Cen Exam

Front 1

admitting hx/admission physical (IDs high risk behaviors), admitting dx (determins need for further evaluation), sx such as chronic or severe cough/diarrhea (possible contagious disease), lab review (determines isolation need)

Back 1

identifying pt with communicable diseases

Front 2

initiate if suspecting or confimation of diagnosis of varicella-zoster virus (VZV), measles, variola (smallpox), TB (droplet <5mm) and MDR organisims

Back 2

airborne infection isolation

Front 3

private neg pressure room with 12 air exchanges/hr outside in and HEPA filters out, door closed with sign, respirators for staff, trasport pt in clean linens at mask, procedures done in room

Back 3

airborne isolation procedures

Front 4

PPE (gloves, gowns, mask, eye shields), hand washing with plain soap or instant antiseptic, private rooms for pt with diarrhea/cough or same infections together

Back 4

standard precautions (tier 1)

Front 5

protects from 3 types of transmissions: small airborne droplets <5mm (measles, TB, varicella); diseases spread by large airborne droplets >5mm (flu, pertussis, strep pharyngitis, PNA, Neisseria meningitis, mumps); diseases sperad by contact and shown MDR (VRE, MRSA

Back 5

Tier 2 isolation

Front 6

Lassa fever, Marburg virus and smallpox

Back 6

combination airborne and contact isolation

Front 7

surgically connects artery and vein such as the the radial-cephalic (most common) or brachial-cephalic; venous protion dilated and hypertrophies allowing repeated use

Back 7

AV fistula

Front 8

ascertain patency auscultating bruit and palapte thrill, cleanse with iodine, use smallest needle puncturing 1-2 cm from anastomosis on venous side (2 for dialysis: distal to machine and proximal returns), pressure for 5 minutes after removal

Back 8

process to access AV fistula

Front 9

infection of epidermis such as yeast or thrush causing pustular erythematous papular rash usually scaly, crusty, and macerated with white cheese like exudate

Back 9

candidiasis

Front 10

worsens with antibiotics; prevent humid moist conditions of skin, controll hyperglycemia, careful cleansing and exposure to air, topical nystatin 4x/day, zinc chloride barrier ointment, oral antifungals fif severe (fluconazole)

Back 10

treatment of candidiasis

Front 11

superficial partial thickness infection of skin caused by toxins producted by a localized Staph infection resulting in generalized erythema follwed in 24-48 hours with blisters that rupture and peel off leaving large areas of superficial necrosis and denuded skin giving a burned appearance

Back 11

SSSS
Staphylococcal scalded skin syndrome

Front 12

most common in neonate and childer <5, can be confused with diaper rash or candidiasis; affects immunocompromised or renal failure adults; pain mild unless infection is wide spread

Back 12

SSSS

Front 13

IV abx (flucloxacillin) followed by oral, maintenance fluids and lytes, debridement, mosture retentive drsg (foam, hydrogels, alginates), tx as parital thickness burns

Back 13

treatment of SSSS

Front 14

locialized response to constact with allergen resulting in rash that may blister and itch

Back 14

allergic contact dermatits

Front 15

ID cause via hx, skin patch test; corticosteriods to control inflammation and itching; soothing oatmeal baths; pramoxine lotion for itching; antihistamines to reduce allergic response; cleanse lesions and observe for infection; abx if necessary; rash open to air and dry

Back 15

treatment of allergic contact dermatitis

Front 16

caused by leakage or incontinence of body fluids (urine, feces exudate) or chemicals to skin (lotions, idodine, soap, solvents, acids adhesives); itching rash to cracks and fissures or denouement of skin (perineal); may be rapid and painful

Back 16

chemical trauma tissue damage

Front 17

ID irritant and eliminate skin contact, gentle cleansing, skin sealants or barriers to protect skin, monitor drsg and periwound condition daily

Back 17

treatment of chemical trauma tissue damage

Front 18

prevelant in healthcare workers and children with myelomeningocele

Back 18

acute latex sentivity

Front 19

irritant (nonimmune): erythematous from contact; contact herm (type 4): response to chemicals causing dry erythema beyond area of contact, purititis, weeping, blistering; IgE (type 1): response to proteins causing urticaria, rhinitis, angioedema, asthma, laryngeal edema, anaphylaxis, shock and death

Back 19

3 types of latex reactions

Front 20

decreased O2 transportation and decreased perfusion throughout the body causing heart to compensate by increasing CO, decreased peripheral resitance due to decreased viscosity resulting in increased blood pumper to heart and increased turbulence causing murmurs and/or failure

Back 20

anemia

Front 21

commonly caused by hemorrhage hemolysis, hematopoiesis or dietary iron deficiency; growth and sexual development may be delayed with chronic; children tolerate better than adults

Back 21

causes of anemia

Front 22

general malaise, weakness, anorexia, pallor, SOB/DOE, HA, dizziness, apathy, depression, slowed thought process

Back 22

symptoms of anemia

Front 23

tachycardia, hypotension, poor peripheral circulation, and pallow

Back 23

shock symptoms (anemia)

Front 24

treat underlying cause, blood or clood components, supportive care (O2, IVF), splenectomy if hemolytic;

Back 24

treatment of anemias

Front 25

autoimmune condition in whichthe platelet count is <150,000 but other blood values are normal

Back 25

idiopathic throbocytopenia purpura

Front 26

causes purple bruises and petechia on skin and mucous membrans from superficial bleeding

Back 26

idiopathic throbocytopenia purpura

Front 27

lasts less than six months occuring primarily in children after viral infections or live virus vaccinations

Back 27

acute purpura

Front 28

lasts more than 6 months commonly in females occuring at any age causing menorrhagia, epistaxis, GI bleeds, bleeding gums, retimal and cerebral hemorrhage

Back 28

chronic idiopathic purpura

Front 29

corticosteriods to increase platelet count, IV immune globulin for severe bleeding (adults <50,000, peds <20,000), volume replacement for hypvolemic shock, eltrombopag 50-75 mg daily to increase platelets

Back 29

treatment for idiopathic purpura

Front 30

abnormal producation of blood cells in bone marrow affected RBCs; common in men >40 realating to conditions causing hypoxia causing increased viscosity

Back 30

polycythemia vera

Front 31

dizziness, HA, weakness, fatigue, dyspnea when supine, flushing, blue tinged skin with red lesions, itching after warm bath, LUQ abd fullness and splenomegaly, phlebitis from clots, vision disturbances, sompications including stroke, hemorrhage and heart failure

Back 31

symptoms of polycethemia vera

Front 32

CBC with diff, lytes, bone marrow bx, Vit B12 level, red cell mass >25% above normal

Back 32

diagnosing polycethemia vera

Front 33

weekly phlebotomy removal of 500mL to decrease viscosity, chemo to suppress marrow production (hydroxyurea), interferon to decrease need for phlebotomy

Back 33

treatment for polycethemia vera

Front 34

viral disease characterized by fever and rash causing morbidity and death; highly infection by droplets 4 days before and after onset of rahs with an incubation period of 7-18 days

Back 34

rubeola (measles)

Front 35

flu like symptoms (cough, fever, runny nose), red maulopapular rash, koplick pots on cucous membranes

Back 35

symptoms of rubeola

Front 36

PNA, seizures, and severe neurologic damage from encephalitis

Back 36

complications of rubeola

Front 37

prevents rubeola and can be given 72 hours after exposure

Back 37

MMR

Front 38

supportive as nothing eradicated the virus; APAP/IBU, Vit A (peds), barrier precautions

Back 38

treatment for rubeloa, mumps and rubella

Front 39

viral disease causing fever and swollen parotid glands, deafness, meningitis and swelling of the testicles; spread through contact with saliva or droplets; incubation 2-3 weeks

Back 39

mumps

Front 40

painful swlling of glands on one or both sides of face, fever, weakness, fatigue; complications include orchitis, encephalitis, menmingitis, ovarian inflammation, pancreatitis, hearing loss

Back 40

symptoms of mumps

Front 41

viral disease casuing rash, fever, arthritis miscarriage or serious birth defects; airborne; incubation 2-3 weeks after exposure; symptoms 2-3 days

Back 41

rubella

Front 42

fever 102 or lower, rhinits, conjunctivitis, anorexia, nausea, red or pink itchy rash starting on face and moving downward clearing as progresses, imflamed lymph nodes behind ears and back of neck

Back 42

symptoms of rubella

Front 43

very infectious resp infection characterized by persistent cough lasting 2 weeks spread by droplets and contagious through infectious process; serious illness in peds (esp <6mos)

Back 43

pertussis (whooping cough)

Front 44

initial sx: fever, rhinitis, sneezing, watery eyes, dry couth; 1-2 weeks later: paroxysmal coughing with inspiratory whoop, productive thick phlegm and pst cough emesis; petechiae on upper body or sclera from coughing exertion

Back 44

symptoms of pertussis

Front 45

ear infections, PNA, bradypnea or apnea, dehydration, CNS damage

Back 45

infant complications of pertussis

Front 46

hernia and muscle damage from coughing

Back 46

ped complications of pertussis

Front 47

fractured ribs

Back 47

adult complications of pertussis

Front 48

bed rest, fluids mist vaporizer, abx (azithromycin or erthromycin), supportive and barrier; infants require hospitalization

Back 48

treatment of pertussis

Front 49

common infectious childood disease baused by vericella zoster resulting in fever, rahs and itching with complications of skin infections, PNA and neuro damage; retreasts to nerves via the spinal cord and can reemerge later as herpes zoster (shingles) causing morbidity in adults

Back 49

chickenpox

Front 50

vaccination at 12 and 15 months; 28 days apart for adults and children >13; contraindicated if allergic to gelatin or neomycin

Back 50

varicella vaccination

Front 51

secondary disorder triggered by trauma, congenital heart disease, nectorizing enterocoltitis, sepsis, and viral infections

Back 51

DIC

Front 52

characterized by both coagulation and hemorrhage causing glycoprotein to enter circulation and bind with coagulation factors triggering the coagulation cascade stimulating thrombin to convert fibrinogen to fibrin casuing aggreation and destruction of platelets and forming clots blocking vessels creating ischemia and necrosis

Back 52

disseminted intravascular coagulation (DIC)

Front 53

bleeding from surgical or IV sites, umbilicus and trachea in newborns, GI bleeding with distention and bloody diarrhea, hpotension and acute shock, petechiae and purpura with bleeding into tissues, prolonged PT and PTT, decreased paltelet counts and fragmented RBCs decreased fibrinogen

Back 53

symptoms of DIC

Front 54

ID and treat cause, blood (platelets and FFP), heparin to increase clotting time, cryo to increase fibrinogen levels, coagulation inhibitor and coagulation factors

Back 54

treatment of DIC

Front 55

hypersecretion of the posterior pituitary gland causing kidneys to reabsorb fluids resutling in retiention triggering a decrease in Na levels with concentrated urine

Back 55

SIADH
syndrome of inappropriate antidiuretic hormone

Front 56

caused by CNS disorders from brain trauma, surgery or tumors, PNX, PNA, and meds

Back 56

causes of SIADH

Front 57

anorexia with N/V, irrtability, somach cramps, personality changes, increasing neuro dysfunction such as stupor and seizures (Na depletion)

Back 57

symptoms of SIADH

Front 58

fluid restriction, loop diuretics (Lasix)

Back 58

treatment of SIADH

Front 59

damage to adrenal cortex from autoimmune disease or gentic disorders; symptoms bague until 80-90% destroyed

Back 59

adrenocortical insufficiency (Addison disease)

Front 60

weakness, fatigue, abd distess with N/V, salt or licorice craving from aldosterone deficiency, hyperpigmentation, hypotension, hypoglycemia

Back 60

Addisons disease

Front 61

hormone replacement with gluccocorticoids (cortisol) and mineralocorticoids (aldosterone) or subq implantation of desoxycoticosterone acetate q 9-12 months; stress requires increase in glucocorticoids

Back 61

treatment for Addisons disease

Front 62

suden life threatening condition resulting from exacerbation of primary chronci adrenal insufficiency precipitated by spesis, surgical stress, adrenal hemorrhage, antocoagulation and cortisone withdrawal

Back 62

acute adrenal insufficiency

Front 63

fever, N/V, abd pain, weakness, fatigue, disorientation, confusion, hypotensive shock, dehydration, hyperkalemia, hypercalcemia, hypoglycemia and hyponatremia

Back 63

symptoms of acute adrenal insufficiency

Front 64

IVF, glucocorticoids, D50 (hypoglycemia), mineralocorticoids

Back 64

treatment of acute adrenal insufficiency

Front 65

lack of clotting factor VII (most common)

Back 65

Type A hemophilia

Front 66

lack of clotting factor IX

Back 66

Type B hemophilia

Front 67

lack of clotting factor XI

Back 67

Type C hemophilia

Front 68

bleeding with trauma or stress, unexplained bruises, swelling and joint pain, spontaneous hemorrhage, epistaxis, mucosal bleeding

Back 68

sypmtoms of hemophilia

Front 69

desompression acetate (IV or nasal) to stimulate clotting factor; infusion of clotting factor or recombinant; infusions of plasma

Back 69

treatment for hemophilia

Front 70

group of congenital bleeding disorders affecting 1-2% of population associated with lack glycoprotein needed by endothelial cells to interact with thrombocytes and create clots to prevent hemorrhage

Back 70

Von Willebrand disease
(lack of vW factor)

Front 71

low levels of vWF and also sometimes factor VIII (dominate inheritance)

Back 71

Type I Von Willebrand disease

Front 72

abnormal vWF may increase or decrease clotting (dominant inheritance)

Back 72

Type 2 Von Willebrand disease

Front 73

absence of vEF and less than 10% factor VIII (resessive inheritance)

Back 73

Type 3 Von Willbrand disease

Front 74

bruising, menorrhagia, recurrent epistaxis and hemorrhage treated with desmopressing and/or factor VIII concentrates with vWF (humante-P)

Back 74

Von Willebrand disease

Front 75

severe acute infection of the liver caused by hep A-E, viruses, chemicals metabolic disease and drugs (APAP) that can result in hepatic necrosiss, encephalopathy, and death within 1-2 weeks

Back 75

fulminant hepatitis

Front 76

divided in stages according to jaundice and encephalopathy:
hyperacute 0-7 days; acute 2-28 days, subacute 28-72 days

Back 76

fulminant hepatitis

Front 77

increased intracranial pressure with cerebral edema dn encephalopathy, coagulopathis, renal failure, electrolyte imbalances

Back 77

symptoms of fulminant hepatitis

Front 78

ID and treat underlying cause, ICP monitoring and treatment, liver trasplant

Back 78

treatment of fulminant hepatitis

Front 79

HIV infection, CD4 count <200, AIDS defining condition (CMV, TB, Kaposi sarcoma, wasting syndrome, dementia); treamtent with highly active anitretroviral therapy (HAART) drugs (3 or more) used concurrently

Back 79

AIDS

Front 80

occurs without history of DM or mild type 2; persistent hyperglycemia causing osmotic diuresis

Back 80

HHNS
hyperglycemic hyperosmolar nonketotic syndrome

Front 81

fluid from intracellular to extracellular maintains osmotic equilibrium but causes glucosuria and dehydration resulting in hypernatremia and icnreased osmolarity

Back 81

HHNS

Front 82

often precipitated by acute illness, stoke, meds (thiazides) or dialysis; glucose breaksdown fat

Back 82

HHNS

Front 83

polyuria, dehydration, hypotension, tachycardia, BS >600, serum osmolality >350, increased BUN/Cr; ALOC, hallucinations, seizures, hemiparesis

Back 83

symptoms of HHNS

Front 84

insulin, IVF with lytes,

Back 84

treatment of HHNS and DKA

Front 85

no glucose for metabolism instead using free fatty acids causing glycerol to convert to ketones

Back 85

DKA

Front 86

Kussmaul respirations (hyperventilating to rid of CO2) with ketone breath, loss of potassium and lytes from cellular death causing dehydration and diuresis (thirst), arrhythmias, hyperglycemia,

Back 86

DKA

Front 87

results from pancreatic islet tumors increasing insulin production or too much insulin; can damage CNS and Cardiopulm systems

Back 87

acute hypoglycemia (hyperinsulinism)

Front 88

defects of Chrom 11, gram negative sepsis/endotoxic shock, TI or alcohol or drugs (ASA), too much insulin, too little food, exercise

Back 88

causes of hyperinsulinism
hypoglycemia

Front 89

BS <60, seizures, ALOC, lethargy, vomiting, myoclonus, resp distress, diaphoresis, hypthermia, hunger, anxiety

Back 89

symptoms of hypoglycemia