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NSG223 EXAM 3 REVIEW
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Fibromyalgia is often treated with long-term opioids. True or False
False. Opioids are not recommended for long tern use.
What life threatening complications can be associated with Guillain-Barre Syndrome?
Respiratory Failure, Cardiac Dysrhythmias, VTE
What labs are used for the diagnosis of Guillain-Barre syndrome?
None. Lumbar puncture
What are classic symptoms of Guillain-Barre syndrome?
areflexia, ascending weakness
What are common side effects of cholinesterase inhibitors?
gastrointestinal upset, diarrhea, nausea, and excessive salivation and sweating
What criteria does a patient need to meet to be considered for a thymectomy for MG?
<65 and dx in last 3 years
What is an ICE test?
Ice pack held over the eyes for 1 minute Ptosis should temporarily resolve in a patient with myasthenia gravis
What is a Tensilon test?
give Tensilon IV; 30 minutes after injection facial muscle weakness & ptosis should resolve for about 5 minutes; Immediate improvement = MG
How is myasthenia gravis diagnosed?
Acetylcholinesterase Inhibitor Test (Tensilon Test); ICE Test; Enlarged Thymus
What are common eye symptoms associated with myasthenia gravis?
Diplopia (double vision) and ptosis (drooping eyelids)
Patients with MS are at risk for injury due to poor coordination. They should be instructed to avoid activity. True or False
False- work and exercise to a point just short of fatigue. AVOID strenuous exercise
How can a patient minimize spasticity and contractures associated with MS?
daily stretching
MS can be cured with disease modifying therapies. True or False
False
Spasticity can be a clinical manifestation of MS. True or False
True
What is the peak time for morphine IV?
10 min
Compartment syndrome involves part of a body area losing perfusion. True or False?
False: Elevation of pressure within an anatomic compartment that is above normal perfusion pressure
What is a fat emboli?
When the fracture occurs, fat globules may diffuse from the marrow into the vascular system; these may occlude blood vessels in the lungs, brain, kidneys, organ
What is the most severe fracture complication?
Hypovolemic shock (hemorrhage)
What is the first indicator of compartment syndrome?
Increased pain
in an emergency with a suspected fracture, what needs to be done first?
Immobilize the body part
What medication is used to treat Diabetes Insipidus?
DDAVP (vasopressin)
What medication is used to treat SIADH?
None- treated with fluid restriction
SiADH consists of high urine output and low sodium. True or False
False (low urine output and low sodium)
High ADH causes which disease?
SIADH
Low ADH causes which disease?
Diabetes Insipidus
What medications are used to treat acromegaly?
Octreotide, Lanreotide
How is acromegaly diagnosed?
Elevated IGF1; Elevated GH serum levels; MRI to assess pituitary
Excessive growth hormone is known as ____.
Acromegaly (Gigantism in children)
What medication is given to treat Cushing's disease?
Ketoconazole
What labs are done to diagnosis Cushing disease?
High serum/urine cortisol; Dex suppression test with elevated cortisol levels
Patients with Cushing Disease have a risk for osteoporosis. What diet would you recommend?
High Vit D, Calcium, Protein
List 5 symptoms of Cushing Disease?
Hirsutism, weight gain, elevated glucose, moon face, fragile skin, buffalo hump
Patients with Addison's Disease should use a salt substitute? True or False
False
Hydrocortisone should be taken with food at 9am. True or False
True (space other doses evenly throughout day)
What labs are expected when diagnosing Addison's Disease?
Low AM serum cortisol, high plasma ACTH
Name at least 5 symptoms of Addison's Disease?
Hyperpigmentation, weakness, weight loss, anorexia, GI symptoms, low BP, Low NA, High K, Low glucose
Adrenal insufficiency is also known as ________.
Addison Disease
Adrenal excess is also known as ______.
Cushing Syndrome
What medication is given as mineralocorticoid replacement in adrenal insufficiency?
Fludrocortisone (replace aldosterone)
What medication is given as glucocorticoid replacement in adrenal insufficiency?
hydrocortisone (corticosteroids)
What hormones are released by the adrenal cortex?
glucocorticoids, mineralocorticoids, androgens
What hormones are released by the adrenal medulla?
Catecholamine hormones: epinephrine, norepinephrine


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