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32 Cards in this Set
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Idiopathic Thrombocytopenic Purpura : description, sx, tx |
(unknown why, low platelets ,rash) Decreased production OR increased destruction of platelets.
Bleeding problems
Tx : spleenectomy(spleen filters platelets), platelet transfusion, plasmapheresis. IG treatment(increases platelets rapidly) |
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Sickle Cell Crisis |
Dehydration, Stress, Infx, heat/cold extremes.
Oxygenation resolves the sickling process of about 80% of cells.
hydroxyurea - impedes sickling, |
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Measles : description. How to identify |
Rubeola virus. Direct contact w/droplets or airborne. Put pt on respiratory isolation.
Rash starts face then trunk, extremetitis last. Kopliks Spots(almost Always measles) - buccal mucosa red/blotchy/grains of salt.
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Mumps |
Benign, viral infx. Swelling and tenderness of salivary and/or parotid gland.
Airborne isolation.
No work/school until swelling gone. |
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Pertussis : transmission, contagious time |
Highly contagious bacterial. Airborne droplet transmission.
Contagious for 3weeks.
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Chicken Pox : name, transmission, contagious time |
Varicella Zoster Virus Direct contact and airborne transmission
Contagious : 1-2days before rash until crusted over, usually 4-5days.
Rash starts on trunk then outwards, not on hands and feet (diff dx - measles face then outward) |
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Dehydration |
Isotonic Fluid Loss : water/NA loss in equal amounts. V/D
Hypotonic Fluid Loss : overuse of diuretics, renal disease, dec Na/water intake.
Hypertonic Fluid loss : intracellular, overall circulation not affected. |
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Hypernatremia |
Causes: renal failure, steroids, cushings syndrome
Brain cells shrink due to water loss.
Tx = decrease NA by 2meq/l/hr |
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Hyperkalemia Tx |
D50 = pushes K into cells Insulin = offset hyperglycemia Ca Gluconate = buffers the cardiac effects of K
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Hypokalemia |
Causes : decreased K intake, losses from V/D.
S/S : weakness, cramps, hypotension. ST depression, PVCs, PACs, 2nd and 3rd degree blocks possible.
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SIADH |
Pituitary gland is causing increased ADH retaining H2O, causing diluted sodium. Hyponatremia AND increased urine osmolarity, decreased serum osmolality, increased urine NA.
Tx : correct the Na deficit, Lasix to treat excess H2O, find underlying cause.(possible pituitary tumor)
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Addisons Disease |
Adreno-cortical insufficiency. Decreased cortisol level(can be due to abrupt stop of chronic steroid use).
S/S : skin changes, weakness, fatigue, hypotension, hypoglycemia.
Tx : ACTH infused, hydrocortisone |
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Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK) |
Concentrated body solution(dehydrated), increased blood sugar, no ketones. Usually older NIDDM
No ketoacidosis bc there is still enough endogenous insulin. Pt unable to maintain adequate hydration.
S/S : Ph usually norma., glucose usually >600, Hyper/Hyponatremia, ketones slightly elevated, elevated urine specific gravity.
Tx : Rehydration 1-2L, K replacement as indicated, insulin as indicated, glucose containing fluids if needed. |
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DKA |
Result of insulin deficiency. Usually IDDM.
S/S : K elevated, Ph acidotic, Na decreased
Tx : IV fluids, insulin bolus and drip. |
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Renal Failure (3) types |
Pre-renal : decreased blood flow to kidneys, leads to ischemia. (shock, PE, sepsis)
Intrarenal : actual tissue damage to kidney.(nephritis, ATN, Glomerular nephritis)
Postrenal : obstructiuon of the urinary collecting system.(Renal calculi, urethral stricture, prostate or cervical CA) |
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Acute Renal failure |
Give fluids (not much of a concern for acute renal failure, it is a concern for chronic renal failure.
Treat underlying cause.
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Graves Disease |
Hyperthyroidism.
TSH decreased(theres enough TSH). T3/T4 elevated. Goiter is common.
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Thyrotoxic Crisis |
Graves Disease with cardiovascular and hemodynamic issues(SVT).
Tx : beta blocker, Propylthiouracil (PTU), antithyroids, thyroidectomy. |
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Reyes Syndrome |
Acute non-inflammatory encephalopathy.
Triad of : Hepatic, Metabolic, Neurologic Dysfx
Cause : Children following viral illness associated with administration of aspirin.
Problems with liver.
S/s : incr ammonia, decr blood sugar, acidosis, cerebral edema. Vomitting. |
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Hepatitis A |
Fecal-Oral route
Infectious period : 2wks before, 1-2weeks after jaundice.
People at risk : immigrants and travelers.
IG effective if given within 1-2weeks of exposure
Vaccination : 2doses
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Hepatitis B |
Parentaral transmission, sexual contact
HBsAG (surface antigen) appears early. HB core antibodies indicate chronic infx.
Acute infx Tx : HepB IG + vaccination |
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Hepatitis C |
Parenteral transmission IVDU
About 50% become chronic. |
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HIV/Aids |
Opportunistic Infx manifest : Pneumocystis Pneumonia (PCP), Cytomegalo Virus (CMV), Kaposis sarcoma.
Acute HIV infx characterized by mononucleosis type presentation. |
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Kernigs Sign |
Flex hip and extend the knee. Will put pressure on meninges.
sign of meningitis
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Brudzinski Sign |
Chin to chest look for nuchal rigidity.
Sign of meningitis. |
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Spinal tap results, what indicate bacterial infx |
Decreased glucose because bacteria eat glucose |
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Mononucleosis |
Viral illness. EBV.
Possibility of splenic rupture, thrombocytopenia, hemolytic anemia.
Red throat, palatial petechiae
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Tinea |
Ringworm, Fungal infx, by direct contact.
Sharply defined annular pattern.
Topical antifungals for most. |
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Gonorrhea |
S/S: yellow purulent discharge, no lesions. Males-dysuria, Females-may be asymptomatic.
Tx : rocephin |
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Chlamydia |
S/S : mucopurulent DC, no lesions, dysuria.
Tx : Zithromax or Doxycycline. |
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Syphillis |
S/S : Chancre(painless) sore on genitals, no discharge, possible fever or lymph node enlargement.
Tx : longterm Bicillin (IM), Doxycycline |
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Tuberculosis |
Droplet Transmission
Latent - asymptomatic but ppd will be + Active - symptomatic and infectious
Tx : abx and rifampin(discolors body fluids and stains clothes |
