Study Guide Questions Flashcards
1
Q
sickness or deviation from a healthy state
A
Illness
2
Q
rapid onset, short duration
A
Acute illness
3
Q
Permanent impairment
A
Chronic illness
4
Q
biologic or psychologic alteration that results in a malfunction of the body organ or system
A
Disease
5
Q
of new diagnoses of a condition in a specific period of time like a year in relation to who was at risk at the beginning of the year
A
Incidence
6
Q
of people with a specific disease at a point regardless of when
A
Prevalence
7
Q
Frequency of disability within a population
A
Morbidity
8
Q
of deaths related to a condition
A
Mortality
9
Q
Remove and reduce risk factors
A
Primary prevention
10
Q
Promote early detection; preventative measure to avoid further complication
A
Secondary prevention
11
Q
Limits the impact of current disease
A
Tertiary prevention
12
Q
o Ex] regular exercise, good diet, seat belts, immunizations
What type of prevention?
A
Primary
13
Q
Skin tests for TB, mammography and colonoscopy are examples of what type of prevention?
A
Secondary
14
Q
Rehab and chemo are examples of what kind of prevention?
A
Tertiary
15
Q
finite event that is a disturbance of cerebral function due to abnormal neuronal discharge
A
Seizure
16
Q
Seizures are reaction of the brain to?
A
Stress Sleep deprivation Fever Alcohol Drugs
17
Q
If someone gets seizure in childhood, whats the most likely cause?
A
Idiopathic
18
Q
Signs and symptoms of seizures can be triggered by:
A
Stress Poor nutrition No meds Flickering lights Illness/Fever No sleep Emotional Heat
19
Q
Types of generalized seizures
A
Absence (petit mal) Tonic Clonic Tonic-Clonic (grand mal) Atonic Myoclonic
20
Q
In younger population; doesn’t persist beyond age 20
Brief loss of consciousness but doesn’t lose postural tone
Come back to full orientation after seizure
A
Absence seizure
21
Q
Describe tonic seizure
A
Rigid and paused movement like tree trunk; muscle contraction continues
22
Q
What can lead to cyanosis with tonic seizures?
A
Arrest of respiratory muscles
23
Q
Repetitive Clonic jerking of extremities and head
A
Clonic seizure
24
Q
They lose consciousness and have an aura (feel its going to happen)
A
Tonic-Clonic
25
Define status epilepticus
Seizure either doesnt stop right away or they occur too fast after one another so they dont have time to regain consciousness
26
Describe atonic seizure
Rag doll loss of muscle tone
27
Sudden bride contractions that are localized to a few muscles or 1 or more extremities
On and off moments
Associated with variety of rare neurodegenerative disorders
Myoclonic
28
Two types of focal seizures
Simple partial and complex partial
29
Which seizure affects one side?
Simple partial seizure
30
Are conscious
Involves unilateral hemisphere
Starts with motor, sensory or autonomic phenomena
Simple partial
31
Can get temporary blindness with this seizure
Simple partial seizure
32
Impaired consciousness but not lost
Lasts 30 sec to 3 min
Discharge arises from mostly temporal lobe (70-80%) or medial frontal lobe
Complex partial seizure
33
Carbamazepine (Tegretol, Carbatrol) treats ?
Tonic Clonic
| Partial
34
Clonazepam (Klonopin)
Myoclonic
35
Phenobarbital (Luminal)
Tonic-Clonic
| Partial
36
Phenytoin (Dilantin)
Tonic Clonic
| Partial
37
Valproic acid (Depakote)
Tonic Clonic
Myoclonic
Absence
Photic induced
**everything except partial
38
Topiramate (Topamax)
Treats ALL seizures
39
o Treats intractable seizures
| o Only if surgery is not successful or not seizure control
Vagus nerve stimulators
40
Pacemaker of the brain
Vagus nerve stimulators
41
2 types of surgical interventions for epilepsy
Callostomy and hemispherectomy
42
Partial = takes out 2/3 of connections in corpus callosum
Complete = cutting remaining 1/3
Not a cure but does reduce frequency and severity
Callostomy
43
half of the brain is removed or disconnected
| - always results in some form of hemiplegia
Hemispherectomy
44
What are the implications for the PT when dealing with patients who have seizures?
1] keep client safe if they have seizure during therapy
2] know psychological implications, triggers
3] exam their home and work etc environment and EDUCATE
45
Parts of the chain of transmission
```
Pathogen
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
```
46
how the pathogen gets inside your body
Portal of entry
47
Ex] respiratory tract, GI tract, urinary tract, mucous membrane, skin
What part of MoT?
Portal of entry
48
Will they be affected more or less?
Susceptible host
49
any microorganism that has the capacity to cause disease
Pathogen
50
environment where the pathogen lives
Reservoir
51
how the pathogen gets transferred
Mode of transmission
52
how the pathogen leaves the reservoir
Portal of exit
53
Ex] people, equipment, water
CHain?
Reservoir
54
excretions, secretions, droplets, open cuts
Chain?
Portal of exit
55
Contact, droplets, airborne, vectorborne, vehicle are examples of what part in chain?
Mode of transmission
56
respiratory tract, GI tract, urinary tract, mucous membrane, skin
What part of chain?
Portal of entry
57
cancer patients, elderly patients, surgical patients, burns, diabetes mellitus are what part of the chain?
Host susceptibility
58
3 lines of defense
```
1st= external
2nd= inflammatory
3rd= specific response
```
59
Normal fever level
98.6
60
What's the 102 degree rule?
Theres one group that dont cause fever past 102 and the other group does cause fever past 102.
61
More than how many degrees is dangerous?
104
62
Gut flora is destroyed
C.diff
63
What's more effective to treat C.diff?
Soap and water
64
Whats the only anaerobe that poses a nosocomial risk?
C. Diff
65
o Risk factors:
Spread by direct contact
Mostly colonized in the nose
Staph
66
Prognosis for staph?
Good with treatment
67
Most common bacterial pathogen
| Ex] Pharyngitis, scarlet fever, impetigo, gangrene, cellulitis, sepsis, toxic shock
Group A strep
68
Usually seen in NICU, newborns, nursery
• Leading cause of neonatal infections
• Part of Norma vaginal flora- 1% of babies get it
Group B strep
69
Through direct contact or droplet inhalation
Risk factors
• Age, flu, respiratory infection, chronic illness, immunosuppressive, alcoholism
Pneumonia
70
Risk for HCWs
Incubated for 45-180 days (avg 60-90)
Needle stick- 22-31% chance of getting it
Trasnsmission: direct or indirect contact
Hep B
71
What virus does NOT have a vaccine?
Hep C
72
Transmitted by needle stick
Incubated 6-7 weeks
Wash hands!
Hep C
73
Transmitted through needle stick or infrequently through mucus
HIV
74
Types of Herpes Virus
HSV Type 1 and 2= herpes simplex
HSV Type 3= varicella zoster
HSV Type 4= Epstein Barr
HSV Type 5= cytomegalovirus (CMV)
75
Chickenpox or shingles
HSV type 3
76
95% ppl 35-40 years old
Transmission: contact with oral secretions, blood or organ transplants
Excellent prognosis
HSV type 4
77
Increased with age
1% newborns
4 out of 5 adults have CMV
Transmitted: human contact with infected secretions like urine, blood breast milk, placenta
HSV Type 5
78
o Heartburn
o Nausea
o emesis (vomit)
o diarrhea- abnormal stool or frequency
o fetal incontinence- cant control bowel movements
o constipation
o anorexia
o dysphagia (difficulty swallowing)
o Achalasia- cant relax smooth muscles of GI tract
o Abdominal pain
And GI bleeding are all signs and symptoms of?
GI DISEASE
79
o Inflammation of esophagus b/c of gastric acid reflux
| o Caused by pressure on lower esophageal sphincter
GERD
80
o Signs and symptoms:
Heartburn soon after eating
Reflux
Painful swallowing
GERD
81
o Inflammation of stomach lining (mucosa)
| - can be acute or chronic
Gastritis
82
Signs and Sx: epigastric pain, ab distension, decreased appetite and nausea
Gastritis
83
Imbalance b/w gastric acid and pepsin secretion occurs during mucosal resistance
PUD (peptic ulcer disease)
84
2 types of PUD
Gastric and duodenal
*duodenal is 2-3x more common
85
90% of cases caused by H.pylori
PUD
86
o Affects intestinal tract
| o Discontinuous process
Crohn's disease
87
o Most common biliary disease
o Risk Factors: age, female, genetic, bacterial infection, estrogen, cholesterol, liver disease
o Sx: RUQ pain
Gallstones
88
o Dx: history, PE, radiography
o Tx: low fat diet, lipid lowering, laparoscopic cholecystectomy
o Prognosis: good
Gallstones
89
Describe the 4 burn stages
1st degree= superficial
2nd degree= superficial- partial thickness
3rd degree= deep partial thickness
4th degree= full thickness
90
o sunburn
o ONLY epidermis
o Redness, no blisters, painful
o Heals in 3-5 days
1st degree burn
| Superficial
91
o damage through epidermis and papillary dermis
o Bright red/pink, minimal discoloration
o Intact blisters
o Random healing
2nd degree= superficial- partial thickness burn
92
```
o damage through epidermis, papillary dermis and reticular dermis
o Red, waxy-white appearance
o Broken blisters, weeping
o Marked edema
o Excessive scarring
```
3rd degree= deep partial thickness burn
93
```
o involves entire skin, down to subcutaneous
can be down to muscle, fascia or bone
Skin grafting
White or charred appearance
No blanching, dry
No pain b.c no receptors
```
4th degree= full thickness burn
94
Full skin and tissue loss
Stage 4 ulcer
95
Full thickness skin loss
Stage 3 pressure ulcer
96
Partial thickness loss with exposed dermis
Stage 2 pressure ulcer
97
Non-blanchable skin redness; intact
Stage 1 pressure ulcer
98
o Slow growing
| o Etiology: prolonged sun exposure, immunosuppress, genetic
Basal cell carcinoma
99
o Arises in sun damaged skin
| o Rim of ear, face, lips, mouth, dorsa of hand
Squamous cell carcinoma
100
o Originates from melanocytes which give skin color
Malignant melanoma
101
4 types of malignant melanoma ?
Superficial
Modular
LMM
ALM
102
o Etiology/risk factors: blonde/red hair, fair skin, blue eyes, prone to sunburn. Scandinavian
Malignant melanoma
103
Which has absence of dystrophin ?
DMD
104
BMD has what kind of dystrophin ?
Altered amount
105
protein that links muscle membrane (sarcolemma) to contractile muscle protein (actin)
Dystrophin
106
o Cant get their heels on floor
| o Straighten legs first then use hands on knees to stand up
DMD
107
Female carrier for this disease
DMD
108
Onset less than 6 months
SMA type 1
109
Onset 6-18 months
SMA type 2
110
Onset after 18 months
SMA type 3
111
Onset is variable; around 4th decade
Heterogenous genetics SMA
112
Sit only with support
Bulbar dysfunction (originates from pons)
• Cant suck or swallow, respiratory failure
Type 1 SMA
113
Sits independently
| 50% can sit until age 14
Type 2 SMA
114
Die before age 2
Type 1 SMA
115
Walks independently
| 50% Can walk with assist until age 7
SMA type 3
116
If onset of SMA type 3 is before 2 years old, half will walks with assist until ?
12
117
If onset for SMA type 3 is after 2 years then half will walk with assist until ?
44
118
Can walk up to 40s
Heterogeneous genetics SMA
119
o mildest form
| o Bleeding is limited to only the lining of the ventricles with little or no ill effects
Grade 1 IVH
120
o Ventricles become enlarged and full of bed
Grade 3 IVH
121
o Blood does not spill into the ventricles, no enlargement or swelling
o Blood is reabsorbed with no long or short term effects
Grade 2 IVH
122
o Blood spills out from ventricles into the brain
Grade 4 IVH
123
Grades 1-3 of IVH are ?
One sided
124
Which IVH grade has extensive bilateral damage?
Grade 4
125
Arterial ischemic injury of white matter
| o Usually in arterial end zones
PVL
126
Two types of PVL and which one has cognition spared?
1] frontal - cognition spared
| 2] parietal
127
2 types of HIE
Slow and abrupt
128
What is HIE?
Lack of oxygen to the brain
129
2 locations of brain lesions
Pyramidal and extra pyramidal
130
Corticospinal tract affected so more motor lesion
Learning new motor skills
70-80% cases
Pyramidal
131
Automatic movement and reflexes
Athetoid and ataxic
Lesion in basal ganglia or cerebellum
Extra pyramidal
132
Types of movement disorder
```
Spastic
Dystonic
Athetoid
Dyskinetic
Ataxia
```
133
Monoplegia
One extremity is impaired like R UE
134
Diplegia
Bilateral UE and LE but more LE impairment
135
Hemiplegia
One sided UE and LE stoke
136
Paraplegia
B LE stroke
137
Triplegia
3 extremities impaired
138
Tetra/quadriplegia
All extremities involved
139
Whats the most severe form of CP
Spastic quadriplegia
140
* walks w/o limitations
| * Decreased speed, balance and coordination
GMFCS 1
141
* walks with limits
| * Climbs stairs with railing
GMFCS 2
142
* Walks with hand held mobility device
| * Needs assisted device to walk
GMFCS 3
143
* Self mobility with limits
* May use powered mobility
* Cant walk on their own
GMFCS 4
144
* Transported in manual wheelchair
* Cant hold head and neck against gravity
* All motor function impaired
* Cant do anything on their own
GMFCS 5
145
What's MACS?
Focuses on how kids with CP use their hands whe handling objects
146
What's CFCS?
Describes everyday communication
147
o Examples: tums, mailbox, mylanta, alka seltzer
Antacids
148
MoA for antacids?
Neutralize gastric acidity
149
o Examples: Zantac, Pepcid, Tagamet, axid
H2RA (histamine 2 receptor antagonists)
150
MoA for H2RA?
Reduces acid secretion by stopping histamine, gastric and acetylcholine receptors
151
o Examples: prilosec OTC, Prevacid, medium, protonix, aciphex
o MoA: irreversibly inhibit the H+/K+-ATPase
PPI (protein pump inhibitors)
152
What is PPI used for?
Long term acid suppression
153
o MoA: increase water absorption (fiber)
o Have to take with full glass of water
o Effect is flatulence
o Can be used long term
Bulk forming laxatives
154
o MoA: lubricates fecal material and wall of intestine
o Short term only, takes 2-3 days to effect
o Can stain clothing
Lubricant laxatives
155
o MoA: draws fluid into large intestine (colon)
| o SE: bloating, rectal irritation, electrolyte abnormalities
HYperosmotic laxatives
156
o MoA: increase osmotic pressure by increasing water and electrolyte secretions into small bowel
o Mg citrate SE: gas/cramps, diarrhea
Saline laxatives
157
o MoA: facilitates propulsive motility of colon by stimulating enteric nervous system
o Short term
o Works overnight, well tolerated
Stimulant laxatives
158
o MoA: facilitate water and fat absorption into the stool
o Does not treat constipation but prevents
Exception= chronic opioid use
Stool softeners
159
Causes of nausea and vomit ?
Meds
Toxic chemicals
Drugs OD
Pregnancy
160
```
Anticholinergics
Antihistamines
Serotonin blockers
Corticosteroids
Neuroleptic drugs
Prokinetic drugs
Cannabinoids
NKIRAs
```
Treatment for nausea and vomiting
161
Inhibits cell wall synthesis by binding to penicillin binding proteins
Penicilin
Cephalosporins
Carbapenams
162
Inhibits cell wall synthesis by binding to cell wall precursor
MoA for vancomycin
163
In bacteria by binding to 30S ribosomal subunits
Aminoglycosides
164
DNA gyrase inhibitor
Fluroquinolines
165
Pneumonia, skin and soft tissue, urinary, stomach infect
Use for fluoroquinolines
166
Respiratory tract infect, urinary infect, pneumonia
Clinical use for aminoglycosides
167
C. Diff infect, skin and soft tissue, MRSAA, meningitis
Clinical use for vancomycin
168
Stomach infections, multi drug resistant organisms
Clinical use for carbapenams
169
Skin and soft tissue, pneumonia, UTI, meningitis
Clinical use for cephalosporins
170
Skin and soft tissue infections, sinus infections, otitis media
Clinical use for penicillin
171
Redman syndrome, nephrotoxicity
Side effect of vancomycin
172
Neprhotoxicity, ototoxicity, neurotoxicity
Side effect for aminoglycosides
173
GI disturbances, prolongation of QT interval, photosensitivity
Side effect for fluroquinolines
174
Name the 3 viral meds
NRTIs
NNRTI
PT (protease inhibitor)
175
Name the 3 fungal meds
Anoles
Polyenes
Echinocandins
176
Which fungal med has side effect of nephrotoxicity?
Polyenes
177
Which fungal med has Side effect of infusion reaction?
Echinocandins
178
1) What is the procedure to cut off half the brain?
a. Hemispherectomy
179
2) What ambulatory type of SMA has onset after 18 months of age?
Type 3
180
3) At which level of GMFCS would you expect child to walk with hand mobility device indoors and outdoors on level surfaces?
GMFCS level 3
181
4) The class of drugs used to treat PUD, GERD and heartburn that works to halt the receptors that stimulate acid secretion?
H2RA
182
5) Isolation strategies used to protect hospital personnel and patients from Blood borne pathogens?
Universal precautions
183
6) Type of seizure commonly treated wth Dilantin (Phenytoin)
Tonic Clonic and partial
184
7) What diagnosis has the absence of dystrophin?
Duchenne's
185
9) Type of CP that’s 7% of spastic forms and most severe?
Quadriplegia/tetraplegia
186
10) Antibiotic treatment is required for patients with PUD when this is present?
H.pylori
187
11) Body excretions, secretions, open wounds and exudates where bacteria can grow and be transmitted?
Portal of exit
188
12) Collection of chronic end stage disorders caused by toxic, metabolic, congestive and inflammatory damage noted by fibrosis of the liver?
Cirrhosis
189
13) Name the condition in which the ventricles of the brain become large and full of blood. This condition is a common causative factor in spastic diplegia cerebral palsy.
IVH 3
190
14) Environment in which bacteria can live and multiply?
Reservoir
191
15) Medical emergency occurs when seizures do not cease on their own or recur too rapidly to allow return to a conscious state.
Status epilepticus
192
16) Finite event that involves transient disturbance of cerebral function?
Seizure
193
17) Which types of NM disorders would there be active destruction of muscle?
Dystrophy
194
Any microorganism that has capacity to cause disease?
Pathogen
195
19) Name the 5 level system used to identify function of children with CP?
GMFCS= gross motor function classification system
196
20) Inflammation in esophagus due to gastric acid penetrating esophageal sphincter?
GERD
