Exam 1
Your patient is presenting with a hypoosmolar plasma space. What is the best treatment plan?
hypertonic solution
There are many different levels of precaution including standard, contact, droplet, and airborne. What are the different reasons a patient would be on contact precaution?
DOUBLE: What are the 3 requirements for this precaution?
MRSA, diarrhea, stool incontinence, draining wounds, or sores.
** Mask, gown, and gloves
Hypertension is defined as a blood pressure over 130/80.
What are the 3 main possible causes?
1. atherosclerosis
2. overdrive of the SNS
3. overdrive of the RAAS system
Osteoporosis is often seen in people with ______________, _______________, and _______________.
DOUBLE:
Some of the different signs and symptoms of hypocalcemia include: (3)
1. longer-term hypocalcemia problems (CKD)
2. PTH over secretion or calcitonin under secretion
3. aging in men and hormonal (estrogen) changes in women
DOUBLE:
S&S: tetany, muscle spasms, and positive Chvostek's
What are the treatment methods for both of these:
Type 1 DM
Type 2 DM
DM 1 - insulin
DM2 - diet, WL, various combinations of medications, and SOMETIMES insulin
Lack of vitamin B1 due to alcohol overuse is known as ___________________ (A type of beriberi).
Expected S&S include:
1.
2.
3.
4.
Lack of vitamin B1 due to alcohol overuse is known as Wernicke Korsakoff Syndrome (A type of beriberi).
Expected S&S include:
1. problems with memory
2. ataxia
3. nystagmus
4. paresthesia
Malaise, aches, pain, fever, leukocytosis, and elevated CRP are all indicators of what response?
systemic
Read this patient stats and find a diagnosis:
- pH: 7.52, HCO3: 26, and PCO2:58
- notes a weight loss of 50 pounds in 4 months
- presented with a barrel chest
- requires the bent overposition to breath
- smoker of 20 year
Emphysema
A 19 year-old male is presenting in the ED with hallucinations, tachycardia, increase appetite yet no weight gain, and psychosis. What is most likely his diagnosis and what if not treated, what could this turn into?
Grave's disease
IF NOT TREATED: thyrotoxicosis (thyroid storm)
Read this patient chart and predict a diagnosis:
- 46 year old female
- weight: 250 lbs | height: 5' 2"
- elevated AST, ALT, and ALP
- biliary colic to the RUQ that radiates to the right shoulder
cholelithiasis that has lead to cholecystitis
FVO - fluid volume overload
There are 3 different types of anemia all of which require different treatments. Name them all, including the treatment that corresponds and MCV.
Each correct one is 300 points (MAX 3 times).
1. Macrocytic = high MCV; tx: injection of B12
2. Normocytic = normal MCV; tx: erythropoietin injection
3. Microcytic = low MCV; tx: iron supplements
A patient comes in with a previous diagnosis of SIADH and a history of smoking. In your assessment, you note that the patient has jugular venous distention, hepatic congestion, ascites, cor pulmonale, and peripheral edema. What is likely the problem?
DOUBLE POINTS: explain the bold word
right-sided heart failure
Cor pulmonale: a condition that occurs when the right side of the heart fails due to high blood pressure in the lungs.
An older, gentleman has come into the ER complaining that he has urinary urgency but is unable to keep a consistent stream. You ask how long this has been happening, and he states, "I think it has been getting worse in the past few weeks/months. My memory isn't as good as it used to be." You do a further assessment and notice he most likely has a post-renal AKI. What would be the cause of this AKI?
DOUBLE POINTS: What is the pathologic problem that a post-renal AKI can result in?
Benign Prostatic Hyperplasia
***hydronephrosis
A patient has come into the ER presenting with blurred vision, has a history of a stroke, and a current diagnosis of PAD. Their glucose level is 110 and have a A1C of 8.3%.
What is most likely the cause?
EITHER type of DM
hypokalemia, hyponatremia, and hypercalcemia combined are presented with what S&S?
DOUBLE POINTS: What polarization is this?
sluggishness, weakness, mental slowness, confusion, bradycardia
**hyperpolarization
A 9-year-old boy comes into the ER presenting with itching, nausea, vomiting, angioedema, and his blood pressure dropped. His mother states that he was just stung by a bee for the 2nd time. While you are getting a history, the boy's throat starts closing up. What is he experiencing and what are the treatment options?
anaphylaxis
TREATMENT: antihistamines, steroids, and leukotriene inhibitors
An 87-year-old patient who has been recovering from a hip arthroplasty (replacement) and has been unable to ambulate for the past few weeks. What is something the patient is at a high risk for?
**DOUBLE POINTS: what are the 2 main components of this risk?
pneumonia
**atelectasis and consolidation
A 68-year-old male presents to the emergency department with a sudden onset of severe headache, dizziness, and difficulty speaking. His wife reports that he was watching TV when he suddenly complained of a "worst headache of his life" and then became confused. On arrival, he is found to be disoriented and has slurred speech. His blood pressure is 180/95 mmHg, and his heart rate is 88 bpm. Neurological examination reveals left-sided weakness, including facial droop and weakness in his left arm and leg. What is most likely his diagnosis?
hemorrhagic stroke
A patient is presenting with iritis, vasculitis, and hematochezia diarrhea and has explained this doesn't happen all the time. What are they most likely going to see with a colonoscopy?
patchy areas of inflammation
(TRANSMURAL - Crohn's)
hyperosmolar plasma space
high osmotic pressure
low blood pressure
high heart rate
A patient is rushed into the ER experiencing rebound tenderness and is noted to have an altered mental status. After getting vital signs and labs you note that the patient's HR is 110, RR is 24, and a WBC of 12,000. You check their temperature and it comes back at 101 degrees F. What is most likely happening?
DOUBLE: What was the initial cause?
sepsis due to infection of the appendix and SIRS due to over active inflammation
**Appendicitis
Your patient is post-op of a lobectomy but has been complaining of SOB, sudden chest pain, and weirdly presenting with hemoptysis. The patient has a history of DVT and has been using compression stockings in hopes of preventing further issues. Not mentioned in the chart was the patient's new diagnosis of atrial fibrillation. What could the patient be experiencing, and what is the pathophysiology behind this?
Pulmonary Embolism
- Due to blood pooling in the right atrium causing a clot to form. When the atrium pumps the blood out, the clot gets pushed into the lung.
A 72-year-old female presents to the emergency department with sudden-onset weakness on her left side and difficulty speaking. Her husband reports that she was preparing breakfast when she suddenly became quiet and seemed confused. Upon examination, the patient is unable to move her left arm or leg and has difficulty speaking. She can still understand simple commands but struggles to form sentences. She is alert but disoriented to time. Her blood pressure is 170/88 mmHg, and her heart rate is 88 bpm. Neurological examination reveals left-sided hemiparesis and expressive aphasia, with no signs of sensory loss. What is most likely happening here?
DOUBLE: what is the goal of treatment?
hemispheric stroke
TX: restore blood flow to the brain as fast as possible
A Rh-negative mother just gave birth to an Rh-positive fetus 5 minutes ago, they notice the baby has a light yellow color.
What is the treatment for this?
DOUBLE: What is the name of this problem?
TRIPLE: Tell me what the mother-baby condition is called and how we treat this.
1. UV light therapy
2. prehepatic jaundice
3. erythroblastosis fetalis
(Rhogam shot after 1st pregnancy)