NMNC 4510 Final Exam(34
diagnosis for cholecystitis - ANSWERSx-ray/ultrasound
won't see w CT
amylase/lipase will diagnose pancreatitis too
elevated liver function tests b/c of backflow of bilirubin from liver
ERCP
Complications of Immobility - ANSWERSCardiovascular - reduced CO, orthostatic HoTN, venous
stasis, DVT
Respiratory - reduced lung expansion, atelectasis, pooling of respiratory secretions
Musculoskeletal - muscle atrophy, joint contractures, demineralization of bone
Integumentary - skin breakdown
Gastrointestinal - constipation
Urinary - renal calculi, urinary stasis, infection
,Psychological - boredom, depression, anxiety, anger, disturbed body image, loss of
self-worth/value
What is Parkinson's disease? - ANSWERSChronic, progressive neurodegenerative disorder
Slowness in execution &initiation of movement
Hallmark s/s of Parkinson's - ANSWERSBradykinesia
Rigidity
Tremor at rest
Gait changes
Parkinson's is the most common type of what disorders? - ANSWERSParkinsonism
(EX) atypical parkinsonism, Parkinson's disease
muscle ridgity - ANSWERSincreased muscle tone - can't relax muscles
Who's at high risk for Parkinson's? - ANSWERSolder ppl & men
Causes of Parkinson's Disease - ANSWERSGenetic risk factors
Exposures - well water, pesticides, herbicides, chemicals, wood pulp mills
Rural residence
,Secondary (atypical) parkinsonism causes - ANSWERSexposures - carbon monoxide, copper
miners
meds - lithium, haldol, reglan
illicit drugs - amphetamines
hydrocephalus, infxn, stroke, brain tumor
most can be reversed once we treat cause
Is atypical parkinsonism or Parkinsion's disease reversible? - ANSWERSAtypical - reversible
Parkinson's - irreversible
Pathophysiology of Parkinsons - ANSWERSDegeneration of dopamine-producing neurons in
substantia nigra
Disturbs normal balance of dopamine (DA) and acetylcholine (Ach) in basal ganglia
Manifestations occur when 80% neurons gone in substantia nigra
Lewy bodies in brains of pts w PD
What happens to DA & ACh in Parkinson's? - ANSWERSDopamine - important extrapyramidal
motor functioning
, Neurons don't produce enough dopamine
Ach - amps up brain/muscles
No dopamine - too much ACh & muscles are constantly overworked
What are Lewy bodies? - ANSWERSclusters of abnormal proteins in brain
cause of these in Parkinson's is unknown
Clinical manifestations of Parkinson's - ANSWERSgradual, ongoing progression - only 1 side of
body may be involved at first
TRAP (tremors, rigidity, akinesia/bradykinesia, postural instability)
TRAP (Parkinson's) - ANSWERSTremors - can worsen with physical/emotional stress
- handwriting will change
- pill rolling
- can affect jaw, tongue, diaphragm
Rigidity - jerky
- cogwheel - extremity gets caught while you are moving it
Akinesia - can't initiate step
Bradykinesia - more prominent in automatic movements (blinking, swinging arms while walking)
diagnosis for cholecystitis - ANSWERSx-ray/ultrasound
won't see w CT
amylase/lipase will diagnose pancreatitis too
elevated liver function tests b/c of backflow of bilirubin from liver
ERCP
Complications of Immobility - ANSWERSCardiovascular - reduced CO, orthostatic HoTN, venous
stasis, DVT
Respiratory - reduced lung expansion, atelectasis, pooling of respiratory secretions
Musculoskeletal - muscle atrophy, joint contractures, demineralization of bone
Integumentary - skin breakdown
Gastrointestinal - constipation
Urinary - renal calculi, urinary stasis, infection
,Psychological - boredom, depression, anxiety, anger, disturbed body image, loss of
self-worth/value
What is Parkinson's disease? - ANSWERSChronic, progressive neurodegenerative disorder
Slowness in execution &initiation of movement
Hallmark s/s of Parkinson's - ANSWERSBradykinesia
Rigidity
Tremor at rest
Gait changes
Parkinson's is the most common type of what disorders? - ANSWERSParkinsonism
(EX) atypical parkinsonism, Parkinson's disease
muscle ridgity - ANSWERSincreased muscle tone - can't relax muscles
Who's at high risk for Parkinson's? - ANSWERSolder ppl & men
Causes of Parkinson's Disease - ANSWERSGenetic risk factors
Exposures - well water, pesticides, herbicides, chemicals, wood pulp mills
Rural residence
,Secondary (atypical) parkinsonism causes - ANSWERSexposures - carbon monoxide, copper
miners
meds - lithium, haldol, reglan
illicit drugs - amphetamines
hydrocephalus, infxn, stroke, brain tumor
most can be reversed once we treat cause
Is atypical parkinsonism or Parkinsion's disease reversible? - ANSWERSAtypical - reversible
Parkinson's - irreversible
Pathophysiology of Parkinsons - ANSWERSDegeneration of dopamine-producing neurons in
substantia nigra
Disturbs normal balance of dopamine (DA) and acetylcholine (Ach) in basal ganglia
Manifestations occur when 80% neurons gone in substantia nigra
Lewy bodies in brains of pts w PD
What happens to DA & ACh in Parkinson's? - ANSWERSDopamine - important extrapyramidal
motor functioning
, Neurons don't produce enough dopamine
Ach - amps up brain/muscles
No dopamine - too much ACh & muscles are constantly overworked
What are Lewy bodies? - ANSWERSclusters of abnormal proteins in brain
cause of these in Parkinson's is unknown
Clinical manifestations of Parkinson's - ANSWERSgradual, ongoing progression - only 1 side of
body may be involved at first
TRAP (tremors, rigidity, akinesia/bradykinesia, postural instability)
TRAP (Parkinson's) - ANSWERSTremors - can worsen with physical/emotional stress
- handwriting will change
- pill rolling
- can affect jaw, tongue, diaphragm
Rigidity - jerky
- cogwheel - extremity gets caught while you are moving it
Akinesia - can't initiate step
Bradykinesia - more prominent in automatic movements (blinking, swinging arms while walking)
