Bones
Patient comes call the clinic to report that their cast got wet this morning. What is your response?
May use hair dryer on cool setting
What can help prevent osteoporosis in 63 year old female?
Calcium and vitamin D supplements, walking. Avoid smoking, alcohol and caffeine
What are early signs of ICP?
Restlessness, lethargy, confusion, agitation, pupil changes, weakness in one extremity, headache
Post op child that had VP shunt placed 2 days ago. They have developed abdominal distention and fever. What do you expect?
Peritonitis
52 year old patient with ischemic CVA on CT scan, symptoms began 1 hour ago. What is your next action?
Get a through medical history, if no contraindication plan to administer TPA
Patient comes to the clinic and reports their cast is too tight. What is the priority?
Perform neurovascular check
What are examples of Bisphosphonates? What do they treat?
Fosamax, Boniva, Actonel, Prolia. Treats Osteoporosis
What are late signs of ICP?
Comatose, bradycardia, hypertension, widened pulse pressure, projective vomiting, posturing, Babinski reflex returns, loss of reflexes (papillary, corneal, gag)
Patient complains of headache 1 week after concussion. What is your response?
Post concussion syndrome can last for weeks to months
Patient admitted with meningitis, nasal culture shows Hemophilus influenzae. What type of meningitis does the patient have and how is it treated?
Bacterial meningitis, treated with antibiotics. Commonly used - Rocephin, Vancomycin.
You walk into a patient room and find traction weights resting on the floor. What is your action?
Reposition patient so weight are no longer on the floor.
What autoimmune disease do see Boutonniere deformity of thumb and swan neck deformity of fingers with ?
Rheumatoid arthritis
What is Cushing's Triad?
Increase SBP, decreased pulse, decreased respirations. It is opposite of shock!
Patient comes to the ER with a closed head injury. You notice flexion of the arm and wrist, along with plantar flexion of the feet. What type of posturing is this?
Decorticate
Not good!
Patient comes in with fever, vomiting, rash, headache and lethargy. When the patients neck is bent forward, the hips and knees flex. What is this called and what illness is it associated with?
Brudzinski Sign, seen in meningitis.
2 year old child admitted with femur fracture, why kind of traction do you expect?
Bryant's traction - used in children under 3 years old
Methotrexate, Plaquenil. Treats rheumatoid arthritis, these drugs affect the immune system response
Early sign of ICP in infants/small child?
Changes in feeding, distended scalp veins, tense bulging fontanels, increase irritability, cranial suture separation.
Check head circumference!
Patient comes to the ER with complaints of weakness of the left arm and difficulty speaking. CT and MRI of the head is negative. What is your next action?
Reassess patient for improvement. Explain this is likely due to TIA and symptoms should resolve within 24 hours. They will likely need further workup such as carotid duplex to assess for blockages, make sure EKG was done to check for Atrial fibrillation
What is the most common cause of autonomic hyperreflexia?
Distended bladder
Upon assessing your patient, you notice calf tenderness and swelling of the fractured extremity. What is this sign?
Homan's sign
You assess your patient and notice Heberden's nodes on the fingers. You expect this with what disease process?
Osteoarthritis
How does Mannitol decrease ICP?
Osmosis
Hemiparesis left upper and lower extremity
Newborn infant with visible spinal defect that contains meninges and spinal fluids. What is this called?