Midterm Review Flashcards
What are the 4 phases of of acute inflammation in order
Hemostasis (blood clotting)
Inflammation
Proliferation
maturation
In which of the 4 phases of inflammation is collagen produced?
Proliferative phase
Maturation phase
In theory if someone cannot produce collagen what would happen during wound healing?
Wound healing would be slower and not as effective
Skills lab
I f someone has an accute abdomen (infection or inflammation of the periniam ) how would they present this pain?
When you push up on the area their muscles will tense up in effort to guard the pain as well as abdominal pain and a cough
Will also have rebound tenderness casuing them pain when you remove pressure from the areas
What happens to HR if someoeone is dehydrated?
HR increases
What happens to hemeglobbin and WBC when someone is dehydrated?
They BOTH increase due to chemoconcentration
Both increaing is a signal that its bc of dehydration
Name a mechanism of cancer
UV light produces free radicals causing cancer
What bacteria is super imposed on to influeza?
Staphylococcous areus
Psychiatric disorder that involves restricted interests and repetitive motions
Autisim spectrum disorder
Cancer that commonly metastisizes via the portal vein to the liver
Colon cancer
Colon cancel travels upstream using the potal vein to get to the liver
A chemotherapy patient presents with elevated K+ and phophate levels and elevated uric acid what is happening?
The patient has Tumor License Sydrome
This liver disease is a type 2 hypersensitivity polyarthritis nodosa and a result of liver disease
Hepatitus B
What is the mimic for asthma? Who doesit normally affect? What is it caused by?
Normally affects kids under 2 years old
Bronchiolitis
Caused by respiratory synctial virus (RSV)
What charachteristics does hand foot and mouth disease consist of?
High fever
Lessions on distal extremeties and mouth and maybe butt too
What diagnosis do honey cristed lessions around the mouth point to
Impetigo
What does HPV casue?
Increased risk for cancer
Skin worts
Cervical cancer
heroine abuser has weakness all ove the body and constipation due to a lack of acetocholine being released from the neuron into the neruomuscular junction, what is this?
Wound botulism
Volvo fungal vaginal infection caused by antibiotics
Candidiasis
Caused by candidia fungus
Chronic disease with high sugar associated with autoimmune disease
Type 1 Diabetes mellitus
Not enough or does not respnd to insulin
What disease shows signs of darken pigmentation of the skin and adrenal insufficiency
Adisons disease
Whats the most common cause of HYPOthhyroidsim
Hashimotos disease
Hot off the press SARS-COVI 2
Symptoms of covvid 19?
Pg (4) Fever/chills Congestion Cough Fatigue Loss of taste/smell Nausea/vomiting Headache SOB
Hot off the press SARS-COVI 2
A patient asks should they be tested for covid (pg5 figure 2)
Reguardless of vax status
If they have symptoms
Asymptomatic in close distance with someone who has had covid
Hot off the press SARS-COVI 2
When should a patient be tested for COVID?
Reguardless of vax status:
If they have recently been on a plane
If they show any symptoms
People who were in close contact with someone who had covid
Hot off the press SARS-COVI 2
Viral RNA curve
Figure 1
Viral antigen has a short spike
Viral RNA has long curve
Hot off the press SARS-COVI 2
How is the viral RNA curve different from the vral antigen curve
Viral RNA curve: a little wider
Viral antigen curve: a little skinnier, starts at a later time
Hot off the press SARS-COVI 2
How is specificity and sensitivity of a PCR test different from an antigen test when taken 28 days after getting covid
The pCR test is more specific and more senitive
What is specificity in regards to viral infections
The specificity of a virus tells us which which hosts the virus can have as well as which cells within the host can be infected
What is sensitivity in regards to viral infections?
How often a test gives a positive result when ssomeone has the disease
How is omicron different than delta
Increased transmission
Less efficacy of vaccines and antibody therapies
What is the impact of discharged patients not being able to go back to their nursinng homes
The hospitals are more full as well as ERs
Patients must be seen in the lobby
Whats the difference in symptoms of a ruptured ectopic pregnancy vs ruptured apendicitis
Rupture etopic pregnancy result si n internal bleeding and therfore pale skin
While ruptured apendicitis sign is High WBC
If the patient has a positive fast exam what might be going on?
Ruptired ectopic pregnancy because we are looking for blood in the belly
What is a fast exam
Focused assesment with sonography in trauma
An bedside ultrasound
What happens to a patients sodium level when they have been vommiting
Sodium levles will decrease
What is the Bipolar disoder
A mental disorder in which a person mood fluctuates between manic and depressed
What is the dfference btw type 1 bipolar, type 2
Type 1: full mania
Type 2: partial mania
What is one feature of mania in bipolar disorder
Sense of grandiosity
What are the 3 indications that someo should be put on a psychiatric hold
Suicidal ideation
Homicidal ideation
Grave disability
What happens to Ohms law if a patient has vasodilation
SVR decreases therfore decreasing MAP
What is ohms law
MAP=Cardiac output (CO) X systemic vascular resistance (SVR)
What type of shock is associated with vasodilation
Distributed shock
What kind of overdose is the following?
Intentional drug overdose
A patient comes in with low RR, tylenol level is high, acetaminophen levels are high
Narcotic overdose and acetaminophen overdose
What are normal vital signs
Temp: 37 C (up to 100.4 F) Blood pressure: 120/80 HR: 60-100 bpm RR: 12-20 SpO2: 92-100% on room air
Should you give charcoal to a patient who is obtundant (groggy low RR)
No becuse theyll aspirate the charcoal(breath it in)
What does AST and ALT test tell us
Tells us liver toxitcity due to drug overdose
How does a lack of glutathion effect tylenol metabolism
When tylenol is taken it is converted into the harmful toxin NAPQI which is neutralized by GLutatione
Without Glutathione there would be NAPQI build up and lver damage
Unilateral leg swelling and shortness of breath/hypoxia
Deep Vein THrombosis
Signs of hypoxia
Difficulty breathing Coughing Wheezing SOB Abnormal HR Palpations
What do you expect for a lung exam with pulmunarty embolism
Clear lungs
Elevated troponin -because of streatching of R heart
Elevated BNP
Causing right heart strain
Draw an antibody on the RBC
Once an antibody biinds to a RBC what happens
It is destroyed by the compliment cascade
Skills labe video: chest X rays
Heart borders are going to be pointed to, know how to name each
TMN staging system, which has the worst prognosis
The one with the metastisis
Patient undergoes neck surgery and starts experiencing paralysisand tetni. What is the mechanism?
Thyroidectomy ->Parathyroid injured/gone-> low calcium -> tetni
If you get a covid shot and you have low antibodies, what is compromised?
Humoral immuntiy is compromised
Acidity of the stomach is what kind of immunity
Innate immunity
What happens in PPD testing for tuberculosis when t cells are compromised
When t cells are ccompromised there is a lower sensitivity (HIV)
What is the connection between low parathyroid and torsades
Low parathyroid = low calcium = long QT interval on EKG= causes torsades
What is torsades de pointe
Tachycardia, very fast heart
If your t cells are comprimised what happens to opsinization
Stayys the same
What are the feature of trichomoniasis
Strawberry cervix (hemmoraging on the cervix)
how does HIV medication, stop HIV
It inhibits reverse transcriptase and keps HIV from converting RNA into DNA
In allergies what is the chemical mediator
Histamine
When we have histamine in our system what is responsible for low blood pressure?
Vasodilation lowers mean arteriole pressure lowering bp
Why do OBGYNs get vaginall swab looking for group B strep (GBS)beffore a vaginal birth?
They want to make sure GBS is not transmitted to the babay
Why do you want a CAT scan with IV contrast when looking for an infection in the belly
Blood vessels dilate due to swelling, making the area of infection easier to find because the area with vaodilation will glow more
When a phogosome cannot fuse with its lysosome?
Chediak Higashi syndrome
What is a granuloma
A bunch of macrophages surrounded by T cells
If tuberculosis spreads to adrenal glands what happens to Na and k+
This is adrenal insuficiency
Low sodium
High potassium
What organs can tuberculosis affect
Brain
Bones etc
Milk article
The consumption of milk is linked to the risk of which cancers (choose one)
(Pg 649)
Prostate cancer
What does the mechanism of gettin g cancer from drinking milk clossely resemble
Growth hormone adenoma
Bc it has to do with (IGF) Insulin growth factors
Does drinking milk prevent the likelihood of bone fractures
No
Rank the cause of mortality due to protein sorces
(Pg 650) Highest processsed meats Eggs unprocessed meat fish ` poultry plant based sources Lowest
Why is it not a good idea to give a vomiting patientwith potential DKA insulin
You migh tank their potassium
New disease showing molecular mimicry
Rheumatic Fever
2 important criteria for being diagnosed with a psychiatric condition
It cant be explained by another medical conditon
It interferes with daily life
What is the diagnosis of someone with EpiGastric abdominal pain with elevated lipase levels
Elevatted lipase levels point to pancreatitits
What should this diagnosis be given these symptoms/labs: Nausea/vomiting Diabetic Blood p: 100/70 RR: 22 EKG: tachycardia Glucose: high Tender upper gastric area High lipase levels High WBc high Hb
DKA
Pancreatitis
Wht is DKA
The body produces excess acetone in the blood due to the break down of fat using counter regulatory hormones (glucagon, epinephrine or cortisol) instead of sugar because there isnt enough insulin
What are two of the counter regulatory hormones in DKA?
Glucagon
Cortisol
Epinephrine
A case Case of: Headache Stiff neck Fever Should point to what diagnosis initially
Meningitis
How is meningitis diagnosed?
Lunbar puncture to get cerebral spine fluid
What is sheehan syndrome
Postpartum hemorrhage causing hypo pituitaryism
If somone has hypothyroidism what would you expect their radioactive Iodine test is going to be
A little lower bc thyroid is not functioning well
Mechanism between postpartum hemmorrhage and hypothyroidism
Postpartum hemmorrhage => pituitary not getting profusion it needs => TSH goes down = T4 goes down = hypo
What is toxic nodular goiter
Produces excess thyroid hormones
Why do people with adisons disease have low blood pressure
Bc they have low sodium—- water likes to follow sodium—— fatigue
What is hyperglycemia
Too much sugar in the bloodstream
In hyperglycemia what happens to the fluid
Fluidis being drawn into the blodstream because of the sugar
What type of people have problems with osteperosis
Chronic steroid use
Prolactinoma
Anorexia nervosa
What does the percentage sensitivity explain
The porportion of samples that arre positive
What disease of the aorta could potentially kill a patient
Ruptered abdominal aortic aneurism(AAA) or aortic dissection
How to diagnose a disease of the aorta
CTA angiogram
When someone has been bitten by a snake what should we be weary of
Compartment syndrome
HUS
In Hemolytic uremic syndrome why is there low hemoglobin and platelets
Hemolysis casuses low Hb
Platelets are being consumed
What should you think about right away for an unresponsive patient
ABC. (Airway, breathing, circulation)
Is there respiratory rate low ——-> give narcan
Are they hypoglycemic (low sugar) ———> give glucose
If someone has lung disease and theyre unresponsive what should you check for
Aspiration pneumonia
