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NR 615 > NR 615 TEST 1 > Flashcards

NR 615 TEST 1 Flashcards

1
Q

Metabolic syndrome aka syndrome X includes….

A

Increased waist circumference (w35,m40)
Triglycerides >150
HDL <50
Fasting glucose>100
HTN>180/85

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2
Q

Release of IGE in early asthmatic response results in…

A

H1 receptor activation which causes the smooth muscles to bronchoconstrict and spasm

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3
Q

What is the karotype for Klinefelter syndrome?

A

XXY

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4
Q

Deficiency in what chemical could result in hypothyroidism

A

Iodine

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5
Q

Best measure for cardiac preload is

A

Left Ventricle Enddiastolic Pressure (LVDEP)

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6
Q

Risk factors for DVT aka Virchows triad

A

Endothelial injury
Venous Stasis
Hypercoagulation

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7
Q

TNM systems to classify cancer:
T

A

T1 is <3cm, T2 >3cm, t3 >3cm and close to airways/chest, T4 in heart muscle or esophagus

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8
Q

TNM systems to classify cancer
N

A

N0- no node involvement
N1- ipsilateral close node involvement
N2- ipsilateral distant node
N3-contralateral node

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9
Q

TNM system to classify cancer
M

A

M0- no Mets
M1-Mets

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10
Q

Stage 1 cancer is…

A

Contained to one organ

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11
Q

Stage 2 cancer is

A

Locally invasive

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12
Q

Stage 3 cancer has…

A

Lymph involvement

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13
Q

Stage 4 cancer has

A

+ Mets

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14
Q

What is a saccular aneurysm and how do you treat it

A

One with a “sac” protrusion…tx is Usually clipping or coiling

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15
Q

What is a fusiform aneurysm and how do you treat it

A

An anureysm that is fat all around. Tx is usually stent

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16
Q

What is a dissecting aneurysm and how do you treat it

A

False lumen to medial wall, arterial wall splits and bleeds. Tx is grafting the tear and betablockers

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17
Q

What is a false aneurysm and how do you treat it

A

A hematoma that looks like an aneurysm. Tx is supportive care

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18
Q

In HTN, pressure- natriuresis causes what?

A

Decrease in NA+ in urine

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19
Q

Angiotensin II usually has what SYSTEMIC type of effects in CHF?

A

Activation of RAAS which causes vasoconstriction and fluid retention. Decreased vasoresistence and an increased in preload and afterload. This causes toxicity to the myocardium which results in decreased contractility and myocardium remodeling. Overall, this leaders to HYPERtrophy of the myocardium

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20
Q

Angiotensin II usually has what local effects in CHF?

A

Promotes catecholamine release

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21
Q

Complex consetallyion of systolic congestive failure

A

Systolic HF -> issue to systole d/t contraction= decrease in cardiac output= RAAS activation to increase CO= increase preload and afterload = remodeling and toxicity to myocardium

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22
Q

stages of atherosclerosis

A

Begins with injury to endothelial cells that make up the arterial walls.
Stage 1 can be seen as early as 8 months when macrophages become lipid foam cells.
Stage 2 seen in puberty, increase in these lipid macrophages
Stages 3/4 fatty streaks become visible.
Stage 5 is in the 30s, when fibrous tissue occurs.

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23
Q

Pathology of atherosclerosis

A

Macrophages fill with LDL and penetrate inner material wall. This results in fat streaks. The fat streak produces more inflammation and toxicity resulting in vessel wall damage.

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24
Q

What is the most common type of childhood cancer up to 14 y.o

A

ALL
2nd is brain tumors

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25
Q

Clinical manifestations of R sided heart failure

A

JVD, hepatospleenomegaly, peripheral edema,fluid retention.

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26
Q

Definition of anaplasia

A

Loss of cell differentiation aka pleomorphism. Irregularities in the size and shape of cell nucleuses, no normal tissue structure.

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27
Q

Clinical manifestations of Cushing disease

A

Truncal obesity, moon face, bronze pigmentation, purple striae, acne, thin extremities, bruising

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28
Q

Hgb A1c levels are…

A

Normal: 4.5-5.6%,
Pre:5.7-6.4%
Diabetic: 6.5%+

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29
Q

The clinical manifestations of congenital hypothyroidism are…

A

Cretinism. Macro gloss is, hypotonia, cognitive delay

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30
Q

Aging does what thyroid gland

A

Atrophy, fibrosis, nodularity, increased inflammation, decreased TSH production

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31
Q

Aging does what to the pancreas?

A

Impaired glucose production, cells are replaced with fat, decreased insulin secretion, increased insulin resistance

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32
Q

Aging does what to growth hormones?

A

Declines (soma to pause), decrease in bone/muscle/fat mass, changes to reproductive and cognitive function

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33
Q

Aging does what to parathyroid hormone

A

Decrease in parathyroid hormone secretions which lead to alterations in calcium

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34
Q

Aging does what to adrenal gland?

A

Cortisol clearance decreases. Related to decline in liver/kidney function, adrenopause (plasma levels decrease)

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35
Q

Aging does what to antidirectic

A

Hyponatremia/ SIADH

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36
Q

Dysfunction of RAAS and hypertension results in

A

Vasoconstriction=Renal salt and water retention=increase in peripheral resistance= increase in blood volume

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37
Q

What is the hematological spread of cancer Mets?

A

Cancer cells break away and travel through bloodstream and go to different parts of the body

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38
Q

What BP is prehypertension

A

120-129/<80

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39
Q

What BP is stage 1 HTN?

A

130-139/80-89

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40
Q

What BP is stage 2 HTN?

A

140 or >140/90 or >90

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41
Q

What BP is HTN crises?

A

> 180/>120

42
Q

What are local s/s of inflammation?

A

Increases redness, warmth, and swelling and pain

43
Q

Systemic s/s of inflammation?

A

Fever, +leukocytes, increased plasm proteins

44
Q

What is the underlying cause of dilated cardiomyopathy?

A

Ischemic heart disease, valve disease, drug toxicity, hyperthyroidism, renal failure. Will have impaired systolic function.

45
Q

Active- acquired immunity is…

A

Direct exposure aka vaccines or natural exposure

46
Q

Passive immunity is…

A

Transferred, temp/short ex IVIG

47
Q

Common allergic responses are mediated through what class of antibodies?

A

IgE antibodies

48
Q

What IGG do?

A

Protective against infections

49
Q

IgM is…

A

The largest and first produced during immune response

50
Q

IgA is…

A

Found in body secretions that defend against pathogens on body surfaces

51
Q

IgD is….

A

Present in plasma and easily broken down, predominant in early B cells

52
Q

B cells are…

A

Responsible for immunoglobulin mediated immunity originated in bone marrow

53
Q

T cells are…

A

Killer, helper cells, or suppressor

54
Q

Complications of micro vascular DM?

A

Nephropathy, Neuropathy, and Retinopathy. Result from capillary basement membranes thickening and endothelial cell hyperplasia.

55
Q

Complications of macro DM

A

CAD, PVD, Stroke

56
Q

Risk factors for endocarditis are…

A

IV drug use, indwelling catheterization, heart valve disease, blood borne pathogen.

57
Q

What is the most common pathogen for infective endocarditis?

A

Staph Aureus

58
Q

Hyperparathyroidism is associated with

A

Increase in ca+ and decrease in phos. Painful bones, renal stones,GI upset, depression/memory loss/psychosis

59
Q

Symptoms of hyperthyroidism include…

A

Tachycardia, palpations, weight loss, increase appetite, goiter

60
Q

What is the pathophysiology of valvular regurgitation?

A

Valve does not fully close which lease to back flow of blood from ventricle to atrium

61
Q

What is seen in primary hypothyroidism that is not seen in secondary hypothyroidism?

A

Hyperpigmentation

62
Q

What are the risk factors for peripheral artery disease?

A

Obesity, HTN, HLD, male, tobacco use, over 40 y.o

63
Q

What are the ways to diagnose DM?

A

Elevated hgA1C
Fasting plasma glucose
Random glucose test
2 hour glucose tolerance test

64
Q

What is the difference between hypoglycemic hyperosmolar nonketotic syndrome vs DKA?

A

HHNS: SEVERE fluid deficiency, profound hypoglycemia (greater than 600), higher mortality, no ketones, less insulin deficiency than DKA, occurs over time
DKA: insulin deficiency, +ketones, +kussmaul, occurs rapidly, dehydration (not as much as hhns).

65
Q

What is cushings disease?

A

Caused by pituitary Adenoma which leads to increase ACTH

66
Q

What is Cushing’s syndrome?

A

Chronic excessive cortisol level aka lack of circadian patterns

67
Q

What causes tachycardia?

A

SNS causes fast heart rate

68
Q

Right sided heart failure vs left sided

A

R- JVD, peripheral edema, retention of fluid. Increased pulmonary HTN
L- Dyspnea, SOB, Cough, frothy sputum, impaired gas exchange, Think blood keeps emptying back to R side of heart and back flowing to lungs.

69
Q

What is the risk of myocardial infarction when referring to LDL and HDL ?

A

LDL: high levels cause toxicity and remodeling of smooth muscles in heart.
HDL: HDL converts cholesterol to steroids or bile. Low HDL means increased coronary risk.

70
Q

Which cancer can H. Pylori cause?

A

Stomach

71
Q

What cancer can HPV cause?

A

Cervical

72
Q

What cancer can hep b and c cause

A

Liver

73
Q

What cancer can hiv cause??

A

Kaposi sarcoma, nonhodgkins, squamous cell carcinoma

74
Q

What cancer can EBV cause?

A

Lymphomas, nasopharyngeal

75
Q

What cancer can HTLV1

A

T cellLeukemia/lymphoma

76
Q

Where are Mets of pancreatic cancer common?

A

Liver, lungs, abdomen

77
Q

Where are Mets of lung cancer common?

A

Colorectal, gastric, pancreatic, breast, prostate, bladder, renal, skin. Brain

78
Q

Where are Mets of brain cancer common?

A

Lung, breast, skin, renal, colorectal

79
Q

Where are Mets of bone cancer common?

A

Breast, prostate, lung, skin, renal, thyroid

80
Q

Where are Mets of prostate cancer common?

A

Bone

81
Q

Understand the blood flow of TOF

A

Blood is shunted from R to L over the VSD. Results in oxygen poor blood from r ventricle flowing right into aorta and increased flow to pulm artery and lungs.

82
Q

How does blood flow with a VSD?

A

Left ventricle to right ventricle, extra blood going to lungs.

83
Q

What are the effects of calcitonin

A

Decreases calcium by inhibiting bone reabsorption. Increases phos.

84
Q

What are the effects of insulin on the body.

A

Helps control blood glucose by signaling liver, muscle, and fat. Secretion is promoted by glucose livers.

85
Q

Know about the adrenal gland

A

Adrenal gland is stimulated by ACTH. Produces hormones that regulate metabolism, immune system. Response to stress.

86
Q

Know about corticosteroids

A

AKA CORTISOL. Increase blood glucose, regulate metabolism, anti inflammatoru, decreases immune responses, stimulates gastric secretion.

87
Q

What is a pheochromocytoma and what does it do

A

Tunor on the adrenal medulla. Causes HTN, palpations, glucose intolerance, sweating, constipation.

88
Q

Clinical manifestations of hypothyroidism

A

Cold intolerance, lethargy, tiredness, diastolic HTN, weight gain, depression, puffy face and eyelids, goiter, edema,

89
Q

Clinical manifestations of Addison disease

A

Bronze skin, hypoglycemia, weakness, vitiligo, hypotension

90
Q

What are the symptoms of adrenal adenoma

A

Overproduces ACTH and causes cushings disease. Benign tumor. Hirtuism, deep voice.

91
Q

What are the the symptoms of primary hyperaldosteronism

A

Excessive secretion by adrenal cortex. HTN, Hypokalemia, hypervolemia d/t increased sodium reabsortion, metabolic alkalosis

92
Q

Autoimmune disorders occurs when

A

Misdirected response against the hosts own cells. Ex. Lupus

93
Q

Consequences of aortic stenosis is

A

Diminished blood from LV to aorta. Heart failure, MI, dysrhythmias.

94
Q

Graves’ disease is cause by…

A

Hyper function of the thyroid gland. Bulging eyes, tremor, irregular heartbeat, sweating, weight loss, emotional instability.

95
Q

What is transposition of great arteries?

A

Pulmonary artery and aorta are swapped. Incompatible with life unless pda/VSD/asd exists to mix oxygenated blood and deoxygenated blood.

96
Q

Parental obesity is associated with …

A

Childhood obesity, increasing risk of HTN

97
Q

A child’s BP will go down if….

A

Both systolic and diastolic BP will decrease with moderate weight loss

98
Q

Sensitivity of target cells will Dow regulate when…

A

High concentrations of hormones decrease the number of receptors.

99
Q

What is the pathophysiology of Cushing’s syndrome

A

ACTH stimulated adrenal gland. Adrenal gland secrets cortisol. Excessive cortisol causes lack of circadian rhythms

100
Q

What are the major contributors to insulin resistance and diabetes type 2?

A

Obesity is major contributor because it increases insulin resistance.
DM type 2- Positive family history and obesity

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