Final Exam Blueprint Flashcards
What type of DM is caused by no insulin production by the beta cells of the pancreatic islet cells of Langerhans?
Type 1 DM
What type of DM is characterized by insulin resistance?
Type 2 DM
What are some DM manifestations?
polydipsia (increased thirst), polyphagia(increased hunger), polyuria (more peeing), weight loss, blurred vision, fatigue, retinopathy, and neuropathy
What risk is increased for individuals with gestational diabetes?
type 2 diabetes for mother and child
What are some complications of diabetes mellitus?
Blindness (from retinopathy) , impaired blood vessels (from prolonged hyperglycemia) causes delayed wound healing and increases risk of infection, neuropathy which can result in gangrene, osteomyelitis, and amputation. Diabetic Ketoacidosis can result from prolonged hyperglycemia and no insulin.
What is metabolic syndrome?
a cluster of cooccurring risk factors (hyperglycemia, hypertension, hypercholesterolemia, and large waste circumference) that increase risk for diabetes, cardiovascular disease, and stroke
What A1C level indicates diabetes?
> 6.7
What is DKA? What it is caused by?
-diabetic ketoacidosis, a complication of diabetes where body produces excess ketones
-triggered by insufficient insulin, which can be caused by infection or illness
What is the name of the insulin resistance that occurs during pregnancy?
gestational diabetes
What are the manifestations of hypoparathyroidism?
hypocalcemia (Chvosteks and Trosseaus), patchy hair loss, fatigue, abdominal cramping, and memory loss
What are the manifestations of hyperparathyroidism?
hypercalcemia, kidney stones, osteoporosis (pathologic fractures), polyuria, constipation, bone pain, and vomiting
What are the manifestations of Cushings Syndrome?
obesity (especially in trunk), “moon face,” “buffalo hump,” thin arms and legs, purple striae, weak muscles, acne, psychosis
What are the manifestations of hypothyroidism?
sluggishness, weight gain, depression, constipation, facial edema, hypotension, goiter
What happens to T3, T4 and TSH in hypothyroidism?
increased TSH (thyroid stimulating hormone), and decrease T3 and T4
What are the manifestations of hyperthyroidism?
everything speeds up (weight loss, thyroid storm, goiter, diarrhea, hypertension, exophthalmos, tremor)
What is thyroid storm?
complication of hyperthyroidism characterized by high temp, hypertension, and arrythmia caused by heart working too fast; can lead to heart attack
What happens to TSH, T3 and T4 during hyperthyroidism?
decreased TSH and increased T3 & T4
What is somatic pain?
pain resulting from noxious stimuli (cutting, crushing, pinching, extreme temps.) to skin, joints, muscles, and tendons
What is visceral pain?
caused by stimuli to internal organs
What is referred pain?
type of visceral pain that occurs away from the site of the stimulus (teeth hurting during a heart attack)
What is phantom pain?
exists after the removal of a body part (amputation)
What is intractable pain?
chronically progressing pain that is unrelenting and debilitating (rheumatoid arthritis, degenerating disks, cancer, and is common in crushing injuries)
What is neuropathic pain?
results from damage to peripheral nerves by disease (diabetes mellitus) or injury; leads to paresthesia + pain = (prickly, stabbing and burning)
What is the concern for sensory impairment?
changes in hearing, vision, and other abnormal responses that can result in risk for injury
What are the manifestations of conjunctivitis?
edema, pain, blurry vision, photophobia, watery/mucus-like exudate with viral infections, and yellow-green exudate with bacterial
What are cataracts?
clouding of the lens of the eye that results in hazy vision caused by breakdown of proteins
What are some common manifestations of Monosomy X (Turner’s Syndrome)?
-deletion of X chromosome
affects only females
-short stature, gonadal streaks (lack of ovaries), lymphedema, broad chest with wide-spaced nipples, low-set ears, and small lower jaw
What are the manifestations of Polysomy X (Klinefelter’s Sundrome)?
-multiple X chromosomes
affects males
-small genitals, sparse facial/body hair, sexual dysfunction, and gynecomastia (female-like breasts)
-increases risk for osteoporosis and breast cancer
Which cellular adaptation occurs due to decreased work demands on a cell, so cell becomes smaller?
atrophy
Which cellular adaptation occurs due to increased work demands, so cells increase in size?
hypertrophy
Which cellular adaptation is an increased number of cells occurring in an organ or tissue ?
ex. endometrial hyperplasia; over secretion of estrogen
hyperplasia
Which cellular adaptation is where one adult cell is REPLACED by another normal cell type?
ex. ciliary changes in a smokers lungs
metaplasia
Which cellular adaptation is where cells mutate into cells of a different size, shape, and appearance (often indicated as precancerous cells)?
ex. cervical cells exposed to HPV- cervix begins growing abnormal cells
dysplasia
What is cellular death caused by injury, disease, or ischemia that causes the cell to swell and burst?
necrosis
This is a type of necrosis in which caustic (capable of dissolving) enzymes dissolve or liquify necrotic cells:
liquefaction necrosis
This is a type of necrosis in which necrotic cells disintegrate, but the cellular debris remain in the area for months or years (cottage cheese-like appearance):
ex. tuberculosis
caseous necrosis
This is a type of necrosis in which lipase enzymes break down intracellular triglycerides into free fatty acids, which then combine with magnesium, sodium, and calcium to form soaps:
fat necrosis
This is a type of necrosis usually caused by interruption in blood flow:
coagulative
which type of necrosis is commonly associated with breast injury or acute pancreatitis?
fat necrosis
What type of immunity provides immediate, nonspecific protection?
innate immunity
What type of immunity takes 7-10 days to provide specific protection from an antigen?
adaptive immunity
what are the 5 components of the innate immunity?
barriers, inflammatory response, pyrogens, interferons, and complement proteins
What type of hypersensitivity reaction is IGE mediated and is common in anaphylaxis and asthma? (<30 mins- several hours)
type I
What type of hypersensitivity reaction is cell-mediated, known and delayed-type and is common in contact dermatitis and Crohn’s disease? (1-3 days)
type Iv (4)
This is programmed cell death that usually occurs because of morphologic (structure or form) changes/ cells shrink and break down:
apoptosis
What can cause cell death due to inadequate blood flow, leading to less oxygen (known as infarction)?
ischemia
What find of immune issue reflects a defect with the immune system?
primary immunodeficiency
What kind of immune issue reflects underlying disease or factors suppressing the immune system?
ex. chemo, liver disease, stress, etc
secondary/acquired immunodeficiency
What type of incontinence is triggered by coughing, sneezing, laughing, exercising, and lifting heavy objects?
stress incontinence
What type of incontinence is characterized by the intense, sudden urge to urinate, followed by an involuntary loss of urine?
overactive/urge incontinence
What type of incontinence is caused by trauma or damage to the nervous system?
reflex incontinence
What type of incontinence is caused by the inability to empty the bladder (retention)? What are the manifestations?
overflow incontinence
-dribbling and weak stream
What type of incontinence is caused by prostate enlargement, urethral blockage, and bladder damage?
overflow incontinence
What kind of incontinence is caused by a physical or mental impairment that prevents toileting in time?
functional incontinence
What type of incontinence is caused by a temporary condition, such as a UTI, delirium, alcohol, etc?
transient incontinence
What type of urinary issue is characterized by a continuous leakage of urine, all times of the day or random large volumes uncontrolled?
gross total incontinence
What are the manifestations of anemia?
weakness, fatigue, pallor, dyspnea, and tachycardia
What are the manifestations of iron-deficiency anemia?
cyanotic sclera, brittle nails, decreased appetite, headache, irritability, stomatitis, pica (unusual cravings)
What are the manifestations of pernicious anemia?
bleeding gums, diarrhea, impaired smell, Babinski’s sign (big toe dorsiflexes and toes fan out)
What are the manifestations of aplastic anemia?
combination of symptoms from anemia (fatigue, weakness, pallor), leukocytopenia (frequent infection), and thrombocytopenia (bleeding)
What are the manifestations of sickle cell anemia?
sickle cell crisis ( painful episodes of ischemia and necrosis) that can be triggered by dehydration, stress or fever
What are the manifestations of polycythemia vera?
sluggish blood flow, tissue ischemia and necrosis, hypertension, heart failure, hemorrhage, organomegaly, vision abnormalities
What is the most alarming manifestation of thrombocytopenia?
risk for bleeding
What is indicated by leukocytosis (increased WBC)?
presence of infection
What are the manifestations of lymphoma?
enlarged lymph nodes, night sweats, pruritus, splenomegaly, and retrosternal chest pain
What type of lymphoma is identified by the presence of Reed-Sternberg Cells?
Hodgkin Lymphoma
What are the manifestations of leukemia?
leukopenia (recurrent infections), anemia, thrombocytopenia, lymphadenopathy, joint swelling, bone pain, weight loss, anorexia, hepatomegaly, and CNS dysfunction
What suspicious and likely indicative of skin cancer on an integumentary system assessment?
Asymmetry
Border Irregularity
Color variations
Diameter> 6mm
Evolving shape
consistent bleeding
What is the most common type of skin cancer that rarely metastasizes?
basal cell carcinoma
What type of skin cancer is least common, most serious, and often metastasizes?
melanoma
Rule of 9’s: head and neck
9%
Rule of 9’s: arms (each)
9%
Rule of 9’s: trunk (anterior and posterior individually)
18% each
Rule of 9’s: legs (each)
18% each
Rule of 9’s: genitalia & perineum
1%
What type of burn is characterized by redness, edema, pain, and impact to epidermis? (superficial)
first degree burn
What type of burn is characterized by partial thickness damage, affecting the epidermis AND dermis, with presence of pain, erythema, and blistering?
second degree burn
What type of burn is a full thickness burn that extends into deeper tissues and causes white, blackened, charred, numb skin?
third degree
What are the manifestations of cellulitis?
swollen, warm, tender area of erythema. Leukocytosis, malaise, etc.
Can lead to necrotizing fasciitis and sepsis
What are the manifestations of psoriasis?
silver plaque due to build up of keratinocytes, psoriatic arthritis
What are the primary risks for pressure injuries?
friction, shear, unrelieved pressure, and moisture
Which stage of pressure injury is characterized by intact, nonblanchable skin with the presence of erythema?
stage 1
What stage of pressure injury is characterized by partial thickness loss of the epidermis, erosion or blister, but no exposed subcutaneous tissue? -shallow open ulcer with pink-red wound bed
stage II
What stage of pressure injury does this BEST describe: full thickness skin loss with damage to subcutaneous tissue, where subcutaneous fat may be visible? -no visible tendon, muscle, or bone
stage III
What stage of pressure injury is characterized by full thickness loss of skin? -possible muscle, bone, and tendon exposure, and possible tunneling
stage IV
What type of injury is expected when there is visible area of purple/maroon skin, and skin is nonblanchable, and upon palpation feels jello-like/mooshy?
deep tissue injury
What type of injury is expected when there is visible area of purple/maroon skin, and skin is nonblanchable, and upon palpation feels jello-like/mooshy?
unstageable
What is the normal blood pH?
7.35-7.45
What is normal range of PaCO2?
45-35 mmHg
What is the normal range of HCO3?
22-26 mEQ/L
What type of solution is responsible for putting more fluid in the intravascular space? When would you use this solution?
isotonic
hypovolemia
What type of solution would cause a cell to swell and burst due to low concentration of solutes?
hypotonic
What type of solution would cause a cell to shrink/crenate due to high concentration of solutes?
hypertonic
What is the term for the amount of blood the heart pumps in one minute?
cardiac output
What compensatory mechanism is activated in the kidney’s when renal blood flow is decreased, as with hypotensive states?
RAAS (renin-angiotensin-aldosterone system)
What are the risk factors for endocarditis?
IV drug use, recent heart procedures, poor dental hygiene, and Marfan Syndrome
What are the risk factors for CAD (coronary artery disease)?
tobacco use, obesity, physical inactivity, stress, DM, hyperlipidemia, and hypertension
What are the manifestations of cad (coronary artery disease)?
angina, nausea, vomiting, fatigue, heart attack
What are the manifestations of valve regurgitation?
dyspnea on exertion, ventricular hypertrophy, lightheadedness/fainting, syncope
What are hypertension risk factors?
age, inactivity, tobacco use, high-sodium diet, excess alcohol, and stress
What are the treatment options of hypertension?
decreased dietary sodium (DASH diet), saturated fat, and cholesterol, as well as minimize sweets, added sugar, and red meat
What type of heart failure is characterized by blood backing up into pulmonary circulation, causing pulmonary congestion, dyspnea, and activity intolerance?
left-sided heart failure
Which heart failure causes blood to back up into the peripheral circulation, causing edema & weight gain?
right-sided heart failure
What is the name of the distinct assortment of symptoms that appears in individuals with cardiac tamponade? (low b.p., muffled heart sounds, JVD)?
Beck’s Triad
What are the three manifestations that make up Becks Triad, the system of manifestations that appear with cardiac tamponade?
low b.p.
muffled heart sounds
jugular vein distensions
What are the three manifestations that make up Becks Triad, the system of manifestations that appear with cardiac tamponade?
low b.p.
muffled heart sounds
jugular vein distensions
What is referred to as the death of the myocardium from a sudden blockage of coronary artery blood flow?
myocardial infarction
What may you expect with troponin levels in an individual who has had a myocardial infarction within the last 2 weeks?
elevated
What is cholelithiasis? What type of diet causes this condition?
gallstones (hard deposit of digestive fluid)
high fat diet
What are the manifestations of cholelithiasis?
colicky pain, abdominal pain, clay-colored stools, abdominal distension, jaundice
Dark, tarry stool associated with a significant amount of bleeding in the g.i. tract?
melena
Blood in the vomitus (coffee ground appearance)?
hematemesis
What is known as bright red blood found in the stool?
hematochezia
What are the manifestations of liver failure?
jaundice, ascites, hepatomegaly, pain in right upper quadrant, vomiting, diarrhea
What is the most common cause of chronic gastritis?
helicobacter pylori
What manifestations are associated with a small bowel obstruction? What function is impaired?
colicky pain (sudden and severe)
-ability to pass gas or stool
What is GERD (gastroesophageal reflux disease)?
the inappropriate movement of stomach contents into the esophagus, causing irritation to esophageal mucosa
What are some causes of inflammatory bowel disease?
genetically associated autoimmune that has been activated by an infection
Which IBD affects mouth to anus and is characterized by skip lesions/cobblestone appearance?
Crohn’s disease
Which IBD is a progressive condition of the rectum and colon and causes erosions, intermittent abdominal pain, and frequent watery stools with blood and mucus?
ulcerative colitis
What condition is characterized autodigestion and can cause upper abdominal pain that radiates to the back?
pancreatitis
What type of acute kidney injury is caused by ureter/bladder obstruction or dysfunction (stones, tumors, BPH)?
postrenal kidney injury
Hypovolemia, hypotension, and fluid loss are associated with what condition?
pre-renal kidney injury
What type of kidney injury is the client who hemorrhaged due to trauma at risk for?
pre-renal kidney injury
What type of acute kidney injury is caused by acute tubular necrosis (impaired blood supply), hemolytic uremic syndrome, glomerulonephritis, or prolonged drug exposure?
intrarenal kidney injury
What are the manifestations of UTI?
dysuria, suprapubic pain, frequency, urgency
What are important treatment options for nephrolithiasis (kidney stones)?
encourage fluids, strain all urine, and make dietary changes based on stone composition
What is the leading cause of chronic kidney disease?
diabetes mellitus
What is chronic kidney disease?
gradual loss of renal function
What lab value is important to assess with CKD?
GFR; when it drops less than 15 clients must go on dialysis
What are some complications of influenza?
secondary bacterial pneumonia, encephalitis, and myocarditis
What are the manifestations of influenza?
sudden onset symptoms (fever, chills, headache, aches)
What should be included in a teaching about tuberculosis?
respiratory isolation, night sweats, and hemoptysis (coughing up blood)
How is tuberculosis diagnosed?
skin test, chest X-ray, and sputum culture
What are the treatment options for cystic fibrosis?
chest physiotherapy, coughing exercises, mucus thinners, and increased fluid
What are the manifestations for asthma?
wheezing, shortness of breath, dyspnea, chest tightness, cough and anxiety
What treatment option is added to emphysema that is not also used in chronic bronchitis?
pursed lip breathing
What are the treatment options for chronic bronchitis?
limited oxygen therapy, bronchodilators, antibiotics, corticosteroids, chest physiotherapy, and increased hydration
What is atelectasis?
collapse of the alveoli
Which STI is known as the “silent STI” and can cause infertility and PID (pelvic inflammatory disease)?
chlamydia
What are some causes of epididymitis?
anal sex, tuberculosis, recent catheterizations, STIs, e. Coli
What is a thrombotic stroke?
CVA caused by a blood clot
What causes a hemorrhagic stroke?
bleeding into the brain by the rupture of blood vessels
What are the manifestations of meningitis?
fever, severe headache, stiff neck, mental status changes, rash, and bulging fontanelle
What are some manifestations of Parkinson’s disease?
tremors, mask-like face, shuffling gait, unsteady movement, rigid movement, monotone voice, etc
What are some major manifestations of a TBI (traumatic brain injury)?
seizures, fluid draining from nose, mouth or ears, inability to move limbs, stiff neck, and vomiting
