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Pathopharm > Patho Exam 2 > Flashcards

Patho Exam 2 Flashcards

1
Q

Opening at the center of the iris

A

pupil

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2
Q

In order to see the pupil constricts and dilates to allow the appropriate amount of light into the
_____

A

retina

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3
Q

Forms the optic nerve, composed primarily of neurons

A

retina

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4
Q

Converts images the brain can understand as vision

A

retina

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5
Q

Innermost layer of the eye. Sensory portion of the eye that changes light waves into neuro- impulses that travel to the brain for interpretation

A

retina

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6
Q

normally yellow circular clearly defined borders

A

optic disk

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7
Q

responsible for central vision

A

macula

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8
Q

central region of the macula responsible for sharp vision

A

fovea

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9
Q

can optic nerve regenerate?

A

no, you will lose vision

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10
Q

Adaptation of the eye for near vision

A

accommodation

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11
Q

A reflex direction of the eye toward an object attracting a person’s attention

A

fixation

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12
Q

condition where pupil accommodates but does not react to light.

A

Argyll Robertson Pupil

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13
Q

Visual field loss secondary to optic nerve damage

A

glaucoma

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14
Q

Leading cause of preventable blindness in the United States

A

glaucoma

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15
Q

Dilates the pupil with _____

A

myDratics

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16
Q

2 types of glaucomas

A

Primary open-angle glaucoma (POAG)
Acute angle-closure glaucoma

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17
Q

Significant structural changes occur in glaucoma involve

A

ciliary muscle, trabecular meshwork, and canal of schlemn.

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18
Q

Contraction of ciliary muscle allows drainage of _____ fluid through the canal of schlemn

A

aqueous

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19
Q

Relaxation of ciliary muscle causes obstruction of the ____

A

canal

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20
Q

________ attached to the trabecular meshwork, allows free flow of aqueous humor between the anterior and posterior chambers of eye

A

The ciliary muscle

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21
Q

Produced in ciliary body

A

Aqueous Humor

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22
Q

regulates IOP

A

canal of Schlemn

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23
Q

Ciliary muscles controlled by the ___

A

ANS

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24
Q

________ stimulation causes the ciliary muscle to relax (enlarge) which can block the
drainage

A

Sympathetic

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25
Q

________ stimulation causes ciliary muscle to contract which allows drainage

A

parasympathetic

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26
Q

If outflow from the anterior chamber is impeded, back pressure will develop and
increase ____ ____ ____

A

Inter ocular pressure (IOP)

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27
Q

Most common form of glaucoma in the United States

A

primary open-angle glaucoma

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28
Q

Devoid of symptoms until significant and irreversible optic nerve injury has occurred
typically has gradual loss of peripheral vision

A

primary open-angle glaucoma

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29
Q

Progressive optic nerve damage, with eventual impairment of vision IOP increases as there is a
slow exit through the trabecular meshwork

A

primary open-angle glaucoma

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30
Q

Primary Open-Angle Glaucoma risk factors

A

Elevation of intraocular pressure (IOP)
Family history of POAG
Advancing age
African and South American ancestry

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31
Q

treatment of primary open-angle glaucoma

A

Directed at reducing elevated IOP (the only
modifiable risk factor)
Principal method: Chronic therapy with drugs

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32
Q

Drugs lower IOP by Facilitating ____ ____outflow, and reducing its production

A

aqueous humor

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33
Q

If drugs are ineffective for glaucoma treatment , surgical intervention is needed to promote outflow of _____

A

aqueous humor

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34
Q

Cholinergic agents

A

Acetylcholine (Miochol)
Echothiophate (phospholine iodide)

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35
Q

Beta-adrenergic blocking agents

A

Timolol (Timoptic)

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36
Q

Mimic parasympathetic action of acetylcholine

A

Cholinergic/MIoTICS

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37
Q

Block sympathetic nerve endings in the ciliary epithelium causing a decrease in aqueous humor production

A

beta blockers

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38
Q

pharmacologic form of naturally occurring neurotransmitter
acetylcholine – constricting pupil

A

direct acting MOA (parasympathomimetics, miotics)

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39
Q

onset, peak, duration of direct acting -Acetylcholine

A

onset and peak- insant
Duration- 10 mins

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40
Q

Another direct-acting commonly used MIOTIC is called
_____ – a derivative of acetylcholine

A

pilocarpine

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41
Q

inhibits cholinesterase enzymes which then allows for the pupils to constrict because acetylcholine is not broken down

A

indirect MOA of echothiophate

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42
Q

onset, peak, duration of indirect acting- Echothiophate

A

onset: 10-30 mins
peak: 24 hours
duration: 7-28 days

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43
Q

for cholinergic drugs, If sufficient amounts enter the bloodstream, _____ effect may occur (most likely with indirect-acting)

A

systemic

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44
Q

adverse effects of cholinergic drugs:

A

Hypotension
Bradycardia
Headache
Nausea/vomiting
Diarrhea/ abdominal cramps
Asthma attacks

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45
Q
  1. increase aqueous outflow
  2. reduces aqueous humor formation thereby
    decreases risk of damage to optic nerve
A

Timolol Maleate (timoptic) MOA

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46
Q

onset, peak, duration of Timolol Maleate (timoptic)

A

onset: 15-30 mins
peak: 1-2 hours
duration: 24 hours

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47
Q

side effects of Timolol Maleate (timoptic)

A

arrhythmia, bradycardia, heart block,
bronchospasm in asthmatic patient

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48
Q

Beta-Adrenergic Blocking Agents local adverse effects are usually _____

A

minimal

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49
Q

Beta-Adrenergic Blocking Agents systemic adverse effects:

A

Heart and lungs if absorbed in sufficient amounts (bradycardia, bronchospasm)

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50
Q

timolol Has drug-drug interaction especially with other _____ drugs

A

cardiac

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51
Q

timolol: Apply light pressure on lacrimal sac for how long after instilling drug to
minimize systemic absorption

A

1 minute

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52
Q

When applying eye drops, have the patient look up to the ceiling, and place the drop in the _______ ___

A

conjunctival sac

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53
Q

also known as narrow-angle glaucoma

A

angle-closure glaucoma

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54
Q

-Develops suddenly and is extremely painful
-No treatment— irreversible loss of vision in 1
to 2 days

A

angle-closure glaucoma

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55
Q

uses of mydriatics

A

Adjunct to measurement of refraction
Intraocular examination
Intraocular surgery

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56
Q

adverse effects of mydriatics

A

Blurred vision and photophobia
Precipitation of angle-closure glaucoma
Systemic effects

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57
Q

A patient is admitted to the hospital for treatment of symptomatic bradycardia and atrioventricular (AV) heart block. What topical medication for the eye should the nurse withhold and discuss with the healthcare provider before administration?

A

timolol (will slow heart down even more)

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58
Q

middle ear Auditory Ossicles:

A

malleus, incus, stapes

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59
Q

Bridge for sound to the inner ear.

A

middle ear

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60
Q

Conducts sound vibrations from outer ear to central hearing apparatus in the _____ ___

A

middle ear

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61
Q

Protects the inner ear by reducing amplitude of loud sounds.

A

middle ear

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62
Q

______ __ allows equalization of pressure on either side of TM so it doesn’t rupture.

A

Eustachian tube

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63
Q

directs sound waves from the auricle to the tymphanic membrane; coated in cerumen (hydrophobic) repels water protects against Fungus/bacteria

A

external ear

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64
Q

bounded by tympanic membrane

A

middle ear

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65
Q

parts of middle ear that transmits sound

A

Malleus, incus, stapes

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66
Q

parts of external ear

A

Auricle or pinna

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67
Q

inner ear that provides balance houses the apparatus for hearing

A

Semicircular canals, cochlea

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68
Q

this connects the middle ear with the nasopharynx and allows passage of air

A

eustachian tube

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69
Q

Normally closed opens with yawning and swallowing.

A

eustachian tube

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70
Q

Sound transmission to the inner ear impaired
(altered sound transmission through outer and middle ear due to obstruction or trauma)

A

conductive hearing loss

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71
Q

Results in ability to hear sound but inability to understand speech, can lead to misunderstanding by others, Hearing aids make sounds louder but not clearer

A

sensorineural hearing loss

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72
Q

Perception of noise without an actual source of sound, ringing of ears

A

Tinnitus

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73
Q

Age-related hearing loss

A

presbycusis

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74
Q

More than ___ drugs cause tinnitus, usually caused by ____

A

200, noise

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75
Q

Determine if a patient can hear a whispered sentence or a series of numbers when whispered from a
distance of 1-2 feet (covering tragus)

A

whisper test

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76
Q

A sticky liquid secreted by glands in the skin of the ear canal.
protects your ears by trapping outside materials such as dirt particles, dust and bacteria.

A

cerumen

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77
Q

Carbamide Peroxide Otic Solution/Debrox

A

Ear wax emulsifier, For use in ear only, class: peroxide, soften, loosens and removes cerumen

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78
Q

Contraindications for debrox

A

-ear drainage
-Tympanic membrane rupture (new/unhealed)
-Significant pain or irritation

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79
Q

t/f: •Hearing loss caused by noise is not reversible

A

true

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80
Q

Avoidance of continued exposure to noise levels greater than __ dB is essential

A

70

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81
Q

Salicylates, loop diuretics, cancer chemotherapy drugs, antibiotics

A

ototoxic substances- drugs

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82
Q

Toluene, carbon disulfide, mercury

A

ototoxic substances- industrial chemicals

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83
Q

ABX =

A

antibiotics

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84
Q

DM =

A

diabetes mellitus

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85
Q

Tx =

A

treatment

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86
Q

BM =

A

bone marrow

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87
Q

_____ _____ must be functioning properly to defend against pathogens/foreign substances

A

immune system

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88
Q

immune response functions:

A

defense, homeostasis, surveillance

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89
Q

substance that elicits immune response

A

antigen (on pathogen)

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90
Q

bodys ability to resist disease

A

immunity

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91
Q

type of immunity that is present at birth, nonspecific response, and first line defense against pathogens

A

innate

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92
Q

type of immunity that is cell mediated and humoral

A

acquired/adaptive

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93
Q

immunity that does not produce antibodies, cell destruction through T lymphocytes, destroys pathogens inside cell

A

cell mediated immunity

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94
Q

immunity that produces antigen-specific antibodies, destroys cells through B cells, destroys pathogens outside cell

A

humoral immunity

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95
Q

_____ activates the immune system but doesn’t always indicate infection

A

inflammation

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96
Q

when defense system fails and pathogen takes over

A

infections

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97
Q

t/f: inflammation is always present with infection; infection is not always present with inflammation

A

true

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98
Q

_______ response is a sequential reaction to cell injury and removes necrotic material; neutralizes and dilates inflammatory agent

A

inflammatory

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99
Q

t/f: inflammation mechanism is the same no matter what the cause

A

true

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100
Q

3 phases of inflammation:

A

vascular response
cellular response
formation of exudate

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101
Q

response that occurs after injury causing arterioles to vasoconstrict, releasing chemicals and histamine to dilate vessels

A

vascular response

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102
Q

during vascular response, _____ mediators cause increased capillary permeability

A

chemical

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103
Q

symptoms of vascular response

A

redness, heat, swelling

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104
Q

plasma protein

A

fibrinogen

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105
Q

accumulation of WBC’s, movement of neutrophis and monocytes move to site of injury during what response

A

cellular

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106
Q

local symptoms of inflammation

A

redness, heat, pain, swelling, fn loss

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107
Q

systemic symptoms of inflammation

A

leukocytosis, malaise, nausea/anorexia, fever, increased HR and RR

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108
Q

body reacts to fever by increase of what?

A

heat production and conservation

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109
Q

bodys method of increasing temp to new set point

A

shivering

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110
Q

body reaches new set point =

A

chills decrease

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111
Q

Released cytokines & fever they triggered =

A

activation of defense mechanisms

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112
Q

fevers are beneficial because they kill _________, increase phagocytosis of ________, and proliferation of __ _______

A

microorganisms, neutrophils, T cells

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113
Q

healing process 2-3 weeks, no residual damages, predominately neutrophils

A

acute inflammation

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114
Q

same as acute process but lasts longer (weeks to months)

A

subacute inflammation

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115
Q

lasts weeks, months, or years, agent repeatedly injures tissues, lymphocytes and macrophages

A

chronic inflammation

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116
Q

hormones secreted by adrenal cortex, available as exogenous drugs

A

corticosteroids

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117
Q

inhibition of inflammatory and immune responses; increases BG level and breakdown of proteins to amino acids, stimulate
bone demineralization & stabilize mast cells

A

corticosteroids MOA

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118
Q

Prednisone is a _______

A

glucocorticosteroid

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119
Q

glucocorticosteroid; anti-inflammatory or immunosuppressant, avoided in presence of serious infection, can be secreted in breast milk

A

prednisone

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120
Q

contraindications of prednisone

A

allergy, serious infections, DM

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121
Q

When give steroids –> causes the endogenous production of hormones
to stop, starts stimulating normal production of endogenous hormones

A

taper dosing

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122
Q

drug that influences every body system

A

prednisone

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123
Q

prednisone adverse effects:

A

moon face, hyperglycemia, psychosis, adrenal suppression, insomnia, nervousness, impaired wound healing

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124
Q

Prednisone: monitor/ caution patient with

A

DM, gastritis, reflux disease, ulcer disease, cardiac/renal/liver disease

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125
Q

one celled organisms, normal flora; cocci, bacillia or spirochetes

A

bacteria

126
Q

gram positive stain ______

A

purple

127
Q

gram negative stain ____

A

red

128
Q

microorganism that causes disease

A

pathogen

129
Q

pathogen invades body, multiplies and produces disease, triggers inflammation and immune responses

A

infection

130
Q

assists body to combat infection, most effective if combined with functional defense mechanisms

A

antibiotics

131
Q

bacteria are present but not with over signs/symptoms, presence of bacteria on body surface without causing disease

A

colonization

132
Q

does colonization require ABX?

A

no

133
Q

infection acquired by person who has not been hospitalized or had a recent procedure

A

community-associated infection

134
Q

AKA nosocomial infection, acquired while getting healthcare tx or in hospital

A

healthcare associated infection

135
Q

therapy where patient requires immediate ABX

A

empiric therapy

136
Q

therapy where lab identifies microorganism, narrow spectrum use

A

definitive therapy

137
Q

ABX to prevent an infection in situations with high contamination, prior to surgery (30 mins)

A

prophylactic/preventative ABX

138
Q

certain bacteria and fungi that maintain normal fn in organs

A

normal flora

139
Q

when normal flora is killed,

A

bacteria/fungi take over

140
Q

inference with bacterial cell wall and protein synthesis and replication of DNA/RNA

A

ABX MOA

141
Q

do not actually destroy bacteria, inhibits growth of bacteria

A

bacteriostatic

142
Q

kill a wide variety of gram pos and some neg bacteria

A

bactericidal

143
Q

bacterial infections no longer response to typical ABX treatment

A

bacterial resistant infections

144
Q

ABX that contain beta lactam ring in chemical structure, provides mechanism for bacterial resistance

A

Beta lactam ABX

145
Q

which ABX was first derived from mold on bread/fruit, bactericidal

A

penicillins

146
Q

bind to protein, inhibit peptidoglycan, interferes with cell wall synthesis

A

PCN MOA

147
Q

contraindications of penicillin

A

drug allergy, cephalosporins

148
Q

semisynthetic ABX, related to PCN

A

cephalosporins

149
Q

cephalosporins adverse effects

A

GI and skin, PCN

150
Q

inhibit protein synthesis, effective against wide range infections, compete with drugs metabolized in liver

A

erythromycin

151
Q

irritates GI tract, stimulates smooth muscle and GI motility, beneficial to patients with delayed gastric emptying

A

erythromycin

152
Q

adverse effects of erythromycin

A

-nausea, vomiting, stomach irritation
-cardiac and liver issues
-tinnitus/hearing loss

153
Q

inhibits bacterial protein synthesis, binds to magnesium, calcium, metallic ions. forms insoluble complexes

A

tetracycline (doxycycline)

154
Q

tetracycline adverse effects

A

teeth discoloration, effects on fetal development, photosensitivity, upset stomach

155
Q

non prescription neosporin

A

neomycin and polymyxin B

156
Q

hypersensitivity reactions to ABX can occur __ mins or up to days later

A

30 (delayed responses can occur after 72 hrs)

157
Q

ADL=

A

activity of daily living

158
Q

TIA=

A

transient ischemic attack

159
Q

what is the 5th most common death in the US

A

CVA

160
Q

2 types of CVA’s

A

-Ischemic
-Hemorrhagic

161
Q

Cerebral blood vessels change ________ in response to BP

A

diameter

162
Q

During ______ CVA, –> autoregulation
may be impaired

A

ischemic

163
Q

our cerebral blood vessels can make changed based on BF

A

Cerebral autoregulation

164
Q

non-modifiable risk factors of CVA

A

gender, age, ethnicity, family history

165
Q

some modifiable risk factors of CVA

A

htn, heart disease, diabetes, SMOKING (90%), obesity, sleep apnea, diet, substance abuse

166
Q

mini stroke with brief episode of neurologic dysfunction, without infarction

A

transient ischemic attack

167
Q

how long does a TIA last

A

<1 hour

168
Q

which stoke involves a microemboli/temporary clot that temporarily blocks BF

A

TIA

169
Q

__ % of strokes are ischemic

A

87%

170
Q

Inadequate blood flow to the brain with blockage of a
cerebral artery by a blood clot

A

ischemic stroke

171
Q

2 types of ischemic strokes

A

thrombotic, embolic

172
Q

most common ischemic stroke, often preceded by TIA, narrowed vessel becomes occluded

A

thrombotic

173
Q

thrombotic and embolic strokes result in _____

A

infarction

174
Q

Embolus lodges & occludes cerebral artery, Most start as plaque, break off & enter circulation, travels to cerebral circulation & lodges in narrow vessel

A

embolic stroke

175
Q

Common causes of embolic stroke

A

Atrial fibrillation, MI, infective, endocarditis, rheumatic heart disease

176
Q

less common for embolic stroke:

A

air and fat emboli (long bone fractures)

177
Q

ischemic stroke that develops suddenly with no warning signs and develops suddenly, conscious with headache

A

embolic stroke

178
Q

Weakened blood vessels rupture and bleeding into the brain/ brain tissue (intracerebral), cells begin to die

A

Hemorrhagic stroke

179
Q

Bleeding into the subarachnoid space or ventricles

A

Hemorrhagic stroke

180
Q

Cause of hemorrhagic stroke where Bulge/ballooning in
blood vessel d/t weakness in the blood vessel wall; can leak and rupture

A

aneurysm

181
Q

Abnormal tangle of blood vessels, connection of arteries and veins, Disrupt normal blood flow and oxygen, can weaken and rupture and lead to hemorrhage

A

Arteriovenous Malformation
(AVM)

182
Q

One side of the brain controls the ______ side of the body

A

opposite

183
Q

Lesion on one side of brain –> affects motor function on opposite side of body =

A

contralateral

184
Q

unable to comprehend what is being said

A

receptive aphasia

185
Q

inability to produce language

A

expressive aphasia

186
Q

inability to communicate

A

global aphasia

187
Q

loss of half of your vision

A

hemianopia

188
Q

Right half or left half of your vision is missing from each eye, Monitor for diplopia, ptosis, loss of corneal reflex

A

Homonymous Hemianopsia

189
Q

during ischemic stroke, In 1 second=
_______ brain cells die

A

32,000

190
Q

during ischemic stroke, In 59 seconds=____ million brain cells die

A

1.9 million

191
Q

door to needle time=

A

< or equal to 60 mins

192
Q

stroke treatment is a multi- ? approach, or supportive therapy

A

drug

193
Q

acute care of ischemic stroke

A

stroke center, treat htn, glycemic control
SBP > 220
DBP > 120

194
Q

golden hour –>

A

CT upon arrival, blood glucose, NIHSS, fibrinolytic therapy, surgical intervention, 12 lead EKG and labs

195
Q

breaks up clots causing stroke

A

fibrinolytic therapy

196
Q

acute care of hemorrhagic stroke

A

antihypertensives, NO anticoagulants or platelet inhibitors, drug therapy, seizure precautions

197
Q

Any process that stops bleeding

A

hemostasis

198
Q

compression at bleeding site

A

mechanical hemostasis

199
Q

clamping or cauterization

A

surgical hemostasis

200
Q

When hemostasis occurs d/t to physiologic clotting of
blood =

A

coagulation

201
Q

Process of Hemostasis

A

initial injury, vasospasm, platelet plug formation, coagulation

202
Q

platelet plug formation in order:

A

adhesion, activation, aggregation, formation

203
Q

tear in blood vessel, endothelium exposed

A

hemostasis injury

204
Q

blood clot

A

thrombus

205
Q

thrombus that moves

A

embolus

206
Q

Hemostasis involves complex interaction of substances that promote ____ ______

A

clot formation

207
Q

each activated clotting factor is a catalyst that amplifies next reaction

A

coagulation CASCADE

208
Q

Result of cascade =

A

large clot forming substance FIBRIN

209
Q

when platelet plug is not enough, use

A

coagulation cascade

210
Q

Blood vessels are damaged by penetration from the outside, thromboplastin released

A

extrinsic pathway

211
Q

examples of extrinsic pathway

A

knife, bullet wound

212
Q

Clotting response to trauma/internal damage inside the blood vessels of body

A

intrinsic pathway

213
Q

Components are present in the blood in inactive forms

A

intrinsic pathway

214
Q

Activated when clotting factors come in contact with collage on inside of damaged blood vessels

A

intrinsic pathway

215
Q

most powerful enzyme in coagulation process

A

thrombin

216
Q

Factor Xa: Prothrombin -> thrombin ->
fibrinogen -> firbin. final product of coagulation:

A

meshwork (stable clot)

217
Q

regardless of how clot began, ______ follows the same final common pathway

A

coagulation

218
Q

the end of coagulation: converts fibrinogen to ____

A

fibrin

219
Q

potent stimulator of platelet adhesion

A

collagen

220
Q

antagonizes thrombin

A

antithrombin

221
Q

thrombin activates conversion of plasminogen
to _____

A

plasmin

222
Q

without thrombin, no ____

A

clot

223
Q

reverse of clotting process

A

fibrinolysis

224
Q

Breakdown of clots & balances clotting
process

A

fibrinolytic system

225
Q

fibrinolytic system starts with activation of ________, then fibrin binds to it

A

plasminogen

226
Q

enzymatic protein that breaks down thrombus

A

plasmin

227
Q

Drugs that affect coagulation, dangerous and preventative, Used to reverse or maintain hemostasis

A

anticoagulants

228
Q

do anticoagulants work on existing clots?

A

no

229
Q

Anticoagulants: Contraindications

A

drug allergy, high risk for bleeding/ active bleeding

230
Q

drug that Turns off 3 major clotting factors

A

heparin

231
Q

Turns off coagulation pathway, Prevents clots from forming, CANNOT lyse clot

A

heparin

232
Q

where do we get heparin from?

A

lungs or intestinal mucosa of pig

233
Q

t/f: heparin is weight based

A

true

234
Q

Large molecule only given IV, low molecular heparin just into really small molecules

A

unfractionated heparin

235
Q

small structure, easier to target specific, more predictable outcome, injectable only

A

LMWH

236
Q

DVT Prophylaxis –>

A

subq

237
Q

Inhibits vitamin K synthesis, inhibits production of certain clotting factors

A

warfarin

238
Q

Foods high in Vitamin K may ↓
______ ability to prevent clots

A

warfarin’s

239
Q

toxic effect of anticoagulants

A

hemorrhagic

240
Q

S/S of anticoag toxicity:

A

hematuria, melena, petechia, ecchymoses,
gum/mucus membrane bleeding

241
Q

warfarin is synthesized in

A

liver

242
Q

May take liver __ hours to resynthesize clotting
factors to reverse warfarin

A

36

243
Q

heparin antidote

A

protamine sulfate

244
Q

main anticoag AE

A

bleeding!

245
Q

warfarin Antidote

A

vitamin K

246
Q

Measure blood clotting time, if number is HIGHER, blood clot takes ______, if number is LOWER, ____

A

longer, quicker

247
Q

Prevent clot formation, Prevent platelet adhesion at the site of blood vessel injury, Occurs before clotting cascade

A

antiplatelets

248
Q

Collagen is stimulator of

A

platelet adhesion

249
Q

After adhesion –>

A

stimulators from activated plts are released

250
Q

stimulators tell platelets to _____, causing platelets to adhere

A

aggregate

251
Q

Affect cyclooxygenase pathways, Final enzymatic pathway that operates within platelets & on cell
walls

A

final platelets

252
Q

Inhibits cyclooxygenase in platelet, Inhibits enzyme so can’t regenerate –> prevents formation of thromboxane A2 (TXA2), TXA2 causes blood vessels to constrict & platelets to aggregate

A

aspirin

253
Q

_____ Result = vessels dilate, prevent platelets from
aggregating and form a clot

A

aspirin

254
Q

contraindications of aspirin:

A

thrombocytopenia, active
bleeding & allergy

255
Q

fibrinogen attaches to receptors on platelet, Platelet will be able to aggregate now since it received the signal, inhibits activation of this receptor, Platelet does not
receive signal to clot

A

Clopidogrel
(Plavix)

256
Q

Reduce risk of thrombotic stroke, TIA
prophylaxis, prevention of thrombosis

A

clopidrogel

257
Q

KAVA is a sedative and ______

A

anxiolytic (acute liver failure)

258
Q

St.John’s wort­ (natures prozac)

A

makes birth control uneffective

259
Q

acute onset, reversible, minutes to hours
-Systemic syndrome characterized by decreased attention span (inattention), doesn’t recognize confused thinking

A

delerium

260
Q

symptoms of delerium

A

hyperactive, with agitation, combative, hallucination, delusional, OR hypoactive, with inability to focus
or concentrate

261
Q

emotional problems of delerium

A

fear, depression, euphoria, perplexity

262
Q

Up to ___% of older adults hospitalized for medical conditions have delirium at some point in hospitalization

A

60%

263
Q

Most common surgical complication among older adults, 15-25% after major elective surgery, 50% after high-risk procedures

A

delerium

264
Q

Disorder characterized by a decline from previous level of
function in 1 or more cognitive domains:
Attention
Executive function
Language
Learning
Memory
Social cognition

A

dementia

265
Q

devastating, progressive memory loss, impaired thinking, Neuropsychiatric symptoms, Inability to perform routine tasks of daily living

A

Alzheimers disease

266
Q

Sixth leading cause of death in the United
States

A

Alzheimers disease

267
Q

degeneration of neurons, early in hippocampus (memory), later in cerebral cortex (speech, perception, reasoning)

A

Alzheimers (pathopshysiology)

268
Q

Degeneration of cholinergic neurons & deficiency of acetylcholine, Beta amyloid plaques form outside neurons and in the cerebral cortex, Presence of neurofibrillary tangles with twists inside of the neurons

A

Alzheimers

269
Q

what gender is a risk factor for alzheimers

A

female

270
Q

sundowning is common with what disease

A

Alzheimers

271
Q

although the treatment of AD is to reverse cognitive decline, and there are no to do so, 3 cholinergic inhibitors approved for the treatment of Alzheimer’s dementia are:

A

Donepezil, galantamine, and rivastigmine

272
Q

what happens if we lose acetocholyine in our brain

A

lose cognitive function

273
Q

AD patients lose __% of their aceticholyine

A

90%

274
Q

Acetylcholinesterase Inhibitors, AD drug
-Therapeutic Use: improves memory w/ mild to moderate AD by enhancing effects of acetylcholine in neurons in cerebral cortex not yet damaged – does not reverse disease

A

donepezil (aricept)

275
Q

cholinergic toxicity (donepezil) symptoms: leads to dumbells

A

Circulatory collapse, Hypotension,
- SLUDGE – Salivation, Lacrimation, Urination,
Diarrhea, GI distress, Emesis

276
Q

DUMBELLS (cholinergic toxicity) stands for:

A

diarrhea, urination, miosis, bradychardia, emesis, lacrimation, lethargy, salivation

277
Q

Largest category of psychiatric problems, second only to HTN as chronic clinical condition

A

depression

278
Q

__% of the U.S. population will experience
some form during their lifetime

A

30

279
Q

Incidence of depression is twice as high in which gender?

A

twice as high in women than men

280
Q

to get diagnosed with depression, symptoms must be present

A

most of the day, nearly every day, for at least 2 weeks

281
Q

Insufficient amount of brain neurotransmitters such as Norepinephrine, Serotonin or Dopamine
- Decreased Serotonin permits it to occur
- Decreased Norepinephrine causes it

A

depression

282
Q

Biochemically derived from Tryptophan, Primarily in the GI tract (90%) with remainder in the CNS serotonergic
neurons (parasympathetic cholinergic
receptors)

A

serotonin

283
Q

Primarily used to relieve symptoms of
depression, Can also help patients with anxiety disorders

A

antidepressants

284
Q

Most commonly prescribed antidepressants

A

selective serotonin reuptake inhibitors

285
Q

Most widely prescribed SSRI in the world, primarily for major depressions, Produce selective inhibition of serotonin reuptake, Produce central nervous system (CNS) excitation

A

fluoxetine (prozac)

286
Q

adverse effects of SSRI

A

-Withdrawal syndrome
-Neonatal effects when used during pregnancy
-Extrapyramidal side effects
- Bleeding disorders
- Sexual dysfunction
-Weight gain

287
Q

Begins 2 to 72 hours after treatment, Altered mental status, resolves spontaneously after
discontinuing the drug

A

serotonin syndrome

288
Q

Toxicity – Serotonin Syndrome

A

SHIVERS:
shivering
hyperreflexia and myoclonus
increased temp
vital sign instability
encephalopathy
restlessness
sweating

289
Q

conditions that affect a
person’s thinking, feeling, mood,
or behavior

A

mental illness

290
Q

examples of mental illness

A

Depression, anxiety, bipolar
disorder, schizophrenia, etc

291
Q

More than __%, 1 in ___ will be
diagnosed with a
mental illness/disorder
at some point.

A

50%, 1 in 5

292
Q

Amino acid neurotransmitter in brain

A

Gamma-Aminobutyric Acid (GABA)

293
Q

Excitatory neurotransmitter, excessive amount = restlessness, nervous tension, anxiety

A

Glutamate

294
Q

GABA is ____ while glutamate is ____

A

inhibitory, excitatory

295
Q

GABA= promotes sense of ___

A

calm

296
Q

Unpleasant state of mind; sense of dread and fear (anticipated or past experiences)

A

anxiety

297
Q

drugs with Goal to decrease anxiety by reducing
overactivity in the CNS

A

anxiolytic drugs

298
Q

Benzodiazepine receptor blocker, reverse effects of benzos, may cause withdrawal symptoms or seizures

A

flumazenil

299
Q

State in which person lacks conscious awareness

A

sleep

300
Q

wakes up or almost wakes up; interrupting continuous sleep

A

fragmented

301
Q

sleeps recommended amount; does not feel refreshed and alert the next day

A

nonrestorative

302
Q

Brain controls changes between sleep & waking, Forebrain & brainstem interact to regulate this

A

sleep wake cycle

303
Q

Maintained by network of arousal systems from brainstem & forebrain, promoted by neurotransmitters

A

wake behavior

304
Q

In hypothalamus –> sleep promoting neurons

A

sleep behavior

305
Q

sleep is stimulated by neurotransmitters and _______

A

peptides

306
Q

Hormone made by pineal gland, Release signals the time for sleep, Secretion is linked to the environmental light/dark cycle

A

melatonin

307
Q

Synchronizes genetic clocks within individualized cells, master clock of body, in hypothalamus, regulates 24h sleep wake cycle

A

superchiasmatic nucleus (SCN)

308
Q

Biologic rhythm pattern in 24 hours, Synchronized to environmental light & day periods, Through specific light detectors in retina

A

circadian rhythms

309
Q

Pattern of nighttime sleep, Recorded using brain waves, eye movement, & muscle tone: NREM and REM

A

sleep architecture

310
Q

difficulty falling and staying asleep, waking too early and feeling unrefreshed, dissatisfaction with sleep quality

A

insomnia

Pathopharm (8 decks)

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