Exam 2 Flashcards

1
Q

Non specific response) 1 line of defense

3rd line of defense

A

1st Line of Defense: Skin, Mucus membranes, Stomach acid (External)
2nd Line of Defense: Inflammatory response (Cap + permeability)

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

Specific / Adaptive response) cells:

A

Phagocytes, Neutrophils, Macrophages & Dendritic cells, Antigen Presenting Cells (Specific Response) “Helps protein & presents flag to T-B cells”
T cells tell B cells to build antigens
Rq cytokines

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

Interferon:
Made from:

A

= virus alarm
= infected cell to warn other cells of virus
A chemical that is released from a virus-invaded cell that provides nonspecific resistance to neighboring unaffected cells.
Interferes with viral replication
Acts as a “Whistle Blower”
warning healthy cells to prepare for a viral attack.

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

Nonspecfic against antigen complement system
Membrane attax complex :

A

attack membrane to create “Leak channel”
This is another nonspecific defense system against antigens
Activated by two ways:
Classical Complement Pathway: Exposure to antibodies produced against a specific microorganism
Primary mechanism: Alternate Complement Pathway
Exposure to a specific carbohydrate chain found on the surface of a microbe

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

Humoral Specific Immunity

A

“Seal Team 6”
Branch of immune system that may occur after reexposure to a particular antigen
Occurs in the extracellular fluid
Permanent defense system against a specific antigen resulting in an attack by antibodies
This involves antibodies!!!!
Degranulation releases (histamine kills)

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

Natural Immunity aka

A

Innate Immunity
Genetically predetermine, breast milk passes antigens &/or via placenta
It is present at birth and has no relation no relation to previous exposure to a particular antigen

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

Artificially Acquired Immunity

A

Acquired through vaccinations
Dead virus
Designed to give us protection from exposure to an antigen at some point in the future

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

pruritus

A

Itching

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

What effect does the release of histamine have on the vasculature?

A

Vasodilation.

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

What type of immunity results from the administration of a vaccine?

A

Active Acquired immunity.

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

What is a nonspecific response by the immune system that directly attacks a foreign substance called?

A

Cellular immunity.

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

Should a patient experiencing an allergic reaction with no signs of respiratory distress or shock receive epinephrine?

A

True.

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

What effect does the release of histamine have on the bronchioles?

A

Bronchoconstriction.

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

What is a possible side effect of epinephrine use?

A

Chest pain.

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

What do mast cells release after exposure to an allergen in which IgE antibodies are released?

A

Histamine.

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

Hymenoptera are

A

a species of insects, some winged, that sting.

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

Caring for chem/ burn, its keen to know if its acid or an alkali b/c:
If carbon monoxide is present should also suspect the presence of:

A

= Alkalis continue to destroy cell membranes via liquefaction necrosis
= Cyanide

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

Fluid accounts for ~% of the body’s weight, Only ~% of the fluid is contained in our vascular system

A

= 60% of the body’s weight, Only about 7% of the fluid is contained in our vascular system

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

If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?

A

2/3s would move out

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

Hyperkalemia) 1st line med:
2) One of two 2nd line meds:
3) One of two 2nd line meds:
4) Hospital only med:
5) Hospital only med to poop:

A

1= Calcium Chloride IV 0.5-1G/3 mins (Stabilizes doesn’t fix)
2= Albuterol 10-20 mg LVN over 15 mins
3= Sodium Bicarb 50 mEq IV mil equivalent
4= Dextrose (25 grams)w/ Insulin IV (10 units)
5= Kayexalate to poop out hyperK via pull interstitial to GI

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

Hydroxocobalamin:
Adult Dose:
Pedi Dose:

A

= Suspected cyanide poisoning
= 5 grams IV/IO over 15 minutes. May repeat a 2nd 5 gram dose for a max of 10 grams
= 70 mg/kg IV/IO (max 5 grams)

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

Alkalotic vs acidotic burns severity

A

Alkalotic burns > Acidotic burns

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

Light Burns:
Inhalation Burns:
Toxic inhalation:
Cyanide & carbon monoxide are released via:

A

= Intense light from arc welder, industrial laser (Ultraviolet keratitis)
= Inhaled gases, heated air, flames, steam; airway & resp/ injury
= Synthetic resins & plastics release toxic gases as they burn
= fake wood & such burning thus Toxic inhalation

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

1 Alkalis are commonly used as:
2 Acids burns:

3 Alkalis burns:

A

1= oven and drain cleaners, agricultural fertilizers, and in industry
2= form thick, insoluble mass where they contact T. via coagulation necrosis, limiting burn damage
3= continue destroy cell membranes via liquefaction necrosis, allowing them to penetrate underlying tissue & causing deeper burns

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

2 cyanide antidote regimens are available:

A

= 1 Pasadena cyanide kit (amyl nitrite, Na nitrite, & Na thiosulfate)
2 newer antidote Cyanokit hydroxocobalamin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ABDMN cavity 3 spaces:

A

peritoneal space
retroperitoneal space
pelvic space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

peritoneal space:
Retroperitoneal space:
pelvic space contains:

A

= contains the stomach, spleen, gall bladder, liver, pancreas, & intestines
= contains the kidneys, proximal ureters, and adrenal glands & most major vascular structures w/in ABDMN
= urinary bladder, distal ureters, proximal urethra, terminal sigmoid colon, rectum, & anal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hollow organs:
Solid organs:

A

= Stomach, Intestines (small & large), Gallbladder, Bladder.
= Liver, Spleen, Pancreas, Kidneys.

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

3 dif/ types of abdominal pain:

A

Visceral (dull), somatic (sharp), &referred

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

What is Kehr’s sign?

A

pain in shoulder w/ side of affected solid ABDMN organ
left shoulder classic of ruptured spleen
Right shoulder liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Radiation) S/S of Exposure:
First sign:
Lethal Dose Exposure:

Organ shutdown:

A

= SLUDGEM PSNS S/S
= slight nausea & fatigue
= Emesis & malaise, Epistaxis, mouth, gums, & rectum (Vomiting usually lethal exposure
= Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

1 Types of Radiation:
2 Radioactive Particles:
3 Alpha:
4 Beta:
5 Ionizing Rays:
6 Gamma:
7 X-Rays:
8 Atomic:

A

1= Radioactive Particles & Ionizing Rays
2= Alpha &Beta:
3= least worry & deflected w/ newspaper
4= flys further w/o skin penetration
5= Gamma & X-Rays
6= worst, several ft of concrete & lead
7= penetrates skin
8= nuclear reactor

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

Rad) S/S of Exposure:
First sign:
Lethal Dose Exposure:

Organ shutdown:

A

= SLUDGEM PSNS S/S
= slight nausea & fatigue
= Emesis & malaise, Epistaxis, mouth, gums, & rectum (Vomiting usually lethal exposure
= Death

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

Geiger Counter:
Dosimeter:

A

= Radiation emission measured w/ Dosimeter
= Cumulative exposure recorded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Bruising around the umbilical region is known as:

A

Cullen’s Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Structure separating the upper & lower GI system?

A

Ligament of Treitz

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

Spleen) organ class
Location quadrant

A

= not an accessory GI organ, but part of immune system
= LUQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The small bowel is composed of the:

A

Duodenum, jejunum, and ileum.

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

A&P) True Abdomen:

A

= Deoudum, S(illium longest & narrowest) &L interesting (illium longest & narrowest), deud/juj distal lower GI,

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

A&P) GI) Starts & Ends@:
Parastalisis:
Digestion Tract:

A

= Mouth to anus
= GI moving stuff down
= 25ft-long hollow muscular tube for digestion & waste products

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

A&P) GI) Lower GI System:
To overcome Lower esophageal & bottom pallor & bottom Sphincter

A

= duodenjejunal junction, to include the rest of the small intestine, large intestines, & rectum/anus.
= 20ml to overcome Lower esophageal Sphincter & bottom stomach pallor Sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

A&P) GI) Accessory GI organ:

A

= Liver, Gall blader, Pancreas (pancreotic juice creates buffer into deuodnium),

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

Mesenteric system

A

membrane vascular GI blood feeder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Mallory-Weiss Tears:

A

(common w/ bulimia), Lower sphincter & espohagus is erroded away from acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Peritoneum:

parietal peritoneum:
visceral peritoneum:

A

= ABDMN membrane lining cavity & organs (resembles lung’s pleura & Fns similarly)
= The portion that lines the cavity
= the portion that covers ABDMN organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

A&P) peritoneal space organs:
Retroperitoneal space organs:
pelvic space organs:

A

= stomach, spleen, gall bladder, liver, pancreas, & intestines
= kidneys, proximal ureters, adrenals & most major ABDMN ves/
= urinary bladder, distal ureters, proximal urethra, terminal sigmoid colon, rectum, & anal canal Females: uterus, Fallopian tubes, ovaries, and upper vagina. males: prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

A&P) retroperitoneal :
Kidneys:

A

= Kidneys, Aorta
= RAAS system, secrete arythoportine hormone to tell bone to dev RBC, mineral reg,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A&P) Intrathoracic )Major vessels:

A

= Descending aorta & inferior organ shears are worst injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

A&P) RUQ contains:

A

=gallbladder, right kidney, most of the liver, some small bowel, a portion of the ascending & transverse colon, small portion of pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

A&P) LUQ contains:

A

LUQ = stomach, spleen, left kidney, most of pancreas, portions of the liver, small bowel, transverse & descending colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

A&P) RLQ contains:

A

RLQ =Appendix, Portions of urinary bladder, small bowel, ascending colon, rectum, (right ovary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

A&P) LLQ contains:

A

LLQ =sigmoid colon, portions of the urinary bladder, small bowel, descending colon, rectum, (left ovary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

!!! Murphy’s signs:

A

= Suspected gall bladder infection→ cupping under rib w/ pressure with breath causing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

!!! McBurny’s point:

A

= RLQ pain w/ rebound tenderness ⅔ of way from umbilicus to illicac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Melana:

A

= Pooping dark black stool (150mL of blood to make)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

A&P) Retroperitoneal space organs:

A

= kidneys, proximal ureters, adrenals & most major ABDMN ves/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

A&P) pelvic space organs:

A

= urinary bladder, distal ureters, proximal urethra, terminal sigmoid colon, rectum, & anal canal Females: uterus, Fallopian tubes, ovaries, and upper vagina. males: prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

A&P) peritoneal space organs:

A

= stomach, spleen, gall bladder, liver, pancreas, & intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Antihistamines=

A

med that arrests the effects of histamine by blocking its receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

cholinergic synapses=

A

Synapses that use ACh as the post&preganglionic neurotransmitter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

adrenergic synapses=

A

Synapses that use norepinephrine as the postgamgliomic neurotransmitter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Effects of Atropine Overdose =

A

“Hot as hell, Blind as a bat, Dry as a bone, Red as a beet, Mad as a hatter”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

“Nitrogen washout”:

A

= preoxygenation/ denitrogenation -> getting lungs oxy-100% & removing nitrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

(ODERS) Fruity breath:
Urine or ammonia:
Bitter almonds:
General bad breath:
Fishy vaginal/penis odor:
Fecal breath:

A

= DKA
= UTI
= cyanide poisoning
= hygiene and/or infection
= infection and/or Ghonearrhea
= GI obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Skin turgor test:
Norm/ skin tugor:
Decreased skin mobility suggests:
“Tenting” Poor turgor:

A

= pulling skin fold over bony area then releasing it
= immediately returns to its original state.
= edema or scleroderma, a progressive skin disease.
= results from dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Medical word for unequal pupils >1mm:
Unequal pupils alert you to:
Medical word used for pinpoint pupils:
Medical word used for dilated pupils:
Name of eye chart used to test visual acuity:
Bitemporal hemianopsia:
Left/Right Homonymous Hemianopsia:
Homonymous Quadrantic Defect:
Medical word for ecchymosis around eyes& sign of:

A

= anisocoria
= Brain trauma!!!
= Miosis
= Mydriasis
= Snell chart
= loss of vision in the outside half of each eye
= loss of vision in right or left half of both eyes
= loss of vision in the same quadrant of both eyes
= Periorbital ecchymosis & basilar skull fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Oxyhemoglobin is:
Carbaminohemoglobin:
Methemoglobin:

Deoxyhemoglobin:
Carboxyhemoglobin:
Sulfhemoglobin:
Glycated Hemoglobin (HbA1c):

A

= oxygen carrying Hemoglobin
= carbon dioxide on hemoglobin amino-acid
= Hemoglobin not picking up ( w/ iron in ferric (Fe3+) vs oxy)
= Hemoglobin not bound to oxygen.
= Hemoglobin bound to carbon monoxide (CO).
= Hemoglobin irreversibly bound to sulfur.
= Hemoglobin bound to glucose for measuring long-term BGL control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Can loose testie from torsion in how many hours:

A

6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

ABDMN consistent pain for how many hours is a surgical emergency:

A

=6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Bristol stool chart & types:

A

= type 4 healthy, type1 hard deer pebbles, type 8 liquid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Priapism penis causes:

A

= sickle cell anemia, meds, spinal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Angionecrosis Edema:
Trimsmis:
Mentim:

A

= angioedemna
= Locked jaw
= tip of chin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Needle cric/ Potential Complications:

A

= Barotrauma, Pneumothorax, Hypercarbia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

2 cyanide antidote regimens are available:

Sodium nitrite dose :
Sodium thiosulfate dose:

A

= Pasadena cyanide kit (amyl nitrite, Na nitrite, & Na thiosulfate) & newer antidote Cyanokit (hydroxocobalamin)
= 300 mg sodium nitrite over 2 to 4 minutes for adults.
= administer 12.5 g of for the adult.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the goal of the immune system?

A

Defend body against foreign invaders & maintain homeostasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the difference between the innate and humoral branches of the immune system?

A

Innate: immediate, non-specific; uses skin, mucous membranes, macrophages, neutrophils. Humoral: adaptive/specific; uses B-cells & antibodies to target specific pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are the three lines of defense that the immune system uses?

A

1st line: physical barriers (skin, mucosa). 2nd line: inflammation, fever, phagocytes. 3rd line: specific immune response (T & B cells).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What cell is considered the most abundant in the immune system?

A

Neutrophils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Carbaminohemoglobin:
Methemoglobin:
Carboxyhemoglobin:

A

= carbon dioxide on hg amino-acid site
= Hg not picking up “Iron Hem/ site broke”
= Hg bound from carbon monoxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Oxyhemoglobin:
Deoxyhemoglobin:
Carbaminohemoglobin:

A

= oxygen carrying Hemoglobin
= Hemoglobin not bound to oxygen.
= carbon dioxide on hemoglobin amino-acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Which antibody is involved with allergic reactions?

A

IgE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the most abundant antibody in the body?

A

IgG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is interferon and its job in the body?

A

Protein released by virus-infected cells to warn neighboring cells & inhibit viral replication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What are the two types of acquired immunity?

A
  • Active: body produces its own antibodies. * Passive: antibodies received from another source.
85
Q

How is naturally acquired active immunity obtained?

A

Infection exposure.

86
Q

How is artificially acquired active immunity obtained?

87
Q

How is naturally acquired passive immunity obtained?

A

Antibodies via placenta or breast milk.

88
Q

How is artificially acquired passive immunity obtained?

A

Injection of immune serum (EX: antivenom).

89
Q

What occurs when a foreign antigen enters the body, such as a bee sting?

A

Antigen triggers IgE production → binds to mast cells → histamine released on re-exposure → allergic response.

90
Q

What cells in the body carry and release histamine?

A

Mast cells & basophils.

91
Q

What is the process called when histamine is released?

A

Degranulation.

92
Q

What are the effects of histamine on blood vessels?

A

Vasodilation → redness & swelling.

93
Q

What happens to bronchioles upon histamine release?

A

Bronchoconstriction → SOB/wheezing.

94
Q

What happens to systemic vascular resistance when histamine is released?

A

Decreased.

95
Q

What happens to blood pressure when histamine is released?

A

Decreased (can cause hypotension).

96
Q

What type of stinger does a honeybee have?

A

Barbed stinger (stays in skin).

97
Q

What type of stinger do wasps or hornets have?

A

Smooth stinger (can sting repeatedly).

98
Q

What is the medical word for hives?

A

Urticaria.

99
Q

What is the medical word for itching?

100
Q

What are the indications for Albuterol?

A

Bronchospasm, wheezing, asthma.

101
Q

What are the contraindications for Dexamethasone?

A

Systemic fungal infections, caution in diabetics.

102
Q

hematemesis?

A

Vomiting blood.

103
Q

hemoptysis?

A

Coughing up blood. “P for phlem”

104
Q

hematochezia?

A

Bright red bloody stool LGI bleed “C for Colon crap”

105
Q

What are the biggest risk factors associated with GI problems?

A

Drinking, NSAIDs.

106
Q

What makes up the upper GI system?

A

Mouth → duodenum.

107
Q

What is the dividing point between the upper and lower GI system?

A

Ligament of Treitz.

108
Q

What is the Enteric Nervous System?

A

Local nervous system of GI tract; controls digestion independently of CNS.

109
Q

Where does the digestive process start in the human body?

110
Q

What is the process that moves food along the GI tract?

A

Peristalsis (wave-like muscular contractions).

111
Q

What enzyme starts the chemical breakdown of carbs in saliva?

112
Q

What muscle must open to allow food to enter the stomach?

A

Lower esophageal sphincter.

113
Q

What is the function of the stomach?

A

Stores & mixes food with acid; starts protein breakdown.

114
Q

Where does food exit the stomach?

A

Pyloric sphincter into duodenum.

115
Q

What is the main job of the small intestine?

A

Absorption of nutrients.

116
Q

What are the three parts of the small intestine?

A
  • Duodenum * Jejunum * Ileum
117
Q

Where do most bowel obstructions occur?

A

Small intestine.

118
Q

What is the main function of the large intestine?

A

Absorb water & form feces.

119
Q

What is the normal assessment process for a patient with a GI complaint?

A

OPQRST + SAMPLE, vitals, abdominal exam, bowel sounds, signs of bleeding.

120
Q

What are the three classifications of abdominal pain?

A
  • Visceral (dull, poorly localized) * Parietal (sharp, localized) * Referred (distant site)
121
Q

What is the most common upper GI problem that produces hemorrhage?

A

Peptic ulcer disease.

122
Q

What is the most likely cause of esophageal varices?

A

Portal HTN from liver cirrhosis.

123
Q

What is the treatment for esophageal varices?

A

Airway, O2, IV, fluids, suction, transport; may need intubation.

124
Q

diverticulosis?

A

Pouches form in the colon.

125
Q

diverticulitis?

A

Infection of the pouches in the colon.

126
Q

Where do people usually have pain with diverticulosis or diverticulitis?

A

LLQ (left lower quadrant).

127
Q

What is appendicitis?

A

Inflammation of the appendix.

128
Q

What is the most common cause of appendicitis?

A

Fecal obstruction.

129
Q

What is cholelithiasis?

A

Formation of stones in the gallbladder.

130
Q

What is pancreatitis?

A

Inflammation of the pancreas; causes = alcohol, gallstones, trauma.

131
Q

What are the major functions of the urinary system?

A
  • Filter blood * Remove waste * Regulate fluid & electrolyte balance * Control BP * Help maintain pH
132
Q

What activates the RAAS system?

A

↓ perfusion to kidneys → renin release → angiotensinogen → angiotensin I → ACE in lungs → angiotensin II.

133
Q

What are the two major functions of the kidneys?

A
  • Waste excretion * Fluid & electrolyte balance
134
Q

What is ammonia converted to in the body?

135
Q

What are common risk factors associated with renal failure?

A
  • Diabetes * HTN * Recurrent UTI * Nephrotoxic drugs * Trauma * Dehydration
136
Q

What structures compose the urinary system?

A
  • Kidneys * Ureters * Bladder * Urethra
137
Q

What is the functional unit of the kidney?

138
Q

What is the average GFR for a healthy person?

A

120 mL/min.

139
Q

What cells in the kidneys monitor incoming pressure?

A

Juxtaglomerular cells.

140
Q

What occurs in the Loop of Henle?

A

Water & Na reabsorption.

141
Q

Why do more women than men experience urinary tract infections?

A

Shorter urethra, closer proximity to anus.

142
Q

What can a UTI lead to?

A

Pyelonephritis, sepsis, renal damage if untreated.

143
Q

What is the leading cause of kidney failure?

A

Diabetes mellitus.

144
Q

What are the three phases of Acute Renal Failure (ARF)?

A
  • Prerenal: ↓ perfusion (EX: shock, dehydration)
  • Intrarenal: direct kidney damage (EX: toxins, infection)
  • Postrenal: obstruction (EX: stones, tumors)
145
Q

What is the leading acute cause of ARF?

A

Hypoperfusion.

146
Q

What is the most common metabolic cause of death with a patient in ARF?

A

Hyperkalemia.

147
Q

What are some signs and symptoms of ARF?

A
  • ↓ urine output
  • Fluid overload
  • Fatigue
  • Nausea
  • Arrhythmias
148
Q

When does renal failure become chronic renal failure?

A

When kidney function is ↓ for >3 months.

149
Q

What is the difference between hemodialysis and peritoneal dialysis?

A

Hemodialysis: blood filtered via machine. Peritoneal dialysis: uses peritoneum as filter.

150
Q

What is the medical term for a kidney stone?

A

Nephrolithiasis.

151
Q

What symptoms indicate a patient may have a kidney stone?

A
  • Flank pain radiating to groin * Hematuria * Nausea/vomiting * Restless behavior
152
Q

What is a priapism?

A

Prolonged, painful erection (not from sexual arousal).

153
Q

What is a testicular torsion?

A

Twisting of spermatic cord → ischemia.

154
Q

What is cystitis?

A

Infection of the urinary bladder.

155
Q

What is pyelonephritis?

A

Kidney infection; UTI traveled up & infecting kidneys.

156
Q

What is toxicology?

A

Study of poisons, toxins, & effects on the body.

157
Q

How can someone be exposed to a toxic substance?

A
  • Inhalation * Ingestion * Injection * Absorption
158
Q

What is the most common way to be exposed to a toxin?

A

Ingestion.

159
Q

dif/ between poisoning & OD?

A

Poisoning: exposure to toxic substance.
OD: excessive amount of a drug or substance.

160
Q

What key information should be obtained from someone who ingested a toxin?

A

How long ago since your exposure.

161
Q

What medication do we administer for chronic alcoholism?

A

Thiamine 100mg.

162
Q

What is delirium tremens?

A

Life-threatening withdrawal syndrome in chronic alcoholics.

163
Q

What is the medical treatment for patients who ingest or inhale a toxin?

A

Support ABCs first.

164
Q

How does carbon monoxide kill us?

A

CO binds to hemoglobin preventing O2 from binding → cellular hypoxia.

165
Q

What is hemoglobin bound with CO called?

A

Carboxyhemoglobin (COHb).

166
Q

How do we manage a patient with a surface-absorbed dry toxin?

A

Brush off for dry powder, flush thoroughly with water for liquid.

167
Q

What is the effect of carbon monoxide on hemoglobin?

A

CO binds to hemoglobin with 200× the affinity of O2, preventing O2 from binding and causing cellular hypoxia despite normal SpO2.
Hemoglobin bound with CO is called Carboxyhemoglobin (COHb).

168
Q

What are the levels of carbon monoxide in carboxyhemoglobin (COHb)?

A
  • Mild
  • Moderate
  • Severe
  • Fatal/Lethal

Specific thresholds for COHb levels can indicate severity of poisoning.

169
Q

What does a CO-Oximeter detect?

A
  • O2Hb (oxygen-bound hemoglobin)
  • COHb (carbon monoxide)
  • MetHb (methemoglobin)
170
Q

How does cyanide kill us?

A

Blocks cellular respiration, preventing cells from using O2 even if available, leading to rapid death.

171
Q

What is the treatment for suspected cyanide poisoning?

A

Oxygen and Cyanokit.

172
Q

What is the pathophysiology of cholinergic exposure?

A

Overstimulation of the parasympathetic nervous system due to excessive acetylcholine (ACh).

173
Q

What is the treatment for cholinergic exposure?

A

Atropine and Pralidoxime (2-PAM).

174
Q

What are the symptoms of beta blocker overdose?

A
  • Bradycardia
  • Hypotension
  • Bronchospasm
  • Altered mental status (AMS)

Treatment includes glucagon if unstable.

175
Q

What are the symptoms of calcium channel blocker overdose?

A
  • Nausea/Vomiting
  • Headache
  • Altered mental status
  • Cardiac arrhythmias
  • Bradycardia
  • Profound hypotension

Emergency dialysis may be required.

176
Q

What are the symptoms of cardiac glycoside (Digoxin) overdose?

A
  • Nausea/Vomiting
  • Visual disturbances (halos)
  • Bradycardia
  • Arrhythmias

Monitoring is crucial for these symptoms.

177
Q

What are the symptoms of tricyclic antidepressant overdose?

A
  • Dry mouth
  • Urinary retention
  • Constipation
  • Respiratory depression
  • Seizures
  • Tachycardia & arrhythmias (wide QRS complexes)

Sodium bicarbonate is a treatment option.

178
Q

anticholinergic toxidromes look like?

A
  • Dry as a bone
  • Blind as a bat
  • Red as a beet
  • Hot as a hare
  • Mad as a hatter

Symptoms include dry skin, blurred vision, flushed skin, and hallucinations.

179
Q

What is activated charcoal?

A

Adsorbent substance; binds toxins in the GI tract to prevent absorption.

180
Q

Primary Rx for any Pt w/ suspected poisoning?

A

Support ABCs, prevent further exposure, rapid transport, consult Poison Control.

181
Q

What is a toxidrome?

A

A group of S&S typical of a specific class of toxins.

182
Q

narcotic opiate antidote:

A

Naloxone (Narcan).

183
Q

Common stimulants?

A

Cocaine
Methamphetamine
Caffeine
Ecstasy

184
Q

stimulant OD S/S:

A

Tachycardia, Hypertension, Dilated pupils, Agitation, Hyperthermia, Seizures

185
Q

What is serotonin syndrome?

A

Toxic levels of serotonin due to SSRI use or drug interaction.

186
Q

What is the main organ affected by drug use and poisonings?

187
Q

Alcohol & Tylenol

A

Increased liver toxicity leading to potential liver failure.

188
Q

inhalant drugs & dangers

A

= Glue & Paint (Golden prefered)
= Hypoxia, Sudden sniffing death, Arrhythmias, Brain damage

189
Q

What is Delirium tremens (DTs)?

A

Severe alcohol withdrawal syndrome.

190
Q

Delirium tremens S/S

A

Tremors
Hallucinations
Agitation
Seizures
Tachycardia
Hypertension

191
Q

dry snake bite?

A

A defensive bite without venom.

192
Q

Coral snakes identifying marks

A
  1. pitted eyes
  2. ‘Red on yellow, kill a fellow. Red on black, friend of Jack.’
193
Q

What is interferon & its job in the body:

A

= Protein released by virus-infected cells to warn neighboring cells & inhibit viral replication.

194
Q

Histamine effects )Blood vessels:
Bronchioles:
Systemic vascular resistance:
Blood pressure:

A

= Vasodilation → redness & swelling.
= Bronchoconstriction → SOB/wheezing.
= Decreased
= Decreased (can cause hypotension)

195
Q

What cell of the immune system is considered the most abundant and makes up approximately ⅔’s of all WBC in the human body:

A

= Neutrophils.

196
Q

What is interferon & its job in the body:

A

= Protein released by virus-infected cells to warn neighboring cells & inhibit viral replication.

197
Q

Active Naturally & artificially acquired:

Passive Naturally acquired & artificially acquired:

A

= Naturally: infection exposure.
= Artificially: vaccines.
= Naturally: antibodies via placenta or breast milk.
= Artificially: injection of immune serum (EX: antivenom).

198
Q

What cells in the body carry & release histamine:

A

Mast cells & basophils.

199
Q

Hematemesis:
Hemoptysis:
Hematochezia:
Melena:

A

= Vomiting blood.
= Coughing up blood.
= Bright red blood in stool (lower GI).
= Black, tarry stool (upper GI).

200
Q

What opens to allow food enter stomach from esophagus?
What is the function of the stomach?
w/ food sloshed in stomach where does it exit?

A

= Lower esophageal sphincter.
= Stores & mixes food w/ acid; starts protein breakdown.
= Pyloric sphincter into duodenum.

201
Q

Aaron’s Sign:
Rovsing’s Sign:

A

= Epigastric pain w/ palpation to McBurney’s Point) referred pain
= Pain in RLQ with palpation to LLQ refered

201
Q

Cyclical vomiting syndrome (CVS) is

A

increasingly common disorder characterized by repeated sudden attacks, called episodes, of severe nausea, vomiting, and physical exhaustion without apparent cause

202
Q

What is the main job of the small intestine?
What is the main function of the large intestine?

A

= Absorption of nutrients.
= Absorb water & form feces.

203
Q

Pancreatitis: Inflammation of pancreas
Four categories based on cause:

A

Metabolic #1,
Mechanical,
Vascular,
Infectious

204
Q

A bowel obstruction that is caused when a portion of the small intestine twists around itself is:

A

Intestinal Volvulus

205
Q

4 dif/ mechanisms that can cause a bowel obstruction:

A
  1. Herniation: outside
  2. Adhesion:
  3. Volvulus: twist
  4. Intussusception: inside
206
Q

The presence of gallstones in a patient’s gallbladder is known as:

A

Cholelithiasis

207
Q

SIR Hernia

A

(strangulated, incarcerated, reducible (best) )

208
Q

What is considered the most common reason for a patient to present with a lower GI hemorrhage?

A

Lower Diverticulosis
Upper: Peptic Ulcers