Test prep Flashcards
1
Q
Cholecystitis
A
Inflammation of the gall bladder, no pain until a fatty meal is eaten 2-3 hours later. 5 F’s.
Murphy’s sign is used to diagnose cholecystitis. The examiner places a hand over the patients right upper quadrant just below the rib cage. The patient takes a deep breath. If the patient experiences sudden pain that causes them to stop breathing. Murphy’s sign is positive.
2
Q
Acute Hepatitis
A
Acute hepatitis is sudden inflammation of the liver that can cause a range of symptoms.
Can be caused by viral infections (hep A, B, C, D, E), alcohol use, drug induced hepatitis, and autoimmune hepatitis.
S/S include: jaundice, dark urine, pale and clay colored stools, fatigue, N/V, abdominal pain, fever and joint pain.
3
Q
Fibrinolytic therapy:
A
The process of dissolving blood clots.
Need to be dissolved in 3.5 to 4 hours of onset of a stroke.
4
Q
Mesenteric ischemia risk factor:
A
A condition where blood flow to the intestines is either reduced or blocked. Usually caused by atherosclerosis, blood clots/emboli or trauma.
5
Q
What would you call an exaggerated response by cellular immunity of the immune system to a foreign substance?
A
Allergic reaction
6
Q
Kidney stones
A
Renal calculi form when an excess of insoluble salts or uric acid crystallizes in the urine. 10% of all people experience, primarily women. Risk factors include diet and hydration.
7
Q
Melena
A
Dark red blood in stool, significant to upper GI bleed.
8
Q
Hemoptysis
A
Coughing up blood
9
Q
Hematemesis
A
vomiting blood
10
Q
Hematochezia
A
Bright red blood in stool, significant to lower GI bleeds.
11
Q
S/S of Influenza
A
Systemic fever, shaking, chills, headache, muscle pain, malaise, and loss of appetite
Respiratory S/S include: dry protracted cough, hoarseness, and nasal discharge.
Duration: is about 3-4 days and complications include viral or bacterial pneumonia.
12
Q
S/S of Peptic Ulcers
A
Pain in the epigastrium that subsides or diminishes immediately after eating and then reemerges 2 to 3 hours later.
Pain is described as a burning or gnawing. Nausea and vomiting, belching, and heartburn are common.
Fatigue and anemia also noted. Some complain of pain waking them from sleep.
13
Q
Chronic gastroenteritis:
A
Condition characterized by persistent inflammation of the stomach and or intestines that lasts more than 30 days. Abdominal pain and cramping, nausea and vomiting, diarrhea, or constipation, bloating, indigestion, heartburn, loss of appetite, weight loss.
14
Q
Cullen sign:
A
Hemorrhagic discoloration of the umbilical area due to intraperitoneal hemorrhage from any cause.
15
Q
Grey Turner’s sign:
A
Rare sign of bruising or discoloration on the flanks or lower back. Indicator of acute pancreatitis or other serious abdominal conditions.
16
Q
Babinski sign:
A
Characterized by the big toe moving upward and the other toes fanning out. It is a neurological response that occurs when the sole of the foot is stroked.
-This is more accurate in pediatrics.
17
Q
Brudzinski’s sign:
A
Patient lies supine, the examiner gently flexes the patient’s neck forward. If this test is positive the patient will involuntarily flex their hips and knees in response to neck flexion.
-Clinical finding that indicates inflammation of the meninges, the membranes that cover the brain and spinal cord.
18
Q
Murphy’s sign:
A
Examiner places their hand over the patient’s right upper quadrant just below the rib cage, the patient then takes a deep breath, if the patient experiences sudden pain that causes them to stop breathing then Murphy’s sign is positive.
-Assess for acute cholecystitis.
19
Q
Mcburney’s sign:
A
located about 2/3 rds of the distance from the umbilicus to the anterior superior iliac spine (ASIS), which is the bony prominence at the front of the hip.
Examiner palpates the right lower quadrant of the abdomen at McBurney’s point, if the patient feels sharp pain or tenderness, it is positive.
20
Q
LLoyd’s sign:
A
Find the 12th rib, find the costovertebral angle (which is the area between the spine and the 12th rib). Place a fist over the area and gently tap it. Ask the patient if they feel pain. if the patient has pain it could indicate a kidney infection or kidney stones.
21
Q
AEIOU-TIPS
A
Alcohol/Acidosis
Endocrine/Epilepsy/Electrolytes
Insulin
Overdose/Oxygen
Uremia
Trauma
Infection
Poisoning/Psychiatric
Stroke/Subarachnoid hemorrhage/Shock
22
Q
Atrovent
A
Ipratropium bromide (anticholinergic-muscarinic antagonist).
Used in patient’s with Asthma, COPD, Nasal congestion and other airway obstructions, such as bronchiolitis in children.
23
Q
Cardiac Ischemia:
A
Tissue damage to cardiac cells due to low oxygen perfusion, causing chest pain and discomfort.
24
Q
Esophageal varices:
A
Enlarged, swollen veins in the lower esophagus that develop as a result of portal hypertension, a condition where high blood pressure in the liver causes blood to flow backwards into the esophagus.
Causes also include liver failure.
S/S can be asymptomatic until they bleed. Bleeding complications include vomiting blood or coffee ground material, black tarry stools, lightheadedness, weakness.
25
H pylori caused chronic gastroenteritis:
A bacterial infection (H Pylori) inflames the stomach lining. Typically spread from person to person.
26
Salmonella caused acute gastroenteritis:
Bacterial infection caused by eating raw or uncooked poultry or eggs, drinking unpasteurized milk, or eating food that has come in contact with raw food with salmonella.
S/S include diarrhea, nausea, vomiting and abdominal cramps.
27
S/S of Embolic Stoke:
A clot travels to the brain from another part of the body, often from the heart.
Sudden weakness, difficulty speaking, vision problems, trouble walking, headache, arm drift and facial droop.
28
S/S of thrombotic stroke:
A clot forms directly within a brain artery.
Facial droop, weakness, visual disturbance, sudden headache, difficulty walking, dizziness and loss of coordination.
29
S/S of ischemic stroke:
A general term for a stroke caused by a blockage of blood flow to the brain, including both embolic and thrombotic strokes.
Sudden weakness, sudden confusion, vision problems, headache, facial droop, paralysis, seizure.
30
S/S of Central stroke:
A stroke specifically affecting the brainstem area of the brain.
Neurologic deficits, sensory changes, speech difficulties, visual disturbances, cognitive impairment, central post stroke pain (burning, stabbing, or aching on the affected side)
31
Renal failure: Pre-renal
Cause by hypoperfusion to kidneys.
32
Renal failure: Intrarenal
Damage to glomeruli capillaries, cells of kidney tubules, or the renal parenchyma.
33
Renal failure: Post-renal
Obstruction of urine output from kidneys.
34
Name for Absence seizures:
Petit mal
35
Management of acute pancreatitis:
Aggressive fluid resuscitation with LR, Pain management, monitor vitals, rapid transport, Maintain NPO status.
36
Leading cause of death in renal transplant patients:
The leading causes are infection (pulmonary or sepsis), cardiovascular disease, or graft-versus-host disease (GvHD), Hepatitis C.
37
H2 receptors (antihistamines) and most likely condition when taking a H2 receptor antagonist.
H2 receptor antagonists reduce production of gastric acid.
GERD (gastroesophageal reflux disease).
38
Result of sinus infection that becomes a serious bacterial infection around the eye:
Orbital Cellulitis
39
You are assessing an unresponsive 32 yo who has a history of asthma. The patient takes a steroid daily to help prevent asthma attacks and a bronchodilator for acute care of asthma. Breathing deeply at 26 times a minute, pulse is 110 bpm and weak, the skin is warm and dry. Which of the following assessments would be an expected finding for this patient?
-Decreased breath sounds
-Expected findings with this patient may include decreased breath sounds due to bronchoconstriction from asthma.
-Tachypnea (breathing rate >20/min) is expected due to difficulty in breathing.
-Tachycardia (pulse rate >100/min) is expected due to increased work of breathing.
40
Types of generalized seizures:
Generalized seizures affect both sides of the brain. Either determined by absence (petit mal; generalized nonmotor) or tonic clonic (generalized motor).
41
Tonic Clonic phases:
-Loss of consciousness-
-Tonic phase: systemic rigidity.
-Hypertonic phase: Arched back and systemic rigidity.
-Clonic phase: Chaotic and disorganized intermittent contractions of major muscle groups: arms, legs, and head movement; lip smacking, biting, clenching teeth.
-Post-seizure: major muscles relax, nystagmus may still be occurring.
-Postictal phase: Reset period of the brain. Can take several minutes/hours for patient to return to pre-seizure LOC.
42
Absence seizure:
Typically occurs in children.
-the child completely stops walking, speaking or moving and stares off into the distance. Typically lasts only a few seconds.
43
What is the medical name for the area that the pancreatic duct and bile duct enter the duodenum:
Ampulla of Vater
44
Most common cause of life threatening anaphylaxis:
Medications, particularly antibiotics like penicillin.
Food allergies follows Medications.
45
B2 Agonistic drugs:
-Smooth muscle relaxants and bronchodilation.
-Epinephrine
-NorEpinephrine
-Dopamine
-Albuterol
46
Focal seizure:
Affects one side of the brain.
47
S/S of Alzheimers:
Memory problems: forgetting recent events or conversations, difficulty recalling familiar people or places, misplacing items frequently, and inability to retrace steps to find lost items.
-Confusion and disorientation
-Difficulty with planning and problem solving.
-Trouble with language: can't find words or understand conversations.
-Impaired judgment and decision making.
-Irritability, agitation or mood swings.
-Withdrawal from social activities.
-Loss of interest in hobbies or pursuit.
-Delusions, hallucinations, or paranoia.
-Sleep disturbances.
48
S/S of polio:
Sore throat, nausea, vomiting, diarrhea, stiff neck, and muscle weakness or paralysis.
49
S/S of Parkinson's
Initial signs: unilateral tremors, leading to bilateral tremors.
Postural instability: stiff posture in which they are stooped over, and the disease alters their gait. Increases risk of falling.
Rigidity: causes the patient to move in fits and starts.
Bradykinesia: (slowing down of routine motions). patient will shuffle in a straight line, with their feet close together. When asked to turn, they take small steps until the turn is complete. Patient also blinks slowly, has soft voice, and decreased facial expressions.
Other S/S include: Depression, dementia, difficulty swallowing, speech impairment, fatigue and dystonia. Foot and leg contractions, in which the leg is arched, and adduction of the arm into a posture where the arm is flexed across the chest or abdomen are commonly seen.
50
S/S of muscular dystrophy
Characterized by weakness and wasting of groups of skeletal muscles, leading to increasing disability. Can include progressive wasting of leg and pelvic muscles producing a waddling gait and abnormal curvature of the spine. No known treatments exist and the patient often dies, most often by a heart disorder by age 20.
51
Prednisone, ipratropium bromide, betamethasone, and metaproteronol:
Medications used to treat respiratory conditions, primarily asthma and COPD.
52
Renal Calculi:
Kidney stones.
53
Pyelonephritis:
Kidney infection: usually caused by the bacteria that ascend from the bladder into the kidneys through the ureters, the tubes that connect the bladder to the kidneys.
54
Diabetic Ketoacidosis or DKA:
Can cause acute kidney injury (AKI) and in severe cases, renal failure. AKI is common in children with type 1 diabetes (T1D) who experience DKA.
55
Lower UTI:
Urinary tract infection located in the bladder or urethra.
56
Appendicitis:
Inflammation of the appendix caused by accumulation of fecal matter in the appendix.
-Pain usually starts around the belly button and moves to the lower right abdomen.
-S/S: nausea, vomiting, fever, loss of appetite.
Treatment: often requires surgical removal of the appendix (Appendectomy).
57
Cholecystitis:
Inflammation of the gall bladder, no pain until a fatty meal is eaten 2-3 hours later.
-Pain in the upper right abdomen, sometimes radiating to the right shoulder or back. Often triggered by fatty foods.
-S/S: nausea and vomiting.
-Treatment: usually treated with gallbladder removal surgery.
58
Hepatitis:
Inflammation of the liver that can be caused by variety of factors, including viruses, drugs, alcohol, and autoimmune disorders.
-Symptoms like jaundice, dark urine, pale stools, fatigue, loss of appetite, nausea and vomiting noted.
-Primarily caused by viral infection, often with a focus on liver function tests.
59
Pancreatitis:
Inflammation of the pancreas.
-Severe abdominal pain, often radiating to the back, accompanied by nausea, vomiting and potential fever noted.
-Can be caused by gallstones blocking the pancreatic duct or excessive alcohol consumption.
60
Known risk factors for gastrointestinal diseases:
Stress, change in normal routine, pregnancy, diet, lacking exercise, low fiber, smoking, too much dairy, age, family history, alcohol and ethnicity.
61
Causes of chronic gastroenteritis that would be responsive to antibiotics:
Bacterial gastroenteritis.
62
Positioning of a patient: Supine
Lie patient flat on their back.
-Utilized for patient's in shock, trauma, or position of comfort.
63
Position of patient: Prone
Lie patient flat on their stomach.
-Used for patients in ARDS to help improve breathing.
64
Positioning of patient: Fowlers
Patient's head up at 90 degree angle.
-Utilized for respiratory distress or position of comfort.
65
Positioning of patient: Semi-fowlers
Patient's head is up at 30 degrees.
-Utilized for respiratory distress of position of comfort.
66
Positioning of patient: Trendeleburg
When patient is lying flat with their feet above their head.
-Utilized for hypotension.
67
Positioning of the patient: Left lateral recumbent
Roll patient to their left side and rest their head on their arm.
-Utilized to prevent aspiration of unconscious or seizure patients.
68
Digestive tract: Mouth to Anus
-Mouth: Food travels through the mouth and through the upper esophageal sphincter (in pharynx).
-Esophagus: Food travels down esophagus because of peristalsis through the lower esophageal sphincter.
-Stomach: food enters the stomach and passes through the pyloric canal/pyloric sphincter.
-Duodenum: Initial part of small intestine. It is 9 to 11 inches in length and has a c shaped curve. Duodenum connects the pancreas, liver and gallbladder to digestive system through the sphincter of Oddi.
-Jejunum: Major site of nutrient absorption. it is approx 8 feet long.
-Ileium: Decreased amount of nutrient absorption, prepares chyme (Food, water, digestive enzymes and stomach acid) for entry into the large intestine through the ileocecal valve.
-Cecum: initial part of the large intestine, absorption of remaining water and salts.
-Ascending colon: begins solidification of chyme into stool.
-Transverse colon: runs from right to left.
-Descending colon: 90 degree turn from transverse colon.
-Sigmoid colon: S shaped
-Rectum: joins anal canal.
-Anus: Exit point.
69
Abdominal quadrant: RUQ
Organs found int the right upper quadrant include the liver, gallbladder, pancreas, stomach, and right kidney.
-Possible problems include: gallstones, cholecystitis, kidney stones, hepatitis, pancreatitis.
70
Abdominal quadrants: LUQ
Organs of the upper left quadrant include: stomach, spleen, left portion of the liver, main body of the pancreas, left portion of the kidney, adrenal glands, splenic flexure of the colon, and bottom part of the colon.
Concerns include: Pancreatic splenomegaly, kidney stones, pyelonephritis, stomach ulcers, diverticulitis.
71
Abdominal quadrants: Right lower quadrant:
Organs in this quadrant include sigmoid colon, and the left ovary and fallopian tube in women.
-Pain in this quadrant may be symptomatic of colitis, diverticulitis, or kidney stones. Ovarian cysts (in women) or PID may also be at the root of pain in this quadrant.
72
Abdominal quadrant: LLQ
Organs in this quadrant include the sigmoid colon, and the left ovary and fallopian tube in women.
-Ovarian cysts (in women) or PID may also be the root of pain in this quadrant. Diverticulitis, Ureteral colic, Colitis, Ulcerative colitis, Crohn's disease, C-Diff, colitis.
72
Appendicitis:
Inflammation of the appendix, an accessory organ projecting off of the cecum, occurs when fecal matter accumulates in the appendix.
-Characterized early on as periumbilical pain, nausea, vomiting, low grade fever, and loss of appetite.
-Ripe stage is characterized by lower right quadrant pain (McBurney's point) 48 hours. Rupture stage is decreased as a sudden relief of pressure and pain due to rupture. Can be fatal due to peritonitis and sepsis.
72
Crohn's disease
Can be caused by genetics, immune system, environmental factors, and microbiome.
-presentation: diarrhea (often bloody, mucousy), abnormal pain and cramping, nausea/vomiting, fistulas and blockages.
72
Deep Vein thrombosis DVT
Causes: Prolonged inactivity, surgery or trauma, obesity, smoking, hormonal changes, inherited blood disorders, heart failure, cancer or inflammatory bowel diseases can also raise risk of DVT.
Presentation: Swelling in leg, pain, redness, warmth, enlarged veins, heaviness of affected leg
73
Diverticulitis:
Causes: age, lifestyle factors, genetics, bacterial infection, weakened immune system, smoking, NSAIDS.
Presentation: abdominal pain, nausea/vomiting, fever, changes in bowel habits, gas/bloating, rectal bleeding.
74
Esophageal varices:
Causes: liver cirrhosis.
Presentation: blood in vomit, blood in stool, lightheadedness, weakness, heartburn, regurgitation, difficulty swallowing, abdominal pain.
75
Brain abscess who has high temp, headache and nuchal rigidity:
Rupture of abscess into ventricles, leading to meningitis.
76
How to rule in and out a AAA
Can be asymptomatic, symptom depend on location of dissection.
S/S may be: dysphagia, hoarse voice, difficulty breathing caused by heart failure/tracheal and bronchial compression.
-Patients typically present with new onset and abrupt pain when dissection occurs, described as a tearing, ripping, sharp and stabbing.
-Ascending Aortic dissection typically is accompanied by substernal, neck/throat/jaw and face pain.
-Descending Aortic Dissection typically presents flank pain and pain between shoulder blades.
77
Determining factors of a Dissecting Aorta:
Anxiety, impending doom, pain, weakness and tingling sensation, myocardial ischemia, S/S of heart failure, AMS or stroke, syncope.
-In dissecting of the ascending aorta one or more of the aortic arch vessels is compromised, typically causing vastly different blood pressure in each arm. (pressure difference of 20 mm Hg).
-Rupture of abdominal aortic aneurysm may cause severe back pain.
78
Tonic Clonic seizures:
Affect both sides, loss of consciousness and muscle spasms.
79
Absence/Petit Mal seizures:
brief changes in awareness and little/no movement.
80
Pseudo Seizures:
Psychologically induced (stress emotion etc) presents with all similar phases as that of a tonic clonic seizure.
81
Paroxysmal nocturnal dyspnea
is dyspnea that comes on suddenly in the middle of the night and may be ominous sign of left sided heart failure.
82
Brochophony
when a patient says "99" repeatedly through a normal lung. it sounds like a hum. Through consolidation you can understand the word "99".
83
Egophony
the patient says "eeeee_ while you are auscultating and you hear "aaaay". The sound may be heard particulary well over a pleural effusion.
84
Whispered pectoriloquy
The patient whispers while you are auscultating and you can understand what they say.
85
Monomorphic sound
If a single bronchus is vibrating, then the wheeze will produce a sound that makes a single note
86
Polyphonic Sound
If many bronchi are vibrating, then the wheeze may have many notes, like a bagpipe.
87
Sputum types:
-Frothy, sometimes with a pink tinge: heart failure
-Thick: dehydration, antihistamine use
-Purulent: infectious process
-Yellow , green, or brown: older secretion in various stages of decomposition.
-Clear or white: bronchitis.
-Blood streaked: tumor, tuberculosis, pulmonary edema, trauma from coughing.
88
Hepatojugular reflex
distention of the jugular veins when the liver is gently pressed.
89
Laryngotracheobronchitis
inflammation of the larynx, trachea, and bronchi.
-Acute form of this is a common cause for CROUP: characterized by stridor, hoarseness, and a barking cough that most commonly occurs in infants and small children.
90
Croup:
Found in children between 6 months and 6 years. Most common in the months between October and March.
-Stridor, hoarseness and barking cough.
-Viral infection is usually the underlying cause. Do not manipulate the airway.
91
Epiglottitis
Severe, rapidly progressive inflammation of the epiglottis and surrounding tissues.
-Caused by infection.
-Life threatening emergency.
-S/S sore throat, fever, drooling, hoarseness, and purposeful hyperextension of the neck.
-Less threatening in adults.
92
Peritonsillar Abscess
Uncommon in children, common in young adults.
-Forms near one pharyngeal tonsil.
-S/S fever and sore throat, may be mistaken for epiglottitis until a lateral abscess is seen in the throat.
-Do not manipulate the airway.
93
Retropharyngeal Abscess
Most common in children
-Infection in the retropharyngeal lymph nodes and by direct pharyngeal trauma.
-S/S fever, sudden stridor, may be mistaken for epiglottitis until laryngoscopic examination reveals retropharyngeal abscess.
-Do not manipulate the airway.
94
Status Asthmaticus:
Severe, prolonged asthmatic attack that cannot be stopped with conventional treatment.
-TRUE EMERGENCY.
95
ARDS
Acute Respiratory Distress Syndrome:
-caused by diffuse damage to the alveoli, perhaps as a result of shock, aspiration of gastric contents, pulmonary edema, barotrauma, or a hypoxic event.
96
Pleural Effusion
Fluid collects between the visceral pleura and parietal pleura.
97
Cape Cyanosis
a deep blue color in the face, neck, chest and back in patient's with light skin tone- despite good quality CPR and ventilation with 100% supplemental oxygen.
-possibly seen in pulmonary embolism.
98
Pulmonary Embolism
Pulmonary circulation may be compromised by blood clot, a fat embolism from a broken bone, an amniotic fluid embolism from leakage of amniotic fluid during pregnancy, or an air embolism resulting from air entering the circulation via a laceration in the neck or an IV administration set that was improperly flushed or not flushed.
99
Stroke definition
Condition in which blood supply to areas of the brain is interrupted, and is the 5th leading cause of death in the US.
100
Posturing:
Abnormal body positioning that indicates damage to the brain.
101
Trismus:
Patient's teeth are clenched tightly.
-Can occur in unconscious and conscious patient's.
-Can indicate a seizure in progress , severe head injury and or cerebral hypoxia.
102
Anisocoria:
unequal pupils with a greater than 1 mm difference.
103
Signs of shock:
-Tachycardia
-Tachypnea
-Hypotension
-Narrowed pulse pressures
104
Signs of ICP:
-Low heart rate
-Lower RR rate
-Hypertension
-Widened pulse pressure
105
Ptosis
drooping or sagging of the eyelids.
106
Coma
state in which a person does not respond to either verbal or painful stimuli.
107
Common reality
sensory stimulation that others can confirm.
108
Delusions
Thoughts, ideas, or perceived abilities that are not based in a common reality.
109
Cranial nerves to know:
(3) oculomotor: movement of the eye pupil and eyelid
(5) Trigeminal: chewing, pain, temperature, touch of the mouth and face.
(7)Facial: movement of the face, tears, salivation and taste.
(10) Vagus: sensation and movement of the pharynx, larynx, thorax, and GI system.
110
Myasthenia Gravis
A condition in which the body generates antibodies against its own acetylcholine receptors, causing muscle weakness, often in the face.
111
Hemiparesis:
Weakness on one side of the body.
112
Hemiplegia:
Paralysis on one side of the body.
113
Ataxia:
Used to describe alterations of a persons ability to perform coordinated motions such as walking.
114
Myoclonus:
type of rapid, jerky muscle contraction that occurs involuntarily.
115
Dystonia:
A part of the body contracts and remains contracted.
116
Rigidity:
Muscles do not contract and relax smoothly, resulting in stiffness in motion.
117
Tremors:
Oscillating (back and forth) movement usually occurs in the hands but can also affect the head, arms, torso and legs.
-Also involves the motion of joints.
118
Rest tremor:
Patient's arms hands or legs shake even while the muscles are relaxed. Tremor partly or completely disappears with voluntary movement.
119
Intention tremor:
Patient is asked to demonstrate movement toward a target, such as touching the nose with a finger or reaching out toward an object. The tremor typically increases as the patient gets closer to the target.
120
Postural tremor:
Body part is placed in a particular position and required to maintain that position for an extended period. As fatigue sets in, the body part being used the most begin to shake.
-Can also occur when a person is standing due to the body's muscles constantly making tiny corrections to maintain posture.
121
Tonic activity:
Rigid, contracted body posture. The arms, legs, neck and back can contract so tightly that the body part shakes form the intensity of the contraction.
122
Clonic activity:
Rhythmic contraction and relaxation of muscle groups. Described as bizarre, nonpurposeful movement of any body part, arms and legs may flail, teeth may clench, the head may bob, and the torso may convulse wildly.
123
Anesthesia:
patient can feel nothing within a body part.
124
Aura:
Visual changes such as flashing lights or blind spots in the field of vision.
125
Herniation:
The movement of a structure from its normal location into another space.
126
BE-FAST
B: Balance- sudden loss of balance, coordination, or dizziness.
E: Eyesight- loss of vision (or changes to vision) in one or both eyes
F: FACE- Facial droop
A: Arms- arm drift or weakness
S: Speech- speech impairment or inability to repeat a simple phrase.
T: Time- Time is critical, T can also represent Thunderclap headache.
127
LAMS:
Scores three things for stroke:
-Face: 0,1,2
-Arms:0,1,2
-Grip strength:0,1,2
If patient is graded a score of a 1 or a 2 this means that they have some degree of full degree of problem.
128
Transient Ischemic Attacks (TIA's)
Episodes of cerebral ischemia that do not inflict any permanent damage.
-Are often signs of a serious vascular condition that requires medical intervention.
129
Status Epilepticus:
A seizure that lasts longer than 4-5 minutes or consecutive seizures without a return to consciousness between seizures.
130
Syncope:
Sudden and temporary loss of consciousness with accompanying loss of postural tone.
131
Prodrome:
Signs and symptoms that precede a disease or condition.
132
Dementia:
Chronic deterioration of memory, personality, language skills, perception, reasoning or judgement with no loss of consciousness.
133
Alzheimer's
The most common form of dementia.
134
Neoplasm:
Medical term for growth's within the body that serve no useful purpose and are caused by errors that occur during cellular reproduction.
135
Metastasis:
Process by which Cancerous cells move to sites distant from their site of origin.
136
Multiple Sclerosis (MS):
Autoimmune condition in which the body attacks the myelin of the brain and spinal cord.
137
Demyelination:
Destruction of Myelin.
138
Guillain-Barre syndrome:
Rare disease in which the immune system attacks portions of the nervous system.
-Patient reports minor respiratory or gastrointestinal infection before the beginning of the weakness.
-Begins with weakness and tingling sensations in the legs, this then moves to the thorax and the arms and can lead to paralysis. Can have very acute onset.
-Some patient's will recover without residual weakness in as little as several weeks.
139
Parkinson's:
Neurologic condition in which environmental and genetic factors can place a patient at risk of damage to certain neurons.
140
Amyotrophic lateral Sclerosis (ALS)
Also known as Lou Gehrig disease, strikes the voluntary motor neurons.
-Subtle and progressive without being noticed.
S/S fatigue, general weakness of muscle groups, fasciculations (muscle twitching), and difficulty doing routine activities such as eating, writing, and dressing eventually develop.
141
Spasmodic torticollis
neck muscles contract, twisting the head to one side and usually pulling it forward or backwards.
-Is a common example of dystonia.
142
Spasmodic Dysphonia
involuntary contraction of the vocal cords, interrupting speech.
143
Encephalitis
inflammation of the brain.
144
Meningitis
Inflammation of the meninges.
145
Endotoxins:
Proteins that are released by gram-negative bacteria when they die.
146
Kernig sign:
Meningeal irritation results in pain when attempting to straighten the knee with the hips flexed.
147
Poliomyelitis:
viral infection transmitted by the fecal-oral route.
-S/S sore throat, nausea/vomiting, diarrhea, stiff neck, and muscle weakness or paralysis.
148
Peripheral Neuropathy
Nerves leaving the spinal cord are damaged, so that the signals moving to or from the brain become distorted.
149
Dysconjugate gaze:
Paralysis of gaze or discoordination between the movements of the two eyes.
150
Conjunctivitis:
Also known as Pink eye.
Is a condition in which the conjunctiva becomes inflamed and red.
151
Chalazion:
Small, usually painless lump or pustule on the external eyelid that appears red and swollen, and that forms because of a blockage and welling in the oil gland in the eye.
152
Hordeolum:
an Infection of an oil gland in the eyelid that produces red, swollen, painful lump in the eyelid or in the lid margin.
153
Open Angle Glaucoma
Aqueous humor ducts drain too slowly, pressure builds up in the eye, damaging the optic nerve.
154
Narrow Angle Glaucoma
Access to the drainage channel is narrowed, preventing proper drainage of the aqueous humor. This results in pressure build up in the eyes posterior chamber, which pushes the lens forward.
155
Normal tension glaucoma
optic nerve is damaged and vision changes occur, although there is no increase in intraocular pressure.
156
Central Retinal Artery Occlusion
Condition in which the blood supply to the retina becomes blocked because of a clot or embolus in the central retinal artery or one of its branches.
-causes include: vascular heart disease, drug abuse, fat emboli, arterial spasm, oral contraceptive use.
Can cause partial blindness.
157
Iritis:
Known as anterior uveitis.
-Involves inflammation of the iris.
-Uveitis is the 3rd leading preventable cause of blindness.
Autoimmune diseases, arthritis, IBS, Crohn's disease can predispose patient's to develop iritis.
158
Papilledema:
Results form swelling or inflammation of the optic nerve at the rear part of the eye.
159
Periorbital Cellulitis
is more prevalent in children than adults, known also as eyelid cellulitis.
160
Tinnitus:
ringing in one or both ears.
161
Labyrinthitis:
Commonly recognized as the feeling of vertigo or loss of balance after an ear infection or upper respiratory infection.
-Irritation and swelling in the inner ear affect the inner ears nerves and produce a loss of balance.
162
Meniere disease:
Chronic condition of the inner ear characterized by 4 symptoms that may or may not occur at the same time:
-Dizziness described as spinning vertigo.
-low frequency hearing loss
-tinnitus
-Feeling of fullness in the affected ear.
163
Otitis:
An infection that results from bacterial growth in the ear canal.
-Categorized as either otitis externa or otitis media. (outer and middle ear cavity).
164
Epistaxis:
Nose bleed.
165
Rhinitis:
Inflammation of the nasal cavity, is a common nasal disorder that may be caused by a bacterial or viral infection, allergens, medications, or changes in the environmental factors.
166
Sinusitis
Occurs when drainage from one or more of the sinuses becomes disrupted, blocking drainage into the nasal cavity.
167
Dysphagia
Swallowing problems
168
Dental abscess:
Occurs when the bacteria growth spreads directly from the cavity into the gums, facial tissue, bones and or neck.
169
Oral candidiasis:
"Thrush" is a condition in which the fungus candida albicans accumulates on the lining of the mouth.
170
Ludwig Angina
Type of Cellulitis caused by bacteria from an infected tooth root or mouth injury.
171
Tracheitis
Infection of the trachea, typically caused by Staphylococcus aureus.
172
Tonsilitis
Swelling and inflammation of the tonsils, the two oval shaped pads of tissue at the back of the throat.
-Caused by viral infections, although this condition may be caused by bacterial infection as well.
173
Urinary retention
Defined as incomplete emptying of the bladder or a complete inability to empty the bladder.
174
Urinary Incontinence
Loss of bladder control, the inability to control the release of urine from the bladder.
175
Kidney stones
form when an excess of insoluble salts or uric acid crystallizes in the urine.
-Most common types of stones are calcium oxalate and calcium phosphate stones.
176
Acute Kidney Injury (AKI)
Sudden decrease in the rate of filtration through the glomeruli, causing toxins to accumulate in the blood.
-Urine output of less than 500 ml/d in an adult and less than 0.5 ml/kg/h in a neonate is called OLIGURIA.
177
Chronic Kidney Disease (CKD)
Progressive and irreversible inadequate kidney function that is result of permanent loss of nephrons.
178
Azotemia:
increased level of nitrogenous wastes in the blood.
179
Uremic Frost
Powdery accumulation of uric acid, presentation is on the face.
180
End stage renal disease (ESRD)
Kidneys are unable to function and toxic waste materials build up in the patient's blood.
-Fatal unless treated by dialysis or renal transplant.
181
Fistula, shunt, Arteriovenous graft
Surgically created arterial-to-venous vessel anastomosis tunneled through the subcutaneous tissue.
182
Disequilibrium syndrome
Condition characterized by nausea, vomiting, headache and confusion.
-Most likely to happen with dialysis patient. These patient's are starting dialysis or have missed a few dialysis sessions and are restarting.
183
Epididymitis
Infection that causes inflammation of the epididymis along the posterior border of the testis.
-When one or both testes become infected, the condition is called ORCHITIS.
184
Orchitis:
Infection causes one or more testes to become enlarged and tender, causing pain and swelling in the scrotum. Swelling may also occur in the groin on the affected side.
185
Fournier Gangrene:
If bacteria enter the scrotum or perineum fournier gangrene may occur.
-Causes necrosis of the subcutaneous tissue and muscle in the scrotum.
186
Priapism:
Painful, tender, persistent erection.
-Can result from sickle cell disease, leukemia, spinal cord injury, and certain medications such as antidepressants, anticonvulsants and those used for erectile dysfunction.
187
Phimosis:
The inability to retract the distal foreskin over the glans penis.
-Can be congenital or acquired.
188
Paraphimosis:
Results when the foreskin is retracted over the glans penis and becomes entrapped.
-this causes the glans to swell even further, making it even harder to slide the foreskin back into the normal position.
189
Benign prostate hypertrophy (BPH):
age related non-malignant (non-cancerous) enlargement of the prostate gland.
190
Testicular torsion:
Twisting of the testicles on the spermatic cord, from which it is suspended.
-Associated with a sudden onset of scrotal pain and swelling.
-Medical emergency if the twisting of the vessels reduces blood flow to the testis. Usually unilateral, occurring in only one testis at a time.
191
Hypoxic drive:
A state in which the stimulus to breathe comes from a decrease in Pao2, rather than from the normal stimulus, an increase in Paco2.
192
Lung consolidation:
Firming of the lungs as a result of fluid accumulation.
193
Orthopnea
Severe dyspnea experienced when recumbent, which is relieved by sitting or standing up.
194
Atelectasis:
Collapse of the alveolar air spaces of the lungs.
195
Aspiration:
The drawing in or out by suction. In the lungs, aspiration of food, liquids, blood or foreign objects can occur when a patient is unable to protect the airway.
196
Polycythemia:
The production of too may red blood cells over time, which makes the blood thick; a characteristic of of people with chronic lung disease and chronic hypoxia.
197
Exotoxins:
Toxins secreted by living cells to aid in the death and digestion of other cells.
198
Nystagmus:
involuntary, rhythmic shaking of the eyes.
199
Pronation:
Rotation of the lower arms in a palms down manner.
200
Uremia:
Severe renal failure resulting in the build up of waste products within the blood, eventually impairs brain function.
201
Cerumen
Earwax.
202
Dentalgia:
Tooth ache.
203
Cataract:
A clouding of the lens of the eye that is normally a result of aging.
204
Battle signs:
Bruising over the mastoid bone behind the ear, commonly seen following a basilar skull fracture, also called retroauricular ecchymosis.
205
Temporomandibular joint (TMJ) Disorder:
A collection of disorders that present with jaw pain, and that occur when the connection between the temporal bone and the TMJ erodes or moves out of proper alignment.
206
Antibody:
Protein the body produces in response to an antigen.
-This protein (globulin) is found in plasma, and is referred to as Immunoglobulin (Ig).
207
IGE
Primary antibody responsible for allergic reactions.
208
Local reaction:
Body limits its response to a specific area after exposure to a foreign substance such as swelling around an insect bite.
209
Systemic reaction:
Occurs throughout the body, possibly affecting multiple body systems.
210
Hypersensitivity:
Occurs when a persons immune system reacts with exaggerated or inappropriate symptoms after coming in contact with a substance perceived by the body as harmful.
211
Biphasic reaction:
Two phase allergic reaction in which the patient's symptoms improve and then reappear without exposure to the trigger (allergen) for a second time.
212
Prolonged (persistent) reaction:
Anaphylaxis symptoms that continue over time, with time frames from 5 to 32 hours.
213
Anaphylactoid reaction:
Response that does not involve IGE antibody mediation.
214
Immune response: Primary response
Cells (macrophages) immediately confront and engulf the foreign substances to determine if they are allowed in the body. If the body cannot identify the substance it uses immune cells to record the salient features of the outside substance.
-These cells record one or two of the proteins on the surface of the invading substance and then design specific proteins (called antibodies) are intended to match up with the antigen and inactivate it.
215
Sensitivity:
The ability to recognize the antigen the next time it is encountered.
216
Immune response: Secondary response
Occurs with re-exposure to a foreign substance.
217
Basophils:
White blood cells that work to produce chemical mediators during an immune response.
218
Kinins:
Proteins produced at sites of tissue injury or inflammation, causing vasodilation and smooth muscle contraction.
-Bradykinin is one of the strongest kinins and is responsible for increased vascular permeability.
219
Anaphylaxis Criterion 1:
Acute onset of an illness with involvement of:
Skin or mucosa: pruritus, flushing, hives, angioedema.
And either
Respiratory compromise: dyspnea, wheeze bronchospasm, decreased peak expiratory flow, stridor, hypoxemia.
OR
Decreased blood pressure or end organ dysfunction: collapse, syncope, incontinence.
220
Anaphylaxis Criterion 2:
Two or more of the following that occur rapidly after exposure to a likely allergen for that patient:
All of criterion 1 Skin, respiratory, or decreased blood pressure/end organ dysfunction are options as well as:
Persistent gastrointestinal Symptoms: Vomiting, crampy abdominal pain, diarrhea.
221
Anaphylaxis Criterion 3:
After exposure to a known allergen for that patient (minutes to hours):
Decreased blood pressure.
222
Lung sounds present during an allergic reaction:
Stridor and wheezing.
223
Symptoms of anaphylaxis:
skin symptoms are often first indications followed by:
-Pruritus.
-Swollen red eyes.
-Swelling of the face and tongue (angioedema)
-Respiratory symptoms reported.
-Edema in the hands and feet.
-Heart rate increase due to hypotension.
-GI symptom including cramping, nausea, vomiting, bloating abdominal distension, watery diarrhea may be present.
-Headache, dizziness, confusion, anxiety.
224
Anaphylaxis three types of shock:
(1) cardiogenic shock due to decreased cardiac output.
(2) hypovolemic shock due to fluids leaking into the tissues.
(3) neurogenic shock due to inability of the blood vessels to constrict.
225
Scleroderma
"Hard skin" is an autoimmune connective tissue disease.
-Has two main classifications: localized and systemic (also known as systemic sclerosis).
226
Most common types of organ transplants:
(1) Kidney
(2) Liver
227
Signs of rejection in Lung transplants:
Cough, dyspnea, vomiting, fever, crackles, rhonchi and a decrease in oxygenation.
228
Common problems with Heart transplants:
sepsis and pneumonia.
-Fever, SOB, hypoxia, hypotension, poorly controlled hypertension, or the development of a new dysrhythmia.
229
Chemical mediators:
Chemicals that work to cause the immune or allergic response; for example, histamine.
