Derrick's Nc4 Notes

Front 1

only disease of parathyroid glands is overactivity

Back 1

Hyperparathyroidism

Front 2

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 ________

Back 2

CA+

Front 3

T/F hyperparathyriodism is a hormone problem secreted by a benign parathyroid tumor. It is not a cancer problem.

Back 3

T

Front 4

Under the presence of ______, bones will give up their calcium in an attempt to increase the blood level of calcium

Back 4

pth

Front 5

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.

Back 5

CA+

Front 6

Too much Ca in blood=

Back 6

tired, poor concentration, osteoporosis, kidney stones.

Front 7

Too little Ca in the blood =

Back 7

tetany, cramps, spasms, paresthesia.

Front 8

UTERINE FIBROIDS are also called?(5)

Back 8

leiomyomas, myomas, fibromyomas, fibromas and myofibromas

Front 9

S/sx of uterine fibroids?

Back 9

hypermenorrhea, (dysmenorrhea or leukorrhea -Vaginal discharge during pregnancy- may occur) pain, reproductive disorders, backache, constipation, urinary frequency or urgency or intestinal obstruction

Front 10

Tx for uterine fibroids?(3)

Back 10

observation, blood transfusion or hysterectomy

Front 11

how are uterine fibroids Dx

Back 11

blood tests, palpation of the tumor, laparoscopy or D & C

Front 12

GESTATIONAL TROPHOBLASTIC DISEASE =

Back 12

hydatidiform mole

Front 13

developmental anomaly of the placenta at the beginning of a pregnancy

Back 13

hydatidiform mole

Front 14

in _________chorionic villi convert into a mass of clear vesicles. (chorionic tumor--"Choriocarcinoma

Back 14

hydatidiform mole

Front 15

s/s of hydaitform mole?

Back 15

rapid growth of the uterus, vaginal bleeding and cramping

Front 16

classic s/s of _______ is uterus that is large for gestational age.

Back 16

hydatiform mole

Front 17

hydatiform mole is dx by?

Back 17

HCG levels are extremely high for early pregnancy

Front 18

UltraSound fails to reveal a _______

Back 18

fetal skeleton

Front 19

what is done if a miscarriage does not occur and the diagnosis is confirmed in mole?

Back 19

therapeutic abortion is performed by suction curettage (D and C), then weekly monitoring of HCG until they remain normal for 3 consecutive weeks

Front 20

Periodic follow-up for 1 to 2 years because of increased risk of ______ in mole

Back 20

neoplasm

Front 21

_______prophylactically is the drug of choice for choriocarcinoma (Folex (methotrexate) immunosuppressant anti-neoplastic

Back 21

methotrexate

Front 22

Give _______ 24-48 hours after Rx to prevent reversal of bone marrow and GI toxicity in mole w/ methotrexate

Back 22

Ca+

Front 23

what must be emphasized w/molar pregnancy?

Back 23

.). Emphasize contraception for a patient following removal of a gestational trophoblastic neoplasm until HCG is normal (may take as long as 2 years).

Front 24

overgrowths of fibrous tissue in the area of the ducts forming small cysts that develop and disappear quickly

Back 24

FIBROCYSTIC DISEASE OF THE BREAST

Front 25

what ages for FBD?

Back 25

30-50

Front 26

when does pain increase in FBD?

Back 26

just before period(inc hormones)

Front 27

Diet should not include ____ and _____ in FBD?

Back 27

caffeine and salt

Front 28

T/F Cysts have no malignant potential; however, breasts that have cysts are more prone to develop cancer

Back 28

T

Front 29

what Tx for FBD? what meds?

Back 29

aspiration of fluid, medication (Danocrine), analgesics for pain

Front 30

hyperplasia and hypertrophy of the circular muscle at the pylorus narrows the pyloric canal

Back 30

PYLORIC STENOSIS

Front 31

pyloric stenosis is common in _____ infants between ages 1-6 months

Back 31

males

Front 32

describe s/s of pyloric stenosis?

Back 32

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

Front 33

what are the 2 major complications of pyloric stenosis?

Back 33

Dehydration is common and metabolic alkalosis (due to vomiting

Front 34

what E to monitor for vomit w/pyloric stenosis

Back 34

K+

Front 35

what test to dx pyloric stenosis?

Back 35

ultrasound ; barium upper GI series; flat film of abdomen; tests for metabolic alkalosis; urinalysis(urine alkaline and concentrated); Hgb, Hct

Front 36

Sx for pyloric stenosis?

Back 36

pyloromyotomy performed by laparoscopy

Front 37

Nrs: pre-op in pyloric stenosis?

Back 37

Rehydration via IV

Front 38

NSG post-op in pyloric stenosis?

Back 38

VS, IV fluids, NG tubes

Front 39

parent teaching p/o pyloric stenosis Sx?

Back 39

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

Front 40

in ______ calculi may develop because of alkalinization of the residual urine

Back 40

BPH

Front 41

Secondary test screening may include transrectal ultrasound or _____ scan of the prostate

Back 41

TRUS

Front 42

which med for BPH inhibits androgens?
how long must be taken?
major SE?

Back 42

Proscar
continuous basis for therapeutic results
erectile dysfunction

Front 43

______are also used to relax muscle in the prostate and the bladder neck(meds)

Back 43

Alpha adrenergic blockers

Front 44

what are the Alpha adrenergic blockers used to Tx BPH?

Back 44

Minipress, Cardura, Hytrin, and Flomax

Front 45

what are the major SE of Alpha adrenergic blockers?

Back 45

hypoTN and fatigue especially when taken w/other cardiac or HTN meds

Front 46

excessive irrigating solution being absorbed during surgery seen in TURP?

Back 46

water intoxication( TURP syndrome)

Front 47

1st s/s of TURP syndrome?
why?

Back 47

confusion and agitation.
cerebral edema

Front 48

If bladder spasms develop p/o TURP the catheter should be checked for _____. If present, the clots should be removed by ______

Back 48

clots
irrigation

Front 49

The output should be at least _______the hourly flow of the irrigation after TURP?

Back 49

50 ml per hour greater than

Front 50

what meds to relieve pain and decrease spasm p/o TURP?

Back 50

B&O suppository and oxybutin -Ditropan

Front 51

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?

Back 51

3 weeks
2

Front 52

drink at least _____ ml of fluids per day to prevent urinary stasis, infection and keep stool soft p/o TURP?

Back 52

2500

Front 53

most common CA for men(3)

Back 53

PROSTATE ,LUNG, COLON/RECTAL

Front 54

most common CA for women (3)?

Back 54

BREAST, then either COLO-RECTAL or LUNG.

Front 55

_____are cancers of epithelial (lining) cells

Back 55

Carcinomas

Front 56

_____refers to carcinoma derived from cells of glandular origin

Back 56

Adenocarcinoma

Front 57

_____ are cancers of the connective tissue, cartilage, bone, muscle, and so on

Back 57

Sarcomas

Front 58

three main types of skin cancer

Back 58

BASAL CELL
Squamous Cell
Malignant melanoma

Front 59

most common form of skin cancer

Back 59

BASAL CELL

Front 60

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.

Back 60

BASAL CELL

Front 61

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

Back 61

BASAL CELL CARCINOMA

Front 62

how is basal cell dx?
Tx and prognosis?

Back 62

biopsy
excisional surgery, chemosurgery, electrosurgery, cryosurgery; 95% cure rate

Front 63

where does basal cell carcinoma usually appear

Back 63

face between hairline and upper lip

Front 64

T/F in basal cell metastasis rare, but it must still be treated to avoid it spreading

Back 64

T

Front 65

who gets squamous cell the most?

Back 65

is caucasian males over the age of 60

Front 66

_____grows faster than basal cell carcinoma and first appear as scaly eczema

Back 66

Squamous cell

Front 67

risk factors for squamous cell?

Back 67

: sun exposure, x-ray therapy, arsenic ingestion (gardener), carcinogen exposure (tar and oil) and chronic skin irritation and inflammation

Front 68

Tx for squamous cell?

Back 68

chemosurgery, radiation, electrodesiccation and curettage and excision

Front 69

which squamous cell lesions have a poor prognosis(2)?

Back 69

lower lip and ears

Front 70

who gets basal cell?

Back 70

40 y/o blond, fair-skinned, caucasian males

Front 71

largest risk factor for basal cell

Back 71

Prolonged sun exposure

Front 72

in ____ the lesions appear as small, smooth, pink, translucent papules that progress to firm raised bordered lesions with depressed centers.

Back 72

Basal cell

Front 73

originates in melanocytes, the cells which produce the pigment melanin? who gets more?

Back 73

melanoma. females

Front 74

Risk factors include sun exposure, fair skin type, pregnancy (hormones increase both growth and incidence), family history

Back 74

melanoma

Front 75

most common places for melanoma?(4)

Back 75

head, neck, legs, and back

Front 76

_____ that change in color, size, texture, have drainage or bleed should be investigated for melanoma

Back 76

moles(nevi)

Front 77

what are the Tx for melanoma?

Back 77

surgical tumor removal with wide resection, lymphadenectomy, chemotherapy and radiation

Front 78

____ CA caused by degenerative changes in gastric ulcers

Back 78

stomach

Front 79

who gets stomach CA more? why?

Back 79

Middle-aged Men in the low socioeconomic group
diet high in starch, with few fresh vegetables and fruits

Front 80

how is stomach CA dx? good or poor prognosis?

Back 80

x-ray exam, gastric analysis and biopsy via gastroscopy.
poor

Front 81

what race gets stomach CA more?

Back 81

japanese

Front 82

Cancer of the esophagus- epidermoid carcinoma is rare and affects people over the age of 60.

Back 82

INFORMATION ONLY

Front 83

_____ CA occurs in middle-aged adults, with low-residue diets of refined carbohydrates and fats

Back 83

intestinal

Front 84

what 3 diseases are risk for intestinal CA?

Back 84

ulcerative colitis, diverticulitis and polyps

Front 85

how is intestinal CA dx(3)

Back 85

guaiac stool tests, digital rectal exam and sigmoidoscopy

Front 86

____ is unreliable, can be elevated in inflammation and other diseases when dx intestinal CA?

Back 86

CEA (carcinoembryonic antigen)

Front 87

A CEA titer less than ___ng/ml is considered normal?
A CEA greater than ____ ng must be investigated

Back 87

5
10

Front 88

Tx for intestinal CA?

Back 88

surgery, radiation and chemotherapy

Front 89

what 2 foods reduce colostomy odor

Back 89

Spinach and parsley

Front 90

Up to____% of the liver can be removed with no loss of function; the liver can regenerate

Back 90

90

Front 91

Portal vein obstruction (liver cancer or cirrhosis) =

Back 91

ascites

Front 92

if the large bile duct becomes obstructed, the result will be

Back 92

obstructive jaundice

Front 93

what test to monitor for liver CA?

Back 93

alk phos

Front 94

Meds to prevent liver transplant rejection are(4)

Back 94

azathioprine, cyclosporine, corticosteroids (such as prednisone), and OKT2 monoclonal antibodies

Front 95

what are the early s/s of prostate CA similar to?

Back 95

BPH?

Front 96

what is the normal PSA?

Back 96

0-4

Front 97

_____ is specifically indicative of cancer of the prostate

Back 97

PAP

Front 98

An increased _____may signal metastic cancer of the prostate

Back 98

alkaline phosphatase

Front 99

what prostate ca depend on to grow? so what is Rx?
SE?

Back 99

androgens
estrogens(DES)
gynecomastica, feminization, decreased libido

Front 100

what meds are given by monthly SQ or IM injections for prostate ca?

Back 100

Premarin, Zoladex, Lupron