WGU D027

50% chance child will have

25% child will have; 50% chance child will carry it

affects pancreas & causes increased secretion in lungs

Down Syndrome

when a male has extra X; female qualities (breast, low sperm)

missing X in females; weblike neck

inherited blood disorder; mild to severe anemia

low hemoglobin; ferrous sulfate is contraindicated

proportion of population affected at certain time

number of new cases divided by population

defense system with which you are born

immune response

cells are disorganized

steroids for adrenal insufficiency, inflammatory & autoimmune disorders, asthma, organ transplant; toxic to lymphoid tissues

Tx of breast CA; Tamoxifen

impairment of ventricle to fill or eject blood; heart can't meet metabolic needs of body

volume overload in pulmonary area; heart can't keep up w/ metabolic needs

reduced EF; ventricular problem ejecting blood

55-60% blood pumped out w/ each heartbeat

preserved

preserved EF; problem is w/ filling

reduced EF; problem is w/ ejection

most common; left ventricle can't pump blood properly; fluid build-up causes breathing difficulty

BNP

echocardiogram

ACE I or Angiotensin II RB for vascular disease or diabetes. (avapro, losartan, benicar, diovan)

crushing/squeezing/sharp pain in neck/jaw/chest; pain worse w/ exertion, hypoxia, abnormal heart sounds (arrhythmias, aFib, ST elevation)

decrease cardiac oxygen demand

nitroglycerine is 1st choice; Beta-blockers if angina occurs w/ effort

5 mins; 3 doses

increases output w/ increased myocardial contractile force; exerts positive inotropic action; can cause severe dysrhythmia

assess apical pulse BEFORE giving therapeutic dose 0.5-0.8 ng/mL

to inactivate & suppress thrombin formation

oral medication to prevent blood clots; start w/ half dose

warfarin, heparin, lovenox; risk of hemorrhage for pts w/ bleeding disorders

influenza that progresses down into lungs

CXR; viral = diffuse (widespread whitening) or bacterial = patchy, consolidated, lobar.

destruction of alveolar walls; air gos in & can't get out = hyperinflation

excess mucous w/ smooth muscle hypertrophy

chronic inflammatory obstruction of bronchi; triggers cause mucus to clog bronchial tubes; reversible w/ beta-agonists & steroids

glucocorticosteroids for long-term control, to suppress inflammation (Pulmicort & Flovent). Oral glucocorticoids = prednisone & methylprednisone; gradually decrease dose

PRN for symptomatic relief during attack, Albuterol; no effect on disease process. Long-acting Beta 2 can be taken w/ glucocorticoids.

give NSAIDS & rest; no imaging until pain persists 4-6 weeks (unless there is near involvement); #1 reason for PCP visits

Diabetes, Acromegaly, Addison's, Cushing's, Graves.

overproduction of growth hormone, overbite & buffalo hump.

decreased hormone production in adrenal gland.

high cortisol levels.

hyperthyroidism

1st dose @ night; slow position changes, beware of hypotension

(-pril) 1st dose causes severe hypotension; reduces Angi II & increases bradykinin; DRY COUGH; contraindicate in pregnancy

Class II antidysrhythmics; slow HR, lower BP, relax vessels, prevent chemical messengers

use carefully in pts w/ lung conditions; DON'T use w/ asthma

metropolol; only Beta-1 receptors affected

labetalol; blocks alpha & beta receptors

class IV antidysrhythmics; vasodilation of arterioles in heart

• Verapamil

dihydropyridines CCB

diltiazem

lipid-lowering agents can increase good cholesterol (HDL); muscle pain can lead to rhabdo, kidney failure & death

onset 2 hrs after oral intake, peaks @ 4-6 hrs, lasts 12 hrs

block reabsorption in distal tubule; may cause hypokalemia; DON'T use w/ kidney failure or sickle cell

furosemide/Lasix; blocks reabsorption in loop of Henle

Spironolactone/Aldactone; (distal nephron); holds potassium, excretes sodium, takes 48 hrs to work

vasoconstriction; increases BP by acting on adrenal cortex secreting aldosterone

-sartan; blocks action of Angiotensin II; 2nd choice if pt can't tolerate ACE for HTN or HF

Hgb A1C = most reliable assessment of blood glucose over 3 month period; bad A1C is >9, goal is < 6.5 in healthy people

Humalog (lispro), Novolog (aspart), Aspirdra (glulisine)

Lantus (glargine) most painful; Levemir (detemir)

#1 drug for new Type 2 diabetes; inhibits glucose in liver, slightly reduces glycose absorption in gut, increases glucose uptake; DOES NOT drive insulin down; very low risk for hypoglycemia

normal range = 0.4-4.0 mu/L

hypothyroid

normal range is 0.5-3.0 mu/L.

neurological issues in fetus

require thyroid treatment within several days, lasts for 3years; prevents changes in mental development & growth patterns; dwarfish

on empty stomach for best absorption

autoimmune disease with weight gain & fatigue

elevated T3 & T4, tacharrhythmias, anxiety, insomnia, rapid speech, hot

women 20-40 most susceptible; remove or destroy thyroid tissue, or suppress w/ methimazole or propylthiouracil; Tx w/ iodine; Beta-blockers used to suppress release of thyroid hormones

result of adenoma/tumor; same as Graves but w/out exophthalmos (eye bluge)

r/t major surgery or severe illness like sepsis; 105 fever, severe tachycardia, restlessness, tremors, HF, coma. Tx w/ Propylthiouracil(PTU) & symptom management

relieve itching, pain, mucous (allergies); cause vasodilation & bronchoconstriction; help w/ memory & sleep; 2nd gen are non-sedating

to control secretion of gastric acid; to Tx gastric & duodenal ulcers

130-139/80-89

> 140/90

Beta-blocker for 6 mos

aspirin or anti thrombotic

21-29 years old cytology q 3 yrs
30-65 years old cytology q 3 yrs + HPV testing q 5 yrs

Confusion, Urea >7, RR > 30, SBP <90 or DBP <60. 0-1 = home Tx. 2 = short hospital stay. 3 = severe pneumonia/ICU

SSRIs, low side effects & high effectiveness

mimics MI, no coronary obstruction

exacerbates health issues; doesn't cause cancer

Amoxicillin

fluids, salt increase, Florinef; rise slowly

tilt test- HR increases by 30 or higher than 120 in the first 10 minutes

Steroid used in the Tx of Addison's, adrenocortical insufficiency, ortho hypo

sleep aid for patients with PTSD

autoimmune neuromuscular disease; muscle fatigue, ptosis (eyelid droop), dysphagia, gen weakness

corticosteroids and cholinesterase inhibitors

excessive salivation, incontinence, sweating, muscle spasms, and bradycardia. Toxic levels and cause CNS depression

oral hydrochlorothiazide & lifestyle modifications

genetic predisposition, Prader Willi & Fragile X Syndromes

deletion of a chromosome from the father.

combined oral contraceptives

single dose Fosfomycin or cephalexin

trimethoprim/sulfamexazole (Bactrim, Septra); or augmentin, cephalosporins

comes from mom; 50% chance

kid carriers 50%
kids w/ sickle cell 25%
kids w/o & not carriers 25%

hydration, heat, O2, pain meds

anemia, jaundice, increased infection risk, crying episodes r/t pain and swelling in extremities;
Tx w/ hydration, Folic Acid, ABX, vaccines, eye exams

chronić, autoimmune, inflammatory; occurs throughout digestive tract, but often in ileum & colon w/ skip lesions

blood & stool testing, colonoscopy & upper endoscopy; small bowel tissue shows cobblestoning

infliximab immunosuppressant, steroids, diet, nutrition therapy & possible bowl resection

CBC, CRP, ESR, LFT, electrolyte panel, & ANA (anti-nuclear antibody

antihypertensive ACE or ARB; reduce salt in diet

Symptoms: neck pain/lump, SOB.
Dx: fine needle aspiration & CEA (carcinoembryonic antigen).
Tx: surgery, chemo to inhibit tyrosine kinases

benzo, seroquel, SSRI and wellbutrin

• diazepam/Valium

anxiety treatment (not benzo)

Tx of panic disorder, decreases frequency & intensity of attacks. ex: Zoloft, Paxil, Prozac

Vistaril

Seroquel

neutropenia

schizophrenia

birth defect affects normal blood flow.
Dx: echocardiogram shows smaller than normal LV & aorta.
Tx: surgery

duloxetine/Cymbalta, pregalbin/Lyrica

X-linked recessive; hemolytic anemia. Avoid: mothballs, all beans, red wine, camphor, soy, tonic water

slow infusion rate, Benadryl, steroids, tylenol

check skin in 48-72 hrs; >10mm is positive. Induration seen on pt w/ TB immunization is normal/NOTpositive.

autoimmune destruction of salivary glands & lacrimal glands

most common lung tumor; central part of lung. Rapid growth & mets; worst prognosis of all lung cancers

ADH (hyponatremia), calcitonin (hypocalcemia), serotonin (carcinoid syndrome), gonadotropins (gynecomastia), adrenocorticotropic hormone (Cushing's). These paraneoplastic syndromes are first manifestations of underlying CA.

CXR, Estimated GFR to check for gene mutation in non-smokers

dopamine receptors

Fluoxetine

hemeprotein that plays key role in metabolization of drugs

heme in animal protein

abnormal tissue in one hemisphere of brain

abnormal tissue in both hemispheres of brain

acne, easy bruising, thin extremities & truncal obesity

frequent fractures, blue sclera, hearing deficit, short stature

erythropoietin

prolonged QT syndrome, electrolyte imbalance, methadone intoxication

Retain water & soften feces; fecal swelling promotes peristalsis.

accelerate drug metabolism

diphenhydramine & acetaminophen

vasodilation, diuresis

gene coding is missing on a specific chromosome

cardiovascular disease( r/t smoking, alcohol & diabetes)

B & T lymphocytes & macrophages

underlying chronic illness

produce more angiotensin

gram-stain technique

prolonged QRS interval

for rapid anticoagulation needed for MI, PE, DVT

Cholinesterase inhibitors

Hemolytic uremic syndrome (HUS)

Verapamil

foramen ovale & ductus arteriosus

fever, arthralgia, rash, nosebleeds, recent bacterial infection

dyspnea, hypoxemia, increased work of breathing, crackles/ rales, pink & frothy sputum

ACE inhibitors

racemic epinephrine

oliguria, hyponatremia, low serum osmolality

uneven mood, unstable BG, poor regulation of body temp

n&v, abd pain, muscle weakness

reduces cholesterol, reduces BG

may be caused by increased norepinephrine when standing

burning stomach pain, heartburn, n&v, black/tarryloody stools, dyspnea, feeling faint, unexplained weight loss

cultural identity, relationships & expectations, and cultural empowerment

Invokana

von Willebrand Factor

Pityriasis rosea

actinic keratosis

decreased cell proliferation, decreased blood supply & depressed immune response

due to increased capillary permeability

drug metabolism

quinolones (cipro)

50%

cleansing ECF, maintain acidase balance, and excrete waste

filtration (in glomerulus), reabsorption (via active transport), active secretion (pumps in proximal convoluted tubule)

highly reabsorptive, 65% of filtered Na & Cl is reabsorbed here

descending limb permeable to water, ascending limb NOT permeable to water

exchanges Na for K, regulated by aldosterone, determines urine concentration, regulated by ADH

Most effective; work in Loop of Henle (for pulmonary edema, CHF • works in 60 mins, lasts for 8 hrs

hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia, ototoxicity, hyperglycemia, hyperuricemia

works in 2 hrs, peaks @ 4-6, lasts for 12 hrs

hypovolemia, acid-base imbalance, and altered electrolyte levels

regulates BP, blood volume and Fluid&Electrolye balance used for HTN, HF, MI

vasoconstriction and simulation of aldosterone release

access to healthy food
Health literacy
housing stability
Socioeconomic status
healthcare access

ACE inhibitors

NSAIDS

Nausea, vomiting, diarrhea, insomnia, fatigue, muscle cramps, incontinence, bradycardia, and syncope

Lantus (not for all people)

increase the risk of bleeding with anti-coag/antiplatelet meds

>60

EGFR (epidurmal growth factor receptors)

X Linked recessive disorder leading to progressive degeneration and proximal muscle wakness.

disrupts immune homeostasis and promotes development of self- reactive antibodies.

Liver

Chrohn's disease

Higher than normal (normal 0.4-4)

DVT

Tylenol

Three immunizations with one injection now (if not given at birth), one injection at two months, and one injection at six months

Children usually outgrow the condition at about three months of age.