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Med Surg Exam 4
Crouch MC 2012
| Question | Answer |
|---|---|
| Severe Right Upper Quadrant colicky pain comes in waves | Cholecystitis |
| What is Murphy's Sign? | unable to take deep breath when pressure is placed over lower liver border |
| Pain in the abdomen with guarding. Often lessen by drawing the knees up & worsen with extension | Pancreatitis |
| Protease initiates what? | a chain reaction of inflammation that results in the conversion of prothrombin to thrombin causing DIC. |
| What is Turner's sign? | purple discoloration in the flanks |
| What is Cullen sign? | purple discoloration around the umbilicus |
| When is demerol given rather than morphine? | with Pancreatitis |
| chronic alcoholic | pancreatitis |
| Pancreatic cancer in the head metastasis | by direct extension |
| Pancreatic cancer in the body metastasis | by blood & lymph |
| What is the Whipple procedure? | removal of the head of the pancreas, duodenum, & parts of the stomach |
| excessive pain is 1st clue | Compartment Syndrome |
| What is Volkman's contracture? | contraction of the hand & fingers & related tissue degeneration caused by decreased blood flow |
| Purpose of treatment for compartment syndrome | restoring blood flow by performing a fasciotomy. once pressure is relieved & swelling goes down fascia & skin are closed. |
| Compartment syndrome important to remember | time means muscle |
| By recognizing compartment syndrome early it prevents what? | complications & deformities |
| Renal failure is caused by what in compartment syndrome? | injured fibers gaining access to bloodstream & filter in to the nephrons |
| For a total hip replacement how should patients sit? | legs abducted & no flexion greater than 90 degree angle |
| #1 Complication of Total Joint Replacement | Hemorrhage |
| Complications of Total Joint Replacement | Hemorrhage, sepsis, thrombophlebitis & embolism, infection, dislocation, skin breakdown |
| treatment includes early ambulation that is what for total joint replacement? | non-weight bearing |
| Type I DM affects what? | metabolism of fat, protein, & carbohydrates |
| Dx DM for HBA1c | >6.5% |
| Dx DM for FPG | >126 mg/dL |
| Dx DM for 2 hr plasma glucose | >200 mg/dL |
| Dx DM for an individual with | classic symptoms of hyperglycemia or hyperglycemic crisis with a random plasma glucose of >200 mg/dL |
| Type I DM Treatment | combination of insulin therapy, meal planning, & exercise regimen |
| What is the symogogy effect? | hypoglycermia in the middle of the night |
| What is the Dawn phenomenon? | increase in morning levels |
| Dx Criteria for Metabolic Syndrome | increased waist circumference >40 males & >35 females plascma triglycerides >150 mg/dL plasma HDL cholesterol < 40 mg/dL males & <50 females BP >130/85 FPG >100 mg/dL |
| How many criterias does one have to have in order to be diagnosed with metabolic syndrome? | 3 out of 5 |
| 3 P's | Polyphagia Polydipsia Polyuria |
| 4 Categories of DM | Type 1, Type 2, Other specific types, gestational |
| What percentage of the beta cells must be destroyed to cause a decline in insulin leading to hyperglycemia? | 80-90% |
| Glucagon's role | acts in the liver to decrease blood glucose by stimulating glycogenolysis & gluconeogenesis |
| in addition to insulin decrease what other hormon is decreased? | amylin |
| What is amylin's function? | suppress glucagon release |
| What causes the weight loss in DM pt? | protein & fat breakdown because of lack of insulin |
| Risk factors for Type II DM | age, obesity, HTN, physical inactivity, & famiily hx |
| metabolic syndrome | is a constellation of disorders that increase the risk of developing Type II |
| Constellation of disorders in metabolic syndrome | central obesity, dyslipidemia, prehypertension, increased fasting glucose level |
| insulin resistance | suboptimal response of insulin-sensitive tissues to insulin & often associated with obesity |
| Nonspecific symptoms & signs for DM | fatigue, pruritis, recurrent infections, visual changes, & sx of neropathy |
| Without treatment what can result? | coronary & peripheral artery & cerebrovascular disease |
| 1st approach for Type II DM | diet & exercise |
| kussmaul respirations & fruity acetone breath | Diabetic ketoacidosis |
| Chronic Complications of DM | reinopathy, nephropathy, neuropathy, macrovascular, infection |
| What is Compartment syndrome? | fascia compresses the swelling tissue causing decrease in vascularity of tissue & nerves |
| Complications of Compartment syndrome? | necrosis, paralysis, volkman's contracture, rhabdomyolysis, renal failure, & infection |
| Treatments for cholecystitis | t-tube after cholecystectomy low-fat diet lithotripsy demoral antispasmodics antiemetics gallstone dissolution meds |
| Pancreatitis is | outlet becomes blocked becuase of inflmmation, gallstones, or digestive enzymes |
| Complications of Pancreatitis | shock respiratory distress renal failure hemorrhage |
| Treatment of pancreatitis | NPO, O2, IV analgesic Demerol,antiemetics, IV fluids, expanders, & PRBC |
| Complications of Pancreatic Cancer | DVT, VCA, DM, postop infection, fistula, peritonitis, paralytic ileus, malabsorption disorder, death |
Created by:
midnight1854
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