68W ALC Phase 3, LPC Exam 2023

pharmacology - Answer- study of substances that interact with living organisms through chemical processes medical pharmacology - Answer- science of substances used to prevent, diagnose and treat disease indication - Answer- reason or condition for which a particular medication is given dose - Answer- amount of medication given within a specified period of time single dose - Answer- amount of medication administered at one time maximum dose - Answer- the largest amount of medication either as a single dose or within a period of time cumulative dose - Answer- sum of all single doses over either a lifetime or a period of time strength - Answer- amount of medication contained per tablet, capsule, suppository, etc titration - Answer- administering a medication with variable strength, interval, and quantity to achieve and maintain a desired observable physiological effect (pain ctrl) contraindication - Answer- medical reason not to give a medication absolute contraindication - Answer- medical reason to NEVER give a medication relative contraindication - Answer- medical reason a medication should not be given, but may be acceptable in certain circumstances allergy - Answer- immune response in which there is a hypersensitivity response induced by exposure to a particular medication side effect - Answer- unintended, but not surprising consequence of a medication which may require a medication dose be changed or discontinued therapeutic effect - Answer- desired change in physiology for administering the medication therapeutic level - Answer- blood level of a medication required to achieve the therapeutic effect toxic level - Answer- blood level of a medication which will cause tissue damage therapeutic range - Answer- variable blood levels of a medication between the therapeutic level and the toxic level therapeutic window - Answer- range of acceptable DOSAGES of a medication needed to keep blood levels within the therapeutic range peak - Answer- when medication is at its highest concentration trough - Answer- lowest blood level of a medication between doses half-life - Answer- time it takes for the body to eliminate half the dose of medication steady state - Answer- relatively constant blood level of medication which is sustained after 5-6 half lives of a medication tolerance - Answer- when the body has adapted to having a medication regularly and now requires a higher or more frequent doses to achieve the therapeutic effect resistance - Answer- when infectious organisms adapt to antibiotics and it takes either higher doses of same medication or a change to a different medication to kill the organisms metabolism - Answer- process of the body to break down and eliminate medications most metabolized by the liver or kidneys dosing interval - Answer- recommended time period between doses of a medication onset - Answer- time until a medication's therapeutic effect begins duration of effect - Answer- time until the medication's therapeutic effect wears off duration of therapy - Answer- length of time a course of medication is continued to ensure the desired effect is maintained dosing parameters - Answer- the limitations, considerations, and instructions required regarding a medication; helps achieve the desired physiological response minimize side effects Body weight, Comorbidities, Age - Answer- What are factors that affect dosing Importance for patients to understand dosing parameters - Answer- -too little: not achieve therapeutic effects -too much: increased side effects/toxic levels Antibiotics - Answer- Medications which kill or inhibit the reproduction of bacteria Gram Stain Testing - Answer- Categorizes bacteria classification based upon chemical properties in the cell's membrane. Gram positive - Answer- Indicates the presence of peptidoglycan Peptidoglycan - Answer- the substance that forms a tough, rigid structure of the bacterium cell wall Gram Negative - Answer- the cell membrane outer structure consists of a cytoplasmic membrane surrounded by a thin layer of peptidoglycan. Aerobic - Answer- bacteria that thrives only in an oxygen environment Anaerobic - Answer- bacteria that grow well in the absence of oxygen Viruses and fungi - Answer- Antibiotics are not effective on what? Sexually or asexually - Answer- How do fungi reproduce Penicillin - Answer- Effective against gram positive aerobic organisms 1st Gen Cephalosporin - Answer- Effective against gram positive bacteria 2nd Gen Cephalosporin - Answer- Effective against gram positive bacteria 3rd Gen Cephalosporin - Answer- Effective against both gram positive and negative bacteria 4th Gen Cephalosporin - Answer- Effective against both gram positive and negative bacteria Cephalosporin - Answer- Patients with allergies to PCN's have 10-20% risk of being allergic to... Macrolides - Answer- Stimulates motilin receptors in the gastrointestinal tract and may cause diarrhea. Tetracyclines - Answer- Inhibit growth of bacteria therefore works slowly; posses anti-inflammatory effect; don't use on children or pregnant women Quinolones - Answer- Long term use may have increased risk of spontaneous tendon rupture Sulfonamides - Answer- Sulfa based, broad spectrum antibiotic; effective against MRSA Nitrofurantoin (Macrobid) - Answer- Safer than most antibiotics; Pregnancy Category B Tinea cruris - Answer- jock itch Tinea corpus - Answer- ring worm Undecylenic Acid - Answer- Army foot powder Tinea pedis - Answer- atletes foot Liver - Answer- Where is Tylenol metabolized at? N - acetylcysteine (Muconyst) - Answer- What is the antidote for Tylenol? Paracetamol - Answer- Tylenol may be labeled a what in Europe or Asia Reduce 1-2 points - Answer- How much will NSAIDS help in regards to the pain scale of 1-10 COX-1 - Answer- Can lead to gastric ulcers; Ex. Naprosyn COX-2 - Answer- Decreases inflammation only; Ex. Mobic Corticosteroids - Answer- Stimulate cortisol, an anti-inflammatory steroid produced in the adrenal glands Class 1 (strongest) to class 7 (weakest) - Answer- How are topical steroids categorized Short Acting Beta Agonists - Answer- Rapidly open the bronchi and are useful in acute cases such as asthma attacks Long Acting Beta Agonists - Answer- Slow onset and longer duration; usually compounded for treatment of chronic asthma H1 blockers sedating - Answer- Benadryl, Hydroxyzine H2 blockers - Answer- Zantac H1 blockers non-sedating/less sedating - Answer- Allegra/Zyrtec, Claritin Reglan (metoclopramide) - Answer- Pro-motility agent which helps the stomach pass its contents into the small intestine faster antispasmodics - Answer- Smooth muscle relaxers that relax the cramping of diarrhea Antidiarrheals - Answer- Cause watery stool to become more formed Stool Softners - Answer- Cause constipation to be relieved or prevented by adding bulk to the stool. Laxatives - Answer- Cause increased peristalsis to relieve constipation by altering water and electrolyte secretion producing net intestinal fluid accumulation and laxation Traumatic Brain Injury (TBI) - Answer- End result of a significant blow or penetrating injury to the head that disrupts normal brain function Blast Injuries - Answer- #1 cause of TBI MVC, GSW, Unspecified Blunt trauma, Airborne and fast rope operations - Answer- MOIs of TBI Mild, Moderate, Severe - Answer- Classifications of TBI's Mild TBI - Answer- Most common type of TBI, often missed, "Dead Man Walking", Transient confusion, delayed verbal and motor responses, disorientation, slurred or incoherent speech, any period of LOC - Answer- S/S of Mild TBI Moderate/Severe TBI - Answer- Penetrating injuries, lucid but deteriorate LOC, personality change, severe persistent headache, repeated vomiting, seizures, inability to waken dilation of pupils, slurred speech, loss of coordination - Answer- S/S of moderate/severe TBI Military Acute Concussion Evaluation (MACE) - Answer- Good tool to form neurological/cognitive baseline before deployment MC4 - Answer- Most effective modality to capture data for TBI testing Semiannually or as mission dictates - Answer- When should TBI testing be done baseline results, MACE results, exposure proximity and frequency to blasts, retest and compare results throughout deployment - Answer- Tracking documents for TBI should include what History and examination - Answer- MACE is broken down into 2 areas of concern Orientation, immediate memory, neurological screening, concentration, and delay recall - Answer- What are the evaluation criteria for the MACE exam Pronator Drift - Answer- A casualty who has suffered a TBI may display what 28/25 - Answer- What is the median score of a MCE exam? What scores indicates the need for further testing Involved in a vehicle blast, collision, or rollover; within 50 meters of a blast injury; direct blow to the head; command directed - Answer- What are mandatory events that require a MACE exam Red flags - Answer- Ominous signs of worsening condition Any positive answer to MACE items V-VIII; double vision; worsening headache; cant recognize people; disorientation to place; LOC greater than 5 minutes; slurred speech; weakness or numbness in arms/legs - Answer- Level 2 Evac for MACE red flags Progressively declining levels of consciousness; pupil asymmetry; seizures; repeated vomiting - Answer- Level 3 Evac for MACE red flags Cognitive, physical, behavioral - Answer- When approaching the possibility of TBI, it is imperative to focus on what 3 areas of evaluation Oxygenation, blood pressure, pupils, GCS - Answer- When assessing casualties for TBI's special attention should be directed to what? Eye response, verbal response, motor responses - Answer- 3 different areas of GCS GCS 3-15/ GCS 8 or below/ GCS less than 14 - Answer- What is the range for GCS? When is someone considered unconscious? When is special interest placed on patients? Airway, ventilation, oxygenation - Answer- Treatment for TBI With signs of cerebral herniation, posturing with asymmetric or bilateral dilated pupils - Answer- When do you hyperventilate TBI patients Hypertonic saline and colloids preferred to maintain SYS above 90 - Answer- Fluid resuscitation for TBI Mannitol 1.4-2.1 g/kg - Answer- May use this with signs of herniation but may exacerbate hypotension Traumatic iridoplegia - Answer- Paralysis of the sphincter of the iris High Altitude Illness - Answer- Cerebral and pulmonary syndromes that can develop in an un-acclimatized persons activity shortly after ascent to high altitude High Altitude Pulmonary Edema (HAPE) - Answer- Acute accumulation of fluid in the aveoli due to rapid ascent in altitude High Altitude Cerebral Edema (HACE) - Answer- Acute swelling of the brain due to rapid ascent in altitude Acute Mountain Sickness (AMS) - Answer- Syndrome due to rapid ascent in altitude consisting of headache, nausea, vomiting, and fatigue Apnea - Answer- Cessation of breathing Edema - Answer- Localized or generalized excessive amount of tissue fluid (swelling) Hypoxia - Answer- Inadequate oxygen content in the blood (hypoxemia) Hypobaric hypoxia - Answer- Hypoxia due to decreased availability ofoxygen in ambient air Acclimatization - Answer- Process whereby the body gradually adapts to the climate and environment Staged Ascent - Answer- Requires soldiers to ascend to a moderate altitude and remain there for 3 days or more to acclimatize before ascending higher Graded Ascent - Answer- limits the daily altitude gain to allow partial acclimatization Diffusion - Answer- The flow of a gas or liquid from an area of higher concentration to an area of lesser concentration Gradient - Answer- The difference in pressures from the high concentration to a lower concentration Partial pressure - Answer- Pressure of one particular gas in a gas mixture. Altitude increases - Answer- What happens when atmospheric pressure decreases Liquid - Answer- Gases in the body are dissolved in what? No referral needed, Stop ascent until symptoms resolve then resume, o2 therapy, antiemetic, acetazolamide, prognosis good within 24hrs - Answer- How to manage Acute Mountain Sickness Immediate descent and evac, continuous o2, dexamethasone, antemetic, furosemide (Lasix), consider hyperbaric therapy, possible rehab, prognosis good with correct care, without care brain herniation likely - Answer- Management of High Altitude Cerebral edema Immediate descent and evac, keep patient warm, O2 therapy, Dexamethasone, Procardia, consider hyperbaric therapy, possibly long term based pulmonary damage, good prognosis with approp. care, death with no care - Answer- Management of high altitude pulmonary edema Gamow Bag - Answer- portable pressure chambers used to treat causalities with altitude disorders 2 hours; 4 hours; 6 hours - Answer- How long does AMS treatment take in the bag?HAPE? HACE?