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Medsurg test 2 > medsurg test 2 > Flashcards

medsurg test 2 Flashcards

1
Q

pts with mG experience

A

weakness of the muscles of the face and throat.. strongest in the AM

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2
Q

Diplopia

A

double vision

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3
Q

Ptosis

A

eye drooping

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4
Q

dysphonia

A

voice impairment

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5
Q

what test is used with MG

A

tensillon test

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6
Q

what drug should be kept on head to control side effects of edrophonium

A

atropine

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7
Q

Management of MG

A

anticholinestrase. immunosuprressive therapy.. predinision

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8
Q

MG perioheral or central

A

peripheral

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9
Q

How does MG work

A

blocked ACH receptors at muscle endplates

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10
Q

MG presenting symtpms

A

ptosis , diplopia

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11
Q

ALS is

A

rare, progressive disorder.. loss of motor neurons

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12
Q

death with ALS occurs within

A

2-6 years

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13
Q

Presenting symptoms of ALS

A

weakness, muscle wasting

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14
Q

ALS peripheral or central

A

both

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15
Q

Mechanism of ALS

A

loss of motor neurons

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16
Q

Diagnoisis of ALS

A

neuro exam EMG, CPK

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17
Q

Advanced stage of ALS

A

speech and swallow

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18
Q

Terminal stage of ALS

A

dyspnea SOB, speaking no longer possible

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19
Q

ALS treatment is

A

Riluzole.. slows progression

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20
Q

GBS peripheral or central

A

peripheral

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21
Q

Mechanism of Illness for GBS

A

PNS, dymyelination, edema, inflammation

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22
Q

Presenting symtomps of GBS

A

lower extremity weakness, URI, of GI infection

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23
Q

Diagnosis of GBS

A

clinical picture EMG, incr CSF protein

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24
Q

Treatment of GBS

A

immunotherapy, Plasmaphoresis

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25
Q

what is myelin

A

lipoprotein from neural support cell bodies that wrap around neural axons

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26
Q

GBS is acute or chronic

A

ACUTE!

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27
Q

with GBS look at to diagnosis

A

brain MRI to rule out MS

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28
Q

genetically transmitted autosomal dominate.. progressive degenerative brain disorder

A

hunningtons disease

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29
Q

with hunningtons disease

A

high caloric requirements. 4,000-5000 calories per day

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30
Q

Uncontrollable and sometimes overwhelming urge to move legs. shows at night.. relaxing makes worst

A

RLS restless leg syndrome

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31
Q

paresthesias

A

abnormal sensations

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32
Q

dyesthesias

A

unpleasant abnormal sensations

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33
Q

RLS which nuerotransmitter

A

dopamine

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34
Q

MS central or peripheral

A

central

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35
Q

Mechanism of MS

A

CNS demyelination, axonal injury, glial scarring

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36
Q

Presenting symtomps of MS

A

numbness, vision changes, depression, dysfunctional elimination

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37
Q

Diagnosis of MS

A

MRI , increase in immunoglobin G, presence of iligoclonal banding in CSF … WEAKNESS and FATIGUE

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38
Q

Treatment of MS

A

immunomodulators. immunosuppreseant

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39
Q

Chronic progressive degenerative disease affecting the myelin sheath of the white matter of the brain and spinal cord

A

MS

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40
Q

3 stages of MS

A
  1. chronic inflammation
  2. demyelination
  3. Scarring
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41
Q

Classifications of MS

A
  1. motor
  2. sensory
  3. Cerebellar
  4. Emotional
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42
Q

Common triggers of MS

A 
infection
trauma
immunization
childbirth
stress
change in climate
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43
Q

Uncontrollable factors of heart disease

A

age
male
family history
race.. African americans greater risk

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44
Q

controllable risk factors of heart disease

A 
high BP 
diabetes
cholestrol
poor diet
obesity
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45
Q

Cyanosis is a what sign of Respiratory distress

A

LATE!

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46
Q

Xanthelasma

A

yellow on eye.. cholesterol so high depositing to skin

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47
Q

ear creases

A

early sign of heart disease.. as early as 18

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48
Q

Systolic BP is

A

biggest thing of showing HD after age 60

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49
Q

Peripheral edema tells us what

A

RIGHT SIDED HEART FAILURE!

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50
Q

LDL should be

A

less than 130.. bad one

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51
Q

HDL should be

A

greater than 40.. good one

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52
Q

total cholesterol should be

A

should be less than 200

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53
Q

calcium causes

A

both hyper and hypo dysrhythmias

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54
Q

magnesium causes

A

life threatening dysrthmias

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55
Q

does negative EKG rule out MI

A

NOOOOO!

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56
Q

p wave is

A

firing of the SA node

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57
Q

QRS complex is

A

ventricles contracting

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58
Q

T wave

A

ventricles repolarising

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59
Q

anabolism

A

positive protein balance

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60
Q

catabolism

A

negative protein balance

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61
Q

Max dextrose peripherally

A

10 percent

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62
Q

PID long term last

A

1-2 years

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63
Q

brown line

A

blood

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64
Q

blue lin

A

meds

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65
Q

white

A

TPN

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66
Q

PICC

A

last up to 1 yr

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67
Q

PICC is inserted

A

by certified nurse at bedside

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68
Q

MLC is a

A

not central line last 1-4 `weeks

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69
Q

MLC is inserted by

A

nurse at bedside

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70
Q

for cite care use

A

alchol 30 sec and chlorhexidine 30 sec

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71
Q

TIDs

A

surgical implant.. 1-2 years

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72
Q

1ml is

A

300 psi

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73
Q

10 ml is

A

7psi

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74
Q

angina pectoris

A

ischemia without infarction

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75
Q

how do you know its angina not mi ?

A

improves with rest

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76
Q

what does angina pain feel like?

A

pressure pain.. elephant on chest or fist

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77
Q

why does pain radiate

A

lactic acid build up

78
Q

what do you teach with aspirin for mi

A

81mg no interacted aspirin .. chewable

79
Q

what teach with nitroglycerin

A

store in dark place.. headache is norm.. take 3 times every 15 min

80
Q

interventions with MI

A

Morphin
oxygen
nitro
aspirin

81
Q

permanent localized dilation asymptomatic emergency

A

aneurysm

82
Q

how do you diagnosis aneurysms

A

CT scan ultrasound

83
Q

classic thing with arterial pain ..not as painful

A

goes away when elevated

84
Q

gangrene

A

infarction of tissue

85
Q

arterial legs look like

A

shiny hairless pale

86
Q

do yo see edema with arterial

A

no just venous

87
Q

with arterial disease open wound what med first

A

iv antibodics

88
Q

intermittent muscle pain percolated by exercise resolves within 10 min of rest

A

intermittent claudication

89
Q

numbs or tingling in toes

A

paresthesia

90
Q

endocarditis effects what

A

the valves

91
Q

manifestations of endocarditis

A

hemorrhages in nail beds osiers nodes janeway lesion roth spots

92
Q

raised nodular lesions on hands and feet

A

oslers nodes

93
Q

nodules on below and end of fingers

A

janeway lesion

94
Q

hemorrhage areas on retina.. splotches

A

roth spots

95
Q

what kind of people need prophylactic antibodies

A

prosthetic joits.. valve problesm

96
Q

when would you give the antibodics

A

dental procedures, respiratory infections, tonsillectomy, go wound infection, UTI

97
Q

what to teach with endocaratitis

A

take full dose of med.. full time 4-6 weeks

98
Q

what can you get from strep throat

A

rheumatic heart disease

99
Q

rheumatic heart disease is

A

inflammation

100
Q

what do you put rheumatic heart disease pts on

A

steriods

101
Q

Ck info

A

nospecific.. detects muscle damage within 12 hours

102
Q

CKMB

A

SPECIFIC! within 12 hrs norm 0-3

103
Q

Myoglobin

A

protein found in heart. rises within 2-3 hours rule out mi

104
Q

Tropinin norm

A

undectable

105
Q

when can you detect troponin

A

4-6 hours highest 10-24

106
Q

what to teach with exercise stress test

A

comfy clothes, no caffeine 24 hrs before, no smoking or exercise 3hrs prior

107
Q

chemical stress test

A

takes 3-4 hrs. dobutanine… no beta blockers.. feel anxious

108
Q

ultrasound of heart to see valves beat and structures

A

echocardiogram

109
Q

CMRI teach

A

tight place loud.. no portable oxygen.. no wire clothes no earrings

110
Q

Xray used to take detailed pics of the heart.. die radiation

A

CT

111
Q

video images of the ventricles .

A

MUGA

112
Q

what hormones does thyroid produce

A

T3 T4 and calcitonin

113
Q

Goiter

A

enlarged thyroid … most common cause lack of iodine. or in us thyroid disease

114
Q

With surgical removal of nodule or cancer for thyroid

A

airway bleeding hypocalcemia

115
Q

inflammation of the thyroid gland . viral or autoimmune

A

thyroditits

116
Q

increased hormones. graves disease. decreased TSH but high T4 T3

A

hyperthyroidism

117
Q

Exophthalmos

A

puppy eyes with graves disease

118
Q

INsufficent horomones..

A

hypothyroidism

119
Q

myxedema

A

sever long standing hypo leads to saccharides in skin

120
Q

moon face, purple stria, facial hair, easy bruising think trunk thing arms legs

A

cushings .. to much corticosteriods

121
Q

low adrencocortical hormones

A

addisons

122
Q

purposes of chest tube

A

remove fluid air blood

123
Q

upper tube used for

A

air

124
Q

lower tube used for

A

fluid

125
Q

mediastinal

A

is not in pleural space.. chest

126
Q

water seal is how many cm

A

2

127
Q

with wet system what determines amount of suction

A

water level .. only sterile water

128
Q

wet system looks like

A

continous bubbly in suction cloumn not in water seal

129
Q

tidal

A

raise up and down with each breath fluctuates

130
Q

when do you call doc with chest tube drainage

A

over 100ml an hour or major change

131
Q

what are your three reasons to clamp chest tube

A

to locate air leak
replace collection unit
verify chest tube removal readiness

132
Q

what if chest tube comes apart from drain

A

clean reattach cough

133
Q

what if the collection unit breaks

A

put end in water

134
Q

what if chest tube pulls out

A

cover ! call doc

135
Q

large intestines does

A

absorption of water and electrolytes

136
Q

what does saliva do

A

lubricates and breaks down starches

137
Q

small intestine does

A

digestion and absorption

138
Q

liver does

A

manufacture store transform and excrete

139
Q

gallbladder does

A

bile conc and storage

140
Q

pancreas does

A

digestive enzymes

141
Q

mixing moves chyme in both directions to promote mixing

A

segmentation

142
Q

propulsion. one way motion

A

peristalisis

143
Q

Gherlin-appetite

A

stimulates

144
Q

Leptin appetite

A

supression

145
Q

food once mixed with gastric secretions

A

chyme

146
Q

stomach absorbs what

A

small amounts of water alcohol electrolytes and certain meds

147
Q

pigment from breakdown of hemoglobin

A

billirubin

148
Q

whats small intestine digest

A

carbs, fats, proteins

149
Q

how do you access abdomen

A

inspect asculate paplate purcuss

150
Q

stomach growling hyperperistalisis . loud gurgles

A

borboygmi

151
Q

delayed emptying of lower esophagus . increased risk of squamos cell tumor

A

achalsia

152
Q

burning squeezing pain while swallowing

A

odynophagia

153
Q

stomach cancer facts

A

adenocarcinoma

weight loss, pain, anemia, feel lump

154
Q

third most common cancer.. screening is imperative!

A

colocrectal cancer

155
Q

CRC left side

A

rectal bleeding, incomplete evacuation, constipation diarehea

156
Q

CRC right side

A

asymtompatic

157
Q

4th most common cause.. linked with Hep c and b

A

liver cancer

158
Q

common chronic functional disorder . intermittent pain or discomfort

A

IBS

159
Q

Diagnosis IBS

A

rule out malabosrption, guleten and lactose intolerance

160
Q

Symtpom based diagnosis for IBS

A

rome three criteria… must have two out of three

161
Q

how do you treat IBS

A

stress management, diet meds

162
Q

how much fiber with IBS

A

20mg/day

163
Q

what are the gas producing foods?

A

brown beans, brussels sprouts, cabbage, cauliflower, raw onions, grapes , plums raisins

164
Q

what drug is given with diarrehea

A

Imodium

165
Q

what drugs are given with constipation

A

alosetron, lubiprostone, linaclotide

166
Q

Inflammation of the intestinal tract

A

IBD

167
Q

inflammation of any segment of the GI tract mouth to anus

A

chrons

168
Q

inflammation and ulceration of the colon and rectum

A

ulcerative colitis

169
Q

IBD signs

A

diarrhea, bloody stools, weight loss, pain , fever fatigue

170
Q

inflammation involves all layers of bowel wall. anywhere in GI tract

A

chrons .. skips lesions. ulcerations deep

171
Q

Common symtomps of CHrons

A

diarrhea crampy abdominal pain

172
Q

a disease of the mucosa layer of colon and rectum .. moves down to cecum

A

ulcerative collitis

173
Q

Common symptoms of U.C

A

fluid and electroyle loss.. bloody diarrhea and abdominal pain

174
Q

syndrome from repeated removal of sections of small intestine

A

short bowerl

175
Q

with ileostomy how much output

A

1500-2000 ml per 24 hrs

176
Q

functions of Gi system

A

digestion
absorption
elimnation
secretion

177
Q

whens Gi tract mature

A

2

178
Q

newborn stomach cap

A

10-20

179
Q

infacnt stomach cap

A

200

180
Q

adult.. older than 16

A

1500

181
Q

can liver be palpated below costal margin in kids

A

yes 2cm.. not in adult though

182
Q

when does lip close in prego

A

5-6 weeks gestation

183
Q

when does palate close

A

7-9 weeks

184
Q

incarceration

A

blood cut off with inguinal hernia

185
Q

incomplete closure of umbilical ring

A

umbilical hernia

186
Q

promixmal segment of bowel tee copes into a distal segment

A

intussuception

187
Q

hallmark sign of intussuception

A

jelly like stool

188
Q

intestines abnormally attached and the mesentery twitst its self off

A

malrotation

189
Q

main symptom of malroatiation

A

billous vommiting

190
Q

hallmark sign of appendicitis

A

pain at mcburneys point

191
Q

Treatment for binary atresia

A

lapartomy.. kasai procedure

Medsurg test 2 (1 decks)

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