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48 Cards in this Set

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What pre-renal cause causes acute renal failure?
DehydrationàVolume depletion (#1 cause)
Hypotension
CHF
Renal artery stenosis (atherosclerotic D)
What renal cause causes acute renal failure?
Glomerulonephritis
Tubular necrosis (nsaid,aBs)
Contrast media injections
Thrombo-embolic activity
What Post-renal cause causes acute renal failure?
Enlarged prostate
Pelvic Tumor blocking ureters
Renal stone in ureter
Renal calculi in pelvis
UTI presents MC as what?
UVeitis/cystitis>pylonephritis
UTI presentation:
­MC no symptoms
Frequency
Urgency
Dysuria (pain on voiding)
± Hematuria
fever, nausea, vomiting
common symptom of bladder cancer?
Gross hematuria (painless)
Clot can form due to Hematuria
This can lead to obstruction of Bladder
± Pyuria (may be painless)
Urinary incontinence in a female?
multiparous (multiple births) = weak pelvic floor
decrease in estrogen
G – B9PH
UTI
Dec. mobility
Drugs (> 40 YO)
Cause of fecal impaction?
Neuro
Dec motility/mobility
poor diet/nutrition
Dec Fluid intake
dental carries are more or less painful in the geriatric?
Less painful
cause an unpleasant taste in the mouth?
Oral mucosa DZ
Chronic Renal Failure(metallic taste)
Oral mucosa DZ causes:
Candidiasis albicans
aka oral thrush
MC from ill fitting dentures
S/Sx Oral mucosa DZ:
asymptomatic
Bad taste in mouth as a side effect of drugs
Burning
Aphthous ulcers – white ulcerations w/red base (found on cheek, floor, lips)
Canker sore – stress, new toothbrush
toothbrush trauma
Herpetic ulcers (Type I) – painful
stress
too acidic
MC cause of xerostomia?
drying around the mouth
a side effect of medications
What dental treatments follow an MI?
no proof that there should not be dental treatments following an MI
most common cause of progressive dysphagia?
esophageal cancer MC
aortic aneurysm
stroke
myasthinia gravis
esophaqeal Ca Sites
M/c cause obstruction & prog dysphagia
site 1 phary-esoph jxn
site2 L-main bronchus
crosses the esophagus
3rd site distal end
60% occlusion before symptoms
hat are the causes of acute gastritis?
NSAID use - MC
Alcohol
Overwhelming stress
Where is the pain with peptic ulcer disease?
poorly localized
L-sided abd pain
lower chest (thoracic)
result of malabsorption in a case such as celiac’s disease?
Weight loss
Steatorrhea
Diarrhea
Anemia
Osteoporosis/Osteopenia/Osteopmalacia
Vitamin loss
Occult blood tests to detect colorectal cancer should be done how often?
sigmoidoscopy every 2-3 years
Guiac at least once a year
Vitamin C = false positive
periodic episodes of constipation
Lack of motility & mobility (movement essential)
Dietary (poor diet/nutrition)
Fluid intake (Dehydration)
fecal impaction – leading to megacolon
Anal sphincter muscle – loss of control (80% is the internal and 20% external sphincter)
Rectal wall compliance – can it be stretched
The Anorectal angle – the muscle that wraps around the anus and forms an angle
Anorectal sensations
diabetes M and stroke inc risk
16. What kind of GI Tract indications is suggested by a patient with unexplained psychological complaints such as depression?
pancreatic cancer
RISK FACTORS
of pancreatic ca?
Smoking
­ Fat diets for a long time
EtOH
Exposure to volatile hydrocarbons
SSX OF PANC CANCER
Unexplained psychiatric complaints – over 75% of elderly have unexplained anxiety or depression
Weight loss
Anorexia
Upper abdominal pains
Steatorrhea
Jaundice
Male feminization is due to?
Cirrhosis of the liver
estrogen is usually detoxified by the liver, anything that may cause severe liver damage (i.e. severe hepatitis)
Dryness from decreased sebaceous activity is found where?
Xerosis (dry skin from cebum)
Excessive washing, detergents
Location = lower legs, forearms, hands, ano-genital region
Fine scaling of skin, fissures
skin is mildly inflamed
Lower leg = varicose veins (stasis deramtitis)
danger of an actinic keratosis?
aka Solar Keratosis
developing into Squamous Cell Carcinoma
thickens hardens
20. Where do decubitus ulcers present?
Heels
Greater Trochanter
Sacrum
Scapulae
Kyphotic spine (T-spine if you weren’t sure) aka dorsal spine
Elbows
Predisposition to decubitus ulcers caused by:
Immobility
Underlying fat
Sensory loss
Poor nutrition
atherosclerosis
findings of decubitus ulcers
Loss of sensory input
Dec Circulation (may be hypotensive as well)
Dec Nutritional status (¯ healing)
Deep ulcerations may form – possible DVT form
Psoriasis Vulgaris
has white scales with an erythematous base found on the anterior thorax
Redness that is well demarcated
Silvery white scales are superimposed on them
spreads with scratching
distrib of psoriasis vulgaris
Scalp
Extensor surface of elbow & knee
Anterior trunk
Pre-sacral area into inter-gluteal fold
Palms & soles
#1 cause of uti
Urinary Stasis
80% of Benign Prostate Hypertrophy
What do you do for benign prostatic hypertrophy?
Proscar Drug, balloonoplasty, TURP
proscar drug for prostatic hyertrophy
Blocks conversion of Testosterone to Dihydrotestosterone
1 year to reach max gland reduction
PRO – decreases size of Prostate by 30%
CON – 50% of the time, it reduces the PSA level
Stages of prostate CA
A Carcinoma In Situ (Foci of Cancer) = feels normal

B (Foci Grows) islets get larger form bump on prostate, intracapsular

C (Tumor Enlarged) MC found here (extracapsular)pelvis film

D (Tumor has taken over the gland)
What causes a “pear shape” of the geriatric patient’s trunk?
Narrow shoulders
Pelvis widens
Inc. Chest AP diameter
progressive skeletal changes
Females 43%, Males 27% bone loss by age 80
dec disc/vb ht, cart grows
bone absorption begins to exceed bone formation, about what age does that occur at?
0-14 – osteoblastic
14-25 – =

25+ – osteoclastic
28. Where does most muscle wasting occurs?
Hands – interosseous spaces bc thin and bony
Arms / legs – thin & flabby
Optimal chng = seen in older Asian females
causes the restless leg syndrome?
MC to AVOID discomfort
Diabetic Hypoglycemia
Hypocalcemia
Diabetic Neuropathy
Hyperventilation/Respiratory Alkalosis
symptoms of a burning tongue?
Giant Cell Arteritis – burning tongue
albicans/oral thrush-whole moulth
pseudogout mc where?
knee
iv. Concurrent DZ
Gouty arthritis
Wilson’s DZ
Hyperthyroidism
Hemochromatosis (accumulated dietary Fe)Normal serum uric acid
Do not respond to colchisine therapy
Joint aspiration for crystals = (+) biofringent (under Polarizing microscope)
35. Which can develop into a beta cell lymphoma?
Sjögrenson’s Syndrome
Nail incurvation?
onycho/crypt/osis (ingrwn nail
Dorsal Exostosis
Hooked nail corner
Dorsal helomata?
hammer toe
corns on PIP & @ end of toe, from hyperkeratosis of skin against the bone
padding/arthroplasty
Sullivan’s sign?
X-ray shows splaying of proximal phalanges (if Neuroma is large enough)
mortons neuroma