final gerit Flashcards

1
Q

risk factors for hep C

A
IVDU
Hemophiliacs who received clotting factors before 1987
Received blood/organs before 1992
Hemodialysis
Medical workers who had needle Sticks
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2
Q

sxs of hep c

A
MC symptom = asymptomatic 
Nausea, vomiting
Fever, fatigue
Dark urine
Jaundice Fever
Pruritus
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3
Q

sxs of CHRONIC hep c

A

Arthritis
Itching
Numbness
Leads to Hepatocellular carcinoma

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4
Q

what diarrhea is characteristic of C diff

A

3 watery bowel movements daily for 2 or

more days

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5
Q

other than diarrhea what sxs do we see associated with C Diff

A

Fever, nausea, abdominal pain

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6
Q

what are the three complciations associated with C diff

A

■ Colitis
■ Sepsis
■ Death

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7
Q

High risk patients for C. diff

A
hospitilized
Nursing Homes
Assisted Living
RCFE (residential care for elderly)
Community Care Facilities
Less so in prisons 
The Elderly
The Ill
Immunocompromised → HIV, Chemo, Chronic steroid use, COPD...etc.
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8
Q

Recent ABX use puts you at risk for c.diff, especially if you’ve recently been on

A

{the drugs that treat oral, tooth UTI and PNA}

Ampicillin
amoxicillin
Cephalosporin (e.g. Keflex)
Fluoroquinolones (eg Levaquin)

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9
Q

sepsis criteria

A

T >39.4 degrees C (102.9 F), RR>30, P>120
WBC>11
Shaking chills, DM, Major comorbidities, AMS, abd pain, and vomiting

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10
Q

MEDS associated with UI

A
ETOH
Adrenergic antagonists
Antidepressants
Antipsych
CCB
Loop
Narcotics
NSAIDS
Sedative 
Thiazolidinediones
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11
Q

Neurological

A
Stroke 
Parkinson’s
Normal pressure hydrocephalus
Dementia
Depression
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12
Q

detrusor activity can be

A
age related 
idiopathic
secondary to a lesion 
due to local irritation
stress related
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13
Q

causes of urge UI

A

interstitial cystitis

spinal cord injury –> impaired detrusor compliance

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14
Q

this type of incontinence occurs with increased intra abdominal pressure

A

stress

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15
Q

most common type of UI in older women

A

Urge and then stress

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16
Q

most common types of UI in older men

A

urge and then outlet obstruction

17
Q

ULS definition of urge/stress UI

A

Residual volume: >50 urge/stress.

18
Q

ULS definition of urinary retention

A

> 250 outlet obstruction ton or detrusor inactivity

19
Q

overflow incontinence is the result of

A

detrusor under-activity bladder outlet obstruction or both

20
Q

stress UI is due to

A

impaired pelvic supports

failure of urethral closer

21
Q

which type of incontinence results from trauma

A

failure of urehtral closure or stress incontinence is due to trauma

can also see outlet obstruction in women who;’ve had surgery for UI

22
Q

peripheral neuropathy can cause what type of incontinence

A

detrusor underactivity or overflow

23
Q

Frailty for FTTT

what are they and how many do you need

A
Wt loss
Exhaustion 
Weakness
Slow Walking
↓ Physical Activity 

(3 out of 5)

24
Q

FTT Neuro

A

Parkinson, Stroke, MS, ALS

25
Medications:
Psychotropics, Anticholinergics, Antidepressants
26
Physical
Chronic heart dz, lung dz, dysphagia, GI and CA
27
detrusor muscle
Contracts via parasympathetic nerves (S2–S4)
28
storage of urine is under control of
SNS
29
when to cath
Short-term decompression of acute urinary retention Chronic retention not manageable surgically/medically Patients with wounds that must be kept clean of urine Very ill patients who cannot tolerate garment changes Patients who request catheterization despite informed consent regarding risks
30
risk factors for catheter blockage
alkaline urine femal gender poor mobility calciuria proteinuria copious mucin proteus colonization preexistant bladder stone
31
CHF criteria for hospice
Class IV failure, EF <20% | 2-3 admits to acute care in a year
32
COPD criteria for hospice
``` O2 dependent(<88% r/a) poor response to bronchodilators resting pcO2>50 PO2<55 on oxygen, cor pulmonale wt loss HR>100 ```
33
Renal Failure criteria for hospice
Cr >8.0, off dialysis
34
Cirrhosis/liver failure criteria for hospice
``` bed bound, albumin <2.5, INR >2.5 + (encephalopathy, SBP - spontaneous bacterial peritoniti refractory ascites recurrent variceal bleed hepatorenal syndrome) ```
35
CHF criteria for hospice
Class IV failure, EF <20%, 2-3 admits to acute care in a year
36
phrase that refers to the changes in health status over time as the patient nears death
Trajectory of death