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102 Cards in this Set
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reductase inhibitors
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finasteride,dutasteride, jalyn
They decrease the size of the prostate gland it takes about 3 to 6 months before seeing improvement SE: decreased libido decreased volume of ejaculation and ed can cause rare form of prostate cancer |
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adrenergic receptor blockers
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tamsulosin, doxazosin, silodosin
Promotes smooth muscle relaxation in the prostate facilitates urinary flow. improvement takes two to three weeks off offers symptomatic relief but doesn't treat hyperplasia |
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jalyn
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combo of finasteride and tamsulosin
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finasteride
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increased risk of ortho hypotension with concurrent use of ed drugs
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tadalafil
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has been used in men with symptoms of BPH alone or in combo with ED. this has been effective in reducing symptoms for both
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saw palmetto (serenoa repens)
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Used for treatment of b p h and alopecia side affects include g_i upset headache back pain and dysuria
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cam
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sildenafil, vardenafil, tadalafil, and alprostadil
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sildenafil- 1st line
These medications treat erectile dysfunction |
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TUMT
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Microwaves that use heat to kill prostate tissue to relieve an obstruction. urinary retention is a common complication patient sent home with catheter for 2 to 7 days
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TUNA
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A procedure using a needle that increases the temperature of prostate tissue it only kills tissue in direct contact with the needle. patient can be expected with an early return to regular activities
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VLAP
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Uses a laser beam to produce deep coagulation necrosis prostate tissue gradually sloths into the urinary stream catheter is inserted to allow for drainage
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PVP
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Uses a high powered green laser to vaporize prostate tissue catheter insert for 1 to 2 days bleeding is minimal
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TURP
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A surgical procedure involving the removal of prostate tissue using a resectoscope inserted through the urethra. this is the most common procedure done . a three-way catheter is inserted for bladder irrigation continuously for 24 hours relatively low risk
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TUIP
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Small incision are made into the prostate gland to expand the urethra relieving pressure and improving urine flow
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Benign prostatic hyperplasia
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An enlarged prostate gland because of an increase of epithelial cells and stromal tissue which can cause a weekend urine Stream
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Uroflowmetry
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Helps determine the extent of urethral blockage and the type of treatment needed
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Digital rectal examination
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Part of a regular physical and how they diagnose b. p. h.
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PSA monitoring
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Rules out prostate cancer aldo levels maybe slightly elevated and patience with the bph
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prostate cancer
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androgen dependent carcinoma. slow growing most common site for bone mets
elevated PSA levels, abnormal dre, biopsy is indicated and that will show prognosis |
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PSA levels
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Normal is 0 to 4
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zoledronic acid, raloxifene, denosumab
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Slows the breakdown of bone may be used to increase bone mass in men who are receiving ADT with prostate cancer
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leuprolide, goserelin,triptorelin,buserelin
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LH-RH agonists
Produce chemical castration give subq/IM |
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degarelix
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LH-RH antagonist
Lowers testosterone levels but doesn't cause flare it directly blocks LH and FSH |
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flutamide, nilutamide, bicalutamide, and enzalutamide
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Androgen receptor blockers oral medication can be used with LH - RH agonists commonly it is used together
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docetaxel, cabazitaxel, paclitaxel, mitoxantrone, vinblastine, cyclophosphamide, estramustine
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Chemo drugs for prostate cancer
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trimethoprim/sulfamethoxazole, ciprofloxin, ofloxacin, carbachol, carbenicillin, cephalexin, doxycyclene, or tetracycline
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Antibiotics commonly used for acute and chronic bacterial prostatitis
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tamsulosin, alfuzosin
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Adrenergic blockers used to reduce discomfort in prostatitis also anti-inflammatory drugs provide a small relief
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hypospadias
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An abnormal urethral meatus is located on ventral surface of the penis anywhere from the corona to the perennial surgical repair maybe necessary if it causes pain in the penis during an errection or prevents intercourse or normal urination
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priapism
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erections lasting longer than 6 hours may consume medical emergency. Treatment generally includes an injection of smooth muscle relaxant directly into penis or aspiration and irrigation with a large bore needle
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cremasteric reflex
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Is the way to test for testicular torsion you lightly stroke inner aspect of the thigh with the tongue blade normal response is contraction of muscle that pulls up the scrotum do on both sides to see if both sides have normal response
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vasectomy
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Patient needs to use alternative form of contraception usually requires at least 10 ejaculations or 6 weeks after surgery
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testosterone
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Normal levels range from 280 to a thousand replacement therapy is considered once levels are below 200
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diethylstilbestrol
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Prescribed for people with prostate cancer who are older to prevent the cancer from getting worse prescribed to people with less than 10 years of their life left
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gonorrhea
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Killed by drying heating or washing with an antiseptic solution if left untreated it can form fibrous tissue and adhesion that lead to tubal pregnancies chronic pelvic pain and infertility prostatitis urethral strictures and sterility . women are often asymptomatic men have purlulent discharge developing 2 to 5 days after infection
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ceftriaxone
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tx gonorrhea one im dose in the thigh
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cefixime
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tx gonorrhea give po
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doxycycline, azithromycin
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may need to be given with multiple stis, also given with chlamydia full course of treatment is 7 days sustained from sexual activity should happen until completion of medication
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Syphilis stages
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Without treatment it progresses to flu like symptoms and in the final stage you can develop Gummas they can cause aneurysms heart failure disorders and paralysis they are little blistery things filled with fluid and the fluid is contagious
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penicillin g
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tx for syphilis if patient has allergy to cillins tetracycline and doxycycline are given together but it doesn't work as well
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Chlamydia
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Mostly asymptomatic sometimes men have symptoms including urethritis, proctitis, and epididymitis sometimes women have cervictitis urethritis perulent exudate dyspareunia which is pain with intercourse and menstrual abnormalities
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herpes
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Non reportable may cuz burning itching and tingling pain sometimes painless legion appear on inner thigh penis scrotum vulva perineum vagina urination might be painful avoid sexual activity when lesions are present but It can still be passed when asymptomatic
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acyclovir, valacyclovir, and famciclovir
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Treatment of herpes infection they reduce transmission and duration of ulcers they are prescribed for primary and recurrent infections they do not cure it
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Genital warts
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Are not a reportable infection caused by HPV asymptomatic except for wards there is no treatment Chemical or laser they can be removed
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gardasil, cervarix
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vaccines for hpv only 6 types most common tho
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Lab test for syphilis
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Rapid plasma reagin card test ( RPR-CT)
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ICP (intracranial pressure)
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5 to 15 normal
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ceftriaxone
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tx for bacterial meningitis
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phenytoin
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tx seizures
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dexamethasone
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tx cerebral edema
steroid |
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mannitol
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tx increased intercranial pressure.
diuretic excreted all electrolytes they all low |
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hypertonic solution
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greater than . 85% of saline
draws water out of the cells because of the higher salt content |
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medroxyprogesterone
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management of endometriosis pain
restores hormonal balance and controls uterine bleeding |
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methotrexate
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treats different cancers
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acyclovir
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interferes with viral synthesis
treats herpes virus |
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valacyclovir
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treats herpes virus same way as acyclovir
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famciclovir
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treats herpes same way inhibiting viral synthesis decreased shedding
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gardasil specifically
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prevents cervical, vulvar, vaginal and anal cancer and genital warts
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factors that influence ICP
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Arterial pressure, venous pressure, intra abdominal and interathoractic pressure, posture, temperature, carbon dioxide levels
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define MAP and range
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measures organ perfusion
70 to 150 |
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CPP
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cerebral perfusion pressure
MAP-ICP 60-100 |
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stages of cerebral blood flow
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Stage 1: total compensation
stage 2: decreased compensation, risk for increased ICP stage 3: failing compensation, Cushing triad stage 4: herniation iminent death |
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Cushing triad
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high BP
low pulse altered respirations |
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clinical manifestations of increased ICP
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change in LOC
change in VS think Cushing triad it starts with rising BP dilation or fixed pupil on one side posturing decorticate (think core), decelerate (think e is worse) headache vomiting progectile |
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what to monitor with hypertonic solution
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BP and sodium levels
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Glasgow coma scale
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8 u intubate higher the score higher level of functioning
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assessments for increased icp
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Glasgow coma scale
pupils motor vs |
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scalp laceration
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bleed perfusily watch for blood loss and infection
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skull fracture
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battles sign (bruising behind ear)
periorbital ecchymosis rhinorrhea (csf leakage from nose) otorrhea (from ear) give antibiotics as prevention for meningitis |
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test for csf fluid
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halo sign on gauze pad
or dextrostix to determine whether glucose is present |
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head trauma
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diffuse (generalized) exp: concussion (isn't so bad) DAI (worse take ICU)
focal (localized) laceration (tearing), contusion (bruising brain tissue usually closed injury) |
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epidural hematoma
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emergency. sx unconciousness brief lucid interval decrease in LOC
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subdural hematoma
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LOC and headache, pupil changes
slow bleed |
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intracerebral hematoma
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bleeding in brain tissue from rupture of vessel
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meningitis manifestations
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nuchal rigidity (resistance to flexion of the neck)
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TIA
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In the name transiet is chemical attack. on and off episodes of neurological disfunction. usually precursor for ischemic stroke
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ischemic stroke
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inadequate blood flow to the brain from partial or complete occlusion of an artery
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thrombotic stroke
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blocks passage of blood through artery from narrowing of the lumen
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embolic stroke
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blood clot circulating in the blood
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hemorrhage stroke
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a burst blood vessel
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receptive aphasia
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loss of comprehension
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expressive aphagia
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inability to produce language
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global aphagia
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total inability to communicate
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dysarthria
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a disturbance in muscular control of speech
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ticlopidine, clopidogrel, dipyridamole
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antiplatlet agents
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and aspirin
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carotid endarterectomy
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artheromatous lesion is removed from the carotid artery to improve blood flow
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transluminal angioplasty
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Ballon to open a stenosis artery in the brain to improve blood flow
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stenting
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maintain patent of artery opens up like anumbrella
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agnosia
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failure to recognize objects
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cervical cancer manifestations
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asymptomatic
eventually leukorrhea and intermenstral bleeding late stage: vag bleeding heavy and pain |
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endometrial cancer manifestations
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abnormal uterine bleeding 1st sx
usually in postmenopausal women late sx pain (from mets) |
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ovarian cancer manifestations
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pelvic/abd pain, bloating, urinary urgency/frequency, difficulty eating (feeling full quickly)
late sx: increased abd girth, unexplained wt. loss/gain, menstrual changes |
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ovarian cancer stages
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Stage 1: disease limited to ovaries
stage 2: disease limited to pelvis stage 3: limited to abd cavity stage 4: distant mets |
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cisplatin, carboplatin,taxane,paclitaxel, docetaxel
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chemo meds for ovarian cancer
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methotrexate
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inhibits the growth of pregnancy in ectopic pregnancy
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estrogen replacement therapy
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decreases risk for bone loss but increases risk for stroke dvts heart attack and breast cancer. it minimizes menopausal sx like hot flashes, night sweats, insomnia
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left side stroke manifestations
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right hemiplagia impaired speech, impaired right left discrimination, slow and cautious performance. slow and fearful performance of tasks
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right side stroke
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impulsivity, left side neglect, and short attention span. overconfidence, spatial disorientation.
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clomiphene
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medication for infertility. stimulates ovulation
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post induced abortion
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avoid sexual intercourse for 2 weeks. call if fever or abnormal bleeding occurs
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Primrose oil
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increased risk for bleeding
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ruptured ectopic pregnancy
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pelvic abd pain and vaginal bleeding. if tube ruptures pain is intense and radiates to shoulder
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brachytherapy
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internal radiation applied directly to the tumor causing destruction of cells resulting in foul smelling discharge. pt is on bedrest
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black cohash, and soy
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herb that helps with menopausal sx
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