Cardiovascular
Patho: dilated superficial bulging veins from weakness of vein walls or valves
Causes: obesity, standing for long time, crossing legs
Treatment: elevate legs, compression socks, avoid standing long periods, lose weight, avoid crossing legs
Varicose Veins
Patho: lack of antidiuretic hormone either neurogenic or nephrogenic
S/S: massive urine output, dehydration, hypotension, hypernatremia, altered mental status
Treatment: fluid replacement, replace ADH or repair kidneys
Diabetes Insipidus
Patho: lack of vitamin B12 due to a lack of intrinsic factor
S/S: slow development, pallor, fatigue, weakness, dyspnea, dizziness, lethargy, tachypnea, tachycardia
Diagnosis: Schilling test, blood test
Treatment: replace vitamin B12 lifetime
Pernicious Anemia
Patho: break all the way through bone and protruding through skin
S/S: swelling, bruising, tenderness, deformity
Diagnosis: x-ray
Treatment: immobilization, closed reduction, surgery
Complete Open Fracture
S/S: poor skin turgor, thirst, oliguria, rapid/thready pulse, altered mental status
Treatment: Levofed
Hypovolemic Shock
Patho: autoimmune increased release of thyroid hormone
S/S: tachycardia, increased body temp, sweating, soft hair and skin, reduced BMI, insomnia, hyperactivity, exophthalmos
Treatment: surgery to remove thyroid or control of TH
Hyperthyroidism (Graves' Disease)
Patho: something is attacking and killing red blood cells
S/S: classic anemia signs + jaundice
Diagnosis: CBC, H&H
Treatment: treat cause, give RBCs
Hemolytic Anemia
Patho: injury to ligament (bone to bone)
S/S: pain, swelling, nutrition, decreased ROM
Diagnosis: H&P, S/S, x-ray
Treatment: protect, rest, ice, compression, elevate, surgery
Sprain
Patho: failure of cardiac valve to open completely which prevents emptying and increases afterload
S/S: adventitious heart sounds, hypertrophy of chamber above valve
Diagnosis: echocardiogram
Treatment: vasodilators, replace valve
Valvular Stenosis
Patho: too much PTH usually from a tumor
S/S: hypercalcemia, osteoporosis, kidney stones, forceful cardiac contractions
Treatment: remove tumor or whole gland
Hyperparathyroidism
Patho: benign, acute, self-limiting infection of B-lymphocytes usually caused by EBV and transmitted through saliva
S/S: flu-like symptoms, fatigue, sore throat, cervical lymph node involvement, lymphadenopathy, splenomegaly
Diagnosis: blood tests that look for atypical T-lymphocytes, CBC
Treatment: self-limiting, lasts several weeks, supportive therapy, fluid
Mononucleosis
Patho: decreased bone mineral density, bone reabsorbed faster than new bone is made, increased osteoclasts
S/S: none except pathologic fracture from porous bones, kyphosis
Diagnosis: x-rays, bone density scans/tests
Treatment: meds to decrease bone reabsorption, fall prevention, moderate weight bearing exercise
Osteoporosis
Patho: autoimmune disease leading permanent occlusion of small arteries in hands and feet, associated with smoking
S/S: browning and thinning of skin that leads to necrosis, cyanosis
Treatment: amputations, vasodilators
Buerger Disease (Thromboangitis obliterans)
Patho: excess growth hormone in adults
S/S: bones become broader and heavier since growth plates are closed, enlarged hands and feet, changes in facial features
Treatment: remove tumor since benign adenoma tumor is usually cause
Acromegaly
Patho: acquired unregulated release of thrombin leading to increased clots, platelets then get used up and we bleed
S/S: bleeding from venipunctures, eyes, nose, gums, injections, hemorrhaging from uterus, hematuria, GI; clotting leads to strokes, heart attacks, PE, DVT, arterial occlusions
Diagnosis: low platelets, increased PT/PTT, positive D-dimer, H&P
Treatment: difficult, treat cause, control clots, maintain organ function, stop bleeding
Disseminated Intravascular Coagulation (DIC)
Patho: increased pressure in fascia leading to damaged nerves and decreased blood flow
S/S: pallor, paresthesia, paralysis, pain, pressure, pulselessness, paresis
Diagnosis: measure pressure in muscle
Treatment: fix cause, remove cast, fasciotomy, fluid replacement
Compartment Syndrome
Patho: vasospasm in small arteries or arterioles in fingers from cold, vibration, or emotional stress
S/S: pallor, cyanosis, rusty color when trigger removed, pain
Treatment: remove trigger
Raynaud Phenomenon
Patho: more common in type 2 DM in response to excess stress
S/S: hyperglycemia, hyperosmolarity, absence of ketoacidosis, depression of sensorium, neuro deficits, muscle weakness, dysphasia, abnormal reflexes
Treatment: fluids, temporary insulin, electrolyte management
Hyperosmolar Hyperglycemic NonKetotic Syndrome (HHS)
Patho: too many myeloblasts cause aggressive and fast growing leukocytes in blood stream more commonly in adults
S/S: sudden onset, fast progression, spreads quickly, high morbidity/mortality, anemia, bleeding, infection, weight loss, bone pain, splenomegaly, hepatomegaly, neuro conditions
Diagnosis: bone marrow biopsy
Treatment: chemo, radiation, stem cell transplant, symptom management
Acute Myelogenous Leukemia (AML)
Patho: rapid breakdown of muscle from really sudden exercise, trauma, bacteria, toxins, or drugs
S/S: muscle pain, systemic weakness, extremely dark urine (from myoglobin release), cardiac dysrhythmias (from potassium)
Diagnosis: CK/CKMB (for muscle breakdown), H&P
Treatment: remove stimuli/trigger, fluid resuscitation
Rhabdomyolysis