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Adult health 3 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Chance of inheriting an Autosomal Dominant disease

A

50%

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2
Q

Types of Autosomal Dominant diseases

A

BRCA mutation, huntington’s

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3
Q

Chance of inheriting an Autosomal Recessive disease

A

25% affected, 50% carrier

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4
Q

Types of Autosomal Recessive diseases

A

cystic fibrosis, sickle cell disease, phenylketonuria

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5
Q

How are X-linked disorders inherited

A

Carried on the female chromosome, sons are affected

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6
Q

Types of X-linked disorders

A

Duchenne muscular dystrophy, Hemophilia factor VII and IX

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7
Q

How are multifactorial disorders passed down

A

make have familiar tendencies, but affected greatly by environment and behavior choices

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8
Q

types of multifactorial disorders

A

Spina Bifida, congenital heart defects, diabetes, heart disease, high BP

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9
Q

types of chromosomal abnormalities

A

intellectual disabilities, down syndrome, trisomy 21, Philadelphia chromosome, chronic myelocytic leukemia

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10
Q

Why do we use genetic testing?

A

to diagnose, confirm, or rule out disease, to see if you are a carrier, and to test how you metabolize certain drugs.

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11
Q

what is your risk of inheriting sickle cell disease

A

25% chance of having the disease (A.R)

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12
Q

problems caused by sickle cell disease

A

fatigue (decr. Hgb), pain (neuropathic, nerve damage, ulcers), incr. risk for infection

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13
Q

complications of sickle cell disease

A

HF, anemia, enlarged face bones, jaundice, ulcers, retinopathy, impotence

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14
Q

SC crisis

A

severe pain d/t vaso-occlusive episode blocking blood flow. can lead to ischemia, infarction, and necrosis from hypoxia. Exercise, cold, and high altitude can aggravate it.

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15
Q

hydroxyurea

A

chemotherapy drug for SC disease to kill the Hgb causing problems. can cause myelosuppression -> higher risk for infection

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16
Q

how to prevent SC crisis

A

hydroxyurea and DVT prophylaxis

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17
Q

What factors contribute to antimicrobial drug resistance in HIV

A

sequencing errors that occur during replication of the genetic material, it can cause the HIV to mutate from drug-specific to drug-resistant

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18
Q

How can antimicrobial drug resistance be decreased?

A

using a multi-drug combination from different classes

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19
Q

HIV testing

A

best is antigen blood test and RNA blood test

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20
Q

Why get HIV tested

A

prevent transmission to others, get treatment for disease before it progresses to AIDS

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21
Q

Stage 0 of HIV “Acute phase” (CM, characteristics, complications)

A

flu-like symptoms, can develop CNS side effects (meningitis, neuropathies). most infectious stage of disease d/t high viral load. pt should avoid any behaviors that could result in transmission.

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22
Q

Stage 1 and 2 “asymptomatic phase”
(CM, characteristics, complications)

A

vague symptoms or none at all. Tcell count <500. lower viral load, but dormant HIV cells still present = transmissible. AIDS may develop in ~10yrs

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23
Q

Stage 3 “symptomatic phase”
(CM, characteristics, complications)

A

persistent fever, night sweats, chronic diarrhea, recurrent headaches, and severe fatigue. T cell count <200. opportunistic diseases can occur, now considered AIDS

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24
Q

opportunistic diseases during AIDs

A

thrush, yeast infection, shingles, Epstein Barr, herpes, Kaposi sarcoma, oral hairy leukoplakia, pneumocystis jiroveci (PCP)

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25
Q

How is HIV transmitted

A

bodily fluids: blood, semen, breast milk, vaginal secretions, sharing needles, amniotic fluid

26
Q

Diagnostic criteria for AIDs

A

CD4 count <200, AIDS-defining illness, or wasting syndrome

27
Q

Chances of passing HIV from mother to baby

A

Without treatment: 25-30% chance, with treatment: <2%

28
Q

Chance of healthcare worker developing HIV

A

0.23% risk of becoming HIV infected after an accidental needle stick

29
Q

What is the purpose of antiretroviral therapy

A

delay disease progression! prevent opportunistic diseases and decr. viral load to reduce trransmission

30
Q

Side effects of ART therapy

A

metabolic syndrome (insulin resistance, dyslipidemia, fat redistribution (buffalo hump) and facial wasting.
S/E often cause non adherance

31
Q

5 classes of ART drugs

A

reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors, fusion inhibtors, CCR5 antagonists

32
Q

how to improve adherence to ART drugs

A

simplify drug regimen, enlist family support, counsel about S/E

33
Q

S/E of NRTI (zidovudine- Retrovir, AZT)

A

SEVERE anemia, neutropenia, fatty liver, myopathy, metabolic syndrome, Lactic acidosis

34
Q

S/E of NonNRTI (enfavirenz- Sustiva)

A

CNS effects, liver damage. Take at Night!

35
Q

S/E of Protease Inhibitors (lopinavir/ritonavir- Kaletra)

A

N/V, diarrhea, asthenia, pancreatitis, metabolic syndrome, decr. bone density

36
Q

HIV Fusion inhibitors (enfuvirtide)

A

first and only of its kind, very expensive, 2xdaily SQ. S/E: ISR, hypersensitivity, bacterial pneumonia

37
Q

CCR5 antagonist (maraviroc)

A

need to do genetic testing first. S/E: URI, hepatotoxicity, CNS depression, fever, rash

38
Q

HIV teaching

A

COMPLIANCE, reducing risk (condoms) promoting healthy and supportive relationships involving an HIV infected partner, coping, Needle exchange for drug users, HIV testing, behavior interventions

39
Q

prevention of HIV

A

take precautions when handling blood products, wear condoms, don’t share needles, avoid accidental needle sticks

40
Q

Bell’s Palsy

A

unilateral facial paralysis with unknown etiology (may be d/t ischemia, virus, or inflam. recovery is spontaneous

41
Q

Bell’s Palsy CM

A

tinnitus, mouth numbness, unilateral loss of taste, drooling, excessive tearing, inability to chew

42
Q

Bell’s palsy management

A

gentle moist heat on thee face daily, nerve stimulation, eye protection, corticosteroids to decr. inflam.

43
Q

Guillan-Barre syndrome

A

autoimmune attack after a viral disease. demyelination in the brain causes ascending weakness. rare disorder

44
Q

Guillain-Barre CM

A

muscle weakness, decr. reflexes, bowel and bladder dysfunction, muscle pains, OH, vagal responses, facial paralysis, dysphagia, blindness, anorexia, respiratory failure!!

45
Q

Guillain-Barre Mgmt

A

for respiratory issues you need rapid response. need EKG for autonomic dysfunction, nutrition support for dysphagia, SCDs and anticoag. for impaired mobility. give IV immunoglobulin in first 2 weeks, plasmapheresis

46
Q

Myasthenia Gravis

A

an autoimmune disease where antibodies block the neuromuscular junction, causing decr. muscle contraction and weakness which incr. throughout the day. no cure!

47
Q

Myasthenia Gravis CM

A

varies per patient, affects eyes, chewing, swallowing, speaking, and breathing

48
Q

MG crisis

A

difficulties with swallowing and breathing. exacerbated by resp. infections, surgery, distress, pregnancy, drug exposure, and corticosteroids

49
Q

Trigeminal Neuralgia

A

debilitating unilateral pain in the face. unknown etiology, but results from compression of the artery and nerve root. pain triggered by touch, chewing, or brushing teeth.

50
Q

Trigeminal Neuralgia treatment

A

goal is pain relief. electrical nerve stimulation, nerve decompression, botox. Drugs: antiseizure drugs (Tegretol, Trileptal), gabapentin, tricyclic antidepressants, antispasmodics (Baclofen)

51
Q

primary Vs secondary spinal damage

A

primary is the initial injury that damages the spinal cord. the secondary is after the injury and occurs when hemorrhage around the cord, vasoconstriction, causing an influx of cells and inflammation causing ischemia, edema, and necrosis

52
Q

spinal shock CM

A

flaccid paralysis below the injury, decr. reflexes (including bowel and bladder). Hypotension and bradycardia

53
Q

Neurogenic shock

A

loss of autonomic and sympathetic function. bradycardia, hypotension. causes decr. CO and venous pooling. cannot sense temperature changes below the injury

54
Q

Mgmt for spinal injury CM

A

Respiratory: affected by cervial injuries - may need mechanical ventilation.
blood thinners and SCDs for immobility
bladder: may need foley for atonic, or intermittent cath/bladder retraining for neurogenic bladder. Baclofen for a spastic bladder. neurogenic bowel may result in and illeus - in which case you will need NG tube for rest the bowel.

55
Q

Autonomic dysreflexia teaching

A

prevent overextended bladder/bowel. keep HOB above 30, report terrible headache to nurse.

56
Q

Hepatitis A prevention

A

hand washing and good hygiene, vaccination

57
Q

Hep A exposure management

A

IM immunoglobulin within 2 weeks post exposure

58
Q

Hep B prevention

A

vaccination, avoid risky behaviors, active immunization for at-risk parties

59
Q

Hep B management

A

peglygated interferon! pair with antivirals. alpha-interferon(has alot of side effects)

60
Q

Hep B exposure management

A

passive immunization, give hours-days after exposure

61
Q

Hep C prevention

A

no vaccine, use prevention control measures- risky behaviors

62
Q

hep C post-exposure treatment

A

no specific treatment. testing to determine the chronic stage, prevent transmission, educate about avoiding liver detoxifying drugs. peglygated interferon

Adult health 3 (2 decks)

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