Brainscape's Knowledge GenomeTM

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


See full index

2b > Chronic Diseases > Flashcards

Chronic Diseases Flashcards

1
Q

What clotting factor is PT?

A

Clotting factor II

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

what does INR stand for?

A

International normalised ratio

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

What drug do you adjust dose for depending on INR?

A

warfarin

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

What does aPTT stand for?

A

activated partial thromboplastin time

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

What drug do you adjust dose for depending on aPTT?

A

Heparin

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

What do INR and aPTT both assess?

A
  • How fast blood clots
  • Assess pathways of coag cascade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What pathway does PT/INR measure?

A

Extrinsic pathway

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

What type of drug is warfarin? how does it work?

A
  • anticoagulant
  • vit K antagonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is normal INR range?

A

1

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

what is Normal INR range on warfarin?

A

2-3

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

Patient is on warfarin. What would value of less than 2 mean?

A

increased risk of blood clots

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

Patient is on warfarin. What would value of more than 3 mean?

A

Increased risk of bleeding

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

What is heparin? how does it work?

A
  • Anticoagulant
  • Indirect thrombin inhibitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is normal aPTT range?

A

30-40 seconds

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

What is normal aPTT range on heparin?

A

1.5-2.5 x the normal range (60-80)

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

What regular blood checks to patients on NOACs/DOACs need?

A

none! ha

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

What does a higher INR value mean?

A
  • Longer it takes for you’re blood to clot
  • increased risk of bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Questions to ask patient on warfarin?

A
  • Why are you taking warfarin?
  • how long have you been taking it?
  • Any side effects?
  • how is it affecting your life?
  • Diet (vit K)?
  • Alcohol ?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What dietary stuff have vitamin K

A
  • all those green things! (celery, green grapes, kale, broccoli, cucumber, green beans, green apples)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is idea number (not range) for INR on warfarin?

A

2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what conditions could cause a raised INR

A
  • reduced clotting factors (bleeding disorders)
  • liver failure
  • too much anticoagulant medicine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How should warfarin be taken (timing)?

A
  • Same time every day
  • Do not double dose to catch up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe action of warfarin (patient friendly)

A

It is an anticoagulant. This means that it stops the blood from clotting too easily.

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

What is warfarin commonly used to treat?

A

DVT, PE, prevent stroke in AF

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

What high INR symptoms?

A
  • Headache
  • Severe stomach ache
  • Increased bruising
  • Prolonged bleeding after minor cuts/ menstural bleeding/ gum bleeding
  • Blood in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What low INR symptoms?

A
  • sudden weakness/numbess/tingling in limb
  • Visual changes
  • Inability to speak
  • New pain, swelling, redness, heat
  • New SOB or chest pain (DVT/PE symptoms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What PMH do you ask about when discussing INR?

A
  • Liver disease
  • Bleeding disorders (haemophilia, factor 7 deficiency)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How would taking a double dose of warfarin impact INR?

A

increase INR

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

How does smoking affect INR?

A

increase INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to treat low INR?

A
  • LMWH, warfarin
  • Compression stockings if immobile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How to treat elevated INR

A
  • Vit K
  • Decrease warfarin dose and recheck INR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is HbA1c? (patient friendly)

A

HbA1c shows the average blood glucose level over the previous 2-3 months as the sugar sticks to cells in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How often does HbA1c need to be tested

A

every 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is is most common haemoglobin and what is it made up of?

A
  • HbA1
  • 2 alpha + 2 beta chains
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

describe HbA1 compared to HbA1c

A
  • have no protein structural differences
  • HbA1c is glycosylated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

why HbA1c high in diabetic patients

A

In diabetic patient: not/reduced insulin response => increase blood glucose => longer encounter with RBC => glycosylated Hb => increase HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What Qs should you ask in general history taking for HbA1c?

A
  • T1 or T2 diabetes?
  • How long ago were you diagnosed?
  • Explain HbA1c and benefits of low HbA1c
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is normal HbA1c range? (% and mmol/L)

A

<6.0% or <42mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is prediabteic HbA1c range? (% and mmol/L)

A

6.0 - 6.4% or 42-47 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is diabetic HbA1c range? (% and mmol/L)

A

> 6.5% or >48 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

HbA1c SH Qs?

A
  • How is it affecting your life?
  • Diet and exercise?
  • Smoking?
  • Alcohol?
  • Medication compliance?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the benefits of reducing HbA1c?

A

Reduce risk of:
- Retinopathy
- Neuropathy
- Diabetic nephropathy
- Cataracts
- Heart failure
- Amputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

HbA1c PC Qs?

A
  • How are they feeling
  • Any recent infection
  • Any hospital admissions for DKA/hypos?
  • Any symptoms of diabetes?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the symptoms of diabetes?

A
  • Polyuria
  • Polydipsia
  • Weight change
  • Visions changes
  • tingling in feet
  • Impotence (ED)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What can HbA1c be falsely raised in?

A
  • Kidney failure
  • Chronic excessive alcohol intake
  • Vitamin B12 deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

HbA1c DH Qs?

A
  • What diabetes medication do you take?
  • How/when are you taking the medication?
  • Site rotation?
  • Any side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

HbA1c SH Qs?

A
  • Mood/ sleep?
  • Home circumstances?
  • Affecting ADL?
  • Diet (dietary restrictions/ trying to lose weight)
  • Exercise
  • Smoking + alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What advice to lower HbA1c?

A
  • Diet: aware of snacking, cars in food
  • Physical activity: regular exercise
  • Take extra care when ill: check blood sugar every 4h, keep taking diabetes meds even when don’t feel like eating
  • Monitor blood sugar level
49
Q

What is spirometry/ what does it measure?

A

measures functional lung volumes (how much you breath in and out)

50
Q

What does FEV1 depend on? why is this important?

A
  • Age, sex, height, mass, ethnicity
  • Used to calculate a predicted FEV1
51
Q

What is FEV1? what is it a measure of?

A
  • Forced expiratory volume in 1sec (greatest vol asap)
  • Measure of ability of air to freely flow out of lungs
52
Q

In what type of lung disease in FEV1 reduced?

A

reduced in obstruction (causing a wheeze)

53
Q

What is FVC? what is is a measure of?

A
  • Forced vital capacity (total col of air a person can exhale after max inhale)
  • Measure of total col of air that person can take into lungs
54
Q

In what type of lung disease is FVC reduced?

A

reduced in restriction

55
Q

Obstruction lung disease: describe FEV1, FVC + FEV1:FVC

A

FEV1: reduced (< 80% of the predicted normal)
FVC: reduced (but to less extent than FEV1 (FEV1 < FVC))
FEV1:FVC < 0.7

56
Q

Explain physiology of lung function tests in patient with obstruction pathology

A
  • There is an obstruction which slows passage of air out of lung
  • Patient can have good total lung vol but air only moves slowly in and out
57
Q

What causes the obstruction in asthma?

A

bronchoconstriction

58
Q

what causes obstruction in COPD?

A

chronic airway + lung damage

59
Q

Other than spirometry and peak flow, how else can you distinguish between asthma and COPD?

A

reversibility of obstruction with bronchodilator indicates asthma

60
Q

What is peak flow?

A

fastest point of a persons expiratory flow of air (peak expiratory flow rate (PEFR))

61
Q

Describe peak flow technique

A
  • Stand tall, deep breath in, good lip seal, expire hard and fast, repeat 3 times
  • Always use same peak flow meter
62
Q

Should you measure peak flow before or after preventer inhaler

A

before

63
Q

peak flow: what do you do with the 3 attempts?

A

record the best attempt

64
Q

How is peak flow recorded?

A

As “percentage of predicted” value

65
Q

Name cause of obstructive lung disease

A
  • Asthma (reversible)
  • COPD (irreversible)
  • Bronchiectasis
  • Inhaled foreign body
  • Tumour
66
Q

Describe restrictive lung disease physiology

A

restriction to the ability of the lungs to expand and take in air.

67
Q

Restrictive lung disease: describe FEV1, FVC + FEV1:FVC

A

FEV1: reduced (< 80% of the predicted normal)
FVC: reduced (<80% of the predicted normal)
FEV1:FVC: normal (> 70% because FVC proportionally lower)

68
Q

Name some restrictive lung diseases

A
  • pulmonary fibrosis
  • sarcoidosis
  • scoliosis
69
Q

describe peak flow/ spirometry in patient friendly terms

A

peak flow: measures how fast you can breathe out so you can see how well your lungs are working
Spirometry: measures lung function, specifically the volume and speed of air that can be inhaled/ exhaled

70
Q

peak flow/ spirometry PC Qs?

A
  • How are you feeling?
  • Any recent illnesses/infections?
  • Any SOB?
  • Particular time you tonic symptoms worsen?
  • Symptoms getting worse?
71
Q

peak flow/ spirometry DH Qs?

A
  • Is your condition controlled?
  • What medications to you take? how often?
  • Chek inhaler technique
72
Q

peak flow/ spirometry SH Qs?

A
  • Any new pets?
  • Recent travel anywhere?
  • Housing situation (damp)?
  • Smoking?
  • Alcohol?
  • Impact of condition on life?
73
Q

peak flow/ spirometry: what advice would you give?

A
  • stop smoking
  • avoid triggers
  • vaccination
  • exercise
74
Q

Where is CRP produced form?

A

protein released by the liver

75
Q

What does CRP do?

A

Travels in blood stream in search of dead or damaged cells => activates complement system

76
Q

What is normal CRP range?

A

<10 mg/L

77
Q

After how many hours from onset of inflammation does CRP begin to rise?

A

6 hours

78
Q

After how many hours from onset of inflammation does CRP peak?

A

24 hours

79
Q

What could cause a rise in CRP?

A
  • Infection
  • Autoimmune conditions (crohns, RA)
  • Pregnancy
  • Burns
  • Increasing age
80
Q

What is ESR?

A

rate at which RBC fall in a test tube over 1 hour

81
Q

What is normal ESR range?

A

0-10 mm

82
Q

After how many hours from onset of inflammation does ESR rise begin?

A

after 48 hours

83
Q

What could cause a rise in ESR?

A
  • infection
  • polymyalgia rheumatica
  • GCA
  • autoimmune conditions (SLE, RA)
  • pregnancy
  • ageing
84
Q

are CRP and ESR sensitive? specific?

A
  • Sensitive
  • Non-specific
85
Q

Give examples of how inflammatory markers can assist with monitoring infection

A
  • Post-op infection
  • Response to Abx
86
Q

Explain physiology of ESR

A

inflam => increased fibrinogen => RBC stick together => fall faster

87
Q

ESR/CRP: how should you start consultation?

A
  • Interpret the inflam markers
  • Check patients understanding of ESR/CRP
88
Q

Explain ESR/CRP in patient friendly terms

A

Its a marker of inflammation which tells us that there could be a flare up in you condition or a new infection detected

89
Q

ESR/CRP DH Qs?

A
  • How well is your condition being controlled
  • What medication do you take? how often?
  • Any side effects
  • Any other medications?
90
Q

ESR/CRP SH Qs?

A
  • Recent travel
  • Smoking
  • Alcohol
  • Impact of condition on life
91
Q

ESR/CRP advice?

A
  • Stop smoking
  • Advice on disease management and compliance
92
Q

How does smoking affect ESR/CRP?

A

raises them

93
Q

What are ALT, AST, ALP + GGT? (brief)

A

enzymes found within the liver and biliary tract

94
Q

What are liver function tests?

A

Blood tests to monitor hepatic function and damage

95
Q

What can be used to assess livers ability to synthesise enzymes and proteins?

A
  • Albumin
  • Prothrombin time (PTT)
96
Q

How would serum albumin levels change in liver disease?

A

Albumin levels fall with liver disease

97
Q

Other than hepatic causes, what else can cause a decrease in albumin blood levels?

A
  • Decreased protein intake
  • Malabsorption
  • Losing protein in urine
98
Q

How would prothrombin time change in liver disease? Explain

A

Prothrombin time would increase
Decline in LF => decreased clotting factors => PTT

99
Q

What can be used to assess livers ability to process bilirubin and secrete bile?

A
  • Bilirubin
  • ALP
  • GGT
100
Q

Briefly describe liver’s role in bilirubin metabolism

A
  • Bilirubin is water insoluble produce of normal ham breakdown and is transported to liver bound to albumin
  • Liver converts it to water soluble
  • Secreted in bile
101
Q

Other than hepatic causes, increased PTT could indicate what?

A
  • Bleeding disorders
  • Vitamin K deficiency
  • Anticoagulants (warfarin)
102
Q

What is normal bilirubin range?

A

3-17 umol/l

103
Q

What is normal alkaline phosphatase (ALP) range?

A

30-100 umol/l

104
Q

What is normal Gamma-glutanyltransferase (GGT) range?

A

8-60 u/l

105
Q

What are ALP and GGT ?

A

enzymes found in tiny bile ducts of liver (+ other tissues)

106
Q

What would raised serum ALP + GGT indicate?

A

Damage to biliary tract

107
Q

Is ALP or GGT more speck in identifying biliary disease?

A

GGT

108
Q

What can be used to assess for extent of liver damage?

A

AST, ALT

(you’re f’ed: at fALT so die fAST)

109
Q

Explain how AST and ALT chain in liver damage (physiology)

A

liver damage => hepatic cell damage => cell content (including enzymes) leak into bloodstream => increased serum AST + ALT levels

110
Q

In which people would you expect the normal range of AST + ALT to be higher?

A

Men
Obese

111
Q

What is normal aspartate transaminase (AST) range?

A

3-30 iu/l

112
Q

What is normal alanine transaminase (ALT) range?

A

3-40 iu/l

113
Q

What is the (one) most specific enzyme to detect liver damage

A

ALT

114
Q

What causes a rise in AST?

A

alcohol

115
Q

What causes a rise in serum GGT?

A

liver damage from drugs and alcohol

116
Q

LFT PMH Qs?

A
  • Gallstones
  • Crohn’s/UC
  • Surgery (bowel removed => malabsorption)
117
Q

LFT DH Qs?

A
  • How well is your condition controlled
  • What medication do you take? how often?
  • Any side effects?
  • Do you take any other medications?
118
Q

LFT SH Qs?

A
  • Recent travel?
  • Smoking?
  • Alcohol?
  • Recreational drugs/toxins?
  • Diet
  • Impact on ADL?
119
Q

LFT abnormalities advice?

A
  • Stop smoking/alcohol/drugs
  • Diet advice
  • Advice on disease management if non-compliant

2b (9 decks)

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