DAY5 Flashcards
deformity of the joint connecting the big toe to the foot..
- Plantar fasciitis
- Morton’s neuroma
- Cmpartment syndrome
- Bunion deformity
- bunion deformity
hallus abducto valgus (or varus)
pain in the heel and bottom of the foot, usually most severe with the first steps of the day or following a period of rest..
- Plantar fasciitis
- morton’s neuroma
- cmpartment syndrome
- bunion deformity
- plantar fasciitis
benign neuroma of an intermetatarsal plantar nerve, commonly between 3rd and 4th intermetatarsal spaces
morton’s neuoma
serious condition involving increased pressure, leads to muscle and nerve damage and problems with blood flow
emergency surgery.. compartment syndrome (fasciotomy)
test for anterior cruciate ligament integrity or tear (ACL)
anterior drawer test..
more reliable is Lachman test.. knee flexed 20–30°, the tibia is displaced anteriorly relative to the femur; a soft endpoint or greater than 4 mm of displacement is positive
test for meniscus both medial and lateral
McMurray test… pain on external rotation (medial meniscus) pain on internal rotation (lateral meniscus)
unhappy triad …diagnosed orthopedic issues?
ACL, MCL, Medial meniscus… diagnosed with MRI
drop arm test for?
weakness on external rotation, pain upon abduction of arm…Rotator cuff tear (also Hawkins - kennedy test)
patients arm in shoulder flexion, external rotation, full elbow extension, forearm supination, manual resistance is then applied… test for bicipital tendonitis
Speed’s test (also can use yegarson’s test)
types of spinal curvatures..
Kyphosis - thoracic curvature (hunchback)
Lordosis - anterior lumbar curvature (swayback)
Scoliosis - lateral curvature
moderate scoliosis
cobb angle 20 to 40 degrees
symmetrical joint pain, morning stiffness last 60 minutes, fatigue, anorexia, pain gets better during the day
Rheumatoid Arthritis (RA)
needle shaped negatively birefringent crystals, in a middle aged obese man, severe pain, redness and swelling in the big toe,
Gout (uric acid accumulation), often put on purine restricted diet
hip fractures, vertebral compression fractures, loss of height and progressive thoracic kyphosis, distal radius fractures (Colles’ fracture), following minimal trauma
osteoporosis (diagnosed with DEXA scan T score -2.5 and lower)
vitamin D deficiency in adults and children
adults osteomalacia, children rickets
osteoblasts vs osteoclast
build up bone vs breakdown
too much PTH (parathyroid hormone) can cause?
osteoporosis…. PTH increases blood calcium, less for bones
hypertension diagnosis…
130/90 pre hypertension
140./90 hypertension
grade 2 160/100
grade 3 180/110
essential hypertension is caused by?
unknown…
secondary hypertension is caused by…
Cushings Hyperaldosterone Aortic Pheochromocytoma Stenosis of renal
major risk factors for ischemic heart disease..
Age>65 Male Family history Hyperttension Smoking Hyperlipidemia DM
medications for hypertension
ACE inhibitors
Beta Blockers
Calcium channel blockers
Diuretics
fat deposits around the eyes showing excess fat in the body (think high levels of triglycerides)
Xanthoma
factors contibuting to atherosclerotic vascular disease…
high LDL, low HDL
total cholesterol
LDL cholestoerol
HDL cholesterol
triglycerides
below 200
below 100
above 40 (this is the cleaner of the pathways)
below 150
substernal chest tightness/pain or SOB with a consistent amount of exertion, relief is OBTAINED with rest or nitroglycerine…
- Stable angina
- unstable angina
- myocardial infarction
- acute coronary syndrome
- stable angina because it is addressed with medication, unstable angina the pain would not improve
59 year old male in ER, history of DM, HTN, hypercholesterolemia, chest pain radiating to the jaw, pain started 6 hours ago, ECG confims anterior MI… what test?
Troponin I
CK-MB is for an attack that occured further into the past…(example 4 days ago)
when would you screen for Abdominal Aortic Aneurysm 1. 45 to 55 for everyone 2. 45 to 55 who ever smoked 3. 65 to 75 everyone 65 to 75 who ever smoked
an ultrasound screening for 65 to 75 year old who have smoked.. surgical candidate if 5.5 cm or larger
right side of the heart pumps blood ….?
to the lungs.. this is the pulmonary circuit and the blood is deoxygenated
the systemic circuits pumps to the whole body
blood vessels that contain oxygenated blood…
pulmonary vein to the heart
aorta oxygenated blood from heart to body
the pulmonary artery takes blood away from the heart to the lungs and is deoxygenated.. the vena cava has deoxygenated blood (from body to heart)
normal ECG patter is composed of…
P QRS T
tachycardia in an adult..
resting heart rate over 100… for a fetus it is greater than 140
bradychardia in an adult is..
resting heart rate under 60bpm
blood pressure regulating hormones called…
renin-angiontensin-aldosteron system RAAS
angiotensinogen (+renin) to angiontensin1 + ACE to angiotensin II to aldosterone (which is one of the ways BP is modified)
angiotensinogen to aniotensinI…
renin (produced in the kidneys)
angiotensin I to angiotensin II…
ACE (produced in the Lungs and Kidneys)
adverse effects for ACE inhibitors (meds that end in -pril)
dry cough.. not productive
actions of angiotension II…
increase symathetic activity
increase aldosterone secretion
increase Na+ reabsorption
vaso constriction..
This increases BP
CPR response
Compressions… Airway… Breathing CAB
compression ventilation ration for an adult (or single resonder for child or infant)
30:2
exposure to threatened death or serious injury… male top causes: rape, combat
Female top cuases: childhood abuse, rape
post traumatic stress disorder.. if less than a month acute stress disorder
Palpitation Abdominal distress Numbness Intense fear of death Choking, chills, chest pain Sweating, shaking, shortness of breath
panic disorder
Cut down?
Annoyed you by criticism?
Guilty for your behavior?
Eye-opener to stead your nerves?
questionnaire for alcohol abuse
Sleep either decreased or increased Interests decreased Guilt Energy decreased Concentration decreased Appetite decreased or increased Psychomotor agitation or retardation Suicidal ideation
major depressive disorder
Distractibilit Insomnia decreased need for sleep Grandiosity (inflated self esteem) Speech pressed Flight of ideas Agitation, psychomotor Recklessness, risky behavior
bipolar disorder
hallucinations, delusions, disorganized speech, bizarre behaviors, no feeling of enjoyment, speaking less
schizophrenia
8 year old boy for last 7 month, easily distracted, difficulty following instructions, disorganization, fidgeting, interrupting others… occured for more that 6 moths in more that 2 settings
attention deficit hyperactivity disorder
18month old, non verbal, rarely gestures or points at things and always plays alone. DOES NOT RESPOND TO HIS NAME OR MAKE EYE CONTACT.
autism spectrum disorder
90 minutes after falling asleep, penile/clitoral tumescence occur,
REM
meds to help with nicotine addiction
Chantix
substance intoxication that causes belligerence, psychosis, VIOLENCE, impulsiveness, psychomotor agitation
phencyclidine hydrochloride PCP
marijuana -slowed sense of time
LSD -delusion, visual hall, pupil dilation
Opioids -pupil contraction (pinpoint), euphoria, CNS depression, resp. depression
Amphetamine, cocaine -psycomotor agitation, pupil dilaion
toxicity: restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation
withdrawal: headache, lethargy, depression, irritability, craving
- alcohol
- nicotine
- caffeine
- sugar
- caffeine
signs.. parotitis, orchitis, meningitis
mumps
mumps - epidemic parotitis
measles -rubeola
german measles -rubella
koplik spots, descending maculopapular rash, cough, coryza, conjunctivitis
C(K)oplik spots
Cough
Coryza (runny nose)
Conjunctivitis
measles rubeola
what is 3 day measles
rubella (german measles)
What is passed from mother to baby? T O R C H
toxoplasmosis other infections...Hep B rubella cytomegalovirus herpes simplex 2
causative agent of whooping cough
bordatella pertussis…
most common STI
HPV
most common viral STI
HPV
most common bacterial STI
Chlamydia
vaccines are available for
Hep A and B
A 15 to 150 fecal/o abrupt yes(vaccine) no(chronic) B 45 to 160 blood insidious yes depends C 14 to 180 blood insidious no 75 to 85% D n/a n/a insidious no n/a E 15 to 60 f/o abrupt no no
abrupt onset
hep A and E
blood borne
hep b and C
incubation of hep C
14 to 180 days
fecal oral transmission high mortality in women
HEP E
common cause of infantile diarrhea, major cause of acute diarrhea in the US during the winter esepcially in day care centers and kindegartens
ROTAVIRUS
non bacterial outbreak of gastroenteritis, spread quickly in closed places like daycare centers, nursing homes, schools, CRUISE SHIPS
NOROVIRUS
primary target of HIV
CD4 helper T cells
when CD4 cells fall below 200 you are considered to have progressed to AIDS, or develop one or more oppotunistic ILLNESSES, regardless of CD4 count
super bug resistant to antibiotics
MRSA meth resistant staph aureus
related to hospital stays because too much antibiotics NOSOCOMAL
not a sign or symptom of meningitis
- fever
- neck stiffness
- mental status change
- babinski sign
Babinski sign is for UMN.. scraping bottom of foot and fanning of toes
neck is flexed and knee and hip flex involuntarily
brudzinski sign for meningitis
hip/knee flexed,inability to straighten knee
kernig sign for meningitis
test for HIV
start with ELISSA and confirm with western blot
poor night vision damage to cornea dry or cracked skin
VITAMIN A deficiency.. mucosa
hemorrhage, rare except in newborn infants
VIT K deficiency
dry beriberi, wet beriberi, wernicke korsoakoff syndrome
VIT B1 thiamine deficiency… WK is caused by alcohol, amnesia, psychiatric
pellagra… dermatitis, diarrhea, dementia (scaly sores, mucosal changes, mental symptoms)
vitamin B3 deficiency .. Niacin
megaloblastic anemia and pernicious anemia
caused by B12 deficiency cobalamin
autoimmune disease in the fundus of the stomach .. no parietal cells which creates intrinsic factor.. without intrinisic factor no absorption of B12
pernicious anemia
vit B9 deficiency .. folate.. in pregnancy
megaloblastic anemia
weakness, anemia, bruising, bleeding glums, loose teeth
Vit C deficiency.. scurvy
b1 deficiency from alcohol abuse..
Wernicke Korsakoff syndrome
wernicke encephalopathy.. ataxia. ophthalmoplegia confusion
korsakoffs psychosis imparied short teerm memory confabulation may be accompanying. (this is the homeless person on the street that makes up stories regarding how they got there)
vitamin d deficiency in children
causes rickets.. this is not a calcium deficiency.. same as osteomalacia in adults
