Clinical Manifestations/complications Flashcards
CKD
High Cr, anemia, uremic frost, fluid retention (edema, CHF, HTN), abnormal electrolytes (high Na, high K, high phosph)
Also: urine problems
4 phases AKI
Initiation
Oliguria
Diuresis
Recovery
AKI classifications with Cr and GFR values
Risk 1.5x cr / GFR down 25%
Injury 2x cr / GFR down 50%
Failure 3x cr / GFR down 75%
Loss = AKI > 4 weeks
ESKD > 3 months
5 phases CKD with GFR values
1: > 90
2: 60-89
3: 30-59
4: 15-29
5: <15
Kidney transplant rejection
Oliguria, fever
Edema, high BP, weight gain, swelling and tenderness
Arrhythmia complications
Cardiac arrest, HF, thromboembolic event (especially with a fib)
Sinus brady
Less than 60
Decreased CO leading to low BP, fatigue, dizzy, SOB, syncope, confusion
Sinus tachycardia
100-150
Decreased CO
HA
A fib
Atrial flutter that is disorganized
Atrial rate of 300 (with ventricular 100-200)
Loss of atrial kick
Low BP
Clot
CAD
Ischemia from plaque buildup
Angina
HF
MI
Epigastric, radiating pain, SOB, atypical symptoms with women (indigestion, nausea, palpitations, numbness, sweating, fatigue)
Angina
Central chest pain - tight, choke, heavy, may radiate
Anxiety, dyspnea, SOB, dizzy, NV, diaphoresis, doom
Older: decreased pain, increased weakness
MI
Ischemia and necrosis, cell death
Chest pain
SOB, indigestion, nausea, anxiety, cool, pale, high HR and RR
ECG: inverted t, ST elevated, abnormal q
Complications of cardiac surgery
Decreased CO, fluid and lyte, impaired gas exchange, impaired cerebral perfusion
Mitral valve prolapse
Blood from ventricle to atrium
Mostly asymptomatic
Mitral click
No known cause
Mitral regurgitation
Flow back into L atrium
Fatigue, diaphoresis, DOE, edema
Acute: HF, PHTN, P edema
Murmer at apical
Mitral stenosis
Low flow from atria to ventricle leads to low CO
Pulmonary arterial pressure increases
R ventricle hypertophies
Murmur, DOE, fatigue, exercise intolerance
Hemoptysis, PND, orthopnea
Aortic regurgitation
Blood back flow to L ventricle from aorta during diastole
Murmur at L 3 and 4
DOE, fatigue, SOB, PND
Aortic stenosis
Calcification
L ventricle hypertrophy
DOE, PND, P edema, syncope
Murmur, S4, palpable vibration
Cardiomyopathy
Low SV stimulates SNS and RAAS
Increased SVR (resistance), Na, fluid
Increased cardiac workload but decreased CO
Decreased EF (ejection fraction)
DCM
Elevated systolic and diastolic volume
Decreased EF
Diastolic murmur
HCM
Thick septum, small cavities, long time to relax after systole
Systolic murmur, ventricular arrhythmia, HF
Syncope
RCM
Rigid ventricular walls
Dilated atria
Poor stretching and filling
Dyspnea, cough
Infection of heart
Fever, fatigue
Murmur, friction rub, HF, tachycardia, palpitations , chest pain
Nodes and legions on hands and feet, cardiomegaly, splenomegaly
Dyspnea, syncope
Angina complications
ACS, MI, cardiac arrest, cardiogenic shock
HF, arrhythmias
MI complications
acute pulmonary edema, HF, cardiogenic shock, arrhythmia and arrest, pericardial effusion and cardiac tamponade
Cardiomyopathy complications
HF, arrhythmias, conduction defects, valve dysfunction
Embolism (pulmonary or cerebral)
Lower UTI
Pain and burn
Frequency
Nocturia
Incontinence
Hematuria
Lower UTI complications
Urosepsis
AKI
CKD
Acute pyelonephritis
Chills, fever, NV, HA, malaise
Leukocytosis, pyuria, dysuria
Chronic pyelonephritis complications
HTN
ESRD
Stones
Urolithiasis
Bladder: like a UTI, hematuria, retention
Kidney: CVA pain, Hematuria and pyuria, flank pain, NV
Ureter: incredible radiating pain
Bladder cancer
Painless hematuria
Frequency and urgency
Pelvic/back pain might be metastasis
Cutaneous urinary diversion complications
Skin irritation
Stoma infection
Leakage
Reflux
Pyelonephritis
BPH
Frequency and urgency
Nocturia
Hard to start
Weak stream
Post dribble
Can’t totally empty
Prostate cancer
Obstruction
Hematuria and hematospermia
Painful ejaculation
Metastasis ss: hip and back pain, peri rectal pain, anemia, weight loss, weak, nausea, oliguria
L HF
Pulmonary congestion, cough
S3, Tachycardia
DOE, SOB, orthopnea, PND
Low O2 sat, Fatigue
R HF
Visceral and peripheral congestion
High CVP
JVD, edema, weight gain
Hepatomegaly and Ascites
HF complications
Pulmonary edema
Hypotension, bad perfusion, cardiogenic shock
Arrhythmias
Thromboembolism
Pericardial effusion
Pulmonary edema
Hypoxemia, tachypnea, dyspnea, low LOC, anxiety
Cool and clammy, cyanosis
Weak rapid pulse
Cough, lung congestion, frothy pink sputum
Cardiogenic shock
Low CO leads to bad perfusion then shock
Pericardial effusion
Chest pain and fullness, pulsus paradoxus, engorged neck veins, low BP, SOB
Cardiac tamponade
Sudden chest pain
Falling systolic BP
Narrowing pulse pressure
Rising venous pressure
Distant heart sounds
PAD
Claudication (cramping pain and weak/fatigue occurring with exercise; relieved with rest)
Ischemic rest pain at night (distal extremity)
Ulcers may become gangrenous
Atrophy, skin changes, nail changes
PAD post op complications
Bleeding
Hematoma
Aneurysm
Sharp sudden pain = rupture
SOB, stridor, dysphagia
Tachycardia
Abdominal aortic aneurysm
Abdominal throbbing, heartbeat, pulsatile abdominal mass, abdominal and back pain
Raynaud’s
Vasoconstriction leading to color change, numb, tingle at hands and feet
DVT
Swelling, painful, warm
Increased pain with ambulation
Pulmonary embolism
Tachypnea
Dyspnea
Chest pain
Anxiety
Tachycardia
Syncope
May mimic HF or pneumonia
Heart infection complications
Effusion and tamponade, cardiomyopathy and HF
DM 1 and 2
Polyuria, polydipsia, polyphagia
Fatigue, weakness
Poor blood flow
DM 1 unique CM
Sudden weight loss
NV and abdominal pain
DM 2 unique CM
Vision
Tingle or numb
Dry skin
Slow heal wounds
Hyperglycemia
Vomiting
Excessive hunger and thirst
Rapid heartbeat
Vision problems
Fruity breath
Hypoglycemia
Hunger
Weakness
Shaking
Headache
Inability to concentrate
Slurred speech
HHS
Polyuria
Profound dehydration
Hypotension
Tachycardia
Altered LOC and seizures due to cerebra dehydration
DI
Large amounts of dilute urine
Extreme thirst (2-20 L cold water)
SIADH
Fluid retention
Hyponatremia
Hypothyroidism
Lethargy and weakness
Numb and tingle
Impaired memory and concentration
Pallor and puffy face
Large tongue, loss of eyebrows and hair
Deep voice
Decreased sweat, cold intolerance
Slow pulse, cardiomegaly
Gastric atrophy, weight gain, increased appetite
Menorrhagia
Edema
Also: constipation, CAD, angina, and nail stuff
Also breathing issues
And myxedema coma complications
Hypothyroidism complications with older patients
Angina and tachyarrhythmias with rapid treatment
Hyperthyroidism
Nervous, tremors, insomnia
Heat intolerance, warm
Flushed, moist
Bulging eyes, fine hair, goiter
Increased appetite, weight loss
High systolic, dysrhythmia, rapid pulse
Hyperparathyroidism
Bone decalcification
Rena calculi
Apathy, fatigue, weak
NVC
HTN and dysrhythmia
Hypoparathyroidism
Tetany, numb, tingle, stiff
Spasm (broncho, laryngeal, carpopedal)
Anxiety, irritable, depressed, delirium
ECG change
Also: seizures if severe hypocalcemia
Addison
Weak, fatigue
GI and anorexia
Dark pigmentation
Low BP, low glucose
Low sodium, high K
Apathy, confusion
Also: ortho hypo, fluid imbalance
Addisonian crisis
Shock, hypotension, rapid weak pulse, rapid RR, pallor, extreme weakness
Cushing
Hyperglycemia, obese, Buffalo hump, moon face, thin extremities
Lethargy, weak, fragile skin, bruising, acne
Slow heal, bad mood, low libido
Gals get masculine traits
Myxedema coma
Hypothermic
Coma
Due to hypothyroid
Macro vascular long term DM complications
CV: MI, CAD
Cerebral: ischemic attack, hemorrhage, memory
Peripheral: atherosclerosis, ulceration/gangrene
Micro vascular long term DM complications
Retinopathy- macular thickening and aneurism
Neuropathy- peripheral, autonomic, hypoglycemic unawareness, sexual dysfunction
Nephropathy- decreased kidney filtration, pyelonephritis
Eosinophilic pituitary tumor
Gigantism
Acromegaly
Basophilic pituitary tumor
Cushing
Hypothyroidism complications
Angina, arrhythmias, atherosclerosis, CAD, myxedema coma if severe
Thyroid storm
Hyperthyroid emergency
High temp, high HR, altered LOC, extreme hyperthyroid ss
