DD Final Exam

What are the 4 categories of immune system disease?

- Hypersensitivity- Allergies - Autoimmune- Rheumatic -Immunoproliferative- Leukemia & Lymphoma -Immunodeficiency- HIV/AIDS

PT's should encourage pts to avoid taking insulin how long before an exercise session? -4 hrs before exercise -3 hrs before exercise -2 hrs before exercise -1 hr before exercise

-1 hr before exercise

Which lvl of blood glucose is most appropriate for a carb snack given before resuming exercise? -130 mg/dl -70 mg/dl -100 mg/dl -160 mg/dl

-70 mg/dl

Which of the following blood tests is used to measure chronic glycemia? -A1C -C reactive protein -Hematocrit -Thromboycte count

-A1C

What is the job of the endocrine system?

-Acts as the hormonal messenger system -Maintains whole body homeostasis

A 55 yr old, married woman reports a history of blddaer infection and repeated bouts of sweating. Which of the following is the most important next step? -Ask about sexual history -Ask about neck pain -Ask about PSA testing -Ask about urinary frequency & pain

-Ask about urinary frequency & pain

What are the screening methods for prostate cancer?

-Digital prostate test (Insert finger to test for prostate enlargement) -PSA blood test

Which of the following questions is most appropriate as a follow up to inquire about stress urinary incontinence? -Do you ever lose urine while lifting or exercising? -Does it feel like your bladder is empty when you are done urinating? -Do you have frequent, strong and sudden urges to urinate? -Can you get to the toilet easy?

-Do you ever lose urine while lifting or exercising?

A non-inflammatory condition resulting in widepsread pain, tenderness, fatigue, & sleep disturbances for greater than 3 mo. is best described as ____. -Ankylosing spondylitis -Rheumatoid arthritis -Fibromyalgia

-Fibromyalgia

Where is UTI referred pain commonly felt?

-Flank -Ipsilateral shoulder

What are the 3 main symptoms of diabetes?

-Increased thirst -Increased hunger -Increased urination

What are the 3 primary categories of urogenital conditions?

-Inflammatory/Infectious Disorders -Obstructive Disorders -Cancers & Chronic Kidney Disease

Where is LTI pain commonly felt?

-Low back -Pelvis/ lower abdominals

Which of the following best describes the pattern of rheumatic disease? -Pain & stiffness in the morn gradually improves w/ gentle activity & movement during he day. -Pain & stiffness accelerate during the day & are worse in the evening. -Night pain is frequently associated w/ advanced joint dmg on imaging -Pain is brought on by activity & resolves predictably with rest.

-Pain & stiffness in the morn gradually improves w/ gentle activity & movement during he day.

What are signs/symptoms of prostatitis?

-Pelvic pain -Urinary symptoms -Ejaculatory pain -Hypotension -Bacterial *Fever/chills

What causes lower tract obstruction?

-Prostatitis -Benign Prostatic Hyperplasia (BPH)

What are the risk factor for hypothyroidism?

-Women over age 60 -Family history of thyroid disease -Autoimmune disease: *Diabetes, celic disease, etc. -Hasimoto's Thyroiditis -Medication/Radiation -Surgery -Post-partum

What is the 3 parts of diagnosis for rheumatoid arthritis?

1. Clinical presentation 2. Labs & imaging 3. Exclusion of other diseases

What age range is SLE commonly found in?

15-40 yrs old

What is the common age people get psoriatic arthritis?

20-30 yrs

What is the normal range of A1C?

4-6%

What is Glycosolated Hemoglobin?

A1C

What is aka Cushing's syndrome, is an excess secretion of cortisol, can be endogenous/exogenous, and leads to hypertension, osteoporosis, and bruising?

Adrenal hyperfunction

What is aka Addison's syndrome & is a reduction in cortisol/aldosterone production which leads to hypotension, weakness, & fatigue?

Adrenal insufficiency

What is skin pain to nonnoxious stimuli?

Allodynia

What is type 1 anaphylactic hypersensitivity ("Allergies")?

Anaphylaxis, the most dramatic and devastating form of type I hypersensitivity, is the systemic manifestation of immediate hypersensitivity. The implicated antigen is often introduced parenterally such as by injection of penicillin or a bee sting. The activation and breakdown of mast cells systematically causes vasodilation and increased capillary permeability, which promote fluid loss into the interstitial space, resulting in a clinical picture of bronchospasms, urticaria (wheals or hives), and anaphylactic shock.

What is a chronic progressive inflammation disorder of fibrous tissue affecting the entheses, or insertions of ligaments, tendons, and capsules into bone, than of synovium, as is common in other rheumatic disorders? It is commonly seen with inflammatory/fibrotic spondlyloarthropathy, low back pain & stiffness, slow progressive limitation in mobility, low grade/intermittent fever, weight loss, & anemia.

Ankylosing spondylitis

What is an enlargement of the prostate that causes impaired bladder emptying, increased urination frequency, strain/weak stream, and leaking?

Benign Prostatic Hyperplasia

How do you treat psoriatic arthritis?

Biologics

What is used to treat rheumatoid arthritis?

Biologics (Has side effect of immune suppression)

What is a disease that is caused by chronic diabetes or hypertension & causes multi-system damage, fluid/electrolyte imbalances, dehydration, & affects the cardiac system?

Chronic renal failure

What is a lower tract urogenital inflammatory disorder?

Cystitis/urethritis -Pelvic/abdominal pain -Painful urination -Female (anatomy) -Older adult (catherization/incontinence management, diabetes, chronic disease, immobility)

What gender is more commonly affected by SLE?

Females

Which gender is more likely to have rheumatoid arthritis?

Females

What is a noninflammatory condition appearing with generalized musculoskeletal pain in conjunction with tenderness to touch in a large number of specific areas of the body and a wide array of associated symptoms?

Fibromyalgia

What type of urinary incontinence has no urogenital pathology, but can't get to the bathroom in time (mobility deficits)?

Functional incontinence

What is a cytopathogenic virus that causes acquired immunodeficiency syndrome (AIDS)? It leads to T-Cell destruction after disease transmission

HIV

What is the condition where thyroid gland becomes inflamed, doesn't function properly, and can lead to hypothyroidism?

Hashimoto's Thyroiditis

Which of the following is the greatest concern, automatic red flag for renal cancer? -Body temp above 99 -Kidney p! beyond 3 wks -Hematuria -Painful urination

Hematuria

What is the disorder that releases Ca from bones into the blood?

Hyperparathyroid

What is aka Grave's disease resulting in elevated metabolism?

Hyperthyroidism

What is the disorder that is characterized by muscle tetany, spasm, and arrhythmia?

Hypoparathyroid

What is a reduction of thyroid size & function resulting in a depressed metabolism?

Hypothyroidism

What is cystitis?

Inflammation of the bladder -Female -Pelvic pain -Back/abdominal pain -Urinary frequency/urgency Infection signs/symptoms

What disease is characterized by a deer tick bite which initially causes a bulls eye rash (erythema migrans) which leads to arthritis?

Lyme disease

What gender is more likely to get ankylosing spondylitis?

Males

What is a phenomenon that has at least 3 of these criteria: -Waist circumference above 40 in male & 35 female -High Triglycerides>150 mg/dl -Low HDL <40 mg/dl -HTN > 130/85 -Fasting blood glucose > 100 mg and can lead to diabetes?

Metabolic syndrome

What type of urinary incontinence has detrusor muscle involuntary contraction?

Overactive bladder

What type of urinary incontinence does the bladder not fully empty, & has overdistension & dribbling?

Overflow incontinence

What is inflammation of the female reproductive system that causes lower abdominal/pelvic pain, abnormal uterine bleeding, vaginal discharge & odor, & painful intercourse/urination?

Pelvic Inflammatory Disease (PID)

What is a systemic rheumatic inflammatory disorder with an unknown cause? (There may be an autoimmune, viral, or stress-induced mechanism) Commonly seen in ppl over 55. Characterized by temporal arteritis, widespread muscle pain, & self-limiting for 2-3 yrs

Polymyalgia Rheumatica

What is a chronic, recurrent, erosive, and inflammatory arthritis associated with the skin disease psoriasis and is not just a variant of RA but is a distinct disease that combines features of both RA and spondyloarthropathy? Characterized by enthesopathy/enthesitis- tendon/ligament/capsule insertion point inflammation

Psoriatic arthritis

How do you perform Murphy's Percussion?

Punch test for Kidney Infection: 1. pt is seated/prone w/ back exposed 2. Examiner places 1 hand on the 12th rib over the costovertebral angle 3. Examiner then raps dorsum of palpatory hand w/ other fist. 4. Normla pt will feel firm thud. (+) test will be pain in back, flank, &/or into lateral abdomen.

What is an upper tract urogenital inflammatory disorder?

Pyelonephritis -Impaired kidney fxn impacts urination -Hypertension, cardiac, pulmonary & neurologic symptoms

What is a type of pain you get when urinary stones block part of your urinary tract?

Renal colic

What is chronic, systemic, inflammatory disorder of unknown cause that can affect various organs but predominantly involves the synovial tissues of the diarthrodial joints? Commonly has bilateral swelling.

Rheumatoid arthritis

What is is characterized by inflammation and fibrosis of many parts of the body, including the skin, blood vessels, synovium, skeletal muscle, and certain internal organs such as the kidneys, lungs, heart, and GI tract? You commonly see skin thickening (beginning in hands), Raynaud's phenomenon, esophageal hyomobility, and restrictive lung disease.

Scleroderma

What type of urinary incontinence has a normal bladder, but has urethral sphincter, ligamentous, and pelvic floor muscle weakness?

Stress urinary incontinence

What is is known to be a chronic, systemic, inflammatory disease characterized by injury to the skin, joints, kidneys, heart and blood-forming organs, nervous system, and mucous membranes? Can still affect all organs.

Systemic lupus erthyematosus (SLE)

What is the disorder where the pancreas doesn't produce insulin or insulin receptors don't work and generally has a childhood onset?

Type 1 diabetes

Under what age do people generally get ankylosing spondylitis?

Under 40 yrs old

What is known as syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and causes water retention=hyponatremia (low blood sodium) which can lead to weight gain, headache/confusion, seizures, muscle cramping, & diarrhea due to excess water intake with inadequate sodium intake?

Vasopressin hypersecretion

What is aka Diabetes Insipidus & causes excessive water loss- dehydration? It could be caused by pituitary/head trauma, infection/encephalitis, or be nephrogenic.

Vasopressin hyposecretion

What is the downstream effect?

When a pathology causes damage to multiple other systems

What is an increased sensitivity to pain?

hyperalgesia

What are called renal stones & progress to uretal stones which are sudden/sharp/severe/spasmodic/radiating pain & cause hematuria?

kidney stones