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99 Cards in this Set

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Mrs. M is a 58 year old African American woma who is seen in the clinic for an H1N1 immunization. While she is waiting, the student nurse takes her BP. Mrs. M's BP is 158/96. This is:
a. Stage 2 HTN
b. Stage 1 HTN
c. Prehypertension
d. Normal for age
b. Stage 1 HTN

* Normal: 120/80
Prehypertension: 120-139/80-89
Stage 1 HTN: 140-159/90-99
Stage 2 HTN: >160/>100
Mrs. M is a 58 year old African American woma who is seen in the clinic for an H1N1 immunization. While she is waiting, the student nurse takes her BP. Mrs. M's BP is 158/96. What are the risk factors for this woman's conditions?
a. High intake of potassium
b. Elevated magnesium level
c. Ethnicity/genetics
d. She has no risk factors, her findings are normal
c. Ethnicity/genetics
Which of the following are associated with primary HTN? Mark all that apply:
a. Genetics and obesity
b. Over-activation of the sympathetic nervous system
c. Increased response by the renin/angiotensin/aldosterone complex
d. Insulin resistance
e. Inflammation
All apply
Patients with sustained, complicated HTN can damage their kidneys by:
a. Developing atherosclerosis of the renal arteries
b. Developing scar tissue that can lead to renal failure
c. Weakening the vessel walls of the renal veins
d. Increasing the workload of the ventricles
b. Developing scar tissue that can lead to renal failure
You are working in a mental health clinic. When the patient stands up to greet you,he becomes dizzy and feels 'faint.' His BP is 120/70 when he is sitting, and 80/40 when he stands. Your assessment:
a. Stage 1 HTN
b. Hypotension
c. Orthostatic hypotension
d. Orthostatic hypertension
c. Orthostatic hypertension

* More than 20 mmHg drop in systolic, 10 mmHg drop is diastolic
What do patients with deep vein thrombus of the leg and atrial fibrillation have in common?
a. They are both at risk for embolism
b. They are usually elderly
c. Most often they have diabetes
d. They are usually immunosuppressed
a. They are both at risk for embolism
_____ plays a fundamental role in the development of atherosclerosis.
a. Undifferentiated cells
b. Apoptosis
c. Renin/angiotensin
d. Inflammation
d. Inflammation
Mr. H is a 300 lb (5 foot 9) man who has the following findings: BP 170/100; chest pain at rest, LDL 160; HDL 31. He has an elevated blood glucose level (300 mg/dL) for the past three months and an elevated C-reactive protein.

Mr. H is at risk for which of the following?
a. Coronary artery disease
b. Raynaud's phenomenon
c. Tetrology of Fallot
d. Klinefelter's syndrome
a. Coronary artery disease

* Total cholesterol (normal): <200
LDL: <100
HDL: 40 (low) - 60 (high)
Triglycerides: <150
Glucose: 70-120
Mr. H is a 300 lb (5 ft 9) man who has BP 170/100, chest pain at rest, LDL 160, HDL 31. He has an elevated blood glucose level of 300 mg/dL for the past three months and has an elevated C-reactive protein.

He has:
a. HTN, normal lipid profile, elevated blood glucose
b. HTN, hyperlipidemia, diabetes, inflammation
c. HTN, normal lipid profile, diabetes, stage angina
d. HTN, hyperlipidemia, diabetes, prinzmetal angina, inflammation
d. HTN, hyperlipidemia, diabetes, prinzmetal angina, inflammation
Which of the following has been shown to increase vasoconstriction in the coronary arteries?
a. Mental stress/cigarette smoking
b. The use of herbal medicines
c. Meditation and yoga
d. Nitric oxide
a. Mental stress/cigarette smoking
The symptom of actue myocardial infarction is USUALLY _____ but can also be _______
a. Back pain/renal failure
b. Chest pain/indigestion
c. Ventricular tachycardia/cardiac arrest
d. Pericardial friction rub/back pain
b. Chest pain/indigestion
Which of the following are specific markers for myocardial infarction (MI)?
a. C-reactive protein
b. Blood glucose
c. Troponins
d. Troponins/CK-MD and LDH1
d. Troponins/CK-MD and LDH1
The pathophysiology of aortic stenosis is related to:
a. Outflow obstruction increases the work load of the left ventricle
b. Outflow obstruction increases the work of the right ventricle
c. Calcifications cause the right ventricle to work harder
d. Congenital defects create too much stress on the right ventricle
a. Outflow obstruction increases the workload of the left ventricle
Patients with mitral stenosis usually have
a. Diabetes
b. Orthostatic hypertension
c. A history of group A hemolytic strep infection as children
d. A history of being born prematurely
c. A history of group A hemolytic strep infection as children
In congestive heart failure, as cardiac output falls, renal perfusion diminishes. This stimulates:
a. The renin/angiotensin system, which further increases the workload of the heart
b. The renin/angiotensin system, which helps to decrease the workload of the heart
a. The renin/angiotensin system, which further INCREASES the workload of the heart
Which of the following conditions are associated with cardiogenic shock?
a. Sepsis, infection, immunosuppression
b. Drug toxicity, myocardial infection (MI)
c. Drug toxicity, MI, sepsis
d. MI, sepsis, Type 1 anaphylaxis
b. Drug toxicity, myocardial infection (MI)
While on a camping trip and long hike, you come upon a 22 year old lying on the trail. According to her companion she has been bleeding from a large wound for 'several hours' and was 'fine' for awhile but now is pale.

This person probably has:
a. Septic shock because of microorganisms in the soild where she is lying
b. Hypovolemic shock, based on blood loss
c. Cardiogenic shock, probably due to MI
d. Anaphylactic shock, from a bee sting
b. Hypovolemic shock, based on blood loss
22 year old has been bleeding from large wound for several hours and was fine for awhile but now is pale. Which of the following would confirm your assessent of hypovolemic shock?
a. Presence of a fever
b. Weak, rapid pulse with poor skin turgor
c. Weak, rapid pulse and chest pain
d. Wheezing and rapid pulse
b. Weak, rapid pulse with poor skin turgor
Woman with hypovolemic shock is in hospital. Why, according to her companion, was she "fine" for awhile before becoming pale?
a. It takes microorganisms a farily long period of time before they infect
b. Renin/angiotensin/aldosterone system compensated for her volume loss
c. Her cardiac ischemia developed slowly
d. Her allergy was not dramatic at first
b. Renin/angiotensin/aldosterone compensated for her volume loss
Children with a ventricular septal defect present with:
a. Congestive heart failure
b. Severe cyanosis
c. Hypertension
d. Prematurity
a. Congestive heart failure

* CHF is occurs when the heart is unable to maintain sufficient CO to meet the metabolic demands of the body. Common complication of many congential heart defects. Sx: tachypnea, tachycardia, and respiratory infections. Most often a result of decreased left ventricular systolic function and the associated left atrial and pulmonary venous hypertensionand pulmonary venous congestion.
WHich of the following statements is true?
a. The symptoms of CHF in children are the same as adults.
b. The causes of CHF in children are the same as adults
c. Unlike adults, hypertension in children often has underlying disease process
d. While obesity in adults can contribute to hypertenion, it is not a risk factor for children
c. Unlike adults, HTN in children often has an underlying disease process
Which of the following immunologic conditions in the Mom can contribute to the development of pulmonary stenosis and coarction in her child?
a. Maternal leukemia
b. Leukopenia
c. Leukocytosis
d. Rubell
d. Rubella
You are doing genetic counseling with a 22 year old who has cystic fibrosis (CF). She is expecting her first child, along with a person who also has cystic fibrosis. You explain to her that:
a. If you have a boy, he will have CF
b. if you have a child with Down's syndrome, they will have CF
c. You have a 1 in 4 chance of having a child with CF
d. You should expect your child to have CF
d. You should expect your child to have CF
Patients who consume foods high in aflatoxins (produced by molds) are at risk for:
a. carcinogenesis
b. type 4 hypersensitivity
c. type 2 hypersensitivity
d. dyslipidemia
a. carcinogenesis
Disruption of the heart rhythm causes an:
a. interference with the normal flow of blood through the heart
b. Ventricular failure
c. Atrial failure
d. Myocardial infarction
a. Interference with the normal flow of blood through the heart
Define pericarditis
inflammation of the pericardium
Define pericardial effusion
fluid in the pericardial cavity
Define dilated cardiomyopathy
Increase in heart chamber volume
Define hypertrophic cardiomyopathy
decrease in heart chamber volume
Define restrictive cardiomyopathy
eventually causes right heart failure
Bradycardia is...
a. Slowing of heart rate; values are based on age
b. Increased heart rate; values are the same irrespective of age
c. Extra beats in the atria, associated with advancing age
d. Cardiac arrest
a. Slowing of the heart rate; values are based on age
Your neighbor has identical twins; one has leukemia and the other is cancer free. She asks you why. Your best answer:
a. Cancer is a combination of genes and environment
b. Cancer research has not given us answers about that
c. There is a new field called epigenetics that tells us there are different gene expressions even between those with the same genes
d. One of your twins has a recessive gene for leukemia and the other does not
c. There is a new field called epigenetics that tells us there are different gene expressions even between those with the same genes
Your patient was admitted after being found wandering the street in a confused state. The physician expects lead toxicity based on both symptoms and lab values. Which of the following list of activites/exposures are important to note in your patient's history?
a. Your patient has HIV
b. He is a potter
c. He has recently been out of the country
d. He has a diet low in vitamin B
b. He is a potter
Aging occurs in part because of a decline in the function of tissue stem cells. Which of the following are factors? MARK ALL THAT APPLY:
a. Cells may become damaged during replication
b. Each cell has a finite program
c. There is an increase in free radicals
d. Aging is not related to genes
a,b,c
A patient arrives to your oncology unit. He is a 45 year old with stage 2 prostate cancer. Define stage 2:
a. His cancer is confined to the prostate
b. His cancer has invaded nearby tissue
c. He is cancer free
d. His cancer has spread to distant sites
d. His cancer has spread to distant sites
Chronic inflammation is an immune response that is recognized as an important contributing factor in cancer development. To which of the following patients does this apply? MARK ALL THAT APPLY.
a. Patents who have an infection with Hep B
b. Children who are diagnosed with brain tumors at 5
c. Elderly individuals who have a history of colitis
d. Middle aged women with a history of asthma since childhood
a,b,c,d,
You have only 15 minutes to lecture a group of highschool student about health promotion. WHich of the following is most important and should be covered?
a. Importance of not smoking marijuana as it is associated wth lung/airway disease
b. The notion that genes play a role in aging
c. The association of sun exposure and eventual skin cancers
a. The importance of not smoking marijuana as it is associated with lung/airway disease
Which of the following has been shown as a positive link to the development of cancer in men and women? Mark all that apply.
a. >BMI
b. an ETOH use of >12/week
c. exposure to molds
d. living near an electromagnetic field
a,b,c
You are caring for a patient diagnosed with CA. You notice there has been little food eaten from his diet tray. He complains feeling full and accuses you of putting something "metallic" in his food. You suspect:
a. He is presenting with fatigue, the most common symptom
b. He has pain, associated with CA
c. He has leukopenia and thrombocytopenia
d. He has cachexia
d. He has cachexia
Mr. J is a 55 year old who is admitted with a cardiac defect and went to surgery. You notice erythema around his sternal wound his WBC count is 17,000. Based on his sx and lab values, this patient has:
a. Wound infection and leukopenia
b. Wound infection and leukocytosis
c. Increased white count
d. Decreased white count
b. Wound infection and leukocytosis

* Normal WBC: 10,000
Mr. J (WBC 17,000 and erythema around sternal wound following cardiac defect surgery) would be considered immunologically challenged b/c of his:
a. age
b. surgery and anesthesia
c. probable diabetes
d. genetic traits
b. surgery and anesthesia
Mrs. I asks you about the safety of the H1N1 vaccine.
a. It is approved by the FDA and was heavily tested over the past 10 years
b. H1N1 has a long history and we know a lot about the virus
c. Vaccines are not always safe, we ask you to sign a consent
d. Vaccies induce immune memory and protect you from getting the disease
d. Vaccines induce immune memory and protect you from getting the disease
You are caring for a patient with pneumonia. After giving her Penicillin, you notice wheals and flares and hear what sounds like a "tight" airway. Your conclusion:
a. Type 1 reaction, IgE mediated
b. Type 1 reaction, T cell mediated
c. Type 2 reaction, specific to the tissue
d. Histamine-induced reaction, probably mild
a. Type 1 reaction, IgE mediated
Patients who develop opportunistic infections should be screened for:
a. Immunodeficiency
b. Hypersensitivity
c. Trisomy 21
d. Turner's syndrome
a. Immunodeficiency

*When you hear "opportunistic infections" think "immunodeficiency"
Mr. Y is a 76 year old with history of smoking. He is admitted to the hospital for pneumonia. he has COPD and Cor Pulmonale. Which of the following are risk factors for respiratory failure in the patient? Mark all that apply.
a. Right heart failure due to lung disease
b. Chronic CO2 retention
c. Infection
d. Age
a,b,c,d
Mr. Ys admitting bld gas is PaO2 82, PaCO2 56, pH 7.37, HCO3 31. This is:
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Compensated respiratory acidosis
d. Compensated respiratory acidosis
You observe dyspnea by:
a. "pulling" shoulders up when breathing
b. Respiratory rate is 16
c. Retractions, seen very easily in his age group (he is 76)
d. He is breathing very deeply
a. He is "pulling" up his shoulders when he breathes
The doctor orders 10 liters of oxygen to be started immediately in a patient with COPD and Cor Pulmonale. He has CO2 retntion and high HCO3. Your response:
a. Obtain a face mask and put O2 to "flush"
b. Call the doctor and remind him the patient is retaining CO2, providing a large amount of O2 will cause him to stop breathing
c. Place his HOB n a 45 degree angle and provide 10 L O2
d. Ignore the order as this is an error
b. Call the doctor and remind him that the patient is retaining CO2, providing a large amount of O2 will cause him to stop breathing
LL is a 22 year old who was a victim of a high-speed auto rollover; she has multiple crush injuries. She arrives to the ER with a RR 40. Her initial blood gas shows respiratory alkalosis. She suddenly becomes dyspnic and her 2nd blood gas shows a PaO2 of 50.

WHich of the following conditions do you expect?
a. Atelectasis
b. Pneumothorax
d. Pleural effusion
e. ARDS
e. ARDS

* Atelectasis: partial or complete collapse of the lung

Pneumothorax: the presence of air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung. Not answer because NO SHIFT IN MIDLINE TRACHEA

ARDS: ARDS leads to a buildup of fluid in the air sacs. This fluid prevents enough oxygen from passing into the bloodstream.
The fluid buildup also makes the lungs heavy and stiff, and decreases the lungs' ability to expand. The level of oxygen in the blood can stay dangerously low, even if the person receives oxygen from a breathing machine (mechanical ventilator) through a breathing tube (endotracheal tube).
LL is a 22 year old who was a victim of a high-speed auto rollover; she has multiple crush injuries. She arrives to the ER with a RR 40. Her initial blood gas shows respiratory alkalosis. She suddenly becomes dyspnic and her 2nd blood gas shows a PaO2 of 50.

Her condition is due to:
a. collapse of individual alveoli
b. rupture of the pleural space causing air to collect in the chest
c. migration of fluids into the pleura
d. massive inflammation and loss of surfactant
d. Massive inflammation and loss of surfactant
Blood gas values: PaO2 48, PaCO2 65, pH 7.07, HCO3 10. This is:
a. Hypoxia; respiratory and metabolic acidosis
b. Hypoxia, compensated acidosis
c. Metabolic acidosis
d. Respiratory acidosis
a. Hypoxia; respiratory and metabolic acidosis
Electrolyte levels of Na 145 and K 6.0. this is:
a. hypernatremia and hyperkalemia due to massive edema
b. hyponatremia and hypokalemia due to fluid loss
c. normal sodium but elevated K due to acidosis
d. normal electrolytes
c. normal sodium but elevated K due to acidosis
In assessig hydration status, which of the following lab values are helpful?
a urine specific gravity
b. urine specific gravity, BUN, creatinine
c. BUN, K
d. urine specific gravity, NA, BUN, Hct
d. urine specific gravity, NA, BUN, Hct
Restlessness in a patient can be due to:
a. multiple conditions including hyperkalemia, hypernatremia and hypoxia
b. hypoxia
c. hyperkalemia
d. hypernatremia
c. multiple conditions including hyperkalemia, hypernatremia and hypoxia
Hyperkalemia as seen in an ECG shows:
a. no effect of the PQRST complex
b. ST depression
c. Tall peaked T waves
d. atrial fibrillation
c. T peaked T waves
Good catheter insertion technique needed to prevent this disorder
UTI
Disorder associated with vesicouretal reflux
Pyelonephritis
Associated with streptococcus
Glomerulonephritis
Associated with spinal cord disfunction
neurogenic bladder
You are monitoring a patient's O2 saturation. While turning the patient, you notice O2 sat alarm alarms at 90. Your assessment:
a. probable interference with the finger monitor
b. this is common when turning a patient
c. the PO2 is 90
d. the PO2 is 60
d. the PO2 is 60

*30-60-90 rule
Age changes in the elderly person's lung includes:
a. loss of compliance, decreased alveolar surface area
b. increased compliance
c. increased alveolar surface area
d. decreased ability to exercise that cannot improve
a. loss of compliance
The ventilation of children differs from that of an older adult because:
a. young children lack muscle development and are abdominal breathers
b. children are born with a rich supply of functional alveoli
a. young children lack muscle development and are abdominal breathers
Mrs. M was in a high-speed auto rollover. She sustained an epidural bleed.

The pathophysiology r/t this injury is:
a. deterioration of the basal ganglia
b. coup and contre-coup injury
c an increase in CSF
d. venous bleeding
e. arterial bleeding
e. arterial bleeding
The MD comes in to do an oculocephalic reflex test. This is to determine if:
a. the patient is in a coma
b. the patient has increased intracranial pressure
c. Mrs. M will need a shunt from her 3rd ventricle into her 3rd ventricle to her peritoneum
d. She has an intact brain stem
d. She has an intact brain stem
Mrs. M's urine output has dropped 10 cc/hour and she is developing edema. Her serum Na is 120. She most likely has (MARK ALL THAT APPLY)
a. an inappropriate secretion of ADH (SIADH)
b. DM
c. DI
d. Grave's disease
a. an inappropriate secretion of ADH (SIADH)

* Urine Output (UO) should be 30 cc/hr. Dilutional hyponatremia (enough salt but too much water)
Which of the following are long-term concerns for patients with DM type 1? (MARK ALL THAT APPLY)
a. eventual renal failure
b. microvascular changes in the retina
c. potential food infection leading to amputation
d. Dawn phenomena
a,b,c
Mild to long term administration of excess cortisone (inflammation) interrupts the normal _________ and requires careful __________.
a. reproductive hormones; dosing
b. ADH mechanisms/fluid balance
c. Pituitary/adrenal feedback loop; weaning before discontinuing
d. parathormone; doses of calcium at bedside
c. Pituitary/adrenal feedback loop; weaning before discontinuing
Jeffery is a 10 year old boy who was ill with Cosackie viral infection 2 weeks ago. He arrives to the Dr's office with a recent history of "eating a lot" and "drinking more". He has to get up to use the br at least 2 times/night. He has lost 4 kg in the past two weeks (8 lbs)

Your assessment:
a. Diabetes type 2
b. DKA
c. Diabetes type 1
d. HHKC
c. Diabetes type 1
Jeffery is a 10 year old boy who was ill with Cosackie viral infection 2 weeks ago. He arrives to the Dr's office with a recent history of "eating a lot" and "drinking more". He has to get up to use the br at least 2 times/night. He has lost 4 kg in the past two weeks (8 lbs)

His sx include:
a. polydipsea, polyuria and polyphagia
b.dehydration, most likely secondary to his recent viral infection
a. polydipsea, polyuria, polyphagia
Jeffery is a 10 year old boy who was ill with Cosackie viral infection 2 weeks ago. He arrives to the Dr's office with a recent history of "eating a lot" and "drinking more". He has to get up to use the br at least 2 times/night. He has lost 4 kg in the past two weeks (8 lbs)

You expect his blood glucose to be:
a. above 200
b. below 100
c. between 100-200
a. above 200
Jeffery is a 10 year old boy who was ill with Cosackie viral infection 2 weeks ago. He arrives to the Dr's office with a recent history of "eating a lot" and "drinking more". He has to get up to use the br at least 2 times/night. He has lost 4 kg in the past two weeks (8 lbs)

Jeff has excess ketones in his urine. You expect blood pH to show
a. respiratory acidosis
b. metabolic acidosis
c. respiratory alkalosis
d. metabolic alkalosis
b. metabolic acidosis
Low level of thyroid hormone at birth
a. DI
b. aphasia
c. SIADH
d. Parkinson's
e. Cretinism
Cretinism
Lack of ADH
a. DI
b. aphasia
c. SIADH
d. Parkinson's
e. Cretinism
a. DI
Excess ADH
a. DI
b. aphasia
c. SIADH
d. Parkinson's
e. Cretinism
c. SIADH
Broca's area infarct
a. DI
b. aphasia
c. SIADH
d. Parkinson's
e. Cretinism
b. aphasia
Destruction of basal ganglia
a. DI
b. aphasia
c. SIADH
d. Parkinson's
e. Cretinism
d. Parkinson's
A 15 year old who sustained head trauma during a soccer game has a dysconjugate gaze and a + Babinski. This is:
a. associated with mid-brain injury
b. a pre-seizure aura
c. a coup/contre coup presentation
d. normal for age
a. associated with midbrain injury
Decorticate:
a. associated with upper motor neuron dysfucntion above the midbrain
b. associated with midbrain function
a.associated with upper motor neuron dysfunction above the midbrain
Decerebrate
a. associated with upper motor neuron dysfunction above the midbrain
b. associated with midbrain dysfunction
b. associated with midbrain dysfunction
Patients with spinal cord injuries tend to have injury to which of the following?
a. lumbar-sacral
b. C1,2 and 4-7
c. vertebral prominences
d. choroid plexus
b. C1,2 and 4-7
Why do patients with spinal cord injuries tend to have injury to C1,2 and 4-7?
a. lumbar-sacral injuries occur with seat belt injuries
b. C1,2 and 4-7 are mobile and contain large amounts of spinal cord
c. vertebral prominences lack flexibility
d. the design of the chroiod plexus make it vulnerable to injury
b. C1,2 and 4-7 are mobile and contain large amounts of spinal cord
Explain the term "autonomic dysreflexia"
Autonomic dysreflexa is an exaggerated and uncompensated sympathetic response that can present itself in patients who suffer injury at T6 and above. If sensory receptors located below the level of te spinal cord are stimulated--for instance, by the pressure of a full bladder or impacted stool--the still functioning autonoic nervous system will respond by increasing blood pressure which triggers baroreceptors to stimulate the parasympathetic nervous system. The heart rate will slow but vessels will fail to dilate since efferent impulses cannot be sent through the damaged cord, leading to hypertensive stroke, seizure, or even death.
Describe the difference between the Kernig's and Brudzinsk's sign.
A positive Kernigs sign is indicated when pain inhibits passive extension of the knee and is assessed by flexing the client's hip and knee to 90 degrees; rather, a positive Brudzinski's sign is indicated by involuntary flexion of he knee and hip when the neck is brought toward the chest and is assessed by placing your hands behind the client's neck and lifting their heads towards their chest.
A patient asks you how their 12 year old got meningitis from a sore throat. Explain in your own words
An upper respiratory tract infection like your child's sore throat is usually a predisposing condition of meningitis. Altough the bacteria that cause meningitis do not cause harm in a healthy individual and are normally present in the nasopharynx, the infection, or sore throat, was the gateway for them to infect the blood and travel to the meninges where they caused meningitis in your child.
Why do AIDS patients develop cognitive dysfunction?
HIV-associated cognitive dysfunction (HIV encephalopathy) results from direct brain tissue infection by the virus, particlarly HIV infected macrophages and monocytes from blood that accumulate in the brain by upregulation ad proinflammatory mediators.
Explain the difference between Multiple Sclerosis and Amytropic Lateral Sclerosis
Multiple Sclerosis is primarily a demyelinating, inflammatory disroder contained within the CNS with the typical age-at-onset being 20-40 yeras old, while ALS ("Lou Gherig's disease) is not inflammatory and diffusely impairs lower motor neurons (not myelin) of the cerebral cortex, brain stem, and the corticospianl tracts and anterior roots of the spial cord with a typical age of onset being around 55-75 years old. MS is approximately twice as common in women than men, while ALS is more common in men.
The Sx of Myasthenia Gravis include:
a. ascending muscle weakness
b. non-progressive destruction of the white matter
c. weakness in eye and swallow muscles
d. inability to walk in a smooth motion
c. weakness in eye and swallow muscles
What is the most common symptom of microcytic, hypochromic anemia?
Iron deficiency anemia is most common symptom
A patient with a "beefy red tongue" and icteric sclera should be screened for
a. Pernicious anemia
b. Sickle cell anemia
c. Iron deficiency
d. Folate excess
Pernicious anemia
Patients who have a large blood loss followign surgery should be screened for each type of anemia?
Post-hemorrhagic anemia
What lab values indicate anemia?
- Low hemoglobin <12 g/dL F <14 g/dl M
- Low hematocrit: <36% F <42% M
- Low RBC count: <4 million/mm3 F <4.5 million/mm3 M
Explain the conditions that cause blood cells to "sickle"
Conditions promoting deoxygentaion, dehydration or drop in pH can cause the RBCs to solidify and stretch into the characteristic "Sickle" shape. Examples of risky conditions: flying at high elevation, exercising at high elevation, undergoing anesthesia
What lab value indicates leukocytosis?
A WBC count that is >10,000 mm3
What is "left shift"
"Left shift" is indicative of a premature release of immature neutrophils (called "bands" since their nucleus is band-shaped) and other leukocytes from the bone marrow that is triggered by an infection which spreads faster than the WBCs being produced to contain it
What are the MOST common symptoms of leukemia?
Anemia, fatigue, bleeding, fever, infection, weight loss, bone pain, liver spleen and lymph node enlargement, elevated uric acid
Epstein-Barr virus is associated with what conditions?
Burkitt lymphoma, infectious mononucleosis, Hodgkin lymphoma, also nasopharyngeal cancer
Patients with a thrombocyte count of <10,000 will have what complicatin?
Severe bleeding
WHat is a hematologic complication of low Vitamin K?
Vitamin K is necessary for synthesis and regulation of prothrombin, the prothrombin factors (II,VII, X, XI) and proteins C and S (anticoagulants) so without it one would not be able to clot their own blood and would experience uncontrolled bleeding (hemorrhage)
DIC begins with what initial event?
Endothelial damage is the primary initiator of DIC