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Med Surg Final Exam
Med surg final exam
| Question | Answer |
|---|---|
| Abortion | Medically any loss of a child before twenty weeks gestation |
| DNC | To scrap the cervix after abortion |
| Cryosurgery | the use of subfreezing tempuratures to perform surgery, commonly used for genetial warts, cutaneous tags, seborrheic keratosis, acitinic keratoses, and others. |
| Anemia | deficent number of red blood cells |
| Amenorrahea | no bleeding |
| Menorrhagia | excessive bleeding longer than 7 days |
| Metrorrhagia | irregular break through bleeding |
| oligomenorrhea | long periods inbetween bleeding |
| Treatment for Gonorrhea | penicillin, rocephin (if pregnant), and suprax, cipro, floxin or levaquin are one time dose. |
| Treatment of syphilis | benzathine (panicillin G) |
| sexually transmitted diesease/infection charactorized by distinct stages of effects over a period of years | syphilis |
| bone healing stage that occurs 3 weeks to six months after intial injury, important to prevent movement at this stage | ossification |
| marked by bradycardia, irregular respiratory rate & systolic hypertension | cushings triad |
| Abbreviation for a lab test used to check for inflammation | ESR |
| Type traction used with hip fractures | russell |
| 2 words: type of cast used for proximal position of femur fractures | hip spica |
| Cells in a common form of skin cancer | basal |
| Type of back surgery | laminectomy |
| Type of headache most commonly affects younger females | migraine |
| Disorder of increased intraocular pressure, evaluated by a tono-pen | glaucoma |
| . Loss of elasticity of the eye develops with advancing age | presbyopia |
| Drainage containing blood (this word is spelled 2 different ways use spelling without the “E”) | sanguinous |
| Dizziness | vertigo |
| May be the result of fluid shifting into the interstitial space leaving the body fluid depleted | hypovolemia |
| Increased convexity in the curvature of the thoracic spine | kyphosis |
| . Ringing sound in the ears, can be caused by Lasix | tinnitus |
| Type of posturing, pulling into the body | decorticate |
| Procedure that a “cleansing” agent is introduced into the vagina under low pressure, advise patients to ONLY do so if for a medical reason discussed with a health care provider | douche |
| . Drug used to treat osteoporosis | fosamax |
| Stage of bone healing where callus formation continues | consolidation |
| Operative procedure designed to improve or restore hearing | tampanoplasty |
| Characteristics of tertiary syphilis | gummas |
| Inflammation of the cornea (use letter “T”) | karititis |
| Disease that results in skeletal pain | pagets disease |
| Furuncle of the margin of the eyelid | hordeolum |
| Formula used for fluid replacement in burn victims | parkland |
| Disease resulting in acute attacks of vertigo, nausea & vomiting | meniere |
| Type of test in which the ear is irrigated with warm water & cold water, in a positive test both irrigations will produce nystagmus | caloric |
| Infection into the bone | osteomyelitis |
| Type of cancer that is rising faster than any other malignancy in the US | melanoma |
| Yellow discoloration of the skin & mucous membranes caused by abnormal amounts of bilirubin in the blood | bilirubin |
| slowed pulse rate | bradycardia |
| General class for drugs such as: beta blockers & calcium channel blockers | antihypertensives |
| Use of subfreezing temperature to destroy tissue | cryosurgery |
| Sexually transmitted disease/infection that many times coincides with Chlamydia | Gonorrhea |
| . Drainage that contains pus | purulent |
| from a chemical, thermal, or electrical medium. Results | burn |
| what is the name of a slowly growing papule with a pearly white center | basal cell carcinoma |
| what type of isolation must a patient be in after a bone marrow transplant | protective or reverese isolation |
| general type of meds used to treat vomiting associated with chemotherapy | antimetics |
| tumor that does not spread to other tissues or organs | benign tumor |
| classification of drugs that you would expect as immediate care for a patient with acute closed angled glaucoma | cholenergic agents |
| a normal finding during a caloric test | vertigo |
| this type of glaucoma has no symptoms of pain or pressure | opened angled glaucoma |
| the name of inflammation of the fluid filled sac commonly found at joints | bursitis |
| bone that has walled itself off created a barrier to antibiotics | sequestrum |
| this type of traction is used for patients with hip fractures | russells traction |
| topical corticosteriod ointments can cause this and must be assessed by the nurse on folow up visits | thinning of the skin |
| what type of neoplasm is related to retrovirus | kaposis sarcoma |
| you would expect to see this amount of output in a severly burned patient during the emergant phase | 200-400ccs per hour |
| this lesion has vasularity and is bright red with radiaing blood vessels caused by dialation | spider angioma |
| during this phase in a patient with a burn injury the patient is at most risk for shock | emergant phase |
| maliginancy charactorized by a persistant lesion of the nipple and aerola with or without a palpable mass | pagets disease |
| this STI can cause infertility, fever, arthragia and/or arthritis | gonorrhea |
| treatment for this disorder is to inhibit estrogen production a TAH may be nessecary | endometriosis |
| this may be caused by hormonal changes during menopause and lactation that results in drying the abdominal wall as well as endometriosis | dyspareunia |
| this is the benign breats lumps that are found in women ages 15-25 that occurs with estrogen sensitivity | fibroandemoas |
| treatment of chlamydial infections | "silent disease", vibramycin, zithromax, alterntives of floxin or levaquin |
| lymphogranuloma venereum | rare in the US, vibramycin, or erythromycin |
| Genital Herpes | acyclovir, valtrex, famvir these drugs inhibit viral replication and supress frequent occurances |
| Genital Warts | caused by HPV, treated with TCA or BCA to remove warts. Podophyllin resin from small warts. |
| Hormone replacement therapy | HRT helps retard bone loss andmay help prevent osteoporosis, also helps to minimize changes in old age. |
| What is HRT | hormone replacement therapy estrogen for women without a uterus, and estrogen and progesterone for women wih a uterus |
| endometriosis | presence of normal healthy tissue in sites outside the endometrial cavity. Not well understood patient may experience dysmenorrhea, infertility, pelvic pain, dyspareunia, painfull bowel movements and dysuria |
| menopause | cessation of menses with declining ovarian function. Usually takes place after 1 yr amenorrhea |
| endometrial cancer | is the most common gynecologic maliginancy accounting for 50% of femal genital tract neoplasms. The average age is 61. Survival rate of 94%. Major risk factor is estrogen. The first sign is abnormal uterine bleeding is postmenopausal women. |
| subtotal hyserectomy | removal of uterus without removing cervix |
| total hysterectomy | removal of uterus and cervix |
| panhysterectomy | removal of uterus, cervix, fallopian tubes and ovaries |
| benign tumors | end with oma (papilloma, adenoma) |
| maliginant tumors | end in carcinoma, sarcoma |
| benign ovarian tumors | polycystic ovaian syndrome, multiple small ovarian follicles, increase LSH and decrease in FSH. Hirtuism (abnormal facial hair, or hair growth) |
| diagnostic tests for ovarian cancer | no screening test exists, should have yaerly bimanual pelvic exam, postmenopaulsal women should not have palpable ovaries. |
| ovarian cancer patho | can metastisize directly by shedding malignant cells or by lymphatic spread |
| ovarian cancer clinical manifestation | abdominal discomfort, pelvi heaviness, loss of appetite, feeling of full ness, change in bowel habits |
| what can be used to visualize vascular changes in ovarian cancer | color doppler imaging |
| what can be used to detect ovarian masses | abdominal or vaginal ultrasound |
| what is stage one collabeative care for ovarian cancer | a TAH and salpingoophorectomy |
| what collaboative care is used for stage two ovarian cancer | external abdominal and pelvic radiation, intrapareoneal radiation, systemic combonation of chemotherapy after removal of tumor |
| what surgical procedures are used for ovarian cancer | sub and total hysterectomy, panhysterectomy, simpla and radial vulvectomy, vaginectomy, radial hysterectomy, pelvic exenteration |
| lyme disease | transmitted by a bit of an infected deer tick. Called the great imitator bc it can mimic other diseases such as MS, monoucleosis, and menigitis. |
| if lymes disease is not treated what will it cause | nervous system problems, severe head aches, temprary facial paralysis (bells palsy), or poor motor coordination. In late disease arthritis and swelling may occur in larger joints. |
| what is gout caused by | an increase in uric acid production, under excretion of uric acid by the kidneys, or increased intake of foods containing purines |
| chronic gout is charactorized by | multiple joint involvement and visible deposites of sodium urate crystals called tophi |
| what drugs are used in pain management with gout | NSAIDS, colchicine |
| Benign Tumors | well differentiated, encapsulated, expansive mode of growth, charatoristics similar to parent cel |
| Maliginant Tumors | able to metastisize, infiltrative and expansive, frequent reoccurance, moderate to marked vascularity |
| Maliginant Cell charactoristics | rapid cell division and growth, cells do not respect boundaries, ability to migrate, loss of differentation, and alteration in structure |
| How do you diagnose cancer | look at anatomical site (where they originate from), histological analysis (graded on differentation), clinical stageing (is it contained), TNM (tumor size, spread to lymphnodes, metastisis), |
| what are the side effects with chemo and radiation therapy | anorexia, skin reactions, pulmonary effects, gastrointestion l effects, reprductive efects (potential for infertility). |
| what is chemotherapy | used to reduce the number of cels in the tumor site, IV is the best route for chemo drugs, |
| what are the main labs to watch with a paient in chemo | WBC,s, Platlete and RBC's (if platlet count fals below 50,000 assess for bleeding) |
| complications of cancer | altered taste sensation, infection, superior vena cava syndrome, spinal cod compression syndrome, third space syndrome, syndrome of inappropriate ADH, hpercalemia, hypercalcemia, tumor lysis syndrome, cardiac tamponade, carotid atery rupture, |
| Wha is an intervention for a cancer patient dealing with malnutrition | suggest supplements as soon as 5% wieght loss is noted, |
| How can you intervene in a patient dealing with taste alteration rt cancer | teach the patient to experiment with spices and seasoning in atempt to mask alterations |
| what are the manifestations of superior venacava syndrome | facial edema, distention ofneck and chest veins, siezures, headache |
| what is spinal cord compression | presence of malignant tumor in epidural space |
| what are the manifestations of spinal cord compression | intense localized and persistant back pain, mmtor weaknes and dysfunction, sensory loss, change i bowel or bladder function |
| What is third space syndrome | shifting of fluid fom vascular space to interstitial space |
| what is a sign of third space syndrome | hypervolemia |
| what is a syndrome of inapropriate ADH r/t cancer | abnormal or sustained production of ADH, cancer cells are able to manufactor store and release ADH, some chemotheraputic agents stimulate the release. |
| What is the treatment for inappropriate ADH syndrome | fluid restriction or IV 3% NACL |
| What cause hypercalcmia in cancer pts | paratthyroid hormone like substance is secreted from cancer cells in absence of bony metastisis, immobility and dehydration can cantibute or exacerbate |
| what are the primary manifestations of hypercalcemia | apathy, depression, fatigue, muscle weakness, polyuria and nocturia, anorexia, N/V |
| what is tumor lysis syndrome | metabolic complication triggered by chemotherapy, results from rapid destruction of tumor cells |
| what are the four hallmark signs of lysis syndrome | hyperurecemia, hyperphosphatemia, hyperkalemia, hypocalcemia |
| how do you treat lysis syndrome | the primay goal is to prevent renal failure and severe electrolyte imbalances, the primary treatment is to increase urine output by hydration, decrease uric acid concentrations |
| what is cardiac tamponade | fluid accumulation in the paricardial sac, consrtiction of the pericardium, or pericarditis |
| What are the manifestations of cardiac tamponade | dyspnea, tachycardia, anxiety, decreased LOC, pulsus paradoxis, distant, muted heart sounds. |
| how do you treat cardiac tamponade | reduce fluid around the heart, establishent of paricardial window or indwelling paricardial catheter |
| what is a coronary artery rupture r/t cancer | invasion of artery wall by tumor or erosion fallowing surgery or radiation |
| menieres disease | symptoms caused by inner ear disease, vertigo, tinnitus, fluctuating hearing loss, and aural fullness. Hearing loss fluctuates with continueing attacks and hearing recovery is decreased with each episode and leads to hearing loss |
| bicarbonate | 22-26 |
| chloride | 95-105 |
| calcium | 9-11 |
| creatinine | .5-1.5 |
| folic acid | 3-25 |
| magnesium | 1.5-2.5 |
| potassium | 3.5-5.5 |
| sodium | 135-145 |
| uric acid | male 4.5-6.5 female 2.5-5.5 |
| mcv | 82-98 |
| MCH | 27-33 |
| platlet count | 150-400 |
| WBC count | 4,500-10,000 |
| what tests are use for HIV | elisa sensitivity test, and western blot confirmatory tes |
| cranicocerebral trauma | alteration in consiousness no matter how brief |
| scalp lacerations | most minor type of head trauma, most major problem is infection |
| linear skull fracture | break of bone without alterations of relationship of parts |
| depressed skull fracture | inward indentation of the skull, low to moderate impact |
| comminuted skull fracture | multiple linear fractures, bone into many pieces, direct high momentem impact |
| compaund skull fracture | depressed skull fracture and scalp lacerated with communicating pathway to intracranial cavity: severe head injury |
| what is morphne contradicted in | a patient with a tramatic injury |
| allogenic bone marrow transplant | from a donor that has been determined a match from the reciepient, usually a family member, most commonly used in leukemia |
| autologous marrow transplant | patients who recieve their own bon marrow |
| syngenic marrow transplant | obtaining stem cells from an identical twin |
| crypreserved | howbine marrow is frozen and preserved untill used |
| pancytopenc period | when the patients own bone marrow is being prepared for reinjection after a large dose of chemo: usuallt takes two weeks for bone marrow to be ready., pt must be in protective isolation |
| graft vs. host disease | the T lymphocytes from the donated bone marrow ecognize the recipients as foriegn and began to attack organs (liver, skin, and intestine) |
| peripheral stem cell transplant | procedre is pretty much the same as BMT except that healing time is much less and less complucations are seen. |
| red bone marrow | actively produces blood cels |
| stem cells | RBCs, WBCs, and platlets develope from the tsem cell within the bone marrow |
| dual energy x-ray | called DEXA, measures bone mass of spine, femur, forearm and total body. allows assessment of bone densitywith minimal radiation exposure |
| sprain | injury to ligament structures surounding a joint usually caused by wrenching or twisting motion |
| strain | excessive strching of a muscle and its acial shealth, often involves a tendon |
| fracture hematoma | stage one healing: when the fracture occurs, a hematoma developes, that changes from aliquid to a semi-solid clot; happen 72 hours after injury |
| Granulation Tissue | stage 2 healing: the hematoma converts to granulation tissue which produces the basis for a new bone substanced called ostiod |
| callus formation | stage three healing: minerals are deposited into osteiod, to make new boen, evidence of callus formation can be confirmed by an xray |
| ossification | stage three healing; occurs from 3-6 months after fracture, paient can be converted from a skeletal traction to a cast, or the cast can be removed |
| consolidation | stage five healing; a callus begans to develope, the difference between bone fragmnets dimishes and eventually colses |
| romodeling | stage six healing; excess bone tissue is reabsorbed into the final stage of bone healing, and union is completed. This phase occurs up to a year after fracure |
| russells taction | used for fractures of femur or hip |
| bucks traction | used for many conditions affecting hip, knee, femur or back. |
| casting | a common procedure following a closed reduction. A fresh cast should never be covered with a blanket, or get wet or soiled |
| what is a lamenetomy used for | surgery fro disk disease, to gain access to all or part of the protrding disk to remove it |
| osteomyelitis | severe infection of the bonw marrow, bone and surrounding soft tissue, the most common infecting organism is staph |
| pagets disease | skeletal bone disorder in which there is excessive bone reabsroption followed by replacement of normal bone marrow, the new bone is larger, diformed and weaker. |
| Rheumatoid arthritis | chronic systemic disease charactorized by inflammation of connective tissue in the synoval joints |
| treatment of RA | DMARDs, drug with potential to lessen the permenant effects of RA |
| anklosing spondylitis | chronic inflammatory disease that primarily afects the axial skeleton. The cause in unknown, xray is essential fpr diagnosis. |
| Hodgkin's disease | characterized by proliferation of abnormal giant, multinucleated cells called Reed-Sternberg cells which are located in lymph nodes |
| Hodgkin's Disease is classified as | a lymphoma, which consists of malignant neoplasm’s that originate in the bone marrow and lymphatic structures resulting in proliferation of lymphocytes. |
| The main cells that destroy the normal structure of lymph nodes in Hodgkin's disease | monocytes and macrophages |
| Normal WBC | 4.0 to 11.0 |
| Megace | for patients with other cancers and AIDS to help with appetite |
| Myasthenia gravis | a disease that affects the nervous system and the musculoskeletal system. In the nervous system, the nerve endings fail to release acetylcholine, which leads to problems in movement of the muscles |
| The most commonly affected muscles with myasthenia gravis | the muscles of the eyes, face, neck, arms, and legs |
| Blood work in 85-90% of MG patients | antibodies to acetylcholine receptors |
| the main difference between myasthenia crisis and cholenergic crisis | with MA there is respiratory insufficency, with CA there is respiratory failure |
| what testing can be performed to distiguish between MA crisis and a cholinergic crisis | TENSILON TESTING is performed: Patients are injected with edrophonium chloride (which is Tensilon), an anticholinesterase agent, and if muscle strength improves the patient has MG. If condition worsens, the patient is in cholinergic crisis and drugs to r |
| The reasoning behind a spinal cord injured patient being on high dose steroids | to improve blood flow, and decrease edema at the site of SCI, reduction of posttraumatic spinal cord ischemia, improvement of nerve impulse conduction, and repression of the release of free fatty acids form spinal cord tissue |
| The three most critical potential infections that a spinal cord injury patient would be monitored for during the duration of his care | pneumonia- stasis of secretions in the lungs, UTI- urinary stasis, and introduction of pathogens associated with presence of indwelling catheter, and spinal stabilization site infection. |
| Obstipation | fecal impaction secondary to constipation, colonic perforation may occur |
| Perforation | life threatening, causes abdominal pain, nausea, vomiting, fever and elevated WBC count |
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