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Questions and Answers

What is a common dietary restriction for someone with hyperuricemia?

  • Fruits and vegetables
  • Legumes
  • Organ meats (correct)
  • Whole grains

What symptom is commonly associated with hyperuricemia?

  • Diarrhea
  • Hair loss
  • Frequent urination
  • Joint redness and swelling (correct)

Which of the following best describes Cushing Syndrome?

  • Excess production of corticosteroids from adrenal glands (correct)
  • A deficiency of glucocorticoids due to adrenal dysfunction
  • An autoimmune disease affecting the pituitary gland
  • Tendency towards hyperkalemia and hypoglycemia

Which gender is more susceptible to urinary tract infections (UTIs)?

<p>Young adult females (C)</p> Signup and view all the answers

What is the primary cause of Cushing Disease?

<p>Pituitary tumor causing high ACTH levels (C)</p> Signup and view all the answers

What is a potential effect of adrenal insufficiency (Addison's Disease)?

<p>Severe hypotension and weight loss (D)</p> Signup and view all the answers

Which symptoms are associated with Cushing's Syndrome?

<p>Moon face and buffalo hump (B)</p> Signup and view all the answers

What is a likely consequence of untreated hyperuricemia?

<p>Nephropathy and nephrolithiasis (C)</p> Signup and view all the answers

What is the gold standard for diagnosing diabetes mellitus?

<p>Fasting plasma glucose levels greater than 126 on two separate occasions (B)</p> Signup and view all the answers

Which condition is more commonly associated with Diabetic Ketoacidosis (DKA)?

<p>Type 1 diabetes (D)</p> Signup and view all the answers

What level of HgbA1c is indicative of diabetes mellitus?

<p>6.5% or greater (A)</p> Signup and view all the answers

What is the first-line treatment for a patient who is unconscious due to severe hypoglycemia?

<p>Dextrose IV or glucagon (A)</p> Signup and view all the answers

What is the primary distinguishing symptom between diabetes mellitus (DM) and diabetes insipidus (DI)?

<p>Hyperglycemia (B)</p> Signup and view all the answers

How does the Rule of 15's guide the treatment of hypoglycemia?

<p>Give 15 grams of carbohydrates, then recheck in 15 minutes (A)</p> Signup and view all the answers

Which condition is more commonly associated with Hyperglycemic Hyperosmolar Syndrome (HHS)?

<p>Type 2 diabetes (C)</p> Signup and view all the answers

To diagnose prediabetes using the Oral Glucose Tolerance Test (OGTT), what postprandial BG level indicates a diagnosis?

<p>Between 140 mg/dL and 200 mg/dL (C)</p> Signup and view all the answers

What defines metabolic syndrome in terms of elevated fasting glucose levels?

<p>Equal to or greater than 100 mg/dL (D)</p> Signup and view all the answers

Which of the following is a characteristic feature of appendicitis?

<p>Pain in the lower right quadrant (D)</p> Signup and view all the answers

What role do goblet cells play in the body?

<p>They produce mucous (B)</p> Signup and view all the answers

Which statement accurately contrasts ulcerative colitis and Crohn's disease?

<p>Crohn's disease lesions extend deeper than ulcerative colitis (B)</p> Signup and view all the answers

What symptom can be caused by liver dysfunction due to portal hypertension?

<p>Caput medusa (A)</p> Signup and view all the answers

What is the function of intrinsic factor in the digestive system?

<p>To help absorb vitamin B12 (C)</p> Signup and view all the answers

Which condition is characterized by reduced HDL cholesterol levels?

<p>Metabolic syndrome (A)</p> Signup and view all the answers

What is a potential consequence of hepatic encephalopathy?

<p>Severe confusion and seizures (D)</p> Signup and view all the answers

Which sign is indicative of acute pancreatitis?

<p>Cullen sign (A), Turner sign (D)</p> Signup and view all the answers

What is a common symptom of kidney stones?

<p>Pain radiating down to the groin (A)</p> Signup and view all the answers

In acute pancreatitis, which symptom is typically experienced when the patient lies supine?

<p>Increased abdominal pain (A)</p> Signup and view all the answers

What diagnostic criterion is used to assess the severity of acute pancreatitis?

<p>Ranson Criteria (A)</p> Signup and view all the answers

Which of the following symptoms does NOT typically indicate acute pancreatitis?

<p>Severe constipation (A)</p> Signup and view all the answers

What is a possible treatment approach for kidney stones?

<p>Pain relief and fluid therapy (A)</p> Signup and view all the answers

Which demographic is typically not affected by kidney stones?

<p>Children under five (D)</p> Signup and view all the answers

What symptom is a classic feature of acute pancreatitis?

<p>Severe back pain (C)</p> Signup and view all the answers

Which of the following is NOT one of the four primary symptoms of Parkinson's disease as characterized by the acronym TRAP?

<p>Anxiety (A)</p> Signup and view all the answers

What is the purpose of the Tensilon test?

<p>To assess muscle weakness in myasthenia gravis (B)</p> Signup and view all the answers

During a seizure, what is one of the primary interventions that should NOT be performed?

<p>Hold the person down to prevent movement (A)</p> Signup and view all the answers

What indicates a positive Babinski reflex test in adults?

<p>Big toe bends back and other toes fan out (A)</p> Signup and view all the answers

What is an expected symptom of osteoporosis?

<p>Fractures from minimal trauma (C)</p> Signup and view all the answers

How does osteoarthritis differ from rheumatoid arthritis?

<p>Osteoarthritis typically affects weight-bearing joints; rheumatoid arthritis affects multiple joints (A)</p> Signup and view all the answers

What is the main purpose of encouraging independence in activities of daily living (ADLs) for a patient with bradykinesia?

<p>To improve self-esteem and confidence (B)</p> Signup and view all the answers

What is the reversal agent given after the Tensilon test if stabilization is required?

<p>Atropine (D)</p> Signup and view all the answers

Which type of arthritis is characterized by the immune system attacking the joints?

<p>Rheumatoid arthritis (A)</p> Signup and view all the answers

What is primarily building up in the body of a patient with gout?

<p>Uric acid (A)</p> Signup and view all the answers

Which anticoagulant is monitored using the activated partial thromboplastin time (aPTT)?

<p>Heparin (B)</p> Signup and view all the answers

What dietary change should a patient with gout consider to manage their condition?

<p>Avoid organ meats (C)</p> Signup and view all the answers

Which pathway is evaluated by the Prothrombin time (PT) test?

<p>Extrinsic pathway (D)</p> Signup and view all the answers

What is the most significant goal when treating a patient on Heparin?

<p>Achieve controlled aPTT (C)</p> Signup and view all the answers

What should the INR level ideally be for a patient on Warfarin therapy?

<p>2 to 3 (A)</p> Signup and view all the answers

In severe chest pain management, what condition differentiates angina from a myocardial infarction?

<p>Duration of pain (A)</p> Signup and view all the answers

Flashcards

Osteoarthritis

A common arthritis caused by cartilage wearing away in joints.

Rheumatoid Arthritis

Immune system attacks joints, starting with the lining.

Gout

Uric acid buildup causes inflammation and crystal deposits.

Hyperuricemia

High levels of uric acid in the blood.

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aPTT

Test measuring intrinsic clotting time.

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Heparin

Anticoagulant that prolongs intrinsic pathway clotting time.

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Prothrombin Time (PT)

Test measuring extrinsic clotting time.

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Warfarin

Anticoagulant that interferes with Vitamin K dependent clotting factors.

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TRAP symptoms

Tremor at rest, rigidity, akinesia (bradykinesia), postural/gait instability.

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Status Epilepticus

A seizure continuing or a series of 3 tonic-clonic seizures.

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Tensilon test

Diagnostic test for myasthenia gravis, a neuromuscular condition of muscle weakness.

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Seizure precautions

Do not restrain the person; do not put anything in their mouth.

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Babinski reflex

Reflex test used in neurological exams, where doctor stimulates the bottom of the foot.

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Osteoporosis

Bone disease causing weakened bones and increased risk of fractures.

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Parkinson's treatment

Encourage independence with ADL's exercises and deep brain stimulation. Exercise in the morning;initiate movement with bradykinesia buy clothes with features like velcro.

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Osteoarthritis vs. Rheumatoid Arthritis

Osteoarthritis is related to wear and tear, Rheumatoid arthritis is an autoimmune disease that causes inflammation.

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Acute Gallstones Symptoms

Severe abdominal pain, often radiating to the back, usually accompanied by nausea and vomiting.

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Acute Pancreatitis Symptoms

Severe epigastric pain radiating to the back, often accompanied by nausea, vomiting, and fever.

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Kidney Stone Symptoms

Flank pain radiating to the groin and inner thigh, possible dysuria (painful urination), hematuria (blood in urine), and nausea or vomiting.

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Ranson Criteria

A set of clinical characteristics used to assess the severity of acute pancreatitis, determining the need for hospitalization.

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Parkinson's Disease Triad

Bradykinesia (slow movement), resting tremor, and muscle rigidity.

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Turner Sign

Reddish-brown discoloration along the flanks (sides of the torso), a sign of acute pancreatitis.

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Cullen Sign

Bluish discoloration around the umbilicus (belly button), a sign of acute pancreatitis.

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Multiple Sclerosis

A chronic condition affecting the central nervous system, leading to a variety of symptoms.

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Metabolic Syndrome

A cluster of conditions increasing the risk of heart disease, stroke and type 2 diabetes. Includes high blood pressure, high blood sugar, unhealthy cholesterol levels and excess body fat around the waist.

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Appendicitis Location

Appendix is located in the lower right quadrant of the abdomen.

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Goblet Cells Function

Goblet cells secrete mucus to protect the lining of the digestive and respiratory tracts from damage and aid in digestion.

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Parietal Cells

Stomach cells that produce hydrochloric acid (HCl), crucial for protein digestion.

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Small Intestine Villi

Finger-like projections in the small intestine that increase the surface area for nutrient absorption.

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Ulcerative Colitis vs. Crohn's

Both are inflammatory bowel diseases, but ulcerative colitis is limited to the colon and rectum (superficial), whereas Crohn's can affect any part of the digestive tract (deeper).

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Liver Dysfunction Symptoms

Liver issues can cause coagulation problems, portal hypertension (leading to swollen abdominal veins called caput medusa), and hepatic encephalopathy (confusion/coma).

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Metabolic Syndrome Risk Factors

Elevated waist circumference, triglycerides, reduced HDL cholesterol, elevated blood pressure and elevated fasting glucose.

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Hyperuricemia

Elevated uric acid in the blood, often triggering inflammation and potentially joint pain.

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Causes of Hyperuricemia

Can be primary (genetic or metabolic purine issues) or secondary (due to things like alcoholism, certain drugs or chemotherapy).

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Hyperuricemia Symptoms

Redness, warmth, swelling of joints, possible fever, and extreme joint sensitivity. Often affects toe joints, hands, wrists, and elbows.

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Hyperuricemia Complications

Can lead to kidney problems like nephropathy (kidney disease) and nephrolithiasis (kidney stones).

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UTI Susceptibility

Young adult males are less susceptible to urinary tract infections (UTIs) than females, or older men compared to younger men.

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Cushing's Syndrome

A hypercortisolism (high cortisol) condition, often due to a pituitary tumor (Cushing's disease) or adrenal gland hyperactivity.

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Cushing's Symptoms

High blood sugar, low potassium, high sodium, hypervolemia (excess body fluids), immune suppression, osteoporosis, and characteristic fat redistribution (moon face, buffalo hump).

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Adrenal Insufficiency (Addison's)

A condition resulting from inadequate adrenal hormone production (hyposecretion).

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Diagnosing Diabetes Mellitus (DM)

Diagnosis involves using fasting plasma glucose (FPG) levels over 126 mg/dL on 2 separate occasions, or random blood glucose (BG) levels over 200 mg/dL more than once. Oral Glucose Tolerance Test (OGTT) can also be used.

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Oral Glucose Tolerance Test (OGTT)

Patient drinks a glucose solution (75 grams). Blood glucose levels are measured 2 hours later. Levels above 140 indicate prediabetes, and levels above 200 diagnose DM.

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HbA1c

Measures average blood glucose over the past 3 months. Levels between 5.7-6.4% indicate prediabetes, and levels above that indicate Diabetes Mellitus.

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Treating Hypoglycemia (conscious)

Consume 15 grams of carbohydrates (e.g., juice, glucose tablets), recheck in 15 minutes. Repeat as needed.

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Treating Hypoglycemia (unconscious)

Administer glucagon immediately. If glucagon is unavailable, give 50% dextrose IV.

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Diabetic Ketoacidosis (DKA)

Serious complication of diabetes, characterized by high blood acid (ketone) levels, often associated with type 1 diabetes.

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Hyperglycemic Hyperosmolar Syndrome (HHS)

Serious complication of diabetes, characterized by extremely high blood glucose and altered mental status, often associated with type 2 diabetes.

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Differentiating DM from DI

Measure blood glucose and assess for other indicators like polyuria, polydipsia, and dehydration, since these can be symptoms of both Diabetes Mellitus and Diabetes Insipidus, measuring blood glucose helps distinguish one from the other.

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Study Notes

10-20 GFR Starting Dialysis

  • Causes of high BUN (blood urea nitrogen) include decreased GFR, dehydration, extremely muscular persons, and high protein diets.
  • A blood urea nitrogen (BUN) test measures urea nitrogen levels in the blood, which indicates how well the kidneys are working.

Comparing Acute Kidney Injury (AKI) and Chronic Renal Failure

  • AKI occurs quickly and is often treatable, while chronic renal failure develops slowly, usually requiring long-term dialysis.

Acute Kidney Injury (AKI) (Acute Renal Failure)

  • Prerenal: Renal ischemia (inadequate blood flow), hemorrhage, or shock.
  • Intrarenal: Nephrotoxic drugs (NSAIDs, aminoglycosides, radiopaque dyes), infections, excess hemoglobin or myoglobin, and purine breakdown.
  • Postrenal: Kidney stones, prostatic hyperplasia.

Acute Kidney Injury (AKI) Phases

  • Initial insult: Prerenal, intrarenal, or postrenal condition disrupts kidney function.
  • Oliguria: Low GFR, lack of urine output, fluid overload.
  • Diuresis: Large unconcentrated urine outflow; kidney not concentrating urine properly.
  • Recovery: Healthy nephrons take over function of damaged nephrons; kidney function resumes.

Chronic Renal Failure (CRF)

  • Progressive gradual loss of kidney function.
  • Stage 1: Kidney damage with normal or increased GFR (greater than 90 mL/min).

Gout Pathophysiology

  • Uric acid (byproduct of protein metabolism) accumulates, forming crystals in subcutaneous tissue and synovial fluid.
  • Hyperuricemia triggers inflammation.
  • May be primary metabolic disorder or secondary to alcoholism, certain drugs, or chemotherapy.
  • Symptoms include redness, warmth, swelling of joints, possible fever.
  • Avoid organ meats, red wine, aged cheese/steaks, shellfish, etc. (high in purines.)

UTIs

  • Young women are more susceptible to UTIs than their male counterparts.

Adrenal Glands

  • Cushing's disease: Hypercortisolism, often due to a pituitary tumor secreting excessive ACTH.
  • Addison's disease: Hypoadrenalism, insufficient secretion of cortisol and aldosterone, typically due to adrenal gland destruction or insufficient ACTH.

Diabetes Insipidus

  • Posterior pituitary insufficient ADH (antidiuretic hormone), causing excessive urination and dehydration.
  • Can be central (lack of ADH) or nephrogenic (kidney not responding to ADH).

Hyper/HypoPituitarism

  • Hyperpituitarism: Excessive hormone secretion (e.g., growth hormone, ACTH).
  • Hypopituitarism: Insufficient hormone secretion (e.g., growth hormone, ACTH).

Thyroid Disorders

  • Hyperthyroidism: Excessive thyroid hormone production (e.g., Graves' disease).
  • Hypothyroidism: Insufficient thyroid hormone production (e.g., Hashimoto's thyroiditis).

Diabetes Mellitus (DM) vs. Diabetes Insipidus (DI)

  • DM: Elevated blood glucose levels.
  • DI: Excessive urination.
  • Crucial to differentiate DM from DI to ensure accurate diagnosis and treatment.
  • Measure BG (blood glucose)* to differentiate DM from DI. DI does not have high BG.

Clinical Manifestations of Diabetes

  • Three Ps: Polyuria, polydipsia, and polyphagia
  • Hypoglycemia: Low blood glucose.
  • Hyperglycemia: High blood glucose.

DKA and HHS

  • DKA (Diabetic Ketoacidosis): Commonly in type 1 diabetes, high blood glucose, insulin deficiency, and the breakdown of fats cause ketone production.
  • HHS (Hyperglycemic Hyperosmolar State): Mainly in type 2 diabetes, severe dehydration and very high blood glucose; without ketone production.

Arterial Blood Gases (ABG)

  • Assess respiratory and metabolic acidosis and alkalosis.

Seizures

  • Status epilepticus: Series of 3 or more tonic-clonic seizures.
  • Tensilon test: For myasthenia gravis.
  • Interventions: Airway management, oxygen.

Osteoporosis

  • Bone density loss, resulting in increased fragility.
  • Symptoms include pain, fractures, and altered posture.

Appendicitis

  • Inflammation of the appendix, typically in the lower right quadrant of the abdomen.
  • Symptoms include pain, nausea, and vomiting.

Crohn's Disease and Ulcerative Colitis

  • Chronic inflammatory bowel diseases.
  • Crohn's: Inflammatory lesions throughout the bowel.
  • Ulcerative colitis: Lesions limited to the colon and rectum and are superficial to the bowel wall.

Liver Dysfunction

  • Causes (e.g., liver disease, toxins).
  • Symptoms (e.g., abnormal laboratory results like high ammonia, coagulation abnormalities), and encephalopathy, bleeding issues (coagulopathy), ascites, neurological changes, etc.

Neuro

  • Lobes of the Brain: Frontal (cognition, movement), Parietal (sensation), Temporal (memory, language), Occipital (vision)
  • Multiple Sclerosis: Progressive autoimmune disorder, causing demyelination of nerve fibers in the brain and spinal cord.

Myasthenia Gravis

  • Autoimmune disorder targeting acetylcholine receptors at the neuromuscular junction, leading to muscle weakness.
  • Symptoms often include fluctuating muscle weakness and fatigue, particularly in the face and neck.

Guillain-Barré Syndrome

  • Autoimmune disorder often following an infection.
  • Characterized by ascending paralysis and weakness of the limbs.

Parkinson's Disease

  • Progressive neurodegenerative disorder affecting dopamine-producing neurons in the brain.
  • Symptoms often include tremors, rigidity, bradykinesia, and postural instability.

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