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exam 3 Flashcards

1
Q

What reflex is tested by using the pointed side of the reflex hammer in the bend of the elbow?

A

Biceps reflex

This reflex assesses the biceps muscle’s response to stimulation.

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2
Q

How is the triceps reflex tested?

A

By using the pointed side of the reflex hammer just above the elbow

This reflex evaluates the triceps muscle’s reactivity.

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3
Q

Which side of the reflex hammer is used to test the brachioradialis reflex?

A

Flat side halfway between elbow and wrist (anterior side)

This reflex helps assess the function of the radial nerve.

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4
Q

Where should the flat side of the reflex hammer be applied to test the patellar reflex?

A

Just below the knee with the patient sitting and leg hanging freely

This reflex evaluates the knee-jerk response.

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5
Q

How is the Achilles reflex tested?

A

By using the flat side of the hammer against the Achilles tendon while holding the patient’s foot

This reflex assesses the function of the gastrocnemius and soleus muscles.

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6
Q

What is the technique for testing the plantar reflex (Babinski reflex)?

A

Scrape lateral edge of the bottom of the foot starting at the bottom and coming up and then medially

This reflex indicates neurological function, particularly in infants.

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7
Q

What object is used to scrape the abdominal quadrants during the abdominal reflex test?

A

A dull object (tongue blade)

This reflex assesses the integrity of the abdominal muscles and spinal nerves.

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8
Q

What are the signs of increased intracranial pressure (ICP)?

A
  • Level of consciousness (LOC)
  • Motor function
  • Pupillary response
  • Vital signs

These assessments help in identifying potential brain injury or swelling.

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9
Q

What is the normal range for ICP?

A

15-20 mmHg

Elevated ICP can indicate serious medical conditions.

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10
Q

Which cranial nerve controls pupil size?

A

Cranial nerve 3

This nerve is crucial for constriction and dilation of the pupils.

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11
Q

What is considered a normal pupil size?

A

3-5 mm

Pupils should also be round in shape.

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12
Q

What does a fixed dilated pupil indicate?

A

Increased ICP, prolonged diffuse hypoxia, atropine

This condition suggests serious neurological issues.

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13
Q

What does a pinpoint pupil indicate?

A

Narcotics

This response is often associated with opioid overdose.

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14
Q

How many pairs of spinal nerves are there?

A

31 pairs

These nerves are categorized into cervical, thoracic, lumbar, sacral, and coccygeal.

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15
Q

List the number of spinal nerves in each category.

A
  • 8 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1 coccygeal

Each category corresponds to different regions of the spine.

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16
Q

What is the Glasgow Coma Scale (GCS)?

A

A scale used to assess the consciousness level of a person based on their responses in three areas: eye opening, verbal response, and motor response.

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17
Q

What are the three components of the Glasgow Coma Scale?

A

Eye opening, verbal response, and motor response.

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18
Q

What is the maximum score on the Glasgow Coma Scale?

A

15

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19
Q

What is the minimum score on the Glasgow Coma Scale?

A

3

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20
Q

True or False: A GCS score of 8 or less indicates a coma.

A

True

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21
Q

What score range on the GCS indicates mild brain injury?

A

13-15

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22
Q

What score range on the GCS indicates moderate brain injury?

A

9-12

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23
Q

What score range on the GCS indicates severe brain injury?

A

8 or less

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24
Q

Fill in the blank: The eye opening response is scored from ___ to ___ on the GCS.

A

1 to 4

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25
Q

What is the highest score for eye opening response?

A

4

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26
Q

What does a score of ‘1’ in the verbal response indicate?

A

No verbal response

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27
Q

What does a score of ‘5’ in the verbal response indicate?

A

Oriented and converses normally

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28
Q

What is the highest score for motor response?

A

6

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29
Q

What does a score of ‘2’ in the motor response indicate?

A

Abnormal extension (decerebrate response)

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30
Q

True or False: The GCS can be used for both adults and children.

A

True

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31
Q

What is the scoring for eye opening in response to speech?

A

3

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32
Q

Fill in the blank: The GCS is primarily used in ___ settings.

A

Emergency and critical care

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33
Q

What does a GCS score of 10 indicate?

A

Moderate brain injury

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34
Q

What is the significance of a GCS score that decreases over time?

A

It may indicate worsening neurological status.

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35
Q

What does ‘localizing to pain’ score in the motor response?

A

5

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36
Q

What is the score for ‘inappropriate words’ in the verbal response?

A

3

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37
Q

What type of response is scored ‘4’ in eye opening?

A

Spontaneous eye opening

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38
Q

Fill in the blank: A GCS score of ___ indicates a fully conscious person.

A

15

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39
Q

What does a score of ‘3’ in eye opening indicate?

A

Eye opening in response to speech

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40
Q

True or False: The Glasgow Coma Scale is a subjective measure.

A

False

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41
Q

What does a score of ‘1’ in the motor response indicate?

A

No motor response

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42
Q

What is the purpose of the Glasgow Coma Scale?

A

To provide a reliable and objective way to assess the level of consciousness.

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43
Q

What are the vertebral levels in humans?

A

7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 3 to 4 coccygeal

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44
Q

What are the prominent surface landmarks of the spine?

A

C7 and T1 at base of neck, interspace between T7 & T8, L4 at iliac crest, and sacrum at posterior superior iliac spines

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45
Q

What is the shape of the vertebral column in a lateral view?

A

Double-S shape with four curves: cervical and lumbar curves are concave; thoracic and sacrococcygeal curves are convex

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46
Q

What is the first step in the order of a musculoskeletal exam?

A

Inspection

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47
Q

What should be noted during the inspection of joints?

A

Size and contour of joint, skin color, swelling, masses, or deformity

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48
Q

What is a key aspect of palpation in a musculoskeletal exam?

A

Palpate each joint for temperature, tenderness, swelling, or masses

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49
Q

What is the range of motion (ROM) assessment?

A

Ask for active voluntary ROM while stabilizing the proximal area

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50
Q

What should muscle strength tests reveal?

A

Strength should be equal bilaterally and fully resist opposing force

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51
Q

What does the shoulder shrug test assess?

A

Integrity of cranial nerve XI (spinal accessory nerve)

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52
Q

What is checked during the elbow examination?

A

Size, contour, deformity, redness, swelling, and olecranon bursa

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53
Q

What tests are used to determine Carpal Tunnel Syndrome?

A

Phalen test and Tinel sign test

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54
Q

What is the common motion dysfunction found in hip disease?

A

Limitation of abduction of hip while supine

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55
Q

What is the purpose of McMurray’s test?

A

To assess for meniscal tears in the knee

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56
Q

What should be inspected in the ankle and foot exam?

A

Contour of joints, alignment with lower leg, and weight-bearing distribution

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57
Q

What should be noted during the spine inspection?

A

Spine straightness, thoracic curve, and lumbar curve

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58
Q

What does kyphosis refer to?

A

Enhanced thoracic curve typically seen in aging people

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59
Q

What does lordosis refer to?

A

Pronounced lumbar curve seen in obese people

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60
Q

What is the significance of the straight leg raising or Lasègue’s test?

A

It may confirm presence of herniated nucleus pulposus if it reproduces sciatic pain

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61
Q

How is true leg length measured?

A

From anterior iliac spine to medial malleolus, crossing medial side of knee

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62
Q

What should be the normal outcome of leg length measurements?

A

Equal or within 1 cm, indicating no true bone discrepancy

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63
Q

Fill in the blank: The lumbar curve should disappear with _______.

A

flexion

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64
Q

True or False: Joints are normally tender to palpation.

A

False

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65
Q

What indicates a positive Phalen test?

A

Numbness and burning during acute flexion of wrist

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66
Q

What should be assessed when testing the hip joint?

A

Symmetric levels of iliac crests, gluteal folds, and equally sized buttocks

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67
Q

What does the assessment of the wrist and hand include?

A

Inspection, palpation, ROM, and muscle strength testing

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68
Q

What are the expected postural changes in pregnancy?

A
  • Progressive lordosis
  • Anterior cervical flexion toward third trimester
  • Kyphosis and slumped shoulders
  • Protuberant abdomen and relaxed mobility in joints create characteristic ‘waddling’ gait

These changes are due to the body’s adaptation to accommodate the growing fetus and maintain balance.

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69
Q

What does an Ortolani’s sign indicate?

A

It is used for detecting hip dislocation in infants.

Ortolani’s sign should be checked at every visit until the infant is 1 year old.

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70
Q

What does a positive Phalen test indicate?

A

Numbness and burning in the wrist due to median nerve compression.

This is often associated with carpal tunnel syndrome.

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71
Q

What does the Tinel sign test assess?

A

It assesses for median nerve irritation.

Percussion of the median nerve produces burning and tingling if positive.

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72
Q

What does McMurray’s Test assess?

A

Meniscal tear in the knee.

This test involves flexing and rotating the knee while applying a varus or valgus stress.

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73
Q

What does the Thessaly test (twist and shout) assess?

A

Meniscal tear in the knee.

The patient rotates on one leg while the knee is flexed.

74
Q

What does the Anterior Drawer Test evaluate?

A

Anterior cruciate ligament integrity.

This test involves pulling the tibia forward while stabilizing the femur.

75
Q

What does the Posterior Drawer Test evaluate?

A

Posterior cruciate ligament integrity.

This test involves pushing the tibia backward while stabilizing the femur.

76
Q

What is the purpose of the Straight Leg Raising or Lasègue’s Test?

A

To reproduce back and leg pain to confirm the presence of herniated nucleus pulposus.

A positive test reproduces sciatic pain.

77
Q

What is the Nucleus pulposus?

A

The disk center composed of soft, semifluid, mucoid material.

It plays a critical role in the flexibility and shock absorption of the vertebral column.

78
Q

What motions of the vertebral column are involved in the function of the nucleus pulposus?

A
  • Flexion
  • Extension
  • Abduction
  • Rotation

These motions are essential for overall spinal mobility.

79
Q

What should be inspected and palpated during a TMJ examination?

A
  • Audible and palpable snap or click
  • Contracted temporalis and masseter muscles
  • Size, firmness, and strength of right and left sides
  • Swelling, limitation of motion, and/or reported pain

This examination assesses the integrity of the temporomandibular joint.

80
Q

What does the Trendelenburg sign assess?

A

Progressive subluxation of the hip.

This test involves observing the pelvis when the patient stands on one leg.

81
Q

What is the procedure for checking for tibial torsion?

A

Note the relationship of forefoot to hindfoot and assess for any twisting of the tibia.

This can be a residual effect of fetal positioning.

82
Q

What is the recommended position for examining an infant?

A

Fully undressed and lying on their back while maintaining temperature.

This approach allows for a thorough examination of the infant’s musculoskeletal system.

83
Q

What is the treatment for bleeding related to clotting factors?

A

FFP, platelets if less than 100,000/uL, ddavp (desmopressin)

FFP stands for Fresh Frozen Plasma, which is used to treat bleeding disorders.

84
Q

What is the largest internal organ and gland in the human body?

A

Liver

The liver performs various vital functions in the body.

85
Q

What is the approximate weight of the liver in males and females?

A

4lbs in males, 3lbs in females

86
Q

What percentage of adult mass does the liver comprise?

87
Q

Where is the liver located?

A

Right upper quadrant of the chest area

88
Q

What ribs does the liver span in the mid axillary line?

A

7th to 11th ribs

89
Q

What covers the liver except for the gallbladder and IVC?

A

Peritoneum (Gibson’s Capsule)

90
Q

How many lobes does the liver have?

A

4: Right, Left, Caudate, Quadrate

91
Q

How many segments is the liver divided into and what is unique about them?

A

8 segments, each with independent blood supply & venous & biliary drainage system

92
Q

What are the major functions of the liver?

A
  • Breaking down or converting substances from food like fats & proteins
  • Extracting energy, vitamins, & minerals
  • Making toxins less harmful and removing them from bloodstream
93
Q

What is the liver’s capacity after injury or damage?

A

Regeneration

94
Q

How much bile does the liver manufacture daily?

A

800 to 1,000 mLs

95
Q

What does the liver release as a toxic by-product of protein breakdown?

A

Ammonia, converted to urea in urine

96
Q

What are the types of liver regulation?

A
  • Autoregulation
  • Metabolic control
  • Buffer response (acids and base)
  • Extrinsic control (hormones, neural control, anesthesia & medications)
97
Q

Which anesthetics preserve hepatic blood flow?

A

Isoflurane & Sevoflurane

98
Q

What is the effect of upper abdominal surgery on hepatic blood flow?

A

Decreases by 60%

99
Q

What is the effect of a spinal block of T4 on hepatic blood flow?

A

Reduces by 20%

100
Q

What major protein is produced by the liver?

101
Q

Which coagulation factor is not produced by the liver?

A

Factor VIII

102
Q

What are the functions of the liver important to anesthesia?

A
  • Bilirubin conjugation and secretion
  • Bile formation
  • Clears fibrin degradation products
  • Hormonal function
  • T4-T3 conversion
  • Inactivation of aldosterone, estrogen, androgen, ADH
  • Immunological support
  • Drug biotransformation (Cytochrome p450 system)
103
Q

Which drugs with high extraction ratios can be affected by hepatic blood flow?

A
  • Propranolol
  • Lidocaine
  • Demerol
104
Q

What are poorly extracted drugs sensitive to?

A

Liver function

105
Q

What is the unique metabolism characteristic of Ketamine?

A

Induces its own metabolism, can result in rapid tolerance

106
Q

What is the liver acinus?

A

Microvascular unit of the liver

107
Q

What are the three zones of the liver acinus?

A
  • Zone 1: oxygen rich, oxidative metabolism, synthesis of glycogen
  • Zone 2: transition zone
  • Zone 3: lowest in oxygen, anaerobic metabolism, responsible for biotransformation of drugs, chemicals & toxins
108
Q

What is cirrhosis?

A

Condition where scar tissue replaces healthy liver tissue

109
Q

What can cause cirrhosis?

A
  • Long-term excessive alcohol use
  • Chronic hepatitis
  • Rare genetic disorders (e.g., Wilson’s disease)
  • Taking too much acetaminophen
  • Insufficient blood supply to the liver
  • Drug overdose
  • Certain herbal or dietary supplements
110
Q

What complications can arise from cirrhosis?

A
  • High pressure in the liver’s portal vein (portal hypertension)
  • Ascites
  • Swollen & painful abdomen
  • Edema
  • Spontaneous bacterial peritonitis (if ascites become infected)
111
Q

True or False: Cirrhosis should be treated immediately.

112
Q

What are the responsibilities of the kidneys represented by the acronym A.W.E.T.B.E.V?

A

A = Acid/base, W = Water, E = Electrolytes, T = Toxin Removal, B = Blood Pressure Regulation, E = Erythropoietin, V = Vitamin D Activation

These functions are critical for maintaining homeostasis in the body.

113
Q

What are the three substances the kidneys excrete?

A
  • Hydrogen Ions
  • Urea
  • Creatinine

These substances are crucial for assessing kidney function and metabolic status.

114
Q

What is the normal range for Blood Urea Nitrogen (BUN)?

A

7 – 20 mg/dl

BUN levels help assess kidney function and hydration status.

115
Q

What is the normal range for creatinine in men?

A

0.7 to 1.3 mg/dL (61.9 to 114.9 μmol/L)

Creatinine levels differ based on sex and muscle mass.

116
Q

What does a specific gravity of 1.03 in urine indicate?

A

Very concentrated urine

This measurement reflects hydration status and kidney concentrating ability.

117
Q

What is the relationship between GFR and creatinine levels?

A

GFR is roughly 3 times that of creatinine

Both elevated levels indicate potential kidney problems.

118
Q

What is the definition of Chronic Kidney Disease (CKD)?

A

Decrease in GFR < 60 for greater than 3 months

This represents at least ½ loss of adult kidney function.

119
Q

What are the first-line therapies for hypertension in patients with CKD?

A

ACEI & ARB

These medications provide renal protective effects.

120
Q

What is the goal hemoglobin level for patients with anemia and CKD?

A

11 - 12 g/dl, but not to exceed 13 g/dl

Maintaining this level helps manage anemia effectively.

121
Q

What medications should be avoided in CKD?

A
  • Non Steroidals
  • IV Contrast Dye
  • Metformin
  • Lithium
  • Digoxin

These can exacerbate kidney injury or impair function.

122
Q

What is the leading cause of Acute Kidney Injury (AKI) in hospitalized patients?

A

Surgery

This is due to factors like hypoperfusion and inflammation.

123
Q

What is the pre-renal ratio of BUN to creatinine in AKI?

A

20 to 1

This ratio indicates prerenal azotemia.

124
Q

What is the treatment of choice for end-stage renal disease (ESRD)?

A

Renal transplant

This procedure is essential for improving quality of life and survival.

125
Q

What are some contraindications for renal transplant?

A
  • Active acute infection or malignancy
  • Uncontrolled systemic disease
  • Uncontrolled psychiatric disorder or substance abuse
  • Evidence of treatment nonadherence
  • Limited life expectancy d/t advanced lung disease or heart failure

These factors can complicate transplant outcomes.

126
Q

How often should low-risk patients be reevaluated for transplant risk?

A

Every 3 years

This applies to patients aged 18-45 with no major comorbidities.

127
Q

What are recommendations to prevent Contrast-Induced Acute Kidney Injury (CI-AKI)?

A
  • Obtain baseline Cr level & eGFR
  • Limit CM volume
  • Use preheated (37°C) iso-osmolar CM
  • Avoid dehydration
  • Administer isotonic saline hydration

These steps are critical to safeguarding kidney function during imaging procedures.

128
Q

What is Addison’s disease?

A

Adrenocortical insufficiency resulting from autoimmune or idiopathic atrophy.

129
Q

What can cause Addison’s disease?

A

Inadequate ACTH from the pituitary or therapeutic use of steroids.

130
Q

List some manifestations of Addison’s disease.

A
  • Muscle weakness
  • Anorexia
  • Dark pigmentation
  • Hypotension
  • Hypoglycemia
  • Low sodium levels
  • High potassium levels
131
Q

What is an Addisonian crisis?

A

A severe condition characterized by circulatory shock and symptoms like pallor, apprehension, and low blood pressure.

132
Q

What are some triggers for an Addisonian crisis?

A
  • Overexertion
  • Exposure to cold
  • Acute infection
  • Decrease in salt intake
133
Q

What diagnostic tests are performed for Addison’s disease?

A

Early morning serum cortisol and plasma ACTH tests to distinguish between primary and secondary adrenal insufficiency.

134
Q

What is the management approach for Addison’s disease?

A
  • Restore circulatory status with fluids and steroids
  • May need antibiotics if infection precipitated crisis
  • Lifelong steroid therapy and mineralocorticoid therapy
135
Q

What causes Cushing’s syndrome?

A

Excessive adrenocortical activity, often due to corticosteroid medications or pituitary tumors.

136
Q

Name some manifestations of Cushing’s syndrome.

A
  • Cataracts
  • Hypertension
  • Truncal obesity
  • Moon face
  • Buffalo hump
  • Sodium retention
  • Hypokalemia
  • Hyperglycemia
137
Q

What diagnostic test is frequently used for Cushing’s syndrome?

A

Overnight dexamethasone suppression test.

138
Q

What is the significance of a cortisol level less than 5mg/dL in the dexamethasone suppression test?

A

Indicates normal functioning of the adrenal glands.

139
Q

What is the primary treatment for pituitary source Cushing’s syndrome?

A

Transsphenoidal hypophysectomy.

140
Q

What are common symptoms of carcinoid syndrome?

A
  • Cutaneous flushing
  • Labile blood pressure
  • Diarrhea
  • Bronchospasm
  • Cardiac failure
141
Q

List treatments for carcinoid syndrome.

A
  • Fluid resuscitation
  • H1 and H2 antagonists
  • Serotonin antagonists
  • Bronchodilators
  • Vasoactive drugs
  • Octreotide
142
Q

What hormones are produced by the thyroid gland?

A

T3 and T4.

143
Q

What is the Wolf-Chaikoff mechanism?

A

An adaptive decline in utilization of iodine due to excess iodine.

144
Q

What is calcitonin’s role in the body?

A

Secreted in response to high serum calcium levels, increasing deposition in the bone.

145
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s thyroiditis.

146
Q

What are some clinical manifestations of hypothyroidism?

A
  • Fatigue
  • Hair loss
  • Dry skin
  • Brittle nails
  • Weight gain
  • Cognitive changes
147
Q

What is the preferred pharmacologic treatment for hypothyroidism?

A

Levothyroxine.

148
Q

What are the signs and symptoms of hyperthyroidism?

A
  • Nervousness
  • Irritability
  • Palpitations
  • Heat intolerance
  • Tremors
149
Q

What is thyroid storm?

A

A life-threatening condition characterized by high fever, tachycardia, and delirium.

150
Q

What medications are used to manage hyperthyroidism?

A
  • PTU (propylthiouracil)
  • Tapazole (methimazole)
  • Sodium Iodide
  • Dexamethasone
151
Q

What is the main function of parathormone?

A

Maintains sufficient serum calcium levels.

152
Q

What are the manifestations of hyperparathyroidism?

A
  • Apathy
  • Fatigue
  • Muscle weakness
  • Nausea
  • Vomiting
  • Constipation
153
Q

What is the primary treatment for hyperparathyroidism?

A

Surgical removal of the parathyroid glands.

154
Q

What are the clinical manifestations of hypoparathyroidism?

A
  • Tetany
  • Numbness
  • Tingling
  • Cramps in extremities
  • Laryngeal spasm
155
Q

How is hypoparathyroidism managed?

A
  • Restore calcium levels to 9-10 mg/dL
  • May need IV calcium gluconate
  • Monitor calcium levels and provide cardiac monitoring
156
Q

What are the two main types of diabetes mellitus?

A

IDDM (Insulin-Dependent Diabetes Mellitus) and NIDDM (Non-Insulin Dependent Diabetes Mellitus)

IDDM is also known as juvenile diabetes, while NIDDM typically occurs in adults.

157
Q

What is the typical age of onset for IDDM?

A

16 years old

Onset is usually abrupt.

158
Q

What is the typical age of onset for NIDDM?

A

Greater than 35 years old

Onset is usually gradual.

159
Q

List three common manifestations of diabetes mellitus.

A
  • Polyphagia
  • Polydipsia
  • Polyuria
160
Q

True or False: Ketoacidosis is common in NIDDM.

A

False

Ketoacidosis is common in IDDM.

161
Q

Does NIDDM always require insulin?

A

No

NIDDM does not always require insulin.

162
Q

What is a common preoperative insulin approach for diabetics?

A

Give 1/4 to 1/2 the daily dose of intermediate-acting insulin subcutaneously

Additionally, adjust for prescribed insulin and start IV glucose.

163
Q

What is diabetes insipidus characterized by?

A

Deficiency of ADH (Antidiuretic Hormone)

Leads to excessive thirst and large volumes of dilute urine.

164
Q

What are the typical manifestations of diabetes insipidus?

A
  • Excessive thirst
  • Urinary specific gravity of 1.001-1.005
165
Q

What diagnostic test is used for diabetes insipidus?

A

Fluid deprivation test

This test assesses the ability to concentrate urine.

166
Q

What is a common management medication for diabetes insipidus?

A

DDAVP (Desmopressin)

Can be given intranasally or IM.

167
Q

What is a pheochromocytoma?

A

A usually benign tumor originating from the chromaffin cells of the adrenal medulla

Can be malignant in 10% of cases.

168
Q

List three clinical manifestations of pheochromocytoma.

A
  • Headache
  • Diaphoresis
  • Palpitations
169
Q

What are the 5 H’s associated with pheochromocytoma?

A
  • Hypertension
  • Headache
  • Hyperhidrosis
  • Hypermetabolism
  • Hyperglycemia
170
Q

What is the primary treatment for pheochromocytoma?

A

Surgical management

Manipulation of the tumor can cause excessive release of catecholamines.

171
Q

What are corticosteroids used to treat?

A
  • RA
  • Asthma
  • MS
  • COPD exacerbations
  • Lupus
  • Other autoimmune disorders
  • Dermatologic disorders
172
Q

What is a key side effect of corticosteroid therapy?

A

Hypertension

Other side effects include increased infection risk and osteoporosis.

173
Q

What hormone does the hypothalamus release that stimulates the pituitary?

A

Corticotropin-releasing hormone

This hormone is involved in the stress response.

174
Q

What is the function of insulin?

A

Stimulates glucose uptake in cells

It plays a crucial role in regulating blood sugar levels.

175
Q

What does the adrenal cortex produce?

A
  • Mineralocorticoids (e.g., aldosterone)
  • Glucocorticoids (e.g., cortisol)
  • Adrenal androgens
176
Q

What is the role of parathyroid hormone?

A

Regulates serum calcium levels

It increases calcium levels in the blood.

177
Q

Fill in the blank: The _______ releases thymosin, affecting T lymphocyte maturation.

178
Q

List two hormones produced by the ovaries.

A
  • Estrogen
  • Progesterone
179
Q

What is the role of melatonin?

A

Affects sleep, fertility, and aging

It is produced by the pineal gland.

180
Q

What are prostaglandins?

A

Local hormones released by plasma cells

They affect various physiological functions.

181
Q

What is the best time to administer corticosteroids?

A

Early morning between 7-8 AM

This timing helps mimic the body’s natural rhythm.

advanced health assessment (2 decks)

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