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STATE EXAM PREP > part 2 > Flashcards

part 2 Flashcards

1
Q

What is multiple sclerosis?

A

Central nervous system demyelination

Demyelinated areas inflame and scarring develops

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2
Q

Cause of multiple sclerosis?

A

Genetics
Autoimmunity
Regional variation
More common in females 20-40 years

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3
Q

Signs of multiple sclerosis?

A

Loss of coordination
Tremor
Fatigue
Memory loss

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4
Q

Treatment for multiple sclerosis?

A

Treat symptoms
Reduce frequency of relapse
Prevent disability

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5
Q

What is the main extracellular cation?

A

Na

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6
Q

What does sodium do?

A

Regulates osmotic forces

Regulated acid-base balance

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7
Q

Where is sodium mainly excreted?

A

urine output

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8
Q

What is hyponatremia?

A

Deficiency in sodium in blood <135mmol/L

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9
Q

What is the cause of hyponatraemia?

A

Vomitting, diarrhoea, excessive sweating

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10
Q

What are 3 main things hyponatraemia causes?

A

Reduced extracellular circulating volume: hypotension, tachycardia, decreased urine output
Osmotic swelling of cells: muscle twitching, weakness
Altered neuronal function: nausea, vomitting, lethargy

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11
Q

What is hypernatremia?

A

Increased sodium in blood >145mmol/L. Water moves from intercellular fluid to extracellular fluid

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12
Q

Signs of hypernatraemia?

A

Thirst
Decreased LOC
hypertension or tachycardia
Oedema

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13
Q

What causes hypernatraemia?

A

Water loss or sodium gain

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14
Q

What is potassium and what does it do?

A

It is a major intercellular cation
It regulates intercellular electrical neutrality
It is maintained by the sodium potassium pump
It is essential for transmission and conduction of nerve impulses, cardiac rhythm, and skeletal smooth muscle contraction

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15
Q

What is hypokalaemia?

A

Potassium level of <3.5mmol/L

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16
Q

Cause of hypokalaemia?

A

Reduced intake of potassium

Increased output of potassium usual through GI tract or urine

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17
Q

Signs of hypokalaemia?

A

Skeletal muscle weakness and leg cramps
Cardiac arrhythmia
Nausea, anorexia, abdominal distension
Hypertension

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18
Q

What is hyperkalaemia?

A

Potassium level of >5mmol/L (rare)

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19
Q

Cause of hyperkalaemia?

A

Increased IV intake
Decreased renal excretion
Cell trauma

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20
Q

Signs of hyperkalaemia?

A

Mild: tingling of lips and fingers, restlessness, intestinal cramping and diarrhoea
Severe: muscle weakness, loss of muscle tone, flaccid paralysis, cardiac arrest

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21
Q

What is the function of the kidneys?

A

Regulates body fluid and composition
Eliminates metabolic waste
Synthesis, release, activates hormones such as erythropoietin: stimulates red bone marrow to produce RBC, renin, vitamin D
Regulates BP

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22
Q

What is a nephron?

A

It is the functional unit of the kidney that filters blood to make urine. There are 1 million per kidney

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23
Q

Components of the kidney?

A 
Glomerulus
Proximal tubule
Loops of henle
Distal tubule
Collecting duct
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24
Q

What are the consequences of altered renal function?

A

Blocking of urine flow
Dilation of structures proximal to obstruction
Injury to renal anatomy

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25
Q

Signs of altered urinary function?

A

Altered volume of excretion
Haematuria
Pain-dull: stretching if renal capsule sharp: relates to ureters or lower urinary tract
N+V

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26
Q

Diagnosis of altered renal function?

A

Hx + physical exam
Blood bichem analysis
Imaging studies

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27
Q

What are kidney stones (nephrolithiasis)?

A

Renal calculi in the renal system which are solid masses caused from filtrate

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28
Q

Cause of renal stones?

A

Urinary stasis
Dehydration
Elevated urinary levels of salt, protein, calcium

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29
Q

What is renal failure?

A

Sudden rapid decline in renal function, retention of metabolic waste, usually associated with neohrotoxicity or hypovolaemia

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30
Q

Cause of renal failure?

A

Prerenal (ischaemic)
Intrarenal (acute tubular necrosis)
Postrenal (obstructive)

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31
Q

What is chronic kidney disease?

A

Irreversible loss of renal function that affects nearly all organ systems

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32
Q

Causes of chronic kidney disease?

A

Diabetes
Smoking
Hypertension
CVD

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33
Q

Signs of chronic renal disease?

A

Increased bp
Increased serum urea
Increase creatinine
Anemia

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34
Q

What is haemodialysis?

A

Using special filters to remove waste that the kidneys can no longer do on their own mechanisms of diffusion, osmosis and ultrafiltration

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35
Q

What is pyelonphretitis?

A

Kidney infection

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36
Q

Cause of kidney infection?

A

When bacteria enters the urethra and travels up the bladder into the kidneys

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37
Q

What is cystitis?

A

infection of the bladder

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38
Q

Who is at risk for kidney infections?

A

Woman
Children
Pts with diabetes
Pts with kidney stones

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39
Q

Signs of a kidney infection?

A

Infection
Pain when urinating
Nausea
Lack of appetite

40
Q

Treatment for a kidney infection?

A

Fluids
Genital area clean
ABs
Pain relief

41
Q

What is insulin produced by?

A

Beta cells in the pancreas

42
Q

What is insulin?

A

Insulin is an anabolic hormone
It is required for the uptake of glucose by many cells: liver, muscle, adipose
It promotes protein synthesis and formation/storage for lipids
It facilitates transport of potassium, phosphate, and magnesium into cells

43
Q

When does insulin increase?

A

When blood glucose, amino acids, glucagon and gastric increase

44
Q

When does insulin decrease?

A

When there is low blood glucose, high insulin levels, alpha cell stimulation

45
Q

What is diabetes mellitus?

A

A disease in which the body does not produce or respond properly to insulin
type 1 or 2

46
Q

What is type 1 diabetes?

A

autoimmune- the body’s immune system destroys cells in the pancreas that produce insulin.

47
Q

What are the signs of type 1 diabetes?

A

Polydipsia
Polyuria
Polyphagia
Fatigue

48
Q

Diagnostic criteria for type 1 diabetes?

A

Hx + physical exam
Blood glucose levels:fasting and random
Gycosylated haemoglobin

49
Q

Treatment for type 1 diabetes?

A

Carbohydrates intake
Exercise
Insulin replacement therapy

50
Q

What is type 2 diabetes?

A

Insulin resistance and decrease mass of B cells

51
Q

Risk factors for type 2 diabetes

A 
Overweight
Unhealthy diet
Metabolic syndrom
Ethnicity
Family hx
52
Q

Signs of type 2 diabetes?

A 
Often symptomatic but
Visual changes
Nephropathy
Recurrent infection
Neuropathy
53
Q

Diagnostic criteria for type 2 diabetes?

A

Blood glucose level

Presence of long term complications

54
Q

Treatment for type 2 diabetes?

A

Weight control- exercise. healthy lifestyle

Oral glycaemic agents: metformin

55
Q

What are 3 acute complications of diabetes?

A 
Hypoglycaemia
Diabetes ketoacidosis (only in DM type 1)
Hyperglycaemia hyperosmolar nonketotic syndrome (HHNK, only in DM type 2)
56
Q

What are the sympathetic effects of hypoglycaemia?

A 
Neuroglycaemia
Hunger
Fatigue
Tachycardia
Increased BP
Palpitations
Tremor
Clammy skin
57
Q

What are the neurological effects of hypoglycaemia?

A 
Confusion
Slurred speech
Headache
Nightmares
Sleep disturbance
58
Q

What is diabetes insipidus?

A

Unrelated to DM type 1 and 2
A disorder of salt and water metabolism marked by intense thirst and heavy urination.
Caused by a lack of the anti diuretic hormone (ADH)

59
Q

Where is ADH (arginine vasopressin) made + what does it do?

A

Hypothalamus, released into blood from pituitary gland

Circulated the blood and produces concentrated urine from kidneys

60
Q

What occurs if your body does not produce enough ADH?

A

The kidneys produce large amounts of dilute urine and you become thirsty

61
Q

What is the cause of diabetes insipidus?

A

Almost any disease affecting the pituitary region of the brain eg
Pituitary tumors
Trauma

62
Q

What is a fluid deprivation test?

A

Blood and urine is monitored when pt is not drinking

ADH is then given to see if kidneys can respond to the hormone

63
Q

How is diabetes insipidus treated?

A

Synthetic form of ADH hormone is given called DDAVP (Minirin) by nostril spray
A tablet form of DDAVP is also available but is not as absorptive

64
Q

Is tuberculosis life threatening?

A

Yes. It can cause haemorrhage from the lungs, although rare

65
Q

How is tuberculosis spread?

A

Aerosolized droplets expelled during coughing by an individual with active disease

66
Q

What is latent tuberculosis?

A

Inactive tb infection in the body that can take many years to develop

67
Q

What are the symptoms of tb?

A 
Coughing for 3+ weeks often with thick phlegm
Tiredness
Night sweats
Weight loss
Swollen glands usually in neck
68
Q

How can tuberculosis be treated?

A 
Four antibiotics for 6 months and if not cured, another 2-3 months:
Isoniazid
Rifampin
Ethambutol
Purazinamide
69
Q

Who is NZ is able to have the fb vaccination? (BCG-Bacille Calmette-Guerin

A

Babies living in a country with higher rates of tb

Babies who may likely have contact with tb

70
Q

What is cancer and what does it do?

A

A disease of the bodies cells
Causes damage to genes that are involved in the process of replacing worn out or damaged cells
Damaged genes cause cells to behave abnormally and they may grown into a tumour at a rapid rate

71
Q

What do malignant tumours do?

A

They invade into surrounding tissue and form a secondary cancer or metastasis into another part of the body

72
Q

What is metastasis?

A

cancer cells leaving a tumor and invading other parts of the body

73
Q

How is cancer treated?

A 
Chemo
Surgery
Immunotherapy
Hormone treatment
Radiation
74
Q

What is rheumatic fever?

A

A disease that follows upper respiratory infection with Group A Beta haemolytic streptococci

75
Q

How does rheumatic fever start?

A

With Group A strep throat

76
Q

How to diagnose rheumatic fever?

A

Carditis
Arthritis
Chorea (jerky movements of the shoulders hips and face)
Subcut nodules (Firm, painless nodules that appear symmetrically over bony prominences)
Erythema marginatum (rash)
Fever
Arthralgia (pain in joints)

77
Q

How does rheumatic fever affect the brain?

A

Rheumatic chorea. Due to inflammation of the basal ganglia. The condition is reversible

78
Q

How does rheumatic fever effect the skin?

A

Subcutaneous nodules occurs over bony prominences and their structure is similar to Aschoff bodies

79
Q

How to manage rheumatic fever?

A 
Admission to hospital
Confirmation of diagnosis
Treat with AB's
Clinical follow up
Commence long term preventative measures
80
Q

What are the long term measures of rheumatic fever?

A

Give Bicillan every month to prevent reoccurrence until age 21

81
Q

What are the risks following having rheumatic fever?

A 
HF
AF
Pulmonary hypertension
Ineffective endocarditis
Stroke
Premature death
82
Q

What is angina?

A

chest pain due to reduced blood flow to the heart caused by Myocardial ischemia and atherosclerosis

83
Q

Common signs and symptoms of angina?

A

Heaviness and tightness in the chest

Discomfort in the back, shoulders, neck and jaw

84
Q

How does GTN work?

A

By quickly relaxing the blood vessels allowing blood to flow more freely to the heart

85
Q

Adverse effects of GTN?

A

Headaches
Flushing
Dizziness soon after use
Hypotension

86
Q

What other meds are used for angina other than GTN?

A

Long acting nitrates (ISMN)
Beta blockers
Calcium channel blockers

87
Q

What is COPD?

A

Chronic obstructive pulmonary disease. An umbrella term for the progressive diseases emphysema, chronic bronchitis, chronic asthma. In pts with COPD, the airway is permanently obstructed and the tissue inside the lungs is damaged making it hard to breath

88
Q

What occurs with emphysema?

A

The air sacs in the lungs are gradually destroyed so pts have difficulty absorbing enough 02

89
Q

What occurs with chronic bronchitis?

A

The airways become narrower and have increased mucus production and inflammation

90
Q

Symptoms of COPD?

A

Coughing
Increased phlegm
Breathlessnes

91
Q

What is the main cause for COPD?

A

smoking

92
Q

What is strep throat caused by?

A

Streptococcal bacteria- commonly from the cold and flu virus

93
Q

What are the signs of strep throat?

A

Chills
Fever
Swollen lymph nodes in neck

94
Q

How can strep throat be treated?

A

Antibiotics such as penicillin or amoxicillin

95
Q

If left untreated, what can strep throat cause?

A

Rheumatic fever and kidney complications

96
Q

Is strep throat contagious?

A

Yes it is spread by close contact with an infected person usually by inhaling airborne droplets from an infected person

STATE EXAM PREP (4 decks)

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