Patho final exam (Chapters 30,32,33,37,39,40,41,46 and comprehensive)

What are the signs and symptoms of Fluid volume deficit?

*Thirst *Decreased skin turgor *Dry mucous membranes *Sunken eyeballs *Depressed fontanel (children) *Hypotension *Weak, rapid pulse

What are the signs and symptoms of SIADH?

*Water retention *Decreased urine output *Decreased serum osmolarity *Hyponatremia *Increased urine osmolarity *Increased urine specific gravity

What are the signs and symptoms of ICP?

-Altered LOC (earliest and most sensitive) -CUSHINGS TRIAD (hypertension, bradycardia, bradypnea) -Vomiting -pupil changes -Headache

What age does endometrial cancer effect?

55-60 year old

What is hypoxia?

A deprivation of oxygen with maintained blood flow EX: COPD, drug overdose, pneumonia

What is a basilar skull fracture?

A fracture of the bones that form the base of the skull **Frequent complication is leakage of CSF from the nose (rhinorrhea) or ear (otorrhea) **High risk for menigeal infection

Which of the following patients'signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? A. A man has an onset of headache, vomiting, and visual disturbances over the last 5 days. B. A woman experienced a sudden loss of balance and slurred speech C. A woman has vomited and complains of a severe headache D. A man states that his left arm and legs are numb and his gait is consequently unsteady

A. A man has an onset of headache, vomiting, and visual disturbances over the last 5 days

The nurse is caring for a preoperative client diagnosed with abdominal aortic aneurysm (AAA). The client reports the onset of severe back pain. What action should the nurse take next? A. Call the physician immediately B. Provide comfort measure to relieve the back discomfort? C. Monitor the client for one-half hour to see if it continues D. Determine if hoarseness of dysphagia is present

A. Call the physician immediately

The nurse is completing a health assessment of a 42 year old female with suspected Hashimoto's thyroiditis disease. The nurse should assess the client for: A. Cold sensitivity B. Weight loss C. Palpitations D. Tachycardia

A. Cold sensitivity

A 47-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood-tinged. What differential diagnosis would be the care team's first priority? A. Gonorrhea B. Trichomoniasis C. Syphilis D. Chlamydia

A. Gonorrhea

What diet should be implemented for a client who is in the early stages of cirrhosis? A. High calorie, high carbohydrate B. High protein, low fat C. Low fat, low protein D. High carbohydrate, low sodium

A. High calorie, high carbohydrate

Diabetics are at higher risk than most of the population for injury to organ systems in the body. Which organs are most at risk? A. Kidney and eyes B. Kidneys and liver C. Liver an deyes D. Pancreas and eyes

A. Kidneys and eyes

A client with diabetes mellitus in diabetic ketoacidosis has a carbon dioxide level of less than 10. The nurse would expect to see which symptom? A. Kussmaul breathing. B. Slow respirations C. Eupnea D. Absence of audible respirations

A. Kussmaul breathing

A client presents to the clinic with a diagnosis of acromegaly. Which of the following should the nurse expect to see during physical examination? Select all that apply. A. Large hands and feet B. Thickening and protruding of the jaw C. Arthritic changes D. Diaphoresis F. Organomegaly F. Hypotension G. Dysphagia H. Deepening of the voice

A. Large hands and feet B. Thickening and protruding of the jaw C. Arthritic changes D. Diaphoresis E. Organomegaly G. Dysphagia H. Deepeining of the voice

Chronic alcoholism often results in complications associated with which organ? A. Liver B. Lung C. Brain D. Kidney

A. Liver

What intervention is the priority for client with addisonian crisis? A. Preventing irreversible shock B. Preventing infection C. Relieving anxiety D. Lowering blood pressure

A. Preventing irreversible shock

When planning care for a client with viral hepatitis, the nurse should review laboratory reports for which of the following abnormal laboratory values? A. Prolonged prothrombin time B. Decreased blood glucose level C. Elevated serum potassium level D. Decreased serum calcium level

A. Prolonged prothrombin time Because the clotting cascade is located in the liver

A patient comes into the Emergency Department with anasarca, 20 lb. weight gain, and hyponatremia. Which disorder will the patient be diagnosed with? A. Syndrome of inappropriate Anti-diuretic hormone (SIADH) B. Diabetes Insipidus (DI) C. Dehydration D. Hypokalemia

A. Syndrome of inappropriate anti-diuretic hormone (SIADH)

A client has a diagnosis of a stroke versus a transient ischemic attack (TIA). Which statement shows the difference between a TIA and a stroke? A. TIAs typically resolve in 24 hours B. TIAs may be hemorrhagic in origin C. TIAs may cause a permanent motor deficit D. TIAs may predispose the client to a myocardial infarction

A. TIAs typically resolve in 24 hours

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as thyroid storm. What are the manifestations of a thyroid storm? Select all that apply. A. Tachycardia B. Very low fever C. Delirium D. Bradycardia E. Very high fever

A. Tachycardia C. Delirium E. Very high fever

The client with Grave's disease is experiencing exophthalmos. Which action taken by the nurse indicates that the nurse is aware of the problems associated with exophalmos? A. The nurse applies artificial tears to the client's lower conjunctiva B. The nurse offers saliva substitute C. The nurse provides frequent mouth care D. The nurse instructs the client to avoid eating uncooked foods

A. The nurse applies artificial tears to the client's lower conjunctiva

A client with an AV malformation is hospitalized. Which nursing measure will be essential to his/her care? A. To provide non-stimulating environment B. To encourage self-care C. To allow natural sunlight in room D. To encourage family and friend visitation

A. To provide non-stimulating environment

When using the Glasgow Coma Scale to evaluate level of consciousness, which of the following most accurately describes a score of 15? A. Would reflect a fully alert, well oriented person B. Indicates the need for nursing care to meet requirements of a comatose client C. Is indicative of a deep coma D. Indicates stabilization of neurological status

A. Would reflect a fully alert, well oriented person

What is decorticate posturing?

Abnormal flexion

What are signs and symptoms of endometrial cancer?

Abnormal, painless bleeding

Dyspnea associated with congestive heart failure (CHF) is due to:

Accumulation of fluid in the interstitial spaces and the alveoli of the lungs

What is autodigestion of the pancreas?

Activated enzymes begin to digest the pancreas cells Severe pain results Enzymes (amylase, lipase) appear in the blood

What does insulin do?

Allows cells to take up glucose from the blood Decrease glucose levels

What is the greatest concern with an abdominal arotic aneurysm? (AAA)

Aneurysm rupture

What is a epidural hematoma?

Arterial bleed Usually caused by head injury in which the skull is fractured

What are the major complications to portal hypertension?

Ascites (fluid accumulation in the abdomen) Esophageal varices (deadly when the varice ruptures) Splenomegaly

What is Type 1 Diabetes?

Autoimmune that causes the pancreas not to be able to produce insulin

A nurse is beginning client care and has been assigned to the following four clients. Which client should the nurse plan to assess first? A. A 60 year old client who had a cholecystectomy 15 hours ago and has been stable through the night B. A 47 year old client with esophageal varices who has influenza and has been coughing for last 30 minutes C. A 54 year old client with cirrhosis and jaundice

B. A 47 year old client with esophageal varices who has influenza and has been coughing for last 30 minutes

Which action of the pancreatic enzymes can cause pancreatic damage? A. Utilization by the intestines B. Autodigestion of the pancreas C. Reflux into the pancreas D. Clogging of the pancreatic duct

B. Autodigestion of the pancreas

A client with advanced liver disease presents with vomiting blood, tachycardia, cool, clammy skin, restlessness, and lethargy. All signs indicate a complication of portal hypertension. Based on the findings, the nurse determines the client is experiences which complication of portal hypertension? A. Duodenal ulcer B. Bleeding esophageal varices. C. Cirrhosis of the liver. D. Hepatomegaly

B. Bleeding esophageal varices

A 34 year old female is diagnosed with hypothyroidsm. Which signs and symptoms would the nurse expect to assess? Select all that apply. A. Rapid pulse B. Decreased energy and fatigue C. Weight gain of 10 lbs D. Fine, thin hair with hair loss E. Constipation

B. Decreased energy and fatigue C. Weight gain of 10 lb Fine, thin hair with hair loss E. Constipation

A patient diagnosed with Type 2 diabetes mellitus is admitted to the hospital with a blood glucose of 800 mg/dL and a diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Which of the following symptoms would the nurse expect to find? A. Fruity breath odor B. Dehydration C. Urine positive for ketones D. Hypertension

B. Dehydration

A client being evaluated for weakness, fatigue, anorexia, and nausea with a 15 lb. weight loss in a month. The diagnosis is addisonian crisis. What is the pathophysiologic changes that caused this crisis? A. An infection B. Exhausted stores of glucocorticoids C. Renal failure D. Lack of thyroid hormones

B. Exhausted stores of glucocorticoids

A person with a diagnosis of type 1 diabetes should understand the symptoms of a hyperglycemic reaction. The nurse will know this client understands if she says these symptoms are: A. Thirst, oliguria, and decreased appetitie B. Flushed cheeks, acetone breath, and increased thirst C. Nausea, vomiting, and diarrhea D. Weight gain, normal breath, and thirst

B. Flushed cheeks, acetone breath, and increased thirst

The client is admitted with Cushing's syndrome. Which symptoms support the diagnosis of Cushing's syndrome? A. Hypoglycemia and weight loss B. Increased risk for infection and pendulous abdomen C. Increased lymphocytes and pale complexion D. Decreased blood pressure and cyanosis

B. Increased risk for infection and pendulous abdomen

The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the intracranial pressure is rising? A. Increasing temperature, increasing pulse, increasing respiration, decreasing blood pressure B. Increasing temperature, decreasing pulse, decreasing respiration, increasing blood pressure C. Decreasing temperature, decreasing pulse, increasing respiration, decrease blood pressure D. Decreasing temperature, increasing pulse, decreasing respiration, increasing blood pressure

B. Increasing temperature, decreasing pulse, decreasing respiration, increasing blood pressure

A 39 year old male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fracture. One of the major concern for this patient is: A. Hematoma formation B. Meningeal infection C. Increased intracranial pressure D. Cognitive deficits

B. Meningeal infection

Which signs and symptoms of increased intracranial pressure (ICP) after head trauma would appear first? A. Bradycardia B. Restlessness and confusion C. Large amounts of dilute urine D. Widened pulse pressure

B. Restlessness and confusion

Which nursing diagnosis is appropriate for a client with Cushing's syndrome? A. Deficient fluid volume B. Risk for infection C. Acute pain D. Functional urinary incontinence

B. Risk for infection

The nurse is assigned to care for a client with complete right-sided hemiparesis. The nurse plans care knowing that in this condition: A. The client has complete bilateral paralysis of the arms and legs B. The client has weakness on the right side of the body, including the face and tongue. C. The client has lost the ability to move the right arm but is able to walk independently D. The client has lost the ability to ambulate independently but is able to feed and bathe himself or herself without assistance

B. The client has lost the ability to move the right arm but is able to walk independently

Which action by the nurse indicates that she understands the necessary action to be taken if the client with diabetes has altered sensorium and skin that is cold and clammy? A. The nurse administers regular insulin as ordered B. The nurse prepares to administer orange juice with sugar added C. The nurse maintains the intravenous infusion of normal saline D. The nurse inserts a foley catheter to monitor urinary output

B. The nurse prepares to administer orange juice with sugar added

During a home visit, the visiting nurse finds a patient with Type 1 diabetes who has been experiencing flu-like symptoms for the last 14-16 hours. Which of the following statements made by the patient indicates a need for further teaching? A. "I am testing my blood glucose every 2-4 hours" B. "I am testing my urine for ketones every 3-4 hours" C. "I am holding my insulin until my appetite returns " D. "I am drinking liquids (water and broth) every hour"

C. "I am holding my insulin until my appetite returns"

Which of the following changes in an 86-year-old male's skin would necessitate further examination and possible medical treatment? A. A decrease in general sebaceous gland activity B. Appearance of new skin tags on his chest C. A new irregular mole like growth on his forearm. D. Appearance of a keratosis on the man's trunk

C. A new irregular mole like growth on his forearm

Which of the following lab results are consistent with a diagnosis of Cushing's disease? A. A blood sugar of 60 mg/dL B. A urinary calcium level of 6.2 mg/dL C. A potassium level of 2.7 mEq/L D. A sodium level of 128 mEq/L

C. A potassium level of 2.7 mEq/L

What is the priority nursing intervention in the postictal phase of a seizure? A. Reorient the client to time, person, and place B. Determine the client's level of sleepiness C. Assess the client's breathing pattern D. Position the client comfortably

C. Assess the client's breathing pattern

A patient is diagnosed with vitamin K deficiency secondary to lack of green leafy vegetables, soybeans, canola oil and olive oil. What of the following findings would you expect? A. Constipations issues B. Hypertension C. Bleeding issues D. Multiple infections

C. Bleeding issues

A 39 year old male suffers an ischemic stroke. What was the cause of the stroke? A. Gender B. Age C. Diabetes D. Renal failure

C. Diabetes

The nurse is assessing the client with epididymitis. The nurse anticipates which of the following findings on physical examination? A. Fever, diarrhea, groin pain, and ecchymosis. B. Nausea, vomiting, scrotal edema, and ecchymosis C. Fever, nausea, vomiting, and painful scrotal edema. D. Diarrhea, groin pain, testicular torsion, and scrotal edema

C. Fever, nausea, vomiting, and painful scrotal edema

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk for developing which of the following diagnoses? A. Genital herpes B. Gonorrhea C. Genital warts D. Candidiasis

C. Genital warts

A client has sustained a basal skull fracture and the nurse notices drainage from the client's right nostril. The priority nursing action is to: A. Notify the physician B. Suction of the nostril C. Give them a Kleenex to look for a halo D. Have a patient blow their nose

C. Give them a Kleenex to look for a halo

A 30 year old male who manages his type 1 diabetes with insulin presents at the emergency department complaining of headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half-marathon. Which of the following is likely to be the cause of his complaints? A. Diabetic ketoacidosis B. Hyperosmolar hyperglycemic state C. Hypoglycemia D. Somogyi effect

C. Hypoglycemia

A client with Addison's disease may present with which of the following signs and symptoms? A. Hypokalemia B. Hypercalcemia C. Hypoglycemia D. Hypernatremia

C. Hypoglycemia

A 2 year old child is admitted to the pediatric unit with the diagnosis of bacterial meningitis. Which measure would be appropriate for the nurse to perform first? A. Obtain a urine specimen B. Draw ordered labroatory specimens C. Place the toddler in droplet isolation D. Explain the treatment plan to the parents

C. Place the toddler in droplet precautions

The client is experiencing somogyi phenomenon associated with diabetes mellitus. Which action by the nurse indicates knowledge of somogyi phenomenon? A. The nurse administers NPH insulin subcutaneously as ordered B. The nurse checks the blood glucose level in the am. C. The nurse suggests that the patient speak with the MD about decreasing the bedtime insulin D. The nurse explains the need for frequent cortisol levels to be checked

C. The nurse suggests that the patient speak with the MD about decreasing the bedtime insulin

What do genital warts look like or are classified by?

Cauliflower shaped lesions

What is an ischemic stroke?

Caused by an interruption of blood flow in a cerebral vessel and are the most common type of stroke, accounting for 70-80% of all strokes

What is a hemorrhagic stroke?

Caused by bleeding into brain tissue, usually from a blood vessel rupture caused by hypertension, aneurysms ect.

What causes Bell's Palsy?

Caused by usually an infection or trauma to the cranial nerve #7 Appears like a stroke with paralysis to one side of the face- however reversible in 4-8 weeks

What is the treatment for gonorrhea?

Ceftriaxone (Rocephin) IM Cefixime, Ciprofloxacin, ofoxacin or levofloxacin orally

What is often a causal link between HPV?

Cervical cancer

Late signs of increased ICP?

Changes in motor function A positive babinski reflex Decorticate or decerebrate posturing Seizures

What is the chief reason for liver transplantation in adults?

Chronic viral hepatitis

What is a key sign and symptom that an aneurysmal subarachnoid hemorrhage has ruptured?

Client states "The worst headache of my life" Vomiting, neck stiffness, and photophobia

What are excess amino acids converted into?

Converted to fatty acids, ketones and glucose

What are significant risks for patients with diabetes?

Coronary artery disease, cerebrovascular accident (CVA), blindness, end stage renal disease, lower leg amputation

What responds to stress levels and inflammatory response?

Cortisol

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the patient from infecting others in the future. Which of the following statements by the patient demonstrates best understanding of his health problem? A. "Either me or a partner could end up with an eye infection from chlamydia that could make us blind" B. Even though I couldn't end up sterile, a woman that I give it to certainly could" C. "Each of the three stages of the disease seems to be worse than the previous one" D. Even if I spread it to someone else, there's a chance she won't have any symptoms or know she has it"

D. "Even if I spread it to someone else, there's a chance she won't have any symptoms or know she has it"

Large amounts of glucagon were recently released into an individual's circulation has now ceased. Which of the following situations could have led to this inhibition of glucagon release? A. A sharp decrease in blood glucose concentration B. Recent strenuous physical activity C. Recent intake of large amounts of protein-rich food D. A decrease in cellular metabolic needs and an increase in glucose levels

D. A decrease in cellular metabolic needs and an increase in glucose levels

During admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? A. Diarrhea B. Hypermenorrhea C. Abnormal bleeding D. Abdominal distention

D. Abdominal distention

Which occurrence, if present in a head injured client, would indicate the need for immediate intervention? A. Temperature of 99 degrees F (axillary) B. Pulse 100 RR (apical) C. Respiration 16 regular rate D. Blood pressure 180/96 in the right arm

D. Blood pressure 180/96 in the right arm

Which condition generally requires the identification and treatment of sexual partners? A. Endometriosis B. Candidiasis C. Bacterial vaginosis D. Chlamydia

D. Chlamydia

The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficult, the nurse asks the client about the presence of which early symptom? A. Nocturia B. Urinary retention C. Urge incontinence D. Decreased force in the stream of urine

D. Decreased force in the stream of urine

The client with chronic pancreatitis should be monitored closely for the development of which of the following disorders? A. Cholelithiasis B. Hepatitis C. Irritable bowel syndrome D. Diabetes mellitus

D. Diabetes mellitus

Serum concentration of thyroid hormones and thyroid stimulating hormone (TSH) are tests ordered for the client with thyrotoxicosis. Which of the following laboratory values are indicative of thyrotoxicosis? A. Elevated thyroid hormone concentrations and normal TSH B. Elevated TSH and normal thyroid hormone concentrations C. Decreased thyroid hormone concentrations and elevated TSH D. Elevated thyroid hormone concentrations and decreased TSH

D. Elevated thyroid hormone concentrations and decreased TSH

Assessment of the diabetic client for common complications should include examination of the? A. Abdomen B. Lymph glands C. Pharynx D. Eyes

D. Eyes

A client with cirrhosis complains that his skin always feels itchy. The nurse recognizes that the itching is a result of which abnormality associated with cirrhosis? A. Increased aspartate aminotransferase level B. Decreased albumin levels C. Prolonged prothrombin level D. Increased bilirubin level

D. Increased bilirubin level

A 28 year old client is admitted to the hospital for a suspected brain tumor. While assessing the client, the nurse would keep in mind that the most reliable indicator of cerebral status is? A. Pupillary response B. Deep tendon reflexes C. Muscle strength D. Level of consciousness

D. Level of consciousness

Which consideration has highest priority when preparing to administer a medication to a client with cirrhosis of the liver? A. Frequency of the medication B. Purpose of the medication C. Necessity of the medication D. Metabolism of the medication

D. Metabolism of the medication

The nurse should recognize which as a cardinal sign or symptom of diabetes mellitus? A. Nausea B. Seizure C. Hyperactivity D. Polyuria

D. Polyuria

The client with diabetes mellitus says, "If I could just avoidwhat you call carbohydrates in my diet, I guess I would be okay." The nurse should base the response to this comment on the knowledge that diabetes affects metabolism of which of the following? A. Carbohydrates only B. Fats and carbohydrates only C. Proteins and carbohydrates only D. Proteins, fats, and carbohydrates

D. Proteins, fats, and carbohydrates

The nurse is reviewing the chart information for a client with increasing ascites. The data include: temperature 99.0 F; Heart rate 118; shallow respirations 26; blood pressure 128/76; and O2 saturation 89% on room air. Which action should receive priority by the nurse? A. Assess heart sounds B. Obtain an order for blood cultures C. Prepare for paracentesis D. Raise the head of the bed

D. Raise the head of the bed

A patient diagnosed with Guillain Barre disorder. What is your greatest concern as a nurse? A. Cardiac dysrhythmias B. Gastrointestinal upset C. Muscle stiffness D. Respiratory depression

D. Respiratory depression

College freshman are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on? A. Water sanitation B. Single dormitory rooms C. Vaccination for hepatitis D D. Safe sexual practices

D. Safe sexual practices

What is the purpose of drug metabolism in the liver?

Detoxification or inactivation

What is the most common complication leading to hospitalization among diabetics?

Diabetic foot ulcers

What is DKA?

Diabetic ketoacidosis Emergency situation Breakdown of fatty acids into glycerol with the increase of fatty acids leads to ketone build up by the liver

What are the diagnostic tests for prostate cancer?

Digital rectal exam Prostate specific antigen (PSA) testing Transrectal ultrasound

What are absence seizures?

Disturbance in consciousness--> Staring

What labs correlate with rheumatoid arthritis?

ELEVATED ESR Low RBC

How do you rule out endocarditis?

Echocardiogram, blood cultures, temperature

What labs correlate with hyperthyroidsm?

Elevated T3 and T4 Decreased TSH

What is the diagnostic test for Chronic viral hepatitis?

Elevated serum asparatate transaminase (AST)

What does bile do?

Emulsifies fats so they can be digested

What is the most common treatment of hyperthyroidism?

Eradication or radiation of the thyroid

What is decerebrate posturing?

Extension posturing

What lab values would be abnormal with fluid volume deficit or hypovolemia?

False elevation of hematocrit

What happens with fat metabolism?

Fatty acid degradation occurs in large part in th eliver that CONVERTS SOME FATTY ACIDS INTO KETONES and release into blood

How is Hepatitis A transmitted?

Fecal oral route

How is Hepatitis E transmitted?

Fecal oral route

What are signs and symptoms of meningitis?

Fever and chills, headache, NUCHAL RIDGIDITY, back, abdominal and extremity pains, nausea and vomiting

What is cirrhosis?

Functional liver tissue is replaced by fibrous tissue Usually associated with alcohol but there are other causes (i.e. viral hepatitis, drugs, chemical)

What is cholelithasis?

Gallstones

How would you treat an hypoglycemic unresponsive patient?

Give dextrose IV

How would you treat an unresponsive hypoglycemic patient or unable to get an IV?

Give glucagon IM

How would you treat a responsive hypoglycemic patient?

Give them oral glucose 15-20 g Orange juice, soda, candy etc.

What happens to glucose in the liver?

Glucose--> stored as glycogen, converted to glucose, also converts excess carbs to triglycerides and stored in the adipose tissue

What are the signs and symptoms of hypothyroidsm?

Gradual onset of weakness Weight gain Cold intolerance Dry rough skin Constipation Flatulence Abdominal distention Bradycardia Lethargy, impaired memory and mental dullness Delayed relaxation of deep tendon reflexes

What are the other names for hyperthyroidism?

Graves disease or thyrotoxicosis

What are complications of acute pancreatitis?

HYPERGLYCEMIA, acute respiratory distress syndrome (ARDS), acute tubular necrosis, hypocalcemia

What are the other names for hypothyroidism?

Hashimoto thyroiditis or Myxedema

What does the thyroid do?

Helps set the body's metabolism Produces T4 and T3

What is a common cause of genital warts?

Human papillomavirus (HPV)

What are the three major classification of DKA?

Hyperglycemia Ketosis Metabolic acidosis

What is an increased risk of an abdominal aortic aneurysm (AAA)?

Hypertension

What lab values does someone with cushing disease/syndrome present with?

Hypokalemia Hyperglycemia Hypertension Hypernatremia Gastric ulceration and bleeding

What is the end results of Addisons disease

Hyponatremia Dehydration Hypoglycemia Hypotension *Hyperkalemia

What are treatments of endocarditis?

Identify causative microorganisms Antimicrobial medications Surgery may be necessary

Where are drugs metabolized?

In the liver, and excreted in the kidneys

What is a cause of angina?

Inadequate O2 supply to the myocardium

What does estrogen help with cholesterol?

Increase HDL and decrease LDL

What lab value would be elevated for cellulitis?

Increased WBC

What is typically found in CSF fluid from meningitis?

Increased neutrophils, increased protein and decrease glucose levels

What is an indication of someone that has SIADH?

Increased retention of water and hyponatremia

What is meningitis?

Inflammation of the pia mater, the arachnoid, an the CSF-filled subarachnoid space

What is the treatment for hypovolemic shock?

Infusion of NS or lactate ringers to improve volume

What does insulin do for K+?

Insulin drives K+ back into the cell

What is priapism?

Involuntary prolonged (greater than 4 hours) abnormal and painful erection UROLOGIC EMERGENCY Most common causes are sickle cell disease or neoplasms

What is needed for thyroid hormone production?

Iodine

What is Disseminated Intravascular Coagulation (DIC)?

It is a widespread coagulation and bleeding issues Comes from a complication of different conditions Clot formation consumes all available coagulation protein and platelets therefore severe hemorrhage results Obstetric conditions, Cancers, Infections, Shock, Trauma or surgery, hematologic conditions Signs and symptoms: Petechiae, purpura, oozing from puncture sites, or severe hemorrhage

What are signs and symptoms of DKA?

Kussmaul respiration (increase in rate and depth of breathing) Nausea Vomiting Fruity smell Abdomen pain and tenderness Polyuria Marked fatigue Hypotension Tachycardia Metabolic acidosis Evental stupor

What can increased ICP lead to?

Leads to brain compression and death

What is the treatment for Addisons disease?

Lifelong hormone replacement therapy Regular schedule meals and exercise secondary to having episodes of hyponatremia and hypoglycemia

What is Addisons disease

Low adrenal cortical hormones Autoimmune destruction is the most common cause

What is the treatment of cholecystitis?

Low fat diet

What labs correlate with hypothyroidism?

Low serum T3 and T4 Elevated TSH levels

What does glucagon do?

Maintains blood glucose between meals and during periods of fasting Increased blood glucose level

What is often the first sign of prostate cancer?

Metastasis Most men are asymptomatic until this happens

What are tonic-clonic seizures?

Most common motor seizure Full body jerking followed by incontinence of bladder and bowel Cyanosis may occur Postictal phase - resting stage after the seizure

What are the signs and symptoms of ischemic stroke?

Most common: weakness of the face and arm sometimes the leg -Sudden onset and focal and usually one sided -Unilateral numbness -Vision loss in one eye -Slurred speech -Sudden, unexplained imbalance or ataxia

What is a complication of TPA?

NOT chest pain High risk for bleeding

Is there a treatment for genital warts?

No treatment to eradicate the virus

What is normal level of intracranial pressure (ICP)?

Normal ICP 0-15 mmHG

What kind of insulin can be given IV?

Only regular insulin can be given IV

What are the 5 P's associated with acute arterial occlusion?

Pallor Pulselessness Pain Paralysis Paresthesia

What is one of most deadly malignancies?

Pancreatic cancer (4-5% survival rate)

What are the signs and symptoms of an epidural hematoma?

Patient presents with a history of head injury and a brief period of lucid then rapidly progresses to coma High risk for death

What are complications of pelvic inflammatory disease (PID)?

Pelvic adhesions, infertility or ectopic pregnancy

What are the 3 polys of diabetes?

Polyuria Polydipsia Polyphasia

How do you prevent endocarditis?

Practicing aseptic technique Taking antibiotics before going to the dentist Avoiding infection

What is the highest priority to report to the physician of someone on TPA?

Presence of blood in the urine

What are the signs and symptoms of Cushing disease/syndrome?

Protruding abdomen Buffalo hump Moon face Thin extremities Purple striae or stretch marks Back pain Compression fractures Muscle weakness *Increased susceptibility to infection

What are other signs and symptoms of Diabetes?

Recurrent blurred vision Fatigue Paresthesia Skin infections

What are the signs and symptoms of cholelithiasis?

Right upper quad pain Abrupt onset Increase intensity of pain Soreness in right upper quad that the pain has ceased

What is the difference between seizures and convulsions?

Seizure is the abnormal behavior caused by an electrical discharge from neurons in the cerebral cortex (Brain activity) Convulsion is specific seizure type of a motor seizure involving the entire body (Movement)

What does T3 stiumlate?

Stimulates metabolism T4 is inactive until converted into T3 in the tissues

What illness is linked to Guillain-Barre syndrome?

Strep infection

What happens when there is a lack of iodine

T3 and T4 are not made There is no negative feedback to the hypothalamus and the thyroid will continue to grow

What is the key to hyperosmolar hyperglycemic nonketotic state?

The absense of ketones

What is the pituitary gland connected to?

The hypothalamus

What is hypospadias?

The opening of the urethra is on the BOTTOM of the surface of the penis

What is epispadias?

The opening of the urethra is on the TOP or side of the penis Depends on the extent or defect

What is the Dawn phenomenon

The patient becomes hyperglycemic around 0500 and 0900 Increase nighttime insulin, no snack

What is the somogyi effect?

The patient becomes hypoglycemic at 0300 then the body responds by secreting glucose therefore causing a hyperglycemic episode Decrease nighttime insulin or provide snack

What is Type 1 Diabetes characterized by?

There is an absolute lack of insulin Elevated glucose Breakdown of body fats and proteins causing ketones in the urine and serum ketones or acetone in the blood

What is Arteriovenous (AV) malformation?

There is no capillary bed present, artery connected to the vein First, blood is shunted from the high-pressure arterial system to the low-pressure venous system without the buffering advantage of the capillary network. Impairs tissue perfusion and can cause hemorrhage, seizures, headaches and progressive neurological deficits

How is Hepatitis D transmitted?

Through blood and body fluids

How is Hepatitis B transmitted?

Through blood and body fluids -Injecting drug users -Heathcare workers who are exposed to needle stick -Unsafe sex -Mom to baby transmission

How is Hepatitis C transmitted?

Through blood and body fluids It is the most common cause of hepatitis, cirrhosis and hepatocellular cancer

How is gonorrhea transmitted?

Through sexual intercourse

What is Cushing Disease/Syndrome?

Too much glucocorticoid hormone

What is a TIA?

Transient Ischemic Attack Focal ischemic cerebral neurological deficits that lasts for less than 24 hours

What is testicular torsion?

Twisting of the spermatic cord that suspends the testes MEDICAL EMERGENCY Severe distress usually sleeping prior Nausea and vomiting and tachycardia Early recognition is key within 6 hours

What is the difference between type 1 and type 2 herpes virus?

Type 1 is cold sores Type 2 is genital herpes

What is cryptorchism?

Undescended testes-one or both

What components are important for clotting?

VITAMIN K and calcium Presence of platelets produced in the bone marrow Von Willebrand factor generated by the vessel endothelium

What is a subdural hematoma?

Venous bleed Develops in the area between the dura and the arachnoid (subdural space)

What are the signs and symptoms of benign prostatic hyperplasia (BPH)?

Weak urinary stream Post void dribbling Frequency of urination Nocturia

What are the signs and symptoms fo hyperosmolar hyperglycemic nonketotic state

Weakness Dehydration Polyuria Excessive thirst

What are the signs and symptoms of hyperthyroidism?

Weight loss Tachycardia, palpitations SOB Excessive sweating Muscle cramps Heat intolerance EXOPHTHALMOS (Bulging of the eyeballs)

Is herpes still transmittable even if there are no active lesions?

Yes