PHCP LAB - RA, DM, HLPD Flashcards

1
Q

It is an autoimmune and inflammatory disease in
which your immune system mistakenly attacks
healthy cells, causing painful swelling

A

RHEUMATOID ARTHRITIS

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2
Q

HPI

A

History of Present Illness

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3
Q

WDWN

A

Well Developed, Well Nourished

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4
Q

DIP

A

Distal Interphalangeal

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5
Q

RRR

A

Regular Rate and Rhythm

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6
Q

PMH

A

Past Medication History

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7
Q

DMARDS

A

Disease modifying anti-rheumatic
drugs

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8
Q

MCP

A

Metacarpophalangeal

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9
Q

MRG

A

Murmur, Rubs, and Gallops

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10
Q

ALL

A

Allergies

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11
Q

ROS

A

Review of Systems

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12
Q

RA

A

Rheumatoid Arthritis

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13
Q

ROM

A

Range of Motion

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14
Q

JVD

A

Jugular vein distention

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15
Q

Rheumatoid Arthritis
Patient Name
Complaint

A

Jannet Hobbs
Generalized arthralgias, a swollen left knee,
and morning stiffness.

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16
Q

Past Medical History of Patient

A

Rheumatoid Arthritis x 6 years
Hysterectomy - 4 years ago
Hypertension x 10 years

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17
Q

A surgical procedure to remove the womb (uterus)

A

Hysterectomy

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18
Q

Jannet Hobs Allergy

A

Penicillin (25 years)

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19
Q

HEENT

A

head, ears, eyes, nose, and throat examination

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20
Q

PERRLA

A

Pupils Equal, Round, Reactive to Light and Accommodation

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21
Q

EOMI

A

Extra-ocular eye movements intact.

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22
Q

JVG

A

Jugular vein distention

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23
Q

CTA

A

Computed Tomography Angiography

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24
Q

RRR

A

Relative risk reduction (RRR)

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25
Q

RRR

A

Relative risk reduction (RRR)

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26
Q

RRR

A

Relative risk reduction (RRR)

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27
Q

NT/ND

A

Non-Tender, Non-Distended

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28
Q

DIP

A

Distal Interphalangeal

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29
Q

PIP

A

Proximal Interphalangeal

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30
Q

MCP

A

Metacarpophalangeal

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31
Q

Hydrochlorothiazide |
Dosage Strength
Use/Indications
S/E

A

25mg
Hypertension
Dizziness, Chest Pain

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32
Q

Norvasc|
Dosage Strength
Use/Indications
S/E

A

10mg
Hypertension
Headache, Dizziness

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33
Q

Nabumetone |
Dosage Strength
Use/Indications
S/E

A

750mg
NSAID
HA, Diz, Diarrhea

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34
Q

Prednisone |
Dosage Strength
Use/Indications
S/E

A

5mg
Anti-Inflammatory
Immunospressive
Weight gain, Indigestion, Insomnia

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35
Q

Methotrexate|
Dosage Strength
Use/Indications
S/E

A

2.5mg
RA
Stomach pain, Black tarry tools

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36
Q

Hydroxychloroquine|
Dosage Strength
Use/Indications
S/E

A

200mg
RA
Dizziness, Fainting

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37
Q

Sulfasalazine EC|
Dosage Strength
Use/Indications
S/E

A

500mg
RA
HA, Diz, N/V

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38
Q

DI | HCTZ and Norvasc

A

dizziness, or feeling like you might pass out

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39
Q

DI | HCTZ and Folic acid

A

decreases the levels of FA by increasing renal clearance

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40
Q

Di | Norvasc and Nabumetone

A
  • increase risk of heart attack
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41
Q

DI | Prednisone and Methotrexate

A

can cause a decrease in blood cell counts

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42
Q

DI | Sulfasalazine EC and Methotrexate

A

increase risk of liver problems

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43
Q

inflammation of a synovial (joint-lining) membrane.
Causes pain and swelling of the joints forming
pannus.

A

Synovial Inflammation (Synovitis)

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44
Q
  • an abnormal tissue that develops because of
    excess inflammation. It is composed of inflammatory
    cells
A

Pannus

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45
Q

source of the Rheumatoid factors and Anti–cyclic citrullinated peptide
antibodies, which contribute to immune complex formation leading to
inflammation

A

B-lymphocyte (humoral mediated inflammation)

46
Q

produce cytotoxins, cytokines and macrophage, which stimulate further
activation of inflammatory processes.
Cytokines: TNF-α, interleukin-1, and IL-6

A

T-lymphocyte (cell-mediated inflammation)

47
Q

expressed on the surface of T-cell, leads to osteoclastmediated synovial inflammation and joint
destruction

A

RANK Ligand

48
Q

SIGNS AND SYM OF RA

A

Multi-joint pain
Stiffness in more than one joint
Multi-joint tenderness and swelling

49
Q

RISK FACTORS OF RA

A

Age
Gender
Genetics
Smoking
Obesity
Hysterectomy

50
Q

May help diagnose rheumatoid
arthritis in the early stages of the
disease. In addition, these imaging
tests can help evaluate the amount of
damage in the joints and the severity
of the disease

A

Magnetic resonance imaging (MRI)

51
Q

uses electromagnetic radiation to
produce images of the body to assess the
severity of joint destruction. Although this
test is not useful in the early stages of
rheumatoid arthritis, it can be used to
monitor the progression of the disease

A

X-rays

52
Q

This blood test checks for anti-CCP
antibodies, which appear in many people
with rheumatoid arthritis. In addition, antiCCP can appear before RA symptoms
develop, which can help doctors diagnose
the disease early.

A

Anti-cyclic citrullinated peptide (anti-CCP) test

53
Q

This blood test measures different
blood cell counts and can help
diagnose anemia, which is
common in people with RA.

A

Complete blood count

54
Q

This test measures inflammation in the
body and monitors disease activity and
response to treatments.

A

Erythrocyte sedimentation
rate (sed rate)

55
Q

RA | PT
This medication reduces pain and inflammation.

A

(NSAIDs), (Ibuprofen, Naproxen, Aspirin )

56
Q

RA | PT
Another category of NSAIDs, with less
common stomach bleeding side effects than those of standard NSAIDs.

A

COX-2 inhibitors (Celecoxib, Etoricoxib, Lumiracoxib )

57
Q

RA | PT
- Have both anti-inflammatory and
immunoregulatory effects. This may be administered orally, intravenously, intramuscularly, or via joint injection. While a disease is still in its early stage, _______ can be used as a temporary adjunct therapy while waiting for DMARDs to start acting as an anti-inflammatory.

A

Corticosteroids (Prednisone, Methylprednisolone ) -

58
Q

RA | PT
__________ have been demonstrated to change the course of the disease and enhance
radiographic results. When rheumatoid arthritis is officially diagnosed, most patients should begin
taking ________.

A

Disease Modifying Anti-rheumatic Drugs (DMARDs)
(Methotrexate, Hydroxychloroquine, Sulfasalazine, etc)

59
Q

RA | PT
Another class of DMARDs are _______
When a patient’s condition doesn’t improve when taking methotrexate alone, rheumatologists
frequently prescribe ____inhibitors.

A

Janus Kinase (JAK) Inhibitors (Tofacitinib, Baracitinib)

60
Q

RA | PT
Your healthcare practitioner may
prescribe _____ response agents if you don’t respond well to DMARDs. The molecules that induce
inflammation in your joints are the target of them. They target the cells more precisely,
according to providers, making them more effective.

A

Biologics

61
Q

Non-Pharmacologic Intervention for RA

A

EXERCISE
DIET
MASSAGE
COUNSELING
STRESS REDUCTION
PHYSICAL THERAPY
SURGERY

62
Q

Diabetes Mellitus
Patient name
Complaint

A

Sarah Martin
Headache

63
Q

Sarah Martin
Allergies

A

Morphine - Urticaria/Hives

64
Q

the need for patients to get up at
night on a regular basis to urinate

A

Nocturia

65
Q

when your body makes too much

A

Polyuria

66
Q

-excessive or abnormal thirst.

A

Polydipsia

67
Q

Polyuria |
Urine output (Adults, Children)

A

exceeding 3 L/day in adults and 2
L/m2 in children

68
Q

An abnormal touch sensation, such as burning or
prickling, that occurs without an outside
stimulus.

A

Paresthesia

69
Q

DM | Glyburide
Dosage
Ind

A

5mg
High blood

70
Q

DM | Lisinopril
Dosage
Ind

A

20mg
ACEi for HTN

71
Q

DM | Zyprexa
Dosage
Ind

A

5mg
Acute manic

72
Q

DM | Carbamazepine
Dosage
Ind

A

200mg
Epilepsy, Bipolar Disorder

73
Q

DM | Lorazepam
Dosage
Ind

A

1mg
Anxiety

74
Q

DM | Fluoxetine
Dosage
Ind

A

20mg
Selective serotonin inh, depressive illness symp

75
Q

DM - EC ASA
Dosage
Ind

A

80mg
NSAID, reduces CHD

76
Q

DM | Prevastatin
Dosage
Ind

A

40mg
statin, lower cholesterol and triglyceride

77
Q

DI | Lorazepam and Olanzapine

A

Low BP, weak pulse, muscle weakness

78
Q

DI | Carbamazepine and Lorazepam

A

Dizziness, drowsiness, confusion

79
Q

DI | Aspirin/Fluoxetine and Glyburide

A

Increase the risk of hypoglycemia

80
Q

DI | Glyburide and Lisinopril

A

May increase the risk of hypoglycemia, or low
blood sugar.

81
Q

autoimmune destruction of the insulinproducing β-cells in the pancreas, which is
thought to be triggered by environmental
factors, such as viruses or toxins, in
genetically susceptible individuals.

A

Type 1 DM

82
Q

characterized by impaired insulin
secretion and resistance to insulin action.
In the presence of insulin resistance,
glucose utilization by tissues is impaired,
hepatic glucose production is increased,
and excess glucose accumulates in the
circulation.
This hyperglycemia stimulates the
pancreas to produce more insulin in an
attempt to overcome insulin resistance

A

Type II DM

83
Q

DM 1 or DM 2
Insulin-dependent or Juvenile-Onset

A

DM 1

84
Q

DM 1 or DM 2
Non-insulin-dependent

A

DM 2

85
Q

DM 1 or DM 2
Usually none, although some residual C-peptides can sometimes be detected at diagnosis, especially in adults

A

DM 1

86
Q

DM 1 OR DM 2
Insulin presents in low, “normal”, or high amounts

A

DM 2

87
Q

DM 1 OR DM 2
Associated with certain HLA types

A

DM 1

88
Q

DM 1 OR DM 2
Defect in insulin secretion, tissue resistance to insulin; INC hepatic glucose output

A

DM 2

89
Q

DM 1 OR DM 2
CP: Moderate to severe symptoms that generally progress rapidly

A

DM 1

90
Q

DM 1 OR DM 2
CP: Rare except in circumstances of unusual stress

A

DM 2

91
Q

DM 1 OR DM 2
TX: Insulin, MNT, PA, Amylin mimetic (pramlintide)

A

DM 1

92
Q

DM 1 OR DM 2
TX: MNT, PA, Antidiabetic agents, Insulin, Amylin mimetic (pramlintide)

A

DM 2

93
Q

Signs & Symptoms Diabetes (5)

A

Polyuria, Polydipsia, Polyphagia, Blurry Vision, Wounds

94
Q

Risk Factors for Type 2 Diabetes

A

-High blood/HTN
-High-fat and carb diet
-Obesity

95
Q

DM | Diagnostic
The average blood sugar level over the previous two
to three months is determined.

A

A1C test

96
Q

DM | Diagnostic
Test your blood sugar on an empty stomach and after an overnight fast.

A

Fasting Blood Sugar test

97
Q

DM | Diagnostic
Measures your blood sugar before and after you drink a liquid that contains
glucose.

A

Glucose Tolerance Test

98
Q

DM | Diagnostic
This measures your blood sugar level at the moment of testing. This
test can be taken whenever you want

A

Random Blood Sugar Test

99
Q

Amylin Analogue

A

Pramlintide

100
Q

Rapid-acting insulin

A

Insulin Lispro

101
Q

Short-acting insulin

A

Humulin-R®

102
Q

Intermediate-acting insulin

A

Humulin-N®

103
Q

Long-acting insulin

A

(Insulin Glargine)

104
Q

1st line initial tx of Type II DM among obese
patients

A

Metformin

105
Q

should only be used in type II diabetics who
are stable, free of liver, kidney, or cardiovascular issues

A

Phenformin

106
Q

can be used in combination with metformin
or a sulfonylurea as dual oral therapy in patients with type 2
diabetes whose blood glucose levels are not well controlled.

A

Rosiglitazone

107
Q

indicated as an adjunct to diet and exercise
to improve glycemic control in adults with type 2 diabetes mellitus.

A

Pioglitazone

108
Q

is an insulin secretagogue that lowers blood
glucose levels in patients with T2DM.

A

Repaglinide

109
Q

the only treatment for type 1 diabetes mellitus that
induces an insulin-independent, the normoglycemic
condition is pancreas transplantation, either using the entire pancreas or just the pancreatic islet cells. Benefits
can include improvements in retinopathy, nephropathy,
and quality of life.

A

Pancreas and Islet Cell Transplants

110
Q

Non-Pharmacologic TX for DM

A

Caloric restriction
Low-fat or low-carb diets
Reduce weight (especially if overweight)
Physical activities (aerobic exercise)
Avoid bedtime and between-meal snacks