Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPS Exam #1 > Case #4 > Flashcards

Case #4 Flashcards

1
Q

What does a Guiac test check for?

A

Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do H2 blockers do?

A

Block Histamine that would promote acid secretion

Used to treat peptic ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hemorrhoids often associated with

A

Liver Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Increased girth with decreased weight may indicate…

A

Ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Jugular venous distention is an indicator of…

A

Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are carotid bruits?

A

Sounds of turbulent blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are rales?

A

Rattling breathing sound heard with stethoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are ronchi?

A

Continuious low pitched rattling sound (kind of like snoring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Two vascular signs often associated with liver damage/portal hypertension?

A

Caput medusae

Spider angiomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Positive shifting dullness + fluid wave =

A

Ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why would patient #4 have gynecomastia?

A

Alcohol inhibits testosterone, making gy. more likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clubbing is assocaited with….

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Asterixis…

A

Flapping tremor of the hand associated with faulty metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BUN is an indicator of

A

High – Kidney Probs

Low – Liver Probs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is gamma-GT used for?

A

Indicator of Liver Enzymes

Elevated in people drinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

High ammonia indicates….

A

low liver fxn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Lactic dehydrogenase indicates…

A

Tissue Damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Direct Bilirubin =

Indirect =

A 
D = Conjugated
I = Unconjugated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macrocytic Anemia is associated with…

A

B12 deficiency, common in alcoholics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
Abdominal fluid colors --
Milky indicates...
Turbid indicates...
Yellow indicates...
Green indicates....
Red indicates....
A 
M --> Triglycerides, Obstruction
T --> Infection
D --> Jaundice/Liver Disease
G --> Bile
R --> Blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Significance of Serum-to-Ascites gradient?

A

Over 1.1 indicates Portal Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Significance of total protein level below 2.5?

A

Indicates cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is gastric lavage?

A

Stomach pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is diazepam used for?

A

Anxiety and anti-seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why would patient #4 start a low-sodium, low-protein diet?

A

To help with edema/ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is lactulose?

A

Sugar that traps ammonia in the colon to help prevent reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do coffee grounds in vom blood indicate?

A

Blood interacting with stomach acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What do tarry stools indicate?

A

Upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What happens in esophageal varicies?

A
  • Venous plexous around the esophagus becomes distended
  • Veins erode into lumen, causing bleeding
  • Exacerbated by coagulopathy
  • Significant cause of death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What might you look to to indicate low intravascular volume?

A

Orthostatic Hypotension
Tachycardia
Water reabs – low hematocrit, hemo, electrolyte conc.

31
Q

What does cirrhosis liver look like?

A

Small, Fibrotic - Regeneration of damaged hepatocytes and fibrosis

32
Q

Why does cirrhosis present with encephalopathy?

A

No blood in liver = no filtering

Ammonia stays put and fucks shit up

33
Q

Why would the liver get larger in an alcoholic?

A

Fatty Deposits, Inflammation

34
Q

Alcoholic Liver…early, later, and end stage tissue type

A

Early - Large, Fatty
Later - Large, Tender, Inflamm., Dying cells
Cirrhosis - Small, Fibrotic, Scar with less liver tissue

35
Q

What liver enzyme levels do you see at diff stages of liver damage?

A

Early – Normal
Later – Greatly increased (due to necrosis)
Cirrhosis – Slightly Elevated-Normal (the cells are already gone)

36
Q

Micronodular cirrhosis typically associated with…

A

Alcohol

37
Q

Macronodular cirrhosis typically associated with…

A

Hepatitis

38
Q

Fibrosis leads to vascular obstruction. This leads to…

A

Portal Hypertension + Ascites

39
Q

Why does vascular block –> Ascites?

A

Lymph can’t get through the liver, percolates off the liver capsule

40
Q

Complications of ascites in liver damage cases?

A

Sodium retention and hypoalbuminemia

41
Q

Three broad causes of cirrhosis? Examples?

A

Toxic: Alcohol
Infectious: Hep B and C
Hereditary: Hemochromatosis, Wilson’s, alpha1-antitrypsin

42
Q

Four signs of ascites?

A

Large, protruding abdomen
Increased girth without weight gain
Umbilical Herniation
Fluid Wave on Exam

43
Q

What are the six Fs of abdominal swelling

A

Flatus, Fat, Fluid, Fetus, Feces, Fatal Growth

44
Q

Problem with lowered albumin?

A

Decreased blood oncotic pressure

45
Q

Symptoms of hyperestrogenism?

A

Spider telangiectasia
Palmar erythema
Gynecomastia
No public hair

46
Q

Why the hypercholesterolemia?

A

Liver processes cholesterol via bile

47
Q

Source of hyperbilirubinemia?

A

Intrahepatic biliary tract obstruction

Lack of Processing

48
Q

Relationship of liver damage and coagulation problems?

A

Liver makes coagulation proteins

Without it – Prolonged PT/PTT, bruising

49
Q

Why can’t you pee out unconjugated bilirubin?

A

It isn’t water souble

50
Q

How would a gall stone alter bili. levels?

A

Increased levels of conjugated, but not un

51
Q

Why is urine dark?

A

Extreme concentration (dehydration)
Hemoglobin/Myoglobin
Conj. Bilirubin
Food/Drug Pigments

52
Q

Hepatic Encephalopathy Symptoms (4)

A

Asterixsis
Impaired Cognition/Obtundation
Impaired Spatial Perception
Day-Night Reversal

53
Q

Cause of hepatic encephalopathy?

A

Decreased ammonia metabolism (due to hepatic shunts and liver failure)

54
Q

Which liver enzyme is especially sensitive to alcohol?

A

Gamma-GT

55
Q

AST vs. ALT – which one is prone to rise the most in alcoholica?

A

AST

56
Q

What might cause the highest AST/ALT values?

A

Acute hepatitis necrosis

57
Q

What disease tends to have elevated alkaline phosphatase?

A

Extrahepatic obstruction like gall stone or cancer

58
Q

Three most significant vitamin deficiencies in alcoholics?

A

Thiamine (B1), B12, and Folic Acid

59
Q

B1 deficiency is associated with what three outcomes?

A

Wernicke’s encephalopathy
Korsakov’s Syndrome
Cerebellar Ataxia

60
Q

Wernicke vs. Korsakov – who is reversible?

A

Wernicke

61
Q

Symptoms of Korsakov?

A

Memory loss, confabulation

62
Q

What is confabulation?

A

The brain fills in gaps with false information

63
Q

What does the gait of a person with cerebellar ataxia look like?

A

Wide based, shuffling

64
Q

Two common symptoms of B12 deficiency.

A

Macrocytic Anemia

Sensory/Vibrational Defecits (subacute combined degen)

65
Q

Symptom of Folic Acid Deficiency?

A

Macrocytic Anemia

66
Q

How to treat patient? (4 steps given)

A

Increase vascular Volume
Decrease varices bleeding with sclerother. and BBlockers
Treat encephalopathy with lactulose and diet
Decrease Ascites with diet

67
Q

What is delirium tremens?

A

Acute Alcohol Withdrawl

Psychomotor Agitation, Can Be fatal

68
Q

How to treat delirium tremens

A

Benzodiasepines (anticonvulsant)

69
Q

What is a Child-Pugh Score?

A

A scoring system used to assess likelihood of cirrhosis mortality.

Score over 9 = 80% perioperative mortality
Our Patient = 14

70
Q

Percentage of US adults with unhealthy alcohol use? abuse/dependence?

A

28%

8.5%

71
Q

How many drinks is unhealthy for an adult man? adult woman?

A

more than 14 drinks/week
more than 7 drinks/week

…the wine glass ceiling

72
Q

Two types of alcohol questioning.

A

Single-Item Alcohol Screening

AUDIT-C

73
Q

Optimal goal of brief alcohol intervention in primary care? for a moderate to severe user

A

Substance Use Disorder Specialized Care

74
Q

What will patients at risk for withdrawl first undergo?

A

Dotoxification.

CPS Exam #1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions