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Clinical Correlation > CC Exam No. 1 Intro Packet/Lectures > Flashcards

CC Exam No. 1 Intro Packet/Lectures Flashcards

1
Q

What are the three components of the coma cocktail?

A

vitamin b1 (thiamine), D50 (dextrose Monosaccharide, principal form of carbohydrate used in the body), and narcan (naloxone).

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2
Q

What is the role of thiamine in the coma cocktail?

A

helps to digest the sugar

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3
Q

Which member of the coma cocktail counters the effects of opiate overdose?

A

Narcan (naloxone)

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4
Q

A syndrome characterised by ataxia, ophthalmoplegia, nystagmus, and confusion. Resulting from inadequate intake or absorption of thiamine (vitamin B1), especially in conjunction with carbohydrate ingestion.

A

Wernicke’s encephalopathy

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5
Q

Wernicke’s encephalopathy is most commonly associated with which patient population?

A

It is most commonly correlated with prolonged alcohol consumption resulting in thiamine deficiency. Alcoholics are therefore particularly at risk, but it may also occur with thiamine deficiency states arising from other causes, particularly in patients with such gastric disorders as carcinoid syndrome, chronic gastritis, Crohn’s disease, and repetitive vomiting, particularly after bariatric surgery.

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6
Q

Another condition caused by a thiamine deficiency - NOT Wernicke’s encephalopathy.

A

Korsakoff’s syndrome. What’s the big diff? Wernicke’s encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff psychosis results from damage to areas of the brain involved with memory.

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7
Q

What is known as First Disease?

A

Measles (rubeola)

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8
Q

Scarlet Fever is which disease? (in terms of 1st, 2nd, 3rd, etc)

A

Second

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9
Q

What is known as Third Disease?

A

Rubella

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10
Q

aka Filatow-Dukes’ Disease

A

Fourth disease

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11
Q

What are 5th and 6th disease?

A

Erythema infectiosum (slapped cheek); Exanthem subitum, Roseola infantum;

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12
Q

A reflex that corrects the orientation of the body when it is taken out of its normal upright position. It is initiated by the vestibular system, which detects that the body is not erect and causes the head to move back into position as the rest of the body follows. Per Lau, this is the reflex that prevents us from falling.

A

Righting Reflex

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13
Q

What is the DOC for PDA?

A

NSAID

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14
Q

describes the three broad categories of factors that are thought to contribute to thrombosis.

A

Virchow’s Triad

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15
Q

Hypercoagulability
Hemodynamic changes (stasis, turbulence)
Endothelial injury/dysfunction
This is the composition of which triad?

A

Virchow’s

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16
Q

a rare autoimmune disease in which antibodies attack the lungs and kidneys, leading to bleeding from the lungs and to kidney failure.

A

Goodpasture’s syndrome

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17
Q

What is the cause of most fevers?

A

viral infection

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18
Q

Why is it that children do not “capture temperature” as well as adults? (Per Lau)

A

b/c they have an underdeveloped hypothalamus

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19
Q

Indication: 1.Assessment of febrile child ages 3-36 months 2.Predicts serious infection (Occult Bacteremia) 3.Quantifies “Toxic Appearance” in children
What is this?

A

Yale observation scale **focus on indication #2

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20
Q

Indications: 1. Assessment of febrile child ages 60-90 days

2. Reassures against serious infection (Occult Bacteremia) What is this?

A

Rochester Criteria for Febril Infants **focus on indication #2

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21
Q

A common subtype of transtentorial herniation, the innermost part of the temporal lobe, can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem, most notably the midbrain.

A

uncal herniation

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22
Q

What is the most common cause of uncal herniation?

A

increased intracranial pressure

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23
Q

Diagnostic sign for uncal herniation?

A

dilated pupil on the side of the herniation

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24
Q

What are the three types of shock?

A

Shock is hypotension with end organ injury: it classified as being due to malfunction of 1) the Pump (cardiogenic), 2 ) the Tubing (distributive), or 3) the Fluid (hypovolemic).

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25
Q

What are the three types of fluid that exist in the human body?

A

ITC, ETC, and third space fluid: areas (spaces) in which fluid can collect that is not available to the circulation; The third space is space in the body where fluid does not normally collect in larger amounts,[5][6] or where any significant fluid collection is physiologically nonfunctional.

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26
Q

Back pain should always be investigated for what?

A

AAA

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27
Q

What should always first be assessed when you have a new patient that presents with pain?

A

If they’ve ever had the pain before

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28
Q

Vitamins and synthroid go into which pregnancy category?

A

A - studies in women failed to show risks.

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29
Q

Tylenol, aspirin and morphine are in which pregnancy category?

A

B - animal studies failed to show risks

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30
Q

Motrin and advil are part of which pregnancy category?

A

C - animal studies have shown adverse effect, but no humans studies - benefits might out weigh the risks

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31
Q

Which pregnancy category shows + evidence of human fetal risk, but the benefits might outweigh the risks?

A

D

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32
Q

Which pregnancy category shows animal or human studies in which the drug is TOX and risk outweighs benefits?

A

X

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33
Q

What is the acronym used to assess the level of consciousness? And what does each stand for?

A

AVPU: alert, verbal, pain, unresponsive/unconscious

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34
Q

What is THE test for consciousness?

A

sternal rub: Make a fist. Take your knuckles and grind them hard into your sternum (the central bony portion of your chest) like you’re trying to crush a pill underneath your hand. This should be quite uncomfortable. Even most unconscious patients should respond with some type of movement within 30 seconds.

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35
Q

a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment.

A

glasgow coma scale (for head injuries only)

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36
Q

What are the three components of the Glasgow coma scale? What is the lowest score you can achieve? What is each section out of - in terms of point?

A

Eyes, Vocal and Motor; 3; 4, 5, 6

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37
Q

What is the acronym used to help remember how to record signs and symptoms?

A

OPQRST: Onset, provokes (better or worse), quality, radiation, severity (1-10), time (how long).

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38
Q

a potentially fatal disease that has numerous detrimental effects to many organs, especially the brain and liver. The classic features are a rash, vomiting, and liver damage.
The disease causes fatty liver with minimal inflammation and severe encephalopathy (with swelling of the brain).

A

Reye’s Syndrome

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39
Q

What is one of the more powerful vasoconstrictors that is also a recreational drug?

A

cocaine

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40
Q

what does the term aao x3 mean?

A

awake alert and oriented to date place and person.

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41
Q

the breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream. Myoglobin is harmful to the kidney and often causes kidney damage (and basically acute renal failure).

A

Rhabdomyolysis

42
Q

what is the one drug that is absolutely contraindicated when a person is on cocaine?

A

beta blockers - why b/c it gives the person a completely unrestricted alpha adrenergic stimulation.

43
Q

muscle relaxant often used to treat serotonin syndrome and also neuroleptic malignant syndrome.

A

dantrolene - and also remember, serotonin syndrome will be a cause of hyperthermia

44
Q

what is the most common cause of hyperthermia?

A

drug induced (mainly general anesthesia); therefore the best treatment is to simply remove the drug by ceasing to take it.

45
Q

technique taught to patients to ease shortness of breath. often employed by COPD patients

A

pursed lipped breathing - also referred to as abdominal or diaphragmatic breathing.

46
Q

a rhythm in which the rate of impulses arising from the sinoatrial (SA) node is elevated. The normal heart rate has been considered to range from 60 to 100 beats per minute (bpm), with this being defined as a sinus rhythm with a rate exceeding 100 bpm but less than _____.

A

sinus tachycardia; 150, 160 bpm

47
Q

what is the normal HR for a newborn?

A

100 - 150 beats per minute

48
Q

anti-arrhythmic drug with no anti-arrhythmic class that is used to treat paroxysmal supraventricular tachycardia (PSVT).

A

adenosine - also can be used to treat SVT per Lau

49
Q

what is the weakest point of the aorta?

A

bifurcation at L4

50
Q

what is this the triad for: nuchal rigidity, sudden high fever, and altered mental status?

A

meningitis (especially looked for altered mental status in AIDS pts)

51
Q

what are the four main organs that are at risk for end organ damage in pts with HTN?

A

eyes, kidney, heart, and brain

52
Q

transient monocular visual loss (i.e., loss of vision in one eye that is not permanent).

A

Amaurosis fugax - a symptom of carotid artery disease and out of control HTN

53
Q

optic disc swelling that is caused by increased intracranial pressure.

A

Papilledema.

54
Q

In the retina, indicates that the blood flow is restricted due to fatty deposits in the artery wall.

A

copper wire arteries

55
Q

what is the first line treatment for hypothermia?

A

warm saline IV; you can also do gastric lavage or irrigation of the bladder with warm water

56
Q

when you have an upper lobe issue, what is the FIRST thing you must rule out?

A

TB

57
Q

what the “end game” result of hypertension?

A

peripheral vascular disease

58
Q

which method of taking temp is solely depended on the operator?

A

tympanic membrane

59
Q

medical condition that is often confused with frostbite and trench foot. tissue injury that occurs when a predisposed individual is exposed to cold and humidity. The cold exposure damages capillary beds in the skin, which in turn can cause redness, itching, blisters, and inflammation.

A

chilblains

60
Q

what is the biggest contraindication to rectal temperature?

A

neutropenia and recent rectal surgery

61
Q

what are the two forms of taking a temperature that are most unreliable?

A

axillary and tactile

62
Q

which side are pregnant women encouraged to sleep on and why?

A

left side to avoid blockage of blood passage from the IVC on the right side; On the right side, pregnant uterus squeezes the IVC and reduces cardiac output. Also, her blood supply of oxygen is reduced and the unborn baby’s is as well.

63
Q

a serious neurologic condition in which there is acute loss of function of the lumbar plexus, neurologic elements (nerve roots) of the spinal canal below the termination (conus medullaris) of the spinal cord.

A

Cauda equina syndrome

64
Q

what is known as “board-like abdomen”

A

Gastrointestinal perforation/peritonitis - Note: Perforation of part of the gastrointestinal tract is the most common cause of peritonitis.

65
Q

what is the normal temp (on both C and F scale)?

A

98.6 F and 37 C

66
Q

what is fever for F and C?

A

100.3 F and 38 C (equal to or greater - orally)

67
Q

does treating fever help to treat the infection?

A

NO, it only helps to make the patient more comfortable.

68
Q

What is this? Resembles bacterial sepsis and can occur after initiation of antibacterials, such as penicillin or tetracycline, for the treatment diseases caused by spirochetes. An association has been found between the release of heat-stable proteins from spirochetes and the reaction. Typically, the death of these bacteria and the associated release of endotoxins or lipoproteins occurs faster than the body can remove the substances. It manifests as fever, chills, rigor, hypotension, headache, tachycardia, hyperventilation, vasodilation with flushing, myalgia (muscle pain), and exacerbation of skin lesions. The intensity of the reaction indicates the severity of inflammation. Reaction commonly occurs within two hours of drug administration, but is usually self-limiting.

A

Jarisch-Herxheimer reaction - Prophylaxis and treatment with an anti-inflammatory agent may stop progression of the reaction.

69
Q

what is the jarisch-herxheimer reaction typically associated with?

A

The Jarisch-Herxheimer reaction is classically associated with penicillin treatment of syphilis

70
Q

rarely seen condition noted in patients with Hodgkin’s lymphoma in which the patient experiences fevers which cyclicly increase then decrease over an average period of one or two weeks.

A

pel-ebstein fever

71
Q

a life-threatening condition that occurs when there is not enough cortisol.

A

adrenal crisis

72
Q

inflammation of the fat cells under the skin (panniculitis) characterized by tender red nodules or lumps that are usually seen on both shins.

A

Erythema nodosum

73
Q

what is the most common bacterial infection from childhood?

A

GAS - but not these are RARE when child is under 3

74
Q

metabolic disease due to deposition of monosodium urate crystals in joints.

A

gout

75
Q

what is the most frequently early clinical manifestations of gout?

A

acute arthritis

76
Q

what is gout called when it involves the big toe?

A

podagra

77
Q

what are the two tests for inflammation?

A

crp and esr

77
Q

Colchicine is an oral drug used for treating what?

A

acute gout

78
Q

what is the primary histological sign of Hodgkin’s disease?

A

Reed-Sternberg Cells - owl eyes

78
Q

hemorrhagic adrenalitis or Fulminant meningococcemia, defined as adrenal gland failure due to bleeding into the adrenal glands, caused by severe bacterial infection (most commonly the meningococcus Neisseria meningitidis)

A

Waterhouse–Friderichsen syndrome

79
Q

what is the most frequent cause of acute adrenal insufficiency?

A

rapid withdrawal of steroids

80
Q

what type of fever lasts longer hen 3 weeks and has no identifiable cause (FUO)?

A

essential fever

81
Q

this type of fever is a number of febrile attacks lasting about 6 days; separated by afebrile intervals.

A

relapsing fever

82
Q

fevers that abate every day but are still not resolved

A

remittent

82
Q

fever resolves COMPLETELY every day

A

intermittent

83
Q

fever characterized by a daily afternoon spike and often accompanied by facial flushing - commonly seen in TB

A

hectic fever

84
Q

in terms of malaria, fever that recurs every 48 hours? every 72 hours?

A

tertian; quartan

84
Q

febrile episode lasting NO MORE than a day or two

A

ephemeral fever

84
Q

infectious fever characterized by profuse sweating and production of sudamina

A

miliary fever

85
Q

wavy appearance of the long temperature curve typically in brucellosis

A

undulant fever

86
Q

what is the best way to measure respiratory rate?

A

when taking pulse

87
Q

what drive are copd patients on?

A

o2 drive

88
Q

what drive are copd patients on? non copd pts? (related to respiration)

A

o2 drive; co2 drive

88
Q

pursed lip breathing is used in COPD pts to increase intraairway pressure by inducing what?

A

Intrinsic Positive End Expiratory Pressure’, or ‘Intrinsic PEEP’ for short.

89
Q

regarding COPD a person where emphysema is the primary underlying pathology

A

pink puffers

90
Q

regarding COPD, a person where the primary underlying lung pathology is chronic bronchitis

A

blue bloater

90
Q

a surgical intervention in which a hole is drilled or scraped into the human skull, exposing the dura mater to treat health problems related to intracranial diseases.

A

trepanning; making a burr hole

91
Q

A deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also renal failure.

A

kussmaul breathing

91
Q

what are the causes of metabolic anion gap?

A

MUDPILES (methanol, uremia, diabetic ketoacidosis, propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylates

91
Q

condition in which severely overweight people fail to breathe rapidly enough or deeply enough, resulting in low blood oxygen levels and high blood carbon dioxide (CO2) levels.

A

Obesity hypoventilation syndrome (also known as Pickwickian syndrome)

92
Q

periods of deep breathing alternating with periods of apnea (absence of respiration for at least 20 seconds).

A

cheyne strokes

Clinical Correlation (10 decks)

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