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100 Cards in this Set

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only disease of parathyroid glands is overactivity
Hyperparathyroidism
one of the parathyroid glands has lost its control mechanism and continues to make large amounts of parathyroid hormone without paying attention to how high the blood ________
CA+
T/F hyperparathyriodism is a hormone problem secreted by a benign parathyroid tumor. It is not a cancer problem.
T
Under the presence of ______, bones will give up their calcium in an attempt to increase the blood level of calcium
pth
Too much PTH means too much _____. in the blood and not in the bones. Too little PTH (eg. if all 4 are removed) means too little Ca. in the blood.
CA+
Too much Ca in blood=
tired, poor concentration, osteoporosis, kidney stones.
Too little Ca in the blood =
tetany, cramps, spasms, paresthesia.
UTERINE FIBROIDS are also called?(5)
leiomyomas, myomas, fibromyomas, fibromas and myofibromas
S/sx of uterine fibroids?
hypermenorrhea, (dysmenorrhea or leukorrhea -Vaginal discharge during pregnancy- may occur) pain, reproductive disorders, backache, constipation, urinary frequency or urgency or intestinal obstruction
Tx for uterine fibroids?(3)
observation, blood transfusion or hysterectomy
how are uterine fibroids Dx
blood tests, palpation of the tumor, laparoscopy or D & C
GESTATIONAL TROPHOBLASTIC DISEASE =
hydatidiform mole
developmental anomaly of the placenta at the beginning of a pregnancy
hydatidiform mole
in _________chorionic villi convert into a mass of clear vesicles. (chorionic tumor--"Choriocarcinoma
hydatidiform mole
s/s of hydaitform mole?
rapid growth of the uterus, vaginal bleeding and cramping
classic s/s of _______ is uterus that is large for gestational age.
hydatiform mole
hydatiform mole is dx by?
HCG levels are extremely high for early pregnancy
UltraSound fails to reveal a _______
fetal skeleton
what is done if a miscarriage does not occur and the diagnosis is confirmed in mole?
therapeutic abortion is performed by suction curettage (D and C), then weekly monitoring of HCG until they remain normal for 3 consecutive weeks
Periodic follow-up for 1 to 2 years because of increased risk of ______ in mole
neoplasm
_______prophylactically is the drug of choice for choriocarcinoma (Folex (methotrexate) immunosuppressant anti-neoplastic
methotrexate
Give _______ 24-48 hours after Rx to prevent reversal of bone marrow and GI toxicity in mole w/ methotrexate
Ca+
what must be emphasized w/molar pregnancy?
.). Emphasize contraception for a patient following removal of a gestational trophoblastic neoplasm until HCG is normal (may take as long as 2 years).
overgrowths of fibrous tissue in the area of the ducts forming small cysts that develop and disappear quickly
FIBROCYSTIC DISEASE OF THE BREAST
what ages for FBD?
30-50
when does pain increase in FBD?
just before period(inc hormones)
Diet should not include ____ and _____ in FBD?
caffeine and salt
T/F Cysts have no malignant potential; however, breasts that have cysts are more prone to develop cancer
T
what Tx for FBD? what meds?
aspiration of fluid, medication (Danocrine), analgesics for pain
hyperplasia and hypertrophy of the circular muscle at the pylorus narrows the pyloric canal
PYLORIC STENOSIS
pyloric stenosis is common in _____ infants between ages 1-6 months
males
describe s/s of pyloric stenosis?
Asymptomatic first 2 weeks of life (or, may have occasional vomiting), then projectile vomiting, visible reverse peristaltic waves, weight loss, constipation and a hypertrophied sphincter, the size of an olive can be felt in the abdomen
what are the 2 major complications of pyloric stenosis?
Dehydration is common and metabolic alkalosis (due to vomiting
what E to monitor for vomit w/pyloric stenosis
K+
what test to dx pyloric stenosis?
ultrasound ; barium upper GI series; flat film of abdomen; tests for metabolic alkalosis; urinalysis(urine alkaline and concentrated); Hgb, Hct
Sx for pyloric stenosis?
pyloromyotomy performed by laparoscopy
Nrs: pre-op in pyloric stenosis?
Rehydration via IV
NSG post-op in pyloric stenosis?
VS, IV fluids, NG tubes
parent teaching p/o pyloric stenosis Sx?
diet from NPO to Clear liquids and elevate head/place slightly right side; pacifier for infants who are NPO ; Possible vomiting within 24 hour of surgery;Report all increase voimting to MD
in ______ calculi may develop because of alkalinization of the residual urine
BPH
Secondary test screening may include transrectal ultrasound or _____ scan of the prostate
TRUS
which med for BPH inhibits androgens?
how long must be taken?
major SE?
Proscar
continuous basis for therapeutic results
erectile dysfunction
______are also used to relax muscle in the prostate and the bladder neck(meds)
Alpha adrenergic blockers
what are the Alpha adrenergic blockers used to Tx BPH?
Minipress, Cardura, Hytrin, and Flomax
what are the major SE of Alpha adrenergic blockers?
hypoTN and fatigue especially when taken w/other cardiac or HTN meds
excessive irrigating solution being absorbed during surgery seen in TURP?
water intoxication( TURP syndrome)
1st s/s of TURP syndrome?
why?
confusion and agitation.
cerebral edema
If bladder spasms develop p/o TURP the catheter should be checked for _____. If present, the clots should be removed by ______
clots
irrigation
The output should be at least _______the hourly flow of the irrigation after TURP?
50 ml per hour greater than
what meds to relieve pain and decrease spasm p/o TURP?
B&O suppository and oxybutin -Ditropan
Post-op TURP: teach pt to avoid vigorous exercise, heavy lifting and sexual intercourse for at least _____; avoid driving/long sitting for ____ wks p/o TURP?
3 weeks
2
drink at least _____ ml of fluids per day to prevent urinary stasis, infection and keep stool soft p/o TURP?
2500
most common CA for men(3)
PROSTATE ,LUNG, COLON/RECTAL
most common CA for women (3)?
BREAST, then either COLO-RECTAL or LUNG.
_____are cancers of epithelial (lining) cells
Carcinomas
_____refers to carcinoma derived from cells of glandular origin
Adenocarcinoma
_____ are cancers of the connective tissue, cartilage, bone, muscle, and so on
Sarcomas
three main types of skin cancer
BASAL CELL
Squamous Cell
Malignant melanoma
most common form of skin cancer
BASAL CELL
which are at the bottom of the epidermis (outer skin layer), continue dividing and form an enlarging mass; related to excessive sun exposure, genetic skin type, arsenicals, x-ray radiation, scars and some type of nevi.
BASAL CELL
s/s of _____ include small, slowly enlarging papule; borders semitranslucent or ÒpearlyÓ, with overlying telangiectasia; erosion, ulceration, and depression of center; normal skin markings los
BASAL CELL CARCINOMA
how is basal cell dx?
Tx and prognosis?
biopsy
excisional surgery, chemosurgery, electrosurgery, cryosurgery; 95% cure rate
where does basal cell carcinoma usually appear
face between hairline and upper lip
T/F in basal cell metastasis rare, but it must still be treated to avoid it spreading
T
who gets squamous cell the most?
is caucasian males over the age of 60
_____grows faster than basal cell carcinoma and first appear as scaly eczema
Squamous cell
risk factors for squamous cell?
: sun exposure, x-ray therapy, arsenic ingestion (gardener), carcinogen exposure (tar and oil) and chronic skin irritation and inflammation
Tx for squamous cell?
chemosurgery, radiation, electrodesiccation and curettage and excision
which squamous cell lesions have a poor prognosis(2)?
lower lip and ears
who gets basal cell?
40 y/o blond, fair-skinned, caucasian males
largest risk factor for basal cell
Prolonged sun exposure
in ____ the lesions appear as small, smooth, pink, translucent papules that progress to firm raised bordered lesions with depressed centers.
Basal cell
originates in melanocytes, the cells which produce the pigment melanin? who gets more?
melanoma. females
Risk factors include sun exposure, fair skin type, pregnancy (hormones increase both growth and incidence), family history
melanoma
most common places for melanoma?(4)
head, neck, legs, and back
_____ that change in color, size, texture, have drainage or bleed should be investigated for melanoma
moles(nevi)
what are the Tx for melanoma?
surgical tumor removal with wide resection, lymphadenectomy, chemotherapy and radiation
____ CA caused by degenerative changes in gastric ulcers
stomach
who gets stomach CA more? why?
Middle-aged Men in the low socioeconomic group
diet high in starch, with few fresh vegetables and fruits
how is stomach CA dx? good or poor prognosis?
x-ray exam, gastric analysis and biopsy via gastroscopy.
poor
what race gets stomach CA more?
japanese
Cancer of the esophagus- epidermoid carcinoma is rare and affects people over the age of 60.
INFORMATION ONLY
_____ CA occurs in middle-aged adults, with low-residue diets of refined carbohydrates and fats
intestinal
what 3 diseases are risk for intestinal CA?
ulcerative colitis, diverticulitis and polyps
how is intestinal CA dx(3)
guaiac stool tests, digital rectal exam and sigmoidoscopy
____ is unreliable, can be elevated in inflammation and other diseases when dx intestinal CA?
CEA (carcinoembryonic antigen)
A CEA titer less than ___ng/ml is considered normal?
A CEA greater than ____ ng must be investigated
5
10
Tx for intestinal CA?
surgery, radiation and chemotherapy
what 2 foods reduce colostomy odor
Spinach and parsley
Up to____% of the liver can be removed with no loss of function; the liver can regenerate
90
Portal vein obstruction (liver cancer or cirrhosis) =
ascites
if the large bile duct becomes obstructed, the result will be
obstructive jaundice
what test to monitor for liver CA?
alk phos
Meds to prevent liver transplant rejection are(4)
azathioprine, cyclosporine, corticosteroids (such as prednisone), and OKT2 monoclonal antibodies
what are the early s/s of prostate CA similar to?
BPH?
what is the normal PSA?
0-4
_____ is specifically indicative of cancer of the prostate
PAP
An increased _____may signal metastic cancer of the prostate
alkaline phosphatase
what prostate ca depend on to grow? so what is Rx?
SE?
androgens
estrogens(DES)
gynecomastica, feminization, decreased libido
what meds are given by monthly SQ or IM injections for prostate ca?
Premarin, Zoladex, Lupron