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Case Report Quiz 1 > Case Report 1 > Flashcards

Case Report 1 Flashcards

1
Q

What is the differentiates an NSTEMI to a STEMI?

A

NSTEMI: occlusion on minor artery leading to partial thickness damage of muscle
STEMI: occlusion of major coronary artery leading to full thickness damage of muscle

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2
Q

To be diagnosed with major depression how many symptoms must you have out of the 9 described in SIGECAPS?

A

5 out of the 9 symptoms

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3
Q

What is a major prevention tactic to avoid a GI bleed?

A

Avoid excess NSAID use

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4
Q

What is the pH of a patient who has DKA? What is the pH of blood normally?

A

<7.3

Blood is normally 7.38-7.42

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5
Q

How many classes of thrombolytic drugs are there?

A

3: Tissue Plasminogen Activator(TPA), Streptokinase (SK), Urokinase (UK)

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6
Q

Is warfarin reversible? If so, what is teh agent to reverse it?

A

Yes, through administration of Vitamin K

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7
Q

What is the general MOA of thrombolytic agents?

A

Plasminogen is converted to plasmin which leads to dissolution of clots through fibrinolysis

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8
Q

List 3 symptoms of a PE?

A

Pink frothy sputum
Low grade fever
Tachycardia

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9
Q

The diagnostic test that can detect clotting and exclude PE if the result is negative is?

A

D-dimer test

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10
Q

Define depression

A

Depressed mood on a daily basis for a minimum of 2 weeks

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11
Q

What is the normal range for fasting plasma glucose for people without diabetes?

A

70-100 mg/dL

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12
Q

What drugs are known to cause or put patients at higher risk for developing a PE?

A

Hormone replacement therapies and oral contraceptives with estrogen

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13
Q

What is the enzyme that is important in degrading fibrin clots?

A

Plasmin

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14
Q

What is the main deficiency that leads to pernicious anemia?

A

Vitamin B12 deficiency

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15
Q

Why do paitens experience SOB in anemia

A

Decreased oxygen carrying capacity of the RBC

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16
Q

What is warfarin MOA?

A

Interferes with the synthesis of Vitamin K depedent clotting factors and anticoagulant protein C and S

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17
Q

Name 3 symptoms of DKA

A 
Hyperglycemia >250
Ketones in urine
Acidosis <7.3
Polydipsia, polyuria, fatigue, confusion, n/v, tachycardia
Hypotension
18
Q

Pink frothy sputum is an indication of what condition?

A

PE

19
Q

What class of drug is Tenecteplace

A

Thrombolytic

Tissue plasminogen activator

20
Q

What is the first thing that should be done when treating a patient with ketoacidosis

A

Correct fluid volume

21
Q

What is Warfarin’s onset of action and why does it take this long to reach peak anticoagulation?

A

An anticoagulation effect generally occurs within 24 hours after warfarin administration. However, peak anticoagulant effect may be delayed 72 to 96 hours; it prevents the creation of new clotting factors but does not get rid of the ones currently in existence

22
Q

Pernicious anemia is caused by impaired absorption of ____________ due to the failure of gastric parietal cells to secrete _________ __________.

A

Vitamin B12; intrinsic factor

23
Q

When diagnosing community-acquired pneumonia, a sputum culture can be obtained. To be considered an adequate sputum culture, what is required?

A

> 25 neutrophils and <10 squamous epithelial cells per low power field

24
Q

Define major depression

A

Depressed mood on a daily basis for a minimum duration of 2 weeks.

25
Q

Venous thromboembolism can lead to pulmonary embolism. What are three risk factors for developing VTE that are also pertinent to our patient?

A 
long-haul air travel
obesity
cigarette smoking
eating large amounts of red meat
oral contraceptives
26
Q

Anticoagulants have 4 principle classes. Name 2.

A

Direct Factor Xa
Direct Thrombin Inhibitors
Indirect thrombin inhibitors
Vitamin K antagonists

27
Q

Which is a better anticoagulation treatment for patients - Unfractionated Heparin (UFH) vs Low-Molecular-Weight Heparin (LMWH)? Explain your reason.

A

UFH blocks factors 2a (Thrombin) and 10a, whereas LMWH blocks factor 10a. LMWH is a better treatment for patients as it has a lower risk of bleeding.

28
Q

In GI bleeding, if blood is coming from the rectum or lower colon, _________ _________ blood will coat or mix with your stool. Describe the color of blood.

A

Bright Red

29
Q

Which anticoagulant is contraindicated in pregnant women?

A

Warfarin

30
Q

Cardiac enzymes typically are elevated in the blood several hours after the onset of a heart attack. Name one cardiac enzyme that is released into the blood by dying heart muscles

A 
Creatine phosphokinase (CPK
Troponin
31
Q

Anticoagulation can be achieved by antagonizing vitamin K epoxide reductase. A good example of a drug that does this is ___________.

A

Warfarin

32
Q

List the clotting factors that are the therapeutic targets of warfarin?

A

VII, X, IX, II

SNOT

33
Q

Signs and symptoms of DKA?

A 
Hyperglycemia >250 mg/dL
Ketones in the urine or blood
Acidosis ph < 7.3; serum bicarbonate <15
Polydipsia, polyuria
Fatigue, flushing of the skin
N/V, abdominal pain (30% of patients)
Difficulty breathing
Fruity odor on breath (due to acetones)
Confusion, tachycardia (increase HR), tachypnea, hypOtension
Weight loss, dehydration
34
Q

What are 2 Nonpharmacologic treatments for PE?

A

Pulmonary embolectomy (high risk patients)
Compression stockings and mechanical ventilation
Vena cava filter to prevent blood clots from traveling to lungs (IVC filter)
Surgery
Stent placement
Ambulation

35
Q

If the patient PK from our case was placed on a TPA for treatment of PE, the drug would bind to fibrin bound ___________ cleaving it to the active protein: __________.

A

Plasminogen, plasmin

36
Q

If patient PK from our case had a recent strep infection and the physician decided to use streptokinase to treat the patient for PE, you would recommend the physician to ___________ the dose relative to the standard dosing of 250,000 units over 30 minutes followed by 100,000 units/hr for 24 hours.

A

Increase

37
Q

Pernicious anemia is due to a lack of ________________ caused by a lack of or decreased production of ___________________ which is produced by ___________________ cells.

A

Vitamin B12, Intrinsic Factor, parietal

38
Q

What are the major signs/symptoms of a pulmonary embolism?

A

dyspnea, calf pain/redness/swelling, tachycardia, chest pain, low BP, coughing up blood or bloody mucus, cyanosis, dizziness/lightheadness, feeling anxious

39
Q

What are 3 signs/symptoms of pernicious anemia?

A

Fatigue, loss of appetite, SOB, dizziness, pale skin, tachycardia, chest pain, confusion, depression, memory loss, dementia, malabsorption, diarrhea, red beefy tongue or pale and smooth tongue, papillaries are absent

40
Q

What is the mechanism of action of Alteplase (Activase®)?

A

Plasminogen is converted to plasmin which leads to dissolution of clots through fibrinolysis

41
Q

What are the characteristics of diabetic ketoacidosis (DKA)?

A

Hyperglycemia and ketoacidosis

Case Report Quiz 1 (1 decks)

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