Notes in Pharm 232 Exam #1

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Published	01/29/2024	2a0bf537992a4afc8c86ff0eddfc9ded-oa-1
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Published	01/29/2024	Hypo/hypernatermia {{c1::concentration of sodium in blood }}not {{c1::total amount of sodium in body}}caused by water control problem{{c2::A…
Published	02/21/2024	Hypo/hypernatremia Normal: {{c1::135-145 mEq/L}}Critical{{c2::< 125 mEq/L}}{{c2::> 155 mEq/L}}**indicates {{c2::serious risk of complicatio…
Published	01/29/2024	ACUTE HYPOnatremia• Nausea and malaise may be seen when the serum sodium concentration falls {{c1::below 130 mEq/L}}Symptoms• {{c2::Headache…
Published	01/29/2024	HypernatremiaACUTE HYPERnatremiaThe EARLY clinical manifestations of acute hypernatremia begin with:• {{c1::Lethargy• Weakness• Irritability}}Whe…
Published	01/29/2024	What is pseudohyponetremia?{{c1::elevated glucose, lipid, or protein levels can falsely lower Na levels}} Increases in plasma glucose induces a shift …
Published	01/29/2024	What happens if you correct hyponatremia too quickly?- {{c1::osmotic demyelination syndrome (ODS) when concentration rises quickly}}What happens if yo…
Published	02/21/2024	What is a potassium imbalance?{{c1::hypo/hyper(kalemia)}}- Potassium is the {{c1::primary intracellular}} cation- regulates {{c1::muscle and nerve}} e…
Published	01/29/2024	5 Physical Assessment Techniques1. {{c1::Communication - ask questions, for permission, tell them what you're doing}}2. {{c2::Inspection- observe…
Published	02/21/2024	What is abnormal temperature?{{c2::>100.4 degrees F ( >38 degrees C)}}How are rectal and axillary temps different?{{c3::- Rectal is 1 degree F (…
Published	01/29/2024	VitalsPulse- {{c1::measure with middle and index finger on radial artery- do not use thumb}}- normal BPM is {{c1::60-100}}RR (respiratory rate)- Norma…
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Published	01/29/2024	Orthostatic Hypotension vs Hypothension{{c1::orthostatic is when systolic blood pressure decreases by 20 mmHg or diastolic decreases by 10 mmHg within…
Published	01/29/2024	BMI calculated by {{c1::kg/m^2 or lb x 703 /in^2}}
Published	01/29/2024	What is the 5th vital?{{c1::Pain, still controversial (use a comparative pain scale)}}
Published	01/29/2024	Examining Skin- {{c1::check for dry/moist- warm/cold- hair/nails}}Edema- can be caused by {{c2::heart failure, renal disease, hepatic disease, thyroid…
Published	01/29/2024	TESTS USED TO EVALUATE DEHYDRATION{{c1::Urinalysis}}• {{c2::Color, specific gravity, output}}{{c1::Capillary refill}}• {{c2::Mild 2 sec, mod…
Published	01/29/2024	PHYSICAL EXAM-HEENT- HEAD, EYES, EARS, NOSE, AND THROATFace - {{c1::expression, symmetry, hair growth}}Eyes• External:- {{c2::Exophthalmos, color, swe…
Published	02/20/2024	HYPERKALEMIA - CAUSESMassive {{c1::hemolysis}} Severe {{c1::tissue}} damage {{c1::Rhabdomyolysis}}{{c2::Acidosis}}{{c2::Dehydration}}Ac…
Published	02/20/2024	hypokalemia causesLow {{c1::potassium}} intakeProlonged {{c1::vomiting or diarrhea}} {{c1::Renal tubular acidosis}} types I and II{{c2::Hype…
Published	02/20/2024	chlorideNot {{c1::actively regulated}} by the body. Normally follows {{c1::sodium}}Normal range: {{c2::98-107 mEq/L}}If chloride change…
Published	02/20/2024	calciumNormal level of total calcium: {{c1::8.5-10.5}} mg/dl Critical levels  {{c1::< 6.5}} or {{c1::> 13.5}} mg/dLIoni…
Published	02/20/2024	ionized or free calcium vs total calciumRelationship to Albumin{{c1::40}}% is bound to {{c1::albumin}}Changes in albumin {{c2::levels}}&nbsp…
Published	02/20/2024	hypocalcemia{{c1::Hypoparathyroidism}}{{c1::Vitamin D}} deficiency {{c1::Renal}} insufficiency{{c2::Magnesium}} deficiency{{c2::Hy…
Published	02/20/2024	hypercalcemia{{c1::Hyperparathyroidism}}{{c1::Malignancies secreting parathyroid}} hormone-related protein (PTHrP) (especially {{c2::squamous cel…
Published	02/21/2024	magnesiumNormal Range: {{c1::1.8 - 3}} mg/dlCritical range: {{c1::< 0.5}} and {{c1::> 4.5}} mg/dLHypomagnesemia is much more common than {{…
Published	02/21/2024	hypomagnesemiaChronic {{c1::diarrhea}}{{c1::Starvation}}Chronic {{c1::alcoholism}} Total {{c2::parenteral nutrition}} with inadequate&n…
Published	02/21/2024	hypermagnesemia{{c1::Dehydration}}{{c1::Tissue}} trauma{{c1::Renal}} failure{{c2::Hypoadrenocorticism}} {{c2::Hypothyroidism}}Drugs: {{…
Published	02/21/2024	bicarbonate co2 or hco3-Measures the {{c1::Bicarbonate-carbonic acid}} buffer important buffer system in {{c1::maintaining normal body fluid pH.}…
Published	02/21/2024	BICARBONATE CO2 OR HCO3-increased inPrimary {{c1::metabolic alkalosis}}{{c1::Compensated respiratory}} acidosis{{c1::Volume}} contracti…
Published	02/21/2024	PhosphorusNormal range {{c1::2.5- 4.5}} mg/dLCritical range is {{c1::< 1}} mg/dLRegulated by the {{c2::Kidneys}}, {{c2::parathyroid}} gla…
Published	02/21/2024	lung functionExchange {{c1::Gas} --> CO2 for O2.{{c1::Oxygenation}} of blood .Help maintain blood {{c2::pH}}.Requires {{c2::ventilat…
Published	02/21/2024	pulmonary function tests are performed to :Evaluate {{c1::respiratory}} symptomsAssess disease {{c1::severity}} Assess {{c1::pre-operatively…
Published	02/21/2024	PFTs are used to assess the various parameters of lung function.Three main categories{{c1::Spirometry}}{{c1::Lung Volume}} Measurements{{c1::Diff…
Published	02/21/2024	spirometryMost {{c1::commonly used}} PFTUsed to {{c1::detect}}, {{c1::confirm}}, and {{c1::monitor}} {{c2::obstructive airway}} disease…
Published	02/21/2024	spirometryResults are compared to predicted values for patients using:{{c1::Height}}{{c1::Gender}}{{c2::Age}}{{c2::Race}}{{c3::WEIGHT}} IS NOT A …
Published	02/21/2024	Major Measurements of Spirometry tests:FVC—{{c1::forced vital capacity}}{{c2::TOTAL}} amount of air {{c2::RAPIDLY exhaled in 1 breath}}.{{c3…
Published	02/21/2024	spirometry -- disease state monitoringUsed in {{c1::asthma}} to help diagnose and monitor {{c2::progression}} and {{c2::severity}}&nbsp…
Published	02/21/2024	pulse oximetry (pulse ox)Measures the {{c1::amount of oxygen}} in the blood ({{c1::saturation %}})NORMAL IS USUALLY {{c1::ABOVE 90%}}Many things …
Published	02/21/2024	radiologyCan be used to identify:{{c1::infections}}{{c1::Hyperinflation}} (eg. COPD)Fixed {{c2::obstructions}}{{c2::Edema}}
Published	02/21/2024	ACID/BASE AND ABGS NORMAL VALUESArterial Blood GasespH  {{c1::7.35 to 7.45 }}PaCO2 (also reported as PCO2)  {{c1::32-48 mmHg}}PO2&…
Published	02/21/2024	pH determines if it is acidosis or alkalosis{{c1::less than 7.35}} --> {{c2::acidosis}}{{c1::greater than 7.45}} --> {{c2::alkalosis}}PaCO2 is a…
Published	02/21/2024	1) Look at the pH{{c1::<7.35}} Acidosis{{c2::>7.45}}  AlkalosisA normal pH still could mean a mixed disorder!2) Evaluate PaCO2 and HCO…
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Published	02/21/2024	neuro exam- {{c2::mental awareness}}: {{c1::awareness of person, place and or time}}- {{c2::motor}} function and {{c2::balance}}- {{c3::sensory}} (tou…
Published	02/21/2024	A focal neurologic problem can affect ...1) {{c1::Movement changes}}- {{c1::paralysis}}/ {{c3::weakness}}- {{c3::loss}} of {{c1::muscle control}}- {{c…
Published	02/21/2024	Deep tendon reflexes are graded as follows: 0 = {{c1::no response}}; always {{c2::abnormal}} 1+ = a {{c1::slight}} but definitely {{c1::present}} resp…
Published	02/21/2024	pain classification/ ways to measure pain1) {{c1::vision analog scale}} (VAS)2) {{c1::mcgill}} pain questionnnaire -- assess {{c2::3 areas}} of pain (…
Published	02/21/2024	types of pain1) {{c1::acute }}- result of {{c2::noxious}} stimuli - usually {{c2::nociceptive}}2) {{c1::chronic}}- usually associated with {…
Published	02/21/2024	Activated Partial Thromboplastin Time (aPTT or PTT) - coagulation test used to test the {{c1::intrinsic}} coagulation pathway - Factors {{c1::XII}}, {…
Published	02/21/2024	Heparin Monitoring parameters:{{c1::Hemoglobin}}, {{c1::hematocrit}}, signs of {{c2::bleeding}} {{c2::fecal occult blood test (guaiac)}}&nbs…
Published	02/21/2024	D-DimerD-dimer is used to help{{c1:: rule out the presence of a thrombus}}Some of the conditions that the d-dimer test is used to help rule out includ…
Published	02/21/2024	C. DIFF.--BACKGROUND• Clostridioides (formerly Clostridium) difficile is a spore-forming, toxin-producing, gram-positive anaerobic bacterium that caus…
Published	02/21/2024	C. DIFF.--PRESENTATION• Watery diarrhea is the cardinal symptom of C. difficile–associated diarrhea(CDAD) with colitis ({{c1::≥3 loose stools in 24 ho…
Published	02/21/2024	C. DIFF.•Laboratory testing does not distinguish between {{c1::C. difficile–associated diarrhea (CDAD) and asymptomatic carriage}}•Conditions res…
Published	02/21/2024	C. DIFF.• The {{c1::GDH (glutamate dehydrogenase) antigen}} test uses antibodies to test for the presence of the {{c1::GDH enzyme}}, a prote…
Published	02/21/2024	HELICOBACTER PYLORI (H. PYLORI)• {{c1::H. pylori}} and {{c1::NSAIDs}} are implicated as the primary causes of ulcer bleeding and perforation.• H. pylo…
Published	02/21/2024	H. PYLORI- INVASIVE TESTS• The diagnosis of H. pylori can usually be established during endoscopy by one of three methods:• {{c1::biopsy urease t…
Published	02/21/2024	NON-INVASIVE H. PYLORI TESTS• Urea Breath Testing (UBT)• UBT is based upon the {{c1::hydrolysis of urea by H. pylori}} to produce {{c1::CO2}} and {{c1…
Published	02/21/2024	PANCREATITISSymptoms:• Moderate {{c1::abdominal discomfort to excruciating pain, nausea, shock, and respiratory distress.}}• Abdominal pain occurs in …
Published	02/21/2024	LIPASE AND AMYLASE• Amylase normal {{c1::20-110 U/L}}• Lipase normal {{c1::0-160 U/L}}
Published	02/21/2024	What does TSH make?What does T3 and T4 do?
Published	02/21/2024	ENDOGENOUS THYROID REGULATION• Maintaining a euthyroid (normal) state utilizes a feedback loopbetween the hypothalamus, the pituitary, and the thyroid…
Published	02/21/2024	ENDOGENOUS THYROID REGULATION• Only small amount circulates as {{c3::“free}}” or {{c3::unbound}}-  {{c1::0.02%}} of T4 and {{c1::0.2%}} of T3.• T…
Published	02/21/2024	THYROID FUNCTION TESTS (TFTS)•MAIN LABORATORY TESTS USED TO ASSESS THYROID FUNCTION•Thyroid function is assessed by one or more of the following tests…
Published	02/21/2024	THYROID FUNCTION TESTS (TFTS)• Consists of Blood Tests and Imaging• Used to diagnose and screen for thyroid disorders -  {{c1::HYPERthyroid}…
Published	02/21/2024	What positives and negatives are dangerous?
Published	02/21/2024	What is the difference between sensitivity and specificity?
Published	02/21/2024	Hypo/Hyperkalemia Mechanisms1. Intracellular/extracellular shifts - can be rapid (but doesn't change t{{c1::he amt of K in the body, only the con…
Published	02/21/2024	PHYSICAL EXAM- LUNGSINSPECTION-• Posture-  {{c1::Tripod}} position in COPD• Pattern– speed and regularity {{c1::(RR)}}• Use of accessor…
Published	02/21/2024	PHYSICAL EXAM- CV CARDIOVASCULARPMI- {{c1::Point of maximal impulse-}}• {{c1::5}}th intercostal space• Loudest point of heart beat- {{c…
Published	02/21/2024	PHYSICAL EXAM- GI GASTROINTESTINAL• 4 quadrants divided as {{c1::left, right, upper, and lower}}• {{c1::RUQ}}- liver, gallbladder, pylorus, duode…
Published	02/21/2024	PHYSICAL EXAM-MS- MUSCULOSKELETAL• Evaluates muscles for strength and function• Evaluates joints for function and range of motion• Inspection for asym…
Published	02/21/2024	THYROID FUNCTION TESTS (TFTS)TSH—Main test for thyroid function.• Must be at {{c1::steady state}} for proper interpretation!• Must wait&nbsp…
Published	02/21/2024	THYROID FUNCTION TESTS (TFTS)MAIN TYPES OF T4 TESTSTotal T4• Measures the amount of {{c1::T4}} in blood• Includes {{c1::free and bound}}&nbs…
Published	02/21/2024	THYROID FUNCTION TESTS (TFTS)T3• Can be used to determine the amount of {{c1::hyperthyroidism}} when TSH is {{c1::totally suppressed.}}…
Published	02/21/2024	OTHER THYROID FUNCTION TESTS (TFTS){{c1::Anti-thyroid peroxidase antibodies}} (Anti-TPOAb)• Autoantibodies directed against peroxidase enzyme• Found i…
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Published	02/21/2024	COAGULATION TESTSAre used to:• Diagnose a {{c1::coagulopathy}}• Monitor the {{c1::efficacy}} of an anticoagulant or thrombolytic dr…
Published	02/21/2024	COAGULATION TESTS• Platelets– {{c1::150-450 x 103/μL}}• Platelets are a critical element in blood clot formation. The risk ofbleeding is low unle…
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Published	02/21/2024	COAGULATION TESTSProthrombin time (PT)• Assesses the {{c1::extrinsic}} pathway• Factors {{c1::VII and Tissue}} factor (extrins…
Published	02/21/2024	ANTICOAGULANT DRUGSWarfarin (Coumadin)Mechanism of Action:• Blocks the {{c1::carboxylation of several glutamate residues}} in prothrombin &a…
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