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Manifestations of Down Syndrome

Trisomy 21; flat facial features, small square head, small nose, upward slanting eyes, neck fat pad, short stature, low birth weight, mental retardation

What is ischemia?

an inadequate blood supply to an organ or part of the body

manifestations of hyponatremia

diaphoresis, stupor, coma, polyuria, tachycardia, hypotension, decreased skin turgor

manifestations of hypernatremia

CNS irritability, tingling, anger, hypertension, retaining water, cannot urinate out water, renal failure

Manifestations of hypokalemia

mental changes, hyperreflexia, dilute urine, metabolic alkalosis, thirst, paralytic ileus. CARDIAC

Manifestations of hyperkalemia

depressed cardiac conduction, prolonged PR interval, tall t wave, wide QRA, muscle cramping, parathesia, nausea, diarrhea, metabolic acidosis. CARDIAC

manifestations of hypomagnesemia

diarrhea, hyperactive DTR, personality changes, cardiac dysrhythmias

manifestations of hypermagnesemia

bradycardia, hypotension, lethargy

manifestations of hypercalcemia

immobility, vitamin D overdose, decreased neuromuscular excitablity, progresses to stupor and coma, decreased cardiac output, arrhythmias

manifestations of hypocalcemia

thyroidectomy, neuromuscular excitability, muscle cramps, seizures, tetany, laryngospasm, asphyxiation, death

Hypothyroidism

fatigue, weakness, cold intolerance, weight gain, anemia, decreased RBC, decrease appetite. DRY SKIN

Primary prevention

removing risk factor so disease does not occur (immunizations)

Secondary Prevention

Detecting disease when still curable (pap smears)

Tertiary prevention \***

Prventing further deterioration or reducing complications of disease (antibiotic use)

Normal Potassium levels

3.5-5.0 mEq/L

Normal Sodium Levels

135-145 mEq/L

Normal magnesium levels

1.7-2.2 mg/dL

normal calcium levels

8.5-10.2 mg/dL

normal phosphate levels

2.8-4.5 mg/dL

ABG Values

NORMAL VALUES
pH \= 7.35 - 7.45
pCO2 \= 45-35
HCO-3 \= 22-26

RAA system activation

activates based on volume

respiratory acidosis

low pH, high CO2; irritability, blurrd vision, psychological change; treat with ventilator; impaired ventilation causes R.A.

respiratory alkalosis

high pH, low CO2; caused by hyperventilation, light headedness, numbness and tingling of extremities, tinnitus, palpitations, blurred vision, chest tightness

metabolic acidosis

mental confusion, tetany, carpopedal spasm (trousseau); increase ventilation to decrease CO2 levels, causes a decrease in acidity (increasing pH)

metabolic alkalosis

losing acid from the stomach from vomiting, gastric suctioning, removing something from the GI tract

Manifestations of multiple myeloma

malignant tumor of the bone marrow cells - bone pain. pathological fractures

manifestations of nonhogkins

swollen painless lymph inflammation, high temp, night sweats, weight loss

thrombocytopenia

low platelet count - bruising and bleeding easily

left shift in lab values

high number of young immature WBC present -\> acute infection of inflammation

hypovolemic shock

shock resulting from blood or fluid loss; thirst, cool and clammy skin, oliguria, changes in mentation, tachycardia, peripheral vasodilation

cardiogenic shock

Shock caused by inadequate function of the heart, or pump failure. blue or purple lips, cyanosis, urine output decreases,

right side heart failure\***

Presents throughout the whole body, peripheral edema. hepatosplenomegaly

left sided heart failure\***

presents in the lungs, won't breathe well, loss of O2, confusion

Ejection Fraction

AMOUNT OF BLOOD PUMPED OUT BY THE LEFT VENTRICLE
Normal: 50-70%
40 and below is heart failure

Manifestations of tension pneumothorax

lung collapses due to blunt trauma; tracheal deviation to unaffected side, cyanosis. absent breathe sounds

Latent TB

encapsulated granulomas lesion on x-ray; cannot be passed on

Tumor Staging

TNM; T for tumor, N for lymph node involvement, M for metastatic.
T1, T2, T3, T4 describe tumor size; N0, N1, N2, N3 describe lymph node involvement; M0 OR M1 is the absence or presence of metastasis

Diabetes type 1

No insulin is produced. Either born with it or developed at a young age. Destruction of the pancreatic beta cells. Autoimmune. Give insulin.

Diabetes Type 2

adult onset diabetes, noninsulin dependent, body produces insulin but not enough, can be controlled by diet. Obesity, insulin resistance

A1C hemoglobin test

test that looks for the lifespan of RBC - want to see under 6%

Why do diabetics not heal well?

microvascular problems and macrovascular problems, circulation issues -\> eye problems, poor healing. nerve problems, kidney problems

receptive aphasia

inability to understand spoken or written words

Manifestations of nephrotic syndrome

not getting rid of fluid (edema), massive proteinuria and lipiduria

Chronic renal failure lab values

BUN: 8.0-12.0 mg/dL
Creatinine: 0.6-1.2 mg/dL
GFR: 90-120 ml/min

Why does anemia happen with chronic renal failure?

not getting eurethrapoesis

S/S of ovarian cancer

SILENT, PAIN, ABDOMINAL ENLARGEMENT, DYSPEPSIA, VOMITING, CHANGE IN BOWEL HABITS, FEEL FULL

Why is ovarian cancer not caught early?

symptoms are so vague so women dont feel like there is anything wrong, dont go see the doctor

Early manifestations of breast cancer (women)

painless lump, palpable axillary nodes, dimpling of tissue, orange peel skin, bone pain with metastasis

Manifestations of Leiomyoma

cramping, bleeding, pressure on nearby organs, ischemic pain, abdominal heaviness - goes away with menopause, Benign tumor

Manifestations of testicular cancer

enlargement of testes, ache in abdomen, scrotal heaviness

varicocele

enlarged, dilated veins in scrotum - see in left side when standing

STI that causes cervical cancer

HPV

Stages of Syphilis

PRIMARY - CHANCRE AT SITE OF EXPOSURE 3 WEEKS AFTER EXPOSURE - HIGHLY CONTAGIOUS

SECONDARY - LASTS 1 WEEK TO 6 MONTHS - RASH ESPECIALLY ON PALMS AND SOLES, FEVER, SORE THROAT, STOMATITIS, NAUSEA, ANOREXIA, INFLAMED EYE LASTING OFF AND ON FOR 3 TO 6 MONTHS

TERTIARY -IF UNTREATED MAY IN 20 YEARS MAY HAVE GUMMAS (LESIONS), CV OR CNS LESIONS

LATENT PERIOD - MAY LAST LIFE TIME - INFECTIVE FOR FIRST 1 TO 2 YEARS

S/S of chlamydia in men

URETHRITIS, URETHRAL DISCHARGE, ERYTHEMA OF MEATUS, ITCHING

S/S of chlamydia in women

NONPURULENT CERVICAL DISCHARGE

Hepatic encephalopathy

the buildup of ammonia in the body due to the liver not clearing the ammonia, happens with cirrhosis. portal HTN

subluxation

partial dislocation of a joint

Green stick fracture

incomplete fracture - kids only, folds doesnt break all the way

commuted fracture

when the bone is splintered or crushed

compound fracture

bone breaks through the skin

Osteoporosis

A condition in which the body's bones become weak and break easily. osteopenia first

Manifestations of Osteoarthritis

Pain, stiffness, enlargement of the joint, tenderness, limited motion, and deformity, redness

Manifestations of gout arthritis

uric acid crystals lodged in the big toes, very red adn painful, need to avoid meats, bacon

What is the difference between a sprain and a strain?

A sprain is an injury to the ligaments and capsule at a joint in the body. A strain is an injury to muscles or tendons

Intracranial Pressure normals

7-15 mmhg

S/S of increased cranial pressure

Decreased responsiveness, LOC, Severe headache, Vomiting, Vital sign changes( increased BP with decreased HR), blown pupils

Myothenia Gravis

The most serious complications of myasthenia gravis is a myasthenia crisis. This is a condition of extreme muscle weakness, particularly of the diaphragm and chest muscles that support breathing. Breathing may become shallow or ineffective. SWALLOWING ISSUE

What causes a hemorrhagic stroke?

sudden bleeding from a blood vessel inside the brain or in the spaces around the brain. age, arteriovenous malformation

thrombolytic stroke

Due to a thrombus (blood clot) that develops at the clogged part of the vessel.

Thrombolysis can break down and disperse a clot that is preventing blood from reaching your brain.

Manifestations of a spinal cord injury\***

bowel problems, one side affected is called hemiparesis, blood pressure goes up, autonomic dysreflexia

Manifestations of Parkinsons

Tremors, shuffling, drooling, stooped posture, low dopamine

epidural hematoma

BLEEDING BETWEEN SKULL AND DURA RESULTING FROM TEAR OF ARTERY

BRIEF PERIOD OF UNCONSCIOUSNESS, CONSCIOUSNESS REGAINED, THEN RAPID PROGRESSION TO UNCONSCIOUSNESS

subdural hematoma

BLEEDING BETWEEN DURA AND ARACHNOID FROM VENOUS TEAR

USUALLY DEVELOPS SLOWLY WITH S & S IN 24 HOURS TO WEEKS OR PROGRESS RAPIDLY MAY PROGRESS TO INCREASED ICP, POSTURING, SEIZURES

coup

initial hit

countrecoup

initial hit affecting the back of the area that was hit

Risk factors of someone to have a stroke ?

High BP, smoking, heart and blood vessel disease, diabetes, family hx

Manifestations of hemorrhagic stroke

vomiting, headache, seizures, hemiplegia, loss of consciousness

Lower motor neuron SCI

bowel and walking

Upper motor neuron SCI

eating and breathing

Decorticate posturing

arms flexed inward and bent in toward the body and the legs are extended

TIA

transient ischemic attack; little stokes that could eventually lead to a big stroke. stroke symptoms come and go

cardiac pathology that causes a stroke

Atriofibulation

Secondary brain injury

damage from swelling, infection, cerebral hypoxia

What makes a person at risk for stasis dermatitis \***

obesity, poor circulation, HTN

What do you look for when assessing someone for skin cancer?

outside job; look for border, color, size around the spot, if spot is raised

Manifestations of polycystic ovarian syndrome

increased testosterone, hirsutism, HTN, develop type 2 Diabetes, risk of endometrial carcinoma, infertility, menstrual problems

manifestations of acute prostatitis

Fever, Pain in perineal region, Urinary frequency & urgency, Dysuria, Decreased urinary stream, chills, discharge

Amuptation pain

phantom pain (neuropathic pain)

Manifestations of endometriosis

INFERTILITY, DYSMENORRHEAL, DYSPAREUNIA, DUB (DYSFUNCTIONAL UTERINE BLEEDING)

Manifestations of cystocele

bladder and anterior vaginal wall into the vaginal canal; bulge outside of the vaginal canal, stress incontinence

STEMI

ST elevation myocardial infarction; abrupt onset of chest pain, not relieved with nitro or rest. ECG changes, bio markers go up

NonSTEMI

unstable angina; non-ST elevation myocardial infraction. sitting down relief

manifestations of cardiac tamponade

elevated CVP; jugular vein distension, decrease in systolic BP

Myocardial ischemia

myocardial demand - not enough blood flow

Causes of hypercoagulability \***

DIC, liver pathology, vitamin K, synthesis problems, leiden factor 5

diabetic ketoacidosis

very high hyperglycemia, type 2 doesnt get it very often, fruity breathe, trouble breathing

Manifestations of meningitis \***

nuchal rigidity - stiffness and pain in the neck, confused, vomiting, altered mental staus, no looking at light (photophobia)

acute pericarditis

short infection or inflammation of the pericardium - pain that increases with deep breath, lean forward for relief

Manifestations cancer

fatigue, pain, nausea, caccia (weak)

what causes metastatic

blood flow from one area to another