Acute Care Exam 1

Front 1

recurrent attacks of acute arthritis associated with increased levels of serum uric acid.

Back 1

gout

Front 2

____ may be related to another acquired disorder or may be the result of drugs known to inhibit uric acid excretion. This may also be caused by drugs that increase the rate of cell death, such as the chemotherapy agents used in treating leukemia.

Back 2

Secondary gout

Front 3

In ____a hereditary error of purine metabolism leads to the overproduction or retention of uric acid. This, which accounts for 90% of cases, occurs predominantly in middle-aged men.

Back 3

primary gout

Front 4

Causes of gout

Back 4

• Acidosis or ketosis• Alcohol use• Atherosclerosis• Chemotherapy drugs• Diabetes mellitus• Drug-induced renal impairment• Hyperlipidemia• Hypertension• Malignant disease• Myeloproliferative disorders• Obesity or starvation• Renal insufficiency• Sickle cell anemia• Exposure to lead• Use of certain common drugs (low-dose aspirin, thiazide, diuretics, niacin)

Front 5

Gout is caused by 3

Back 5

(1) an increase in uric acid production; (2) underexcretion of uric acid by the kidneys; or (3) increased intake of foods containing purines, which are metabolized to uric acid by the body.

Front 6

In the acute phase, gouty arthritis may occur in one or more joints but usually less than four. Affected joints may appear dusky or cyanotic and are extremely tender. Inflammation of the ____is the most common initial problem.Other affected joints may include wrists, knees, ankles, and midtarsal area of the foot. Olecranon bursae may also be involved.

Back 6

great toe (podagra)

Front 7

The onset of symptoms typically occurs at night with sudden swelling and excruciating pain peaking within several hours, often accompanied by low-grade fever. Individual attacks usually subside, treated or untreated, in____

Back 7

2 to 10 days.

Front 8

_____ is characterized by multiple joint involvement and visible deposits of sodium urate crystals (____). These are typically noted in the synovium, subchondral bone, olecranon bursae, and vertebrae; along tendons; and in the skin and cartilage

Back 8

Chronic gout

tophi

Front 9

In gout, serum uric acid levels are usually elevated above ____mg/dL.

Back 9

6 

Front 10

Acute gout is treated with drug therapy. Because ____ has antiinflammatory effects but no analgesic properties, a ____ is added to the treatment regimen for pain management.

Back 10

colchicine

NSAID

Front 11

Adequate urine volume with normal renal function (2 to 3 L/day) must be maintained to prevent precipitation of uric acid in the renal tubules.

Back 11

nursing

Front 12

Future attacks of gout are prevented in part by a maintenance dose of urate-lowering drugs such as a ___,___

Back 12

xanthine oxidase inhibitor (allopurinol)

Front 13

a chronic multisystem inflammatory disorder associated with abnormalities of the immune system.

Back 13

systemic lupus erythematosus (SLE)

Front 14

Women are ___ times more likely than men to develop SLE.

The etiology of the abnormal immune response in SLE is ____

Back 14

10

unknown

Front 15

No characteristic pattern occurs in the progressive involvement of SLE. Any organ can be affected by an accumulation of circulating immune complexes. The most commonly affected tissues are the skin and muscle, the lining of the lungs, the heart, nervous tissue, and the kidneys. Generalized complaints such as fever, weight loss, arthralgia, and excessive fatigue may precede an exacerbation of disease activity.

Back 15

Nursing

Front 16

Arthritis occurs in more than 90% of patients with ____

Anemia, mild leukopenia, and thrombocytopenia are often present.

Increased risk for infection

butterfly rash

Back 16

SLE

Front 17

The diagnosis of SLE is based on distinct criteria revealed through patient history, physical examination, and laboratory findings ( No specific test is diagnostic for SLE, but a variety of abnormalities may be present in the blood.

Back 17

Nursing

Front 18

a retrovirus that causes HIV infection and acquired immunodeficiency syndrome.

Back 18

human immunodeficiency virus (HIV)

Front 19

This viral infection causes the person to be susceptible to infections that would normally be controlled through immune responses.

Back 19

HIV

Front 20

HIV can be transmitted as a result of contact with__4__. Transmission of HIV occurs through sexual intercourse with an infected partner; exposure to HIV-infected blood or blood products; and perinatal transmission during pregnancy, at delivery, or through breastfeeding.

HIV-infected individuals can transmit HIV to others within a few days after becoming infected

Back 20

infected blood, semen, vaginal secretions, or breast milk

Front 21

Health care workers have a low risk of acquiring HIV at work, even after a needle-stick injury.

Back 21

nursing

Front 22

RNA viruses are called ____ because they replicate in a “backward” manner (going from RNA to DNA).

Back 22

retroviruses

Front 23

Adults without immune dysfunction normally have _____ T cells per microliter (µL) of blood.

HIV destroys about 1 billion CD4+ T cells every day.

Back 23

800 to 1200

Front 24

The interval between untreated HIV infection and a diagnosis of AIDS is about 10 years. During this time, CD4+ T cell counts remain above ____ cells/µL

Back 24

500

Front 25

AIDS is diagnosed when an individual with HIV develops CD4+ T cell count drops below ____ cells/µL.

Back 25

200

Front 26

HIV-antibody tests detect HIV-specific antibodies, but typically it takes several weeks after the infection before antibodies can be detected on a screening test. This delay is known as the ____

Back 26

window period.

Front 27

Despite new developments in the treatment of HIV infection, many patients eventually experience disease progression, disability, and death. Sometimes these occur because treatments do not work for the patient. Sometimes the patient's HIV becomes resistant to all available drug therapies. In addition, ART is now allowing people living with HIV to live longer and to develop diseases of aging, such as cardiovascular and endocrine problems that lead to death.

Back 27

Nursing

Front 28

· Immunity is the body’s ability to resist ___ Promotes:3

Back 28

disease

Defense / Homeostasis / Surveillance

Front 29

A____ is a substance that elicits an immune response. Most are composed of protein.

Back 29

antigen

Front 30

____ is present at birth, and its primary role is first-line defense against pathogens.

Back 30

Innate immunity

Front 31

____ is the development of immunity

Back 31

Acquired immunity

Front 32

____results from the invasion of the body by foreign substances such as microorganisms and subsequent development of antibodies and sensitized lymphocytes. With each reinvasion of the microorganisms, the body responds more rapidly and vigorously to fight off the invader. This may result naturally from a disease or artificially through immunization with a less virulent antigen.

Back 32

Active acquired immunity

Front 33

____ implies that the host receives antibodies to an antigen rather than synthesizing them.

This may take place naturally through the transfer of immunoglobulins across the placental membrane from mother to fetus. ____ occurs through injection with gamma globulin (serum antibodies).

Back 33

Passive acquired immunity

Natural passive acquired immunity

Artificial passive acquired immunity

Front 34

Immune globulins produced by lymphocytes inresponse to antigens

Back 34

· Antibodies

Front 35

_____ Produced in bone marrowo Eventually migrate to peripheral organso

T cells = 70-80% // B cells 10-20% // Naturalkiller cells <10%

Back 35

· Lymphocytes o

Front 36

_____o Medication given to promote formation of RBCo Give often to patients with cancer, dialysis,anemia

Back 36

· Epogen

Front 37

· Allergy immunoglobulin

Back 37

IgE

Front 38

HIV/Aids · Patients are put on _____,standard precautions, and transmission based precautions

Back 38

Universal Precautions

Front 39

____ can occur when mediators are released systemically (e.g., after injection of a drug, after an insect sting). The reaction occurs within minutes and can be life threatening because of bronchial constriction and subsequent airway obstruction and vascular collapse.

Back 39

Anaphylaxis