👩🏾‍🎓- Neuro, HIV, Immunity Test Flashcards

Question

Amyotrophic lateral sclerosis Pathophysiology, manifestations

Answer 1

Pathophysiology- affects voluntary muscle control. Progressive degenerative disease of motor neurons in the brain and body Manifestations- muscle cramp or stiffness, muscle weakness, slurred speech and difficulty swallowing

Answer 2

Upper motor neuron - damage associated with spasticity. The nerves within the cord that carry messages from the brain to the spinal nerves Lower motor neuron - damage associated with flaccidity. Spinal nerves that branch out from the spinal cord to specific areas of the body

Answer 3

The diaphragm

Answer 4

Kept- touch, position, vibration Lost- motor, pain, temp

Answer 5

Kept- motor Lost- vibration, touch, position

Answer 6

Kept- position, vibration, touch (variable) Lost- motor function (loss is more extensive in upper extremities)

Answer 7

Occurs when one lateral half of spinal cord is affected Lost ipsilateral- motor, position, vibration, deep touch Lost contralateral- pain, temperature, light touch

Answer 8

Ipsilateral- on the same side as the injury Contralateral- on the opposite side of the injury

Answer 9

Cervical- inability to breathe and quadriplegia Thoracic- paraplegia Lumbar- decreased control of legs, bowel/bladder function and sexual function

Answer 10

Positive- strengthen the force of the ❤️ beat Negative- weaken the force of the ❤️ beat

Answer 11

Occurs immediately after injury Compete but temporary loss or depression of all or most spinal reflexes as well as sensory, motor autonomic activity below the injury Brain unable to transmit signals to muscles and organs, resulting in loss of sensation, movement, and other body functions

Answer 12

Can last from 24 hours to 1-6 weeks and return of reflex activity below the level of injury

Answer 13

A type of distributive shock that occurs in patients with brain, upper thoracic and cervical injuries. Caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls Results in ⬇️ cardiac output, bradycardia and hypotension

Answer 14

Reflex hypertension in patients with injury above T5-T6 level. Observe for rapid increase in BP ; remove the stimulus that initiated Stimulus- full bladder, full bowel, pain

Answer 15

1 stabilize the spine 2 treat the trauma (maintain airway, cpr, manage hemorrhage 3 assess neuro status for current baseline: GCS, motor, sensory, cognitive 4 ask: what happened, did they lose consciousness, were they moved, what was baseline neurological status

Answer 16

Fluid resuscitation Inotropics: dopamine, dobutamine Vasopressors: vasopressin, norepinephrine, phenylephrine

Answer 17

Classification based of cellular characteristics Grade 1- well differentiated tumor, closely resembles tissue of origin in structure/function Grade 4- poorly differentiated, does not clearly resemble the tissue of origin in structure/function

Answer 18

Classification based in size of tumor and if metastasis present T- extent of primary tumor (size) N- number of regional lymph nodes involved M- extent of metastasis

Answer 19

C - change in bowel/bladder habits A- a sore that doesn’t heal U- unusual bleeding or discharge T- thickening or lump in breast, etc I- indigestion or difficulty swallowing O- obvious changes in a wart or mole N- nagging cough or hoarseness

Answer 20

- gently wash skin with mild soap - don’t wash off treatment markings - pat skin dry - use powders, ointments, lotions, creams prescribed by oncologist - wear soft loose clothing - avoid sun exposure - avoid heat exposure

Answer 21

- private room - sign “caution radioactive material” - keep door closed - limit visitors to 10-30mins - stay 6ft away from client - no pregnant women - no children < 16yrs

Answer 22

Local skin changes and hair loss Altered taste and fatigue Taste, swallowing, xerostomia (dry mouth) Bone (can lead to fractures)

Answer 23

Tx: lung, breast, leukemia, lymphoma, multiple myeloma Action: directly damages dna to prevent cell reproduction, work in ALL PHASES of cell cycle Route: IV/po SE: n/v, alopecia, STERILITY, leukopenia, HEMORRHAGIC CISTIS (urine has blood), myelosuppression (7-14 days), cardio toxicity with high doses, oral mucositis, NEUROTOXICITY Ex: CYTOXAN (cyclophosphamide)& cisplatin

Answer 24

Tx: breast, lung, lymphomas, brain, gi, leukemia, pancreatic Action: interferes with dna and rna growth, damage cells during the S PHASE Route: IV/topical SE: n/v, alopecia, STOMATITS (gi), leukopenia, bone marrow suppression, hepatic and renal dysfunction, diarrhea, photosensitivity Ex: 5-FU or 5-Fluorouracil, Methotrexate

Answer 25

Tx: breast, lung, cervix, sarcomas, lymphomas, Wilm’s tumor Action: stop mitosis and prevents cell reproduction, work during the M PHASE of cell cycle, but can damage cells in ALL PHASES route: IV SE: n/v, alopecia , constipation, EXTRAVASATION (vesicant-destroys tissue if IV leaks) NEUROTOXICITY (paresthesia), leukopenia, mild myelosuppression Ex: Vincristine (Oncovin)

Answer 26

Tx: breast, lung, lymphoma, esophageal, gi, Head & neck, kaposi sarcoma, melanoma’s m, pancreatic, testicular Action: damage the cells dna and interrupts dna or rna synthesis, are cell cycle specific and work in the s phase Route: IV/vessicant SE: n/v, alopecia, RED URINE, cardiotoxicity, pulmonary, myelosuppression, vesicant Ex: adriamycin (doxorubicin), bleomycin (blenoxane)

Answer 27

Tx: melanomas, renal, ovarian, skin Action: stimulate immune system to destroy non-self CA cells & stimulates bone marrow production Route: IV SE: generalized inflammation (fever, chills, rigors, flu-like symptoms), PERIPHERAL NEUROPATHY, dry skin, itching and peeling Ex: cytokines (interleukins & interferons)

Answer 28

Tx: many tumors w/ identified targets Action: proteins are identified that are needed for cell division and are blocked Route: po, eye drops SE: vary depending on med- diarrhea and liver problems, skin rashes, delayed wound healing & hypertension Ex: tyrosine kinase inhibitors (gleevec), multikinase inhibitors (sutent), proteasome inhibitors (velcade)

Answer 29

Tx: used in breast, prostate, endometrial Action: sex hormones, or hormone-like drugs, that alter the action or production of female or male hormones deprives estrogen-sensitive tumors/or blocks testosterone synthesis Route: oral SE: n/v, chest or facial hair, no menstrual period, HYPERCALCEMIA, hepatic dysfunction, venous thromboembolism Ex: tamoxifen (nolvadex)

Answer 30

Tx: used in ocular tumors, gi tumors, lung CA affecting airway Action: selective destruction of CA cells or shrinks tumors, an agent given IV that sensitizes CA cells to light, laser light used SE: must protect SKIN and EYES from light for 3 months Teach: avoid light sources & avoid drugs that are photosensitizing

Answer 31

ANC= WBC x (% segs + % bands) Less than 1500 (mild) Less than 1000 (moderate) Less than 500 (severe) Normal range: 1500-8000

Answer 32

The lowest point in bone marrow suppression after chemotherapy (mainly WBC & platelets) The nadir time is usually about 10 days after treatment Blood counts return to normal within 3-4 weeks The next dose of chemotherapy is given only after a persons blood counts have left the nadir and recovered to a safe level

Answer 33

Low platelet count in blood Mild: 50k-100k Moderate: 20k-50k Severe: <20k Normal range: 140k-450k

Answer 34

Sepsis with gram-negative infections

Answer 35

-no pee- Antidiuretic hormone is secreted by posterior pituitary gland Brain tumors are most common cause ⬇️ Na levels (hemodilution) S&S: weakness, muscle cramps, weight gain, pulmonary edema, personality changes, confusion, seizures, HTN, heart failure, coma & death Treatment: monitor for S&S if fluid overload, limit fluids, increase Na intake

Answer 36

Bounding pulse Neck vein distention Crackles in lungs Peripheral edema Decreased urinary output

Answer 37

- due to radiation or chemo induced cell destruction - kidneys unable to excrete large volumes of released cellular metabolites - leads to electrolyte imbalances: HYPERKALEMIA & HYPERURICEMIA - patients at risk following radiation/chemo; up to one week after therapy completed Treatment: hydration (3000ml before, during and up to 3 days after treatment)

Answer 38

Recognizing self from non-self proteins to prevent healthy body cells from being destroyed along with invaders

Answer 39

The number of immature neutrophils released from the bone marrow has increased, usually more than segs Often found in a patient with an acute inflammatory process such as appendicitis or cholecystitis

Answer 40

Segs- mature neutrophils Bands- immature neutrophils

Answer 41

Some antibiotics , lithium , phenothiazines (often used as antiemtics) and tricyclic antidepressants *antineoplastic drugs produce bone marrow depression and can significantly lower the neutrophil count*

Answer 42

Antibodies rate produced by sensitizing B lymphocytes Most long lasting immunity Why some illnesses only occur once (b-cells) recognize antigen as non self

Answer 43

Build own antibodies, long term immunity Natural active- you get sick (b lymphocyte) Artificial active- immunizations

Answer 44

Donated antibodies, temporary immunity Natural passive- breast milk/placenta Artificial passive- rabies shot

Answer 45

-Flu like symptoms: Fever, fatigue, night sweats, chills, headache, muscle aches, lymphadenopathy (swollen lymph nodes), diarrhea, sore throat -lymphocytopenia (⬇️ lymphocytes)

Answer 46

Stage 1- cd4 count > 500 (asymptomatic) Stage 2- cd4 count between 200-499 (asymptomatic) Stage 3- cd4 count < 200 + OI = AIDS Normal range: 800-1500

Answer 47

Fungal/protozoan infection S&S- nonproductive dry cough, crackles, dyspnea, tachypnea, Fever, fatigue and weight loss (insidious) Treatment- Bactrim or Septra Nursing care- monitor respiratory status, fever management, oxygen, energy conservation/⬇️ O2 demand

Answer 48

S&S- cough, dyspnea, chest pain, fever, chills, night sweats, anorexia Cd4 count < 200 won’t have a positive PPD (must confirm with sputum or chest X-ray)

Answer 49

Rash Co-infection with herpes Dx: biopsy Tx: antiretroviral therapy, chemotherapy, radiation

Answer 50

Infection of the brain/CNS Memory impairment/personality changes, hallucinations, loss of balance, slower response

Answer 51

ELISA- screening test that requires a blood sample be sent to a lab. Can give a false positive because it picks up other viral infections Western blot- detects specific antibodies to hiv , used to confirm Elisa

Answer 52

The only FDA approved HIV antibody test Draws blood-derived fluids from the gum tissue Not a saliva test

Answer 53

MMR and chickenpox *no live viruses*

Answer 54

HAART- 3 different cell interruption drugs in 1 cocktail NRTI/NNRTI- prevent RNA from changing to DNA Protease inhibitors- prevent exit from cell Fusion inhibitors Entry inhibitors Integrate inhibitors- prevent from going into nucleus/growing

Answer 55

White lesions on the lateral aspect of tongue Associated with hiv

Answer 56

Sjögren’s syndrome - triad of symptoms: Dry eyes (sicca syndrome) Dry mouth (xerostomia) Dry vagina Caplan’s syndrome- rheumatoid modules in lungs and pneumoconiosis (a restrictive lung disease noted primarily in coal miners and asbestos removal workers)

Answer 57

- weight loss, fever and extreme fatigue - exacerbation with remissions - subcutaneous nodules (non-tender & movable) - vasculitis - periungual lesions (brownish nailbeds) - paresthesia (burning or tingling) - pulmonary complications - eye complications (iritis or scleritis) - osteopenia (⬇️ bone density) - pleuritis & pericarditis

Answer 58

Swan neck deformity- deformed position of the finder, joint closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it Boutonnière deformity- deformed position of finders or goes, joint nearest knuckle is permanently bent toward the palm while the farthest joint is bent back away

Answer 59

Hand deformity in which the swelling of the metacarpophalangeal joints (the big knuckles at the base of the fingers) causes the fingers to become displaced, tending towards the little finger

Answer 60

PPD rest given before administration and should be negative Ex: etanercept (embrel), remicaide, humira

Answer 61

Liver toxicity Bone marrow depression- ⬇️ WBC and platelets Immunosuppression issues- infection 4-6 weeks for medication to start showing pain control STRICT BIRTH CONTROL is advised - can cause stillbirth & defects Folic acid (prevents oral ulcers) Avoid alcohol (liver toxic)

Answer 62

Early- joint stiffness, swelling, pain, fatigue, generalized weakness and morning stiffness, anorexia/weight loss, persistent low grade fever, joint involvement is bilateral & symmetric