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NPTE > Other Systems > Flashcards

Other Systems Flashcards

1
Q

Metabolic Syndrome criteria

A

3 or more of:
1. Waist Circumference >40 (M) or >35 (F).
2. HDL <40 (M) or <50 (F).
3. Triglyceride >150.
4. SBP >130 and/or DBP >85.
5. Glucose >100.

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2
Q

The anterior & posterior Pituitary Glands are controlled by…

A

Hypothalamus

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3
Q

Anterior Pituitary secretes what hormones? (Just list them)

A
  1. ACTH
  2. TSH
  3. FSH & LH
  4. GH
  5. Prolactin
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4
Q

Posterior Pituitary secretes what hormones? (Just list them)

A
  1. ADH & Vasopressin
  2. Oxytocin
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5
Q

ACTH stimulates…

A

Adrenal cortex to secrete Cortisol & Aldosterone

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6
Q

TSH stimulates…

A

Thyroid to secrete T3 & T4

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7
Q

FSH & LH stimulate…

A

Ovaries/Testes to secrete Estrogen, Progesterone, Testosterone.

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8
Q

GH stimulates…

A

Bone/tissue growth & metabolism

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9
Q

Prolactin stimulates…

A

Breasts to produce milk

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10
Q

ADH & Vasopressin stimulate…

A

Kidneys to retain water & manage water/mineral balance.

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11
Q

Oxytocin stimulates…

A

Uterine contractions & breast milk ejection

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12
Q

Cortisol functions

A

Glucose production
Regulates BP
Decrease stress
Decrease inflammation

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13
Q

Aldosterone functions

A

Retains Na & water
Kicks out K

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14
Q

Addison’s Disease definition

A

Adrenal insufficiency (not enough cortisol & aldosterone).

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15
Q

Cushing’s Disease definition

A

Elevated cortisol & aldosterone.

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16
Q

Addison’s Disease is caused by…

A

Infections
Tumors
Autoimmune

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17
Q

Cushing’s Disease is caused by…

A

Pituitary tumor = increased ACTH production

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18
Q

Addison’s Disease symptoms

A

Decreased glucose
Decreased BP
Weight loss
Poor tolerance to cold & stress
Bronze skin tone
Generalized weakness

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19
Q

Cushing’s Disease symptoms

A

Increased glucose
Increased BP
Weight gain
Infections, poor wound healing
Red skin
Moon face
Proximal muscle weakness
Osteoporosis

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20
Q

How do adrenal conditions affect potassium levels?

A

Addisons = hyperkalemia
Cushings = hypokalemia

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21
Q

Difference between Cushing’s Syndrome & Cushing’s Disease

A

Syndrome = problem at the adrenal gland. Only cortisol is elevated.
Disease = problem at the pituitary gland. Both cortisol and ATCH elevated.
Symptoms are the same.

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22
Q

Examples of HYPER-Thyroid conditions

A

Grave’s
Exophthalmos

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23
Q

Examples of HYPO-thyroid conditions

A

Hashimoto’s
Myxedema

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24
Q

HYPER-Thyroidisim: hormone levels

A

High T3 & T4
Low TSH

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25
Q

HYPO-thyroidisim: hormone levels

A

Low T3 & T4
High TSH

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26
Q

HYPER-Thyroidisim: BMR

A

High

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27
Q

HYPO-thyroidisim: BMR

A

Low

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28
Q

HYPER-thyroidisim: HR & BP

A

HR high
BP low

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29
Q

HYPO-thyroidisim: HR & BP

A

HR low
BP high

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30
Q

HYPER-thyroidisim: glucose

A

Increased absorption
Lower blood glucose levels

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31
Q

HYPO-thyroidisim: glucose

A

Decreased absorption
Higher blood glucose levels

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32
Q

HYPER-thyroidisim: DTRs

A

Hyperreflexia

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33
Q

HYPO-thyroidisim: DTRs

A

Delayed/prolonged

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34
Q

HYPER-thyroidisim: symptoms

A

Diarrhea
Silky hair
Moist palms
Increased sweating
Restlessness, insomnia
Heat intolerance

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35
Q

HYPO-thyroidisim: symptoms

A

Constipation
Brittle, dry skin/hair
Decreased sweating
Proximal mm weakness
Cold intolerance

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36
Q

HYPER-thyroidism increases risk of…

A

Osteoporosis
Adhesive capsulitis

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37
Q

HYPO-thyroidism increases risk of…

A

Diabetes
Adhesive capsulitis

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38
Q

Parathyroid function

A

Calcium & phosphate metabolism

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39
Q

HYPER-Parathyroid Conditions: serum calcium & phosphate levels

A

Calcium high
Phosphate low

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40
Q

HYPO-Parathyroid Conditions: serum calcium & phosphate levels

A

Calcium low
Phosphate high

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41
Q

HYPER-Parathyroid Conditions: symptoms

A

Osteopenia, gout, arthralgia.
Kidney stones, renal insufficiency.
GI ulcers.
Fatigue, confusion.
Weakness.

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42
Q

HYPO-Parathyroid Conditions: symptoms

A

Convulsions.
Arrhythmias.
Mm twitching/tetany.
Mm spasms.

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43
Q

HYPER-Parathyroid Conditions: sensory changes

A

Glove & stocking loss

44
Q

HYPO-Parathyroid Conditions: sensory changes

A

Fingers & mouth paresthesias.

45
Q

Type 1 vs Type 2 Diabetes: definitions

A

Type 1: insulin dependent (pancreas does not PRODUCE insulin).
Type 2: insulin resistant (body does not RESPOND to insulin).

46
Q

Common symptoms of diabetes (both Type 1 and 2)

A

3 P’s: Polyphagia (hunger), Polydipsia (thirst), Polyuria.
Weight loss.
Blurred vision.
Dehydration.
Ketoacidosis (rare with Type 2).

47
Q

Diabetes diagnosis (lab values)

A

Fasting glucose >126
Random glucose >200
HbA1c elevated (normal = 4-6%).

48
Q

When is immediate insulin therapy indicated?

A

HbA1c >10%

49
Q

Hypoglycemia glucose level

A

<70

50
Q

Hyperglycemia glucose level

A

> 300

51
Q

Hypoglycemia sxs

A

Early: tachycardia, irritable, restless, excessive hunger, dizzy.
Late: slurred speech, confusion, loss of consciousness, coma.
Mnemonic = cold and clammy, give them a candy.

52
Q

Hyperglycemia sxs

A

Early: more exaggerated 3 P’s, deep rapid breathing, diminished reflexes.
Late: fruity odor breath, coma.
Mnemonic = hot & dry means sugar high.

53
Q

Exercise considerations w/ diabetes & insulin injections

A

-Avoid exercise during peak insulin hours (2-4hrs after dose).
-OK to exercise 1hr after dose or 5hrs after dose.
-Following exercise, next insulin dose should be decreased.
-Injections in abdomen or non-active extremity.

54
Q

Safest pre-exercise glucose levels

A

100-250

55
Q

Avoid exercise if pre-exercise glucose levels are…

A

<70 or >300

56
Q

What to do if pre-exercise glucose level is 70-99

A

Give 15g carb snack, re-check glucose after 10-15mins.
Continue to give snacks every 20mins.

57
Q

What to do if pre-exercise glucose level is 250-300

A

Exercise with caution, as long as not in ketoacidosis.
No exercise if ketoacidosis.

58
Q

Diabetes FITT

A

F: 3-7 days/wk.
I: Moderate, RPE 11-13 (progress to 17).
T: >150min/wk (progress to 300min/wk).
T: Aerobic & large mm groups.

59
Q

Diabetes foot care considerations

A

-Wash daily, but do NOT soak (bc risk of maceration).
-Soft sole shoes.
-Shoe shopping later in the day to ensure snug fit w/ swelling.

60
Q

Stress Incontinence: definition, causes, & treatment

A

Definition: leakage when stress on pelvic floor (cough, sneeze, exertion).
Cause: weak pelvic mm, typically d/t pregnancy.
Treat: pelvic floor strengthening.

61
Q

Urge Incontinence: definition, causes, & treatment

A

Definition: bladder contracts too much.
Cause: infections, PD, UMN lesion.
Treat: voiding schedule.

62
Q

Overflow Incontinence: definition, causes, & treatment

A

Definition: underactive bladder (not contracting enough). Bladder fills too much & does not completely empty.
Cause: diabetes, prostate enlargement.
Treat: behavioral modificiation (e.g., double voiding).

63
Q

Functional Incontinence: definition, causes, & treatment

A

Definition: unable to get to bathroom in time and/or can’t remember to go.
Cause: mobility, dexterity, or cognitive deficits.
Treat: clear clutter, improve access, prompted voiding (e.g., alarms).

64
Q

MSK changes with pregnancy

A

Weight gain 25-35lb.
Forward head, kyphosis, lordosis, anterior pelvic tilt (continues postpartum w/ lifting/carrying baby).
COM shifts upward & anterior.
Relaxin.

65
Q

Cardiopulmonary changes with pregnancy

A

Increased CO & blood volume.
Decreased BP in 1st & 2nd trimester.
Increased BP in 3rd trimester.
HRrest increases 10-20bpm.
Increased O2 consumption.

66
Q

Positioning concerns w/ pregnancy

A

NO SUPINE after 1st trimester - risk of Supine Hypotensive Syndrome (compression of IVC = decreased CO).
LEFT sidelying ideal - maximizes CO, limits IVC compression, decreases GERD.

67
Q

Gestational Diabetes definition

A

DM during pregnancy.
Same dx criteria as regular DM.
Resolves post-partum.

68
Q

Preeclampsia definition

A

Acute HTN during pregnancy in 3rd trimester (BP>140/90).
EMERGENCY.

69
Q

Eclampsia definition

A

Seizures after giving birth in patient with preeclampsia.
EMERGENCY.

70
Q

Sxs of preeclampsia

A

Increased protein in urine.
Hyperreflexia.
Headaches.
Sudden weight gain.
Edema.

71
Q

How is a preeclampsia diagnosis confirmed?

A

After first abnormal BP reading, must have a second reading 4hrs later.

72
Q

Key difference between preeclampsia & eclampsia

A

Eclampsia ALWAYS characterized by seizures.
Preeclampsia MAY have seizures.

73
Q

Pregnancy: contraindications to exercise

A

Medical History:
-Hemodynamically significant heart disease.
-Restrictive lung disease.
-Severe anemia.
-Uncontrolled Type 1 DM.

Pregnancy-Related:
-Incompetent cervix.
-Vaginal bleeding.
-Placenta previa.
-Preeclampsia.
-Premature labor (before 37wks).

74
Q

Diastasis Rectus: how to measure

A

Do a curl-up (clear the scapula).
Palpate the gap.
(+) if >2cm.

75
Q

Diastasis Rectus: treatment for 2-4cm

A

Stabilization & bracing.
Start w/ head lifts.
Progress to head lift + posterior pelvic tilts.

76
Q

Diastasis Rectus: treatment for >4cm

A

Abdominal bracing & breathing exercises ONLY.

77
Q

Diastasis Rectus: treatment for >6cm

A

Refer to MD

78
Q

Diastasis Rectus: key consideration with exercise

A

NO VALSALVA
Always exhale during ab contractions.

79
Q

GERD: definition

A

Gastric contents reflux up into esophagus.
Due to weak lower esophageal sphincter.

80
Q

GERD: symptoms

A

-Heartburn (especially 30min after eating & when lying supine).
-Dysphagia.
-Sour taste.
-Hoarseness.
-Head/neck P!

81
Q

GERD: how to differentiate from cardiac issue?

A

GERD pain relief with movement & exercise.
GERD pain worsened by lying down.
Cardiac symptoms would be opposite.

82
Q

GERD: treatment

A

-Maintain upright as much as possible.
-Sleep on L side.
-Eat 3-4hrs before sleep.
-Exercise 2-3hrs after eating.
-Avoid: spicy, fatty, peppermint, chocolate.

83
Q

Pancoast Tumor: definition & presentation

A

Upper lung tumor.
Mimics TOS: pain refers to C8-T2 distribution & top of ipsilateral shoulder.
Dyspnea.
Coughing.
Weight loss.
Night pain.

84
Q

Kehr’s Sign

A

Procedure: supine, raise leg.
(+) = pain with elevating leg.
Indicates blood in abdomen, typically spleen rupture.

85
Q

Hiatal Hernia: presentation

A

Diaphram weakness
L shoulder P!
Similar sxs to GERD

86
Q

Hiatal Hernia: considerations post-surgical repair

A

NO VALSALVA.
Avoid abdominal strengthening for 6-8wks.

87
Q

Femoral Hernia: pain location

A

Lateral pelvic wall
Groin

88
Q

Inguinal Hernia: pain location

A

Groin

89
Q

Umbilical Hernia: pain location

A

Mid-low abdomen

90
Q

Cholecystitis (gall stones) symptoms & test

A

Pain: RUQ & R scapula.
Agg: fatty foods.
Nausea, vomiting, fever.
Murphy’s Sign: palpate subcostal angle while pt takes deep breath. (+) = pain/tenderness during inspiration.

91
Q

Peptic Ulcers (gastric & duodenal) symptoms

A

R shoulder P!
Burning/cramping in epigastric region.
Coffee ground emesis.
Dark tarry stool.

92
Q

Gastric Peptic Ulcers: causes

A

-Chronic NSAID use.
-Stress/anxiety.
-H. Pylori.

93
Q

Aggs of Gastric vs. Duodenal Peptic Ulcers

A

Gastric: presence of food (after eating).
Duodenal: absence of food (in the morning, btwn meals).

94
Q

Duodenal Peptic Ulcers: causes

A

H. Pylori

95
Q

Treatment of Peptic Ulcers

A

Gastric: antacids
Duodenal: medical treatment of H. Pylori infection

96
Q

UC vs. Crohn’s: inflammation characteristics

A

UC: large intestine & rectum, continuous.
Crohn’s: anywhere in GI tract, discontinuous.

97
Q

UC vs. Crohn’s: pain location

A

UC: LLQ
Crohn’s: RLQ

98
Q

UC symptoms

A

-Bloody diarrhea
-Mucous/pus
-LBP
-Weight loss
-Fecal urgency

99
Q

Crohn’s symptoms

A

-Abdominal pain
-Weight loss
-Reactive arthritis
-Passing gas = pain relief

100
Q

Reactive Arthritis involves…

A

-Conjunctivitis
-Urethritis
-OA of LEs
Mnemonic: can’t see, can’t pee, can’t climb a tree

101
Q

IBS: definition, causes, & presentation

A

Definition: spastic, nervous, irritable colon.
Causes: stress/anxiety, high fat, lactose.
Pain: LLQ.
Ribbon-like stool.
Relief w/ defecation.

102
Q

Appendicitis presentation

A

RLQ pain
Nausea, fever
Elevated WBC

103
Q

Tests for Appendicitis

A

All (+) if pain in RLQ.
-McBurney’s Point: pain when palpating RLQ.
-Rosving’s Sign: pain in RLQ when palpating LLQ.
-Blumberg’s Sign: pain when pressure released.
-Psoas Sign: resisted R hip flex or passive ext.
-Obturator Sign: resisted R hip ER or passive IR.
-Hop Sign: hop on R leg.
-Markle’s Sign: stand on toes & drop suddenly.
-Pinch an Inch: pinch skin & release.

104
Q

Pinch an Inch Test

A

Pinch skin & release.
For appendicitis: RLQ.
For diverticulitis: LLQ.
(+) = pain.

105
Q

Signs of liver or pancreas issue

A

Dark colored urine
Clay colored stool

NPTE (8 decks)

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