Pathophysiology Flashcards
CVA
Etiology: Blockage of arteries that limit blood circulation to the brain and result in brain damage
CC: Unilateral/focal sx; weakness/numbness/visual& speech deficits
RF: HTN, HDL, DM, Smoking, FHx of CVA, PMHx of CVA or TIA, AFIB
PE: 1. Hemiparesis
2. Unilateral Paresthesia
3. Neurological deficits (Visual field & Aphasia)
Dx: Clinically; CT is clear
MED: tPA (Blood-thinner that reverses CVA Sx)
Document time of onset & Sx improve rapidly
Hemorrhagic CVA/Brainbleed
E: spontaneous or traumatic rupture of blood vessels in the brain
CC: sudden, throbbing HA
Assox sx: HA, seizure, AMS, numbness, weakness, changes in vision & speech
PE: Unilateral Neurological Deficits
Dx: CT & LP
TIA
E: temporary changes in vessels depriving brain of O2
CC: transient focal neurological deficits (strength, sensation, vision, speech)
Dx: clinically
**Sx last <1hr
Meningitis
E: inflammation and infection of meninges
CC: Neck pain & HA
ASx: Neck stiffness, neck pain, fever, AMS
PE: Meningismus & Nuchal Rigidity
Dx: LP
Bacterial or Viral
Spinal Cord Injury
E: Trauma causing bilateral numbness & weakness in extremities
CC: neck p, back p, extremity weakness & numbness
PE: mid-line bony tenderness, deformities (or step-offs), rectal tone, bilateral extremity numbness & weakness
Dx: C-spine CT, T-spine CT, L-spine CT
Seizures (SZ)
E: abnormal electrical activity in the brain causing abnormal physical manifestations
CC: seizure activity, syncope
ASx: confusion, HA, injuries (tongue-bite), incontinence
PE: Somnolent, postictal (confused)
M: Keppra, Depakote, Neurontin, Dilantin, Tegretol
Bell’s Palsy
E: inflammation or infection of facial nerve causing weakness in muscles of one side
CC: sudden onset droopy face
Pertinent negative: no extremity weakness; no changes in vision or speech
PE: Unilateral weakness of upper and lower facial muscles
Dx: Clinically
HA/Cephalgia
E: HTN, Sinusitis, migraines
CC: pressure, throbbing HA w/ gradual onset
Pert.Neg: No fever, numbness, weakness, neck-pain or stiffness
AMS
E: multiple causes: infection, neurological, hypoglycemia
CC: confusion, decreased responsiveness
RF: dementia, old age, MD, EtOH * drug use
*maybe caused by UTI, demntia, hypoglycemia
Syncope
E: Temporary loss of blood circulation to the brain due to dehydration or hypovolemia
CC: passing out vs. about to pass-out
Vertigo
E: room-spinning due to inner ear infection or neurological probs
CC: room spinning, disequilibrium, worsens w/ head motion
ASx: N/V & Tinnitus
PE: Nystagmus, Roberg, Dix-Hallpike test
Dx: Clinically
Appendicitis
E: infection of the appendix causing inflammation and possible rupture
CC: RLQ pain that is constant, gradual, and that worsens upon movement
PE: RLQ tenderness, McBurney’s point tenderness
Dx: CT A/P w/ PO contrast
ASx: Fever, N/V, decreased appetite
SBO
Small Bowel Obstruction
CC: abd pain, constipation, vomiting
RF: elderly, infants, narcotic drug usage, abd surgery
PE: abd tenderness, abd distension
Asx: abd distention, bloating, no BMs
Dx: CT A/P w/ PO contrast & Acute abd series (AAS)
Cholelithiasis/Cholecystitis
E: condensation of bile from liver to form stones that can irritate, inflame, and obstruct gallbladder
CC: sharp pain that worsens upon eating, taking a deep breath, and palpitation
Dx: US
PE: RUQ tenderness
worsened by eating fatty food
GI Bleeding
E: Bleeding in upper or lower GI tract
CC: Hematemesis, Hematochezia, Melena, Coffee ground emesis
ASx: SOB, lightheadedness, weakness, abd pain, rectal pain
PE: melena, conjunctiva, pallor, tachycardia, grossly bloody stool
Dx: positive heme in stool
Diverticulitis
E: inflammation and infection of diverticuli RF: old age, diverticuli CC: LLQ pain ASX: N, diarrhea, fever Dx: CT A/P w/ PO contrast
Pancreatitis
E: inflammation of the pancreas CC: LUQ & epigastric pain RF: EtOH abuse & cholecystitis ASx: N/V PE: LUQ and epigastric tenderness Dx: heightened lipase & amylase levels (lipase primarily)
