NR 509 Final
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
ANS-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - ANS-early morning
erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in the hypogastric
arterial system, impaired neural innervation, and diabetes
When performing a breast exam, know what abnormal masses should do when the arm
- ANS-may be fixed to skin or underlying tissues (may cause dimpling of skin or
retraction when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - ANS-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - ANS-BSE
Breast stage 1 - ANS-preadolescent- elevation of nipple only
Breast stage 2 - ANS-breast bud stage- elevation of breast and nipple as a small
mound; enlargement of areolar diameter
breast stage 3 - ANS-further enlargement of elevation of breast and areola, with no
separation of their contours
breast stage 4 - ANS-projection of areola and nipple to form a secondary mound above
the level of breast
breast stage 5 - ANS-mature stage- projection of nipple only; areola has receded to
general contour of the breast (although in some individuals the areola continues to form
a secondary mound)
Know where pain is located with pancreatitis: acute - ANS-epigastric, may radiation
straight to the back of other areas of the abdomen; 20% with severe sequelae of organ
failure
Know where pain is located with pancreatitis: chronic - ANS-epigastric, radiating to back
, Know how hepatitis A is transmitted - ANS-Transmitted through fecal-oral route. Fecal
shedding followed by poor handwashing contaminates water and foods leading to
infection of household and sexual contacts
Stress incontinence - ANS-the urethral sphincter is weakened so that transient
increases in intra-abdominal pressure raise the bladder pressure to levels that exceed
urethral resistance. Causes include childbirth and surgery, postmenopausal atrophy of
the mucosa, and urethral infection. May follow prostate surgery in men.
urge incontinence - ANS-detrusor contractions are stronger than normal and overcome
the normal urethral resistance. The bladder is typically small. Mechanisms: Decreased
cortical inhibition of detrusor contractions from stroke, brain tumor, dementia, and
lesions of the spinal cord above sacral level. Also hyperexcitability of sensory pathways
ie: bladder infections, tumors, and fecal impaction. Deconditioning of voiding reflexes ie:
frequent voluntary voiding at low bladder volumes.
overflow incontinence - ANS-detrusor contractions are insufficient to overcome urethral
resistance, causing urinary retention. The bladder is typically flaccid and large, even
after an effort to void. Mechanisms: obstruction of the bladder outlet ie: BPH or tumor.
Weakness of the detrusor muscle associated with peripheral nerve disease at S2-4
level. Impaired bladder sensation that interrupts the reflex arc ie: diabetic neuropathy.
functional incontinence - ANS-the patient is functionally able to reach the toilet in time
because of impaired health or environmental conditions. Mechanism: problems in
mobility resulting from weakness, arthritis, poor vision, or other conditions. Also
environmental factors such as an unfamiliar setting, distant bathroom facilities, bed rails,
or physical restraints.
Incontinence secondary to medications - ANS-drugs may contribute to any type of
incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic blockers,
and potent diuretics
Know where lymph nodes should be with strep - ANS-· Strep throat àstreptococcal
pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
ANS-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - ANS-early morning
erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in the hypogastric
arterial system, impaired neural innervation, and diabetes
When performing a breast exam, know what abnormal masses should do when the arm
- ANS-may be fixed to skin or underlying tissues (may cause dimpling of skin or
retraction when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - ANS-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - ANS-BSE
Breast stage 1 - ANS-preadolescent- elevation of nipple only
Breast stage 2 - ANS-breast bud stage- elevation of breast and nipple as a small
mound; enlargement of areolar diameter
breast stage 3 - ANS-further enlargement of elevation of breast and areola, with no
separation of their contours
breast stage 4 - ANS-projection of areola and nipple to form a secondary mound above
the level of breast
breast stage 5 - ANS-mature stage- projection of nipple only; areola has receded to
general contour of the breast (although in some individuals the areola continues to form
a secondary mound)
Know where pain is located with pancreatitis: acute - ANS-epigastric, may radiation
straight to the back of other areas of the abdomen; 20% with severe sequelae of organ
failure
Know where pain is located with pancreatitis: chronic - ANS-epigastric, radiating to back
, Know how hepatitis A is transmitted - ANS-Transmitted through fecal-oral route. Fecal
shedding followed by poor handwashing contaminates water and foods leading to
infection of household and sexual contacts
Stress incontinence - ANS-the urethral sphincter is weakened so that transient
increases in intra-abdominal pressure raise the bladder pressure to levels that exceed
urethral resistance. Causes include childbirth and surgery, postmenopausal atrophy of
the mucosa, and urethral infection. May follow prostate surgery in men.
urge incontinence - ANS-detrusor contractions are stronger than normal and overcome
the normal urethral resistance. The bladder is typically small. Mechanisms: Decreased
cortical inhibition of detrusor contractions from stroke, brain tumor, dementia, and
lesions of the spinal cord above sacral level. Also hyperexcitability of sensory pathways
ie: bladder infections, tumors, and fecal impaction. Deconditioning of voiding reflexes ie:
frequent voluntary voiding at low bladder volumes.
overflow incontinence - ANS-detrusor contractions are insufficient to overcome urethral
resistance, causing urinary retention. The bladder is typically flaccid and large, even
after an effort to void. Mechanisms: obstruction of the bladder outlet ie: BPH or tumor.
Weakness of the detrusor muscle associated with peripheral nerve disease at S2-4
level. Impaired bladder sensation that interrupts the reflex arc ie: diabetic neuropathy.
functional incontinence - ANS-the patient is functionally able to reach the toilet in time
because of impaired health or environmental conditions. Mechanism: problems in
mobility resulting from weakness, arthritis, poor vision, or other conditions. Also
environmental factors such as an unfamiliar setting, distant bathroom facilities, bed rails,
or physical restraints.
Incontinence secondary to medications - ANS-drugs may contribute to any type of
incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic blockers,
and potent diuretics
Know where lymph nodes should be with strep - ANS-· Strep throat àstreptococcal
pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
