Genetics
Three friends with the same disease process, polydactyly, all have different forms of the disease. One has an extra finger, another has an extra toe, and another has two extra toes. What's another word to describe this disease presentation?
What is expressivity
Which patient(s) would you recommend a referral to a burn unit?
a. A child with chemical burns on both arms.
b. a 21 year old with suburns covering most of his body.
c. a patient with complicated lung injury following the inhalation of chemical smoke
d. A patient with third degree burns following an electrical fire
a. A child with chemical burns on both arms.
c. a patient with complicated lung injury following the inhalation of chemical smoke
d. A patient with third degree burns following an electrical fire
Molly is on a drug regimen following her recent cancer diagnosis. She can't remember the name of the drug, but was told that it will kill her cancer cells and is the largest anti-cancer drug class. She's curious if there are any potential side effects.
What medicine is she taking and what potential side effects should we make her aware of?
Cytotoxic drugs; this drug class works by killing cells of all types, specifically cancer, and can cause things like
Bone marrow suppression, stomatitis, alopecia, and reproductive toxicity
This common symptom of cancer is poorly understood and may be r/t decreased activity level, treatment, and poor nutrition.
Fatigue
Mark finds out he has stage two pancreatic cancer. Describe the typical findings of cancer in this stage.
Tumor of cm, at least one node of involvement, no metastasis
T2, N1, M0
This disease process is a result of cell division error also known as ________. Clinical manifestations include: small head, epicanthal folds, large, protruding tongue, and developmental delays.
Nondisjunction; what is down syndrome
Following a traumatic car incident that broke this patient's leg, she started complaining of paresthesia, exhibited pallor, dimished peripheral pulses, and exhibited a loss in peripheral reflexes. What do you suspect as being the cause?
NSAIDS can be used in management of RA, what type side effects do we need to be aware of when giving these to patients?
GI ulceration and bleeding may occurr, along with thrombotic events
I have an unlimited life span, am genetically unstable, lack the P53 gene, am unresponsive to appropriate cell regulation, and am poorly differentiated. What am I?
Neoplastic cells
Your patient is an 8-year-old male admitted to the ED for pain and swelling in the transverse tibial region. Following an x-ray, you discover a corner fracture. What must you rule out first? What is the second method of action?
Must first rule out osteogenesis imperfecta; next step would be to involve DSS because this could be a potential case of child abuse.
Disease caused by deletion of 4 mb pairs on the long arm of chromosome 15; inherited from the mother
What is Angelman Syndrome?
Your patient comes in from a really bad house fire. They are covered in burns that look mottled, pink, and have waxy white areas with blisters. They complain of pain 9/10 and are requesting interventions. What degree of burn would you classify this as?
Second-degree full-thickness; involves the entire epidermis and dermis.
Your patient has been complaining of nasuea, hot flashes, and "feeling bloated." Which medication do you suspect they are on and what is its method of action?
Tamoxifen; blocks estrogen receptors of breast cancer cells to prevent cell proliferation
This gene is considered the "master break" in cell division. Mutations of this gene allow cell division to proceed unchecked and the occurrence of neoplastic cells may begin.
RB gene
A male patient has sustained 3rd degree burns to the posterior right arm, anterior trunk, posterior left leg, and anterior head and neck. Using the Rule of Nines, caclulate the TBSA percentage that is burned
36%
For disorders resulting from nondisjunction, which parent is more likely to pass down the disorder?
The mother because her eggs increase in age as she does, which creates more room for genetic errors. The father is capable of creating new sperm each time. Hence why the occurrence of Down syndrome is more likely to occur from the mother.
A 75 year old male is admitted for chronic renal failure. You note that the patient has white/yellowish nodules on the helix of the ear and fingers. The patient reports they are not painful. As you document your nursing assessment findings, you will document this finding as?
A. Nodosa
B. Keloid
C. Dermoid
D. Tophi
D. Tophi
Tophi are white/yellowish nodules that are urate crystals. They start to form together in large masses and can be found under the skin (helix ears, elbows, fingers, toes etc.), joints, bursae, bones, which can lead to bone deformity and joint damage. Patients with chronic renal failure are at risk for chronic gout due to the kidney’s inability to remove uric acid remove the body.
This medicine takes around 3-6 weeks to work and can have major side effects such as bone marrow suppression, GI ulceration, hepatic fibrosis, and pneumonitis. Which medication do you suspect as the cause and what is it used for?
Methotrexate; used for RA
Proto-oncogene
Mallory has been a smoker for 18 years and also likes to binge drink on the weekends. She has fallen and broken her hip. DEXA scan reports <648 mg/cm and a bone histology shows a lack of structural integrity. Which disease process do you expect and what recommendations do you have?
Osteoporosis.
Stop smoking and drinking, increase vitamins D, C, and magnesium. Increase weightbearing activity
Hemophilia is an X-linked recessive disorder that impacts blood clotting. If a carrier woman and a hemophiliac man reproduce, what is the percent chance that they will have a child with hemophilia?
What is 50%?
This patient complains of morning stiffness last at least an hour, arthritis of the hands and three other joint areas, and exhibits swan neck deformities. Which disease process do you suspect?
Rheumatoid Arthritis
While taking this specific medicine, the patient first exhibited flu-like symptoms. As time progressed, they were admitted to the ED complaining of fatigue, nausea, edema, rapid weight gain, and pain. What type of medication do you suspect as being the cause?
Mark has shown a dramatic decrease in his intake since the beginning of his cancer treatment. He states that food tastes different, is too nasueous to eat, or sometimes feels "too tired" to eat. What is he at the greatest risk of?
Cachexia - malnutrition in cancer patients related to a hypermetabolic state and altered nutrient metabolism
Your patient presents with thin and short stature, bowed bones, abnormal dentition, and blue sclera. They were admitted to the ED because they are at a high risk for aortic aneurysm. What disease do you suspect?
Osteogenesis imperfecta