ppts 5- 9 Flashcards
Difference between type 1 and type 2 diabetes
1: insufficient
2: defective (90%)
The endocrine function of pancreas is __ while the exocrine function is ___
endo: insulin and glucagon
exo: digestive
What is the most common race to have DM type II
Native Americans
age: >35-40
Gender: males slightly > F
Which is not a sign of DM A) polydipsia B) irritability C) fatigue D) excessive weight gain
D) weight gain
signs include: polyuria, polydipsia, weight LOSS, fatigue, weakness, blurred vision, irritability, recurring infection, parestheias, delayed healing
If your patient has a fasting glucose of 120 are they considered to have DM ?
no, >126
What are some long term affects of DM?
Atherosclerosis (CAD, PVD)
Infection (amputation)
Neuorpathy (charcot foot)
Which of the following is not found in the anterior pituitary gland A) antidiuretic hormone B) Human growth hormone C) thyroid stimulating hormone D) prolactin
A)
Antidiuretic hormone and oxytocin are in the anterior
HGH, ACTH, TSH, FSH, prolactin and LH in the posterior
Hyperpituitarism is characterized by
Increased HGH
- gigantism - children
- acromegaly - adults
What is Addison’s disease
decreased ACTH
- hyotension
- fatigue
- weight loss
What is Cushing’s syndrome
hypercortisolism
- muscle wasting / weakness
- osteoporosis
- hypertension
What will be the appearance of a patient with cushing syndrome
moon face
buffalo hump
enlarged abdomen
Grave’s disease
hyperthyroidism
F > M
age: 20 - 40
Increased metabolism ( thin, elevated vitals, hyperactive reflexes)
what is the most common thyroid dysfunction in US?
hypothyroidism
Hypothyroidism
F > M Age: 30 - 60 cold intolerance weight gain fatigue heaches dry skin neruromuscular symtoms
What does the parathyroid hormone regulate ?
calcium and phosphorus metabolism
Sings of hyperparathyroidism
F > M age: >60 osteopenia kidney damage proximal muscle weakness weight loss peripheral neurophy
hypoarathyroidism
neuro musclular irritability (spasms, cardiac arrhytmias)
dry skin
brittle fingernails
WHat is the most prevelant bone disease
osteoporosis
T or F: smoking is a risk factor for osteoporosis
true
What are the 5 clinical prediction rules for osteoporotic vertebral compression fractiures
1) Age >65
2) (-) leg pain
3) BMI or = 4 /5 rule in
T or F: immobilization is a risk factor for hematologic disorders
T
What are the 5 main things to look at for hematolgic disorders
exertion skin and fingernails neurologic stool/emesis infections
Signs of anemia… HgB below __ for F and below __ for M
F: 12
M: 14
T or F: anemia is a disease
F ; symptom of a disease
Which of the following is a disorder that would cause anemia A) chronic blood loss B) dietary deficient C) complication of chemo D) All of the above
D
hemoglobin less than ___ don’t exercise
she said 7 but I thought it was 8
T or F: a low D BP is a sign of anemia
true
Thrombocytopenia is platelet count less than
150,000
Signs of thrombocytopenia
gum, nose or GI bleed petechiae melena hematuria excessive menstrua bleeding
T or F: RA is an autoimmune disease
T
What are the 3 stages of RA
1) swelling of synovium
2) development of pannus
3) eroision of bone and cartilage
Morning stiffness >60 minutes is a sign of
RA
Of the major 7 symptoms, how many need to be present to diagnosis RA and what are they ?
4 of the following need to be present :
1) morning stiffness > 1 hour
2) soft tissue swelling in hand joint
3) ST swelling in 3 out of 14 joint groups
4) symmetrical swelling in 1 joint area
5) rheumatoid nodules
6) (+) Rheumatoid factor
7) Radiographic changes in wrist or hand
Your patient has : joint space narrowing, subchondral cyst formation and body erosion at the joint margin. Do they have OA or RA ?
RA
hallmark sign = erosion at the joint margin
What is the hallmark sign of OA?
osteophytosis
What are the 4 categories of immune system disorders
immunodeficiency : AIDS
Hypersensitivity: allergies, contact dermatitis,
autoimmune: fibromyalgia, RA, SLE, Guillain-Barre
Immunoproliferative: leukemia
Does fibromyalgia have more generalized or localized pain?
generalized
What is the leading cause of death in people under 85
cancer
What type of cancers are most common
Which causes the most deaths ?
prostate and breast most common
lung = most deaths
3 types of neoplasms and which a PT is most likely to see
1) benign
2) invasive
3) metastatic - secondary ** PT most likely to see
When referring to cancer what does cautions stand for
C - changes in bowel/bladder habits A - a sore that does not heal in 6 weeks U - unusual bleeding or discharge T - thickening or lump in breast or else where I - indigestion or difficulty swallowing O - obvious change in wart or mole N - nagging cough or hoarseness S - supplemental signs and symptoms (weight loss, night pain)
What percent of cancers spread to brain and which are the most common ?
20 -25 % lung colon kidney breast melanoma
Mets in the ___ spine account for 60% of spinal cord compression
thoracic
Screening for cancer
age: >50 failure to improve with PT history of cancer unexplained weight loss > 1 month of pain no relief with bed rest insidious onset
4 clinical findings for detecting presence of cancer from LBP
1) failure to improve within 1 month of conservative medical treatment
2) previous history of cancer
3) age > 50
4) unexplained weight loss (more than 10 pounds in 6 months)
* need to have at least 1/4
* absence of all 4 can help rule out cancer
To help see fluid/swelling on an MRI, should you use T1 or T2
T2
hemophilia is a lack of ___
factor 8
BUN should be between
7 and 20
serum chloride shold be 101 - 111
101 - 111
CO 2 should be
20 - 29
critical values for glucose test =
700
critcal levels for serum potassium =
6.5
critical value for serum sodium =
160
Chem test for albumin is to test the ___
liver
BUN represents ___ function
glomerular
Which is the first enzyme to show elevation in AMI
creatine kinase
general rules of thumb
BACTERIAL INFECTIONS: CBC
(increased PMNs) + Culture and sensitivity
VIRAL INFECTIONS: CBC (increased
lymphocytes)+ Serological (Immuno.)
PARASITIC / FUNGAL INFECTIONS: CBC (increased eos) + Microscopic Detection
Real reason F > M for anemia
estrogen blocks EPO
