Miscellaneous 3 Flashcards
What are the cardinal signs of carbon monoxide poisoning?
Headache, nausea, malaise, altered cognition, dyspnea, angina, seizures, coma, cardiac dysrhythmias, heart failure, or bright “cherry red” lips.
> are some causes of low pulse pressure?…
> What is the normal sitting PP?
> PULSE PRESSURE IS CONSIDERED LOW IF IT IS LESS THAN 25% OF THE SYSTOLIC BP.
Low PP can be the result of:
-decreased stroke volume due to acute blood loss with loss of preload
-decreased stroke volume due to CHF or shock
-Aortic stenosis
-Cardiac tamponade
> USUALLY, THE RESTING PULSE PRESSURE IN HEALTHY ADULTS, SITTING POSITION, IS ABOUT 30-40 MMHG
> The PULSE PRESSURE INCREASES WITH EXERCISE DUE TO INCREASED STROKE VOLUME,[5] healthy values being UP TO PULSE PRESSURES OF ABOUT 100 MMHG, simultaneously as total peripheral resistance drops during exercise. In healthy individuals the pulse pressure will typically RETURN TO NORMAL WITHIN ABOUT 10 MINUTES.
> If the usual resting pulse pressure is consistently greater than 100 mmHg, the most likely basis is stiffness of the major arteries, aortic regurgitation (a leak in the aortic valve), arteriovenous malformation (an extra path for blood to travel from a high pressure artery to a low pressure vein without the gradient of a capillary bed), hyperthyroidism or some combination. *A high resting pulse pressure is harmful and tends to accelerate the normal aging of body organs, particularly the heart, the brain and kidneys.
> A meta-analysis in 2000, which combined the results of several studies of 8,000 elderly patients in all, found that a 10 mm Hg increase in pulse pressure increased the risk of major cardiovascular complications and mortality by nearly 20%.[9] Heightened pulse pressure is also a risk factor for the development of atrial fibrillation.[10] The authors of the meta-analysis suggest that this helps to explain the apparent increase in risk sometimes associated with low diastolic pressure, and warn that some medications for high blood pressure may actually increase the pulse pressure and the risk of heart disease.
What are the medical complications of Anorexia Nervosa?(which has a 5-6% mortality rate).
Medical complications of anorexia nervosa CONSTITUTION/WHOLE BODY: Cachexia and low body mass index Arrested growth Hypothermia CARDIOVASCULAR: Myocardial atrophy Mitral valve prolapse Pericardial effusion Bradycardia Arrhythmia, which may cause sudden death Electrocardiogram (ECG) changes Long QT syndrome (QTc prolongation) Increased PR interval First-degree heart block ST-T wave abnormalities Hypotension Acrocyanosis GYNECOLOGIC AND REPRODUCTIVE: Amenorrhea Infertility Pregnancy and neonatal complications ENDOCRINE: Osteoporosis and pathologic stress fractures Euthyroid hypothyroxinemia Hypercortisolemia Hypoglycemia Neurogenic diabetes insipidus GASTROINTESTINAL: Gastroparesis (delayed gastric emptying) Constipation Gastric dilatation Increased colonic transit time Hepatitis Superior mesenteric artery syndrome RENAL AND ELECTROLYTES: Decreased glomerular filtration rate Renal calculi Impaired concentration of urine Dehydration Hypokalemia Hypomagnesemia Hypophosphatemia Hypokalemic nephropathy Hypovolemic nephropathy PULMONARY: Pulmonary muscle wasting Decreased pulmonary capacity Respiratory failure Spontaneous pneumothorax and pneumomediastinum Enlargement of peripheral lung units without alveolar septa destruction HEMATOLOGIC: Anemia (normocytic, microcytic, or macrocytic) Leukopenia Thrombocytopenia NEUROLOGIC: Cerebral atrophy (decreased gray and white matter) Enlarged ventricles Cognitive impairment Peripheral neuropathy Seizures DERMATOLOGIC: Xerosis (dry skin) Lanugo hair (fine, downy, dark hair) Telogen effluvium (hair loss) Carotenoderma (yellowing) Scars from self-injurious behavior (cuts and burns) MUSCULAR: Muscle wasting VITAMIN DEFICIENCIES Medical complications of anorexia nervosa Constitution/whole body Cachexia and low body mass index Arrested growth Hypothermia Cardiovascular Myocardial atrophy Mitral valve prolapse Pericardial effusion Bradycardia Arrhythmia, which may cause sudden death Electrocardiogram (ECG) changes Long QT syndrome (QTc prolongation) Increased PR interval First-degree heart block ST-T wave abnormalities Hypotension Acrocyanosis Gynecologic and reproductive Amenorrhea Infertility Pregnancy and neonatal complications Endocrine Osteoporosis and pathologic stress fractures Euthyroid hypothyroxinemia Hypercortisolemia Hypoglycemia Neurogenic diabetes insipidus Gastrointestinal Gastroparesis (delayed gastric emptying) Constipation Gastric dilatation Increased colonic transit time Hepatitis Superior mesenteric artery syndrome Renal and electrolytes Decreased glomerular filtration rate Renal calculi Impaired concentration of urine Dehydration Hypokalemia Hypomagnesemia Hypophosphatemia Hypokalemic nephropathy Hypovolemic nephropathy Pulmonary Pulmonary muscle wasting Decreased pulmonary capacity Respiratory failure Spontaneous pneumothorax and pneumomediastinum Enlargement of peripheral lung units without alveolar septa destruction Hematologic Anemia (normocytic, microcytic, or macrocytic) Leukopenia Thrombycytopenia Neurologic Cerebral atrophy (decreased gray and white matter) Enlarged ventricles Cognitive impairment Peripheral neuropathy Seizures Dermatologic Xerosis (dry skin) Lanugo hair (fine, downy, dark hair) Telogen effluvium (hair loss) Carotenoderma (yellowing) Scars from self-injurious behavior (cuts and burns) Muscular Muscle wasting Vitamin deficiencies Refeeding syndrome
> What is the mechanism underlying referred pain?
> Pain in the right shoulder can originate from which non-musculoskeletal causes or organs?
> Pain in left shoulder can originate from which non-musculoskeletal origin?
> What is the mechanism of referred pain from the abdominal viscera?
> Pain between the shoulder blades can be referred from what organ?
> Referred pain happens when NERVE FIBERS FROM REGIONS OF HIGH SENSORY INPUT (SUCH AS THE SKIN) AND NERVE FIBERS FROM REGIONS OF NORMALLY LOW SENSORY INPUT (SUCH AS THE INTERNAL ORGANS) HAPPEN TO CONVERGE ON THE SAME LEVELS OF THE SPINAL CORD. THE best known example is pain experienced during a heart attack. Nerves from damaged heart tissue convey pain signals to spinal cord levels T1-T4 on the left side, which happen to be the same levels that receive sensation from the left side of the chest and part of the left arm. THE BRAIN ISN’T USED TO RECEIVING SUCH STRONG SIGNALS FROM THE HEART, SO IT INTERPRETS THEM AS PAIN IN THE CHEST AND LEFT ARM.
> liver, gall bladder, stomach, lungs, or pericardial sac
> spleen, heart
> The LIVER, GALL BLADDER, STOMACH, LUNGS AND PERICARDIAL SAC ALL PRESS ON THE DIAPHRAGM. The diaphragm is innervated by the left and right Phrenic nerves which carry sensory fibers that emerge from levels C4-C5. Neurons at this level also receive signals from the shoulder via the supraclavicular nerves. When signals come in from diaphragm the brain gets confused and thinks its from the shoulder
> Visceral afferent fibers from the STOMACH, via the splanchnic nerves, enter the cord at levels T5-T6 which is the same level that receives nerves from the shoulder blades.
What are the causes of Cutaneous Vasculitis?
It is estimated that infections, medications, connective tissue diseases, and malignancy account for 23, 20, 12, and 4 percent of cases of cutaneous vasculitis, respectively [7]. In contrast, the primary systemic vasculitides (granulomatosis with polyangiitis, polyarteritis nodosa, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis) are even more uncommon causes of cutaneous vasculitis. Taken together, they account for only 4 percent of cases. The cause of vasculitis is unidentifiable in 3 to 72 percent of patients
