Unit 6 & 7 Patho Exam
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Questions and Answers

What is the recommended dosage and administration method for sublingual Nitroglycerin?

  • 1 tablet ingested orally every 5 minutes, maximum of 3 doses.
  • 1 tablet under the tongue every 5 minutes, call 911 after the first dose. (correct)
  • 1 tablet every 10 minutes until chest pain resolves.
  • 2 tablets under the tongue every 5 minutes as needed.

Which medication is indicated for the treatment of unstable angina?

  • Beta blockers. (correct)
  • Calcium channel blockers.
  • Aspirin.
  • Thrombolytics.

What is a critical sign of hypovolemic shock that should be monitored?

  • Increased heart rate. (correct)
  • Increased temperature.
  • Increased respiration rates.
  • Increased urine output.

Which wave in the PQRST complex represents atrial contraction?

<p>P wave. (C)</p> Signup and view all the answers

What is the appropriate response if a fever over one degree is detected post blood transfusion?

<p>Stop the transfusion and notify the healthcare provider. (B)</p> Signup and view all the answers

What is the primary effect of diuretics on the body?

<p>Affect electrolyte balance (A)</p> Signup and view all the answers

What happens to urine if it becomes too acidic?

<p>The kidneys retain bicarbonate to neutralize it. (B)</p> Signup and view all the answers

What is a consequence of kidney failure on red blood cell production?

<p>Diminished production of erythropoietin (A)</p> Signup and view all the answers

What is the normal range for glomerular filtration rate (GFR) in healthy individuals?

<p>Greater than 90 (A)</p> Signup and view all the answers

At which stage of kidney disease do patients typically require transplantation or dialysis?

<p>Stage 5 (B)</p> Signup and view all the answers

What should not be done around a fistula in a dialysis patient?

<p>Use the area for intravenous drug administration (A), Take blood pressure readings (B), Apply a tourniquet (D)</p> Signup and view all the answers

Which of the following terms describes the progression of chronic renal failure?

<p>Chronic renal failure evolves to end stage renal disease. (D)</p> Signup and view all the answers

Acute kidney injury can typically be described as:

<p>Self-limiting and often reversible. (A)</p> Signup and view all the answers

What can be a consequence of hypokalemia?

<p>Lethal cardiac arrhythmia (C)</p> Signup and view all the answers

Which of the following diuretics is potassium-sparing?

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

What is a common cause of coronary artery disease (CAD)?

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

What is the significance of cranberry in urinary health?

<p>Increases acidity of the urine (D)</p> Signup and view all the answers

What is indicated by the presence of ventricular fibrillation?

<p>Cardiac quivering instead of pumping (A)</p> Signup and view all the answers

What is a key side effect of Amiodarone?

<p>Pulmonary toxicity (C)</p> Signup and view all the answers

What is a primary function of calcium channel blockers such as Verapamil?

<p>Reduce automaticity in the heart (C)</p> Signup and view all the answers

In a medical emergency, which condition is classified as shock?

<p>Inadequate blood flow to tissues (A)</p> Signup and view all the answers

What is the role of packed red blood cells in treatment?

<p>Help with severe symptomatic anemia (D)</p> Signup and view all the answers

What should be avoided while taking Verapamil?

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

Which condition is primarily indicated by low urine output and shrinking kidneys?

<p>Oliguric phase of acute kidney disease (D)</p> Signup and view all the answers

What is the primary action of erythropoietin in kidney function?

<p>Stimulate RBC production (C)</p> Signup and view all the answers

Which blood type is known as the universal donor?

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

In the context of coronary artery disease, what characterizes myocardial ischemia?

<p>Inadequate oxygen to meet metabolic demands (B)</p> Signup and view all the answers

Which diuretic is known to be potassium-sparing?

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

Which medication is commonly used in the management of unstable angina?

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

What should be carefully monitored when administering loop diuretics such as furosemide?

<p>Serum potassium levels (B)</p> Signup and view all the answers

What is the recommended action before administering blood products?

<p>Start a wide-bore IV with normal saline (D)</p> Signup and view all the answers

Which of the following angina types usually subsides with rest?

<p>Stable angina (C)</p> Signup and view all the answers

What is a common cause of hyperkalemia in patients with kidney damage?

<p>Decreased excretion of potassium (A)</p> Signup and view all the answers

What is the primary mechanism of action of nitrates in the treatment of angina?

<p>Dilate both veins and arteries (A)</p> Signup and view all the answers

Which type of angina is characterized by predictable patterns of chest pain?

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

What is a common adverse effect of calcium channel blockers?

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

Which medication is contraindicated due to its interaction with nitrates?

<p>Phosphodiesterase-5 inhibitors (C)</p> Signup and view all the answers

Which statement about beta-adrenergic blockers is correct?

<p>They do not lead to tolerance buildup. (D)</p> Signup and view all the answers

What symptom is commonly associated with iron deficiency anemia?

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

In treating chronic kidney disease (CKD), what is a significant goal for GFR?

<p>GFR should be above 60 mL/min (D)</p> Signup and view all the answers

What is the primary role of ferrous sulfate in treatment?

<p>Treat iron deficiency anemia (A)</p> Signup and view all the answers

Which medication is most likely to cause bradycardia as a side effect?

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

What should be monitored in patients receiving treatment with spiralactone?

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

What is the primary electrolyte that diuretics primarily affect in the body?

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

In case of urine becoming too acidic, which substance do the kidneys retain to help neutralize it?

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

What is a significant consequence of kidney failure related to blood cell production?

<p>Decreased platelet count (C)</p> Signup and view all the answers

What GFR value indicates kidney impairment that requires close monitoring?

<p>Below 60 (D)</p> Signup and view all the answers

What is the final stage of chronic renal failure progression before transplantation or dialysis is necessary?

<p>End stage renal disease (A)</p> Signup and view all the answers

What should be avoided around a fistula in a dialysis patient to prevent complications?

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

Which of the following correctly describes the mechanism of action of beta-adrenergic blockers?

<p>They slow heart rate and reduce contractility by blocking beta1-adrenergic receptors. (A)</p> Signup and view all the answers

What is a common adverse effect associated with the use of nitrates for angina management?

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

Which condition is least likely to be effectively treated with calcium channel blockers?

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

Which of the following interventions should be monitored carefully in patients receiving furosemide?

<p>Serum potassium levels (C)</p> Signup and view all the answers

Which adverse effect is specifically associated with nitrates through administration of topical or patch forms?

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

What is a key characteristic of Prinzmetal's angina?

<p>It results from spasms of the coronary arteries. (B)</p> Signup and view all the answers

What is a common side effect of furosemide that healthcare providers should monitor?

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

Which of the following characteristics is NOT associated with hypokalemia?

<p>Increased heart rate (C)</p> Signup and view all the answers

Which medication can lead to pulmonary toxicity as an adverse effect?

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

What is a significant consequence of untreated chronic pyelonephritis?

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

In the management of angina pectoris, which of the following statements is true?

<p>Angina typically resolves with rest. (D)</p> Signup and view all the answers

What should be monitored in patients receiving treatment with beta-blockers?

<p>Heart rate and blood pressure (D)</p> Signup and view all the answers

Which electrolyte must be corrected before starting Amiodarone therapy?

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

What physiological change occurs during depolarization in cardiac action potentials?

<p>Calcium ions influx into the cell (D)</p> Signup and view all the answers

Which of the following medications is primarily used to treat stable angina by decreasing heart rate?

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

Which condition is most likely to lead to increased levels of potassium in a patient with chronic kidney disease?

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

What is the primary rationale for using thrombolytics in acute coronary syndrome?

<p>Break apart clots (A)</p> Signup and view all the answers

Which one of the following is a critical intervention for managing severe kidney damage due to hypovolemia?

<p>Reestablishing fluid volume (C)</p> Signup and view all the answers

Which is a primary effect of administering furosemide to patients?

<p>Block sodium and chloride reabsorption (D)</p> Signup and view all the answers

What is a common adverse effect associated with long-term use of procainamide?

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

Which dietary modification should patients on spironolactone adhere to in order to prevent significant adverse effects?

<p>Limit potassium-rich foods (D)</p> Signup and view all the answers

In assessing a patient with acute coronary syndrome, which medication is critical for pain management?

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

Which blood product is typically administered to patients experiencing massive hemorrhage?

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

What is the recommended action regarding potassium levels before administering any form of diuretics?

<p>Check serum potassium levels before administration (A)</p> Signup and view all the answers

Flashcards

Diuretic effect on electrolytes

Diuretics primarily affect sodium and potassium levels.

Acidic urine compensation

If urine becomes too acidic, the kidneys retain bicarbonate to neutralize it.

Kidney failure & erythropoietin

Kidney failure reduces erythropoietin, leading to lower red blood cell (RBC) and platelet counts.

Glomerular Filtration Rate (GFR)

GFR is a measure of kidney function; higher is better, ideally above 90.

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Kidney failure stages

Kidney failure stages (1-5) show increasing impairment, with stage 5 requiring dialysis or transplant.

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Filtrate composition

Filtrate in Bowman's capsule initially resembles plasma, but its composition progressively changes.

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Tubular reabsorption

Essential substances are reabsorbed from the filtrate back into the blood within the nephron.

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Dialysis access precautions

Avoid drawing blood, IVs, blood pressure checks, and tourniquets near dialysis fistulas.

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BPH (Benign Prostatic Hypertrophy)

An enlargement of the prostate gland, often causing difficulty urinating.

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Furosemide

Loop diuretic; it reduces fluid volume by increasing urine output, but it does not save potassium.

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Hypokalemia

Low potassium levels in the blood.

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Normal Potassium Levels

3.5-5.0 mEq/L.

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Thiazide Diuretics

Diuretics that reduce fluid volume, similar to loop diuretics but less potent, also not potassium-sparing

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Spironolactone

Potassium-sparing diuretic that can cause tumors.

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Pyelonephritis

Kidney infection affecting collecting ducts, renal parenchyma, and pelvis.

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Coronary Artery Disease (CAD)

Narrowing of the arteries supplying blood to the heart.

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Angina Pectoris

Chest pain due to reduced blood flow to the heart, goes away with rest or stopping exertion

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Shock

Medical emergency where organs aren't getting enough blood flow.

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Massive Hemorrhage

Severe bleeding requiring immediate intervention, often requiring blood transfusions.

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Universal Blood Donor

Blood type O negative (O-). It can be transfused to any blood type in an emergency.

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Universal Blood Receiver

Blood type AB positive (AB+). It can receive blood from any type.

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Kidney damage (Pre-renal)

Kidney damage caused by reduced blood flow to the kidneys.

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GFR

Glomerular Filtration Rate. A measure of how well the kidneys filter blood; a high number means healthy function.

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Stable Angina

Chest pain that subsides with rest and is triggered by exertion.

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Troponin

A protein released into the blood after a heart attack.

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Myocardial Infarction (MI)

A heart attack; blockage of blood flow to the heart, causing cell damage.

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Thrombolytic

Medication to break up blood clots.

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Loop Diuretics

Drugs that increase urine output by blocking the reabsorption of sodium and chloride in the kidneys; watch for electrolyte imbalance.

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Stable Angina

Predictable chest pain, often triggered by exertion, resolving with rest or stopping the activity, managed with beta-blockers like atenolol.

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Unstable Angina

Sudden, unpredictable chest pain that does not resolve with rest. Serious and requires urgent medical attention, treated with sublingual Nitroglycerin.

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STEMI

A severe heart attack requiring prompt treatment with MONA (Morphine, Oxygen, Nitroglycerin, Aspirin).

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Blood Administration

Procedure requiring priming with normal saline solution, double-checking ABO/RH compatibility, and monitoring vital signs throughout for adverse reactions

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Norepinephrine/Vasopressin in Shock

Hormones used to treat shock by constricting blood vessels to maintain adequate blood pressure. This is often a part of the treatment for Hypovolemic Shock (low blood volume).

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Angina Types

Angina is categorized as stable (predictable) or unstable (unpredictable) or Prinzmetal (coronary artery spasms).

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Nitroglycerin MOA

Nitroglycerin (Nitro) dilates both veins and arteries, significantly and rapidly.

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Nitroglycerin Precautions

Administer Nitro up to every 5 minutes, maximum 3 doses, screen for concomitant use of ED meds.,antihypertensives and/or alcohol.

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Beta-blocker MOA

Beta-blockers decrease heart rate and contractility by influencing the sympathetic nervous system.

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Beta-blocker use in angina

Beta-blockers are often used to prevent stable angina, but not for vasospastic angina.

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Calcium Channel Blocker MOA

Calcium channel blockers relax smooth muscles, dilate coronary arteries and treat atrial dysrhythmias.

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Unstable Angina/MI Differentiation

Unstable angina and a possible MI are differentiated based on Troponin 1 and/or T levels, if increased, confirms a MI. If not, it is Unstable, and MONA is the treatment.

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Anemia Classification

Anemia can be categorized as macrocytic (large cells), microcytic (small cells), or normocytic (normal cells) based on RBC morphology.

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Pernicious Anemia Cause

Pernicious anemia arises from the body's inability to absorb vitamin B12 due to a lack of intrinsic factor, often associated with stomach surgeries.

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Iron Deficiency Anemia Cause

Iron deficiency anaemia is frequently linked to blood loss (GI bleeds, menstruation, pregnancy), inadequate iron intake and absorption.

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Diuretic effect

Diuretics primarily affect sodium and potassium electrolytes.

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Acidic urine compensation

Kidneys hold bicarbonate to neutralize overly acidic urine.

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Kidney failure & RBCs

Kidney failure reduces erythropoietin, impacting red blood cell and platelet production.

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GFR & Kidney health

Glomerular Filtration Rate (GFR) measures kidney function; a higher number (above 90) is ideal.

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Fistula precautions

Avoid drawing blood, IVs, blood pressure checks, and tourniquets near dialysis fistulas.

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Acute kidney recovery

Acute kidney disease or injury can sometimes be reversed.

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BPH

Enlarged prostate causing urination difficulty.

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Furosemide

Loop diuretic. Increases urine output, but LOSES potassium.

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Hypokalemia

Low potassium levels.

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Normal Potassium

3.5-5.0 mEq/L.

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Pyelonephritis

Kidney infection in collecting ducts, renal tissue, & pelvis.

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Coronary Artery Disease

Narrowing of coronary arteries.

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Angina Pectoris

Chest pain from reduced blood flow. Stops with rest.

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Shock

Medical emergency; organs don't get enough blood.

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Stable Angina

Predictable chest pain triggered by exertion, relieved by rest.

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Unstable Angina

Sudden, unpredictable chest pain not relieved by rest, serious, urgent care needed.

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Prinzmetal Angina

Angina caused by coronary artery spasms, cyclical pain.

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Nitroglycerin MOA

Dilates both veins and arteries, rapidly.

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Beta-blocker MOA

Slows heart rate and reduces contractility, affecting sympathetic nervous system.

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Troponin levels and MI

Elevated Troponin levels indicate a heart attack (MI).

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Massive Hemorrhage

Severe bleeding requiring immediate intervention, often needing blood transfusions.

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Universal Donor

Blood type O negative (O-). Can be transfused to anyone.

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Universal Receiver

Blood type AB positive (AB+). Can receive from any blood type.

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Pre-renal Kidney Damage

Kidney damage caused by reduced blood flow to the kidneys.

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GFR (Glomerular Filtration Rate)

A measure of kidney function; higher is better, ideally above 90.

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Stable Angina

Chest pain triggered by exertion, subsides with rest.

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Troponin

Protein released into blood after a heart attack.

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Myocardial Infarction (MI)

Heart attack; blockage of blood flow results in cell damage.

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Thrombolytic

Medications that dissolve blood clots.

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Loop Diuretics

Drugs increasing urine output by blocking sodium and chloride reabsorption.

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