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Human Disease Test 3 > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Basal cell carcinoma accounts for what % of skin cancers?

A

75%

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2
Q

What is the most common malignant tumor in Caucasians?

A

basal cell carcinoma

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3
Q

What usually causes basal cell carcinoma?

A

over exposure to the sun (radiation and chronic irritation)

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4
Q

Basal cell carcinoma usually appears how?

A

pearly white papule that develops a central ulceration, no pain or itching, very rarely metastasizes

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5
Q

Squamous cell carcinoma appears how?

A

slightly elevated lesion with irregular border

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6
Q

Squamous cell carcinoma often develops from what?

A

actinic keratosis

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7
Q

Treatment for both squamous and basal cell cancer?

A

surgery

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8
Q

Mohs Micrographic procedure is what?

A

a procedure where a sample will be taken from the effected tissue, frozen, cut, and examined under a microscope immediately to verify presence of cancer. Repeated till no cancer cells are left

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9
Q

Cryosurgery

A

applied liquid nitrogen to effected area then remove

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10
Q

Radiation therapy

A

high energy xrays are used to damage/kill the cancer cells and prevents the growth of new cancer cells

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11
Q

Electrodesiccation/curettage

A

removes tumor by scraping or curetting and then burning the base with an electric needle

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12
Q

Malignant melanoma is what?

A

tumor originating from melanocytes

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13
Q

What % of malignant melanomas develop on the skin?

A

90%

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14
Q

Approx 1/2 of malignant melanomas originate from where?

A

pre existing freckles or moles

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15
Q

Clinical features of skin cancer ABCDE

A

A=asymmetry of pigmented lesion (flat/elevated), B= borders (irregular margins with notching), C= color (varies, black dark brown red bleached), D= diameter or lesion (usually >6mm diamter), E=evolving (different from rest or changes in size, shape, and color)

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16
Q

Treatment of malignant tumors

A

surgery

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17
Q

Prognosis of malignant tumors

A

88%, 5% survival if treated early, at stage IV subcutaneous invasion 25% survival

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18
Q

Brain cancer has a relatively high mortality rate due to what?

A

due to the presence of malignancy and location in a closed craium this adds pressure to cerebral structures

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19
Q

What % of malignant brain cancer cases are in children?

A

20%

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20
Q

What % of brain cancers are primary neoplasms

A

50%

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21
Q

What % of brain cancers are tumors of glial cells?

A

75%

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22
Q

Cause of brain cancer

A

unknown for primary neoplasms, genetic factors seem to play a role

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23
Q

Death due to brain cancer occurs due to what?

A

compression of vital centers

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24
Q

What cancer is the leading cause of cancer deaths in the US?

A

lung cancer, more prevalent in women, kills approx 150,000 people/year

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25
Q

What % of patients with lung cancer smoke?

A

90%

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26
Q

Many lung cancers are metastases from other sites like what?

A

due to blood flow through the pulmonary capillary bed by way of the thoracic duct that empties into the superior vena cava

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27
Q

Squamous cell carcinoma

A

30% of lung cancers, tends to arise in central portion of lung (segmental bronchi), if caught early can resect that part and follow up with chemo/radiation

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28
Q

Adenocarcinoma

A

33% of lung cancers, tends to arise in periphery usually upper lobes, if caught early can also be resected and followed up with chemo/radiation, seen as thickened plaque white mucosa

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29
Q

Small cell carcinoma (Oat cell cancer)

A

20% of lung cancers, usually originates near hilum, metastasizes very early, best treated with chemo and has a high recurrence rate

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30
Q

Wilms tumor

A

one of the most common solid tumors in young children, diagnosed at ages 2-5 years

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31
Q

Wilms tumors is usually associated with deletions on what chromosome?

A

11

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32
Q

Colorectal cancer is detected how?

A

colonscopy

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33
Q

Colorectal cancer accounts from approx what % of cancer related deaths in the US?

A

15%

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34
Q

Colorectal cancer is associated with a diet low in what?

A

fiber, high in fat, sugar, and red meat

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35
Q

Signs and symptoms of colorectal cancer?

A

can be asymptomatic for years, change in bowel habits, occult blood in stool

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36
Q

Treatment for colorectal cancer

A

surgical removal, radiation, chemo

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37
Q

definition of neoplasm (tumor)

A

cellular growth not responding to normal body controls

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38
Q

Benign tumors

A

rarely kill yet can be fatal, dont penetrate adjacent tissue borders, dont spread to distant sites, grow slowly, usually encapsulated, do no usually recur when surgically removed

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39
Q

Malignant tumors

A

life threatening, invade nearby tissues, metastasize to distant sites via blood and lymphatic vessels, rapid growth, anaplastic, not encapsulated, usually distorted in size, shape, and structure

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40
Q

Classification of cancers

A

carcinomas, sarcomas, leukemia, lymphoma, myeloma, mixed

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41
Q

Carcinomas make up what % of cancer cases?

A

80-90%, largest group

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42
Q

Carcinomas is located where?

A

in epithelial tissue

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43
Q

Carcinomas tend to affect what?

A

organs/glands, breast, lung, colon, or prostate

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44
Q

Benign tumors or epithelial orgin usually are named using the suffix what?

A

-oma

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45
Q

Malignant tumors of epithelial origin are named with the term what?

A

carcinoma added to the type of tissue involved

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46
Q

Sarcomas refers to cancer that originates where?

A

supportive and connective tissues such as bones, tendons, cartilage, muscle, and fat

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47
Q

The most common sarcoma often develops as what?

A

painful mass on the bone

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48
Q

Benign tumors of connective tissue are named by appending the suffix what?

A

-oma to the type of tissue involved

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49
Q

Malignant tumors of connective tissue are named by adding what term to the type of tissue involved?

A

sarcoma

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50
Q

Leukemias

A

cancer of the bone marrow

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51
Q

Leukemias is often associated with the overproduction of what?

A

immature white blood cells

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52
Q

Leukemia also affects red blood cells and can cause what?

A

poor blood clotting and fatigue due to anemia

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53
Q

Lymphomas

A

develop in the glands or nodes of lymphatic systems, a network of vessles, nodes, and organs that purify bodily fluids and produce infection fighting white blood cells

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54
Q

Lymphomas are sometimes called what?

A

solid cancers

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55
Q

Lymphomas are subclassified into what two categories?

A

Hodgkin lymphomas, and Non hodgkin

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56
Q

What distinguishes Hodgkin lymphoma from non hodgkin lymphoma?

A

Reed stern berg cells

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57
Q

Local effects of tumors are what?

A

pain, obstruction, tissue necrosis and ulceration which may cause infection

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58
Q

Systemic effects of cancers

A

weight loss and cachexia (tissue wasting), anemia, infection

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59
Q

Risk factors to cancer

A

genetic predisposition, oncogenic viruses (HPV, AIDS), Radiation, chemicals, chronic irritation and inflammation, hormones

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60
Q

Grading based on degree of Anaplasia

A

Grade 1:well differentiated, Grade 2: moderately differentiated, Grade 3: poorly differentiated, Grade 4: anaplastic

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61
Q

Staging is based on what?

A

extent of spread (TNM)

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62
Q

TNM stands for what?

A

T=size of primary tumor, N= regional lymph node involvement, M= metastasis of primary tumor

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63
Q

Types of cancer treatment

A

surgery, chemotherapy and consists or a combo of 2-4 drugs

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64
Q

Adverse effects of chemotherapy

A

damage heart muscle, bone marrow depression, dec WBC, inc chance of infection, decr thrombocytes, and inc risk of hemorrhage, nausea and vomiting, hair loss and skin breakdown

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65
Q

Radiation therapy causes alteration in what?

A

tumor cell DNA

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66
Q

Radiation therapy may be applied how?

A

externally or internally

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67
Q

Adverse effects of radiation therapy

A

bone marrow depression, epithelial cell damage, sterility, and scarring

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68
Q

When youre cured of cancer it means what?

A

5 years cancer free post treatment

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69
Q

What youre in remission of cancer it means what?

A

period of time when there are no clinical signs

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70
Q

anemia definition

A

reduction in O2 transport ability leads to less energy produced in cell

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71
Q

General signs of anemia

A

fatigue, pallor, tachycardia

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72
Q

Severe anemia may cause angina during what/

A

stress

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73
Q

Cause of iron deficiency anemia

A

low dietary intake of iron, chronic blood loss, and malabsorption of iron

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74
Q

Iron deficiency anemia

A

insufficient iron impedes synthesis of hemogloblin

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75
Q

Diagnosis of iron deficiency anemia

A

low hemoglobin and hematocrit, RBC’s appear hypochromic and microcytic

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76
Q

Treatment of iron deficiency anemia

A

identify and resolve underlying cause, iron supplements

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77
Q

Transferrin

A

a beta one globulin of the plasma which acts as an iron transporting protein

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78
Q

Ferritin

A

an iron protein complex containing up to 23% iron, found in intestial mucosa, spleen and liver

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79
Q

Pernicious anemia

A

vitamin B12 deficiency, lack of intrinsic factor leading to inability to absorb B12 into the liver

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80
Q

Lack of intrinsic factor may be caused by what?

A

formation of autoantibodies against if in the stomach, chronic gastritis (common in ETOH abuse), gastrectomy or resection of ileum, dietary insufficiency is rare cause

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81
Q

Lack of B12 impairs maturation of what?

A

RBCs

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82
Q

Treatment of pernicious anemia

A

B12 injection, vitamin supplements

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83
Q

Aplastic anemia

A

impairment of bone marrow function leading to loss of stem cells

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84
Q

Decrease stem cells causes what?

A

pancytopenia

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85
Q

Possible causes of secondary aplastic anemia

A

radiation, chemotherapy, industrial chemicals, drugs, viruses

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86
Q

Signs and symptoms of aplastic anemia

A

general signs of anemia, multiple infections due to leukopenia, petechiae (tiny hemorrhage spots in skin)

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87
Q

treatment of secondary aplastic anemia

A

remove underlying cause

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88
Q

Treatment of primary aplastic anemia

A

bone marrow transplant, use chemo/radiation, infusion of donor stem cells

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89
Q

Sickle cell anemia

A

autosomal recessive disorder formation of HbS

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90
Q

Sickle cells obstruct what?

A

small vessels and form clots

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91
Q

Signs and symptoms of sickle cell anemia

A

begins about 1 year old, general signs of anemia, hyperbilirubinemia (jaundice, gallstone formation), vascular occlusion leading to periodic painful episodes, delayed growth and development, congestive heart failure

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92
Q

Treatment of sickle cell anemia

A

if symptomatic bone marrow transplant, analgesics, blood transfusion, avoid stenous activity, droxia

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93
Q

Polycythemia vera

A

neoplastic disorder of unknown orgin, inc. production of erythrocytes in bone marrow causes viscous or very thick blood

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94
Q

Polycythemia vera most commonly develops between what ages?

A

40-60

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95
Q

Signs and symptoms of polycythemia vera

A

bluish-red tone of skin and mucosa, hepatomegaly/splenomegaly, inc. BP, congestive heart failure, inc. risk of thromboses and infarction, hematocrit >55%

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96
Q

Treatment of polycythemia vera

A

periodic phlebotomy, drugs or radioactive phosphorus (32P) to suppress bone marrow

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97
Q

Prognosis of polycythemia vera

A

depends on age of patient and when diagnosis, treatment, and if there are complications, inc. risk for thrombosis, heart attack or stroke

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98
Q

General signs of blood clotting disorders

A

persistent bleeding from gums, repeated nosebleeds, petechiae, purpura and eccymoses, more bleeding than warraned by trauma, coughing or vomiting blood, blood in feces, general signs of anemia

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99
Q

Hemophilia A

A

classic hemophilia, x lined recessive trait, deficit or abnormality of clotting factor VIII

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100
Q

Hemarthrosis

A

bleeding into joints very painful

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101
Q

Hematuria

A

bleeding kidney, urinating blood

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102
Q

Treatment of Hemophilia A

A

Factor VIII replacement therapy

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103
Q

Disseminated intravascular coagulation (DIC)

A

involves excessive bleeding and excessive clotting,

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104
Q

DIC occurs as a complication of what?

A

a primary problem which activates clotting process in microcirculation

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105
Q

Primary problems that lead to tissue thromboplastin release include what?

A

obstetric complications (thromboplastin release from placenta), bacterial infections that release endotoxins, major trauma, some carcinomas

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106
Q

Signs and symptoms of DIC

A

depends on obstertric hemorrhage or thrombosis damage, depends on underlying causes, general signs of blood clotting disorders, vascular occlusion may cause infarcts, low BP or shock, respiratory and or renal failure possible

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107
Q

Treatment of DIC

A

heparin anticoagulation, replacement of platelets and clotting factors

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108
Q

Prognosis of DIC

A

depending on primary cause and severity

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109
Q

leukemia

A

neoplastic disorder involving white blood cells

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110
Q

many leukemias are associated with what?

A

chromosomal translocations

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111
Q

Acute lymphocytic leukemias is the most common what?

A

childhood cancer/ onset 2-6 years of age

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112
Q

Signs and symptoms of acute leukemia

A

infection, hemorrhage, signs of anemia, severe bone pain, weight loss, fatigue, enlarged lymph nodes/spleen/liver

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113
Q

Lymphoma

A

malignant neoplasm involving lymphocyte proliferation in lymph nodes

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114
Q

Cause of lymphoma?

A

unknown

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115
Q

Hodgkins lymphoma

A

occurs primarily in young adults, initally occurs in one lymph node and then spreads to other lymph nodes and then other organs

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116
Q

Stage 1 lymphoma

A

cancer affects a single node

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117
Q

Stage 2 lymphoma

A

2 or more lymph nodes on same side of diaphragm

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118
Q

Stage 3 lymphoma

A

involves nodes on both sides of the diaphragm

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119
Q

Stage 4 lymphoma

A

involves cancer spreading to the bone, lung or liver

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120
Q

Signs and symptoms of lymphoma

A

enlarged, nontender, painless lymph node (early sign), late sign is splenomegaly and other enlarged nodes

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121
Q

Treatment of lymphoma

A

radiation/chemo/surgery, excellent prognosis when found in the early stages

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122
Q

Non Hodgkins lymphoma

A

on the rise, more difficult to treat, widespread metastases often present at diagnosis

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123
Q

congestive heart failure

A

inadequate pumping ability of the heart and usually occurs as a complication secondary to another condition

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124
Q

ejection fraction

A

measurement of blood leaving your heart each time it contracts

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125
Q

general signs and symptoms of CHF

A

fatigue/weakness, tachycardia, pallor, oliguria

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126
Q

signs and symptoms of left sided heart failure

A

dyspnea/orthopnea, cough due to fluid in airways, paroxysmal nocturnal dyspnea, abnormal breath sounds (crackles/rales in bases)

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127
Q

signs and symptoms of right sided heart failure

A

heart receives blood back from the body, dependent edema, hepatomegaly/splenomegaly, ascites (abdominal distention), distended neck veins

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128
Q

Treatment of CHF

A

treat underlying cause (O2, surgery), drugs to reduce blood volume and vasoconstriction, low sodium diet

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129
Q

Primary Hypertension

A

Ateriosclerosis, (inc. BP) idiopathic, genetic factors and diet play a role

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130
Q

Secondary hypertension

A

results from renal disease, adrenal tumor, endocrine disease

131
Q

Malignant hypertension

A

usually due to nephrosclerosis damage in renal blood vessels, severe when diastolic BP >120mm Hg

132
Q

arteriosclerosis

A

general hardening of the arteries due to plaque, blood clots, anywhere in the body

133
Q

Cause of arteriosclerosis

A

increased arteriolar vasoconstriction, dec. blood flow through kidneys causes them to further inc. BP,

134
Q

Signs and symptoms of arteriosclerosis

A

defined as BP >140/90, usually asymptomatic in early stages, may be associated with fatigue, malaise, headache

135
Q

Treatment of arteriosclerosis

A

dec sodium in diet, dec. weight, dec. stress, inc. exercise, drugs like diuretics/ACE inhibitors/alpha blocker/calcium channel blocker

136
Q

Aortic aneurysms

A

localized dilation in arterial wall abdominal or thoracic

137
Q

Cause of aortic aneurysms

A

damage to arterial wall, dilation may take different shapes like saccular (bulging wall on 1 side), fusiform (circumferential dilation), many anerurysms eventually rupture

138
Q

Signs and symptoms or aortic aneurysms

A

usually asymptomatic, abdominal aneurysm may be palpable, thrombus may obstruct branches of aorta, pain, loss of pulses, dec BP, organ dysfunction

139
Q

Treatment of aortic aneurysms

A

surgical resection and grafting, pending surgery need to prevent sudden inc. in BP (cough/bear down)

140
Q

Insufficient blood supply to the myocardium can result in what?

A

myocardial ischemia, injury, infarction, or all 3

141
Q

Ischemia definition

A

reduced or insufficient blood supply to an organ

142
Q

Injury definition

A

occurs to organ/tissue when ischemia becomes more severe

143
Q

Infarction definition

A

organ/tissue necrosis or death

144
Q

Cause of Myocardial ischemia/infarction

A

usually caused by atherosclerosis or blockage of the coronary arteries that nourish the heart

145
Q

What is the predominant site for infarction

A

left ventricle

146
Q

What happens during myocardial infarction

A

central area of necrosis in generally surrounded by an area of injury, this in turn is surrounded by an area of ischemia

147
Q

Cause of shock (severe hypertension)

A

BP is the function of the blood volume, heart contraction, and peripheral resistance

148
Q

A drop in BP may be caused by what?

A

hypovolemic shock (loss of blood volume), cardiogenic shock ( dec. pumping capability of the heart), Septic shock, neurogenic shock (loss of signals to the sympathetic NS), Anaphylactic shock

149
Q

Bodys compensation for dec. BP how?

A

inc. HR, Vasoconstriction, fluid retention (retains Na+), inc. RR

150
Q

Signs and symptoms of shock

A

thirst, agitation, cool/pale skin, tachycardia, oliguria, dizziness

151
Q

Complications of shock

A

acute renal failue, hepatic failure, DIC, cardiac ischemia and arrhythmias, multi system organ failure

152
Q

Treatment of shock

A

supine position, treat underlying problem, give O2

153
Q

Electrocardiogram (EKG/ECG)

A

noninvasive, compare basline results for any changes, useful for diagnosis and monitoring of arrhythmias/infarction

154
Q

Holter monitor

A

records EKG while patient goes about daily activites

155
Q

Echocardiography

A

cardiac ultrasound, used to record images of heart wall and valve movement, can estimate ejection fraction

156
Q

Exercise stress test

A

check general function and stress induced problems

157
Q

Chest xray

A

shape and size of heart, pulmonary congestion associated with left heart failure

158
Q

Induced hypothermia

A

used to lessen the degree of permanent tissue damage to the brain and the heart, reduce the inflammatory response, slows the metabolic rate of consumption

159
Q

Goal induced hypothermia

A

decrease core body temp to 32-34 degrees C within 2 hours of arrival for a max of 24 hours

160
Q

Cardiac catheterization

A

pass catheter through blood vessel into ventricle and pulmonary artery, measures pressure, measures CO, monitor blood movement

161
Q

Coronary angiography

A

thread catheter through aorta to coronary arteries, inject dye to locate coronary artery obstruction

162
Q

Blood Tests

A

serum triglyceride and cholesterol levels, electrolyes, serum enzymes

163
Q

Arterial blood gas

A

check o2, check acid base balance

164
Q

Coronary artery bypass graft definition

A

common surgical intervention used to bypass obstructed or blocked coronary arteries by grafting in arteries/veins harvested from other areas of the patients body

165
Q

general treatment measures for cardiac disorders

A

dietary modification, exercise, smoking cessation, drug therapy (vasodilators/beta blockers/digoxin/calcium channel blockers), antihypertensive drugs, anticoagulants

166
Q

orientated times 3

A

person, place, time

167
Q

vegetative state

A

loss of awareness and mental capabilities, unresponsive to verbal stimuli, make have sleep awake cycles

168
Q

Brain death

A

cessation of brain function, absence of brain stem reflexes, absence of respiration

169
Q

Contralateral paralysis or paresis is due to what?

A

brain damage on the opposite side, crossover or corticospinal tract

170
Q

Decerebrate definition

A

adducted arms with extension, legs and head extended. body arched

171
Q

Decerebrate position is usually due to what?

A

brain stem damage; GCS 2 motor

172
Q

Decorticate definition

A

adducted with arms flexed, internal rotation of hands, legs extended and also rotated internally; GCS 3 motor

173
Q

Optic nerve is divided where?

A

optic chiasm

174
Q

Aphaisa definition

A

the inability to comprehend or to express language

175
Q

Dysphasia definition

A

partial impairment

176
Q

Expressive aphasia definition

A

inability to speak or write appropriately

177
Q

Expressive aphasia occurs because of damage to what area in the brain?

A

Brocas area

178
Q

Receptive aphasia definition

A

inability to read or understand spoken words

179
Q

Receptive aphasia occurs because of damage to what area in the brain?

A

Wernicke’s area

180
Q

Global aphasia

A

combination of expressive and receptive, likely major damage to brain

181
Q

Seizures

A

uncontrolled excessive discharge of neurons in the brain

182
Q

Petit mal seizure definition

A

absence seizure

183
Q

Grand mal seizure definition

A

very physical

184
Q

Any increased in the brain volume causes an increase in what?

A

ICP

185
Q

Increased pressure limits arterial blood flow to brain leading to what?

A

ischemia and infarction

186
Q

What causes cerebral arteries to dilate leading to more blood volume in brain?

A

hypoxia

187
Q

What helps reduce brain swelling?

A

manitol

188
Q

Decreased what causes cerebral vasoconstriction leading to decreasing ICP?

A

PaCO2

189
Q

Transient ischemic attacks (TIA)

A

mini strokes;lasts few minutes to a few hours, temporary localized reduction in blood flow to brain

190
Q

TIA is usually caused by partial occlusion of artery due to what?

A

arteriosclerosis, embolus, vascular spasm

191
Q

Signs and symptoms of TIA

A

person remains conscious, short episodes of muscle weakness/numbness, transient aphasia or confusion

192
Q

Cerebrovascular accident (CVA, stroke)

A

infarction of brain tissue due to lack of blood flow

193
Q

CVA may be caused by what?

A

arteriosclerosis, embolus, intracerebral hemorrhage

194
Q

Signs and symptoms of CVA

A

sudden weakness/numbness/tingling, loss of speech, confusion, sudden loss of vision, sudden severe headache, unusual dizziness

195
Q

Treatment of CVA

A

thrombolytics, carotid endarterectomy if blocked, external vent. drain, control hypertension, rehab

196
Q

Cerebral aneurysm usually occurs at points of bifurcation on what?

A

circle of Willis

197
Q

Rupture causing bleeding into subarachnoid space and CSF causes what?

A

inc. ICP (the blood irritates tissue)

198
Q

Signs and symptoms of cerebral aneurysm

A

headache, photophobia, nuchal rigidity due to irritation of spinal nerves

199
Q

Treatment of cerebral aneurysm

A

surgery to clip or tie off aneurysm, ICP monitoring, external vent. drain

200
Q

The two main reasons EVDs are inserted are what?

A

to divert infected CSF away from the brain and allow antibiotics to be given directly into the CSF to remove infection and to reduce pressure inside the brain

201
Q

Meningitis

A

inflammation of the membranes surrounding the brain and spinal cord

202
Q

Acute bacterial meningitis is when bacteria reaches the blood how?

A

blood (septicima), extension from nearby tissues, direct access through wounds

203
Q

Most common bacteria in acute bacterial meningitis is what?

A

hemophilis influenzae, neisseria meningitides, streptococcus pneumoniae

204
Q

Signs and symptoms of acute bacterial meningitis

A

sudden onset, severe headache, back pain, nuchal rigidity, vomiting,

205
Q

Treatment of acute bacterial meningitis

A

fatal in 10-40% of cases, antibiotics, vaccines

206
Q

head trauma definition

A

non congenital insult to the brain from an external mechanical force

207
Q

Cerebral concussion

A

reversible interference with brain function, often associated with a brief loss of consciousness, usually resolves with 24 hrs

208
Q

for males sports related TBIs were sustained most often by playing what sports?

A

football or bicycling

209
Q

for females sports related TBIs were sustained most often by playing what sports?

A

soccer and bball

210
Q

cause of cerebral concussion

A

blunt impact to the head causing the brain to strike and rebound from the skull

211
Q

Signs and symptoms of cerebral concussion

A

loss of consciousness with shallow breathing, low pulse rate, flaccid muscle tone

212
Q

Once consciousness is regained from a concussion what are the signs and symptoms?

A

amnesia, bradycardia, faintness, pallow, hypotension, photophobia

213
Q

Delayed symptoms of a cerebral concussion

A

headache, nausea, vomiting, blurred vision

214
Q

How do you diagnose a cerebral concussion?

A

cranial CT scan, MRI

215
Q

Treatment of concussion

A

bed rest, close monitoring for progressive brain injury, behavioral changes, difficulty speaking, confusion

216
Q

Subdural Hematoma (SDH)

A

when the head sustains a severe blow, blood will collect b/w the dura mater and the second membrane covering the brain known as the arachnoid membrane

217
Q

Cause of SDH

A

caused by blood leaking from ruptured vessels below the dural membrane, almost always caused by a severe head injury

218
Q

Signs and symptoms of SDH

A

difficulty walking, headache, confusion, slurred speech, visual problems, initial loss of consciousness,

219
Q

Delayed symptoms of SDH

A

unilateral paralysis, severe headache, dilated pupils

220
Q

How do you diagnose a SDH

A

CT/MRI, ICP monitoring

221
Q

Treatment of SDH

A

craniotomy

222
Q

Subarachnoid hematoma (SAH)

A

blood vessel rupturing resulting in release of blood into the subarachnoid space b/w the pial and arachnoid membranes

223
Q

Cause of SAH

A

may be caused by head injury, spontaneous rupture of a cerebral aneurysm

224
Q

Signs and symptoms of SAH

A

sudden onset of severe headache, nausea/vomiting, meningeal irritation, photophobia/visual changes, focal neurologic deficits, sudden loss of consciousness, seizures

225
Q

How do you diagnose an SAH

A

CT scan, angiography, lumbar puncture

226
Q

Treatment of SAH

A

surgical treatment to prevent rebleeding which involves clipping the ruptured aneurysm or endovascular treatment

227
Q

Cerebral contusion

A

bruising of brain with rupture of small vessels located beneath or along the surface of the brain

228
Q

Cause of cerebral contusion

A

blunt blow to head or by an impact that causes the brain to twist against the inner surface of the skull

229
Q

Signs and symptoms of cerebral contusion

A

depends on loca and extent of injury, transient loss of consciousness, coma, lower BP and body temp, hemiparesis, severe headache, nausea/vomiting, lethary, apathy, drowsiness, hostility, combativeness

230
Q

How do you diagnose a cerebral contusion

A

Cranial CT scan and MRI, ICP monitoring

231
Q

Treatment of cerebral contusion

A

depends on severity , external vent drain, mech vent if needed, surgery

232
Q

Closed head injury

A

skill isnt fractured but brain tissue is injured, inc ICP due to tissue swelling

233
Q

Depressed skull fracture

A

displacement of a piece of bone below level of skull

234
Q

Basilar skill fracture

A

occurs at base of skull, may leak CSF thru ears/nose, black eyes

235
Q

Countrecoup

A

injury to area of brain contralateral to area of direct damage

236
Q

most common spinal cord injury occurs where?

A

high mobility areas of the spine, C1-7 and T12-L2

237
Q

Spinal cord nerves do not do what?

A

regenerate

238
Q

What is the leading cause of spinal cord injuries?

A

motor vehicle accidents

239
Q

What else causes spinal cord injuries

A

falls, acts of violence, sports, alcohol, diseases

240
Q

Signs and symptoms of spinal cord injuries

A

depends on loca, spinal shock period, flaccid paralysis, post spinal shock period

241
Q

Treatment of spinal cord injuries

A

surgery, glucocorticoids to reduce edema, aggressive PT and rehab

242
Q

Guillain Barre Syndrome is seen in what?

A

post infections; polyneuritis, acute idiopathic polyneuropathy

243
Q

Cause of GBS

A

exact cause may be unknown, may be abnormal immune response precipitated by viral infection

244
Q

Where does GBS start?

A

process beings in legs; may rise to include respiratory muscles

245
Q

GBS is what kind of paralysis?

A

ascending

246
Q

Signs and symptoms of GBS

A

history of recent virus or immunization, progressive muscle weakness starting in legs, pain, vision and speech may be impaired, ANS impariment, cardiac arrhythmias, fluctuating BP

247
Q

Treatment of GBS

A

may require vent and bronchial hygiene, supportive, PT

248
Q

Multiple sclerosis

A

progressive demyelination of neurons of brain, spinal cord and cranial nerves, interferes with conduction of impulses

249
Q

In MS what is usually not affected

A

intellectual function

250
Q

MS may be considered to be what kind of disease?

A

autoimmune

251
Q

signs and symptoms of MS

A

progressive degeneration with remissions and exacerbations, being age 20-40, blurred vision/double vision, muscle weakness, bladder and bowel disfunction

252
Q

Treatment of MS

A

no specific treatment, glucocorticoids, interferon drugs

253
Q

Parkinsons disease

A

progressive degenerative disease, dec number of neurons that secrete dopamine

254
Q

A decrease in dopamine results in what?

A

excess stimulation which causes inc. muscle tone and activity

255
Q

Primary idiopathic parkinsons usually develops after what age?

A

60, occurs in men and women

256
Q

Secondary parkinsons may appear earlier due to what?

A

encephalitis, trauma, and vascular disease

257
Q

Signs and symptoms of parkinsons

A

involuntary movement, repetitive motion of hands, inc. muscle rigidity, difficulty initiating movement, stooped/foward leaning posture, unblinking face

258
Q

Signs and symptoms of parkinsons in the late stage?

A

urinary retention, constipation, orthostatic hypotension

259
Q

Treatment of parkinsons

A

medications like L-dopa (replaces lost dopamine), Eledepryl (blocks breakdown of L-dopa), speech pathology, sugery (deep brain stimulation)

260
Q

Complete fracture

A

extends through entire thickness

261
Q

Incomplete fracture

A

extends only partway through the bone (partial)

262
Q

Closed fracture

A

skin not broken at fracture site

263
Q

Open (compound) fracture

A

skin broken at fracture site where a piece of bone protrudes

264
Q

Simple fracture

A

single break in bone due to a direct blow

265
Q

Comminuted fracture

A

multiple fracture lines/bone fragments embedded in tissue

266
Q

Compression fracture

A

bone is crushed or collapses into small pieces

267
Q

Impacted fracture

A

a break in which the bone is broken with one end forced into the interior of another

268
Q

Pathologic fracture

A

usually a symptom not a cause, results from weakness in bone because of tumor, osteoporosis, ect

269
Q

Spiral fracture

A

break angles around bone usually due to twisting injury

270
Q

Greenstick fracture

A

bone bends but does not break (splits like a new twig), common in kids

271
Q

Colles Fractures

A

extra articular fractures of the distal radius that occurs as a result of a fall onto an out stretched hand

272
Q

Potts Fractures

A

fracture of the lower part of the fibula, with serious injury of the lower tibial articulation (rolled ankle or awkward landing)

273
Q

Healing of fractures

A

may require open or closed reduction to align bone ends

274
Q

Open reduction

A

surgical repair and external fixation (may require pins, plates, cast)

275
Q

Closed reduction

A

bone manipulation and casting without surgery

276
Q

Dislocations

A

separations of 2 bones at a joint

277
Q

Subluxation

A

partial displacement with partial contact b/w surfaces of 2 bones

278
Q

Treatment of dislocations

A

reduction to return bone to normal position, immobilization during healing, therapy

279
Q

Spinal deformities

A

may be congenital or due to trauma/disease

280
Q

Lordosis

A

anterior convexity of the spine, sway back, inward curvature of lumbar spine

281
Q

Kyphosis

A

outward curvature of the spine, humpback

282
Q

Scoliosis

A

lateral curvature of the spine

283
Q

Treatment of spinal deformities

A

physical therapy, back braces, surgery (spinal fusion)

284
Q

Osteoporosis

A

metabolic bone disorder characterized by decreased bone mass and density

285
Q

Predisposing factors of osteoporosis

A

female, age >50 years, sedentary lifestyle, prolonged deficit of vitamin D or calcium, cigs smoking, small light bone structure, prolonged intake of glucocorticoids

286
Q

Signs and symptoms of osteoporosis

A

early stages are asymptomatic, bone fracture, compression fractures of vertebrae

287
Q

Treatment of osteoporosis

A

dietary supplements of calcium and vitamin D, fluoride supplements, biphosphonates, weight bearing exercise program

288
Q

Rickets are seen in who?

A

children

289
Q

Osteomalacia is seen in who?

A

adults

290
Q

Rickets and osteomalacia is due to what?

A

lack of vitamin D and phosphates required for bone mineralization

291
Q

Rickets and osteomalacia may be a result of what?

A

inadequate diet, not enough sunlight exposure, malabsorption syndromes, chronic renal failure

292
Q

Signs and symptoms of rickets and osteomalacia

A

bone pain in larger bones, loss of height, muscle cramps, inc. bone fractures, skeletal deformity. Rickets bow legs and short stature

293
Q

Treatment of rickets and osteomalacia

A

inc. exposure to sunlight, inc. dietary intake

294
Q

Pagets Disease

A

progressive bone disease

295
Q

What are the 3 stages of Pagets Disease

A

destructive stage, mixed, and osteosclerotic

296
Q

Destructive stage

A

rapid bone resorption

297
Q

mixed stage

A

bone resorption continues along with new formation of course bone

298
Q

osteosclerotic stage

A

excess destruction ends deposition of abnormal bone continues

299
Q

Signs and symptoms of Pagets disease

A

deformity of long bones, enlarged cranial bones, bone fractures, bone pain

300
Q

Treatment of Pagets Disease if symptomatic

A

analgestics, biphosphonates to prvent bone resorption

301
Q

Osteoarthritis

A

degenerative joint disease, most common joint disease

302
Q

What are the 2 theories that may represent why it happens?

A

repeated injury to articular cartilage, autoimmune disorder

303
Q

Disease process of osteoarthritis

A

articular cartilage shows surface defects and thinning, surface of cartilage becomes rough and fragments go into synovial fluid, bone develops cysts ans spurs, surrounding tissues may become inflamed

304
Q

Signs and symptoms of osteoarthritis

A

most often affects weight bearing joints, frequently affects fingers and toes, pain in joint with weight bearing and movement, stiff joints, crepitus (grating)

305
Q

Treatment of osteoarthritis

A

analgesics and anti inflammatories, ambulatory aids or weight reduction, surgery (joint replacement)

306
Q

Rheumatoid arthritis

A

chronic systemic inflammatory disease, probably an autoimmune disease, more common in women

307
Q

Course of rheumatoid arthritis

A

inflammation of synovial membrane, pannus formation on articular cartilage, cartilage erosion, pannus becomes fibrotic, ankylosis and deformity develop, osteoporosis on both sides of joint, muscle atrophy

308
Q

Signs and symptoms of rheumatoid arthritis

A

exacerbations and remissions, insidious onset, symmetrical stiffness and aching joints, usually begins in fingers/wrists/toes, red/swollen joints, nodules, ulnar deviation of fingers

309
Q

Treatment of rheumatoid arthritis

A

ASA and NSAIDS, COX-2 inhibitors (celebrex), balance b/w rest and moderate activity, PT, surgery

310
Q

Hyperuricemia

A

deposit of uric acid crystals in joint

311
Q

Cause of Gout

A

primary gout is idiopathic, secondary gout is related to another condition

312
Q

Hyperuricemia may result from what?

A

overproduction of uric acid from the kidneys

313
Q

Signs and symptoms of gout

A

sudden onset of severe joint pain, acute inflammation causes redness/swelling, fever, malaise, develop tophi (large hard urate crystal nodules around joints)

314
Q

Treatment of gout

A

drugs to reduce serum uric acid levels, low purine diet, analgesics and anti imflammatory meds

315
Q

ankylosing spondylitis

A

chronic progressive inflammation affecting sacroiliac joints, inververtebral spaces, and costovertebral joints

316
Q

Ankylosing Spondylitis is an autoimmune disorder with genetic basis given with the presence of what in the serum of patients?

A

HLA-B27

317
Q

Signs and symptoms of Ankylosing spondylitis

A

develops at 20-40 yrs of age, usually starts at sacroiliac joint then up the spine, low back pain/morning stiffness, dec lung expansion

318
Q

Treatment of Ankylosing spondylitis

A

NSAIDS, COX-2 inhibitor

319
Q

Myasthenia Gravis

A

acquired automimmune disease, the bodys own antibodies block/destroy acetylcholine receptors at the neuromuscular junction

320
Q

Signs and symptoms of myasthenia gravis

A

periodic remissions and exacerbations, weak and fatigue muscles, eyelid dropping, impaired speech/chewing/swallowing, loss of facial expression

321
Q

Myasthenia gravis is what type of paralysis?

A

descending

322
Q

How do you diagnose myasthenia gravia?

A

tensilon test, electromyography, pulmonary function testing, CT scan

323
Q

Treatment of Myasthenia gravis

A

thymectomy, corticosteroids, anti cholinesterase drugs, plasmapheresis, IV immunoglobulin therapy

Human Disease Test 3 (1 decks)

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