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ACNP--Rosh review.
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Exam of 8 pages for the course Accounting 405 at Accounting 405 (ACNP--Rosh review.)
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ACNP--Rosh reviewPossible side effects of Amiodarone - ANS-side effects include hypothyroidism,
hyperthyroidism. interstitial lung disease, elevated liver enzymes. When starting a pt of
this drug, remember to check TFTs, LFTs, and PFTs.
Ankle-brachial index (ABI) - ANS-
Acute appendicitis - ANS-Most common in 10-19 y/o, RLQ pain, anorexia, N/V,
Periumbilical pain that migrates ot RLQ, Fever, Pain at McBurney's Point
McBurney's point - ANS-RLQ point (1/3 of the way from the ASIS to the umbilicus)
tenderness indicative of appendicitis
Rovsing sign - ANS-pain in the RLQ when the LLQ is palpated (indicative of
appendicitis)
What is the preferred diagnostic imaging study in patients where appendicitis is
suspected? - ANS-CT scan
Obturator sign - ANS-pain in the lower abdomen or inside of thigh when the hip is flexed
and internally rotated; a sign of appendicitis
Psoas sign - ANS-RLQ pain with extension of right thigh indicative of appendicitis
Mitral stenosis murmur - ANS-mid-late diastolic rumble at apex and/or opening snap; no
radiation; left sternal border thrill
Ramsay Hunt Syndrome (Herpes Zoster Oticus) - ANS-Caused by reactivation of a
latent varicella zoster virus infection in the geniculate ganglion of the 7th cranial nerve;
Signs=unilateral facial nerve palsy, severe pain, and a vesicular eruption. Vesicles may
appear on the pinna, external auditory canal, tympanic membrane, within oral cavity, on
face/neck.
Treatment for Ramsay Hunt Syndrome - ANS-Oral steroids and antiviral therapy
(prednisone and oral valacyclovir)
Hunt and Hess grade I - ANS-Mild HA, normal mental status, no nerve deficits
, Hunt and Hess grade II - ANS-Severe HA, normal mental status, may have cranial
nerve deficits
Hunt and Hess grade III - ANS-Somnolent, confused, may have cranial nerve or mild
motor nerve deficit
Hunt and Hess grade IV - ANS-Stupor, moderate to severe motor deficit, mayu have
intermittent reflex posturing
Hunt and Hess grade V - ANS-Coma, reflex posturing or flaccid
symptoms of hypothyroidism - ANS-Fatigue, weakness, cold intolerance, bradycardia;
DOE, cognitive dysfunction, dry skin; brittle dry hair; weight gain; constipation; delayed
deep tendon reflexes, slow movement and speech, hoarseness, edema, enlargement of
tongue
What are the patient safety goals? - ANS-Identify patients correctly, Improve effective
communication, Improve the safety of high-alert medication, ensure correct-site, correct
procedure, correct patient surgery, reduce the risk of healthcare associated infections,
reduce the risk of patient harm resulting from falls
postive Murphy's sign - ANS-Suggestive of acute cholecystitis; push on liver & have pt
inhale in, patient stops breathing
Cullen's sign - ANS-ecchymosis around the umbilicus associated with retroperitoneal
bleeding. (associated with ruptured ectopic pregnancy and hemorrhagic pancreatitis.)
Kehr's sign - ANS-Pain that radiates to the left shoulder and down the left arm and LUQ
pain associated with splenic rupture.
Ipsilateral Mydriasis - ANS-Fixed, dilated pupil one one side (earliest sign of uncal
herniation--pupil dilated on same side as herniation due to compression of third cranial
nerve.
Subfalcine or Cingulate herniation - ANS-Brain tissue extending under the falx in the
supratentorial cerebrum; small reactive pupils, HA, contralateral leg paralysis
Uncal herniation - ANS-Medial temporal love pushes downward into the posterior fossa
through the incisura. Causes ipsilateral pupil dilation (earliest sign), contralateral
hemiparesis, decerebrate posturing.
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