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Winland Brown Review Book > Content 2 > Flashcards

Content 2 Flashcards

1
Q

Preferring peer group activity over adult activities, conforming to group rules, using secret codes, desiring acceptance

A

School age child

6-10 years

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2
Q

When does growth spurt occur in males

A

2 years after girls
Usually ends in tanner stage 5
Deepening of voice occurs during growth spurt

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3
Q

Reproductive changes in men as they age

A

Slightly decreased sperm production, decreased semen volume, testicular softening, decreased testosterone levels

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4
Q

Most common inherited cause of intellectual disability in children

A

Fragile x SYNDROME

x-linked

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5
Q

Infant crosses legs when lifted from behind

A

Cerebral Palsy

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6
Q

Child can speak in short sentence, give full name, use plurals, know 2 or 3 prepositions and tell a story

A

3 years old

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7
Q

Older aging changes in cell mediated immunity

A

Antibodies switch to auto antibodies

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8
Q

Annual weight gain for school age child

A

5-7ib

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9
Q

When can a child remember and reverse a sequence of 6 numbers

A

Adolescence

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10
Q

HEADSS assessment

A

Use in adolescents

Home life, education, alcohol, drugs, sexual activity, suicide thoughts

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11
Q

When should child be able to hop and jump rope

A

hop: age 4

jump rope: age 5

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12
Q

Age of separation anxiety

A

begins around 8-9 months and peaks at 14 months

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13
Q

By what age do children have a strong preference for one hand over the other

A

End of preschool period: age 4-5

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14
Q

Skin changes in elderly

A

Decreased number of melanocytes, decreased langergans cells

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15
Q

Successful aging paradigm

A

Physical health, cognitive abilities, social involvement and engagement, productivity, life satisfaction are all major components of healthy aging process

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16
Q

Get up and go test

A

Assesses functional mobility

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17
Q

Erikson stage for learning self-assertion, spontaneity, self-sufficiency, direction, and purpose

A

Initiative vs guilt

3-5 years old

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18
Q

When is fragile X usually diagnosed

A

After the toddler stage

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19
Q

When do children start to enjoy interaction with other children rather than parallel play

A

Age 3

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20
Q

Child can fasten and unfasten buttons, draw stick figures with 3 parts, successfully use scissors, lace shoes

A

Age 4

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21
Q

Marasmus

A

Form of protein calorie malnutrition

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22
Q

Erikson’s last ego stage in older adults; results in adults feeling comfortable with their life choices and the knowledge that they would have done everything the same way again

A

Integrity vs despair

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23
Q

When does menarche occur

A

Typically 2 years after thelarche, at the end of tanner stage 3

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24
Q

Height growth during school age years

A

3in annually

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25
Q

Being easily overwhelmed by stimuli, excessive chewing on clothes and frequent tantrums

A

Fragile X

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26
Q

When does nocturnal emissions occur in males

A

At about age 14; 1 year after penis begins to grow

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27
Q

Most common organism in endocarditis for drug abusers

A

Staph aureus

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28
Q

Egg allergy in children

A

Strict avoidance can cause children to outgrow

Most will outgrow it

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29
Q

Eluxadoline

A

Mu-opioid receptor agonist and delta-opioid receptor antagonist
Tx for IBS with diarrha

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30
Q

Lubiprostone

A

Enhances fluid secretion

Tx of IBS with constipation

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31
Q

TMJ

A

Pain that is unilateral and radiates to the posterior neck, ear, jaw and temporal area
Face may show asymmetry on inspection

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32
Q

Acoustic neuroma

A

Tumor within the ear that causes asymmetrical sensorineural hearing loss
MRI preferred dx tool

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33
Q

Trigeminal neuralgia

A

Sudden intense lancinating electric shock pain

Tx: carbamazepine

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34
Q

GLP-1 agonists has a black box warning for

A

Medullary thyroid cancer

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35
Q

Skin manifestations of hypothyroidism

A

Dry, coarse, pale skin; coarse hair; periorbital edema

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36
Q

Teenager with 2 month history of diffuse paresthesias and ataxic gait; loss of vibratory sense and proprioception

A

Abusing NO

Changes B12 into inactive form, causing neurologic manifestations of deficiency to occur

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37
Q

WHat can occur if tetracyclines are given to children

A

Deformity in bone structure or discoloration of teeth

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38
Q

Sacroiliitis and a bamboo spine caused by calcification of spinal ligaments

A

Ankylosing spondylitis

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39
Q

What is the pathophysiologic mechanism causing paresthesias during anxiety attack

A

Hyperventilation causes respiratory alkalosis, which in turn reduces ionized calcium concentration; leads to excitability of peripheral nerves causing the neurologic symptoms

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40
Q

Which hard disorder can cause hemoptysis

A

Mitral stenosis

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41
Q

How can you tell that dyspnea is due to pulmonary rather than cardiac cause

A

Pulmonary hypertension causes compensatory right ventricular hypertrophy and dilation that produces a lower sternal lift on chest palpation causing PMI at 4th intercostal space

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42
Q

Complication of biphosphanate therapy

A

Osteonecrosis of the jaw

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43
Q

Marked fatigue + generalized pruritus that is worse at night for 3 weeks; elevated alkaline phosphatase and serum mitochondrial antibodies present

A

Patient has primary biliary cirrhosis
Hyperpigmentation occurs
Primary disease of women

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44
Q

Fever, maculopapular rash, eosinophilia, azotemia with pyuria

A

Intersitital nephritis
Usually caused by NSAIDs, penicillins, sulfonamides, rifampin, allopurinol
Recovery takes weeks to months

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45
Q

What class of antibiotics are nephrotoxic

A

Aminoglycosides

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46
Q

Number needed to treat

A

Represents how many people must be treated with the drug to prevent one outcome

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47
Q

Dabigatran

A

Direct thrombin inhibitor

Can be used for patients who have non-valvular A Fib or venous thromboembolism or pulmonary embolism

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48
Q

Primary mechanism by which ACEI reduces albuminuria

A

Dilates efferent arteriole of glomerulus

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49
Q

Which mechanism is most likely to cause atelactasis

A

Brochial obstruction

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50
Q

How can you dx mumps

A

IgM antibody titer

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51
Q

Most effective interventions available to HCP for reducing incidence and severity of leading causes of disease and disablity

A

Counselling interventions that address the personal health practices of clients

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52
Q

How to manage effects of scleroderma

A

Avoid becoming chilled, maintain good skin care, perform physical therapy. wear loose and warm clothing, stop smoking

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53
Q

Exposures to pesticides, PCBs and dioxins has been linked to

A

Endocrine disorders

54
Q

What might exacerbate MS symptoms

A

Hot showers

55
Q

When counseling parents about accidental poisonings in children, instruct the parents to administer

A

Ipecac syrup to induce vomiting

56
Q

Diet for athlete endurance

A

High carbohydrate diet

Carb loading before a competition: high carb diet first 4 days of the week followed by moderate carbs the last 3 days

57
Q

Cheapest and easiest remedy for head lice

A

Mayo to scalp and hair

58
Q

Effective interventions for someone with OA

A

Encourage to rest frequently, apply heat to painful joints, apply splints to affected joints, use good body mechanics, lose weight if overweight

59
Q

What organization has jurisdiction over enforcement of ADA

A

Equal employment opportunity commission

60
Q

Patient education for trigeminal neuralgia

A

Always wear protective sunglasses or goggles when outside, working in dusty areas, mowing the lawn; use artificial tears and a patch at night; chew on unaffected side; avoiding eating or drinking hot foods or fluids; have regular dental exams;

61
Q

Notable signs of Vitamin C deficiency

A

Bleeding gums and broken capillaries

62
Q

Best indicator of body fluid balance in elderly

A

Body weight due to decrease in the amount of total body water

63
Q

Presence of what differentiates hyperthyroidism caused by Graves from hyperthyroidism caused by high dose of thyroid hormone

A

High radioiodine uptake

64
Q

What is a patient at risk for when they have a congenital bicuspid aortic valve

A

Developing severe aortic valve stenosis or aortic valve regurgitation
Classic triad of sx of aortic stenosis: angina, dypnea, effort syncope

65
Q

Frank starling law

A

States that the greater the end-diastolic volume in the left ventricle, the greater the force of ventricular contraction and stroke volume (pre-load)

66
Q

Excessive diuresis in diastolic heart failure can cause which CV state

A

Decreased filling of stiff left ventricle, followed by decrease in CO and hypotension

67
Q

Woman taking methotrexate should be counselled to do what

A

Take folic acid supplement

-Methotrexate is a folic acid antagonist

68
Q

2 most common causes of microcytosis

A

Iron deficiency and thalassemia

69
Q

When can you code a new patient visit for a patient who has been seen before

A

If not been seen >3 years

70
Q

Preferred initial tx of tics in tourette syndrome

A

Dopamine receptor blockers–fluphenazine or pimozide

71
Q

Bilateral carpal tunnel syndrome should cause clinician to suspect

A

Hypothyroidism, acromegaly, amyloidosis, DM

72
Q

Most common disorder responsible for developmental delays in children

A

FAS

73
Q

Thymectomy is performed in

A

Myasthenia Gravis

Due to dysplasia of thymus gland; recommended to have thymectomy within 2 years of dx

74
Q

Move client’s head to the left and the eyes move to the right

A

Doll’s eyes; normal response!

If damage to brainstem, then eyes do not move

75
Q

Initial drug choices for OCD in children

A

SSRIs or clomipramine (TCA)

76
Q

Cardiac diseases related to increased risk of stroke

A

Artificial cardiac valves, cardiac structural abnormalities, heart failure

77
Q

In the depressed client, antidepressants are most effective in alleviating

A

Sleep and appetite disturbances

78
Q

MMSE score

A

Total =30
20-25=early AD
10-19= Middle AD
<10=Late stage AD

79
Q

Most common cause of death for patients with AD

A

Pneumonia

80
Q

Research has indicated an elevated frequency of what with psychogenic non-epileptic seizures

A

Sexual abuse

81
Q

Classic findings of normal pressure hydrocephalus

A

Wacky, wobbly, wet (confusion, ataxia, urinary incontinence)

82
Q

Marijuana tests positive in the urine for how long

A

30 days

83
Q

In stroke victims, what is the body’s way to try and maintain perfusion

A

hypertension

84
Q

most common of the intracranial hematomas

A

Subdural hematoma

Headache, drowsiness, agitation, slowed thinking, confusion

85
Q

Presentation of epidural hematoma

A

Momentary loss of consciousness followed by 1-2 days of lucidity and then rapid deterioration

86
Q

Middle aged men who suffer from migraines are more likely to have what comorbiditiy

A

MI

87
Q

Encopresis

A

Repeated involuntary defecation into the clothing

Rule out neurological disorder affecting the lumbosacral spinal cord

88
Q

Effective tx of smoking cessation that does not increase risk of seizures

A

Verenicline

89
Q

What should be avoided in patients with AD who have vascular risk factors

A

Atypical antipsychotics

90
Q

Tx of MS

A

Interferon B–Decreases frequency of exacerbations

Steroids for acute exacerbations

91
Q

TRAP

A

For PD

Tremor, rigidity, akinesia, postural disturbances

92
Q

Most common cause of cerebellar disease

A

Alcohol

93
Q

Stages of anticipatory grieving

A

Shock, denial, anger, bargaining, depression, acceptance

94
Q

Most common bacteria in adult meningitis

A

Strep pneumoniae

95
Q

Where is herpes simplex encephalitis commonly located

A

Temporal and frontal lobes
Caused by HSV-1
Presence of lymphocytes and increased protein and RBC in spinal fluid

96
Q

When do OCD sx usually occur first

A

<15 years old

97
Q

Most common sx of MS

A

Focal weakness, optic neuritis, focal numbness, cerebellar ataxia, diplopia, nystagmus, bowel/bladder changes

98
Q

Most sensitive diagnostic test for identifying alcoholic client

A

y-glutamyltransferase (GGT)

99
Q

Predisposing conditions for furuncolosis

A

DM, HIV, Injection drug use

100
Q

Dense, black, necrotic eschar gradually forming over initial lesion

A

Anthrax

101
Q

Adverse effects of prolonged or high potency topical steroids

A

Cutaneous atrophy, telangiectases, easy bruisability, systemic absorption (growth retardation, electrolyte disturbances, hyperglycemia, hypertension, increased infection)

102
Q

Acne rosacea, acne vulgaris, folliculitis, candidiasis and miliaria are all classified as

A

Pustular lesions

103
Q

Warts, corns, kaposi sarcoma, basal cell carcinoma, scabies are classfieid as

A

Papular lesions

104
Q

Herpes, varicella, herpes zoster are classified as

A

Vesicular lesions

105
Q

Which guideline has a scale for malignant melanoma to show the thickness of the lesion

A

Breslow’s guidelines

106
Q

MOA of silvadene

A

Bactericidal agent that acts on the cell membrane and cell wall of susceptible bacteria and binds to cellular DNA
Effective against G+ and G-

107
Q

Acquired disorder of childhood characterized by complete loss of pigment of the skin

A

Vitiligo

108
Q

Ecthyma

A

Pruritic, tender, red vesicles or pustules surrounded by erythema that will eventually ulcerate
Deeper version of impetigo

109
Q

Acrochordon

A

Skin tag–benign tumor that forms where skin creases form (neck and armpit)

110
Q

Differential of scarring alopecia

A

Bacterial infection of the scalp

111
Q

Connection between the surface of the skin and underlying structure

A

Sinus

112
Q

Depressed lesion in which the epidermis and part of the dermis have been lost

A

Ulcer

113
Q

Moist, red, shiny, circumscribed lesion that lacks upper layer of skin

A

Erosion

114
Q

Circumscribed collection of pus that involves the deeper layers of the skin

A

Abscess

115
Q

Loss of all hair on all parts of the body

A

Alopecia universalis

116
Q

Loss of all hair on the entire scalp

A

Alopecia totalis

117
Q

The 5 p’s –purple, polygonal, planar, pruritic, papules–are present in

A

lichen planus

118
Q

The majority of malignant melanomas are

A

Superficially spreading

119
Q

Dark field examination is used to diagnose

A

Syphilis cutaneously

120
Q

Who can use DEET

A

Everyone 2 months and older, including pregnant women

121
Q

Herald patch (single, oval shaped scaly plaque from 2-5m on the patient’s chest) that progresses into numerous smaller lesions

A

Pityriasis rosea

122
Q

Guttate psoriasis

A

Multiple small lesions on the trunk with a thick scale; presents 2-3 weeks after associated streptococcal infection

123
Q

Cauliflower like wart on the anogenital region

A

Condyloma acuminata

Due to HPV

124
Q

Who is acyclovir recommended for in tx varicella

A

Anyone >2 years old

For children <2, cool baths and calamine lotion can be used

125
Q

Pastia lines

A

Present in scarlet fever

126
Q

Anogenital pruritus is typically due to

A

Constipation

127
Q

Vitamin A deficiency results in

A

thickened skin that is dry or rough

128
Q

Stork’s beak mark

A

Usually occurs on the nap of the neck and blanches with pressure

129
Q

Port wine stain

A

Deep red to purple, does not blanch on pressure and does not fade with age

130
Q

Orf skin ulcer

A

Results from parapoxvirus infection, which causes a common skin disease of sheep and goats

131
Q

Fingerlike flesh colored projections emanating from a narrow or broad base

A

Filiform/digitate warts

132
Q

Dry, itchy skin in older adults results from

A

Reduction of sweat and oil glands

Winland Brown Review Book (5 decks)

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