patho exam 3 Flashcards

1
Q

sodium lab value

A

136-145

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2
Q

potassium lab value

A

3.5-5

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3
Q

magnesium lab value

A

1.7-2.2

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4
Q

calcium lab value

A

9-11

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5
Q

phosphate

A

3.2-4.3

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6
Q

leukocytes

A

subcat: gran & agran
-neutrophils (gran)
-lymphocytes (agran)
-monocytes (agran)
-eosinophils (gran)
-basophils (gran)
immunity & inflammation

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7
Q

granulocytes

A

have cells w/ a nucleus in several lobes & granules -> they release mediators w/ immunity & inflammatory properties

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8
Q

agranulocytes

A

have a nucleus but have few to no granules -> still aid in immunity & inflammation

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9
Q

neutrophils

A

-1st to arrive
-bands (immature/left) & segs (mature/right)
-shift to left = acute phase
increase w/ acute bacteria infections & trauma

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10
Q

lymphocytes

A

-primary cells of immune response (T&B cells) that live in the lymphoid tissues
increase w/ chronic bacterial infection & actute viral infection

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11
Q

monocytes

A

phagocytosis
increase w/ bacterial infections & cancers (or could be lower for cancer)

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12
Q

eosinophils

A

increase w/ allergic rx or parasitic infections
worms, wheezes & weird disease

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13
Q

basophils

A

increase w/ allergic rx

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14
Q

low hgb indicates

A

bleeding, folate/b12 defic, cancers, kidney & liver disease

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15
Q

high hgb indicates

A

polycythemia, COPD, high alt, heavy smoking

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16
Q

low hct indicates

A

anemia, bleeding, bleeding disorders, fluid imbalances

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17
Q

high hct indicates

A

polycythemia, COPD, dehydration, shock, congenital heart disease

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18
Q

neutropenia precautions

A

-good hygiene
-avoid contact w/ sick people
-avoid raw fruits, veg, & grains
-keep doors closed

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19
Q

neutropenia

A

absolute count < 1000

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20
Q

infectious mononucleosis

A

infection of B lymphs caused by epstein barr virus

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21
Q

myelodysplastic syndrome

A

a group of related hematologic disorders characterized by a change in the quantity and quality of bone marrow elements (bone marrow failure)

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22
Q

myelodysplastic syndrome CM

A

(cytopenias) anemia, infection & spontaneous bleeding or bruising

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23
Q

leukemias

A

malignant neoplasms of cells originally derived from a single hematopoietic cell line (WBC that are unregulated and/or undifferentiated)

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24
Q

leukemic cells

A

-immature & unregualated
-proliferation in bone marrow
-circulate in blood
-infiltrate spleen, lymph nodes

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25
Q

leukemia classifications

A

according to their predominant cell (lymphocytic or myelocytic) & whether the condition is acute or chronic

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26
Q

what is the most common childhood leukemia

A

acute lymphocytic (lymphoblastic) leukemia

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27
Q

what is the most common leukemia in older adults

A

chronic lymphocytic leukemia

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28
Q

malignant lymphomas

A

neoplasms of cells derived from lymphoid tissues (hodgkin disease & nonhodgkin disease)

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29
Q

what cell is specific to hodgkin disease

A

reed-stenberg cell: a distinctive tumor cell found w/ lymph biopsy

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30
Q

hodgkin disease

A

characterized by painless, progressive, rubbery enlargement of single node or group of nodes, usually around the neck (good prognosis)

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31
Q

nonhodgkin disease

A

neoplastic disorder of lymphoid tissue that spreads early (to liver, spleen & bone marrow), characterized by painless, superficial lymphadenopathy

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32
Q

multiple myeloma

A

plasma cell cancer (B cells), atypical proliferation of one of immunoglobulins “M protein” which increases osteoclast activity unable to maintain humoral immunity

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33
Q

multiple myeloma characteristics

A

bone pain/fractures, impaired production of RBC & WBC
hypercalcemia

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34
Q

hyponatremia causes

A

-GI loses
-renal losses (diuretics)
-skin loses (burns, wounds)
-fasting diets, polydipsia (water intox)
-excess hypotonic fluid

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35
Q

hyponatremia S/s

A

-confusion/altered LOC
-anorexia, muscle weakness
-can lead to seeizures/coma

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36
Q

with Na, think

A

brain

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37
Q

hyponatremia treatment

A

-Na replacement (slowly)
-PO/IV
-IV fluids
-treat underlying problem
for dilutional, fluid restriction

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38
Q

hypernatremia causes

A

-IV fluid
-near drowning
-not enough fluid intake or too much water loss
-profound diuresis
will not get from eating too much salty food

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39
Q

hypernatremia S/s

A

-altered LOC/confusion, seizure, coma
-extreme thirst (hypereosmolality)
-dry, sticky mucous membranes
-muscle cramps

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40
Q

hypernatremia

A

-if H20 loss, add water
-if Na excess, remove sodium

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41
Q

what is the main source of K+

A

diet

42
Q

hypokalemia causes

A

-renal or GI losses
-acid base disorders

43
Q

hypokalemia S/s

A

-cardiac rhythm disturbances (can be lethal)
-muscle weakness, leg cramps
-decreased bowel motility

44
Q

magnesium

A

helps stabilize cardiac muscle cells by blocking K+

45
Q

hypomagnesium causes

A

-GI or renal losses
-limited intake
-alc abuse
-pancreatitis
-hypergly

46
Q

hypomagnesium S/s

A

-hyperactive reflexes
-confusion
-cramps
-tremors
-seizures
nystagmus

47
Q

hypermagnesium causes

A

-increased intake accompanied by renal failure (chronic renal failure pt who take milk of mag, OB pt)

48
Q

hypermagnesium S/s

A

-lethargy
-floppiness
-muscle weakness
-decreased reflexes
-flushed warm skin
-decreased pulse/BP

49
Q

calcium think

A

bone & thyroid

50
Q

K+ think

A

heart

51
Q

hypocalcemia: positive chovstek’s

A

-ipsilateral twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior to the ear eye will close if present

52
Q

hypocalcemia: positive trousseau’s

A

-carpal spasm upon inflation of a BP cuff to 20 mmHg above the pt’s systolic blood pressure for 3 mins will see twitch

53
Q

hypercalcemia causes

A

-hyperparathyroidism
-cancers (breast, lung, hematologic)
-tums overdose

54
Q

hypercalcemia S/s

A

calcium acts like a sedative
-fatigue
-lethargy
-confusion
-weakness
-leading to seizures
-coma

55
Q

what form of phosphorous is measured

A

inorganic (circulating and measured)

56
Q

phos

A

-essential for ATP formation
-needed for glucose, protein, & fat metabolism
-part of DNA & RNA

57
Q

hypophos causes

A

-decreased absorption
-antacid
-severe diarrhea
-increased kidney elimination
-malnutrition

58
Q

hyperphos

A

-kidney failure
-laxatives

59
Q

hyperphos S/s

A

-usually asymptomatic
-muscle spasms
-paresthesia
-tetany
(sim to hypoCa)

60
Q

fungal transmission: implementation

A

tineas -> skin to skin touching

61
Q

fungal transmission: inhalation

A

cryptococcal -> through air

62
Q

fungal transmission: taking antibiotics

A

candidiasis

63
Q

superficial fungal skin lesions

A

-tinea pedis/captitis/versicolor
-candidiasis

64
Q

tinea corporois

A

ringworm of the body

65
Q

tinea pedis

A

athlete’s foot - dry, scaling pruritic lesions
treatment: topical anti fungals

66
Q

tinea versicolor

A

skin on the upper chest, back or arms - rash - risks are hot climates, sweating, oily skin, weakened immune system not contagious
treatment: topical anti fungal including shampoos

67
Q

tinea capitis

A

hair (cradle cap) - scaly erythematous lesions and hair loss
treatment: PO systemic anti fungals

68
Q

tinea cruris

A

ringworm of the groin

69
Q

herpes zoster is

A

shingles , activated by immunosuppression, stress or illness
treatment: anti virals

70
Q

prodrome

A

burning/tingling along dermatome & then rash develops w/ vesicles that dry and crust over

71
Q

bacteria skin infections

A

-impetigo
-abscess
-furuncle
-cellulitis
-MRSA

72
Q

impetigo

A

-causative agents: staph & strep
-acute & contagious
-appearance: vesicles, pustules, crust
-treatment: tropical antibacterial (bactroban)

73
Q

abscess

A

-inflamed skin w/ pus
-tender
-treatment: incision & drainage -> antibiotics

74
Q

furuncle

A

bacterial infection of hair follicle
treat w/ I&D -> PO antibiotics

75
Q

carbuncle

A

painful, deep swelling of the skin caused by bacteria
treat w/ I&D -> antibiotics

76
Q

cellulitis

A

-causes: bacteria infection of skin & surrounding tissues (initial wound becomes infected)
-not contagious (possible bite)
-appearance: red, swollen, warm
-treatment: PO systemic antibiotics, IV based on severity

77
Q

MRSA high risk

A

high school wrestlers, child care workers, & people who live in crowded conditions

78
Q

MRSA treatment

A

-hospital: IV vancomycin or zyvox
-community acquire: bactrim or dicloxacillin

79
Q

prophylaxis

A

bactroban nasal ointment prior to surgery

80
Q

actinic keratosis

A

-benign lesions
-d/t damage by sun’s UV rays
-common in fair skin persons
-rough, scaly, red plaques

81
Q

solar lentigos

A

-benign lesions
-also known as liver/age spots
can indicate cancer risk

82
Q

skin cancer: basal cell

A

most common, least often malignant (usually won’t be problematic)
-sun
-translucent, shiny, pearly nodule -> ulcer

83
Q

skin cancer: squamous cell

A

2nd most common, can metastasize to remote areas
-sun
-curable if early treatment
-red & scaling, slightly elevated lesion, irregular border, shallow

84
Q

skin cancer: melanoma

A

rarer, but high rates of metastasis
-can spread to epidermis & dermis
-risks: blonde/red hair, freckles upper back, blistering sunburn before 20, outdoor job as a teenager

85
Q

pulmonary embolism

A

most serious DVT complication
the thrombus becomes lodged in our permanent pulmonary circulation preventing gas exchange

86
Q

chronic thromboembolic pulmonary HTN

A

rare, most common symptom is SOB
caused by repeated clots in the lung which causes increased pressure in the lung circulation

87
Q

post thrombotic syndrome

A

8-70% of pt who have DVT/VTEs can develop
related to chronic inflammation & chronic venous htn
causes damage to the vein walls leading to pain, achy, fatigue, sensation of swelling, cramps, itching, parenthesis, bursting pain w/ exercise, color change

88
Q

phlegmesia cerula dolens (pain blue inflammation)

A

when clots are in your major leg veins and they become totally occluded sudden massive swelling w/ deep pain
-can lead to amputation or gangrene

89
Q

what is the first sign of a GI tract disorder

A

diarrhea

90
Q

episodic diarrhea

A

intermittent food allergies or irritant (like caffeine)

91
Q

osmotic diarrhea

A

increased amounts of osmotically active solutes (**epsom salt & mag sulfate), water rushes into the colon area resulting in diarrhea
tube feeding

92
Q

secretory diarrhea

A

causes by some kind of bacteria or toxin which increases secretion & inhibits reabsorption of water in the gut bacteria: vibrio cholerae & staph aureus

93
Q

exudative diarrhea

A

active sites of inflammation in the bowel lumen that results in excitation of mucus, blood & protein from those sites open internal wounds, water gets pulled into the intestines leading to diarrhea Crohns & UC

94
Q

diarrhea related to motility disturbances

A

result of decreased absorption in the small intestine so large amounts of fluid will be delivered to the colon gastrectomy, dumping syndrome & IBS

95
Q

hypersen: type 1

A

-allergens
-IgE on Mast Cells
-Mediator release
allergic rhinitis, asthma, urticaria

96
Q

hypersen: type 2

A

-IgG and IgM antibodies
-attach cells (on surface, leads to cell death)
-cell lysis
wrong blood given, newborn/mother Rh incompatibilliaty, autoimmune disorders

97
Q

hypersen: type 3

A

-IgG or IgM antibodies
-accumulate in tissues (deposits)
-inflammation
arthritis, glomerulonephritis, lupus

98
Q

hypersen: type 4

A

-delayed Tcell activation
-cytokines
-48 to 72 hr peak
contact dermatitis, tuberculin

99
Q

opioid onset, peak & duration

A

onset: 12-24 hr
peak: 72 hr
duration: less @1wk

100
Q

benzo onset & peak

A

onset: 6-12hr
peak: 2 wks

101
Q

alc onset & peak

A

onset: 8 hr
peak: 1-3 day

102
Q

treatment for benzo & alc withdrawal

A

-thiamine
-lorazepam
-diazepam