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