Test 4 Flashcards
1
Q
What are three complications of diverticulitis?
A
Abscess formation, rupture, and peritonitis.
2
Q
What are seven clinical manifestations seen in people with Alzheimer’s?
A
Dementia, absentmindedness, emotional upset and behavioral changes if posterior frontal lobe is involved, rigidity, and changes to posture and gait.
3
Q
If you are experiencing an lower GI bleed, what are the three sites that could be producing that bleeding?
A
The jejunum, ileum, or colon.
4
Q
What does the basilar artery supply blood to?
A
It supplies blood to the brain stem and cerebellum.
5
Q
Which tract carries sensations of pain, temperature, crude and light touch from the body to the brain for processing?
A
The spinothalamic tracts.
6
Q
What treatment and/or prevention is used in regards to hepatitis A virus?
A
Vaccines for prevention and immunoglobulin shots for acute exposures.
7
Q
What is the most common cause of Addison’s disease?
A
Autoantibodies that cause adrenal atrophy and hypofunction.
8
Q
What is the most common cause of hyperthyroidism?
A
Graves’ disease.
9
Q
What are five things considered when observing a person’s level of consciousness (LOC)?
A
- Being alert or easily arousable to alertness if asleep.
- Being oriented x4: self, time, place, events
- Following commands appropriately
- Having normal speech
- Conversing appropriately
10
Q
What are six signs and symptoms associated with the hepatitis A/B/C virus?
A
Fairly acute fever, malaise, jaundice, NandV, and diarrhea that is usually mild with full recovery; (HBV and HCV can be asymptomatic for years).
11
Q
When is Immitrex supposed to be used in relation to a CNS disorder?
A
At the first sign of the prodromal stage of a migraine.
12
Q
What is a severe, life-threatening disorder associated with the escape of pancreatic enzymes into the pancreas and surrounding tissues, causing autodigestion and hemorrhage?
A
Acute pancreatitis.
13
Q
What is status epilepticus?
A
A seizure that is unremitting and not-responsive to medications.
14
Q
Following an illness, a patient becomes hypocalcemic. Which of the following negative-feedback, endocrine compensatory mechanisms will increase the calcium in her blood?
A
The parathyroid will increase its secretion of PTH.
15
Q
*What are six signs and symptoms associated with acute pancreatitis?
A
Epigastric pain, abrupt onset post-prandial or post-ETOH ingestion, pain radiation to the back, possible jaundice due to biliary obstruction/inflammation.
16
Q
What are six possible causes of cirrhosis?
A
Excessive ETOH intake, toxic reactions to drugs and chemicals, viral hepatitis, bile duct disease, and genetic disorders.
17
Q
What would the lab results look like in acute pancreatitis?
A
High amylase and lipase which may occur with leukocytosis too.
18
Q
What is Graves’ disease?
A
An autoimmune disorder where autoantibodies attack/stimulate TSH receptors on the thyroid, resulting in oversecretion of T3 and T4.
19
Q
What is another name for a thyrotoxic crisis?
A
A thyroid storm.
20
Q
What are several expected lab results in a person who has cirrhosis?
A
High indirect and low direct bilirubin, and elevated AST, ALT, and ALP.
21
Q
What does myelin do?
A
It gives white matter its color and increases the speed of nerve impulse transmission.
22
Q
Where does a microbe that causes meningitis most commonly enter the body?
A
Through the highly vascular nasopharyngeal area where it can be taken to the choroid plexus.
23
Q
What are several symptoms associated with hypercalcemia?
A
Asthenia, lethargy, renal calculi, osteoporosis, and hyperpolarization.
24
Q
Upon assessing his patient, a nurse notes hemiparesis of the right arm & leg and dysphasia which the patient states began 2 days ago. What does the nurse most likely think caused this?
A
A stroke involving the left hemisphere of the brain.
25
Which organs are located in the LUQ?
Stomach, spleen, and transverse colon.
26
What is the hypophysis?
The pituitary gland.
27
What is a patient's status like in the post-ictal stage?
They are often dazed, confused, and sometimes combative because the brain's "circuits" are still not back to normal.
28
How does dysarthria differ from dysphasia?
Both are difficulty speaking, but dysarthria is due to an issue with the jaws, while dysphasia is due to a neurological problem.
29
A patient with Type I diabetes has a pH of 7.32. This is most likely caused from the byproducts of increased what?
Gluconeogenesis.
30
What are four signs and symptoms seen with abnormal protein catabolism like in Cushing's disease?
Myasthenia and muscle atrophy, short stature in children, and weakened collagen fibers which leads to purple striae.
31
What two conditions are known to cause stones in the gallbladder and the gallbladder duct?
Hypercholesterolemia and dehydration.
32
What substance(s) or chemical(s) is/are refluxed in GERD?
Hydrochloric acid and pepsin.
33
What happens because of the decreased dopamine levels present in people suffering from Parkinson's disease?
There is an increased cholinergic effect which causes a variety of symptoms.
34
What are known causes of GERD?
Relaxation of the lower esophageal sphincter and/or delayed emptying of the stomach.
35
What part of the brain is most likely being affected when there are changes in heart rate and blood pressure?
The medulla.
36
What is the issue(s) in Cushing's syndrome (NOT Cushing's disease)?
Hypercortisolism due to receiving chronic steroid treatment.
37
What two types of medications are given in treatment of Parkinson's disease?
Anticholinergics and ones that contain dopamine.
38
What level of serum glucose would be considered hypoglycemic?
A blood glucose \<70.
39
If you suspect a patient is having a stroke, which four vital signs should you check?
BP, HR, RR, and temperature.
40
A patient who just came out of general anesthesia has lab work done. The serum osmo is 165. The nurse taking care of this patient suspects that his _____ is due to \_\_\_\_\_\_\_\_\_.
hypoosmolality; syndrome of inappropriate ADH (SIADH)
41
What happens if you don't eat after your body has told you to eat and after it has released epinephrine and cortisol?
GH and glucagon are then secreted to begin glycogenolysis first, then gluconeogenesis if the former isn't enough.
42
Which cranial nerve would be affected in the brain/brain stem to cause problems with the heart rate?
CN X, the vagus nerve.
43
What are seven signs and symptoms associated with ulcerative colitis?
Dehydration, bloody diarrhea, abdominal cramps, obstruction, fistula, confluent inflammation, and a mild risk for malnutrition.
44
What is the hallmark sign of posthepatic jaundice?
Gray-colored or clay-colored stool.
45
What are several, eleven, signs and symptoms seen in patients with hyperthyroidism?
Tachycardia, increased afterload, exophthalmus, goiter, increased body temperature, heat intolerance, diaphoresis, thin hair, alopecia, and overall increases to CNS and GI systems.
46
If a patient is having issues with their BP, HR, RR, or temperature, in addition to there being a suspected stroke, which part of the brain is most likely affected by the CVA?
The brain stem.
47
What treatment(s) is indicated for age-related macular degeneration?
There is no effective treatment.
48
A patient with cirrhosis and all its associated problems has an RBC count of 2 million, thrombocytopenia, and ascites. In reviewing the patient’s lab work, the nurse understands that one likely cause of the ascites is what?
A serum osmolality \<280 due to decreased serum proteins.
49
What are three acute conditions that can precipitate a seizure?
Head injury, stroke, and cerebral edema.
50
What is the hallmark of myasthenia gravis?
Myasthenia that increases during periods of activity and improves after periods of rest.
51
What are the three main problems that result from portal hypertension?
Ascites, splenomegaly, and varices (hemorrhoidal, umbilical, or esophageal).
52
What are five etiologies indicated in diabetes insipidus?
Sick kidneys with decreased response to ADH, pituitary tumor, acute head injury, cerebral edema, or increased ICP.
53
What is Barrett's esophagus?
An uncommon disorder with dysplastic changes in esophageal tissue due to GERD.
54
What are nine signs and symptoms associated with hypocortisolism?
Hypoglycemia which can cause asthenia, fatigue, apathy, psychosis, anorexia, NandV, and diarrhea.
55
How does meningitis usually spread?
Via sneezing, tussis, and sharing eating utensils.
56
What are nine signs and symptoms seen in Cushing's syndrome/disease?
Increased glycogenolysis and gluconeogenesis, abnormal lipolysis, abnormal protein catabolism, increased osteoclastic activity, prostaglandin suppression, hypokalemia, hirsutism, and hypervolemia.
57
What are three stressors that have been known to elicit a thyroid storm?
Infection, trauma, and surgery.
58
How is prehepatic jaundice treated when it has a physiologic etiology in neonates?
With UV light therapy to help immature glucuronyl transferase convert unconjugated bilirubin to conjugated.
59
A jaundiced patient has a higher than normal direct bilirubin. The mechanism most likely responsible for this is \_\_\_\_\_\_\_\_, and a likely responsible disease process is \_\_\_\_\_\_\_\_\_\_\_\_.
posthepatic obstruction; cholelithiasis
60
What makes up intracranial pressure?
Arterial and venous pressures, CSF pressure, and brain tissue--the totalities of pressures in the brain.
61
What are several, ten, signs and symptoms associated with a thyrotoxic crisis?
Extreme restlessness and agitation, delirium, seizures, coma, tachycardia, HF, shock, hyperhidrosis, and hyperthermia.
62
A patient with myasthenia gravis is on a drug to block an enzyme called cholinesterase. This drug’s action will help the patient by decreasing what?
The breakdown of acetylcholine in neuromuscular junctions.
63
What are three signs and/or symptoms seen in GERD?
Pyrosis, epigastric pain, and coughing within one hour of eating.
64
What are some signs and symptoms of a hiatal hernia?
GERD, epigastric pain, and dysphagia, or asymptomatic.
65
What happens to steroids in a body suffering from cirrhosis?
They cannot be broken down normally, so people can experience Cushing's disease, gynecomastia, and hirsutism.
66
What are several risk factors associated with cholecystitis?
Obesity, excessive estrogen, starvation, genetic component, and European heritage.
67
What is another name for the ascending sensory tracts used for observing neurologic function below the shoulders?
The spinothalamic tracts.
68
What are the three main functions of calcium in our bodies?
Building and maintenance of appropriate bone density, cell electrical activity, and clotting.
69
What is edema and inflammation of the optic nerve where it enters the retina that cannot be detected without an ophthalmoscope?
Papilledema.
70
What are four things known to exacerbate the signs and symptoms of GERD?
Lying down, alcohol, coffee, and smoking.
71
What causes ascites to occur in cirrhosis?
Increased pressure in the portal veins which causes increased venous hydrostatic pressure, forcing fluid into the abdominal cavity.
72
What are two treatments used with IBD?
Steroids to control inflammation and sometimes surgery for a colectomy.
73
What are several signs and symptoms of myxedema coma?
Sudden impaired LOC, hypotension, and hypoventilation.
74
What are three known causes of prehepatic jaundice?
Hemolytic anemia, erythroblastosis fetalis, and simple physiologic immaturity in newborns
75
What immediate interventions are carried out in a medical setting once a patient has been diagnosed with a CVA?
O2, BP management, HOB elevated at least 30 degrees, diuretics, and sometimes an ICP monitor.
76
What is homonymous hemianopia and what typically causes it?
A visual deficit in one side of both eyes due to cerebral focal edema around the right CN II.
77
What is the normal fasting serum glucose range?
70-99.
78
Which tends to be milder, viral or bacterial meningitis?
Viral meningitis.
79
Besides oral steroids, what else is recommended that patients with Addison's disease do as a treatment?
To take in lots of fluids and to eat a high-sodium diet.
80
What are the two general types of Alzheimer's disease seen in people?
Familial which makes up 30% of cases, and non-hereditary (sporadic) Alzheimer's which makes up 70% of cases.
81
Why are NSAIDs and steroids considered to worsen GI issues with the stomach?
Because they decrease synthesis of prostaglandins which normally have a protective effect on the stomach lining.
82
What does the treatment of migraines usually consist of?
Trigger-avoidance, NSAIDs, and "abortive" drugs like Immitrex.
83
If both pupils respond equally to light and constrict to the same size, which cranial nerves are intact according to this assessment?
CN II and III.
84
What does the treatment of diverticulitis consist of?
Increased dietary fiber, avoidance of seeds and nuts, and sometimes antibiotics and surgery.
85
Regardless if a CVA's origin is ischemic or hemorrhagic, what are ultimately the actual two causes of the negative effects seen in these conditions?
Cerebral edema and increased ICP.
86
What are some symptoms present in people with age-related macular degeneration?
Good peripheral vision, but central vision is affected which feels like having a black spot in the middle of one's vision.
87
What is mydriasis?
Pupillary dilation normally due to NE stimulating alpha-1 adrenergic receptors.
88
What is a mostly age-related disease process where there is an elevation of intraocular pressure that results in a loss of visual fields and can eventually lead to blindness?
Glaucoma.
89
What is the normal range of bicarbonate (HCO3) in our bodies?
22-26.
90
Where do diverticula most commonly occur?
In the sigmoid colon.
91
What are the two types of inflammatory bowel disease?
Crohn's disease and ulcerative colitis.
92
\*What are five symptoms that are unique to a hemorrhagic stroke?
Intense headache (10/10), cervicalgia, photophobia, and N&V.
93
Which two lab results are expected to be seen in a patient with hypothyroidism?
High TSH and low T4.
94
What are some characteristics of conjugated bilirubin?
It is made in the liver to be water soluble so that is can more easily be incorporated into bile to emulsify fats.
95
What is the chronic inflammatory condition of the stomach and proximal duodenum where disturbance of their mucosal lining allows acid to ulcerate the underlying tissues?
Peptic ulcer disease (PUD).
96
Which two forces is the maintenance of effective cerebral blood flow dependent on?
Cerebral perfusion pressure (CPP) and intracranial pressure (ICP).
97
What is the main culprit in causing increased ICP, causing a loss of balance between the ICP and CPP?
Cerebral edema.
98
In which type(s) of diabetes mellitus is micro- and macroangiopathy seen?
Type I and II.
99
What are two lab results expected to be seen in patients suffering from cholecystitis?
Leukocytosis and high direct bilirubin.
100
Which type of stroke has a higher mortality rate, ischemic or hemorrhagic?
Hemorrhagic strokes have a higher mortality rate.
101
What kind of stroke occurs when fragments break from an arterial thrombus and travel downstream until they get stuck in a smaller artery of the brain?
An embolic stroke.
102
What is an Addisonian crisis?
Severe hypotension due to fluid losses.
103
What are five signs and/or symptoms associated with Schwartz-Bartter syndrome?
Oliguria, hyponatremia, peripheral and pulmonary edema, and low serum osmolality.
104
What two lab results are expected to be seen in someone suffering from hyperthyroidism?
High T4 and low TSH.
105
If a patient has a focal lesion of the brain, would you expect their signs and symptoms to be unilateral or bilateral?
Unilateral.
106
What are some of the most common causes of an UGI bleed?
Acute hemorrhagic gastritis, esophageal varices, & peptic ulcers.
107
Which arteries form the right and left middle cerebral arteries (MCA) that supply blood to the right and left cerebral cortices?
The right and left internal carotid arteries.
108
How would you differentiate a partial seizure from a general seizure?
They are normally local (not diffuse) and the patient has some varied level of consciousness.
109
What is the most common cause of esophageal varices?
Liver disease.
110
What are eight signs and symptoms associated with Crohn's disease?
Bloody diarrhea, abdominal cramps, transmural patchy inflammation, malabsorption, obstruction, fistula, malnutrition, & weight loss.
111
How is HAV normally transmitted?
Via enterally (fecal/oral) like with tainted oysters.
112
What risk factors are associated with the development of AMD?
HTN, smoking, Caucasian race, and diabetes.
113
What are several, six, known causes of hemorrhagic strokes?
HTN, atherosclerosis, aneurysm, congenital vascular malformations, bleeding into a tumor, and coagulation disorders.
114
In which type(s) of diabetes mellitus is neuropathy seen?
Type I and II.
115
What is an autoimmune disorder where autoantibodies attack/stimulate TSH receptors on the thyroid, resulting in oversecretion of T3 and T4?
Graves' disease.
116
Which three lab results reflect the existence of posthepatic jaundice?
High total, normal indirect, & high direct bilirubin.
117
What are three types of treatments used for myasthenia gravis?
Anti-cholinesterase drugs, steroids, and sometimes thymectomy.
118
What is a chronic autoimmune disease sometimes associated with thymic abnormalities that cause the body to block, alter, or destroy receptors for acetylcholine?
Myasthenia gravis.
119
If a patient were experiencing a head injury, a brain tumor, or stroke, would this disrupt cerebral perfusion pressure of intracranial pressure?
Intracranial pressure.
120
What causes hepatic encephalopathy?
Cirrhosis causing the liver to have a decreased ability to break down ammonia into urea, which can cause encephalitis at toxic levels.
121
What is asymptomatic diverticular disease known as?
Diverticulosis.
122
What are eight unique signs and symptoms associated with bacterial meningitis?
Restlessness, decreased LOC, leukocytosis, petechiae, purpura, hyperproteinemia, decreased CSF glucose, and blood in CSF.
123
What should nurses teach laypeople about CVAs if they think someone is experiencing one?
Teach them to act FAST: Face, Arms, Speech, and Time. Is one side of the face drooping? Does one arm drift downward? Can the person repeat a simple sentence? If any of the previous questions are answered with a yet, go to the nearest hospital emergency room.
124
What is another name for jaundice?
Icterus.
125
What is one complication due to chronic gastritis?
Pernicious anemia due to the loss of intrinsic factor.
126
What are a few known causes of syndrome of inappropriate antidiuretic hormone?
General anesthetics, cerebral trauma, and an ectopic source (i.e. small-cell bronchogenic cancer).
127
What is a volvulus?
A torsion or twisting of the intestine with occlusion of blood supply.
128
What is multiple sclerosis?
A relatively common autoimmune disorder that results from previous viral insult and causes the body's own T-cells to attack myelin proteins in brain neurons.
129
What are eleven known causes of PUD?
NSAID use, chronic steroid use, heavy ETOH use, cigarette smoking, chronic gastritis, liver disease, CKD, diabetes, COPD, severe psychological stress, and *H. pylori*.
130
What are four precipitating factors that are known to cause a myxedema crisis in patients with hypothyroidism?
An infection, drug, exposure to cold, or trauma.
131
What are some signs and symptoms that are noticed in the prodomal stage of some people who suffer from migraines?
An aura that may be perception of a strange light, an unpleasant smell, or confusing thoughts.
132
What is sometimes another name for "closed-angle" glaucoma?
Acute glaucoma.
133
What are several, nine, signs and symptoms associated with both viral and bacterial meningitis?
Photophobia, HA, irritability, N&V, nuchal rigidity, pyrexia, and Brudzinski's and/or Kernig's signs.
134
What are seven signs and symptoms associated with hepatic encephalopathy?
Lack of mental alertness, confusion, coma, blurred vision, tremors, seizures, and an early-sign is asterixis.
135
A patient with cirrhosis and all its associated problems has an RBC count of 2 million, and thrombocytopenia. These low numbers are most likely caused by what?
Splenomegaly secondary to portal hypertension.
136
What most often causes appendicitis?
Fecal matter getting caught in the lumen of the appendix, which then causes infection and inflammation.
137
What are a few known etiologies of hypoglycemia?
Not eating or food isn't absorbed, over-exercising, natural hyperinsulinism, or too much exogenous insulin.
138
What are several signs and symptoms of a LGI bleed?
Occult bleeding and hematochezia.
139
What six conditions are known to be associated with paralytic ileus?
Immobility, post-anesthesia effects, surgery (especially abdominal), peritonitis, electrolyte imbalances, and spinal trauma.
140
What are some causes of nonviral hepatitis?
Autoimmunity, microbes, and idiopathic.
141
What are the two most common strains of bacteria that cause bacterial meningitis?
Meningococcus and pneumococcus.
142
How would you differentiate a general seizure from a partial seizure?
General seizures always cause unconsciousness with the tonic-clonic convulsions.
143
What are three signs and symptoms seen in people with colorectal cancer?
Occult or visible blood in stool, and overall changes in bowel habits.
144
Which type or types of diabetes mellitus use Kussmaul respirations as a compensatory response to a crisis?
Type I.
145
Which organs are located in the LLQ?
Descending colon and sigmoid colon.
146
What are several signs and symptoms of pancreatic cancer?
Insidious pain, posthepatic jaundice, and weight loss.
147
When do fat emboli normally occur?
When a person with osteoporosis fractures a bone and then fat is released from the marrow of the injured bone to systemic circulation.
148
What are several known etiologies of an intestinal obstruction?
Adhesions from scar tissue (from surgery or chronic inflammation), hernia, tumor of intestinal lumen, intussusception, volvulus, and paralytic ileus.
149
What are eight signs and symptoms seen in people who are suffering from Addison's disease?
Hypoglycemia, anorexia, N&V, diarrhea, polyuria, hypovolemia, and hypotension.
150
What causes papilledema?
The blockage of venous return from the retina mainly because of increased ICP.
151
With any kind of brain lesion, which absent or diminished reflexes might be clinically manifested?
The deep tendon, gag, or coughing reflexes.
152
In which type(s) of diabetes mellitus is DKA seen?
Type I.
153
Where does jaundice cause abnormal pigmentation?
In the skin, sclera, inferior portion of tongue, and the oral palate.
154
What are three major aspects associated with myxedema coma?
Hypothermia, fluid and electrolyte imbalance, and CO2 retention with hypoxemia.
155
What does the treatment of cirrhosis consist of?
Sobriety, liver transplant, low-protein diet, diuretics, and sometimes IV albumin.
156
What is the shifting of fluid from portal veins throughout the abdomen into the abdominal cavity known as?
Ascites.
157
What is papilledema?
Edema and inflammation of the optic nerve where it enters the retina.
158
What are five abilities and skills associated with the right hemisphere of the cerebrum?
Spatiality, insight, creativity, facial recognition, and musical ability.
159
What is another name for the corticospinal tracts?
The pyramidal or motor tracts.
160
What are six signs and symptoms associated with hypocalcemia?
Muscle spasms, tetany, CKD, petechiae, purpura, and positive Chvostek's.
161
What are seven risk factors associated with the occurrence of CVAs?
Preexisting atherosclerosis, preexisting HTN, age greater than 65, family history, diabetes, smoking, and a high-fat diet.
162
What produces insulin in the human body?
The beta cells of the pancreas.
163
If a patient was experiencing hyper- or hypotension, or an arterial blockage of the blood flow to the brain, would this disrupt cerebral perfusion pressure or intracranial pressure?
Cerebral perfusion pressure.
164
What is are three known causes of acute gastritis?
The overuse of NSAIDs or ETOH, and cancer therapy.
165
What are six signs and symptoms associated with DI?
Polyuria, polydipsia, dehydration, hypotonic urine, poor skin turgor, and dry mucosa.
166
What are six signs and symptoms associated with an intestinal obstruction?
Abdominal distention, severe-colicky abdominal cramping, NandV, constipation, and sometimes liquid diarrhea.
167
What is the effect seen with drug metabolism when someone is suffering from cirrhosis?
Drug effects are amplified because there isn't enough albumin to bind to.
168
What are some types of behaviors, skills, and abilities that are associated with the left hemisphere of the brain?
Speech, math, organization, reason, and analyzing.
169
\*What are seven risk factors that predispose someone to colorectal cancer?
Age over 50, high-fat diet, obesity, sedentary lifestyle, smoking, excessive ETOH, and family history.
170
What is paralytic ileus?
The loss of peristaltic motor activity in the intestine.
171
What are several signs and symptoms PUD?
Can be asymptomatic, epigastric pain 1-3 hours after meals, pain that wakes you up at night, and GI bleeding.
172
What are three factors known to cause acute pancreatitis?
Gallstones that cause obstruction in the pancreatic duct, biliary reflux, and ETOH consumption.
173
What are sensorimotor abnormalities below the neck and shoulders you would expect to see in someone right hemispheric stroke?
Drooping of the left arm and left leg.
174
Which are the two primary causes of symptoms in persons suffering from Alzheimer's disease?
Amyloid proteins abnormally build up in the brain causing _senile plaques_, and microtubules of brain neurons become distorted and twisted creating _neurofibrillary tangles_.
175
Which organs are located in the RUQ?
Liver, gallbladder, pancreas, and transverse colon.
176
What are seven factors that increase the risk of a person suffering from an embolic or thrombotic stroke?
A-fib, carotid atherosclerosis, air emboli (usually iatrogenic during surgery), clot around mitral/aortic valve prosthesis or vegetation from infected valve, or intracranial artery plaque.
177
What is cirrhosis defined as?
The end-stage, irreversible disease of liver.
178
How is the pathogenesis of migraines once an episode is triggered?
The trigger causes an alteration in the production of neurotransmitter chemicals, activating the inflammatory response that causes vasodilation, increased capillary permeability, and a throbbing unilateral HA.
179
What is another name for chronic gastritis?
Atrophic gastritis.
180
In which type(s) of diabetes mellitus is there a risk of dehydration seen?
Type I and II.
181
What are the two etiologies of type 2 DM?
Abnormally low insulin production and impaired insulin utilization.
182
What is myxedema?
A dermatological symptom of hypothyroidism that causes water to get trapped under the dry, coarse skin, causing an overall puffy appearance.
183
Which three lab results reflect the existence of prehepatic jaundice?
High total, high indirect, & normal direct bilirubin.
184
What is another name for posthepatic jaundice?
Obstructive jaundice.
185
What are five signs and symptoms associated with metabolic syndrome?
Type II DM, increased triglycerides, decreased HDLs, HTN, and abdominal obesity.
186
What are a few conditions known to exacerbate the manifestations of multiple sclerosis?
Stressors like heat, cold, and emotional pressure.
187
What are three issues known to cause nystagmus to exist?
Congenital defect, cerebellar dysfunction, or inner-ear dysfunction.
188
What does the vertebral artery merge with to supply blood to both the brain stem and cerebellum?
The basilar artery.
189
What is the medical term for pupillary constriction?
Miosis.
190
What is miosis?
Pupillary constriction on the iris responding to acetylcholine released by CN III.
191
What is a severe and irreversible loss of central vision due to destruction of the macula?
Age-related macular degeneration.
192
What is the telescoping of one portion of the bowel into the other, causing strangulation of blood supply that is more common in infants called?
Intussusception.
193
What is the specific part of the nervous system that is affected in Parkinson's?
The basal ganglia of the extrapyramidal tracts (AKA the extrapyramidal system) that travel downward regulating fine motor control, gait, and posture.
194
What are the results of hypoparathyroidism?
Hypocalcemia which leads to hypopolarization.
195
What is the primary glucocorticoid?
Cortisol.
196
In which type(s) of diabetes mellitus is diabetic coma seen?
Type I and II.
197
What is the pressure required to get oxygenated blood into the brain to perfuse the cells of the brain?
Cerebral perfusion pressure.
198
What is one infectious organism found in most patients who have been diagnosed with PUD?
Helicobacter pylori.
199
How does acute gastritis normally resolve?
It resolves spontaneously once the offending agent is removed.
200
What are three signs and symptoms of diverticulitis?
Pain that is most often in the LLQ, pyrexia, and leukocytosis.
201
What does the word decussate mean when talking about the CNS?
Decussation is the anatomical crossing over of neurologic axons in the corticospinal tracts, giving them a pyramidal appearance.
202
What kind of stroke occurs from a clot/plaque that blocks off an artery in which it has developed and causes distal ischemia?
A thrombotic stroke.
203
What is a basal ganglia dysfunction disease caused by an unknown source, but is suspected to be genetic, viral, or environmental toxin-induced depletion in dopamine?
Parkinson's disease.
204
What are the demographics of people suffering from multiple sclerosis?
Onset between 20 and 50 years of age with a male to female ratio of 1:2.
205
Where is Crohn's disease normally found?
Any part of the intestines can be infected, but 70% of cases involve duodenum, ileum, and cecum; and 20% of cases involve the large intestine.
206
Would infections, acidosis, or alkalosis disrupt cerebral perfusion pressure or intracranial pressure?
Intracranial pressure.
207
What is the normal function of aldosterone in the body?
It directs the kidneys to hold onto sodium (therefore holding onto water since H2O generally follows Na+) and to get rid of potassium.
208
Which manifestations are associated with protein depletion problems in a patient suffering from cirrhosis?
Ascites, generalized edema, and decreased levels of clotting associated with prolonged and easily bleeding (so thrombocytopenia and splenomegaly).
209
What are six of the most common etiologies of a cerebrovascular accident?
Cerebral, carotid, and vertebral atherosclerosis; hypertension; brain aneurysms and heart problems involving decreased cardiac output.
210
What is a myasthenia crisis?
When myasthenia begins to affect breathing.
211
How does *H. pylori* normally enter the human body?
It is ingested via food, drinking water, or other oral/fecal route more commonly seen in the same families or other crowded conditions.
212
What is intussusception?
The telescoping of one portion of the bowel into the other, causing strangulation of blood supply that is more common in infants.
213
If a patient were suffering from hypocalcemia, would Chvostek's sign be positive or negative?
It would be positive.
214
What are ten signs and symptoms seen in appendicitis?
Epigastric or periumbilical pain that migrates to the RLQ, pain exacerbated by movement, rebound tenderness, N&V, diarrhea, anorexia, pyrexia, and leukocytosis.
215
In which population does atrophic gastritis mainly occur?
The elderly.
216
If there is a present issue with CN VII related to a stroke, what signs and or symptoms might be seen?
Facial expression abnormalities.
217
What are always almost the two causes of cholecystitis?
Cholelithiasis and choledocholithiasis.
218
What are two signs and/or symptoms associated with open-angle glaucoma?
Slow loss of peripheral vision, and is normally painless.
219
What are four signs and symptoms associated with hypoaldosteronism?
Possibly hyponatremia, polyuria, hypovolemia, and hypotension.
220
What nutritional problems, if any, arise in people suffering from cirrhosis?
Bile salt production is impaired which causes impaired fat and fat-soluble vitamin absorption, and impaired glycogenolysis and gluconeogenesis (leading to hypoglycemia).
221
What are some known causes of the two inflammatory bowel diseases?
Infectious agents like bacteria and viruses, family history, and autoimmune response that is known to occur with arthritis and vasculitis.
222
What is another name for viral meningitis?
Aseptic meningitis.
223
What are eight signs and symptoms of cholecystitis?
RUQ and epigastric pain, painful spasms known as biliary colic, exacerbation after a high-fat meal, pain radiation to R shoulder and scapula, N&V, and posthepatic jaundice.
224
True or false, any dysfunction that affects the extrapyramidal system results in "parkinsonianisms"?
True.
225
In which type(s) of diabetes mellitus is acetone-like breath seen/smelled?
Type I.
226
What are cataracts?
A cloudy, opaque area of the lends resulting from protein coagulation in the lens.
227
Which organs are located in the epigastric region?
Pyloric valve, duodenum, and pancreas.
228
What disease results because of hypocortisolism and hypoaldosteronism?
Addison's disease.
229
A patient presents with signs and symptoms of dehydration, weight loss, and a blood glucose of 50. What is a likely diagnosis?
Addison's disease.
230
What are eight signs and symptoms that occur in people with Parkinson's disease?
Mask-like face, overall hypertonia, dysarthria, dysphagia, "cog-wheel" rigidity of forearms, dyskinesia, "pill-rolling" tremor, and stooped-shuffling gait.
231
In which type(s) of diabetes mellitus is the symptom of polyphagia seen?
Type I.
232
What is a cloudy, opaque area of the lens that results from protein coagulation in the lens called?
Cataracts.
233
How do you describe epilepsy when talking about seizures in patients?
Epilepsy is a congenital seizure disorder, while the word seizure only refers to convulsions.
234
Which hormone or hormones does the adrenal cortex secrete?
Cortisol and aldosterone.
235
What abnormal levels of cerebral perfusion pressure can cause cerebral edema and increased ICP?
Both too low and too high CPP can cause those conditions.
236
What is the role of H. pylori in peptic ulcer disease?
The gram-negative bacteria doesn't produce ulcers itself, but it damages the mucosa making it more vulnerable to pepsin and HCl.
237
What are four signs and symptoms seen with suppression of prostaglandin activity?
Anti-clotting effects, anti-immunocyte effects, decreased protection of stomach lining, and increased peripheral vasoconstriction.
238
Which three types of medications are used to treat PUD?
H2-blockers, PPIs, and antibiotics if *H. pylori* is present.
239
What is the general term that means pathologically "porous bone"?
Osteoporosis.
240
What is the name of the abnormal breathing pattern seen in comatose patients who are not on a ventilator and suspected of suffering a brain/brain stem attack?
Cheyne-Stokes respirations.
241
What is the normal level of osmolality in humans?
280-295.
242
What is the primary mineralcorticoid?
Aldosterone.
243
What word means the movement of a substance back into the circulation from somewhere else?
Resorption.
244
What are some characteristics of unconjugated bilirubin?
It is released by the spleen as a water-insoluble substance, so it must bind to a protein carrier to be taken to the liver.
245
What is peptic ulcer disease?
A chronic inflammatory condition of the stomach and proximal duodenum where disturbance of their mucosal lining allows acid to ulcerate the underlying tissues.
246
What are three expected lab results to be seen in hepatic jaundice?
High or normal total, high indirect, & low direct bilirubin.
247
Which hormone increases calcium movement from blood into bone?
The thyroid hormone calcitonin.
248
Why does portal hypertension occur in cirrhosis?
Because of the development of fibrotic tissues in the liver cause it to become resistant to normal portal venous flow.
249
What are the signs and symptoms of a migraine during an episode?
HA that is often unilateral, N&V, photophobia, and phonophobia.
250
What is the issue(s) in Cushing's disease?
Pathologic oversecretion of ACTH, or the presence of an adrenal cortex tumor or malfunction that causes it to hypersecrete cortisol and aldosterone.
251
The nurse caring for a patient with cirrhosis notices signs and symptoms of encephalopathy such as confusion and asterixis. What is the cause of these most likely?
Increased serum ammonia.
252
In what four ways is hepatitis B and C normally transmitted?
Normally parenterally via IV drug abuse, blood transfusion, needlestick injury, and sexual intercourse.
253
What are three known causes of chronic gastritis?
H. pylori, autoimmunity, and reflux of post-gastric contents.
254
A patient complains of severe vertigo and nausea. The RN notes the presence of nystagmus. What is the most likely cause of these symptoms?
A cerebellar stroke.
255
What is another word for a patient who is in a post-seizure condition?
Post-ictal.
256
What is myasthenia gravis?
A chronic autoimmune disease sometimes associated with thymic abnormalities that cause the body to block, alter, or destroy cholinergic receptors.
257
How is Cushing's diagnosed?
Observation of signs and symptoms, and obtaining cortisol levels at different times of the day.
258
If you are not eating enough food even though your body is telling you that you're hungry, what hormone(s) is/are released first?
Epinephrine and cortisol are secreted causing shakiness, irritability, diaphoresis, & hunger pangs.
259
In which type(s) of diabetes mellitus is hyperglycemic-hyperosmolar-nonketotic syndrome (HHNKS) seen?
Type II.
260
What is cretinism?
The manifestations of untreated congenital hypothyroidism.
261
What is the principal process in diabetes insipidus?
The undersecretion of ADH.
262
What are seven signs and symptoms seen in a cerebellar stroke?
Vertigo, nystagmus, N&V, ataxia, falls, and vertebral-basilar artery occlusion.
263
What treatments are available for hepatitis B and C?
Vaccine and immunoglobulin available for B, but neither is available for C.
264
What are several signs and symptoms associated with a patient suffering from closed-angle glaucoma?
Acute pain, blurred (especially peripheral) vision, and halos around objects.
265
\*What are nine known factors that increase the risk of pancreatic cancer?
Smoking; diet high in fat, meat, salt, dehydrated, and fried foods; refined sugars; genetic risk; and age between 60-80 years.
266
What are some signs and symptoms of acute gastritis?
Epigastric pain, pyrosis, sour stomach, hemorrhage, and hematemesis.
267
What treatments are implemented in people suffering from an ischemic stroke?
Correction of underlying problems (like a-fib), thrombolytic drugs must be started in 3-4.5 hours of incident, and anticoagulation therapy that starts with Heparin then Coumadin.
268
What are some known triggers to migraines in some people?
Chemicals in red wine, chocolate, and certain cheeses; a stressful event; a smell; or a sound.
269
What is ascites?
The shifting of fluid from portal veins throughout the abdomen into the abdominal cavity.
270
What are three of some of the most common causes of a lower gastrointestinal bleed?
IBD, diverticulitis, and neoplasms.
271
If a person were experiencing signs and symptoms like hearing loss, vertigo, nystagmus, and tinnitus, which cranial nerve would most likely be affected to result in these conditions?
Cranial nerve VIII, the vestibulocochlear nerve.
272
Which organs are located in the RLQ?
Cecum, appendix, and ascending colon.
273
What are five signs and symptoms associated with an upper gastrointestinal bleed?
Visible, occult, or coffee ground hematemesis, and occult fecal bleeding or melena.
274
What is diverticulosis?
Asymptomatic diverticular disease.
275
Which organs are located in the umbilical region?
Lower duodenum, jejunum, and ileum.
276
What is the time frame of a transient ischemic attack?
A transient stroke that only had symptoms that last less than 24 hours and have no lasting neurologic deficit.
277
Why is smoking considered to cause or exacerbate several GI disorders?
Because it stimulates HCl secretion and decreases blood flow to tissues in the area.
278
Is primary or secondary/tertiary Addison's disease associated with autoimmune conditions?
Primary Addison's disease is associated with autoimmune conditions, not secondary/tertiary.
279
\*What are several signs and symptoms seen with multiple sclerosis?
Paresthesia, myasthenia, vertigo, ataxia, dysarthria, diplopia, and incontinence--all of which are usually asymmetrical.
280
What is a fast, deep breathing pattern which is also a compensatory response to metabolic acidosis in which the lungs "blow off" CO2 to increase the pH?
Kussmaul respirations.
281
Why is there an increased risk of infection in cirrhosis?
Because the Kupffer cells (macrophages) of the liver no longer filter bacteria properly.
282
What is the most common form of a brain attack?
Ischemic CVAs which make up 80% of all strokes.
