Term
| Distinguish between terminal hair & Vellus hair. |
|
Definition
Terminal - course, thick pigmented hair (scalp, eyebrows)
Vellus - short, fine - arms, chest |
|
|
Term
| Sebaceous glands are found on all skin surfaces except _____ & _____. |
|
Definition
|
|
Term
| Distinguish between eccrine & apocrine glands. |
|
Definition
both sweat glands
eccrine (merocrine) - widely distributed, help with thermoregulation
apocrine: found in axillary & genital areas - open into hair follicles; stimulated by emotional stress. |
|
|
Term
| T/F. The epidermis contains blood vessels. |
|
Definition
| false - no blood vessels in epidermis. |
|
|
Term
| List and define the two layers of stratified epithelium in the epidermis. |
|
Definition
stratum corneum - outermost, horny layer - comprised of nonliving cells
stratum lucidum - comprised of living cells; produces melanin responsible for skin color. |
|
|
Term
| What is the dermis comprised of? What structures are found here? |
|
Definition
collagen, elastin fibrous connective tissues
mucopolysaccharide matrix & elastin fibers provide elasticity, strength to skin
contains lymphatics, blood vessels, nerves, & nerve endings, sebaceous & sweat glands |
|
|
Term
| Define dermatitis & list the causes. |
|
Definition
inflammation of the skin with itching, redness, & skin lesions
Causes: allergic or contact dermatitis, poison ivy, harsh soaps, chemicals, adhesive tape |
|
|
Term
| Differentiate between actinic & atopic dermatitis. |
|
Definition
actinic: photosensitivity, reaction to sunlight, UV
atopic: etiology unknown, associated with allergic, hereditary, or psychological disorders |
|
|
Term
| List & describe the 3 stages of dermatitis. |
|
Definition
Acute: red, oozing, crusting rash: extensive erosions, exudate, pruritic vesicles
Subacute: erythematous skin, scaling, scattered plaques
Chronic: thickened skin, increased skin marking secondary to scratching, fibrotic papules & nodules; postinflammatory pigmentation changes - course can be relapsing. |
|
|
Term
|
Definition
| due to reduced oxygen level in the blood; causes include advanced lung disease, congenital heart disease, & abnormal hemoglobins. |
|
|
Term
| Differentiate between HSV1 & HSV2. |
|
Definition
HSV 1 - itching & soreness followed by vesicular eruption of the skin on the face or mouth; a cold sore or fever blister
HSV 2: spread by sexual contact; in newborns, may cause meningoencephalitis; may be fatal |
|
|
Term
| Herpes zoster is caused by ______ virus. What causes the initial onset if the disease is dormant? |
|
Definition
| varicella-zoster: reactivation of virus lying dormant in cerebral ganglia or ganglia of posterior nerve roots |
|
|
Term
| Describe the symptoms of shingles. |
|
Definition
| red papules along distribution of infected nerve usually accompanied by fever, chills, malaise, GI disturbances Ocular complications with cranial nerve (CN) III involvement: eye pain, corneal damage; loss of vision with CN V involvement postherpetic neuralgia pain |
|
|
Term
| What is contraindicated in shingles? |
|
Definition
| MHP & US - can increase severity of symptoms |
|
|
Term
|
Definition
| chronic disease of skin with erythematous plaques covered with a silvery scale - common on ears, scalp, knees, elbows, & genitalia. |
|
|
Term
| List medications & treatments for psoriasis. |
|
Definition
topical preparations - corticosteroids, occlusive ointments, coal tar; systemic drugs methotrexate)
PT intervention: long-wave ultraviolet (UV) light; combo UV light with oral photosensitizing drugs (psoralens) |
|
|
Term
| Differentiate between discoid lupus erythematosus (DLE) & systemic lupus erythematosus (SLE) |
|
Definition
discoid - only affects skin - flare-ups with sun exposure, lesions can resolve or cause atrophy, permanent scarring, hypopigmentation, or hyperpigmentation
SLE- chronic, systemic inflammatory disorder affecting multiple organ systems, including skin, joints, kidneys, heart, nervous system, mucous membranes - can be fatal - characteristic butterfly rash across bridge of nose |
|
|
Term
| What two other skin disorders are commonly seen with Raynaud's phenomena? |
|
Definition
|
|
Term
|
Definition
a chronic, diffuse disease of connective tissues causing fibrosisof skin, joints, blood vessels, & internal organs (GI tract lungs, heart kidneys
PSS (progressive systemic sclerosis) is a relatively rare autoimmune form |
|
|
Term
| List characteristics of scleroderma. |
|
Definition
skin is taut, firm edematous, firmly bound to subcutaneous tissues
limited disease/skin thickening: symmetrical skin involvement of the distal extremities & face - slow progression of skin changes, late visceral involvement |
|
|
Term
| Describe medical management of scleroderma. |
|
Definition
| corticosteroids, vasodilators, analgesics, immunosuppressive agents |
|
|
Term
| Define polymyositis (PM). |
|
Definition
| a disease of connective tissue characterized by edema, inflammation, & degeneration of the muscles - dermatitis associated with some forms |
|
|
Term
| List the characteristics of polymyositis. |
|
Definition
Affects proximal musculature, shoulder & pelvic girdles, neck, pharynx, symmetrical
rapid, severe onset: could require vent assistance |
|
|
Term
| Describe medical management of polymyositis. |
|
Definition
| corticosteroids & immunosuppressants |
|
|
Term
| describe precautions with polymyositis. |
|
Definition
| additional muscle fiber damage with too much exercise; contractures & pressure ulcers from inactivity, prolonged bed rest |
|
|
Term
| Define Seborrheic keratosis. |
|
Definition
proliferation of basal cells leading to raised lesions.
multiple lesions on trunk of older individuals, untreated unless cause irritation & pain - can be treated with cryotherapy |
|
|
Term
| Define actinic keratosis. |
|
Definition
| Flat, round, or irregular lesions, covered by dry scale on sun-exposed skin - precancerous - can lead to squamous cell carcinoma |
|
|
Term
| Define basal cell carcinoma. |
|
Definition
| slow growing epithelial basal cell tumor, characterized by a raised patch with ivory appearance - has rolled border with indented center. - rarely metastasizes - common on face in fair-skinned individuals - associated with prolonged sun exposure |
|
|
Term
| Define squamous cell carcinoma. |
|
Definition
| poorly defined margins, presents as a flat red area, ulcer, or nodule - grows more quickly, common on sun-exposed areas, face & neck, back of hand - can be confined or invasive to surrounding tissues |
|
|
Term
|
Definition
| lesions of endothelial cell origin with red or dark purple/blue macules with progress to nodules or ulcers - associated with itching & pain |
|
|
Term
| List characteristics of Kaposi's sarcoma. |
|
Definition
common on LE's; may involve internal structures producing lymphatic obstruction
increased incidence in individuals of central European descent & with AIDS-associated immunodeficiency. |
|
|
Term
|
Definition
| excessive dryness of skin with shedding of epithelium; can indicated deficiency of thyroid function & diabetes |
|
|
Term
|
Definition
| thickened & rounded nail end with a spongy proximal fold; indicative of chronic hypoxia secondary to heart disease, lung cancer, & cirrhosis. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| flat spot greater than 1 cm. |
|
|
Term
| Differentiate between papule, plaque, nodule, & wheal. |
|
Definition
| all are palpable, elevated solid mass papule: small, up to 1 cm plaque: elevated, 1 cm or larger nodule: (marble-like lesion) wheal: irregular, localized skin edema - ex. hives |
|
|
Term
| Differentiate between vesicle, bulla/blister, & pustule. |
|
Definition
elevated lesions with fluid-filled cavities
vesicle: up to 1 cm
bulla or blister (1 cm or larger)
pustule - contains pus |
|
|
Term
| Describe the 3 zones of injury in burns. |
|
Definition
Zone of coagulation: cells are irreversibly injured, cell death occurs
Zone of stasis: cells are injured, may die without specialized treatment, usually within 24-48 hours.
Zone of hyperemia: minimal cell injury, cells should recover |
|
|
Term
| Describe the Rule of Nines. How do you use percentages of the body for children? |
|
Definition
Child: use Lund-Browder chart
Adults: Head & neck - 9%
Ant. Trunk - 18%
Post. Trunk - 18%
Arms - Each 9%
Legs: each 18%
Perineum: 1%
Child:
Head 14%
Trunk 18% each side
Arms 9% each
Legs 16% each |
|
|
Term
| Differentiate between critical, moderate, & minor burns. |
|
Definition
critical = 10% of body with 3rd degree burns & 30% or more with second-degree burns
moderate = <10% with 3rd degree burns & 15-30% second-degree burns
minor: less than 2% with 3rd degree burns & 15% with with second-degree burns |
|
|
Term
|
Definition
| epidermis only - spontaneous healing in 3-7 days - no scarring |
|
|
Term
| Superficial partial thickness burn. |
|
Definition
Epidermis & upper layers of dermis are damaged
spontaneous healing, typically in 7-21 days - minimal scarring; discoloration |
|
|
Term
| Define Deep partial thickness burn. |
|
Definition
damage to epidermis & all of dermis with injury to nerve endings, hair follicles, & sweat glands
Healing is through scar formation & re-epithelialization - excessive scarring without preventative treatment |
|
|
Term
| Define Full-thickness burn. |
|
Definition
Destruction of epidermis, dermis, & subcutaneous tissues
removal of eschar & skin grafting are necessary d/t destruction of dermal & epidermal tissue - risk of infection increased - hypertrophic scarring & wound contracture likely without preventative measures. |
|
|
Term
|
Definition
Complete destruction of epidermis, dermis, subcutaneous tissues & muscle damage
heals with skin grafting & scarring - requires extensive surgery, amputation may be necessary |
|
|
Term
| Describe the inflammatory, proliferative, & maturation phase. |
|
Definition
Inflammatory phase: characterized by redness, edema, warmth, pain, & decreased ROM - lasts 3-5 days (neutrophils and macrophages common)
Proliferative - fibroblasts form scar tissue (deeper tissues) - wound contraction, re-epithelialization - continues for several weeks - may occur at wound surface if viable cells remain - characterizeed by granulation buds & epithelialization
Maturation phase - begins within 2-4 wks of injury and continues even after wound is healed - weaker collagen is replaced with stronger collagen - healing is complete when epithelium covers surface, but remodeling of scar tissue can last up to 2 years |
|
|
Term
| Describe common topical medications applied to wounds. |
|
Definition
silver nitrate - applied with wet dressings, requires frequent dressing changes
silver sulfadiazine
sulfamylon (mafenide acetate) - penetrates through eschar |
|
|
Term
|
Definition
use of other human skin: ex. cadaver skin - temporary until autograft is available.
patient will recieve immunosuppresive drug cyclosporine when an allograft is used. |
|
|
Term
|
Definition
| use of skin from other species (ex. pig) - used as a temporary graft |
|
|
Term
| Differentiate between split-thickness & full-thickness graft. |
|
Definition
split-thickness - epidermis & upper layers of dermis from donor site
full-thickness - requires epidermis & all of dermis from donor site. |
|
|
Term
| Differentiate between venous & arterial ulcers in terms of pulses, pain, color, trophic changes, temperature, & edema. |
|
Definition
Arterial: absent pulses, pain, esp. with legs elevated, pallor on foot elevation & dusky rubor on dependency, trophic changes include thin, shiny, atrophic skin; loss of hair on foot & toes, nails thickened, irregular, smooth edges, cool temperature, usually no edema, found on distal lower leg, toes, feet, lateral malleolus, & ant. tibial area
Venous: normal pulses, irregular dark pigmentation, usually shallow, distal lower leg, on med. malleolus, little pain, comfortable with legs elevated, mod. to lg. amt. of exudate |
|
|
Term
| Describe the staging of Pressure ulcers. |
|
Definition
Stage I: non-blanchable erythema of intact skin
Stage II: partial-thickness skin loss - involves epidermis & part of dermis
Stage III: Full-thickness skin loss - involves epidermis & dermis with damage to subcutaneous tissues
Stage IV: involves full-thickness skin loss & tissue necrosis - damage to muscle, bone or supporting structures. |
|
|
Term
|
Definition
| Ulcer that is slow to heal; is not painful. |
|
|
Term
| List some common topical antimicrobial agents. |
|
Definition
| silver nitrate, silver sulfadiazine, erythromycin, gentamicin, neomycin, triple antibiotics |
|
|
Term
| Typical subatmospheric pressures for wound vacs is ____. |
|
Definition
| 125 mm Hg below ambient pressure |
|
|
Term
| How do hyperbaric O2 chambers work for wound healing? |
|
Definition
Pt. breathes in 100% O2 in a sealed, full body chamber with elevated atmospheric pressure, between 2.0 & 2.5 atmospheres absolute
Hyperoxygenation reverses tissue hypoxia & facilitates wound healing due to enhanced solubility of O2 in the blood |
|
|
Term
| When is hyperbaric O2 treatment contraindicated? |
|
Definition
| untreated pneumothorax & some antineoplastic medications (doxorubicin, disulfiram, cisplatin, mafenide acetate) |
|
|
Term
| What is the purpose of cleansing topical agents? Why should their use be limited? |
|
Definition
contain surfactants to lower surface tension
may be toxic to healing tissues (ex. iodine, betadine, Dakin's solution, acetic acid solution, hydrogen peroxide |
|
|
Term
| What are normal pressures used for pulsed lavage? |
|
Definition
|
|
Term
| Describe indications & contraindications for autolytic debridement. |
|
Definition
indications - best for Stage III & IV wounds with min.-mod. exudate
not used for infected wounds, immunosuppressed individuals, or dry wounds
autolytic - using body's own enzymes under occlusive or semiocclusive moisture retentive dressings |
|
|
Term
| Describe indications & contraindications for enzymatic debridement. |
|
Definition
on any wound with a large amount of necrotic debris
should not use on dry wounds & ischemic wounds |
|
|
Term
| List indications/contraindications for mechanical debridement. |
|
Definition
indicated in wounds with moist necrotic tissue
contraindicated in clean or infected wounds |
|
|
Term
| LIst indications for sharp debridement. |
|
Definition
| infected wounds, wounds with a lot of eschar |
|
|
Term
| List the E-stim parameters for wound healing. |
|
Definition
capacitive coupled electrical current to transfer energy to a wound, improve circulation, facilitate debridement, & enhance tissue repair
Continuous waveform with direct current
HVPC (high-voltage pulsed)
MENS (microcurrent electrical stimulation
alternating/biphasic current |
|
|
Term
| Patient's should be on a turning/repositioning schedule every ____ hours in bed, & every _____ minutes in w/c. |
|
Definition
| 2; 15 minutes should reposition in w/c |
|
|
Term
| Gauze should be packed (loosely/tightly) into wounds. Why? |
|
Definition
| loosely - packing too tightly causes compromised blood flow & delays wound closure |
|
|
Term
| Which kind of gauze should be used for debridement & protection? |
|
Definition
debridement - wide-mesh
protection - fine-mesh |
|
|
Term
| Where are immune cells produced? |
|
Definition
|
|
Term
| What are the peripheral immune structures? |
|
Definition
| lymph nodes, spleen, & other accessory structures |
|
|
Term
| List another name for antibodies. |
|
Definition
|
|
Term
| What are the primary cells of the immune system? |
|
Definition
|
|
Term
| Which cells present antigens to the lymphocytes? |
|
Definition
|
|
Term
| Which molecules link immune cells with other tissues & organs? |
|
Definition
|
|
Term
| Which cells serve as master regulators of the immune response by influencing the function of all other immune cells. |
|
Definition
|
|
Term
| Which molecules function to recognize foreign threat from self? |
|
Definition
| MHC - major histocompatability complex |
|
|
Term
| What is the primary central gland of the immune system? |
|
Definition
|
|
Term
| Describe the thymus gland throughout the lifespan. |
|
Definition
| Fully developed at birth; reaches max size by puberty, then slowly diminishes & turns into adipose tissue |
|
|
Term
| The thymus gland produces ______. |
|
Definition
|
|
Term
| ____, ____, & ____ are formed in lymph nodes. |
|
Definition
| lymphocytes, monocytes, & plasma cells |
|
|
Term
| Where is the spleen located? |
|
Definition
| upper L abdominal cavity between the stomach & the diaphragm |
|
|
Term
| What is the function of the spleen? |
|
Definition
| filters antigens from the blood & produces leukocytes, monocytes, lymphocytes, & plasma cells in response to infection |
|
|
Term
|
Definition
| Natural resistance to disease & consists of rapidly activated phagocytes (macrophages, neutrophils, NK cells). Barriers (skin also provide a natural defense, as do inflammation & fever. |
|
|
Term
| Define adaptive immune response. |
|
Definition
includes slower acting defenses mediated by lymphocytes - repeated exposure activates more rapid & efficient response
w/ an excessive immune response, result causes allergies or autoimmune responses |
|
|
Term
| Differentiate between primary & secondary immunodeficiency disorders. |
|
Definition
primary - defect in T cells, B cells, or lymphoid tissue - could be congenital disorders of failure of immune organs to develop & produce mature lymphocytes or SCID (severe compromised immunodeficiency disease)
Secondary - result from underlying pathology or tx that depresses the immune system resulting in failure of the immune response - ex. include leukemia, bone marrow tumor, chronic diabetes, renal failure, liver cirrhosis, CA tx, organ transplant, graft vs. host disease |
|
|
Term
| List common opportunistic infections associated with AIDS. |
|
Definition
| Pneumocystis carinii pneumonia; also oral & esophageal candidiasis, CMV, cryptococcus, atypical mycobacteriosis, chronic herpes simplex, toxoplasmosis, Mycobacterium tuberculosis |
|
|
Term
| List common malignancies associated with AIDS. |
|
Definition
| Kaposi's sarcoma, Non-Hodgkin's lymphoma, primary brain lymphoma |
|
|
Term
| List common neurological diseases associated with AIDS. |
|
Definition
| focal encephalitis (CNS cryptococcal meningitis |
|
|
Term
| Describe AIDS-related complex (ARC) |
|
Definition
presence of acute symptoms secondary to immune system deficiency (early/middle AIDS)
- includes recurrent fever & chills, night sweats, swollen lymph glands, loss of appetite, weight loss, diarrhea, persistent fatigue, infections, apathy, & depression - could last weeks-months - precursor to AIDS |
|
|
Term
|
Definition
| some or all of the symptoms of ARC, general failure to thrive, & opportunistic infections, HA, blurred vision, dyspnea, dry cough, oral or skin lesions, dysphagia, dementia, seizures, & focal neurological signs |
|
|
Term
| List two lab tests that would indicate a person has AIDS. |
|
Definition
| HIV-1 antibody test - enzyme-linked immunosorbent assay (ELISA): 30,000-50,000 copies of HIV/mL Absolute T4 (CD4) counts: normal - 800-1200/mL AIDS - 200-500/mL |
|
|
Term
| List the 3 primary drugs used for AIDS treatment. |
|
Definition
Nuceloside reverse trascriptase inhibitors (NRTI) - zidovudine, previously AZT
Protease Inhibitors
Non-nuceloside reverse trasncriptase inhibitors (NNRTI's) |
|
|
Term
| With hepatotoxicity, signs of _____ may be seen |
|
Definition
|
|
Term
| With chronic fatigue syndrome (CFS), _____ is common. |
|
Definition
|
|
Term
| How many trigger points must there be for a diagnosis of fibromyalgia? |
|
Definition
|
|
Term
| MRSA is resistant to ALL ______ & _______. |
|
Definition
| penicillins & cephalosporins |
|
|
Term
| LIst examples of group A strep. |
|
Definition
|
|
Term
| List examples of Group B strep. |
|
Definition
| S agalactiae - neonatal & adult strep B infections |
|
|
Term
| Describe transmission & Prevention of Hepatitis A. |
|
Definition
primarily transmitted through fecal-oral route - contracted through contaminated food or water
prevention = good personal hygiene, hand-washing, sanitation, & immunization |
|
|
Term
| List transmission & prevention for Hep B. |
|
Definition
transmission is from blood, body fluids, or body tissues, blood transfusion, oral or sexual contact, & or contaminated needles
prevention - education, use of disposable needles, screening of blood donors, precautions for healthcare workers; immunization (vaccine) |
|
|
Term
| List transmission & prevention for Hep C. |
|
Definition
| transmission from bodily fluids |
|
|
Term
| Describe the 3 stages of Hepatitis. |
|
Definition
Initial (preicteric stage)1-3 wks: low grade fever, anorexia, nausea, vomiting, fatigue, malaise, headache, abdominal tenderness & pain
Jaundice (icteric) phase 6-8 weeks: fever, jaundice, enlarged liver w/ tenderness, abatement of earlier symptoms
recovery period = 3-4 mo. |
|
|
Term
| Describe the disease course for Hepatitis |
|
Definition
Acute: could last for several weeks to months
Chronic: HBV & HCV may lead to cirrhotic liver infection, including necrosis, cirrhosis, & liver failure |
|
|
Term
| List medical interventions for TB. |
|
Definition
| chemotherapy, isolation & bed rest |
|
|
Term
|
Definition
| sterilization of instruments by heat (250-270 degrees farenheit) & water pressure; contraindicated with heat-sensitive articles. |
|
|
Term
| Water boils at ______ degrees farenheit & kills non-______ forming organisms. |
|
Definition
|
|
Term
| Plasma comprises ____ of total blood volume. |
|
Definition
|
|
Term
| Plasma is composed of _____% water, ___% PRO, & ___% other small molecules. |
|
Definition
|
|
Term
| What is the importance of electrolytes in plasma? |
|
Definition
| determine osmotic pressure & pH balance - important in the exchange of capillaries & tissues |
|
|
Term
| Iodines are used in hydrotherapy when a filtering system is not possible - it provides full bactericidal activity when ____ is present. |
|
Definition
| organic matter - skin, feces, urine. |
|
|
Term
| List the three most common plasma proteins. |
|
Definition
| albumin, globulins, & fibrinogen |
|
|
Term
|
Definition
| plasma without the clotting factors |
|
|
Term
| Erythrocytes comprise ____ total blood volume. |
|
Definition
|
|
Term
| What is the most important feature of RBC's? |
|
Definition
| contain hemoglobin - responsible for transporting O2 to tissues |
|
|
Term
| RBC's are produced in _____ and are controlled by ____. |
|
Definition
| bone marrow; hormones (erythropoietin) |
|
|
Term
| RBC's are time-limited; survive approximately _____ days. |
|
Definition
|
|
Term
| List normal RBC count for men & women. |
|
Definition
Men: 4.2-5.4 x10^6
Women 3.6-5.0 x 10^6 |
|
|
Term
| Leukocytes comprise ___ of total blood volume & circulate through ____ tissues. |
|
Definition
|
|
Term
| List the function of leukocytes. |
|
Definition
| immune processes - are phagocytes of bacteria, fungi, & viruses - also aid in capturing toxic proteins resulting from allergic reactions & cellular injury. |
|
|
Term
| Leukocytes are produced in _____. |
|
Definition
|
|
Term
| List the 5 types of leukocytes: |
|
Definition
| lymphocytes, monocytes, neutrophils, basophils, & eosinophils |
|
|
Term
|
Definition
| normal function & generation of blood cells in the bone marrow |
|
|
Term
| Hematopoiesis is regulated by ____ & _____ acting on blood forming cells (_____). |
|
Definition
cytokines & growth factors
pluripotent stem cells |
|
|
Term
| List two common disorders of hematopoiesis. |
|
Definition
| aplastic anemia & leukemias |
|
|
Term
| CBC determines the number of ____, ____, & _____ per unit of blood. |
|
Definition
| RBC's, WBC's, & platelets |
|
|
Term
| Define White cell differential count. |
|
Definition
| Determines the relative percentages of individual white cell types |
|
|
Term
| Define ESR. What do elevated values mean? What are normal values? |
|
Definition
rate of red blood cells that settle out in a tube of unclotted blood - expressed in mm/hr
elevated values indicate presence of inflammation
normal: 1-13 mm/hr men & 1-20 mm/hr for women |
|
|
Term
|
Definition
| termination or arrest of blood flow by mechanical or chemical processes - mechanisms include vasospasm, platelet aggregation, & thrombin & fibrin synthesis |
|
|
Term
| List the components needed for blood to clot & where each component is produced. |
|
Definition
| platelets (produced in bone marrow), von Willebrand's factor (produced by endothelium of blood vessels), & clotting factors (produced by liver using vitamin K) |
|
|
Term
|
Definition
| clot dissolution that prevents excess clot formation. |
|
|
Term
| List causes of hypercoagulability disorders. |
|
Definition
increased platelet function (atherosclerosis, DM, elevated blood lipids, cholesterol)
accelerated activity of the clotting system (seen in CHF, malignant disease, prenancy & use of oral contraceptives, immobility) |
|
|
Term
| List causes of hypocoagulopathy. |
|
Definition
| bone marrow dysfunction, thrombocytopenia, thrombocytopathia, coagulation defects as seen in hemophilia & von-Willebrand's disease, & vascular disorders as seen in hemorrhagic telangiectasia, vitamin C deficiency, Cushing's disease, & senile purpura |
|
|
Term
| List red flags for PT treatment associated with patients with blood disorders. |
|
Definition
Use extreme caution with manual therapy & use of some modalities
Strenuous exercise is contraindicated owing to the risk of increased hemorrhage |
|
|
Term
| Define anemia & list 3 possible causes. |
|
Definition
decrease in Hgb levels in the blood: normal is 12-16 g/dL women & 13.5-18.0 g/dL for men
Causes
Decrease in RBC production: nutritional deficiency (iron, vitamin B, folic acid), cellular maturation defects, decreased bone marrow stimulation (hypothyroidism), bone marrow failure (leukemia, aplasia, neoplasm), & genetic defect
Destruction of RBC's: autoimmune hemolysis, siclke cell disease, enzyme defects, parasites (malaria), hypersplenism, chronic diseases (rhematoid arthririts, TB, CA)
Loss of blood (hemorrhage): trauma, wound, bleeding, peptic ulcer, excessive menstruation |
|
|
Term
| How should exercise tolerance be monitored in patients with anemia? |
|
Definition
|
|
Term
| Define sickle-cell disease. |
|
Definition
a group of inherited, autosomal recessive disorders; erythrocytes, specifically hemoglobin S (Hb S), are abnormal - rbc's are crescent or sickle-shaped instead of biconcave
sickle-cell train - heterozygous form of sickle cell anemia characterized by abnormal red blood cells.
Individual are carriers and do not develop the disease |
|
|
Term
| List characteristics of sickle-cell disease. |
|
Definition
chronic hemolytic anemia (sickle-cell anemia): hemoglobin is released into plasma with resultant reduced O2 delivery to tissues - results from bone marrow aplasia, hemolysis, folate deficiency, or splenic involvement
Vaso-occlusion from mis-shapen erythrocytes: results in ischemia,k occlusion, & infarction of adjacent tissue
chronic illness; can be fatal. |
|
|
Term
| Define sickle cell crisis. |
|
Definition
acute episodic condition occurring in children with sickle cell anemia.
pain: acute & severe from sickle cell clots formed in any organ, bone, or joint
acute abdominal pain from visceral hypoxia
painful swelling of soft tissue of the hands & feet (hand-foot syndrome)
persistent HA's |
|
|
Term
| List the possible complications with sickle cell anemia. |
|
Definition
vascular complications: stroke, leg ulcers, bone infarcts, avascular necrosis of femoral head
Renal complications: enuresis, nocturia, hematuria, renal failure
anemic crisis: rapid drop in Hgb levels
Aplastic crisis: characterized by severe anemia, associated with acute viral, bacterial or fungal infection, increased susceptibility to infection
splenic sequestration crisis: liver & spleen enlargement, spleen atrophy |
|
|
Term
| Which therapeutic modalities are indicated/contraindicated with physical therapy treatment of patients with sickle-cell anemia? |
|
Definition
warmth is soothing (hydrotherapy) - indicated
cold is contraindicated as it increases vasoconstriction & sickling |
|
|
Term
| Which clotting factors are deficient with hemophilia. |
|
Definition
| Factor VIII (hemophilia A) - most common & Factor IX (hemophilia B or Christmas Disease) |
|
|
Term
| Hemorrhage into muscles most commonly affects which muscles? |
|
Definition
| forearm flexors, gastrocnemius/soleus, & iliopsoas. |
|
|
Term
| List gait deviations associated with hemophilia. |
|
Definition
| equinus gait, lack of knee extensor torque. |
|
|
Term
| What treatment intervention is contraindicated with hemophilia? Why? |
|
Definition
| passive stretching - rarely used d/t risk of myositis ossificans. |
|
|
Term
| Cancer is the _____-leading cause of death in the US. |
|
Definition
|
|
Term
|
Definition
| a malignant tumor originating in epithelial tissues - skin, stomach, colon, breast, rectum. |
|
|
Term
|
Definition
| malignant tumor originating in connective & mesodermal tissues - muscle, bone, fat. |
|
|
Term
|
Definition
| affecting the lymphatic system - ex. Hodgkin's disease, lymphatic leukemia |
|
|
Term
| Define leukemias & myelomas. |
|
Definition
| affect the blood (unrestrained growth of leukocytes) & blood-forming organs (bone-marrow) |
|
|
Term
| Describe how cancers are staged. |
|
Definition
Primary tumor (T)
Regional lymph node involvement (N)
Metastasis (M)
Numbers used to denote extent of involvement, from 1-4
ex. T2, N1, M1 |
|
|
Term
| Define biotherapy for cancer. |
|
Definition
strengthens host's ability to fight cancer cells
can include interferons, IL-2, & cytokines
bone-marrow (stem-cell) transplant; follows high doses of chemotherapy or radiation that destroys both cancer cells & bone marrow cells |
|
|
Term
| Define Paraneoplastic syndrome & give examples. |
|
Definition
signs & symptoms are produced at a site distant from the tumor or its metastasized sites, from ectopic hormone production by tumor cells or metabolic abnormalities from secretion of tumor vasoactive products
Cushing's syndrome can result from small cell lung cancer
symptoms can result from cancer stimulation of antibody production |
|
|
Term
| Exercise is contraindicated in patients with _____ platelets or less. Patients with ____-____ platelets; use caution |
|
Definition
|
|
Term
| Describe the use of physical agents with cancer patients. |
|
Definition
do not use heat or cold over a tumor or dysvascular tissue (tissue exposed to radiation therapy); do not use heat over an area of increased hemorrhage, typically the result of corticosteroid therapy.
Do not use whirlpool in areas of increased bleeding or hemorrhage or open wounds, or because risk of cross-infection is high with immunosuppressed patients |
|
|
Term
| Describe the upper GI tract. |
|
Definition
| Consists of mouth, esophagus, stomach - functions for ingestion & initial digestion of food |
|
|
Term
| Describe the middle GI tract. |
|
Definition
| small intestine - major digestive & absorption processes occur here |
|
|
Term
| Describe the lower GI tract. |
|
Definition
| large intestine - primary functions include absorption of water & electrolytes, storage, & elimination of waste products |
|
|
Term
| List the major GI hormones. |
|
Definition
| cholecystokinin, gastrin, & secretin |
|
|
Term
|
Definition
| intractable constipation with resulting fecal impaction, retention of dry, hard stools in the rectum & colon |
|
|
Term
| Where can constipation refer pain to? |
|
Definition
abdomen, anterior hip, groin, or thigh
may develop as a result of muscle guarding & splinting |
|
|
Term
|
Definition
| condition in which the lower esophageal sphincter fails to relax & food is trapped in the esophagus |
|
|
Term
| Where does abdominal pain usually occur? |
|
Definition
epigastric region (T3-5 sympathetic)
periumbilical region (T10 sympathetic)
lower abdominal region (T10-L2 sympathetic) |
|
|
Term
| Visceral pain from the esophagus can refer to the ____. |
|
Definition
|
|
Term
| Mid-thoracic spine pain can appear as _____ pain. |
|
Definition
|
|
Term
| Visceral pain from the liver, diaphragm & pericardium can refer to _____. |
|
Definition
|
|
Term
| Visceral pain from the gallbladder, stomach, pancreas, or small intestine can refer to the ______ & _______ regions. |
|
Definition
|
|
Term
| Visceral pain from the colon, appendix, or pelvic viscera can refer to the ______, ______ , or _______. |
|
Definition
| pelvis, low back, or sacrum |
|
|
Term
| Complications of GERD include _____ & ______. |
|
Definition
| stricture & Barrett's esophagus |
|
|
Term
| List medical management of GERD. |
|
Definition
| acid-suppressing proton pump inhibitors (PPI's) (Prilosec, H2 blockers, ranitidine (Zantac), cimetidine (Tagamet), & antacids (tums) |
|
|
Term
|
Definition
| protrusion of the stomach upward through the diaphragm or displacement of both the stomach & gastroesophageal junction upward into the thorax |
|
|
Term
| Describe medications for Gastritis. |
|
Definition
| no NSAIDS - acid-suppressing PPI's, H2 blockers, & antacids |
|
|
Term
| With duodenal ulcers, the pain is brought on by ____ of food in the stomach. |
|
Definition
| absence; relieved by food & antacids |
|
|
Term
| Pain from peptic ulcers located on the posterior wall of the stomach can present as __________ or refer to _______. |
|
Definition
| radiating back pain & R shoulder |
|
|
Term
| List some causes of malabsorption syndrome. |
|
Definition
| can be caused by gastric or small bowel resection (short-gut syndrome) or a number of different disease including CF, celiac disease, Crohn's, pancreatitis, and pernicious anemia - Malabsorption can also be drug-induced |
|
|
Term
|
Definition
| Ulcerative colitis & Crohn's disease |
|
|
Term
| With IBD, joint pain & _____ can occur. |
|
Definition
|
|
Term
| Differentiate between Crohn's & UC. |
|
Definition
Crohn's - involves a granulomatous type of inflammation that can occur anywhere in the GI tract - areas of adjacent normal tissue called skip lesions are present. 25% have some form of arthririts associated
UC - involves an ulcerative & exudative inflammation of the large intestine & rectum - characterized by varying amounts of bloody diarrhea, mucus, & pus - no skip lesions |
|
|
Term
| Differentiate between Diverticulosis & Diverticulitis |
|
Definition
| Osis-pouch-like herniations of the colon, esp. sigmoid itis - inflammation/infection of one or more diverticula |
|
|
Term
| Where is McBurney's point? what is it associated with |
|
Definition
| site of the appendix located 1&1/2 to 2 in. above the ant. superior iliac spine in RLQ |
|
|
Term
| List a red-flag lab value with appendicitis. |
|
Definition
| immediate medical attention is required when elevations in wbc are >20,000/mm^3 |
|
|
Term
|
Definition
| inflammation of the peritoneum, the serous membrane lining the walls of the abdominal cavity |
|
|
Term
|
Definition
| bacterial invasion & infection of the peritoneum - common agents include E.coli, Bacteroides, Fusobacterium, & Strep |
|
|
Term
|
Definition
| tear or ulceration of the anal canal - constipation & large, hard stools are factors |
|
|
Term
|
Definition
| aka piles - varicosities in the lower rectum or anus caused by congestion of the veins in the hemorrhoidal plexus |
|
|
Term
| _____ increases the risk of hemorrhoids. |
|
Definition
|
|
Term
| Describe treatment for hemorrhoids. |
|
Definition
| topical medications to shrink the hemorrhoid, dietary changes, sitz bath, local hot or cold compress, & ligation or surgical excision. |
|
|
Term
| Female sex hormones are ____ & ____ and are produced under control of the hypothalamus (______) & the anterior pituitary gland (________). |
|
Definition
estrogens & progesterone;
hypothalamus - gonadotropin-releasing hormone &
ant. pituitary - gonadotropic follicle-stimulating & luteinizing hormones |
|
|
Term
| Estrogen decreases the rate of bone ______. |
|
Definition
|
|
Term
| Estrogen increase the production of the _____ & increase _____. |
|
Definition
|
|
Term
| The breasts are located between the ____ & ____ ribs. |
|
Definition
|
|
Term
| Normal pregnancy weight gain = ______. |
|
Definition
|
|
Term
| List postural changes with pregnancy. |
|
Definition
COG shifts up & forward
shoulders & upper back rounded with protraction
forward head, kyphosis
weight shifts towards heels to bring COG posterior
wide BOS
increased lordosis |
|
|
Term
| List the changes to the following as a result of pregnancy: blood volume, venous pressure in LE's, HR, CO, BP. |
|
Definition
| blood volume: increased (35-50%) venous pressure in LE's: increased HR: increased (RHR increases 10-20 bpm) CO: increased, esp. in L SL position (uterus puts less pressure on aorta) BP: decreased d/t venous distensibility (greater decrease in diastolic BP) |
|
|
Term
| Define diastasis recti abdominis. |
|
Definition
| lateral separation or split of the rectus abdominis; separation from midline (linea alba) greater than 2 cm is significant; associated with loss of abdominal wall support, increased back pain |
|
|
Term
| List & define the three most common pelvic floor disorders. |
|
Definition
cystocele: herniation of the bladder into the vagina
Rectocele: herniation fo the rectum into the vagina
Uterine prolapse: bulging of the uterus into the vagina |
|
|
Term
| A red flag sign of pelvic floor dysfunction is pain _____. |
|
Definition
| radiating down the posterior thigh. |
|
|
Term
|
Definition
| pregnancy induced, acute hypertension after the 24th week of gestation - evaluate for symptoms of HTN, edema, sudden excessive weight gain, headache, visual disturbances, or hyperreflexia |
|
|
Term
|
Definition
| an inflammation of the upper reproductive tract involving the uterus (endometritis), fallopian tubes, or ovaries - caused by a polymicrobial agent that ascends through the endocervical canal. |
|
|
Term
| List symptoms & complications of PID. |
|
Definition
lower abdominal pain that typically starts after a menstrual cycle, purulent cervical discharge, & painful cervix - increased wbc count & increased ESR
complications - pelvic adhesions, infertility, ectopic pregnancy, chronic pain, abscesses |
|
|
Term
| Describe treatment for PID. |
|
Definition
| involves antibiotic therapy to treat the infection & prevent complications. |
|
|
Term
| Sperm production requires an environment 2-3 degrees ____ than body temp. |
|
Definition
|
|
Term
| The ____ & _____ gland maintain endocrine via gonadotropic hormones (FSH & LH) for the male reproductive system. |
|
Definition
| hypothalamus & ant. pituitary |
|
|
Term
| FSH initiates ______. LH regulates ______. |
|
Definition
| spermatogenesis; testosterone production |
|
|
Term
| Are kidneys located inside or outside the peritoneal cavity? What vertebral level? |
|
Definition
outside; retroperitoneal
T12-L2 |
|
|
Term
| What is the proper name for Viagra? |
|
Definition
|
|
Term
| List red flag signs for prostatitis. |
|
Definition
| Dull aching pain may be found in the lower abdominal, rectal, low back, sacral, or groin regions |
|
|
Term
| The bladder is located behind the ______. |
|
Definition
|
|
Term
| List some lesser-known kidney functions. |
|
Definition
BP regulation through angiotensin-aldosterone mechanisms & salt & water elimination
contributes to bone metabolic function by activating vitamin D & regulating calcium & phosphate conservation & elimination
controls the production of rbc's in the bone marrow through the production of erythropoietin |
|
|
Term
|
Definition
the amount of filtrate that is formed each minute as blood moves through the glomeruli & serves as in important gauge of renal function
regulated by arterial BP & renal blood flow
measured clinically by obtaining creatinine levels in blood & urine samples
normal creatinine clearance is 115-125 mL/min |
|
|
Term
| Define BUN. What are normal values? What does a high BUN mean? |
|
Definition
measures urea nitrogen in blood - liver produces ammonia, which contains nitrogen, after it breaks down proteins used by the body's cells - nitrogen combines with other elements to form urea, chemical waste product - healthy kidneys filter urea & other waste products from the blood
6-20 mg/dL
High BUN is indicative of kidney disease. |
|
|
Term
| BUN levels are elevated with increased ___ intake, ___ bleeding, & ____. It is also abnormal in _____ disease |
|
Definition
PRO, GI, dehydration
liver |
|
|
Term
| What are normal specific gravity, pH, PRO, & sugar values of urine. |
|
Definition
specific gravity = 1.010=1.025
ph = 4.6-8.0 (avg. 6)
PRO = 0-8 mg/dL
Sugar = 0 |
|
|
Term
| Homeostasis is regulated through thirst mechanisms & renal function via circulating _____. |
|
Definition
|
|
Term
| dehydration is closely linked to sodium _____. |
|
Definition
|
|
Term
| Pitting edema occurs when the amount of interstitial fluid exceeds the ______. |
|
Definition
| absorptive capacity of tissues. |
|
|
Term
| Normal serum potassium level is ____. |
|
Definition
|
|
Term
| List the symptoms of hypokalemia. |
|
Definition
(decreased potassium)
muscle weakness & fatigue, muscle cramping, hyporeflexia
postural hypotension, dizziness, arrhythmias, ECG abnormalities: flat T, prolonged Q-T, depressed S-T, U wave appears |
|
|
Term
| List the symptoms of hyperkalemia. |
|
Definition
| common in acute renal failure; muscle weakness, flaccid paralysis, tachycardia, then bradycardia; tall, peaked T wave, prolonged P-R interval, & QRS duration |
|
|
Term
| Normal serum sodium level is _____. |
|
Definition
|
|
Term
| List symptoms of hypo/hypernatremia. |
|
Definition
hypo - m. weakness & twitching, hypotension, tachycardia; progressive circulatory collapse & shock
skin is cold, clammy, & decreased turgor
Hyper: circulatory congestion, pitting edema, weight gain, pulmonary edema, flushed skin, sticky mucous membranes |
|
|
Term
| List the symptoms of hypo/hypercalcemia. |
|
Definition
hypo: muscle cramps, tetany, spasms, paresthesias, anxiety, irritability, twitching, convulsions, arrhythmias, hypotension
hyper: decreased m. tone, weakness, bone pain, pathological fractures, heart block, cardiac arrest, hypertension
anorexia, nausea, weight loss, lethargy |
|
|
Term
| List the characteristics of hypo/hypermagnesia |
|
Definition
hypo: hyperirritability, confusion, delusions, hallucinations, convulsions, tetany, leg & foot cramps, arrhythmias, vasomotor changes (vasodilation & hypotension, occasionally hypertension)
hyper: hyporeflexia, muscle weakness, flaccid paralysis, respiratory muscle paralysis, drowsiness, flusing, lethargy, confusion, diminished sensorium, bradycardia, weak pulse, hypotension, heart block, & cardiac arrest |
|
|
Term
| Normally a ratio of ___ base to ___ acid. |
|
Definition
|
|
Term
| What symptoms are associated with an upper UTI? |
|
Definition
| tenderness over the costovertebral angle (Murphy's sign) & tenderness upon palpation or percussion over the kidney |
|
|
Term
| Define renal cystic disease & symptoms. |
|
Definition
renal cysts are fluid-filled cavities forming along the nephron & can lead to renal degeneration or obstruction.
symptoms include pain, hematuria, & hypertension. fever can occur with associated infection - cysts can rupture producing hematuria - simple cysts are generally asymptomatic |
|
|
Term
| What are the constituents of kidney stones? |
|
Definition
| calcium, magnesium ammonium phosphate, uric acid, & cystine |
|
|
Term
| List treatments for kidney stones. |
|
Definition
| increased fluid intake, thiazide diuretics, dietary restriction of foods high in oxalate, acidification or alkalinization of urine depending on stone type |
|
|
Term
|
Definition
| an end-stage toxic condition resulting from renal insufficiency & retention of nitrogenous wastes in the blood - symptoms can include anorexia, nausea, & mental confusion |
|
|
Term
| What is a major contraindication in dialysis patients. |
|
Definition
| taking BP at the shunt site |
|
|
Term
| List the hormones relased by the pituitary. What controls the pituitary? |
|
Definition
corticotropin-releasing hormone
thyrotropin-releasing hormone
growth-hormone releasing hormone, & somatostatin
hypothalamus controls release of pituitary hormones |
|
|
Term
| List the hormones released by the anterior pituitary. |
|
Definition
| growth hormone, adrenocorticotropic hormone, follicle-stimulating hormone, luteinizing hormone, & prolactin |
|
|
Term
| List the hormones released by the posterior pituitary. |
|
Definition
| controls the release of antidiuretic hormone & oxytocin |
|
|
Term
| List the hormones released by the adrenal cortex. |
|
Definition
| mineral corticosteroids (aldosterone), glucocorticoids (cortisol), adrenal adrogens (deydroepiandrosterone), & androstenedione |
|
|
Term
| List the hormones released by the adrenal medulla. |
|
Definition
| epinephrine & norepinephrine |
|
|
Term
| List the hormones released by the thyroid gland. |
|
Definition
triiodothyronine & thyroxine
Thyroid C cells control the release of calcitonin |
|
|
Term
| List the hormones released by the parathyroid gland. |
|
Definition
|
|
Term
| The pancreatic islet cells control the release of ____, ____, & _____. |
|
Definition
| insulin, glucagon, & somatostatin |
|
|
Term
| The kidney controls the release of ______. |
|
Definition
| 1, 25-dihydroxy vitamin D |
|
|
Term
| The ovaries control the release of what hormones? |
|
Definition
|
|
Term
| The testes control the release of _____. |
|
Definition
|
|
Term
|
Definition
| modulates rate of nutrient delivery (gastric emptying) - suppresses the release of glucagon |
|
|
Term
|
Definition
| depresses secretion of both insulin & glucagon - decreases motility of stomach, duodenum, & gall bladder; decreases secretion & absorption of GI tract |
|
|
Term
| List what pancreatic cells in Islets of Langerhans release the following hormones: insulin, glucagon, amylin, & somatostatin. |
|
Definition
insulin - beta cells
glucagon - alpha
amylin - beta
somatostatin - delta |
|
|
Term
| Which form of diabetes is prone to ketoacidosis? |
|
Definition
|
|
Term
| Define metabolic syndrome (syndrome X). |
|
Definition
A group of risk factors that increase the likelihood of developing heart disease, stroke, & Type II DM - requires 3 or more for dx:
- abdominal obesity (waist circumference >40 in. men or >35 in. women
- elevated trigylcerides: >150 mg/dL
- low HDL cholesterol: <40 mg/dL men & <50 mg/dL women
- increased BP: systolic >130 & diastolic >85
fasting plasma glucose level >110 mg/dL (btwn 100 & 125 considered pre-diabetes) |
|
|
Term
| Define secondary diabetes. |
|
Definition
| Associated with other conditions (pancreatic disease or removal of pancreatic tissue), endocrine disease (acromegaly, Cushing's, pheochromocytoma), drugs (diuretics, diazoxide, glucocorticoids, levodopa), & chemical agens |
|
|
Term
| Define impaired glucose tolerance. |
|
Definition
| asymptomatic or borderline diabetes with abnormal response to oral glucose test - 10-15% will convert to Type II DM within 10 yrs |
|
|
Term
| List integumentary changes in patients with DM. |
|
Definition
| degenerative connective tissue changes, anhidrosis, increased risk of ulcers & infections |
|
|
Term
| List musculoskeletal impairments associated with DM. |
|
Definition
| increased risk of adhesive capsulitis, contractures, tenosynovitis, plantar fascitis - increased risk of osteoporosis |
|
|
Term
| Differentiate between mononeuropathy & entrapment neuropathies. |
|
Definition
mononeuropathy - focal nerve damage resulting from vasculitis with ischemia & infarction
entrapment - resulting from repetitive trauma to superficial nerves |
|
|
Term
| List change to the liver & kidney associated with DM. |
|
Definition
| kidney failure & fatty liver disease (steatosis) |
|
|
Term
| List the diagnostic criteria for DM. |
|
Definition
symptoms of diabetes plus causal plasma glucose concentration >200 mg/dL - "causal" means any time of day, without regard to time of last meal
fasting plasma glucose test >126 mg/dL (no caloric intake for at least 8 hrs)
2-hour post-load glucose equal to >200 mg/dL during an oral glucose test - uses a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water |
|
|
Term
| Oral hypoglycemic agents are usually used for ______, while injections, infusions, & pumps are usually used for _____ or more severe _____. |
|
Definition
|
|
Term
| Exercise in contraindicated in patients with DM whose glucose level is > _____ or < _______. |
|
Definition
| 300 without ketones, 250 with ketones, 70 |
|
|
Term
| Patients with DM should not exercise without eating at least ___ hours before exercise. |
|
Definition
|
|
Term
| Where should short-acting insulin be injected if the patient plans to exercise? |
|
Definition
| in abdomen - should not be close to exercising muscles (insulin absorbed more quickly) |
|
|
Term
| Which glycemic crisis is associated with fruity breath? |
|
Definition
| hyperglycemia - ketoacidosis |
|
|
Term
|
Definition
| dividing an individual's weight in kilograms by the square of the person's height in meters. |
|
|
Term
| List the values for a BMI of overweight, obese, & morbidly obese. |
|
Definition
25-29.9 - overweight
30 - obese
40 - morbidly obese |
|
|
Term
| With caliper measurements, what measures are indicative of excess body fat? |
|
Definition
|
|
Term
| List medications that assist with weight loss. |
|
Definition
|
|
Term
| Bariatric surgery is for individuals with a BMI of over ___ or a BMI of > ____ with comorbid conditions. |
|
Definition
|
|
Term
| List the cause of hypothyroidism. |
|
Definition
decreased thyroid-releasing hormone secreted by the hypothalamus or pituitary gland
-atrophy of thyroid gland; chronic autoimmune thryoiditis (Hashimoto's disease) - overdosage of anti-thyroid medication |
|
|
Term
| List symptoms of hypothyroidism. |
|
Definition
| weight gain, mental & physical lethargy, dry skin & hair, low BP, constipation, intolerance to cold, & goiter |
|
|
Term
| If hypothyroidism is left untreated, it could lead to ______. |
|
Definition
| myxedema (severe hypothyroidism with symptoms of swelling of hands, feet, & face - can lead to coma & death |
|
|
Term
| List symptoms of hyperthryoidism. |
|
Definition
| nervousness, hyperreflexia, termor, hunger, weight loss, fatigue, heat intolerance, palpitations, tachycardia, & diarrhea |
|
|
Term
| List other treatments for hyperthyroidism other than anti-thyroid medications. |
|
Definition
| radioactive iodine & surgical ablation |
|
|
Term
| Define & Describe Addision's disease. |
|
Definition
partial or complete failure of adrenocortical function; decreased production of cortisol & aldosterone
etiology: autoimmune processes, infection, neoplasm or hemorrhage |
|
|
Term
| List the S & S of Addison's disease. |
|
Definition
| increased bronze skin coloring, weakness, decreased endurance, anorexia, dehydration, weight loss, GI disturbances, anxiety, depression, decreased cold tolerance, stress intolerance |
|
|
Term
| List treatments for Addison's disease. |
|
Definition
| replacement therapy - glucocorticoids, adrenal corticoids, adequate fluid intake, control of sodium & potassium, diet high in complex carbs & PRO |
|
|
Term
| Describe secondary adrenal insufficiency. |
|
Definition
| results from prolonged steroid therapy (ACTH); rapid withdrawal of drugs, & hypothalamic or pituitary tumors |
|
|
Term
| Define Cushing's syndrome. |
|
Definition
| metabolic disorder resulting from chronic & excessive production of cortisol by the adrenal cortex of from drug toxicity. |
|
|
Term
| List the most common cause of Cushing's. |
|
Definition
| pituitary tumor with increased secretion of ACTH |
|
|
Term
| List S & S of Cushing's disease. |
|
Definition
| decreased glucose tolerance, moon face, obesity, buffalo hump, decreased testosterone levels or decreased menstrual periods, edema, hypokalemia, & emotional changes, HTN, hypocalcemia, increased protein metabolism, & muscle catabolism |
|
|
Term
| list medical interventions for Cushing's disease. |
|
Definition
| goal is to decrease excess ACTH: irradiation or surgical excision of pituitary tumor or control medication levels - monitor weight, electrolyte, & fluid balance |
|
|
Term
|
Definition
| covering up a weakness by stressing a desirable or strong trait |
|
|
Term
|
Definition
| a refusal to recognize reality |
|
|
Term
|
Definition
| refusal or inability to recall undesirable past thoughts or events |
|
|
Term
|
Definition
| the transferring of an emotion to a less dangerous substitute |
|
|
Term
| Define reaction formation. |
|
Definition
| a defensive reaction in which behavior is exactly opposite of what is expected. |
|
|
Term
|
Definition
| the attributing of your own undesirable behavior to another |
|
|
Term
|
Definition
| the justification of behaviors using reasons other than the real reason - ex. presenting an attitude of not caring. |
|
|
Term
|
Definition
| resorting to an earlier, more immature pattern of functioning - ex. in TBI, common under high stress situations. |
|
|
Term
| List the stages of Grief by Kubler-Ross. |
|
Definition
Denial
Anger
Barganing
Depression
Acceptance |
|
|
Term
| List precautions to PT with a dialysis patient. |
|
Definition
| Patient is not to have BP taken in arm with AV fistula, patient is on anticoagulant - risk of hemorrhage, & PT is best done before dialysis or on dialysis off days |
|
|
Term
| What is a dialysis AV fistula? |
|
Definition
| connection between radial artery & cephalic vein used for long-term dialysis access |
|
|
Term
| Define indolent & induration. |
|
Definition
indolent - a long standing, often painless wound that is very slow to heal & is a characteristic of a venous insufficiency ulcer
induration - the hardening of skin around an ulcer - often occurring with pressure sores or venous insufficiency ulcers |
|
|
Term
| List two diseases that are airborne. |
|
Definition
|
|
Term
| List two diseases that are contracted by touching wounds, dressing, secretions, blood, excretions, or contaminated surfaces. |
|
Definition
|
|
Term
| ______ is increased in both the blood & urine with kidney disease. |
|
Definition
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Term
| Which protein, if found in the urine, can be indicative of renal disorder (proteinuria), can be seen in marathon runners without concern, & is decreased after burns? |
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Definition
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Term
| _____ is a protein that helps in resisting infection & is elevated in patients with MS |
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Definition
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Term
| T/F. Medication in aqueous solution is more bioavailable than a tablet, capsule, or suspension. |
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Definition
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Term
| What are the best sites for IM (intramuscular) medications? |
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Definition
| deltoid or vastus lateralis |
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Term
| Highly _____ drugs can cross the blood brain barrier. |
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Definition
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Term
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Definition
| a drug that is inactive when first administered but then is metabolized to an active form by something in the body - ex. liver metabolizes inactive cortisone to hydrocortisone |
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Term
| Define clearance of drugs. |
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Definition
| the volume of blood that is completely cleared of a drug per unit of time. |
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Term
| If clearance is decreased but the dose remains the same, what happens to the half life? |
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Definition
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Term
| Describe antagonists vs. agonists with drugs. |
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Definition
| agonists bind to a receptor site and have an effect; antagonists bind to a site & prevent the agonist from binding, but have no effect. |
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Term
| What happens if Cipro and theophylline (bronchodilator used in asthma) are used together? |
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Definition
| Cipro inhibits enzymes that metabolize theophylline - theophylline levels would increase in the blood, leading to potential toxicity |
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Term
| What happens if a patient has Naringenin & Zocor or Mevacor together? |
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Definition
| Naringenin - enzyme found in grapefruit juice - extensively metabolizes Zocor on first pass |
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Term
| What drugs negatively interact with ASA? What are the effects? |
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Definition
competes with coumadin (warfarin) at PRO binding sites
can displace phenytoin (Dilantin) & oral insulin from binding sites
ASA decreases excretion of methotrexate, a CA drug, which could increase methotrexate toxicity |
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Term
| NSAIDS are _______ COX inhibitors. |
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Definition
| non-selective - still have GI side effects |
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Term
| What conditions use glucocorticosteroids extensively? |
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Definition
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Term
| List examples of DMARDs, what they are used for, and possible side effects. |
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Definition
used with active, continuing, inflammatory disease, often used with NSAIDS & corticosteroids - can be used for cancer treatment
methotrexate - anticancer agent - hepatic dysfunction, GI disturbances, blood complications, cannot be used with renal dysfunction, & folic acid may decrease adverse effects
anticytokines - anti TNF-alpha (Enbrel) - used for RA
Leflunomide, Infliximab, Anakinra, Sulfa drugs, Cyclosporine |
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Term
| What is gold therapy? What are the side effects? |
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Definition
DMARD - gold salts - can be oral or IM (more effective) decreases pain & swelling of arthritis while preventing joint damage
adverse effects - blood disorders, renal dysfunction, & dermatitis & other skin problems |
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Term
| What is the purpose of taking oral vitamin D? What else can be taken to produce the same effect? |
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Definition
| facilitates absorption of calcium from the Gi tract - cod liver oil & calcitrol have same effect |
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Term
| What are side effects of tums? |
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Definition
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Term
| calcium binds with _______ & may prevent its absorption resulting in treatment failure. |
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Definition
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Term
| What natural foods bind with calcium & may decrease absorption of calcium? |
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Definition
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Term
| Why does caffiene increase osteoporosis? |
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Definition
| demineralizes skeleton by increasing calcium excretion |
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Term
| What is the purpose of bisphonates? |
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Definition
inhibit osteoclastic bone resorption without affecting bone formation
increase bone mass density & decrease risk of fracture |
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Term
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Definition
| risedronate (Actonel) & Alendronate (Fosamax) |
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Term
| List side effects of bisphonates. |
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Definition
| GI problems, myalgias, esophogeal lesions - needs to be taken with a full glass of tap water & pt. must remain upright for 30 minutes afterwards |
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Term
| What class of drug is Etidronate? What disease is it used to treat? What cannot not be taken in conjunction with it? |
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Definition
bisphonate - Paget's disease & heterotopic ossification
cannot be taken with antacids - bind it |
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Term
| What kind of drug is Teriparatide (Forteo)? What does it do? What are potential side effects? |
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Definition
bisphonate, contains parathyroid hormone & raloxifine (Evista) - selective antiestrogen agent - used to prevent & treat osteoporosis in postmenopausal women
side effects: hot flashes, leg cramps - can't use in premenopausal women or patients at risk for osteosarcoma |
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Term
| What kind of drug is calcitonin? What does it do? How is it administered? What are side effects? |
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Definition
bisphonate - inhibits osteoclastic activity - cannot prevent osteoporosis - given as a nasal spray
side effects: pain, myalgias, HA, & nasal symptoms |
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Term
| Why is hormone replacement therapy no longer used? |
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Definition
| increased risk of breast CA & cardiovascular problems vs. osteoporosis |
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Term
| What kind of drug is Valium? What are side effects? What are possible drug interactions? |
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Definition
muscle relaxant
side effects: drowsiness, abuse
Tagamet, Viracept, & Norvir & some AIDS medications can inhibit enzymes that metabolize Diazepam (increased blood levels of diazepam) |
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Term
| What kind of drug is Tizanidine (Zanaflex)? What are side effects? |
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Definition
muscle relaxant - treats spasticity
hypotension adverse side effect |
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Term
| What are Flexeril, Soma, Robaxin, & Norflex? What are possible side effects? |
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Definition
temporary relief of local, acute muscle spasm (muscle relaxant)
side effects: can interact with MAOIs such as Nardil & Parnate & potentially cause a hypertensive crisis - can also cause tachycardia, blurry vision, & dry mouth |
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Term
| What kind of drug is Baclofen? What does it do? What are the side effects? |
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Definition
muscle relaxant - used to treat spasticity or reduce painful flexor or extensor muscle spasm
side effects: drowsiness & increased seizures if patient has epilepsy |
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Term
| What kind of drug is Dantrolene? what does it do? What are the side effects? |
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Definition
muscle relaxant - used for chronic spasticity - blocks release of calcium - dizziness, drowsiness, diarrhea, & photosensitivity are side effects
adverse effects: toxic hepatitis, seizures, tachycardia, muscle weakness - should not be used with cardiac & respiratory dysfunction because of decreased muscle strength |
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Term
| What are opioid narcotics therapeutic uses? What are side & adverse effects? |
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Definition
uses: analgesia, antitussive (codiene in cough syrup), antidiarrheal, dyspnea associated with MI, acute pulmonary edema, left ventricular failure (morphine)
side effects: mental status changes, drowsiness, N/V
adverse effects: postural hypotension, respiratory depression, seizures, tremor, tolerance to drugs, dependence with addiction, physiological withdrawl |
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Term
| What is Fentanyl characterized as? What does it do? |
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Definition
| opioid narcotic - used for stable, chronic pain, applied as a patch or lozenge next to cheek - acts for 15-45 minutes for "breakthrough" pain that may exceed the usual pain level |
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Term
| In large doses, Tylenol can cause _____ failure. |
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Definition
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