last pathopharm test ever!!!!! Flashcards
DKA sx
-ketones
-fruity breath
-polyuria / polydipsia
-N/v
-dec skin turgor
-dry mucus membranes
-tachycardia
-hypotension
-metabolic acidosis
-decreased K+
-weight loss
BG for DKA
350-500
HHS sx
-decreased K+
-polyuira & polydipsia
-weight loss
-lethargy / obtunded
-coma
-volume depletion
-electrolyte imbalance
-hyperosmolarity
thyroid storm
-fever
-tachycardia
-afib/aflutter
-n/v
-agitation
-tremor
-psychosis
-stupor/coma
-hypotension
myxedema (10)
-hypothyroidism
-hard non pitting swelling
-coma
-hypothermia
-hypotension
-hypoglycemia
-hypoventilation
-slowing of functions of other organs
-bradycardia
-hypoNa
addisonian crisis
-hypotension
-salt craving
-hypocortisolism
-hypoglycemia
-weakness
-hyperpigmentation
-N/V/D
-hyperK+
DKA & HHS treatment
-fluid replacement
-electrolyte corrections
-IV insulin
-sodium bicard (if pH <7.2)
-dextrose (<200 and anion is still open)
thyroid storm drugs
-beta blocker (sx control)
-thionamide (propylthiouracil/PTU): suppresses conversion of T4 & T3
-iodine solution: to block the release of thyroid hormone
-glucocorticoids: reduce T4 to T3, promote vasomotor stability & treat adrenal insufficiency
-bile acid sequestrates: recycling of thyroid hormones
myxedema drugs
-levothyroxine & liothyronine
-glucocorticoids
-IV fluid
-lytes
-glucose
addisonian crisis drugs
-IV hydrocortisone
-NS
-dextrose
primary HTN
direct dysfunction of the thyroid gland itself
-low levels of T3 & T4
-high levels TSH
-causes: thyroiditis, cogenital hypothyroidism, surgical removal of thyroid or radiation to thyroid
secondary hypothyroidism
dysfunction of the pituitary gland
-low T3, T4, & TSH
-causes: pituitary tumors, radiation, therapy or pituitary surgery
tertiary hypothyroidism
dysfunction of the hypothalamus
complications of uncontrolled DM
-infection
-wound healing
-DKA/HHS
-micro & macro vascular
microvascular comps of uncontrolled DM
-damage to capillaires
-retinopathies
-nephropathies
-neuropathies
macrovascular comps of uncontrolled DM
-damage to large vessels
-coronary artery
-peripheral vascular
-cerebral vascular
patho of T1DM
activation of cellular immunity (macrophages & T cells) & humoral immunity towards beta cells-> beta cells in the pancreas are destroyed
alpha cells secrete
glucagon
beta cells secrete
insulin
patho of T2DM
insulin resistance d/t receptor fatigue and decrease insulin secretion
main cause of left sided heart failure
HTN
main cause of right sided heart failure
COPD
assessment finding w/ left sided heart
-pulmonary congestion
-LV increases in size
-back flow into pulmonary veins
-cough, crackles, wheezes
-frothy sputum, may be blood tinged
-paroxysmal nocturnal dyspnea
-orthopnea
assessment finding w/ right sided heart
-COPD w/ cor pulmonale
-RV increases in size
-back flow into vena cava, decrease to the lung
-congestion in JV, liver & lower extremities
-dependent edema
-weight gain
-hepatosplenomegaly
-fatigue
-ascites
-GI distress/fullness
medications for HF
-BB (carvedilol)
-CCB (idipine)
-Digitallis
-nitrates
-dapaglifozin
-HTN drugs
-spironolactone
-ranolazine
ACE, ARBs, ARNI holds
hyper K & hypotension
beta block holds
less than 100, less than 60
dapaglifozin holds
low BG
digitalis holds
-hold if pulse <60
-low K+
S/s of OA
->40
-osteophytes
-deep, aching pain w/ exertion & relieved by rest
-worsens w/ cold
-crepitus
-joint swelling
-altered gait
-bowed leg
-limited ROM
-B&H nodes
-wear & tear on unilateral joints
-localized
-no biomarker
S/s of RA
-young to middle age
-positive RF & ANCP
-systemic affects to start
-joint swell soft, warm & tender
-stiffness
-deformities & joint subluxation
-sjorgren’s syndrome
-rheumatoid nodules
-autoimmune
Cimetidine & Famotidine (H2 receptor antagonists) MOA
-blocks H2 receptors in the stomach
-reduces gastric acid secretion by 60-70%
-increases stomach pH
omeprazole, pantoprazole, esomeprazole (PPIs) MOA
binds to proton pump and inhibits the hydrogen potassium ATPase (proton pump)
+ irreversibly inhibits the section of HCl
antacids (aluminum, calcium, magnesium, Al+MG)
neutralizes acid by approximately 50%
complications of acute viral gastroenteritis
fluid volume deficit / electrolyte imbalance caused by watery diarrhea, abdominal pain, N/v, fever & malaise
HIV patho
retrovirus that destroys CD4 Tcells
targets CD4 cells on T lymphs, monocytes & macrophages -> enters cells -> reverses transcriptase -> HIV integrase -> HIV protease
CD4 drops, Viral load will increase
expected findings for IDA
-microcytic, hypochromic
-pallor
-glossitis, cheilitis
-brittle hair & nails
-koilonchia
-pica & pagophagia
sucralfate (mucosal protectant)
alters when exposed to gastric acid and turned into a sticky, thick gel to make a protective barrier
carcinogens: known
smoking, asbestos, estrogen, alcohol, HPV or HIV
proto oncogenes
genes that stimulate and regulate a cell’s movement through the cell cycle, resulting in cellular growth and proliferation -> when mutated, proto oncogenes becomes oncogenes that stimulate constant, unrelenting cellular proliferation and cell cycling
main causes of CKD
DM
HTN
Beta Blocker SE
hypotension, mask hypogly, fatigue & lethargy
ACE SE
cough, first dose hypotension, angioedema, renal insufficiency
ARBs SE
angioedema, renal insufficiency
CCB SE
orthostatic hypotension and peripheral edema
IV heparin things to know
-labs: PTT & anti Xa
-discoloring of fingers and toes
-black patches on hands & feet
-black tarry stools
-common signs of bleeding
-anemia
-antidote: protamine sulfate
rapid acting insulin
lispro & aspart
-onset: 15 mins
-peak: 1 hr
-duration: 2-4 hr
short acting insulin
regular
-onset: 30-60 mins
-peak: 2-6 hr
-duration: 3-8 hrs
intermediate insulin
NPH
-onset: 2-4 hrs
-peak: 4-10
-duration: 10-20
long acting insulin
glargine
-onset: 70 mins
-peak: none
-duration: 24 hrs
SE of chemo
do not give chemo at nadir
-decreased WBC, RBC, platelets (pancytopenia)
-GI effects
-alopecia
-stomatitis
-toxic to fetus
-hyperuremia
-organ damage
-extravasation
inhaled steroids
beclomethasone dipropionate
budesonide
fluticasone
systemic steroids
prednisone
hydrocortisone
dexamethasone
which type of steroid has more side effects
systemic because inhaled are limited to the lungs
-hypotension
-weight gain
-glaucoma
-hypergly
-GI upset
-osteoporosis
-adrenal problem (cushings)
Asthma CM
bronchoconstriction / vasoconstriction
wheezing
dyspnea / SOA
inflammation
cough
chest tightness
accessory muscle use
diaphoresis
respiratory failure
chronic bronchitis CM
-persistent productive cough
-SOA
-congestion
-pulmonary htn (late)
emphysema CM
-gradual inc in breathlessness (esp w/ exertion)
-SOA at rest
-wheeze
-malnourished
-barrel cheset
-pursed lip breathing
-decreased breath sounds
