Brainscape's Knowledge GenomeTM

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


See full index

Adult 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

3 stages of Primary Gout

A

1) Hyperuricemia
2) Acute Gouty Arthritis
3) Chronic Tophaceous Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • Deposits of urate crystals under skin
  • Other major organs (renal)
  • Kidney stone formation
  • 3-40 years after acute episode
  • Uncommon in US
A

Chronic Tophaceous Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • Sodium urate deposited in synovium
  • Excruciating pain
  • Inflammation in small joints, usually great toe (podagra)
A

Acute Gouty Arthritis

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

Most common inflammatory arthritis in older adults

A

Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • May be genetic X-linked
  • Inborn errors of purine metabolism
  • Production of uric acid exceeds excretion
A

Primary Gout

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

-Excessive uric acid in the blood caused by another dz

Renal insufficiency, crash diets, diuretics, chemo

A

Secondary Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Allopurinol pt instructions

A

Take after meals with a glass of water to prevent GI distress

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

DOC for Gout

A

Allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can cause a gout attack?

A

Alcohol and starvation diets

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

Diet instructions for gout

A

Increase alkaline ash foods (to increase pH) such as citrus fruits, juices, dairy products

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

How to treat Polymyositis

A
  • High dose steroids
  • Immunosuppressive agents
  • Monitor nutrition for swallowing problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Polymyositis coupled w/ a rash?

A

Dermatomyositis

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

What type of rash w/ Dermatomyositis?

A

Heliotrope rash (iliac) & periorbital edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What Dz?

  • Mostly men
  • Involves every body system
  • Renal and cardiac problems: leading cause of death
A

Polyarteritis nodosa

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

What Dz?
Most common form of vasculitis
Skin lesions as an allergic response

A

Hypersensitivity vasculitis

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

What Dz?

  • Japanese women in 20s
  • Aortic arch syndrome
  • Cerebral ischemia
  • Visual changes, syncope, vertigo
A

Takayasu’s arteritis

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

DOC for vasculitis dzs?

A

Steroid therapy (prednisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

First symptoms of systemic Necrotizing Dzs?

A

Arteritis, ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DOC for Temporal Arteritis

A
  • Corticosteroids URGENTLY

- Calcium and Vitamin D for prevention of osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What Dz?

  • 20% of patients with PMR
  • Systemic affecting large and mid size arteries
A

Temporal Arteritis

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

Women over 50 report declining vision, probably have?

A

Polymyalgia rheumatica (PMR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What Dz?

  • Stiffness, weakness, aching
  • Low grade fever, arthralgias, stiffness, fatigue, weight loss
  • Neck, shoulder, hip joints most affected
A

Polymyalgia rheumatica (PMR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What Dz?Exact cause unknown
-Genetic risk: HLA-B27 alleles
Affects vertebral column, spinal deformities
-White men

A

Ankylosing Spondylitis

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

What Dz?

  • Genetic association: HLA-B27 antigens
  • Mostly young white men
  • From exposure to STD or Intestinal infection
A

Reiter’s Syndrome

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

Reiter’s Syndrome Triad of Symptoms

A
  1. Arthritis
  2. Conjunctivitis
  3. Urethritis
    * May also experience balantitis circinata (inflammation around penis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What Dz?

  • Autosomal dominant
  • Abnormalities of skeletal, ocular, cardiopulmonary & CNS
  • Excessively tall, scoliosis, funneled chest
  • Decreased visual acuity or glaucoma
  • Hyperextensibility of joints
  • Elongated hands and feet
A

Marfan Syndrome

27
Q

Why do most deaths from Marfan Syndrome occur?

A
  • Cardio problems (usually in 30s)
  • Mitral valve prolapse
  • Mitral valve regurgitation
  • Aortic aneurysm rupture
28
Q

Treatment of Marfan Syndrome?

A
  • Palliative (deal w/ symptoms, not cause)
  • Monitor CV status
  • CV medications
  • Orthopedic surgery
29
Q

What Dz?

  • Systemic infectious disease
  • Borrelia burgdorferi spirochete
  • Bite of infected deer tick
  • Most common vector borne disease in US
A

Lyme Dz

30
Q

Stage 1 Lyme Dz

A
  • Localized, flu-like symptoms
  • Round or oval, flat or slightly raised rash
  • Pain and stiffness in muscles and joints
  • Bull’s-eye lesion
  • Symptoms usually 7-14 days after bite
  • With treatment (ABX), no symptoms 4-5 weeks
31
Q

Stage 2 Lyme Dz

A
  • Early disseminated (spread), 2-12 weeks after bite
  • Pt may develop carditis, dysrhythmias, dyspnea, dizziness, palpitations, CNS disorders, Meningitis, facial paralysis, peripheral neuritis
32
Q

Treatment of Stage 2 Lyme Dz

A

IV antibiotics for 30 days

33
Q

Stage 3 Lyme Dz

A 
Chronic persistent
Arthritis
Chronic fatigue
Memory and thinking problems
Months to years after bite
34
Q

What Dz?

  • Mimics gout
  • Deposited crystals are calcium pyrophosphate
  • Crystals migrate to cartilage
  • Older hospitalized males
  • Highest in men with metastatic cancer
A

Pseudogout

35
Q

What Dz?

  • 30% of people with psoriasis
  • 30-50 years of age
  • Genetic, environmental, infectious agents, immune system dysfunction
  • Early morning stiffness, neck and back pain
  • Fingernail and toenail lifting
A

Psoriatic arthritis

36
Q

Psoriatic Arthritis Tx

A
  • Manage joint pain and inflammation
  • Control skin lesions
  • Health teaching similar to skin care for lupus
  • Management similar to rheumatoid arthritis
37
Q

What Dz?

  • Chronic pain syndrome, not inflammatory
  • Arthritis commonly present
  • Pain, stiffness, tenderness
  • Neck, upper chest, trunk, low back, extremities (trigger points)
  • Pain intermittent but worsens with stress, increased activity, weather
  • 30-50 years of age
A

Fibromyalgia

38
Q

Precipitating factors of Fibromyalgia

A
  • Chronic fatigue syndrome
  • Lyme disease
  • Trauma
  • Flu-like illness
39
Q

Fibromyalgia Tx

A
  • Antidepressants
  • Teach that these drugs cause drowsiness
  • Avoid alcohol
  • NSAIDS
  • Sleep aids
  • Be careful with older pts (may cause confusion and orthostatic hypotension)
  • Muscle relaxants
  • Physical Therapy
40
Q

What Dz?

  • Chronic illness w/ fatigue 6 months or longer
  • Flu-like symptoms
A

Chronic Fatigue Syndrome

41
Q

Four of more of what criteria must be met for Chronic Fatigue Syndrome?

A
  • Sore throat
  • Substantial impairment in short-term memory or concentration
  • Tender lymph nodes
  • Muscle pain
  • Multiple joint pain with redness or swelling
  • Headaches of a new type, pattern, or severity (not familiar to the patient)
  • Unrefreshing sleep
  • Postexertional malaise lasting over 24 hours
42
Q

Supportive Treatments for Chronic Fatigue Syndrome

A
  • Aches and Pains: NSAIDS
  • Sleeplessness and depression: Antidepressants
  • Teach: adequate sleep, proper nutrition, regular exercise, stress management, energy conservation, CAM
43
Q

What Dz?

  • Symptoms atypical of any one connective tissue disease
  • 10% of patients with CTD
  • 2 diseases may overlap at one time
  • Systemic lupus erythematosus AND systemic sclerosis
  • Rheumatoid arthritis AND SLE
A

Mixed Connective Tissue Dz

44
Q

What Dz?

“I’m sick of always being sick”

A

Mixed Connective Tissue Dz

45
Q

What do you assess for Scleroderma?

A

-Skin: painless pitting edema of hands and fingers, taunt, shiny, wrinkle free, decreased ROM, ulcerations, contractures
-Myocardial fibrosis: EKG changes, dysrhythmias, chest pain
-Vasculitic lesions
-Nailbeds: digit necrosis
Autoamputation
-Renal:malignant HTN, urine output and BP
-Respiratory: pulmonary fibrosis, pulmonary HTN
-Gastrointestinal: ability to swallow

46
Q

Main cause of death in Scleroderma?

A

Renal

47
Q

Important teaching priorities for SLE

A

Skin Protection, monitor body temperature

48
Q

SLE leading cause of death?

A

Renal: Lupus Nephritis

49
Q

Classic sign of exacerbation for SLE

A

Fever

50
Q

What Dz?

-Affects skin ONLY, round coin-like scarring lesions

A

Discoid DLE

51
Q

What Dz?

  • Alopecia (hair loss), dry, scaly, raised rash on the face (butterfly rash), mouth ulcers
  • Autoimmune
  • Combination of genetic and environmental factors
  • Onset 20-40 years of age
  • Women 10 times more than men
  • Women of color more often affected
A

SLE

52
Q

Patho of SLE

A

-Antinuclear Antibodies (ANA) affect DNA, RNA
-Immune complexes form in serum & organ tissues
-Inflammation, damage, destruction
-Invade organs or vessels (vasculitis)
*Particularly attracted to kidney glomeruli
(leading cause of death)
-Deprives organs/tissues of arterial blood & oxygen

53
Q

Chronic therapy complications of RA

A

-Diabetes mellitus, infection, fluid/electrolyte imbalances, HTN, Osteoporosis, Glaucoma

54
Q

Teaching for RA

A
  • Take steroids with calcium plus vitamin D

- Rest and ice after injection in single joint

55
Q

DOC for RA

A

Prednisone

56
Q

Cox-2 inhibitor for RA

A
  • Celebrex

* Cardiovascular WARNING!

57
Q

Pts with MS or TB cannot take what drugs?

A

BRMs

58
Q

BRMs for RA

A 
etanercept (Enbrel)
Monitor CBC, creatinine, liver panel
infliximab (Remicade)
Infusion reaction: tachycardia, shortness of breath, lightheadedness
adalimumab (Humira)
anakinra (Kineret)
Patients with MS or TB cannot take  this drug
abatacept (Orencia)
59
Q

Most pts w/ RA are managed with what initially?

A

DMARDs

60
Q

DMARDs for RA

A
  • Leflunomide (Arava)
  • Hair loss, diarrhea, decreased WBCs/platelets, increased liver enzymes, avoid alcohol, pregnancy not recommended
  • Hydroxychloroquine (Plaquenil), Antimalarial drug
  • Retinal damage, generally tolerated well, mild stomach discomfort, light-headedness/headache
61
Q

DOC for RA

A

Methotrexate (MTX) (Rheumatrex)
*Immunosuppressive= decreased WBCs, platelets, elevated liver enzymes/creatinine, pregnancy not recommended, risk for infection, avoid crowds

62
Q

Arthrocentesis

A

Fluid is drained from a joint, can be done with RA

63
Q

Sjögren’s Syndrome

A
  • Dry eyes, dry vagina, dry mouth

- Seen in RA

64
Q

Infectious organism possibly causing RA?

A

Epstein-Barr virus

Adult 1 (8 decks)

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