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CMN 572 FINAL EXAM QUESTIONS WITH ALL CORRECT ANSWERS

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CMN 572 FINAL EXAM QUESTIONS WITH ALL CORRECT ANSWERS force fluids - Answer-conditions that require force fluids usually need 1.5x normal maintenance amounts 100 cc/kg/24hrs for first 10 kg 50 cc/kg/24hrs for second 10 kg 10-25 cc/kg/24hrs for every kg over 20 oral rehydration for dehydra...

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  • September 19, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • cmn 572 final exam questions

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CMN 572 FINAL EXAM QUESTIONS
WITH ALL CORRECT ANSWERS
force fluids - Answer-conditions that require force fluids usually need 1.5x normal
maintenance amounts

100 cc/kg/24hrs for first 10 kg
50 cc/kg/24hrs for second 10 kg
10-25 cc/kg/24hrs for every kg over 20

oral rehydration for dehydration - Answer-mild: 3-5% loss without loss of turgor; 50
cc/kg over 4 hrs plus losses (try 3 cc every 5 min if vomiting)

moderate: 6-9% loss with decreased turgor and <1 cc/kg/hr of urine output; replace with
100 cc/kg over 4 hrs plus losses

severe: admit for rehydration

formed elements of the blood - Answer-RBC, WBC, platelets

if more than one is decreased, think bone marrow dysfunction

pancytopenia: depression of all formed elements

neutrophils - Answer-leukocytosis (increased)= BACTERIAL INFECTION, stress, burns,
leukemia, steroid use, RA

leukopenia (decreased)= folate/B12 deficiency, aplastic anemia, chemo, sulfonamides

lymphocytes - Answer-lymphocytosis (increased)= VIRAL INFECTION, leukemia,
adrenal insufficiency

lymphocytopenia (decreased)= HIV, aplastic anemia, glucocorticoid use, SLE, RA

eosinophils - Answer-eosinophilia (increased)= ALLERGIES, PARASITIC INFECTION,
leukemia, autoimmune

decreased with nutritional deficiencies, glucocorticoid use

basophils - Answer-increased with allergic reaction, CML, hodgkins, oral contraceptives

decreased with nutritional deficiencies, glucocorticoid use

,monocytes - Answer-increased with CHRONIC INFLAMMATION, stress, cushings, viral
infection, sarcoidosis

decreased with aplastic anemia, AML, glucocorticoid, myelotoxic drugs

platelets - Answer-thrombocytes

aid in coagulation

thrombocytosis (increased)= acute blood loss, CML, iron deficiency, polycythemia vera,
hypospleenism

thrombocytopenia (decreased)= ITP, HELLP, hemplytic/uremic syndrome

bands - Answer-immature neutrophils

shift to left means increased bands and acute infection (sometimes pernicious anemia
or leukemia)

iron deficiency - Answer-universal screening at 1 yr

if mild anemia is present, provide iron supplements and repeat hgb in 1-3 months

all infants with anemia should have serum feritin and CRP measured

children with severe anemia, family hx of hematologic illness or infants with f/u hgb <10
should be further eval'd with venous blood draw

management of irone deficiency is iron supplements and education

lead poisoning - Answer-risk screening should be done at 1 yr

also indicated in children with persistent anemia, live in house built before 1977, or have
developmental delay

lead poisoning= plubism

many children have levels high enough to cause neuro/intellectual delay; they are also
at risk for kidney damage, encephalopathy, and seizures

all characteristics of ADD can be caused by low dose exposure to lead

sx: acute crampy abdominal pain, vomiting, constipation, anorexia, HA, decreased
developement, lethargy

, major sources: lead based paint #1, lead solder, lead pipes, occupations/hobbies that
involve lead, some cosmetics and pottery, imported cans

diets deficient in iron and calcium and high in fat increase risk for lead poisoning
because it allows lead to be more quickly and readily absorbed; IRON DEFICIENCY IS
GREATEST DIETARY RISK FACTOR

90% of lead is stored in bones and teeth where it is inert; it is exreted by kidneys, GI,
and through sweat; 90% of lead in the blood attaches to RBC

tx: remove source, improve nutrition, chelation therapy IM

iron deficiency anemia - Answer-microcytic, hypochromic

due to insufficient intake of iron or excessive blood loss

most common cause in women: menstrual blood loss
most common cause in men: GI blood loss
most common cause in childre: insufficient intake/intestinal hookworms

adolescent growth spurt can result in iron def. anemia

tx: oral feSo4 6 mg/kg/day in 3 div. doses; adults= 300 mg/day; continue therapy for 3-6
months after H&H returns to normal to rebuild iron stores

milk, antacids, and tea interfere with iron absorption; vit C and citrus acid aid absorption

liquid iron stains teeth- use straw

iron def. anemia is most common anemia during pregnancy- all pregnant women should
take supplements to PREVENT, it increases risk for pre-eclampsia, eclampsia, and
postpartal hemorrhage; may delay healing of episiotomy; newborn may be low birth
weight and hypoxic at birth


chlamydia - Answer-gold standard of testing is CX

NAAT can be used to also test for gonorrhea

treatment: azithromycin 1 g PO once (doxy if PCN allergy); azithromycin is OK with
pregnancy

gonorrhea - Answer-NAAT, cx, or gram stain for testing

treatment: 250 mg ceftriaxone IM once PLUS azithromycin 1 g PO once

gonorrhea and chlamydia often occur together

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