WGU D027 Study Guide 2022 with complete solutions

WGU D027 Study Guide 2022 with complete sWGU D027 Study Guide 2022 with complete solutions What organ does cystic fibrosis affect? Ans- Affects the pancreas causing secretions into the lungs What is Klinefelter syndrome? Ans- An extra X chromosome for males so example XXY causing female-like qualities What is Turner Syndrome? Ans- females. missing or deformed x chromosome. right hemisphere dysfunction, hearing loss, ear infection, language and articulation disorders, visual spatial and attentional problems What is beta thalassemia? Ans- a condition in which the synthesis of the beta-globin chains is decreased or absent. Causes low hemoglobin. Which medication is contraindicated in a patient with Beta Thalassemia? Ans- Ferrous Sulfate What drug is used in combination with other agent to treat lymphoid tissue (leukemia). Directly toxic to lymphoid tissues Selective estrogen receptor modulators (SERM) - for hormone receptor positive and advanced breast cancer. (Tomaxafin - reduces risk and recurrence risk) Ans- Glucocorticoids What is the normal ejection fraction? Ans- 55-60%. Less than 50% is BAD Is an ejection fraction of 50% reduced or preserved? Ans- Preserved What are symptoms of left sided heart failure? Ans- Think PULMONARY. JVD, FVO, rails, S3 murmurs. Number one cause of right sided heart failure! What are symptoms of right sided heart failure? Ans- Think peripheral vascular. Lower extremity edema, abdominal distension. What is the gold standard lab test for heart failure? Ans- BNP. Heart failure is a result greater than 100 What heart disease is worse with exertion? Ans- Ischemic heart disease because the demand requirements are higher. What should you assess before giving Digoxin? Ans- Apical pulse How should Warfarin be started? Ans- Start initial dose at half to monitor the effects What causes the destruction of alveolar walls? Air goes in but can't get out which leads to hyperinflation Ans- Emphysema What causes excess mucus production and smooth muscle hypertrophy? Ans- Bronchitis What is a chronic inflammatory obstruction of bronchi? Ans- Asthma, Triggers cause mucus to clog bronchial tubes. What causes an overbite and buffalo hump? Ans- Endocrine disorder called acromegaly (overproduction of growth hormone) What causes Addison's disease? Ans- Decreased glucocorticoid (due to autoimmune destruction of adrenal cortex) What causes Cushing's syndrome? Ans- excess cortisol What causes Grave's disease? Ans- overproduction of thyroid hormone. HYPERthyroidism. When should you instruct the patient to take their FIRST dose of antihypertensive? Ans- At night to avoid orthostatic hypotension. Educate slow position changes and lay down if needed. What are side effects of ACE inhibitors? Ans- dry cough angioedema hyperkalemia *Contraindicated in pregnancy Which type of antihypertensive should NOT be given to patients with Asthma? Ans- Nonselective beta blocker (-lol) because both beta-2 receptors are effected What is the first choice of calcium channel blocker? Ans- Verapamil What side effect should you watch for in a patient taking a statin drug? Ans- Muscle pain which can lead to rhabdomyolysis, kidney failure, and death. Which diuretic is NOT used in patients with kidney failure and sickle cell disease? Ans- Thiazide diuretics What type of drug is spironolactone? Ans- potassium sparing diuretic Which type of insulin is the most painful during injection? Ans- Lantus (long-acting) Why test glycosylated hemoglobin (HgbA1c)? Ans- Most reliable assessment of blood sugar over the past 3 months. The goal is < 6.5%. A poor result is > 9% What is the normal range for TSH level? Ans- The normal range of TSH levels is 0.4 to 4.0 milli-international units per liter. If you're already being treated for a thyroid disorder, the normal range is 0.5 to 3.0 milli-international units per liter. A value ABOVE the normal range usually indicates hypothyroidism. What lab test would we recommend for thyroid? Ans- Thyroid peroxidase antibodies (TPO) symptoms of hypothyroidism Ans- Bradycardia; cold intolerance; lethargy; memory loss; dry skin; brittle dry hair; decreased appetite; weight gain; constipation; increased serum lipids; decreased libido; erectile dysfunction What if a newborn has hypothyroidism? Ans- Requires replacement within a few days and last for 3 years to prevent mental development changes and dwarfism. What is Hashimoto's disease? Ans- An autoimmune cause of hypothyroid. Symptoms include weight gain and fatigue. Symptoms of hyperthyroidism (thyrotoxicosis) Ans- Tachyarrhythmias, anxiety, insomnia, rapid flow/speech, hot GRAVES DISEASE how to treat grave's disease? Ans- Remove or destroy thyroid tissue or suppress with drug (methimazole or propylthiouracil) Treat with Iodine-131 Beta blockers also used to suppress release of thyroid hormones and reduce HR. What causes vasodilation, bronchoconstriction, and helps with memory and sleep? Ans- histamine- 1 What are side effects of antihistamines? Ans- sedation (only H-1), dry mucus membranes, urinary hesitancy, and constipation. Which medication is given after an MI? Ans- Beta blocker is given for 6 months to prevent another MI When should medication reconciliation be done? Ans- Within 30 days of discharge Which drug class is used as the first line of treatment for depression? Ans- SSRIs because of the low side effects and effectiveness. What is the first line of treatment for uncomplicated otitis media in pediatric patient without comorbidities? Ans- Amoxicillin How do you test for postural orthostatic tachycardia syndrome? Ans- Tilt test What is Florinef (corticosteroid) used for? Ans- Used to treat postural hypotension and adrenal insufficiency. What are the side effects of Florinef? Ans- Nausea, headache, sleep problems, and mood changes. What is the off label use for prazosin/minipress (alpha- 1 blocker)? Ans- Sleep aid for patients diagnosed with PTSD Which medications are used to treat myasthenia gravis? Ans- Corticosteroids and cholinesterase inhibitors. Side effects of cholinesterase inhibitors (neostigmine): Ans- Excessive salvation, urinary urgency, sweating, spasm, bradycardia What is the first line of treatment for uncomplicated hypertension? Ans- Hydrochlorothiazide(thiazide diuretic) orally with lifestyle changes. What might cause ataxia in a pediatric patient? Ans- - Fragile X syndrome - Prader Willie Syndrome by deletion of chromosome 15 from father Combined ___________ are contraindicated when breast feeding. Ans- Oral contraceptives Which antibiotic would you use for treatment of UTI during pregnancy? Ans- One-time dose of Fosfomycin and cephalexin. NO PENCILLINS How to treat pediatric UTI with no comorbidities? Ans- Trimethoprim/sulfamethoxazole (Bactrim, Septra) Augmentin Cephalosporins Which parent does color blindness come from? Ans- X-linked so mother. 50% chance of getting it. Gene OPN1MW on chromosome 23 is mutated causing color blindness. What is the first treatment for sickle cell crisis? Ans- Hydration Parental care of the newborn with sickle cell anemia: Ans- - Infant will be anemic - Increased risk for infection - May have spleen or liver damage causing jaundice - May have crying episodes from pain and swelling of extremities - Hydrate, administer vaccines, antibiotics when necessary, folic acid administration, and regular eye exams Should you admit or monitor a young athletic patient with bradycardia? Ans- Monitor as it is normal. Which part of the GI tract does Crohn's disease effect? Ans- Affects all GI tract and has skip lesions Which patients have an increased risk of inflammatory bowel disease? Ans- Patients with atopic dermatitis and eczema What diagnostic labs will be drawn for ulcerative colitis? Ans- CBC, CRP, ESR, LFT, electrolyte panel, and ANA A Japanese male present with hypertension and chronic kidney disease, which antihypertensive would you give? Ans- ACE inhibitor or ARB. Next course of action is to reduce amount of salt in diet. Which medications are given PRN for anxiety? Ans- Benzodiazepines (Diazepam), Vistaril (antihistamine), Seroquel (antipsychotic effects), SSRIs (Prozac, Paxil, Zoloft), and Wellbutrin (antidepressant), and Risperidone (side effect is neutropenia) Which medication can be given to treat schizophrenia? Ans- Chlorpromazine (antipsychotic) Which medications could be alternatives to treat neuropathic pain? Ans- Cymbalta (Duloxetine) and Lyrica (pregabalin) What should be avoided if a patient has a G6PD deficiency? Ans- Mothballs (naphthalene), fava beans, red wine, all beans, blueberries, soya products, tonic water, and camphor. G6PD deficiency Ans- - Low NADPH leads to hemolytic anemia (free radicals) - X-linked recessive What should you do for a mild reaction to IgM? Ans- If fast, slow the infusion. Administer acetaminophen, diphenhydramine, and steroids. What is the most common type of lung cancer? Ans- Small cell lung carcinomas (SCLCs) How do you diagnose lung cancer? Ans- - Chest X-ray - Test for mutation in epidermal growth factor receptor (EFGR) Name an adrenocortical steroid indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome Ans- Florinef What are side effects of Florinef? Ans- Retention of sodium and water (edema), hypertension, cardiac enlargement, congestive heart failure, hypokalemia. What is the off label use for Prazosin/minipress (alpha 1 blocker)? Ans- Benign prostatic hyperplasia (BPH) and a sleep aid for patients diagnosed with PTSD. Which medication is best for a diabetic with hypertension? Ans- ACE inhibitor Do not combine an _______ with an angiotensin II Receptor Blockers ARB (-sartan) Ans- ACE inhibitor What do cholinesterase inhibitors do? Ans- - a chemical that inhibits the acetylcholinesterase enzyme from breaking down acetylcholine, thereby increasing both the level and duration of action of the neurotransmitter acetylcholine. - Treats myasthenia gravis What are some side effects of cholinesterase inhibitors? Ans- Nausea, vomiting, loss of appetite, diarrhea, bruising muscle cramps, headaches, fatigue, and insomnia. Side effects of corticosteroids Ans- Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies, edema, What is the first line of treatment for uncomplicated hypertension? Ans- Hydrochlorothiazide (thiazide diuretic) Drugs with _______ are contraindicated during pregnancy. Ans- -flox- drugs. For example, ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin) which are all fluoroquinolones. What antibiotics must be avoided in pregnancy? Ans- SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby) pharmacology micro Which antibiotic would you use to treat UTI in a pediatric patient who is vomiting? Ans- Cephalosporin IV What is the first line of therapy with sickle cell crisis? Ans- IV fluids, HYDRATION What does the small bowel tissue of a patient with Crohn's disease look like under a microscope? Ans- cobble stoning A Japanese patient comes in with hypertension, already taking an ACE inhibitor with stage 3 hypertension. What medication would we suggest next? Ans- Amlodipine Normal TSH levels Ans- 0.4-4.0 WGU D027 Study Guide 2022 with complete solutions What does it mean if the TSH levels are ABOVE normal? Ans- - thyroid is underactive - hypothyroidism What is the most common cause of hypothyroidism and presents with thyroid peroxidase antibodies (TPO)? Ans- Hashimoto thyroiditis What is the most common cause of hyperthyroidism and presents with thyroid stimulating hormone receptor (TSH) antibodies? Ans- Graves disease Where can RET oncogene be found and what does it mean? Ans- - Located on chromosome 10 - Seen on all cells in the body in patients with the hereditary forms of Medullary carcinoma of thyroid (MTC) Which medication is given to a patient experiencing rigors during a immunoglobulin M (IgM) infusion? Ans- Demerol (meperidine) Which immunoglobin is associated with Celiac disease? Ans- IgA What glands are affected by Sjograns syndrome? Ans- Tear and saliva glands olutions