Term
|
Definition
- Atopic
- Red…blistering…itchy…scaly…skin disease
o Hereditary
o Chronic
o Typically occur at puberty
o Occurring on flexor areas
§ Neck…wrist
o ongoing |
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Term
|
Definition
o Antigen antibody reaction
o Localized
o Poison ivy
o Around nose…edge of mouth
o Topical steroids |
|
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Term
|
Definition
- Cold temp
- Caused by compulsive scratching of skin
- b/c skin is dry and it itches
- keep skin moist …. Lubricated
- topical steroids…calm skin down |
|
|
Term
|
Definition
- Edema
o swelling
- Erythema
o Redness
- 99% reflective of allergic reaction
o Food…medication
- If severe response
o Steroids to calm response down
- Maybe a bit of benadryl |
|
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Term
|
Definition
- Thick….scaly lesions…silvery white color
- Resemble fish scales
- Classically on the Knees, elbows, scalp
- Appear at any age
- Older people after 50 years
o Correlated w/ Arthritis
o 1—2 % at age 50—65 also 1—2% w/ psoriasis
- If early in life
o Real problem rest of life
- Runs in family
o Not genetic
o Possibly reflective of immune disorder |
|
|
Term
Cutaneous Infections
- Warts |
|
Definition
o Caused by DNA Virus
§ Communicable…contagious
§ Flat warts
· Appear almost anywhere
§ Planters
· Almost exclusively…bottom of foot
- As virus invades
o Kind of V—Form
o Planters warts can hurt…painful to walk….must excise tissue…nerve inflammation
o Compound W
§ Works ok
§ Salicylic acid |
|
|
Term
|
Definition
o Vitamin A…toxic to virus
o Topical….6 days…1 day off….3—6 weeks…kill virus
- Planters
o Duct tape |
|
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Term
|
Definition
Cold sore/fever blister
1.Some People…just have cold sores
2.What precedes these…immunologically compromising event
3.Some people…never get them
4.Chronic…. Greater than 6 a year
a. Small pox vaccine
b.70% never another cold sore |
|
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Term
|
Definition
1.Only communicable…when outbreak of herpes
2.Difficult thing…predicting outbreak
3.Manifesting itself 24—48 hours before person knows it
4.Concerned…in females…who are pregnant…ready to deliver and currently have an outbreak
a. Child pick up virus on skin
b.Disseminated herpes
c. Body—wide herpes
d.50% mortality
e. Secondarily infected |
|
|
Term
|
Definition
- VZ Virus
- Pox…latin…mark
- Some kids…few lesion…..some kids…covered
o Depends on degree of exposure
- Shingles
o Almost exclusively in adults
o Re-infection…someone who has had the POX
o VZ virus
§ 1st time….always POX
§ Immune system only recognizes circle portion of virus…antibodies go |
|
|
Term
|
Definition
- When re—introduced
o Only coming from square of virus
o Re – infection of partially immune host
o Most of the time w POX
§ Find virus in dorsal ganglia in particularly sensory nerve cells
§ Sit there forever
- Classically when compromised (immune)
o Virus grows/reproduces in dorsal ganglia cells
- Doesn’t look that bad
o But painful
o Narcotic pain
o Affected nerve
o Last a 1-2 weeks…may never come back….may arise w flu
- You w chicken pox could give the person shingles
o Big time problem…female pregnant….1st 26 weeks….infected w shingles
o Birth defects….fingers…toes…urinary bladder
o Virus…mutated cell…. |
|
|
Term
|
Definition
1.New borns….gums/mouth…thrush
2.Vaginal lining…yeast infection |
|
|
Term
|
Definition
- Most common
- Arises from basal (basement) epidermal layer of skin
- Directly correlated with age
- Inversely correlated w pigmentation of skin
- Increase with age
- Very correlated w sun exposure
- 80% = face, neck, head….(routinely sun exposed areas)
- Rarely metastasize
- Biopsy….thats it…no chemo..no radiation…easily dealt with |
|
|
Term
|
Definition
- 2nd most common
- Arises from epidermis
- Rarely metastasizes if occurs on routinely sun exposed area
o If on butt….higher probability
- Typically surgically removed….typically that’s it
- D
- Basal and squamous….comprise 97% of skin cancers |
|
|
Term
|
Definition
- 3% CA=60% death
- Frequent metastasize
- Melana…greek…dark…black….melodrama
- Very correlated w Sun exposure
- Until a decade ago
o Between 4th and 7th decade of life
- Now increases in teens…20 year olds….why we say wear sunscreen
- Runs in family…seems to be genetic predisposition
o Not sure where gene is YET
- Asymmetry
- Border
o ragged
- Color
o Uneven…shades of black,brown
- Diameter
o Change in size over time
- Elevation
- If diagnosed early
o Good prognosis
- Can arise somewhere besides skin
o Eye..vaginal
- From epidermis |
|
|
Term
Cerebral Vascular Accident |
|
Definition
- CVA = strokes
o 3rd most common cause of death in this country
- 4 mechanisms of CVA…….most common to least common
o Thrombis
o Embolis
o Bleed
o Aneurism |
|
|
Term
|
Definition
o 40% of cases
o Plaque…cerebral circulatory system
o 60-69=peak age
o Hopefully…TIA…transient ischemic attack
§ Some transitory loss/episode of cerebral dysfunction
o TIA is to brain…angina is to heart
o Onset of symptoms
§ In early morning hours…or shortly after awaking
§ Also the onset of MI’s
§ Platelets are stickier in early morning hours
· Correlated w circadian rhythms
o S & S
§ Occurring in step wise fashion…not gradual fashion
§ Suddenly lost feeling in left arm
§ Now my entire left side
§ Left leg numb
§ Boom….boom |
|
|
Term
|
Definition
o 2nd most likely…Younger population
o Manifestation of heart disease (cardiovascular disease)
o From thrombosis in heart
§ Thrown embolis from vascular…into cerebral
o Most common site…mid-cerebral artery |
|
|
Term
|
Definition
o Rupture cerebral artery/vein
o Cranial bleed
§ Problem….swelling brain tissue…from increased fluid…nowhere for expansion….w solid skull
o Displacement and compression
§ If push long enough…compress vessels…lose blood supply…occlude supply
o Real question
§ Where and how much is bleed
o If slow
§ Can put 100 ml of blood in entire cerebral hemisphere….and would be ok
o 5 ml. in brain stem
§ I’m dead
§ Pushes against base of skull…cut off respiratory…cardiovascular
o Severe headache
§ Worst headache of my life….gets your attention
o Vomiting…often projectile
o CT scan
§ Used to do spinal tap....if bloody…positive
o If bleed…and anticoagulants
§ More blood accumulation |
|
|
Term
|
Definition
- Least likely….Asymptomatic
o First sign…funeral….rupture and dead
- Very similar to aortic aneurysms
- Rupture during activity
o Pressure goes up
- “like something snapped in my head”
- Back to bleed scenario
o How big is blow…vessel…how much…anticoagulants
- Most likely cite…circle of willis
- Few aneurysms that run in family
o Structural abnormality in a few vessels |
|
|
Term
|
Definition
- Female less 40 yrs.
- Overall males/females….about 5% of population
- 75% of population have positive history in the family
- Very correlated with menstrual cycle
o If on birth control…makes migraines worse
- Vasodilation….vasoconstriction….localized vessel inflammation
- Cerebral blood flow
o Reduced…during period before headache….
o Increased…during actual headache
- Constriction…before
- Dilation…during
- 2 basic types
o Classic
o Common
o Minimal difference
- Blood flow |
|
|
Term
|
Definition
o Prodromal phase
§ Pre headache phase
§ Some kind of neurological cue…bout to have migraine
· Lose vision…ringing in ears…smell |
|
|
Term
|
Definition
o No pre phase
- Unilateral pain
o Start out as dull ache…very quickly pulsating pain (vascular)….throbbing pain
o Hurts between temple
o Frontal…temporal pain
- Don’t wanna be touch…comforted…just wana go in room…lights off…go away
o Reason
o Sleep relieves headache…throbbing pain ???? |
|
|
Term
|
Definition
o No pre phase
- Unilateral pain
o Start out as dull ache…very quickly pulsating pain (vascular)….throbbing pain
o Hurts between temple
o Frontal…temporal pain
- Don’t wanna be touch…comforted…just wana go in room…lights off…go away
o Reason
o Sleep relieves headache…throbbing pain ???? |
|
|
Term
|
Definition
- Nightly few weeks or months
- Males = more common
- Associated with REM
o Tend to occur w REM sleep patterns
o Wake up take med…sleep…wake up
- May be a form/type of migraine
- Cluster
o Occur in a cluster of time
o Couple of months….goes away for a “year”
- Different kind of pain in terms of migraine pain
o Constant
o Starts out and stays unilateral
o Localized on one side of face or one side of eyes (orbital tissue)
- Cluster headaches
o People move…can’t sit still
o Not hide in room
o Often times pain will wake you up
- Seen in children |
|
|
Term
|
Definition
- Band like tightness
- Pain going down back of neck
- Head in a vice
- Muscle contractions
o Tylenol…ibuprofen
- Chronic headaches
o Taking Tylenol
o Doesn’t make it go away completely
o Comes back
- Ibuprofen
o Anti-inflammatory….anti prostaglandins
o Prostaglandins
§ Cause smooth muscles to constrict
o Menstrual cramps
§ Tylenol no
§ Ibuprofen yes
o Prostaglandins…Produced by uterus….and muscles in head and neck
o Early labor
§ Inhibit prostaglandins …stop uterus from contracting |
|
|
Term
|
Definition
- Secondary
- Meningitis, inf. Sinus, teeth etc.
- Inflammatory headaches
- Secondary to something else in vicinity
o If meningitis…infected sinus…absess wisdom tooth…broken nose…eye strain |
|
|
Term
|
Definition
1.Highest incidence of primary epilepsy 75% develops before age of 20
2.Can a 30 year old suddenly develop epilepsy
a. Probably not
b.secondary |
|
|
Term
Partial/Focal
two presentations |
|
Definition
|
|
Term
|
Definition
o Jacksonian motor seizures
o Start w twitching of a finger…then hand…then arm…then shoulder….right side of chest….right leg
o Only on one side of body
§ Presentation of seizure…..one side motor
o Don’t lose upright stance….conscious |
|
|
Term
|
Definition
- Purposeless movement
- Clapping of hand….slapping lips…blinking eyes
- Typically conscious
- Upright position maintained
- Publicity
o Video games causing seizure
o No they weren’t
o Video games
§ Can initiate psychomotor seizures
o Also strobe lights
o Any kind of flashing light
o Visual and auditory stimuli
§ Can initiate seizure
- Looking at isolated/focal area in cerebral cortex |
|
|
Term
Generalized
- Bilateral
- Absence/petit mal |
|
Definition
o Almost exclusively in children
o Brief period
§ Absent
§ Just kinda staring at you
§ May/not osciltation of the eyes |
|
|
Term
- Tonic/clonic = Grand mal |
|
Definition
o Often times…patients will have aura prior to seizure
o Aura
§ Talking about classic migraines
§ Warning u will have seizure
· Smell…tingling…ringing ears
§ Some don’t have auras
· Their seizure are difficult to control
· Seizure dogs
o May last for 3-4-5 minutes
o lose bladder control
o not conscious
§ last thing remembered…aura…no recall |
|
|
Term
|
Definition
o Increases in Temp
o Children less 5 yrs.
- Idiopathic
- Suddenly spiked temp of 102
o What looks like and what is grand mal seizure
o Cool child down…end of seizure….thanks/bye
- Runs in family
o All kids w probably have it
- Almost always
o Grow out of this
o Stops…around 10—12
o Small percentage
§ Never stops |
|
|
Term
| Amyotrophic Lateral Sclerosis (ALS |
|
Definition
- Affects 4th – 7th decade of life
- Idiopathic
o Genetic
o Virus
o Autoimmune
o Not too sure it’s any of these
- Changes in
o Spinal cord
o Lower brain stem
o Motor neurons in cerebral cortex
§ Lose / Deterioration of neurons
- unaffected
o Sensory neurons
o Intellectual ability
- Can’t breath/talk
o Pneumonia
o Put you on respirator…or let you die
- High incidence of ALS
o Athletes
o Lou gehrig
§ 15 concussions
o Statistically based upon general population
§ NFL 14 vs. 1 in normal cases
§ Boxing same stats |
|
|
Term
|
Definition
- 38 yrs = onset
o Average onset of symptoms
- can live another 20 years
- ultimately bed—ridden
- Uncommon
- Genetic
o We know that
o Abnormal gene on chromosome 4
- Slow…nasty…progressive
- Cell decrease in basal ganglia and cerebral cortex
- All neurons
- Motor neurons
o Noticed first to go
- If in family
o Really think twice…reproduce
o If parent
§ 50/50 chance
- Huntington Indiana
o Huntington family
o Settled in area
o Half family developed this pathology |
|
|
Term
|
Definition
- Tremors
o At rest
- Bradykinesia
o Very slow movements
- Decrease dopamine production
- Deficit in dopamine pathways
- If stimulated dopamine pathways….fight/flightt |
|
|
Term
|
Definition
- Young population
- Female = more common
- Rare tropics
- Lesions in white matter of CNS
o Demyelinate nerve cells
o Insulation of nerves
o Keeps current from leaking out
- Symptoms occur ….get better
o Remyelinate neurons
- 98% of patients
o Antibody to proteins in myelin sheath
- Not cure…but alleviate symptoms
o Inject w/ bovine myelin
o More attractive antigen to antibody
o Antibody attacks bovine vs. somatic myelin |
|
|
Term
|
Definition
- Grave/profound muscle weakness
- 1:10,000
- 20 yrs = peak
- Lil more common in malesvs. females
- Decrease acetylcholine receptors
- Autoimmune
- Antibody to protein in acetylcholine receptors
- Localized antigen-antibody reaction
- Symptoms
o Associated with ocular muscles
- Nystagmus
o Repeatedup/down left/right
- 90% of patients
o Nothing but eye stuff…. Stops there
- Eye…. Face… laryngeal… pharyngeal… |
|
|
Term
|
Definition
- 10% population over 65 years
- Decrease hippocampal and cortical neurons
- Classic chronic neurological disease
- Also lose acetylcholine production
- Aluminum toxicity
o Part of pathology of disease
o Don’t get alzheimers… from drinking soda/can
Genetic component |
|
|
Term
|
Definition
- Presentation
- Initially
o Recent or short term memory
§ Did I turn the light off
- Next
o Trouble organizing daily activities
- Eventually
o Confused
o Disorientated
o Don’t know how to get there from here
o Can still play piano
- Some long term memories
o Never be affected
- Brain
o Always tries to protect itself
o To degree that it can
§ Make up an excuse
- Average course of disease
o Contraction…death
o 6—8 years |
|
|
Term
|
Definition
- Diagnosis of exclusion
o Don’t have stroke… encephalitis… ok u have alzheimers
- ADAP
o Alzheimers disease associated protein
o Unique/specific protein
o Requires spinal tap
§ Invasive
- Can’t really be diagnosed until post—mortum
- Occasionally
o Young onset
o Usually 45—50
Etiology
- Virus
- Autoimmune
- Aluminum toxicity |
|
|
Term
Increased intercranial pressure (ICP) |
|
Definition
- Normal ICP = 50-200 mm H20
- Increases periodically
- Sustained…need to worry
o 24-36-48 hrs
- Bleeding…trauma
- As brain expands… come up against immovable skull
- Limiting blood flow
- Typically Closed head trauma
- Increases ICP = decreased blood flow
Head Trama Brain Tissue Damage
Breakdown of BL-Brain Barrier
Cerebral Edema
Increased ICP
Decreased Cerebral Blood Flow
Hypoxia, Ischemia
Increase PCo2, Decrease Ph |
|
|
Term
|
Definition
1.Seizures
2.Comas
Glascow Comma Scale 1-5
- Eye Opening 1-4
- Verbal responses 1-5
- Motor responses 1-6
Just know what they are…in text |
|
|
Term
|
Definition
- 50% mortality
- Temporal lobe down and inward
- Dilation of pupils
- Often arterial |
|
|
Term
|
Definition
- Venous
- Brain stem
- Loss BP and respiration
Just know what they are…in test…..S & S a bit |
|
|
Term
|
Definition
- Dysmenorrheal
- Post partum blues….psychosis…depression
- Gave women progesterone after ovulation
o Didn’t do very good
- Calcium being upped and maintained…helps
- Rarely occurs in women
o Who have disrupted their menstrual cycle
§ Birth control
§ Pregnant
- Can be severe
- Dysmenorhea
o Painful menstruation
o Not a physical condition involving uterus
o Related to Increased prostaglandin from endometrial lining
§ Innermost lining of uterus
o Combination Birth control pill
§ Prevents ovulation
§ If you don’t ovulate don’t build up such endometrial tissue
§ Not as much prostaglandins
§ In direct method |
|
|
Term
|
Definition
- IUD = increased risk
- Pelvic inflammatory disease
- Generalized inflammatory reaction
- Almost always related to infection
- Two concerns
o In pelvic area – infection – reproductive area
- Often result of STD
- Other concern
o Pelvic area – vascular area
o Organisms being absorbed and circulating throughout body
§ Septicemia
- Walk…PID
o PID shuffle
o Waddle like a duck…try not to move your hips |
|
|
Term
|
Definition
- S. aureus
- Small % of women 8% carry staph aureus in their vagina
- 10% carry staph aureus in nasopharynx
o Of no consequence
- But if you work in ICU…infection control
- Newborns are incredibly susceptible to staph pneumonia
- Super absorbant tampons….cotton…breaking down…cottonàsugar
o Staph loves sugar
o As staph grows…releases exotoxins
o Absorbed through mucosal lining of vagina
o Exotoxin causes rash (resembles sunburn)…fever (101-2-3 degrees)…diarrhea (most importantly)
- What kills people
o Combination of fever and diarrhea
o Fluid and electrolytes
o Not enough vein to get fluid into you
o Cardiac and respiratory failure
- Diabetic
o Pee out lots of sugar
o Staph – sugar – toxic shock syndrome |
|
|
Term
|
Definition
- In situ = full thickness epithelium
- Dysplasis = less than full thickness
- Unique cancer
- Carcinoma in situ
o Unique
o Malignant
o More like a benign tumor
o Surrounded by perfectly normal cells
o Not terribly invasive
- Encapsulated malignancy
- 75-80%
o Result of STD
o Males are giving you HPV & herpes
- More frequent sexual exposure…more likely of having cancer
- Pap smear
- Other 20-25%
o Runs in family
o Some history in family…pap smears a bit more often |
|
|
Term
|
Definition
- After menopause
- Ovary = site metastasis
- Most likely develops after menopause
- Between 55 and 65 years of age
- Predictable cancer
- Cannot be diagnosed early
o Big enough tumor and your getting symptoms
- Myometrium…ovaries…metastasis
- Birth control
o Decreases certain forms of cancer
o Combination pill
o Deceptive
o If your 60 why u gonna be on birth control |
|
|
Term
|
Definition
- 26% of the cancers involving reproductive system
- Most occurs Post menopause
- Whats going on w ovaries post menopause
o Nothing
o Hard to diagnose early
o Aren’t detected until big enough…cause pain…palpate
- Some do occur pre-menopause
- At least if occurring
o In ovary ovulating out of (women favor one ovary over another) |
|
|
Term
|
Definition
- Rare
- May never see this
- Good that its rare…extremely poor prognosis
- How are we gonna pick it up
- Metastasizes
o Ovaries and uteries
- 5 year survival rate
o Near 0 (zero) |
|
|
Term
|
Definition
- Fibrocystic breast disease
o Characterized by
§ Cyst formation
§ Ductal epithelial proliferation
§ Ductal adenosis
· With formation of fibrous tissue
o All that means is
§ Palatable masses in breast tissue
§ And sometimes discharge
o Correlated with Increased estrogen and deficiency progesterone during luteal phase of menstrual cycle
- Affects about 50% of all females
- Bilateral
- Probably not a disease…renamed
o Fibrocystic changes in breast
- Some of these changes
o Correlated increase probability of breast cancer
- Proliferation of epithelial tissue in ducts
o Increased correlation
- Most predominant after ovulation
Soon after disappear |
|
|
Term
|
Definition
- Second most common form of cancer in females
- Common in north America/ western Europe
- Rare in japan
- Increase risk for breast cancer if never given birth
o Nuns
- Increase risk
o Started menstruation early
o Menopause late
o Something to do w ongoing estrogen levels (exposure)
- Slight increased risk
o First pregnancy after age of 30
- Decreased risk
o Breast feeding
- Virus in mice
o Causes breast cancer
o In humans
§ Next to no evidence of virus correlations |
|
|
Term
|
Definition
§ Lobular carcinoma in sutu
· In situ (non invasive)
· Lump ectomy
§ Not necessary to remove entire breast
§ Chances are it will return |
|
|
Term
|
Definition
§ Ductal carcinoma in situ
o Ductal system
o Maybe lump ectomy maybe a bit more radical surgery
o Ductal
§ Possible secretion of cells
o 1st two
§ About 20% |
|
|
Term
|
Definition
§ Invasive ductal carcinomas
o 80%
o Not confined or in situ
§ Invasive
o Classic presentation
o Slow growing
o 1 cm mass…about smallest you can palpate
§ Takes 7 years to get there
§ Statistically at this point 25% have metastasized
- Ductal system
- Thought mammograms be big diagnosing tool
o Can miss stuff
o Too small
- Diagnosis
o Real key…breast exams |
|
|
Term
|
Definition
- Nipple ducts
Inflammatory CA
- Extremely Rapid growth
- Surgery ASAP
- Very guick aggressive metastasizes
- Poor prognosis
- Not common |
|
|
Term
|
Definition
- Decrease in testosterone
- Prepubertal period
o Delay epiphysis closings on bone
- In 25 year old
- More like 18 and on
o Correlated with libido
o Sperm counts decreased
- End result…less testosterone |
|
|
Term
|
Definition
- 19% CA in males
o 95% = adenocarcinoma
o Gland
- No relationship in benign prostatic hyperplasia
o BPH and cancer of prostate
- 85 years old (half)…95 years old (2/3) will have it
- Depending on where on gland…slow growing
- Treatment…function of who you ask
- Prostate…very sensitive to androgens and estrogens
- Treatment
o Estrogen…inhibit activity on prostate
o Side effect…breast tissue |
|
|
Term
|
Definition
o Prostate specific antigen
o Correlated w prostate cancer
o If elevated …
o Located precariously
§ Removing prostate meant…75% of time…imcompetent impotent
§ b/c of cutting nerves
§ if 90 years old no problem
- nerve sparing surgery
o go in and cut around all o nerves
o 20% chance of impotence & incontinence
- Assuming no history of prostate cancer
o PSA prostate exam yearly
- We are concerned with continually elevating PSA
- Runs in family
o Probably soon find a gene
- If family
o Back up exams to age 40
- PSA…proven very helpful |
|
|
Term
|
Definition
- 1% of cancer in males
- If male has a growth in testes…its cancer…its malignant…bottom line
- Males don’t usually get growths
- Peak = 20-35 years
- Testes…pretty simple…seminiferous tissue
o Uncoiled tube…40 yards long…compressed 2in x 1in
- Probability of getting pregnant…astronomical
- Once sperm inside egg
o Egg repels the rest |
|
|
Term
|
Definition
- Very delicate bacteria
- Not environmental…must be passed person to person
- 3-5 days incubation
- Discharge
- Must appear in WBC |
|
|
Term
Neisseria gonorrhea
males |
|
Definition
- Males = urethra
o Infected urethra…localized
o Symptoms develop in 3-5 days
o Pain burn during urination
o Discharge from penis…pus
o Motivating symptoms |
|
|
Term
Neisseria gonorrhea
females |
|
Definition
- Females = urethra and cervix
o 50% have same thing
§ 3-5 day incubation
§ Discharge vaginal
§ Pain burn—urination
o Other 50%
§ 6 weeks
§ Remain Sexually active…cohort of transmission
§ This group is getting off worse
§ Incidence of PID increases
§ Infection uterus/fallopian tubes increases |
|
|
Term
Neisseria gonorrhea
S&S
diagnosis |
|
Definition
- Direct gram stain of pus
o Intercellular gram negative cocci
o Pus is mostly SEG’s
- Pain…burning (urination)…discharge(pus)…gram – cocci….all put togetherà
o 85% chance of being gonorrhea
o Non gonnococyl urethritis other 15%
- We deal w 2-4 million new cases each year
o That are reported
- Obstetrics
o At time of delivery…antibiotics into eyes of infant…gonorrhea…just in case
- Can get repeat cases of gonorrhea
o Each time…urethra scars up |
|
|
Term
|
Definition
- T. Pallidum
o Very hardy
- One of few Spiral shaped pathogens
- Historical significance
- Edgar allen poe…christopher Columbus
- Predictable stages
o Incubation period 2—6 weeks
o Primary syphillus…chancre at point of entry…soft ulcer
o Chancroid…
§ Looks like à
§ Viral
- Painful
- Only be transmitted…when chancre is present (2—4 weeks)
- When disappears |
|
|
Term
|
Definition
o Secondary stage
§ Looks like flu
§ Temperature
§ Chicken pox
§ Few days…week…then they go away
§ Rash all over body
- Latent stage
o Symptom free for year
o Latent = equilibrium
o Infective powers vs. defensive powers are equal
o No better no worse
|
|
|
Term
|
Definition
- If untreated
o Headed to brain or heart valves
o Bicuspid valve
- Pre—maritial blood work
- Children
o Transmitted prenatally
o Find organism in blood stream
- Mother gets pregnant and contracts syphillus
o 40 weeks til pregnant
o 6 weeks syphillus
o Infant has syphillus in brain and cardiac problems
o Assuming no medical attention
- Child
o First sign…permanent teeth come in…central front incisors
o Each tooth comes in w prominent notch in center of two
o Hutchinsons teeth…obvious notch
- Syphillus
o Never mutated…plain old penicillin |
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Term
VOLUME IMBALANCES
Primarily involve extracelluar fluids
ECF volume deficit = hypovolemia
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Definition
- Loss = amts. Water and sodium
o Equal loss or gains of water/sodium
- This is not dehydration
o What happens to sodium…hypernatremia
- Almost always related to Renal and/or extra renal loss of body fluids
- Most common reason = prolonged vomiting, NG suction, massive diarrhea, bleedings, burns
- Renal
o Anything from kidneys that causes polyuria
- Most common
o Vomiting
o Nasogastric suction
o Diarrhea
- All 3 most common
o Involve GI tract
o b/c GI tract involves Na/H2O
- patients can also lose
o large amounts of fluid
- Temp 101-103 over a 24 hr. period
o fluid increase requirements of 500 mL
- Temp above 103 over a 24 hr. period
o fluid increase requirements 1000 mL |
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Term
VOLUME IMBALANCES
Primarily involve extracelluar fluids
ECF volume deficit = hypovolemia |
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Definition
- Hypovolemia reduces/impairs cardiac output
o Not ejecting enough out of left side of heart
o Affects blood pressure
- Decrease renal profusion activates rennin-angiotensin-aldosterone mechanism
o Hold onto Na/H20
o Generally do fine for a while
- Stay lying down
- 3-4K mL fluid deficit
o Skin pale…clammy
- Volume deficits impair cardiac output |
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Term
ECF Volume Excess = Hypervolemia |
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Definition
- Water and NA+ retained in same proportions
- As fluid accumulates
o Trying to save person from congestive heart failure
- Shift fluid into interstitial fluids
- Edema – localized or generalized
- Renal failure…congestive heart failure (two classics)… also, in cirrhosis of liver
- Any scenario
o Cant get rid of fluid |
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Term
OSMOTIC IMBALANCES
Intracellular fluids |
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Definition
1.Unequal loss/gains in sodium/water
2.Hypo/hyper natremias
3.Sodium NA+ major osmotic active solute in ECF
Hypoosmotic = hyponatermia
Hyperoosmotic = hypernatremia |
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Term
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Definition
- Definition…lab standpoint…Serum NA+ below 135 mEQ/L
o Loss of NA+ in excess of water
§ Vomiting…diarrheas
o Gain water in excess of NA+
§ Congestive heart failure…renal failure
- Psychological
o Psychogenic polydipsia
o Compulsive drinking of water |
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Term
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Definition
- Definition…lab standpoint…Serum NA+ above 145 mEQ/L
- If increase in Na…water shifts from intracellular to extracellular
- Insufficient water intake
o Had a stroke couldn’t tell you they were thirsty
o Burns…dehydrations
- Loss of water in excess of NA+
- NA+ gain in excess of water
o Near drownings in the ocean
o No one is paying attention to IV’s
- Protective mechanism = thirst
- Stroke and elderly patient…may not respond to thirst |
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Term
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Definition
K+ Imbalances
- Serum 3.5-5.5 mEq/L
- Inside cell 160 mEq/L intracellular
- Without altering osmotic activity |
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Term
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Definition
- Serum K+ below 3.5 mEq/L
- K+ pH connection…high correlation
o 0.1 unit fall in pH, K+ increases 0.5 mEq/L
o 0.1 unit increase in pH, K+ decreases 0.5 mEq/L
o Vomiting = increase in renal excretion of K+
- Alcoholics
- NG suction
- Top 3 most common
o Vomiting
o Diarrhea
o Naso Gastric Sucitoning
§ Losing particularly upper gastric fluid…losing acid from stomach
§ If, then blood pH going to rise…
§ Clearing K through kidneys |
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Term
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Definition
- Serum K+ greater 5.5 mEq/L
- Higher K less cardiac cells excitable
- Renal failure…cant pee out K
- ER!! |
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Term
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Definition
Normal = 7.35 – 7.45 (St. Basic)
Less 7.35 = Acidosis
More 7.45 = Alkalosis
Buffer System
H2O + HCL = H+ + Cl- (ph = 7)
pH (acid)
H2O + NaOH = Na+ + OH-
ph (base)
H2CO3 = Carbonic Acid
NaHCO3 = Sodium Bicarbonate
ACID
HCL + NaHCO3 H2CO3 (Carbonic Acid Weak) + NaCl (Salt = Neutral)
Carbonic
H2CO3 Anhydrase H2O + CO2
(RBC) (Expired)
Base
NaOh + H2CO3 NaHCO3 (St. Basic Salt) + H2O
Carbonic Acid – Excess base
Sodium Bicarbonate – Excess acid
Ratio 1:20
1 Carbonic Acid
20 NaHCO3 Normal pH
H2CO3 pH
NaHCO3 pH
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Term
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Definition
- Control pCO2
CO2 + H2O H2CO3
CO2 H2CO3, pH buffer more acid
CO2 H2CO3, pH buffer less acid
Depth, rate resp. = pCO2
Acid
Depth, rate resp. = pCO2
Acid
H2CO3
Factor Kidney retains H+ and excretes Base (HCO3)
NaHCO3
Normal Ratio restored
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Term
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Definition
Factor H2CO3 Kidney Excretes H+
Causes NaHCO3
Reabs Base (HCO3)
Normal ratio restored |
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Term
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Definition
- Decrease in HCO3- = decrease in pH
- Diarrhea = most common
- RTA, hypoaldosteronism, increase lactate, ketoacidosis, starvation, ASA
- Respiratory = hyperventilation = decrease PCO2 |
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Term
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Definition
- Increase in HCO3 = increase in pH
- Vomiting, NG suction, Cushings, hyperaldosteronism, antacids
- Compensation
- H+ exits cell to buffer
- Increase in lactic acid
- Decrease ventilation
- Excretion of excess HCO3- |
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