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Semester 5 Med Surg Midtterm > Med Surg Midterm 1 > Flashcards

Med Surg Midterm 1 Flashcards

1
Q

Major center for regulation, maintaining homeostasis, regulation of organs

A

Hypothalamus

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2
Q

Normal reflex rating, brisk, none, very strong

A

Normal 2, brisk 3, none 2, very strong 4

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3
Q

Agnosia

A

Can’t id objects, people

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4
Q

Dementia

A

Chronic state, no cure

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5
Q

Delirium

A

Cns damage, increase temp, dehydration, reversible

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6
Q

Paroxysmal

A

Uncontrolled electrical discharge of brain neurons. Most seizures sudden, transient. Often associated w other conditions, not epilepsy then.

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7
Q

Seizures causes

A

Fever, brain issues, metabolic disorders, hypoxia, stroke, tumor, fluid accumulation in brain, toxins, withdrawal, drugs, sleep deprivation

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8
Q

Partial seizure

A

Starts in 1 part of brain, can be simple or complex. Person remains alert.

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9
Q

Generalized seizures

A

Involving whole brain.

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10
Q

Tonic

A

Loss consciousness, apnea, dilated pupils, lasts 15-60 sec. muscles contracted.

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11
Q

Clonic

A

Jerking, lasts 60-90 sec, hyperventilating, inhibitory neurons interrupt seizure discharge.

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12
Q

Postictal

A

Deep sleep, sore, dysphagia, variabile time, hours.

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13
Q

Seizure response

A

Turn on side. Time seizure. Don’t grab, restrain. Suction available. Loosen clothes. Bed low, padded side rail. O2. Document.

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14
Q

Seizure dx

A

EEG, no sleep 24hrs, blood labs. Ct and mri for structural problems.

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15
Q

Epilepsy

A

Spontaneous unprovoked recurrence caused by chronic underlying condition. Causes: idiopathic, acquired/hypoxemia.

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16
Q

Tx epilepsy

A

Tx meds by weight, sudden withdrawal can cause^ in seizures/status e. Take meds on empty stomach not w other meds, no etoh. Dilantin, tegratol. Ketogenic diet= 4:1 fats : protein. Surgery: subdural grids, vagal nerve stimulator.

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17
Q

Dx epilepsy

A

EEG, ct, mri, spect. Tox screen, genetics, lumber puncture for csf check.

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18
Q

Nystagmus

A

Rapid eye movements

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19
Q

Status epilepticus def

A

Every 15-30 min. 911. Respiratory interruption, arrest. Hypoxemia. Can lead to anoxia, cerebral edema, brain damage, death. Causes: withdrawal, fever, infection, fever over 104, uncontrolled epilepsy, od w narcan reversal too fast.

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20
Q

Status E tx

A

Et tube/ not when seized, o2, meds IV, monitor eeg, vs, labs esp glucose. Suction, side lying. Barbiturates, Valium, anesthesia, Dilantin. Watch respiratory, cardiac.

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21
Q

Sheehan syndrome

A

Pituitary gland dies. Hormone replacement for life. Can result from status e.

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22
Q

Parkinson’s s and s

A

Gradual onset of muscular stimulation . Tremors at rest, bradykinesia, psych changes, mask face, micrographic , shuffles, monotone, difficult swallowing, about 50% get dementia. Pill rolling, low libido, tired, constipation, pain, soft voice.

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23
Q

Parkinson’s tx

A

Teach family to suction. Rn should feed. Thickened fluids. Carbidopa-levodopa, works in 45 min. Take meds 30min to hr before eating so pt can swallow. Beta blockers. No specific tests to dx, ct and mri to rule out structural issues. Surgery: palidotomy, stimulation, stem cell implant. Keep moving, use wide base, sliding shoes. Increase fiber, fluids. Increase spices, eat high calories several times day.

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24
Q

Parkinson’s cause

A

Decreased dopamine means decrease nerve impulses. Genetics, toxins. Part of basal ganglia degenerated.

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25
Q

Multiple sclerosis def and causes

A

Autoimmune. Attacking brain, spinal cord. Demyelination of nerves. Many types. Mostly women, 20-40. First shows up in eye damage. Permanent damage, impacts mobility, gait. Genetic component, maybe viral.

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26
Q

MS s and s

A

Numb, weak limbs. Vision loss, double. Shock sensation, fatigue, ataxia. Dizzy, slurs, paralysis. Mental changes, depression. Abn reflexes. Epilepsy.

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27
Q

MS risks

A

Dm1, inflammatory bowel, smoking, thyroid issues.

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28
Q

MS tx

A

No cure. Adls w out fatigue is goal. Meds: cytotoxins, antiviral, muscle relaxers: baclephan, pain meds, help w elimination meds. Plasmaphoresis (for all autoimmune) plasma exchanges to remove antibodies. Pt. Check sugar. Self cath. Keep moving. Avoid temp extreme. Increase fluids and protein and carbs, decrease gluten and fats. Oral mj. Bowel protocol. Eye patch for double vision. Relaxation methods.

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29
Q

MS dx

A

Based on s and s, hx. Test pulmonary function, spinal tap, mri.

30
Q

Myasthenia gravis def and causes

A

Breakdown in com between muscle and nerve. Weakness. Autoimmune. Antibodies attacking receptor sites at neural junction. AcH is there but can’t transmit. Thymus tumor for 15%. Genetics. Trigger: fatigue, stress, meds. Men over 60. Women under 40. Thyroid issues.

31
Q

Myasthenia gravis s and s

A

Weaknesses starts at top and goes down. Ptosis: drooping eyelids. Pt stronger in am. Expression , speech impaired. Swallow impaired. No effect on sensation or reflexes. Respiratory weakness.

32
Q

Myasthenia gravis dx

A

Coordination improvement w rest. Tensilon test admin to see increased strength w in 1 hr eyes open = positive(or ice pack). Blood test for antibodies. Nerve testing. Scan for thymus tumor. Pulmonary function tests.

33
Q

Myasthenia gravis tx

A

Anticholinesterase. Steroids. Immunosuppressant. Plasmaphoresis. IV immunoglobulin G. Thymectomy. Monochromatic antibodies. Take meds 30min to hr before eating.

34
Q

Myasthenia gravis crisis

A

Acute weakness in chest muscles. Need vent. Blood filtration. Aspiration. Respiratory problems.

35
Q

Gillian-barre syndrome def and causes

A

Autoimmune, destroyer of nerve myelin. Acute, segmental demyelination of peripheral/cranial nerves. Remyelinization in recovery. Starts from bottom and goes up. Causes: immune system stimulation, infection, flu, immunization.

36
Q

Guillain-b s and s

A

Begins w hyporeflexia, muscle weakness of lower extremities, goes up. Can impact breathing, need vent. Optic, voice impaired. Dysphagia. Orthostatic hypotension. Abn vagal responses. Retention urine, feces. Credae: squeezes out bladder. BP, heart rate fluctuates. Paralyzed. Pain, numbness.

37
Q

Gullain -b dx

A

Pt hx, s and s, spinal tap for elevated protein after 7-10. Emg and other nerve tests.

38
Q

Guillain-b tx

A

Rom, check bedsores, check ht rate and BP. High protein diet post vent. Meds for BP, tachycardia. Tpn feedings, check glucose. Trach set, ekg, vent at bedside. Check for respiratory distress. Plasmaphoresis.

39
Q

Antigen

A

Foreign substance

40
Q

Immunoglobulin involves in allergic reactions

A

IgE

41
Q

1 allergies

A

Hay fever, allergic rhinitis , asthma

42
Q

Atopic dermatitis

A

Genetic, increase in histamines , itches

43
Q

Dermatitis medicamentosa

A

Drug reactions, stops when med is d/c, sudden rash

44
Q

Urticaria, angioneurotic edema

A

Large areas hives

45
Q

Hereditary angioedema

A

More severe, no itch, tx epi, steroids , gi issues

46
Q

Latex allergic also to

A

Banana, avocado , kiwis, pineapple, passion fruit, chestnut. Spina bifita often allergic.

47
Q

Primary chemical mediators

A

Have initial, immediate effect on vessels. Histamine w in 15min for max, hives, runny nose, bronchioconstriction. Eosinophils, inhibitors of some histamine reactions. Platelet activating factor, bronchoconstrictor, nose runs. Prostaglandins, sm muscle contractions, vasodilation, fever and pain. Mediated by IgE.

48
Q

Secondary chemical mediators

A

Response to 1st, primary wave. Initiates inflammation process. Leukotrienes. Bradykinin, vasodilatior, decreases BP, edema, pain. Serotonins, vasoconstrictor, contraction of bronchi.

49
Q

Hypersensitivity type 1

A

Anaphylactic. Insects bites, drugs, foods, allergy shots. stridor. Decrease in BP, local hives, rhinitis, angioedema, asthma. systemic, give o2, throat closes.

50
Q

Hypersensitivity type 2

A

Cytotoxic , transfusions reaction, baby in utero, thrombocytopenia, rbc destruction.

51
Q

Hypersensitivity , immune complex type 3

A

Immune complex type 3. serum sickness: joints, kidney, RA, lupus, hives, fever, rash.

52
Q

Hypersensitivity type IV

A

Delayed type. Tissue damage, hasimoto, contact dermatitis.

53
Q

Allergies dx

A

Blood work, eosinophils count, IgE levels. Skin tests. Provocative testing. Radioallergosorbent : rast .

54
Q

Epi pen size normal, large . Dose.

A

Normal 0.3, large 0.5. dose 1 to 1000

55
Q

Allergies tx

A

Antihistamines, epinephrine, mast cell stabilization, steroids, immunotherapy 3-4 years. DNA vaccines, isoforms, monoclonal antibody, plasmaphoresis (can cause shock, can decrease Ca from blood). O2 mask, full blast.

56
Q

Autoimmune diseases list

A

Lupus, scleroderma, ms, myasthenia gravis, guillian b, ra, type 1 diabetes. Many more.

57
Q

Autoimmune triggers

A

Stress, hormones, metals, foods, pesticides, toxins.

58
Q

Antibodies formed by

A

Lymphocytes and plasma cells

59
Q

Autoimmune diet

A

No dairy, grains, tomatoes, potatoes, peppers. Can have meats, some veggies.

60
Q

Lupus def and causes

A

Autoimmune. Chronic inflammation of connective tissue. Increased production of antibodies. Causes drug, genetics, hormones, environmental, viruses, sunburn. Types SEL, Discoid LE= skin only. Mild or deadly. Abn b and T cells.

61
Q

Lupus s and s

A

Sudden onset. More in women, aa and Asian. Multiple organs. Morning stiffness. Photosensitive. Pericarditis, Raynaud’s phenomena. Renal damages. Scaling. Hair loss. Fatigue, fever, behavior changes. Sob. Seizures. Englarged lymph nodes. Abd discomfort. Mallor rash. Eral ulcers.

62
Q

Lupus dx

A

Antismith antibodies test. A and A positive in 90%.

63
Q

Lupus tx

A

Prevent progression. Aspirin ok, minimize steroids. No sun. Immunosuppressant, antirhumatic, no smoking. Antimalerial. Heat and cold. Fish oil, vit d. Dhea.

64
Q

HIV def, causes

A

Reverse transcriptase, retro virus. Progressive destruction of lymphocytes, cd4 (T cells. )

65
Q

Normal cd4 (t cell) count

A

800-1300 normal. Under 500 not good. Under 200 opportunistic infection. Under 50 close to death.

66
Q

Goals of art

A

Decrease viral load, increase cd4, delay opportunistic infection.

67
Q

Pregnant mom w hiv, baby?

Mom gets hiv when pregnant, baby?

A

Preg w hiv, baby born positive but in 6 months negative.

Gets hiv when pregnant, baby stays positive.

68
Q

3 stages hiv

A 
1= acute, 2-3 weeks post exposure. Very contagious.
2= latency, low levels, may last decades. At end T cells down.
3= aids. T cells below 200. Survival 3 years.
69
Q

Globally live w hiv

In USA

A

40 million

1.2 million

70
Q

Hiv transmitted

A

Blood, semen, rectal/vag fluids, breast milk. W other stds 3x chance-for transmitting.

71
Q

Hiv dx

A

ELISA first and western blot if positive. Can take 2 months to detect. P24 for viral load, blood bank testing.

Semester 5 Med Surg Midtterm (1 decks)

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