Exam 3 Flashcards
What are early manifestations of thyroid or parathyroid disease?
- muscle weakness, myalgia, cramps and fatigue - proximal upper/lower limb symmetrically
- bilateral carpal tunnel syndrome
- periarthritis and calcific tendinitis
What often occurs in the shoulders of people with endocrine disease?
periarthritis and calcific tendinitis
acromegaly S&S
- bony enlargement
- amenorrhea
- DM
- diaphoresis - excessive sweating
- HTN
- Carpal tunnel
- hand pain and stiffness
- back pain
What is Addison’s disease and what are S&S
hyposecretion by adrenal glands
- dark pigmentation of skin, especially mouth and scars
- hypotension
- progressive fatigue
- hyperkalemia
- GI issues
What is Cushing’s syndrome pathophys
increased secretion of cortisol by adrenal cortex
- cortisol suppresses the inflammatory response and an increase causes poor wound healing
What is a warning sign of cushing’s disease?
unexplained fever w/o other symptoms
- medical referral
Cushing’s disease S&S
- moonface
- buffalo hump
- kyphosis and back pain
- easy bruising
- slow wound healing
- masculinizing effects
What is Graves’ disease? What are some signs?
hyperthyroidism
- goiter leading to a swollen neck
- protruding eyes
S&S of hyperthyroidism in older adults
- tremors
- anxiety
- palpitation
- weight loss
- heat intolerance
S&S of hyperthyroidism in younger patients
- cold intolerance
- weight gain
- dry skin
- constipation
- mental and physical slowing
S&S of hyperthyroidism
- severe tachycardia
- hyperthermia
- restlessness
- chest pain
- abdominal pain
risk factors for hypothyroidism
Depression of body metabolism
- women > 65 and increases with age
S&S of hypothyroidism
- cold intolerance
- excessive fatigue and drowsiness
- HA
- weight gain
- irregular menstrual bleeding
- skin dryness
- brittle hair and nails
- palpable nodules of thyroid
What is Woltman’s sign? What does this occur with?
Woltman’s sign - delayed relaxation phase of an elicited deep tendon reflex; more observable in the achilles
occurs with hypothyroidism
blood glucose levels needed to diagnosis DM
fasting blood glucose >/= 126 mg/dl on 2 different days
- risk factor if >/= 100 mg/dl
At what glucose level should exercise be postponed?
> 250 mg/dl
eat snack if < 100 mg/dl
S&S of hyperglycemia
- thirst
- hyperventilation
- fruity breath
- lethargy/confusion
- cramps
- poluria/dehydration
- flushed face
- elevated temp
S&S of hypoglycemia
- pallor
- perspiration
- irritability/nervousness
- weakness
- shakiness
- blurred vision
- HA
- fatigue
- slurred speech
What is tophi? What is it a sign of?
tophi - lumps under the skin, or actual eruptions through the skin of chalky urate crystals
- sign of gout
Osteoporosis T scores
normal - -1 or above
osteopenia - -1 - -2.5
osteoporosis - < -2.5
severe osteoporosis - < -2.5 or less with 1 or more fragility fractures
What is Paget’s disease?
localized excessive osteoclastic bone resorption f/b compensatory increased osteoblastic activity
risk factors for paget’s disease
- > 40 years old
- Europe or Australia
- anglo-saxon descent
- genetic factors
What is anisocytosis and hypochomia?
anisocytosis - abnormal variations in size of erythrocytes
hypochromia - erythrocytes deficient in hemoglobin
anemia is a ___________, not a __________
is a symptom, not a disease
S&S of anemia
too few erythrocytes
- skin pallor or yellow-tinged skin
- fatigue or listlessness (lack of energy)
- dyspnea on exertion with heart palpitation and rapid pulse
- chest pain with minimal exertion
- decreased diastolic BP
- nervous system manifestations
thrombocytosis vs thrombocytopenia
cytosis - abnormally high
cytopenia - abnormall low
S&S of hemophilia
- progressive loss of motion
- muscle atrophy
- flexion contractures
What are the most common symptoms of polycythemia? Other S&S
- general malaise and fatigue
- SOB
Other
- headache
- dizziness
- irritability
- blurred vision
- decreased mental acuity
- easy bruising
- cyanosis and digital clubbing
- HTN
monocytes
- largest circulating blood cells
- travel to the tissues and form macrophages
granulocytes
contain lysing agents (digest various foreign materials)
S&S of leukocytosis
- fever
- symptoms of localized or systemic infection
If a patient is leukopenia, what would require a medical referral?
leukopenia - decreased leukocytes
- greater risk for infection
S&S for medical referral
- fever
- chills
- diaphoresis
S&S of leukopenia
- sore throat, cough
- high fever, chills, sweating
- ulceration of mucous membranes
- frequent or painful urination
- persistent infections
Thrombocytosis vs Thrombocytopenia
thrombocytosis - abnormally high platelets
thrombocytopenia - abnormally low platelets
_____________ boosts the production of chemical activators that destroy unwanted clots.
___________ promotes coagulation
Exercise
Vitamin K
S&S of thrombocytosis
- thrombosis
- splenomegaly
- easy bruising
S&S of thrombocytopenia
- bleeding after minor trauma
- spontaneous bleeding
- excessive bleeding - gums and menorrhagia
- melena (black, tarry stools)
common sites of bleeding with hemophilia
- large muscles of the LE
- flexor surface of the forearm
HIV results in what
destruction of CD4 white blood cells
Criteria for referral of a person with early inflammatory symptoms like RA
- significant discomfort on the compression of the MCP and MTP joints
- the presence of 3 or more swollen joints
- a report of morning stiffness lasting longer than 60 min
S&S of RA
- swelling in 1 or more joints, typically symmetrical and bilateral
- morning stiffness lasting several hours
- recurring pain or tenderness in any joint
- redness and warmth in joint
0 unexplained weight loss, fever, or weakness with joint pain - symptoms last > 2 weeks
What is the most common inflammatory rheumatic disease in elderly?
polymyalgia rheumatica
polymyalgia rheumatica S&S
- bilateral muscle pain in proximal muscles
- morning stiffness > 30 min
- fatigue, malaise, anorexia
- low-grade fever
- headaches
- vision loss
Lupus characteristic
malar (butterfly rash across cheeks and nose)
Lupus S&S
- skin changes
- MSK changes - joint pain and arthritis
- neuro - seizures, depression, confusion, psychosis
- peripheral neuropathy
What is scleroderma?
- chronic, multi-system disease
- inflammation and fibrosis of many parts of the body
Scleroderma S&S
- circumscribed plaques w/ ivory-colored center
- widespread skin involvement
- muscle atrophy
- sclerodactyly
- telangiectasis - dilated blood vessels
Who is at higher risk for reactive arthritis?
- adults
- women after enteric infection
- men after venereal infection
S&S of psoriatic arthritis
- skin lesions
- nail lesions
- arthritis
- morning stiffness > 30 min
- ankylosis of the spine
- dactylitis (sausage fingers)
- mouth ulcers
Lyme disease S&S
- red rash
- flu-like symptoms
- migratory MSK pain
- neuro symptoms - headaches, numbness/pain, poor motor control, cog dysfunction
What is gel phenomenon?
stiffness in the morning 1 hour after waking, symptoms relieved with activity, recurrence of symptoms after sitting/ inactivity and then attempting to resume activity
