HTHRHSC: 2500 Medical Terminology Application 6

She also developed ventricular tachycardia type symptomatology due to sick sinus conduction system disease. At that time a permanent pacemaker was placed to control the arrhythmia. Select all correct responses that describe this arrhythmia.

- potentially fatal condition because the heart is beating so rapidly that it is unable to adequately pump blood through the body - a very rapid heartbeat that begins within the ventricles

Richard Smith is a 57 y/o male who is here for a routine annual physical exam. His blood pressure was elevated to 162/94 and lab work was normal except for elevated total cholesterol of 336. His family physician discussed weight reduction, diet low in fat and sodium, exercise, and prescribed an antihypertensive and cholesterol-lowering medication. Richard asked the doctor to explain what the cholesterol-lowering medication was for in layperson's terms.

"A cholesterol-lowering drug reduces the amount of cholesterol and other fats in your blood stream. This will prevent the fatty build-up that can clog your arteries. If you have this kind of fatty build-up in your arteries, you can develop high blood pressure, and possibly, a heart attack.

Thomas Bleu is a 72 y/o male with complaint of pain in his legs that is relieved with rest, swelling in his lower legs and ankles, and a dark reddish-blue discoloration of both lower legs. Ultrasound of veins in lower extremities show venous insufficiency due to clot formation partially blocking veins and leakage of venous valves. Diagnosis: Chronic venous insufficiency. Plan: Anticoagulant therapy; LASER ablation; weight loss, exercise, compression stockings. The peripheral vascular surgeon describes the condition to Mr. Bleu in language that he can understand.

"Chronic venous insufficiency is a condition in which the veins and valves in the veins in your legs are weakened or damaged and can't pump or return enough blood to your heart. The remaining blood increases pressure in the veins, causing swelling and pain and discoloration to the skin."

Continuation of Q 9: Angela Pector The cardiologist explains the treatment plan for angina to Ms. Pector. It includes weight reduction, diet low in saturated fats, small meals, stress reduction, exercise and medications. One of her medications is Lopressor, which is a beta-blocker. The cardiologist explains how this drug works in layperson's terms.

"Lopressor makes your heart beat more slowly with less force and decreases blood pressure. This medication also helps blood vessels relax and open up to improve blood flow and reduce or even prevent the chest pain and pressure you are having."

Subjective: Sharon Palure is a 32 y/o female who complains of exhaustion, shortness of breath, weight loss, swollen tongue, and irritability. Objective: She appears very pale and listless. She is a vegan and does not eat meat, fish, eggs, or dairy products. Her symptoms have been increasing over the past several months; however, the shortness of breath and weight loss are more recent. Laboratory: CBC - erythrocytopenia and megaloblastic red cells. Vitamin B12 - low. Antibodies test - negative. Assessment: Megaloblastic anemia due to vitamin B12 deficiency. Plan: Vitamin B12 injections weekly; Dietitian consult; multivitamin qd. The doctor explains the disease (in layperson's terms) so Sharon can understand and be aware of her diet deficiency.

"Megaloblastic anemia can occur when red blood cells do not mature properly. It can result from a lack of vitamin B12, which you get from meat, fish, eggs, and dairy products. People with your type of anemia have fewer red blood cells and the red blood cells they do have tend to be larger than normal. Your symptoms are a result of not enough red blood cells to carry oxygen through your body."

Reginald Klot is a 72 y/o male who presents to ED with sudden onset of headache, nausea, vomiting and left-sided numbness. He has a history of hypertension and hyperlipidemia. These symptoms occurred approximately two hours ago. CT scan: rt carotid artery thrombolic occlusion. Plan: tPA. Dr. Emergin explains the procedure to Mr. Klot's wife in layperson's terms.

"Mrs. Klot, your husband has a blood clot in the major artery to his brain. We will be giving him a drug called tissue plasminogen activator through a vein in his arm. This medicine will break up the clot and improve his chances to recover more fully."

Office Progress Note: Angela Pector cc: 54 y/o Caucasian female with c/o of squeezing pressure and fullness in the center of her chest accompanied by shortness of breath. She states that sometimes it feels as if "someone is standing on my chest". These events may occur 3-4 times a week frequently after eating a heavy meal and lasting less than 20 minutes. She has been taking Tums, which she indicates sometimes helps. Lab: Cardiac enzyme elevation-neg. Procedure: Chest x-ray-neg; Echocardiogram-positive for decreased blood flow left venticles; Cardiac stress test-positive for decreased exercise capacity. Dx: Angina Pectoris. The cardiologist explained angina to Ms. Pector in layperson's terms.

"Ms. Pector, I know you are worried about having a heart attack. Angina is a type of chest pain or discomfort caused by less blood flow to the heart muscle. This pain or pressure occurs because your heart isn't getting enough oxygen-rich blood."

Nursing home resident: Sara Ault 78 y/o African-American female with CHF, HTN (hypertension), DM type II (diabetes mellitus) Progess Note: Subjective: c/o memory decline, tremors, difficulty sleeping, and fatigue. Objective: tremors in hands, MMSE score 24/30; previous score 29/30 (mini mental status exam for evaluation of Alzheimer's or other dementia; 30/30 is normal) Medications: Altace (CHF), Gluocophage (DM); Lasix (CHF), Slow K (potassium supplement to replace potassium loss when on diuretic). Lab: B-12 levels-low; Antibodies Test: +antibodies against intrinsic factor;Schilling Test: intrinsic factor (-) Assessment: symptoms likely due to lack of B-12 absorption; autoimmune disorder with absence of intrinsic factor and medications glucophage and Slow K decreasing absorption of B-12 from intestines Dx: Pernicious anemia Plan: Discuss with resident and daughter; B-12 injections weekly; change glucophage, reduce Slow K and monitor potassium levels. The nursing home physician discusses the medication changes and explains pernicious anemia in layperson's terms.

"Pernicious anemia is caused by the lack of a protein that is necessary for vitamin B-12 to be absorbed from your intestines. You need vitamin B-12 to make red blood cells that carry oxygen throughout your body. These new symptoms might be caused by not having enough oxygen."

Betsy Raye is a 23 y/o female who is a ski instructor. During the past winter season she has experienced discoloration, coldness, and numbness and tingling in her hands and feet. It comes and goes; however, she has noted that the problem occurs when she is in cold temperatures. She is a pack per day smoker (cigs) for 7 years. Physical exam is normal except for cold-stimulation test which was positive for Raynaud's with hands responding to cold water by turning pale, then cyanotic and mottled red (see attached photo). DDx: Antinuclear antibodies and ESR negative [ruling out other autoimmune disease or inflammatory cause]. Dx: Raynaud's Disease. The doctor explained this condition to Ms. Raye.

"Raynaud's is a condition that causes some areas of your body, like your fingers and toes, to feel numb and cool when your body is exposed to cold temperatures or stress. In Raynaud's, smaller arteries that supply blood to your skin become narrow, and this limits blood circulation to your fingers and toes."

David Thomas is an 84 y/o male who is being treated for CHF. Because he also has diabetes mellitus, the cardiologist is changing his calcium channel blocker antihypertensive drug to an ACE inhibitor. Besides treating hypertension and heart failure this drug also has a protective effect on the kidneys that can be damaged when blood sugars and blood pressure are not well-controlled. Dr. Hart explains the new medication to Mr. Thomas in layperson's terms.

"This medication helps relax blood vessels by blocking the formation of the angiotensin-converting enzyme that narrows blood vessels. Your blood pressure then goes down into a more normal range and that helps to manage heart failure."

Susan Varies is a 65 y/o woman who complains of heavy, aching pain in her lower legs and ankles along with swelling and twisted, blue veins in the calves. She has an ultrasound of her leg veins, which shows malfunctioning valves. The doctor diagnoses varicose veins. Ms. Varies asks for an explanation of this condition in non-medical terms.

"Varicose veins are twisted and enlarged veins that usually occur in your legs and feet. There are valves in your veins that help to move the blood back to your heart. When the valves aren't working well, the blood can collect in your veins causing them to bulge and get bigger."

Mrs. Doe is also on Coumadin to prevent clots from forming at the stent site. The drug category for Coumadin is ___.

anticoagulant

Before placement of the pacemaker, Mrs. Doe also experienced bradycardia. What is this arrhythmia?

an abnormally slow resting heart rate of less than 60 beats per minute

Since the hospitalization, Mrs. Doe has been taking many medications to treat her heart disease and other chronic conditions. Amiodarone is a/an ________ (category) medication that controls irregularities of the heartbeat.

antiarrhythmic

The cardiologist is concerned that the Plavix was not continued in the nursing home. The consult to the attending physician suggests that this medication be added to the drug regimen to reduce clot formation around the stent site. Plavix is a/an _______ (category), which acts to _______.

antiplatelet; prevents aggregation and clumping of platelets

The assessment indicated that the tachyarrhythmia was due to malfunction of the pacemaker, which was reprogrammed with subsequent resolution of the arrhythmia. Other conditions to be stabilized include the chronic obstructive pulmonary disease, _____ and hypertensive heart disease. Hypertension is ____.

diabetes mellitus; the elevation of arterial blood pressure to a level that is likely to cause damage to the cardiovascular system

Mrs. Doe had a previous history of ____ myocardial infarction, which is __________.

non-Q wave; the closure of one or more coronary arteries caused by fatty plaque buildup or a thrombotic occlusion

Mrs. Doe is also taking Toprol XL 50 mg daily. Toprol is a beta blocker which acts to _______.

reduce the workload of heart by slowing the rate of the heartbeat. This drug also lowers blood pressure

During her hospitalization for the MI, Mrs. Doe had a PTCA and ___ placement with good results. PTCA is a ____

stent; percutaneous transluminal coronary angioplasty in which a small balloon on the end of a catheter is used to open a partially blocked artery.

"The patient was treated with Solu-Medrol in the emergency room and was given Lasix 40 mg IV." Lasix is a diuretic, which is given to ________.

stimulate the kidneys to increase the secretion of urine to rid the body of excess sodium and water; and thereby, decreasing the blood pressure and workload of the heart