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Internal Medicine > Final Exam New Material > Flashcards

Final Exam New Material Flashcards

1
Q

Skin body weight %

A

15-20%

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2
Q

Skin function

A

-protection
-holding organs
-sensory
-fluid balance
-temp control
-absorb radiation
-vit D making
-synth. lipids

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3
Q

Primary Skin Lesion

A

-1st
-response to meds or radiation
-Macule, papule, tumor, wheal

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4
Q

Secondary Skin Lesion

A

-changes to primary lesion
-scale, crust, scar, ulver, atrophy

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5
Q

Factors Affecting Ability to Heal

A

-tobacco, psychological status, nutrition

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6
Q

Skin Lab Values

A

-Pre-albumin: nutritional status
-glucose
-hemoglobin
-hemocrit: wound healing

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7
Q

Aging in Integumentary Sys.

A

-changes in hair (color, thinning, balding, pattern)
-Changes in skin (hyperpigmentation, wrinkling, pain perception, thinning, temp regulation, less vit D production—> osteoporosis)
-Vascular changes (decreased healing, decreased vascularity, thinning)
-Decreased protection (statrum corneum, less langerhans cells (loss of immune surveillance)

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8
Q

Atopic Dermatitis

A

-chronic or relapsing inflammatory skin disease characterized by pruritus
-precursor to allergies

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9
Q

Contact Dermatitis

A

-acute or chronic skin inflammation caused by exposure to an external agent, that may act as an irritant or allergen

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10
Q

Eczema/Dermatitis

A

-superficial itchy inflammation of the skin caused by irritant exposure, allergies, or genetics
-ebbs and flows

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11
Q

Stasis Dermatitis

A

-development of erythematous itchy plaques that may open to form shallow ulcers on the lower legs
- underlying venous hypertension and resultant venous insufficiency

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12
Q

Rosacea

A

-chronic facial disorder of middle-aged and older people
-form of acne, vascular and allergen components

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13
Q

Incontinence-Associate Dermatitis

A

-skin damage resulting from chronic urine or feces exposure

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14
Q

Bacterial Skin infections

A

-impetigo
-cellulitus

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15
Q

Viral Skin infections

A

-Herpes Zoster
-Warts

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16
Q

Fungal Skin infections

A

-Ringworm
-Athelets foot
-Yeast

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17
Q

Parasitic Skin infections

A

-Scabies
-Pediculosis (lice)

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18
Q

Skin Cancer Benign lesions

A

-Seborrheic keratosis
-nevi (moles)

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19
Q

Skin Cancer Premalignant Lesions

A

-actinic keratosis
-bowen disese

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20
Q

Skin Cancer Malignant Nonmelanoma Carcinomas

A

-basal cell carcinoma
-Squamous cell carcinoma

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21
Q

Skin Disorders Associated with Immune Dysfunction

A

-Psoriasis
-Lupus
-System sclerosis
-Polymyositis

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22
Q

Burn Severity

A

-depth (determined by temperature, source, and duration) and total body surface involved

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23
Q

1st Degree Burn

A

-epidermis damage
-sun, UV, brief flame/water/flash
-mild, no blisters
-painful, tingling, eased by cool water
-3-7

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24
Q

2nd Degree Burn

A

-epidermis and dermis
-Scalding liquids or immersion of liquids
-blisters, edema, weaping
-pain, cold sensitive
-14-28 days

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25
Q

3rd Degree Burns

A

-epidermis, dermis, subcutaneous damage
-prolonged exposure
-fat exposed, dry surface
-no pain
-no healing w/o grafts, skin liquifies in 2-3 weeks, hypertrophic scarring

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26
Q

Wallace Rule of Nines

A

-9% on arms and head (3)
-18% on legs and both sides of torso (4)
-1% on genitals

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27
Q

Burn Admissions

A

-75% thermal (43% flame, 34% scalding)
-Chemical
-Electrical
-Radiation

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28
Q

Burn Mortality Determinants

A

-TBSA
-age
-inhalation injuries

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29
Q

Cardiovascular Sys. effects of Burns

A

-vasoactive substances from injured tissues
-decreased circulating blood volume
-increased HR
-CO: decreases in the beginning, returns to normal, then increases in 24 hrs

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30
Q

Renal and GI sys. effects of Burns

A

-shunting of blood from kidneys to intestines
-Oliguria: decreased urine output
-Paralytic ileus: intestinal dysfunction

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31
Q

Immune Sys. effects of Burns

A

-immunosuppression
-increased infections

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32
Q

Electrical Burns

A

-multi system injuries as it travels through the body
-small entrance wounds, large exit wounds
-Alternating Current worse than Circulating Current

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33
Q

Chemical Burns

A

-continue to burn until neutralized
-alkaline burn deeper

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34
Q

Burn Locations/Effects

A

-Hand and joint burns can cause loss of use
-Circumferential burns can create a tourniquet

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35
Q

Inhalation Injuries

A

-respiratory failure, pneumonia, sepsis

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36
Q

Emergent phase of Burns

A
  • fluid retention
    -ventilatory magement
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37
Q

Acute Phase of Burns

A

-wound management
-infection prevention
-debridement
-skin grafting
-PT

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38
Q

Rehabilitative Phase of Burns

A

-return to max independence and function

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39
Q

Autografts

A

-full thickness burn to permanently close the burn

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40
Q

Allografts

A

-homografts
-cadaver skin

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41
Q

Xenografts

A

-heterografts
-pigskin

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42
Q

Biosynthetic Grafts

A

-collagen and synthetics

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43
Q

Integumentary Ulcers

A

-Diabetic Ulcers: neuropathic ulcers
-Wagner System:
0: preulcerative
1: superficial
2: Penetrate through subcutaneous
3: Osteitis, abscess
4: Gangrene of digit
5: Gangrene of foot

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44
Q

Pressure Injuries

A

-unrelieved pressure; Interface (externally) and Shearing forces
-Bony prominences: heels, sacrum, ishtub, greater troch, elbows, and scapula
-can’t be back staged, must be resolved

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45
Q

Pressure Injury Stages

A

1: Intact skin
2: Partial thickness; exposed dermis
3: Full thickness skin loss
4: Full thickness skin and tissue loss
Unstageable: Obscured full thickness and loss
Deep Tissue: Persistent deep red discoloration

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46
Q

Pressure Injury RF

A

Intrinsic Factors: decreased sensation, mobility, incontinence, activity levels, nutritional status

Extrinsic factors: pressure, shear, friction, moisture

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47
Q

Pressure Injury Lab values

A

Hemoglobin, hematocrit, prealbumin, total protein

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48
Q

CVD Signs & Symptoms & biomarkers

A

Biomarkers: BP, PVC, LDL
-edema, heart attack symptoms

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49
Q

Aging and CVS

A

Quiz: Cyanosis, decreased HR, increased cholesterol

-reduction in function, myocytes, capillary density
-Atheroscerlosis
-Arterial walls stiffen with age and become dilated, loss of elasticity

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50
Q

Gender Differences CVS

A

Women (more): mitral valve prolapse, fatal arrhythmias, increased bleeding episodes

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51
Q

Metabolic Syndrome

A

-3/5
1. Waist circumference
2. Reduced HDL <40 and 50
3. High BP
4. High BG >100
5. Elevated triglycerides >150

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52
Q

Ateriosclerosis

A

group of diseased of thickening and loss of elasticity of arterial walls

  1. Atherosclerosis: plaques of fat in inner layer
  2. Monckeberg Arteriosclerosis: middle layer destruction from calcium diposites
  3. Arteriolosclerosis: thickening of walls of small arteries
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53
Q

PCI

A

-Percutaneous coronary intervention
-balloon in LCA

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54
Q

CABG

A

-coronary artery bypass graft
-saphenous graft

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55
Q

Coronary Stent

A

-stent to open artery and move plaque

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56
Q

Adrenergic receptor agonist

A

orthostatic hyotension; hypertension

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57
Q

Adrenergic receptor antagonist

A

-hypertension

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58
Q

ACE inhibitor

A

-heart failure, hypertension

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59
Q

Angiotensin II blockers

A

-heart failure, hypertension

60
Q

Beta blockers

A

-angina, arrhythmias, hypertension, heart failure

61
Q

Antiarrhythmics

A

-arrhythmias and heart failure

62
Q

Direct Renin Inhibitiors

A

hypertension

63
Q

Calcium channel blockers

A

angina, hypertension, arrhythmias

64
Q

Hemostatics

A

Excessive bleeding

65
Q

Cholesterol-modifying agents

A

-CHD prevention, dyslipidemias, high cholesterol, arterosclerosis

66
Q

Antidiuretics

A

-central diabetes

67
Q

Diuretics

A

Heart failure, hypertension, edema

68
Q

Phosphodiesterase inhibitors

A

-pulmonary arterial hyperension

69
Q

Vasodilators

A

angina

70
Q

Angina Pectoris

A

-workload exceeds o2 supply to heart and demand
-pain discomfort in chest

71
Q

Hypertensive CVD

A

Primary (idiopathic), secondary (cause), Malignant (target organ damage)

72
Q

Myocardial Infarction

A

Type 1: atherosclerotic plaque
Type 2: Mismatch between o2 supply and demand, no plaque

73
Q

Orthostatic Hypotension

A

-decrease in BP 20 with pulse increase standing from sitting

74
Q

Arrhythmias

A

-HR disturbance from SA node

75
Q

Rheumatic Fever

A

-endocarditis from strep may lead to heart disease

76
Q

Aneurysm

A

-stretching of BV 50% or more
-most common in abdominal aorta
-abdominal and low back pain

77
Q

Thrombophlebitis

A

-deep vein thrombosis
-pulmonary embolism: DVT breaks lose and travels to heart, most common hospital readmission and death
-varicose veins: dilation of veins with incompetence of valves

-swelling of vein from clot

78
Q

Lymphatic System

A

-one way system to cary filtrate, pressure driven
-absorb macros, maintain fluid balance, fight infection, removal of debris

79
Q

Lymphedema

A

-accumulation of water and proteins in tissue leading to tissue fibrosis and swelling
-goal to put fluid back into ducts
-Primary (idiopathic) or Secondary (acquired: filariasis (most common in world) from parasitic worm, radiation, surgery, cancer(most common cause of secondary in US)
-Stage 0 to Stage III (elephantiasis)

80
Q

RUE Lymphatics

A

-drain into right lymphatic duct

81
Q

LUE Lymphatics

A

-drain into left subclavian vein
-3/4ths of flow

82
Q

Superficial Lymphatic vessels

A

-rely on osmotic pressures

83
Q

Deep lymphatic vessels

A

-venous pumps from muscles

84
Q

Initial lymphatics

A

-lymphatic capillaries
-1 cell thick

85
Q

Lymphatic valves

A

Lymphangion: segment of vessels btwn valves

-prevent backflow

86
Q

Lymphatic trunks

A

-increase in size gradually

87
Q

Lymph Vessel network

A

-contracts rhythmically
-embedded in fatty ttissue
-ANS innervation
-high pressure can deteriorate walls
-backflow of lymph causes lymphedema

88
Q

Lymph Nodes

A

-filter, adjust fluid concentration, produce lymphocytes and macrophages
-100x the normal resistance

89
Q

Lymphedema PT Implications

A

-consider effects on skin and structures
-check lymph nodes (immobile, increase in size, enlarged)

90
Q

Lymphangitis

A

inflammation of lymphatic vessels
-usually due to strep

91
Q

Lymphadentits

A

inflammation of lymph nodes
-infections in the body

Acute: LN enlarged
Chronic: scarred LN with fibrous CT

92
Q

Lymphedenopathy

A

enlargement of lymph nodes

93
Q

Normocytic Anemia

A

normal size

94
Q

Macrocytic Anemia

A

abnormally large

95
Q

Microcyic Anemia

A

abnormally small

96
Q

Normochromic

A

normal amounts of hemoglobin

97
Q

Hyperchromic

A

high hemoglobin

98
Q

Hypochromic

A

low hemoglobin

99
Q

Anisocytosis

A

various sizes

100
Q

Poikilocytosis

A

various shapes

101
Q

Destruction of RBC

A

-hemolysis
-congenital or acquired

102
Q

Decreased Production of RBC

A
  1. Low erythropoietin
  2. Lack of response to EPO
  3. Nutrition deficiency: Fe, B12, folate
  4. Anemia of chronic disease (ACD): inflammation
  5. Chronic kidney disease
  6. Bone marrow disorders
  7. Radiation induced bone marrow failure
103
Q

Anemia PT Implications

A

-less exercise tolerance
-fatigue
-vital signs

104
Q

Primary Hemostasis

A

-platelet plug for blood clotting
- need platelets and von willebrand factor
-easy bruising and mucosal bleeding

105
Q

Thrombocytopenia

A

-decreased platelets below 150,000

106
Q

Secondary Hemostasis

A

-vascular damage exposes tissue factor
-necessitates the presence of clotting factors

-hemophilia A (80%, lack of CF 8) and B (15%, lack of CF 9)
-serious bleeding

107
Q

Mild Hemophilia

A

-15%
-spontaneous hemorrhages
-need trauma

108
Q

Moderate Hemophilia

A

-15%
-minor trauma

109
Q

Severe Hemophilia

A

-60%
-spontaneous bleeding or slight trauma
-joints and muscles

110
Q

UTI

A

-ecoli
-most common infection in hostpitals
-pain in suprapubic, lower abs, flank
-catheter care

111
Q

Pyelonephritis

A

-urine backs up into renal pelvis

Acute: ecoli, abrupt, flank pain over costovertebral angle
Chronic: vesicoureteral reflux

112
Q

Renal Neoplasms

A

-Renal cell (most common): resistant to chemo
1. Clear cell
2. papillary
-urothelial carcinoma
-renal sarcoma
-wilms tumor
-renal lymphhoma

Metastasizes to sternum

113
Q

Renal Calculi

A

-nephrolithiasis
-Calcium most common
-colicky pain from groin to flank
-hematauria

114
Q

Chronic kidney disease

A

-decreased GFR <60 for 3 months

RF
-diabetes
-high BP
-neuropathy

Signs
-hyperglycemia
-angiotensin II (vasoconstriction)
-elevated BUN and creatine

115
Q

Stages of CKD

A

G0 >90: reversible
G3a 45-59: increases albumin
G4 15-29: proteinuria
G5 <15: uremia

116
Q

Hemodialysis

A

-arm
-requires BV merging (fistula)

117
Q

Peritoneal Dialysis

A

-ambulatory or cycling
-peritoneum

118
Q

Sensory and motor control of Detrusor

A

-parasympathetic
-pelvic nerve

119
Q

Control of PV

A

-pudendal
-somatic motor

120
Q

Most common Pelvic disorder in PT

A

-chronic pelvic pain syndrome

121
Q

Acute Bacterial prostatitis

A

-infection of prostate
-bacterial, viral, std
-issues with voiding

122
Q

Chronic Prostatitis

A

-recurrent infection
-sexual dysfunction

IIIA: dysfunction with inflammation, no infection

IIIB: dysfunction w/o inflammation or infection

123
Q

Asymptomatic Prostatitis

A

-WBC in semen and prostate

124
Q

Benign prostatic hyperplasia

A

-decreased cell death
-hyperplasia
-Rectal exam or PSA test

125
Q

Prostate Cancer

A

-adenocarsinoma (most common)

126
Q

Hypoxemia

A

-lack of o2 of arterial blood
-most common pulmonary condition
-hypoxia

127
Q

Pneumonia

A

-aspiration, chemicals or infections
-most common hospital acquired infections
-mostly viral and non life threatening

-preceded by an infection
-rust colored spitum (bacterial)
-watery (viral)

128
Q

Acute Bronchitis

A

-inflammation of trachea and bronchi
-viral

129
Q

COPD

A

-preventable and treatable
-airflow limitation to airway and alveoli due to loss of competency or increased mucus
-environmental

  1. chronic bronchitis
  2. emphysema
130
Q

Chronic Bronchitis

A

-productive cough lasting 3 months for 2 years
-scarring of bronchus, obstruct airways

131
Q

Emphysema

A

-enlargement of air spaces and loss of elasticity
-centriacinar (most common)

132
Q

Asthma

A

-inflammation and bronchoconstriction and airflow resistance
Extrinsic (allergic: t cells, IgE) intrinsic (nonallergic)

133
Q

Sleep Apnea

A

-obesity related
-obstructed (most common): daytime symptoms too

134
Q

Adverse Drug Event

A

-Injury due to meds
-Dose related (predictable)
-Non-dose related (unpredictable)

135
Q

Drug-Drug interaction

A
  • drugs react unfavorably
136
Q

Drug-Disease

A

-worsen existing disease

137
Q

Side effects

A

-occur within therapeutic dose ranges

138
Q

Overdosage toxicity

A

-predictable toxic effect

139
Q

Mild Overdose

A

-altered tasted, anxiety, dizziness, shakiness

140
Q

Moderate Overdose

A

-cramps, dyspnea, hyper or hypotension, heart issues

141
Q

Severe Overdose

A

-arrythmia, seizures, edema, hypotension, cardiac arrest

142
Q

Rheumatoid Arthritis

A

-autoimmune of synovial tissue
-osteoporosis, nodules, heart issues, dry eyes, nerve neuropathy, weight loss

143
Q

Sepsis

A

-organ dysfunction due to infection
-can also be caused from non-infection and immune response

-Septic shock: circulatory shut down with hypotension

-elevated lactate, acidosis, low WBC

144
Q

Multiple organ dysfunction syndrome

A

-most often caused by sepsis
-complications of disease
-common cause of death

-Increased BUN, lactate, low WBC, low platelets, acidosis

145
Q

pH maintenance

A

-7.35-7.45
- blood buffer systems
-excretion of carbonic acid from lungs
-excretion of bicarbonate by kidneys

Co2 increases/decreases = respiratory acidosis (hypoventilation and CO2 retention)/alkalosis (hyperventilation; pulmonary or non)

Internal Medicine (4 decks)

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