Final Exam Flashcards
patho of rheumatoid arthritis
- synovial inflammation and joint architecture destruction
- rheumatoid factor: antibody against IgG fragments in most pts
- Pannus: destructive vascular granulation tissue destructive to adjacent cartilage and bone (causes necrosis)
assessment of rheumatoid arthritis
- Pannus at the joint cavity
- fatigue, weakness and limited ROM, morning stiffness
- diagnosed before age 60
assessment of gout
tophi in the nodules (accumulation of crystalline deposits
oliguric phase of acute renal failure
- elevated BUN and creatinine
- decreased specific gravity
- decreased GFR
- decreased urine output
hemolytic anemia
premature destruction of RBCs, retention of iron and the other products of Hgb destruction, and a compensatory increase in erythropoesis
thalassemias
inherited disease that causes anemia; deficiency in Hb due to decreased sythesis of the effective chain and increased production of the ineffective chain
nephritic vs nephrotic syndromes
- nephritic: acute onset, proteinuria, HTN, azotemia (increased BUN), renal insufficiency
- nephrotic: hypoalbuminemia causes edema, worse proteinuria
cause of glomerulonephritis
strep
pancreatitis
- autodigestion of the pancrease
- starts with trypsin
- cullen’s sign: discoloration of the abdomen and periumbilical area
- turner’s sign: bluish discoloration of the flanks
- guarding
- enzymes are elevated 3x the normal amount and appear in the blood (amylase, lipase)
GERD can lead to…
Barrett esophagus, which can lead to adenocarcinoma
assessment of liver cirrhosis
liver border would feel lumpy
patho of liver cirrhosis
- scar tissue doesn’t do what it’s supposed to- there is less blood flow through the liver, the blood backs up into the organs before the liver
- this is portal HTN- veins from stomach, intestines, spleen, pancreas merge into the portal vein
- non-reversible
carpal tunnel tests
- Phalen’s test: wrists together for 3 mins
- Tinel sign: light percussion on the median nerve
transverse fracture
problem with lots of bleeding to the surrounding structures (most concerning is blood vessels
-has to have tons of force
spiral fracture
- from spinning
- kids putting arms in washing machines
- child abuse
comminuted fracture
- more than one piece of bone
- need external fixation
segmental fracture
piece of the bone comes out
butterfly fracture
- bite of the bone comes out
- seen in osteopenia, osteoporosis, bone cancer
impacted fracture
from compression (jumping out of the window and landing on feet)
test for osteoporosis
dexa scan
vaginitis
thin, grayish-white discharge with foul, fishy odor
-treat with flagyl
primary syphilis
chancre at the site of exposure
secondary syphilis
skin rash, fever, sore throat, stomatitis, nausea, loss of appetite, inflamed eyes, alopecia, genital lesions
tertiary syphilis
- happens after a latent phase
- localized gumma lesions, CNS lesions, CV effects
- Gumma lesions- start as a soft ulcer, burrows down into the tissues
- bodies reaction to the spirochete is that it tries to get rid of it, but it destroys tissue instead
risk of ovarian cancer
- increases the older you have children
- BRCA1 and BRCA2 increase susceptibility
- high fat diet and genital talc powders
problem with hyperglycemic hyperosmolar state
dehydration
Somogyi effect
rebound effect: sugar gets so low that body compensates and gets super high
Dawn phenomenon
hyperglycemia in the morning- no bottoming out like with Somogyi effect
diabetic ketoacidosis (DKA)
- severely high blood glucose
- body turns to fat for energy → produces ketones → ketones build up and make body acidic → DKA
s/s of DKA
- extreme thirst and dry mouth
- frequent urination
- high glucose levels
- ketones in urine
- n/v
- Kussmal’s respirations
- fruity odor
problem with Grave’s disease
cardiac output
thyroid storm
- HR, BP, and body temp elevate to dangerously high levels
- fatal without prompt treatment
signs of hypercalcemia
- decreased memory
- headache
- muscle weakness, decreased deep tendon reflexes
signs of hypocalcemia
- increased bleeding tendencies
- increased deep tendon reflexes, tremors, muscle spasms, tetany
- seizures
- laryngeal spasms
- **positive Trousseau’s and Chvostek’s signs
hyperosmolar hyperglycemia (HHNS)
- most often from uncontrolled type 2 diabetes
- high blood sugar → body tries to get rid of it by passing it into urine → dehydration
metabolic acidosis
low everything
metabolic alkalosis
high everything
respiratory acidosis
high everything except low PH
respiratory alkalosis
low everything except high PH
anisocoria
unequal pupil size- “blown pupil”
retinal problems are most commonly from…
diabetes
papilledema
- swelling and inflammation of the optic disk
- optic disk is pale yellow to white
central cord syndrome
arms more affected than the legs
anterior cord syndrome
motor functions affected; touch sense not affected
brown-sequard syndrome
motor function lost on that side; pain and temp sensation lost from the other side
conus medulllaris syndrome
bowel, bladder, sexual function defects
autonomic dysreflexia
BP gets out of control
UMN injury
- spinal reflexes still work
- no longer modulated by the brain
- hypertonia, spastic paralysis
LMN injury
- cells in spinal reflex damaged
- flaccid paralysis
tonic-clonic seizures
muscle contraction, loss of consciousness
absence seizure
disturbances in consciousness
myoclonic seizure
muscles of the face, trunk, extremities contract
tonic seizures
voluntary muscles of the legs and arms contract
clonic seizures
bilateral, symmetric, rhythmic muscle contractions
atonic seizures
loss of muscle tone
L sided HF
blood backs up from left heart → lungs → right heart → body
- body lacks blood
- lungs fill with blood
R sided HF
blood backs up from the right heart → body → left heart → lungs
- body fills up with blood
- lungs do not oxygenate enough blood
worst artery to get an MI
lateral ascending artery (widow maker)
Patho of Parkinson’s
Destruction and degeneration of nerve cells in the basal ganglia
Crackles-fine
- Late inspiration: Pneumonia or CHF
- Early inspiration: bronchitis, asthma. Emphysema
Crackles- course
Pneumonia, pulmonary edema, pulmonary fibrosis
High pitched wheeze (sibilant)
Acute asthma or chronic emphysema
Low pitched wheezes (sonorous)
- Bronchitis or single obstructions
- snoring before apnea episode
Stridor
Broncharygospasm, such as with croup
1 cause of blindness in the world
Entropion- lashes turning inward and sticking to sclera
Cause of conjunctivitis
Staph or strep
Stye
Hordeolum
