NR507 Week 7 Quiz Study Guide

Acute complications of diabetes mellitus - answer-DKA (type 1) and HHS (type 2) avulsion - answer-fragment of bone connected to a ligament or tendon breaks off the main bone Bulimia nervosa and anorexia nervosa - answer-what they are and complications from study guide Causes of elevated liver function tests - answer-TYLENOL portal hypertension hepatic encephalopathy ascites jaundice hepatitis acute liver failure cirrhosis Many liver diseases cause increase in liver function tests (ALT and AST) because of the release of cytoplasmic enzymes into the circulation when there is damage to the hepatocyte. -obstruction of bile canaliculi or ducts results in regurgitation of bile back into the hepatic sinusoids and into the circulation (increased bill levels) Causes of GERD - answer--loss of muscle tone in lower esophageal sphincter (LES) -conditions that increase the abdominal pressure -impaired esophageal motility -defective mucosal defense -delayed gastric emptying -reflux of gastric contents Characteristics of gastric ulcers - answer--usually occur between 50-70 years of age -less common than duodenal ulcers -increased risk of cancer!! -develop in antral region of the stomach (near the acid-secreting mucosa of the stomach body) -primary defect in gastric ulcers is an abnormality that increases the mucosal barrier's permeability to hydrogen ions. This is a vicious cycle. The damaged mucosa liberates histamine which stimulates the increase of acid and pepsinogen production, blood flow, and capillary permeability. The disrupted mucosa becomes edematous and loses plasma proteins. And the destruction of the small vessels causes bleeding Chronic complications of diabetes mellitus - answer-Microvascular (damage to capillaries including retinopathies, nephropathies, and neuropathies. Macrovascular (damage to larger vessels, including coronary artery disease and peripheral vascular and cerebral vascular disease) Infections Classic signs of Type 1 diabetes mellitus and their causes - answer-Polydipsia: water follows sugar (into blood) and out of cells, so body is dehydrated and thirsty. Polyuria: hyperglycemia acts as an osmotic diuretic polyphagia: depletion of cellular stores of carbs, fats, and proteins so they are hungry weight loss: bc of fluid loss in osmotic diuresis and loss of body tissue as fat and proteins are used as energy fatigue: metabolic changes result in poor use of food products, contributing to lethargy and fatigue; sleep loss from severe nocturia also contributes to fatigue Classic signs of Type 2 Diabetes and their causes - answer-Recurrent infections: high blood sugar is good medium for pathogen growth, impaired blood supply hinders wound healing, and decline in immune protection Genital pruritus: hyperglycemia and glycosuria favor fungal growth and candid infections resulting in itching. more common in women Visual changes: blurred vision occurs as water balance in the eye fluctuates because of elevated blood glucose levels. diabetic retinopathy is another cause of vision loss Paresthesias: common manifestations of diabetic neuropathies Fatigue: metabolic changes result in poor use of food products Acanthosis nigricans: brown to black pigmentation in body folds associated with insulin resistance Clinical manifestations of gastric ulcers - answer-Pain (located in the upper abdomen) The pain occurs after eating (w/in the first hour after eating). Eating helps at first. The food helps until the food moves into the duodenum. Pain happens when the stomach is empty!! There is increased acid in stomach when empty and it causes the pain closed - answer-bone did not go through skin comminuted - answer-two or more fragments (multiple breaks) Complete - answer-break all the way through the bone compound - answer-open between bone and skin (infection is problem) like an open fracture Diagnosing Rhabdomyolysis - answer-Creatine kinase, which is an enzyme found in the skeletal muscles, the brain, and the heartMyoglobin in blood and urine, which is a protein that's a byproduct of muscle breakdownPotassium, which is another important mineral that may leak from injured bone and musclesCreatinine in blood and urine, which is a breakdown product created by muscle that's normally removed from the body by the kidneys displaced - answer-fracture with one, both, or all fragments out of normal alignment Epicondylopathy - answer-Epicondylitis is inflammation of a tendon where it attaches to a bone (at its origin). It is also related to smoking, obesity and work activities that involve forceful or repetitive cyclic flection a pain syndrome of the lateral and medial segments of the elbow joint, is one of the more prominent joint pain syndromes. The occurrence of pain in the periarticular tissues, often referred to as periarthritis, is a frequent cause of major limitations on the patient's limb mobility. Usually caused by overuse. lateral (tennis elbow) medial (golfer's elbow) Gastric secretion in gastric ulcers - answer-Gastric secretion may be normal or less than normal, and there may be a decreased mass of parietal cells Gout (cause of pain) - answer-The formation of urticaria acid crystals in the joints due to excess uric acid greenstick - answer-perforates and splinters. bending bone and splinters outside of bone and not the inside. COMMON IN CHILDREN Hip fractures secondary to osteoporosis - answer--most serious due to their resultant chronic pain, disability, diminished quality of life, and premature death. -Fracture of the neck of the femur (intertrochanteric fracture) tends to occur in older adult women with osteoporosis. -Fatal complications of fractures include fat or pulmonary embolism, hemorrhage, and shock. -Approximately 20% of persons with a hip fracture die as a result of surgical complications. impacted - answer-being pushed into another structure or a fracture fragments are pushed into each other incomplete - answer-not all the way through the bone Interpretation of hepatitis B vaccine serological markers (HbsAb) - answer-anti-HBs or HBsAb (Hepatitis B surface antibody) - A "positive" or "reactive" anti-HBs (or HBsAb) test result indicates that a person is protected against the hepatitis B virus. This protection can be the result of receiving the hepatitis B vaccine or successfully recovering from a past hepatitis B infection. This test is not routinely included in blood bank screenings. A positive anti-HBs (or HBsAb) test result means you are "immune" and protected against the hepatitis B virus and cannot be infected. You are not infected and cannot spread hepatitis B to others. Kidney function in the patient with diabetes insipidus - answer-The renal tubules do not respond to ADH appropriately. So, the kidneys can't concentrate the urine and excrete large amounts of urine linear - answer-parallel to long axis of bone Manifestations of GERD - answer-heartburn, regurgitation, and abdominal pain within one hours of eating Microvascular Disease (accelerated atherosclerosis) - answer-Cardiovascular Disease Stroke Peripheral After Disease Microvascular Disease (tissue hypoxia from capillary closure) - answer-Diabetic retinopathy Diabetic Kidney Disease Diabetic neuropathies (lack of pain from injury) oblique - answer-angle to bone shaft occult - answer-a fracture we don't know about (hidden fracture) ABUSE open - answer-bone went through skin Osteomalacia - answer-softening of the bones, typically through a deficiency of vitamin D or calcium. Etiology: small bowel, hepatobiliary and pancreas disorders INADEQUATE/ DELAYED MINERALIZATION IS THE CAUSE!! called "Rickets" in children. pain, bone fractures, vertebral collapse, bone malformation. pathologic - answer-point where bone is weakened by disease- OSTEOPOROSIS Pathological features of degenerative joint disease AKA osteoarthritis - answer-Nonneoplastic disorder of progressive erosion of articular cartilage associated with aging, trauma, occupational injury -non-inflammatory -ARTICULAR CARTILAGE -local areas of damage and loss of articular cartilage, new bone formation of joint margins, mild synovitis, and thickening of joint capsule --Bouchard's nodes: proximal joints of fingers --Herberden's nodes: appear on the sides of the distal joints to the fingers -hands and knees most common joints affected Pathophysiology of type 1 diabetes - answer-In autoimmune-mediated DM, environmental and genetic factors are thought to trigger cell-mediated destruction of pancreatic beta cells. A specific cause is still unknown. Affected individuals have varying degrees of insulin deficiency, lack islet autoantibodies and HLA association, and have intermittent proneness to ketosis. Reflux esophagitis aka gastroesophageal reflux disease (GERD) - answer-The reflux of acids, pepsin or bile salts (chyme) from the stomach to the esophagus that causes esophagitis Risk factors of gastric ulcers - answer-H. Pylori infection duodenal reflux into stomach (acids, bile, and pancreatic fluids) NSAIDs Screening test for osteoporosis - answer-measuring bone mineral density (BMD) by using dual x-ray absorptionmetry (DXA) continues to be the most common method of estimating bone mass. The fracture risk assessment (FRAX) determines probability of a fracture. Signs common to both type 1 and type 2 diabetes - answer-Polydipsia Polyuria Polyphagia Fatigue Blurry vision numbness/tingling (paresthesia) unexplained weight loss impaired wound healing spiral - answer-curves around and encircles the bone. Bone is being twisted. happens in ATHLETES stress - answer-mini fracture. Fatigue stress fracture- micro fracture due to repeated strain (obese person or running is example in normal person) insufficiency stress fracture- rheumatoid arthritis, osteoporosis, etc. TRANSCHONDRAL FRACTURE - answer-Separation of cartilaginous joint surface (articular cartilage) from main shaft of bone. A type of incomplete fracture. It consists of fragmentation and separation of a portion of the articular cartilage that covers the end of a bone at a joint. The fragments may consist of cartilage alone or cartilage and bone. Typical sites of this type of fracture are the distal femur, the ankle, the kneecap, the elbow, and the wrist. MOST PREVALENT IN ADOLESCENTS transverse - answer-horizontal break T