medsurg test 2 Flashcards
1
Q
pts with mG experience
A
weakness of the muscles of the face and throat.. strongest in the AM
2
Q
Diplopia
A
double vision
3
Q
Ptosis
A
eye drooping
4
Q
dysphonia
A
voice impairment
5
Q
what test is used with MG
A
tensillon test
6
Q
what drug should be kept on head to control side effects of edrophonium
A
atropine
7
Q
Management of MG
A
anticholinestrase. immunosuprressive therapy.. predinision
8
Q
MG perioheral or central
A
peripheral
9
Q
How does MG work
A
blocked ACH receptors at muscle endplates
10
Q
MG presenting symtpms
A
ptosis , diplopia
11
Q
ALS is
A
rare, progressive disorder.. loss of motor neurons
12
Q
death with ALS occurs within
A
2-6 years
13
Q
Presenting symptoms of ALS
A
weakness, muscle wasting
14
Q
ALS peripheral or central
A
both
15
Q
Mechanism of ALS
A
loss of motor neurons
16
Q
Diagnoisis of ALS
A
neuro exam EMG, CPK
17
Q
Advanced stage of ALS
A
speech and swallow
18
Q
Terminal stage of ALS
A
dyspnea SOB, speaking no longer possible
19
Q
ALS treatment is
A
Riluzole.. slows progression
20
Q
GBS peripheral or central
A
peripheral
21
Q
Mechanism of Illness for GBS
A
PNS, dymyelination, edema, inflammation
22
Q
Presenting symtomps of GBS
A
lower extremity weakness, URI, of GI infection
23
Q
Diagnosis of GBS
A
clinical picture EMG, incr CSF protein
24
Q
Treatment of GBS
A
immunotherapy, Plasmaphoresis
25
what is myelin
lipoprotein from neural support cell bodies that wrap around neural axons
26
GBS is acute or chronic
ACUTE!
27
with GBS look at to diagnosis
brain MRI to rule out MS
28
genetically transmitted autosomal dominate.. progressive degenerative brain disorder
hunningtons disease
29
with hunningtons disease
high caloric requirements. 4,000-5000 calories per day
30
Uncontrollable and sometimes overwhelming urge to move legs. shows at night.. relaxing makes worst
RLS restless leg syndrome
31
paresthesias
abnormal sensations
32
dyesthesias
unpleasant abnormal sensations
33
RLS which nuerotransmitter
dopamine
34
MS central or peripheral
central
35
Mechanism of MS
CNS demyelination, axonal injury, glial scarring
36
Presenting symtomps of MS
numbness, vision changes, depression, dysfunctional elimination
37
Diagnosis of MS
MRI , increase in immunoglobin G, presence of iligoclonal banding in CSF ... WEAKNESS and FATIGUE
38
Treatment of MS
immunomodulators. immunosuppreseant
39
Chronic progressive degenerative disease affecting the myelin sheath of the white matter of the brain and spinal cord
MS
40
3 stages of MS
1. chronic inflammation
2. demyelination
3. Scarring
41
Classifications of MS
1. motor
2. sensory
3. Cerebellar
4. Emotional
42
Common triggers of MS
```
infection
trauma
immunization
childbirth
stress
change in climate
```
43
Uncontrollable factors of heart disease
age
male
family history
race.. African americans greater risk
44
controllable risk factors of heart disease
```
high BP
diabetes
cholestrol
poor diet
obesity
```
45
Cyanosis is a what sign of Respiratory distress
LATE!
46
Xanthelasma
yellow on eye.. cholesterol so high depositing to skin
47
ear creases
early sign of heart disease.. as early as 18
48
Systolic BP is
biggest thing of showing HD after age 60
49
Peripheral edema tells us what
RIGHT SIDED HEART FAILURE!
50
LDL should be
less than 130.. bad one
51
HDL should be
greater than 40.. good one
52
total cholesterol should be
should be less than 200
53
calcium causes
both hyper and hypo dysrhythmias
54
magnesium causes
life threatening dysrthmias
55
does negative EKG rule out MI
NOOOOO!
56
p wave is
firing of the SA node
57
QRS complex is
ventricles contracting
58
T wave
ventricles repolarising
59
anabolism
positive protein balance
60
catabolism
negative protein balance
61
Max dextrose peripherally
10 percent
62
PID long term last
1-2 years
63
brown line
blood
64
blue lin
meds
65
white
TPN
66
PICC
last up to 1 yr
67
PICC is inserted
by certified nurse at bedside
68
MLC is a
not central line last 1-4 `weeks
69
MLC is inserted by
nurse at bedside
70
for cite care use
alchol 30 sec and chlorhexidine 30 sec
71
TIDs
surgical implant.. 1-2 years
72
1ml is
300 psi
73
10 ml is
7psi
74
angina pectoris
ischemia without infarction
75
how do you know its angina not mi ?
improves with rest
76
what does angina pain feel like?
pressure pain.. elephant on chest or fist
77
why does pain radiate
lactic acid build up
78
what do you teach with aspirin for mi
81mg no interacted aspirin .. chewable
79
what teach with nitroglycerin
store in dark place.. headache is norm.. take 3 times every 15 min
80
interventions with MI
Morphin
oxygen
nitro
aspirin
81
permanent localized dilation asymptomatic emergency
aneurysm
82
how do you diagnosis aneurysms
CT scan ultrasound
83
classic thing with arterial pain ..not as painful
goes away when elevated
84
gangrene
infarction of tissue
85
arterial legs look like
shiny hairless pale
86
do yo see edema with arterial
no just venous
87
with arterial disease open wound what med first
iv antibodics
88
intermittent muscle pain percolated by exercise resolves within 10 min of rest
intermittent claudication
89
numbs or tingling in toes
paresthesia
90
endocarditis effects what
the valves
91
manifestations of endocarditis
hemorrhages in nail beds osiers nodes janeway lesion roth spots
92
raised nodular lesions on hands and feet
oslers nodes
93
nodules on below and end of fingers
janeway lesion
94
hemorrhage areas on retina.. splotches
roth spots
95
what kind of people need prophylactic antibodies
prosthetic joits.. valve problesm
96
when would you give the antibodics
dental procedures, respiratory infections, tonsillectomy, go wound infection, UTI
97
what to teach with endocaratitis
take full dose of med.. full time 4-6 weeks
98
what can you get from strep throat
rheumatic heart disease
99
rheumatic heart disease is
inflammation
100
what do you put rheumatic heart disease pts on
steriods
101
Ck info
nospecific.. detects muscle damage within 12 hours
102
CKMB
SPECIFIC! within 12 hrs norm 0-3
103
Myoglobin
protein found in heart. rises within 2-3 hours rule out mi
104
Tropinin norm
undectable
105
when can you detect troponin
4-6 hours highest 10-24
106
what to teach with exercise stress test
comfy clothes, no caffeine 24 hrs before, no smoking or exercise 3hrs prior
107
chemical stress test
takes 3-4 hrs. dobutanine... no beta blockers.. feel anxious
108
ultrasound of heart to see valves beat and structures
echocardiogram
109
CMRI teach
tight place loud.. no portable oxygen.. no wire clothes no earrings
110
Xray used to take detailed pics of the heart.. die radiation
CT
111
video images of the ventricles .
MUGA
112
what hormones does thyroid produce
T3 T4 and calcitonin
113
Goiter
enlarged thyroid ... most common cause lack of iodine. or in us thyroid disease
114
With surgical removal of nodule or cancer for thyroid
airway bleeding hypocalcemia
115
inflammation of the thyroid gland . viral or autoimmune
thyroditits
116
increased hormones. graves disease. decreased TSH but high T4 T3
hyperthyroidism
117
Exophthalmos
puppy eyes with graves disease
118
INsufficent horomones..
hypothyroidism
119
myxedema
sever long standing hypo leads to saccharides in skin
120
moon face, purple stria, facial hair, easy bruising think trunk thing arms legs
cushings .. to much corticosteriods
121
low adrencocortical hormones
addisons
122
purposes of chest tube
remove fluid air blood
123
upper tube used for
air
124
lower tube used for
fluid
125
mediastinal
is not in pleural space.. chest
126
water seal is how many cm
2
127
with wet system what determines amount of suction
water level .. only sterile water
128
wet system looks like
continous bubbly in suction cloumn not in water seal
129
tidal
raise up and down with each breath fluctuates
130
when do you call doc with chest tube drainage
over 100ml an hour or major change
131
what are your three reasons to clamp chest tube
to locate air leak
replace collection unit
verify chest tube removal readiness
132
what if chest tube comes apart from drain
clean reattach cough
133
what if the collection unit breaks
put end in water
134
what if chest tube pulls out
cover ! call doc
135
large intestines does
absorption of water and electrolytes
136
what does saliva do
lubricates and breaks down starches
137
small intestine does
digestion and absorption
138
liver does
manufacture store transform and excrete
139
gallbladder does
bile conc and storage
140
pancreas does
digestive enzymes
141
mixing moves chyme in both directions to promote mixing
segmentation
142
propulsion. one way motion
peristalisis
143
Gherlin-appetite
stimulates
144
Leptin appetite
supression
145
food once mixed with gastric secretions
chyme
146
stomach absorbs what
small amounts of water alcohol electrolytes and certain meds
147
pigment from breakdown of hemoglobin
billirubin
148
whats small intestine digest
carbs, fats, proteins
149
how do you access abdomen
inspect asculate paplate purcuss
150
stomach growling hyperperistalisis . loud gurgles
borboygmi
151
delayed emptying of lower esophagus . increased risk of squamos cell tumor
achalsia
152
burning squeezing pain while swallowing
odynophagia
153
stomach cancer facts
adenocarcinoma
| weight loss, pain, anemia, feel lump
154
third most common cancer.. screening is imperative!
colocrectal cancer
155
CRC left side
rectal bleeding, incomplete evacuation, constipation diarehea
156
CRC right side
asymtompatic
157
4th most common cause.. linked with Hep c and b
liver cancer
158
common chronic functional disorder . intermittent pain or discomfort
IBS
159
Diagnosis IBS
rule out malabosrption, guleten and lactose intolerance
160
Symtpom based diagnosis for IBS
rome three criteria... must have two out of three
161
how do you treat IBS
stress management, diet meds
162
how much fiber with IBS
20mg/day
163
what are the gas producing foods?
brown beans, brussels sprouts, cabbage, cauliflower, raw onions, grapes , plums raisins
164
what drug is given with diarrehea
Imodium
165
what drugs are given with constipation
alosetron, lubiprostone, linaclotide
166
Inflammation of the intestinal tract
IBD
167
inflammation of any segment of the GI tract mouth to anus
chrons
168
inflammation and ulceration of the colon and rectum
ulcerative colitis
169
IBD signs
diarrhea, bloody stools, weight loss, pain , fever fatigue
170
inflammation involves all layers of bowel wall. anywhere in GI tract
chrons .. skips lesions. ulcerations deep
171
Common symtomps of CHrons
diarrhea crampy abdominal pain
172
a disease of the mucosa layer of colon and rectum .. moves down to cecum
ulcerative collitis
173
Common symptoms of U.C
fluid and electroyle loss.. bloody diarrhea and abdominal pain
174
syndrome from repeated removal of sections of small intestine
short bowerl
175
with ileostomy how much output
1500-2000 ml per 24 hrs
176
functions of Gi system
digestion
absorption
elimnation
secretion
177
whens Gi tract mature
2
178
newborn stomach cap
10-20
179
infacnt stomach cap
200
180
adult.. older than 16
1500
181
can liver be palpated below costal margin in kids
yes 2cm.. not in adult though
182
when does lip close in prego
5-6 weeks gestation
183
when does palate close
7-9 weeks
184
incarceration
blood cut off with inguinal hernia
185
incomplete closure of umbilical ring
umbilical hernia
186
promixmal segment of bowel tee copes into a distal segment
intussuception
187
hallmark sign of intussuception
jelly like stool
188
intestines abnormally attached and the mesentery twitst its self off
malrotation
189
main symptom of malroatiation
billous vommiting
190
hallmark sign of appendicitis
pain at mcburneys point
191
Treatment for binary atresia
lapartomy.. kasai procedure
