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Spring 2024 > patho midterm > Flashcards

patho midterm Flashcards

1
Q

respiratory acidosis

A

cause: shallow breaths/respiratory congestion
effect: increase CO2
compensation: kidneys->more H+ ions and reabsorb more bicarbonate

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2
Q

metabolic acidosis

A

cause: shock, renal failure, diarrhea, diabetic ketoacidosis
effect: decreased bicarbonate
compensation: rapid breaths

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3
Q

respiratory alkalosis

A

cause: hyperventilation
effect: decreased CO2
compensation: kidneys-> less H+ ions and reabsorb less bicarbonate

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4
Q

metabolic alkalosis

A

cause: vomiting
effect: increased bicarbonate ion
compensation: slow, shallow breaths

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5
Q

decompensation

A

compensation mechanisms fail, additional problems, or problems become more severe
LIFE THREATENING

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6
Q

to treat imbalances…

A

treat underlying issue

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7
Q

what role do OTs play in joint injuries

A

-ergonomics
-joint protection
-splinting
-massage
-various modalities

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8
Q

what are the weight bearing precautions

A

NWB: non weight bearing
TTWB: toe touch weight bearing
FFWB: foot flat weight bearing
WBAT: weight bearing as tolerated (no extra weight)
FWB: full weight bearing

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9
Q

what is compartment syndrome

A

-edema of the limb btwn. fascia
-ischemia/infarction may occur b/c of compression of arterial blood supply
-gangrene possible->amputation
-tight cast can cause this

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10
Q

what is osteomyelitis

A

bone infection caused by bacteria or fungi

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11
Q

s/s of osteomyelitis

A

-local inflammation and bone pain
-fever/excessive sweating
-chills
-general malaise

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12
Q

treatment for osteo myelitis

A

-antibiotics
-possibly surgery
-WB precautions

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13
Q

Dislocation

A

-separation of two bones at a joint
-significant soft tissue damage
-joint distortion
-may req. surgery
-trauma

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14
Q

what is heterotopic ossicifcation (HO)

A

hardening/ calcification of bone in tissue where it does not normally exist
-post traumatic
-neurogenic

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15
Q

what are treatments for HO

A

-passive ROM
-radiation
-surgery (staged)

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16
Q

subluxation

A

-joint unaligned, not completely disconnected like dislocation
-common after stroke
-common with RA in multiple joints

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17
Q

characteristics of bone tumors

A

-common site of secondary tumors from breast, lung or prostate
-most primary tumors, “sarcomas” are malignant

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18
Q

what is osteosarcoma

A

-most common primary neoplasm of bone
-occurs in shaft of long bones of leg
-more common in children, adolescence and young adults
-warning sign: bone pain at rest

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19
Q

what is Ewing Sarcoma

A

-malignant neoplasm
-common in adolescence
-occurs in diaphysis of long bones

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20
Q

what is muscular dystrophy

A

degeneration of skeletal muscle over time
-group of inherited disorders (autosomal recessive, X-linked recessive/Duchennes)

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21
Q

how can OT assist w/ MD

A

maximize function and adaptation

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22
Q

what is diffusion

A

solutes from high -> low concentration

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23
Q

what is osmosis

A

H2O from low -> high solute concentration

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24
Q

what is filtration

A

H2O and solutes move across a membrane
high->low pressure (hydrostatic-“push”)

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25
Q

active transport

A

requires carrier molecules

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26
Q

causes of edema

A
  • increased capillary hydrostatic pressure (increased BP), pulmonary edema
  • loss of plasma proteins (albumin), decreased osmotic pressure
  • obstruction of lymphatic circulation, localized
    -increased capillary permeability
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27
Q

effects of edema

A

restricts ROM
reduced vital capacity
impaired diastole
impaired arterial circulation
dental complication

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28
Q

interventions for edema

A

address source: kidney, CHF, albumin
elevation
compression
mobilization of joints
massage
thermal modalities
kines. tape

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29
Q

purpose of lymphatic system

A

transport fluid
absorb proteins, fats, vitamins
recognize foreign cells, microbes, cancer cells

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30
Q

What is the difference between Hodgkin and non-Hodgkin lymphoma

A

Hodgkin: one lymph node that spreads to other parts of body
non-Hodgkin: multiple nodes, unorganized, wide spread

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31
Q

edema s/s

A

rapid onset
bilat./ symmetrical
clear fluid/blistery
deep pitting
shiny skin
(-) stemmer sign (will lift)

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32
Q

lymphedema s/s

A

slow onset
unilat./bilat. not symmetrical
non-pitting
thick skin
(+) stemmer sign (wont lift)

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33
Q

organs of lymphatic system

A

spleen, thymus, tonsils

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34
Q

what are common areas of lymphedema

A

extremities, head/neck, intestinal, genitals

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35
Q

what is complete decongestive therapy (CDT)

A

treatment for lymphedema.
includes:
manual lymphatic drainage
compression
skin care/education
exercise/mobility

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36
Q

what is lymphoma

A

-lymphatic tumors that are often malignant
-first signs: anemia, weight loss, weakness, fever
- painless enlargements of lymph nodes

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37
Q

what is phlebolymphedema

A

when lymphatic load exceeds the maximum transport capacity

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38
Q

what is myasthenia gravis

A

-an autoimmune disorder that affects the neuromuscular junction
-the immune system attacks and damages receptors in the muscle cells

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39
Q

symptoms of myasthenia gravis

A

-muscle weakness in face/eyes
-impaired vision
-head drops, arms weaker
-upper respiratory infections common
-can cause difficulty speaking, chewing and swallowing

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40
Q

Raynaud’s Phenomenon

A

-sudden decreases in circulation in the digits
-usually in response to stress or temp. change

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41
Q

Characteristics of a first degree burn

A

-superficial (epidermis)
-dry, red, NO blisters
-3-7 days to heal
-example: sunburn

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42
Q

Characteristics of a second degree burn (SPT)

A

-epidermis and 1/3 dermis
-wet, blisters, red
-<2wks to heal
-example: hot metal

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43
Q

iatrogenic

A

relating to illness caused by medical examination or treatment

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44
Q

idiopathic

A

disease of unknown cause

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45
Q

Hypersensitivity reactions

A

type I: RAPID, allergies, can be genetic
type II: RAPID, cytotoxic (transfusion reactions, HOLD THERAPY)
type III: DELAYED, autoimmune conditions (SLE, AIDS)
type IV: DELAYED, cell-mediated (tissue matches, organ transplants, rash where contracted)

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46
Q

causes of cancer

A

abnormal cell division
genetics
carcinogens
age
environment
viruses

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47
Q

benign tumor characteristics

A

slow growing, encapsulated, expands but doesnt spread, similar to normal tissue, low mortality rate

48
Q

malignant tumor characteristics

A

rapid growing, non-encapsulated, metastasizing, undifferentiated, high mortality if untreated

49
Q

most common secondary cites for malignant tumors

A

liver, lungs, bone, brain

50
Q

precautions during cancer treatment

A

treatment-related and neutropenic: to protect ourselves and from chemo and to protect pt who is immune compromised

51
Q

what are the stages of lymphedema

A

0: latency
1: mild
2: moderate
3: severe

52
Q

infection chain

A

agent: microbe causing infection
reservoir: environmental source, infected person/animal
portal of exit: leaves reservoir
mode of transportation: air, water, direct contact, food
portal of entry: access to new host

53
Q

what are signs and symptoms of infection

A

local inflammation: pain, swelling, red, warm
systemic inflammation: fever, fatigue/weakness, headache

54
Q

what is inflammation?

A

process that attempts to minimize injury to tissue, thus maintaining homeostasis

55
Q

what is the process of inflammation

A
  1. start with stimuli (trauma, toxins, virus, irritants, cell damage)
  2. cell damage occurs
  3. inflammation mediators are released
56
Q

what are signs and symptoms of blood clotting disorders

A

-hematemesis: throwing up blood (coffee grounds)
-Hemoptysis: spitting up blood (usually from lungs)
-epistaxis: a bloody nose
-melena: dark stool (from higher up)
-anemia
-ecchymosis: black and blue (internal bleeding)
-hemarthrosis: blood in joints
-persistent bleeding
-low BP/faint/anxious (shock)
-rapid pulse

57
Q

what are some causes of excessive bleeding

A

-thrombocytopenia (low platelets or defective function)
-low vit. K
-liver disease
-anticoag. meds
- hemorrhagic fever
-inherited defects

58
Q

Characteristic of thrombocytopenia

A

-clotting disorder: bleeding from many small vessels

59
Q

What are the OT implications for blood clotting?

A

-critically high INR/PT: high risk of hemorrhage w/functional mobility (especially with fall risk pt.)
-critically low INR/PT: high risk of thrombus formation (DVT/VTE)
get clearance before mobilizing pt w/ critical values

60
Q

Characteristics of Hemophilia A

A

-most common inherited clotting disorder (mother->son)
-factor VIII: clotting factor needed to form prothrombin activator
-signs: bruising, deep muscle hemorrhage, nosebleeds, hematuria, brain bleed, joint bleeding, pain/joint deformity
-rx: prevent injury, avoid clot altering meds, factor VIII, DDVAP

61
Q

define thrombus, thrombosis, embolus

A

-thrombus: stationary blood clot
-thrombosis: formation of a blood clot in blood vessel
-embolus: clot dislodges and circulates through the blood stream (pulmonary embolism)

62
Q

what is cardiogenic shock

A

any type of heart failure where it cant pump blood effectivly

63
Q

what is anaphylactic shock

A

acute allergic reaction (also blood vessel dilation)

64
Q

what is septic shock

A

infectious agents release toxins into the blood (also blood vessel dilation)

65
Q

what is not an appropriate intervention for a pt w/ an unruptured aneurysm

A

restrict to sedentary occupations (causes high BP)

66
Q

what is claudication

A

-symptom of PVD
-pain caused by too little blood flow to muscles during exercise

67
Q

what is an HLA

A

-antibodies in our tissues to recognize/differentiate btwn. self and non self
-impact on transfusions

68
Q

what is neurogenic shock

A

widespread dilation of the blood vessels due to an imbalance in autonomic stimulation of smooth muscle

69
Q

what is hypovolemic shock

A

-loss of blood volume in blood vessels
- hemorrhage
-loss of interstitial fluid

70
Q

what is the therapeutic range for PT, PTT, INR

A

has to do with what anticoagulant meds the pt. is on

71
Q

Characteristics of a second degree burn (Deep)

A

-epidermis and 2/3 dermis, hair follicles, sweat glands
->2wks to heal
-red/white, ruptured blisters
-most painful
-high infection risk
-example: flames/intense heat

72
Q

Characteristics of a third degree burn

A

-full thickness including nerve endings
-surgery required
-no pain (only peripheral)
-dry, pale
-months to heal
-example: chemical

73
Q

Characteristics of a fourth degree burn

A

-full thickness and underlying tissue
-surgery required, sometime amputation
-charring, no pain, peripheral nerve damage
-example: electrical

74
Q

OT and burns:

A

avoid position of comfort, promote stretch of skin, mobility work

75
Q

symptoms of Raynaud’s Phenomenon

A

-pale in affected fingers, numbness, cyanosis
-when blood returns to digits they are dark, red, painful, swollen

76
Q

what is circulatory shock

A

-failure of the circulatory system to adequately deliver O2 to the tissue
-caused by: reduced blood flow throughout vessels

77
Q

what is arteriosclerosis

A

thickening of arterial walls, progress to hardening as calcium deposits form
-reduces blood flow to tissues

78
Q

effects of arteriosclerosis

A

blocks arteries, weakens arterial walls, lumen narrows, loss of elasticity, increased BP

79
Q

Causes of arteriosclerosis

A

diabetes, high fat and cholesterol diets, HTN, smoking, old age

80
Q

what is atherosclerosis

A

most common type of arteriosclerosis
-blockage by lipids, fatty deposits become fibrous and calcified

81
Q

What is treatment for arteriosclerosis or atherosclerosis

A

vasodilators, angioplasty, stents, surgically bypassed or replaced

82
Q

What is the difference between MI and cardiac arrect

A

-MI (heart attack): occurs from heart block from blood clot, stops blood flow to heart
-cardiac arrest: sudden loss of heart function, stops blood flow to body, can be caused by MI, arrhythmia, drug overdoes, trauma

83
Q

What is vitamin K’s role in blood clotting

A

Vitamin K stimulates liver cells to increase the synthesis of prothrombin

84
Q

What should OT do if pt. is getting transfussion

A

Hold treatment, patients nurses and doctors are looking for reactions in patient to transfusion

85
Q

What are the components of the blood

A

plasma, buffy coat, formed elements
formed elements: RBC, WBC, platelets

86
Q

what is hematopoiesis

A

generation of blood

87
Q

what is scleroderma

A

-disease from overproduction of collagen
-hard, shiny, tight skin
-facial expression become hard
-unknown primary cause

88
Q

what is septic shock

A

infectious agents release toxins into the blood (also blood vessel dilation)

89
Q

what signs and symptoms would you see with someone with hypoalbumenia

A

fatigue, mental confusion, weakness

90
Q

what are signs and symptoms of dehydration? over hydration?

A

-dehydration: decreased skin turgor
-overhydration: confusion/lethargy, seizures/coma (severe)

91
Q

what are 3 common mechanisms causing edema

A

-obstruction of lymphatic circulation (retention of sodium in ecf)
-increased capillary blood pressure (hydrostatic pressure)
-decrease in concentration of plasma proteins
-increased capillary permeability

92
Q

what are the bodies 3 lines of defense?

A

1st: non-specific, mechanical, skin/mucous membranes, tears and gastric juice
2nd: non-specific, phagocytosis, inflammation
3rd: specific, antibodies/cell-mediated immunity

93
Q

characteristic of HIV

A

-RNA retrovirus
-attacks immune system and destroys WBC
-leads to AIDS if not treated
-transmitted through blood, sexual contact, , needles, breast feeding

94
Q

what are the areas most affected by HTN

A

kidneys, heart, brain, retina

95
Q

treatments of HTN

A

-lifestyle changes
-lower sodium intake
-weight reduction
-reduces stress
-drugs

96
Q

what are initial signs of HTN

A

-fatigue
-malaise
-sometimes occipital HA

97
Q

What can atherosclerosis cause in the heart

A

-Angina pectoris (ischemic heart attack->partial occlussion)
-MI (complete occlussion)

98
Q

What can atherosclerosis cause in the brain

A

-TIA (partial occlusion)
-cerebrovascular attack (total occlusion)

99
Q

what is an aneurysm

A

-can be caused by damage from arteriosclerosis
-section of artery abnormally widened due to weakened wall
-tend to burst which can cause hemorrhage or death

100
Q

causes of a stroke?

A

-brain aneurysm: ischemia of brain tissue from a ruptured aneurysm
-severity is determined by location and amount of tissue

101
Q

what is the route of circulation (systemic and pulmonary)

A

LV->blood into aorta->arteries->tissues/organ capillaries->veins->inferior (lower half) or superior (upper half) vena cava->RA->RV->pulmonary artery->capillaries (gas exhange)->venules (4 primary veins)->LA->LV

102
Q

what is neurocytosarcosis

A

parasitic infection caused by larval cysts of the pork tapeworm
-epilepsy
-requires vector

103
Q

What can atherosclerosis cause in the aorta

A

aneurysm (occlusion, rupture, hemorrhage)

104
Q

What can atherosclerosis cause in the legs

A

PVD-> gangrene and amputation (iliac arteries)

105
Q

what are the most common sites of PVD

A

-abdominal aorta
-carotid aorta
-femoral and iliac arteries

106
Q

what is the process of gangrene from PVD

A

ischemia->infarction->necrosis->gangrene

107
Q

what are factors for thrombus development

A

-stasis of blood or sluggish blood flow
-endothelial injury
-increased coag.

108
Q

what is a DVT

A

deep vein thrombosis
-usually in femoral or popliteal veins
-can cause pulm. embolism, or stroke

109
Q

what is a VTE

A

venous thromboembolus: a blood clot that is moving

110
Q

what is orthostatic hypotension

A

-decreased BP, increased HR against gravity when getting up too quickly
-vessels do not constrict how theyre supposed to

111
Q

what is a Homan’s sign

A

pain in the calf during ankle dorsiflexion-may indicate a DVT

112
Q

what is the treatment for DVT

A

-preventative measures (exercise/leg elevation)
-anticoag. therapy
-surgery (clot retrieval or inferior vena cava filter)

113
Q

s/s of a DVT

A

-often unnoticed
-aching, sharpness, burning, tender in affected leg
-systemic: fever, malaise, leukocytosis
-notify nurse or doctor if you notice signs

114
Q

what are the precautions with a DVT

A

initial bedrest

115
Q

what is cellulitis

A

-most common lymphedema related infection
-caused by bacteria
-hot, red, tender. skin
-can lead to sepsis or death if untreated
-treatment: antibiotics
-trackable by drawing lines where it started

116
Q

what is anigina pectoris and treatment

A

severe chest pain when myocardium is deprived of O2
rx: aspirin, coronary bypass/ angioplasty

Spring 2024 (3 decks)

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