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MedSurg > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Parkinson’s Disease

A

Chronic neurodegenerative disease
Damage to dopamine production - lack of dopamine
Imbalance of dopamine and acetylcholine
Lewy bodies: Clumps of proteins

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2
Q

Characteristics of Parkinson’s Disease

A

TRAP
Tremors - pill rolling
Rigidity: - cogwheel rigidity, jerky movements
Akinesia - loss of voluntary movement, bradykinesia
Postural instability - Propulsive gait

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3
Q

Parkinson’s Disease tx

A

Levodopa carbidopa: Dopamine

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4
Q

Dementia

A

Slower onset degenerative disease
- Infection, trauma, heart disease

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5
Q

Alzheimer’s Disease patho

A

Chronic progressive neurodegenerative disease
Build up of (amyloid) plaques and neurofibrillary tangles

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6
Q

Rheumatic Diseases patho

A

Inflammation from immune systems autoimmune response, mistaking own tissue as harmful stimuli
Degenerates joints, muscles, and soft tissue

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7
Q

Osteoarthritis

A

Progressive deterioration of cartilage in joints
AKA Degenerative joint disease

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8
Q

Labs that indicate Osteoarthritis

A

Increased ESR (Sed rate) and C-reactive protein

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9
Q

Rheumatoid Arthritis

A

Systemic rheumatoid disease
Rheumatoid factors attack healthy tissue
Inflammation in synovial joints

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10
Q

Gout

A

Systemic inflammatory disease
Malfunction in purine metabolism - uric acid crystals damage joints

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11
Q

Labs that indicate Gout

A

Increased uric acid
Increased BUN/Creatinine

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12
Q

Foods high in purine

A

Red meat/poultry
Fish
Alcohol
Soda

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13
Q

Lyme Disease

A

Spirochete (tick) transmitted by deer tick
Bullseye rash 3-30 days after tick bite

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14
Q

Untreated Lyme Disease s/sx

A

Heart block
Joint pain/arthritis
CNS - memory loss, numbness/tingling
Fatigue

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15
Q

Lyme Disease tx

A

Oral Doxycycline
IV Rocephin

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16
Q

Septic Arthritis

A

Infection in joint or joint replacement
Commonly MRSA
Transmitted through cut/incision

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17
Q

Ankylosing Spondylitis

A

Chronic inflammation
- Effects joints in spine, hips, knees, shoulders

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18
Q

Psoriatic Arthritis

A

Starts as Psoriasis
Destruction of joint, tendons, ligaments, nails

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19
Q

Systemic Lupus Erythematosus patho

A

Autoimmune process that effects DNA/RNA
Can cause organ failure

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20
Q

Systemic Lupus Erythematosus s/sx

A

Butterfly rash
Fever, malaise
Joint inflammation
Kidney failure
Reynaud’s disease
Pain

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21
Q

Systemic Sclerosis

A

AKA Scleroderma
Autoimmune disease of connective tissue
- Similar to Lupus

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22
Q

Polymyositis and Dermatomyositis

A

Autoimmune inflammatory disease that causes symmetrical proximal muscle weakness

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23
Q

Polymyositis and Dermatomyositis s/sx

A

Butterfly rash (like Lupus)
Difficulty raising head
Difficulty going up stairs

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24
Q

Sjogren’s Syndrome

A

Systemic autoimmune disorder
Effects lacrimal (eyes) and salivary glands
Goes along with other autoimmune disorders

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25
Q

Fibromyalgia patho

A

Chronic pain syndrome
CNS ascending and descending pathways increase pain signals

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26
Q

Polymyalgia Rheumatica and Giant Cell Arteritis

A

Disorders that present together
Proximal muscles of arms and legs are affected

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27
Q

Esophageal sphincters

A

Upper and lower/cardiac sphincters

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28
Q

Stomach sphincters

A

Upper = cardiac sphincter
Pyloric sphincter

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29
Q

Parietal cells

A

Release HCl (hydrochloric acid) which secretes Pepsin (digestive enzyme) production
Releases Intrinsic Factor - required for B12 absorption

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30
Q

Pernicious anemia

A

Lack of B12

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31
Q

Order of small intestines

A

Duodenum
Jejunum
Ileum

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32
Q

Pancreatic digestive enzymes

A

Amylase - carbs
Lipase - fats
Pancreas - proteins

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33
Q

Barium swallow

A

AKA Upper GI series
Looking for lesions, varices, tumors, obstructions

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34
Q

Barium enema

A

AKA lower GI series
Looking at large intestine for colorectal cancer or polyps

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35
Q

Esophagogastroduodenoscopy (EGD)

A

Looking at upper GI looking for inflammation

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36
Q

Video Capsule Endoscopy (VCE)

A

Looks at small intestine for GI bleed, IBS, celiac

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37
Q

Manometry

A

Tests the pressure and constriction of muscles in the esophagus as you swallow

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38
Q

Electrophysiologic studies

A

Looks at GI muscle motility and sphincters for peristalsis or spasms

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39
Q

Gastric analysis

A

Looks at gastric fluid for gastric irritation
- To see if tx is effective or to dx cause

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40
Q

Laparoscopy

A

Looks at abdominal organs for peritoneal disease, masses, etc.

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41
Q

Types of enteral nutrition

A

Short term: Nasoenteric tube (NET) or Nasogastric tube (NGT)
Long term: Percutaneous Endoscopic Gastrostomy (PEG/G tube)
Percutaneous Endoscopic Jejunostomy (J Tube)

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42
Q

Complication of enteral nutrition

A

Dumping syndrome: Rapid emptying of food from stomach to small intestines
- Avoid by watering down formulas

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43
Q

Parenteral nutrition reasons

A

If GI tract is inaccessible for more than 7-10 days
- Abd surgery, burn, trauma

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44
Q

Locations of parenteral nutrition

A

Peripheral (PICC)
or Central line (CVC)

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45
Q

Types of formula/solutions for parenteral nutrition

A

Partial Parenteral (PPN) or Peripheral Parenteral Nutrition (PPN)
Total Parenteral (TPN) or Total Nutritional Admixture (TNA)

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46
Q

Periapical abscess

A

Infection/pus at the apex (bottom) of tooth
- Tx with aspiration, tooth extraction, ABX, and saline rinse

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47
Q

Periodontitis

A

Gum inflammation leading to recession (oral thrush)
Tx: Chlorhexadine rinse

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48
Q

Candidiasis

A

Caused by Candida Albicans yeast

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49
Q

Parotitis

A

Swelling of your parotid glands (located between ear and jaw)
Caused by virus (mumps/herpes) or Epstein-Barr

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50
Q

Sialadenitis

A

Inflammation of salivary glands
- Can remove glands for tx

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51
Q

Salivary calculus

A

Calcium stone in submandibular gland
Tx: Lithotripsy

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52
Q

Erythroplasia

A

Red lesion
Earliest sign of CA

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53
Q

Glossectomy

A

Excision of tongue (partial or total)
Tx for CA

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54
Q

What is used to dx GERD

A

Endoscopy
Barium swallow study
pH monitoring

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55
Q

Medications commonly used for GERD

A

Antacids - Mylanta
Histamine blockers - Pepcid, Zantac
Proton Pump Inhibitor - Protonix, Prilosec

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56
Q

Types of Hiatial Hernias

A

Sliding: Stomach bulges upwards
Rolling: (Para-esophageal): Balloons out

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57
Q

Tx for hiatial hernias

A

Medications: Antacids, PPI (Prilosec), H2 blockers (Zantac)
Surgical: Laparoscopic repair

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58
Q

S/sx of esophageal CA

A

Dysphagia, pain, bad breath, hiccups, fear of choking, weight loss

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59
Q

Esophageal diverticula

A

Outpouching through weak area of esophagus
Dysfunctional sphincter

60
Q

Esophageal diverticula tx

A

Diverticulectomy

61
Q

Achalasia

A

Absent/ineffective peristalsis of distal esophagus
- Eat slowly

62
Q

Barrett’s esophagus

A

Damaged cells in lower esophagus caused by acid reflux
Tissue cells regrow and are cancerous

63
Q

Reason for neck dissection

A

When malignant/cancerous cells travel to cervical lymph nodes they respond poorly to chemo and radiation

64
Q

Radical neck dissection

A

Removal of cervical lymph nodes, sternocleidomastoid muscle, intrajugular vein, and spinal accessory muscle on one side

65
Q

Modified radical neck dissection

A

Removal of cervical lymph nodes only (no muscles or IJ vein)

66
Q

Selective neck dissection

A

Tries to save lymph nodes

67
Q

Reconstructive flap (neck dissection)

A

Muscle and skin from other areas used at neck dissection surgical site for repair

68
Q

What is normal JP drainage during the first 24 hours post op

A

80-120 mL

69
Q

Neck dissection complication

A

Neck drop: Prevent with exercise and ROM in shoulder and neck

70
Q

Most common cause of Peptic Ulcer Disease

A

H. pylori infection

71
Q

Tx of PUD

A

Abx: Flagyl (for H. pylori infection)
PPI: omeprazole
Surgery: Remove diseased portion of stomach

72
Q

Gastritis

A

Disruption of mucosal barrier that protects stomach from gastric acid causing inflammation
Pernicious anemia from lack of B12 by stomach

73
Q

Tx for gastritis

A

Abx: Flagyl (for H. pylori infection)
Pepcid for acid
B12 to replace
Surgical: Gastric resection (NGT)

74
Q

GI bleed main cause

A

PUD

75
Q

Upper GI bleed s/sx

A

Vomiting
- Coffee ground = occult blood in stomach
- Bright red = esophageal/oral bleed

76
Q

Lower GI bleed s/sx

A

Melena (dark bloody) stool
Bright red = hemorrhoid

77
Q

Tx for GI bleed

A

Surgical resection of pylorus or jejunum
Gastric lavage: Withdraws clots
Embolization: Liquid clotting factor stops bleeding artery

78
Q

IBS

A

Disorder of motility (increased or decreased)
Nausea, diarrhea, gas, constipation
Tx: Modify lifestyle, Metamucil (fiber) - drink with water to avoid bowel abstruction
Alosetron - med to slow motility
Rifaximin - abx

79
Q

Appendicitis patho

A

Opening to appendix is obstructed, leading to infection

80
Q

Peritonitis

A

Acute inflammatory bowel disorder
Inflammation of abdominal lining (peritoneum) - rigid abd
- Caused by bowel rupture
- Tx: Abx, IVF

81
Q

Gastroenteritis

A

Acute inflammatory bowel disorder
Causes: Norovirus, E. coli, Campylobacter, Shigellosis

82
Q

Ulcerative Colitis

A

Chronic inflammatory bowel disorder
- Mainly in rectum and sigmoid colon
Epithelial cells shed (thin) and leads to ulcers
Increased risk of colon CA

83
Q

Crohn’s disease

A

Chronic inflammatory bowel disorder
- Caused by hereditary, immune, or environmental factors
Bowel wall thickens - Fissures, fistulas, abscesses
Common in ileum and colon

84
Q

Complications of Crohn’s disease

A

Perforation, hemorrhage, obstruction, adhesions, CA, structures

85
Q

Tx for Crohn’s and Ulceratic Colitis may include

A

Colostomy for fecal diversion - rest bowels

86
Q

Low residue diet

A

For bowel disorders
Reduce fiber, nuts, milk, whole grains, popcorn
Good foods: White bread, cooked vegetables, eggs

87
Q

Types of bowel obstructions

A

Partial or total obstruction
1. Mechanical: Adhesions, strictures, fecal impaction, tumors
2. Functional/Paralytic ileus: Decreased peristalyis - possibly neuro disorder

88
Q

Types of GI tubes

A

Levin tube: Single lumen, intermittent use only
Salem sump: Dual lumen with blue port for ventilation - so tube tip doesn’t adhere to stomach wall
- Blue vent above waist to bring air in, prevent backflow of stomach acid
Miller Abbott: Weighted balloon (filled with mercury) travels to site of obstruction to irrigate and suction at site of obstruction

89
Q

Polyps

A

Small growth protruding from a mucous membrane of the intestine
Hyperplastic = non neoplasm
Adenomatous = neoplastic -> linked to CA

90
Q

Polyp s/sx

A

Usually asymptomatic

91
Q

Polyp tx

A

Lysis or polypectomy

92
Q

Colorectal cancer s/sx

A

Rectal bleeding
Change in stool consistency
Gas pain
Loose/bloody stool
Poor PO intake due to nausea

93
Q

Types of colostomy (locations)

A

Ascending colostomy - RLQ *liquid stool
Transverse colostomy - Upper quadrants
Descending/sigmoid colostomy - LLQ *firmer stool

94
Q

Ileostomy

A

Surgical opening in ileum or small intestine to redirect fecal matter into a pouch

95
Q

Proctocolectomy with ileal pouch ( or J ) pouch

A

Ileum made into pouch/pseudorectum and connected to anus

96
Q

Continent ileostomy (with Kock pouch)

A

No external appliance
Stool removed with catheter
High complication risk

97
Q

Diverticulosis

A

Presence of pouches without inflammation
- In intestines, mostly colon
Common in older adults, asymptomatic

98
Q

Tx for diverticulosis

A

Lots of fluids
High fiber diet

99
Q

Diverticulitis

A

Infection/inflammation of diverticuli/pouches
Material trapped and causes infection

100
Q

Diverticulitis dx

A

WBC - increased = inflammation
CT Scan
Colonoscopy

101
Q

Types of hernias

A

Epigastric
Umbilical
Inguinal (groin - most common)
Femoral

102
Q

Reducible hernia

A

Can be placed back with gentle pressure

103
Q

Irreducible hernia

A

Requires surgery to be placed back

104
Q

Strangulated hernia

A

Blood supply is cut off
- Can lead to necrosis or perforation

105
Q

Celiac disease

A

Malabsorption syndrome
Autoimmune response to gluten

106
Q

Celiac disease dx

A

Endoscopy with biopsy
Serum IgA (Immunoglobulin A) tests for antibodies

107
Q

Hemorrhoid

A

Internal or external
Swollen vein(s) around anus
Caused by strain/pressure

108
Q

Hemorrhoid tx

A

High fiber diet
Topical antiseptic
Hemorrhoidectomy

109
Q

Anal fissure

A

Tear in lining of anus
Bleeding with defecation
- Stool softener

110
Q

Anal cancer risk factors

A

Smokers, women with cervical cancer, HPV positive

111
Q

Anal fistula

A

Tunneling from anus to rectum
May extend to outside of the body
Caused by abscess or Crohn’s

112
Q

Pilonidal cyst

A

Pilonidal sinus in sacrococcygeal (upper butt) area
If hair grows inward it may lead to infection, cyst, abscess

113
Q

Tx for abcesses

A

I&D - incision and drainage
- Packing or surgical closure
Sitz bath
Side lying position

114
Q

Gynecomastia

A

Hormonal imbalance causing excessive breast tissue in men

115
Q

Klinefelter syndrome

A

Genetic disorder when male has extra X chromosome
- Less testosterone, more risk of male breast cancer

116
Q

Tx for male breast cancer

A

Total mastectomy
Sentinel lymph node biospy (SLNB)
Axillary lymph node dissection (ALND)

117
Q

Chlamydia patho

A

Bacterial chlamydia trachomatis

118
Q

Dx for chlamydia

A

Sample cells from urethral

119
Q

Tx for chlamydia

A

Abx: Zithromax or Doxycycline

120
Q

Gonorrhea patho

A

Bacteria neisseria gonorrhoeae

121
Q

Gonorrhea s/sx

A

Female: May be asymptomatic - untreated leads to pelvic inflammatory disease
Male: Yellow/green discharge, pain and increased urinary frequency
Both: Blisters in throat, sore throat

122
Q

Tx for gonorrhea

A

Cephalosporins: Rocephin IM with PO zithromax or doxycycline
Expedited Partner Therapy (EPT)

123
Q

Trichomoniasis patho

A

Parasite trichomonas vaginalis

124
Q

Trichomoniasis s/sx

A

Female: Vaginal itch, burning with urination, painful intercourse
Male: Burning with ejaculation/urination
Both: May be asymptomatic

125
Q

Tx for trichomoniasis

A

Abstinence
Flagyl, Tindamax
EPT

126
Q

Genital Herpes patho

A

Incurable, recurrent
Virus Herpes Simplex

127
Q

Genital herpes s/sx

A

Asymptomatic
Mild tingling/itching 1-2 days before outbreak
Lesions rupture and leave an erosion

128
Q

Tx for genital herpes

A

Antivirals:
Zoverax
Valtrex
IV Acyclovir

129
Q

HPV

A

Human papillomavirus
Cause of genital warts (condylomata acuminata)

130
Q

HPV prevention

A

Gardasil

131
Q

HPV tx

A

Cream or jel Condylox
Chemical ablation/cryotherapy of warts

132
Q

Syphilis

A

Treponema Pallidum
Can lead to systemic diseases

133
Q

Syphilis s/sx

A

Primary: Chancre
Secondary: Systemic disease
Tertiary: No longer contagious
Flu symptoms

134
Q

Prostate function

A

Produces fluids for semen

135
Q

Function of testis

A

Produces testosterone and sperm

136
Q

Meatospermia

A

Blood in ejaculate

137
Q

Prostate-Specific Antigen

A

Increased levels may indicate CA, prostatitis, or urinary retention
Less than 4 ng/mL
Beginning at age 50

138
Q

Nocturnal penis tumescence status

A

Sleep study
Measures engorgement/erection
Determines erectile dysfunction cause

139
Q

Benign Prostatic Hyperplasia

A

Prostate swells upwards towards bladder and constricts urethra
Caused by aging or increased estrogen or DHT (dihydrotestosterone)

140
Q

Increased risk for BPH

A

Smoking, ETOH, HTN, DM, obesity

141
Q

Tx for BPH

A

Transurethral Microwave Therapy (TMT): heat to prostate increase necrotic tissue slough
Transurethral Needle Ablation (TUNA): heat to prostate to increase necrotic tissue slough
Transurethral Resection of the Prostate (TURP): removal of inner portion of prostate

142
Q

Continuous bladder irrigation (CBI)

A

Irrigates the surgical site after removal of prostate to removes clots/obstruction
Saline irrigates bladder through foley
Monitor for bladder spasms

143
Q

Transurethral Resection Syndrome

A

NS in continuous bladder irrigation (CBI) can be absorbed into circulatory system
Leads to fluid and electrolyte imbalance - hyponatremia

144
Q

Prostate cancer patho

A

BRCA 1 and 2, DHT

145
Q
A

MedSurg (5 decks)

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