52B Exam II (all)

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charparker4
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52B Exam II (all)
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2010-05-21 02:48:05
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52B Exam II (all)
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  1. Define stomatitis
    Painful, ulcerations in mouth, that can last 5-7 days, can fully heal in 2 weeks.
  2. Oncology
    Cancer
  3. What are the 2 types of stomatitis?
    Primary stomatitis- most common apthos (non-infectious), caused by herpies simplex/trauma

    Secondary stomatitis- Infection from oppertunistic organsms or drugs suck as chemo.
  4. List the causes of stomatitis?
    • Chemo/Radiation - cause quickly replicating cells not to form
    • Immunosuppression
    • Virus
    • Allergey
    • Decrease nutrition
  5. What are s/s of stomatitis?
    Painfull sore, 2-5mm, yellow w/ white base
  6. Give another name for thrush.
    Candidiasis
  7. What is thrush?
    A yeast like fungal infection of the mouth.
  8. Causes of thrush.
    • Antibiotics lead to super infection.
    • Decrease immune status from cancer/ cancer treatments, corticosteriods, hiv, rundown body
  9. S/S of thrush
    • Hot dry patches, cottage cheese like
    • red when scraped
    • can extrend all the way down the esophagus.
  10. How do you diagnose thrush
    c/s of lesions
  11. how do you treat thrush
    • Rinses of NaBicarb, H2O2, lidocane, TNHC rinse(aka stanford rinse)
    • analgesics(opiate/nonopiate)
    • Cold food/drink
    • antibiotics etc.
  12. gastroesophageal reflex desease is also known as
    GERD/ acid reflux
  13. What leads to Berrett's esophagus
    GERD
  14. List causes of GERD
    • Anything that delays gastric emptying, or increases gastric pressure
    • age
    • ng tube
    • decrease in pressure of lower esophageal sphincter(estrogen/progesterone, calcium channel blockers, nitroglycerine, theophyline, diazepan, beta blockers)
    • hiatal hernia
  15. what do theophyline, diazepan and beta blockers do?
    it is an antihypertensive, but also decreamses pressure of LES, and increases GERD.
  16. What are s/s of GERD
    • Dysphagia(difficulty swallowing)
    • Odynophasia(Painful swallowing)
    • Pyrosis(heart burn)
    • regurgitation
    • chest pain
    • coughing/wheezing at night
  17. How do you diagnose GERD?
    • Upper GI series(Xray w/ Barrium Swallow)
    • 24hr PH monitoring
    • Endoscope(concisious sedation) **
  18. How do you treat GERD?
    • Antacids- 1hr ac/2-3hr pc and hs
    • Histamine 2 blockers- decrease stomach acid
    • Antiemetic and prokinetic or promotility agents - Shorterm use due to sideffects, tighten LES and increase gastric emptying
    • Proton pump inhibiters(PPI)- blocks secretion of H+ from perital cells
  19. What is Berrett's esophagus
    Squamous cells change to collumnar in lower esophagus from acid exsposure(increase cancer risk)
  20. What is the most common type of hiatal hernia
    Sliding
  21. Fundoplication
    Suturing of fundus 360 degrees around the esophagus
  22. What is another name for fundoplication
    Laproscopic nissen fundoplication
  23. What is another name for Rolling Hiatal Hernia
    Paraesophogeal Hernia
  24. Volvolus is
    Twisting
  25. What are causes of acute gastritis
    Radiation therapy/ drugs (alchohol, NSAID's, ASA, Corticosteriods, Bacterial endotoxins, Corosive Substances)
  26. What are the causes of chronic gastritis
    • A- Autoimmune
    • B- H.Pylori
    • Atropic - after exsposure to toxic substances
  27. What is EGD?
    Esophagogastrodoudenocopy**
  28. Where is gastrin secreted?
    The "G" cells in the antrum
  29. Contrast gastric ulcer conditions to duodenal ulcer conditions
    Gastric Ulcer Conditions- Normal acid secretion / delayed stomach emptying / increased acid diffusion

    Duodenal Ulcer Conditions- Increased acid secretion / Increased stomach Emptying / Normal Acid diffusion
  30. What is Urease and how is it secreted?
    Urease is an enzyme the neutralizes acid in the stomach. Secreted by H pylori
  31. How do we diagnose PUD
    • ALYSA test (Blood test) - detects antibodies to H pylori
    • Breath test - Increased carbon from H pylore breaking down urea
    • Tissue Test** - Biopsy by EGD
  32. What is Misoprostol
    (sytotec) Synthetic Prostaglandin - take with food may cause cramping
  33. What is Sucrafate
    Mucosal barrier fortifier
  34. What is the most effective treatment for H pylori
    Antibiotics(tetracycline/amoxicillin) w/bismuth salts(Bismuth subsalicylate) and Flagyl (mytronidazole - an amebacide)

    PPI
  35. What is a Vagotomy
    Sniping the vagas nerve - will increase motility and secretion
  36. Atresia
    Failure to form a continious pathway
  37. Fistula
    Abnormal Connection between passageways
  38. Ascites
    Fluid in Abdomin
  39. What is another name for celiac disease?
    Gluten Sensitive enteropathy
  40. Whats another name for Hirchsprungs Disease
    Aganglionic Colon/ pseudo obstruction
  41. What is metal Retardation?
    Decreased Intelectual skills
  42. What are the 2 pervasive development disorders?
    Autistic Disorder - Impaired communication, imagination, responsiveness, intrest

    Asperger's disorder - similar to autisim w/ later onset and decreased symptons.
  43. How does anxiety disorder differ in children
    Mostly seperation anxiety
  44. What are the types of disruptive behavior disorders
    oppositional defiant disorder - hostile behavior w/o violating others rights

    conduct disorder - consitant violation of others rights, with out remorse
  45. What is Urolithiasis
    Kidney Stones
  46. What are the 4 type of stones and their prevention?
    Calcium Oxalate/ phosphate(most common) - Avoid oxalate foods such as darkgreen foods, coco, wheat, picans, okra, peanuts/decrease calcium intake if calcium phosphate stone

    Struvite(bacteria formed, consists of magnesim, amonium, phosphate, incarbinate) - Check for UTI/admin antibiotics, limit phosphate(dairy, redmeat, whole grain)

    Uric acid - Allopurinol, potasium citrate, sodium bicarb, decrease purine(poultry, fish, redwine)

    Cystine - alkalize urine, increased hydration, ace inhibiters, decrease animal protien
  47. What is the diffrence between nephrotic syndrome and glomerulonephritis
    Glomerulonephritis - has hematuria, no hyperlipidemia, High BP, does not respond to corticosteriods

    Nephrotic syndrome - no hematuria, hyperlipademia, normal or low bp, treat with corticosteriods
  48. What is the value of osmolarity
    285-295
  49. Normal range for glucose
    70-100
  50. normal value for BUN
    10-20
  51. Normal value for NA
    135-145
  52. Normal value for K+
    3.5-5
  53. Normal value for Ca
    8.5-10.5
  54. normal value for HCO3-
    22-26
  55. Normal value for Cl
    95-105
  56. Normal value for Cr
    0.5-1
  57. Formula for plasma osmolarity
    POSM = (Na x2) + Glucose/18 + BUN/2.8
  58. When is aldosterone released and what does it do
    when there is decrease kidney flow. it causes decreased Na loss and increased K+ loss
  59. Cause of isotonic fluid deficit
    Hemorage, Diaphoresis, GI fluid loss
  60. Thirst shows what % fluid loss
    1% - 2%
  61. Osmotic Diuresis
    Due to increased concentration of salutes such as urea or glucose, increase osmotic pull to kidneys
  62. Hydrostatic Pressure
    The pushing force
  63. Oncotic pressure
    The pulling force
  64. What happens if Na levels are between 120-123
    Nausia and malaise
  65. What happens if Na levels are between 115-120
    Headache, Lethergy, obtundation(inability to talk right)
  66. What happens if Na level is less than 115
    Seizures/coma
  67. How should sodium levels be increased
    no more than 0.5/hr for a total of 12/day
  68. What is hydrochlorothiazide
    Thiazide diuretic that increases K+ and Na excretion
  69. Explain reflexes in hyponatremia and hypernatremia
    Hyponatremia - hypo reflexes

    hypernatremia - hyper reflexes
  70. What is SALT
    • S/s of Hypernatremia
    • S- skin flushed
    • A- agitation
    • L- Low grade fever
    • T- Thirst
  71. Where is K+ most prevalent
    ICF
  72. How does metabolic alkalosis lead to hypokalemia
    H+ switch with K+ inside the cell to keep it electrically neutral and takes K+ out of the vascular system
  73. Why do you watch Dig levels with hypokalemia
    There is more space for Dig to bind with Na/K+ pumps so normal doses can be toxic
  74. What is high in K+
    Instant coffee and salt substitutes
  75. What is the only way for K+ to be elimimated
    by the kidneys so monitor kidney function
  76. Explain muscular excitability in hyperkalemia and hypokalemia
    Hyperkalemia - hyper excitability

    Hypokalemia - hypo excitability
  77. What is lasix
    K+ waisting diuretic
  78. what is Kayexalate
    (sodium polystyrene) exchanges Na for K+ in intestine, used when K+ is >6
  79. What does dextrose with insulin do
    Puts K+ in to cells
  80. Explain where calcium is
    99% in Bone, 1% in blood(of that 50% is bound to protien)
  81. How is Ca balance regulated
    • Parathyroid hormone - promotes transfer of Ca from bone to plasma and augments intestinal adsorbtion
    • Calcitonin(from thyroid gland) - transfers Ca from plasma to bone to lower Ca plasma levels
  82. How does hyperphosphatemia effect Ca
    Decrease in serum Ca
  83. What is troussus sign
    Corpal spasms from BP cuff
  84. What is Chvostek's sign
    Twitch of facial nerve
  85. How do you treat hypercalcimia
    • Large volumes of NS to dilute serum Ca and Increase excretion
    • Calcitonin, Pamidorante, Zoledronic acid - inhibits bone resorbtion(loss)

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