B3 deficiency result in
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Pellagra (dermatitis, glossitis, GI and CNS dysfunction), will have red edges of tongue
Toxicity: flushing
125
95
| what does Folate deficiency result in
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| megaloblastic anemia; neural tube defects
126
96
| what does B6 deficiency result in
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| seizures, anemia, neuropathies, seborrheic dermatitis- looks like eczema
127
97
| what does vit C deficiency result in
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| scurvy (bone defects, gingivitis, loose teeth, hemorrhages); will have a mapped tongue, and possible bone pain
128
98
| What are your fat Soluble vitamins
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| ADEK
129
99
| what does Vit A Deficiency result in
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| night blindness, xerophthalmia, keratomalacia; goose flesh skin, cataracts
130
100
| What does Vit D deficiency result in
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rickets (weakness and softening of the bones, Heberden nodules), osteomalacia
toxicity: anorexia, renal failure
131
101
| What does Vit E deficiency results in
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| red blood cell hemolysis, neurologic deficits, dry scaly skin, follicular hyperkeratosis, alopecia
132
102
| What does Vitamin K deficiency result in
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| bleeding, osteopenia
133
103
| Diarrhea is usually caused by what deficiencies
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| protein, Vitamin B3, Folic Acid, Vitamin B12, K+
134
104
| Alcoholism can lead to what deficiencies
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| magnesium, zinc, thiamin
135
105
| Which leukocyte deals with bacteria (and some viruses)
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| Neutrophils
136
106
| which leukocyte deals with allergic reactions (and worms)
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| Eosinophils
137
107
| which leukocyte deals with histamine and heparin reactions
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| basophils
138
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108
which agranulocyte (mononucleus WBC) becomes macrophages to ingest bacteria and also secrete lysine
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| monocytes
139
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109
which agranulocyte (mononucleus WBC) is produced in the bone marrow and moves to lymph tissues- has two types: B & T Cells
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| lymphocytes
140
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110
which agranulocyte (mononucleus WBC) produce immunoglobulins due to bacteria and toxins
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| B-Cells
141
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111
which agranulocyte (mononucleus WBC) attach to antigen bearing cells like bacteria and kill toxins
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| T- Cells
142
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?
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Iron deficiency anemia(microcytic)
Labs: H&H, TIBC, Iron (ferritin)
143
113
| this type of anemia is d/t B12 deficiency, may have a beefy red, smooth red tongue w/o taste
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pernicious anemia (macrocytic)
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144
114
this type of anemia is the excessive destruction of RBCs due to: SLE (lupus)
What lab tests would you order?
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Hemolytic
ANA, H&H, ABO-Rh
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115
this type of anemia is when the bone marrow is unable to produce sufficient new cells
What labs would you order?
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Aplastic
CBC, Bone Biopsy
146
116
| How long can RBCs live for:
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| 100-120 days
147
117
| What is the function of RBCs:
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| transport oxygen, carbon dioxide, and nitric oxide
148
118
| How long do WBCs live for
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| 13 days
149
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
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Sickle Cell
(its a form of hemolytic anemia)
150
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
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| Thalassemia (a type of microcytic anemia- low MCV hypochromic)
151
121
this WBC disease has S/S such as: fatigue, dyspnea with exertion, splenomegaly, hepatomegaly, swollen lymph nodes, epistaxis, bleeding gums, chronic fever, unexplained weight loss, and bone pain.
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| leukemia
152
122
| What is the universal blood recipient
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| AB
153
123
| what is the universal blood donor
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| 0
154
124
| RBCs can be elevated due to
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| Polycythemia, renal disease
155
125
| RBCs can be low due to
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| anemia, hodgkins lymphoma, sickle cell
156
126
| HCT/HGB can be high due to
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| dehydration, shock, COPD, polycythemia
157
127
| HCT/HGB can be high due to
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| dehydration, shock, COPD, polycythemia
158
128
| HCT/HGB can be low due to
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| anemia, hyperthyroidism, trauma
159
129
| WBC can be high due to
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| acute infection, leukemia
160
130
| WBC can be low due to
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| bone marrow problems, immunodeficiency, AIDS, chemo
161
131
| Iron levels could be low due to
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| acute hepatitis, nephrosis
162
132
| iron levels could be low due to
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| anemia, RA, hypothyroidism, pregnancy (3rd tri)
163
133
| BUN is high due to
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| renal pathology, GI bleeding, heart failure, high protein diet,
164
134
| BUN is low due to
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| pregnancy, liver pathology
165
135
| creatinine is high due to
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| renal pathology, hyperthyroidism
166
136
| creatinine is low due to
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| muscle atrophy
167
137
| uric acid is high due to
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| gout, arthritis, renal stones
168
138
| uric acid is low due to
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| hypothyroid, ethanol
169
139
| LDLs should be under what number
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| <100
170
140
| High T4 is elevated in and low in...
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| high in hyperthyroid and low in hypo
171
141
| MCH is elevated/low in ...
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| high in macrocytic anemia, low in microcytic anemia
172
142
| Mean copruscular hemoglobin concentration is low in
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| iron deficiency anemia
173
143
| ALT is very specific for testing/diagnosing what disease
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| Liver disease
174
144
| what are some S/S for ordering an ALT test
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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
175
145
| AST is a less specific test for hepatic disease but will be elevated in..
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| acute injury or acute skeletal or cardiac injury (MI)
176
146
| AST S/S for ordering would include
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long term medication use, obesity, diabetes. Pregnant women who have had muscle strain or medication injections may also have elevated AST
177
147
| ALP (alkaline phosphatase) is high in
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| Bone disorders, liver disease
178
148
| S/S for ordering ALP lab
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| osteomalacia, hepatitis, Pagets disease, rickets, sarcoidosis, blood type O or B= fatty foods
179
149
| When AST/ALT are high and ALP are high it indicates
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| LV disease
180
150
| When ALT/AST are low and ALP is high it indicates
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bone disease or bone cancer
Note: if GGT is high with elevated ALP then bone disease is usually not the problem
181
151
| GGT is indicative of
Gamma-Glutamyl Transferase
enzyme found in organs throughout the body
highest in the Liver (jaundice, dark urine, light poop)
elevated cause damage to Liver or bile ducts
