USA PCM3 Practice questions for this set Terms in this set (145) What deficits occur with a stroke to the frontal lobe? Impulse control Attention Organizing Planning movement (Apraxis) What central gyrus controls motor? Pre-central What central gyrus c

USA PCM3 Practice questions for this set Terms in this set (145) What deficits occur with a stroke to the frontal lobe? Impulse control Attention Organizing Planning movement (Apraxis) What central gyrus controls motor? Pre-central What central gyrus controls sensory? Post-central gyrus What deficits occur with a stroke to the Orientation in space USA PCM3 What is apraxia? Loss of the ability to execute or carry out learned (familiar) movements, despite having the desire and the physical ability to perform the movements After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 1.) Demonstrating Lateropulsion (pusher's) a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D. Parietal After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 2.) Hemiplegia a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe B.) Precentral Gyrus After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 3.) Has difficulty with spatial organization? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D.) Parietal lobe After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 4.) Demonstrate impulsive behavior? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A.) Frontal After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 5.) Difficulty planning movement? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A&D.) Frontal/Parietal lobe USA PCM3 After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 6.) Decreased sensation a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe C.) Postcentral gyrus After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 7.) Decreased attention span? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A.) Frontal lobe After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 8.) Apraxia? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D.) Parietal lobe What is Broca's area? motor speech area Where is Broca's area located? frontal lobe What does damage to Broca's area cause? expressive aphasia Expressing words verbally. Where is Wernicke's area located? temporal lobe What does damage to Wernicke's area cause? receptive aphasia Can speak but can't understand. What is the difference of an UMN versus LMN of the facial (CN7) nerve? UMN lesion - spares the forehead. LMN = full sided facial weakness. What is uremia? Uremia is the condition of having high levels of urea in the blood. Normally eliminated from the body from normal functioning kidneys. What is another word for uremia? azotemia (azot, "nitrogen" + -emia, "blood condition") What are symptoms of Uremia? Nausea, vomitting, anorexia, lethargy, sensory/motor neuropathy. Involuntary jerking movements of the hands. "Flapping-like motion when you lift the USA PCM3 What is glomerular filtration? Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. What is Glomerular filtration rate (GFR)? Amount of blood that passes through the kidneys per minute. What is the normal GFR? 90 mL/min What GFR may signify kidney disease? 60 ml/min What GFR signifies kidney failure? 15ml/min What physically happens to the kidneys that explains theor the decrease in value of GFR? Surface area of the kidneys (functional space where blood is filtered) is reduced. During kidney failure, does calcium or phosphate increase sin the blood? Which subsequently decreases. Increased = Phosphate Decreased = Calcium What physiological even occurs when the body detects a decrease in calcium in the blood? Parathyroid hormone secretion (From the parathyroid gland) Releases Ca2_ from bone via demineralization. What are the cardiovascular manifestations of End stage renal disease (ESRD)/kidney failure? CAD HTN CHF PE DYSPNEA PERICARDITIS What are the S/S of cardiovascular manifestations of ESRD/kidney failure? Chest pain Nausea SOB Sweating What are the musculoskeletal manifestations of ESRD/Kidney failure? Renal osteodystrophy - (Osteomalacia or rickets in children) -Osteitis Fibrosis (Weak bones due to hyperparathyroidism) Both are dec bone mineralization with reduced calcium absorption from the gut and compensatory hyperparathyroidism. What is the first step in the development of heart failure? Injury to the myocardium (ischemic episode) or valve. What happens to the left or right ventricle during heart failure? Hypertrophy. How does the body initially compensate for the reduced cardiac output during CHF? Renin-angiotensin-aldosterone system (RAAS) and other sympathetic stimulation helps restore cardiac output. Is RAAS beneficial or harmful in consideration to long term? Harmful. They cause damage to the myocardium over time, causing other cellular and molecular reactions such as apoptosis, remodeling and inflammatory cytokines. What is the initial medical treatment for the beginning stages of heart failure? Rx RAAS blockers ACE inhibitors Beta blockers Aldosterone antagonist Blocks initial compensations of the myocardium. What are some clinical signs of HF? Dyspnea with exercise Fatigue Cough Swelling in limbs Elevated jugular venous pressure Bilateral lung crepitations, 3rd heart sound gallop. What is the ejection fraction of patients with HF? 55-70%. What happens to the cardiac output with left sided HF? Decreases Where does the blood go with L sided HF? L ventricle backs up to the L atrium backs up into the lungs. What symptoms of the lungs occurs with blood backing up into it from the L atrium? SOB and coughing. What increases with R sided HF? Increased PA pressure Where does the blood back up into, with R sided HF? R ventricle to R atrium to venous vascularization. What are the 4 diagnostic tests used for HF? ECG Chest X-ray Echocardiography Lab (Brain natriuretic peptide) (Normal levels 100pg). How many stages of HF are there? 4 What are the pharmacological ways to manage HF? Alpha/beta blockers ACE inhibitors Angiotensin receptor blockers Vasodilator Inc blood flow to area Positive inotropes Digoxin) Diuretics. What are non-pharmacological management of HF? Oxygen therapy Heart healthy diet Exercise Surgical ~ LVAD, ICD, Pacemaker, transplant What are 4 causes/risk factors of COPD? 1.) Cig smoke 2.) Pollution 3.) Genetic-alpha 1 antitrypsin 4.) deficiency Lack of surfactant. What are the two pathophysiology of COPD? 1.) Chronic bronchitis 2.) Emphysema Between Obstructive and Restrictive lung dysfunction, which one can't get air out? Obstructive = can't get air out Restrictive = can't get air in What are the 4 summarized points of how chronic bronchitis occurs? Smoke/irritants causes hypertrophy of mucous glands in the main bronchi Increase Mucous production Smoke/irritants damage cilia mucous gets trapped. In summary, what physical part of the lungs is damaged with chronic bronchitis? Mucus glands of the main bronchi What is the nick name for patients with chronic bronchitis? Blue bloaters (barrel chested) . What are the clinical signs of chronic bronchitis? Decreased FEV1 (Very low) Decreased FVC Increased TLC. For all of the classification of COPD, What is the FEV1/FVC value? FEV1/FVC 70%. What is the classification of mild (1) COPD? FEV1/eq 80%. (May not have cough/sputum) What is the classification of mod(2) COPD? FEV1 = 50-79% (SOB w/ exercise. May or may not have cough/sputum) What is the classification of Severe (3) COPD? FEV1 = 30-49%. (SOB w/exercise, decreased capacity, fatigue and repeated exacerbation; What is the classification of very severe (4) COPD? FEV1 30%. (chronic respiratory failure) what are the 5 summarized points of the pathology of emphysema? Smoke/irritant damages alveoli Alveoli lose elasticity leads to breakdown of septa Alveoli fuse due to collapsed space reduced ventilation due to decreased surface area. In summary, what physical part of the lungs is damaged with emphysema? Alveoli Is inspiration or expiration impacted with emphysema? Expiration. Exhalation relays on the elastic recoils of the lungs. What is the nick name for patients with emphysema? Pink puffers. What are some characteristics of pink puffers? Rosy cheek & using pursed lipped breathing to oxygenate blood, skinny/malnutrition person, the opposite of chronic bronchitis. What are 6 symptoms of patients who have emphysema? 1.) Dyspnea with exercise 2.) Weight loss from inc. WOB 3.) Pursed lip breathing ~ works to increase thoracic pressure to keep airways from closing. 4.) Flattened diaphragm 5.) Hypoxia Clubbing 6.) Cough with varying amounts of sputum. What are 5 pharmacological intervention for patients with emphysema? 1.) Antitussives (anti cough medicine) 2.) Decongestants (helps open up the upper respiratory tract) 3.) Mucolytic agents (help loosen up sputum) 4.) Leukotrienes 5.) Anti-inflmmatory, steroids, antibiotics. What are 4 non pharmacological management of COPD? 1.) O2 therapy 2.) Arterial blood gas studies 3.) Exercise 4.) Pursed lip breathing. What is diabetes mellitus? A syndrome with metabolic, vascular, and neural components that originates from glucose intolerance, which in turn leads to hyperglycemic states (increased plasma glucose levels.) Which type is insulin dependent DM? Type 1 What is type 1 diabetes mellitus? Autoimmune disorder with a genetic-environmental etiology that leads to the selective destruction of beta cells in the pancreas. Leads to absent or minimal insulin secretion. What is type 2 diabetes mellitus? non-insulin dependent diabetes where the beta cells are producing insulin but the uptake or utilization of the insulin is not working properly, or receptors of the cells are defective Significantly linked to obesity, a sedentary lifestyle, and aging. What can occur with type 2 DM? increased insulin production because of compensatory hyper secreation from the pancreatic beta cells that ultimately leads to a failure in insulin production. What is the normal fasting plasma glucose level? 100 mg/dL What is pre-diabetes fasting plasma glucose level? 100-125 mg/dL What is diabetic fasting plasma glucose levels? 125 mg/dL What is insulins function? Promotes storage of glucose as glycogen in muscle and liver tissue. Which ethnic group is 2x more at risk for type 2 DM? African Americans. What is diabetic ketoacidosis? DKA is an end result of ineffective levels of circulating insulin decreased levels of insulin leads to uncontrolled lipolysis increased free fatty acids from the liver overproduction of ketone bodies. What are the dangers of ketoacidosis in general? Increased ketone bodies which signifies increased acidity with the blood. Decreased pH levels in the blood can damage the heart, liver, kidneys, etc. Which range of glucose levels can patients who progress to DKA get to? 500-700 mg/dL How many main physiological health complications accompany diabetes? 4 What are the 4 main physiological health complications that accompany diabetes? 1.) Microangiopathy (microvascular disease) 2.) Macroangiopathy (macrovascular disease) 3.) Neuropathy 4.) Infection What is microangiopathy? Disease that affects smaller blood vessels. i.e - capillaries of the retina. (occurs 60-80% of patients) What is macroangiopathy? Disease that affects large blood vessels. Decreased blood flow ulcer/poor healing. What is neuropathy? disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness. What are some s/s of hypoglycemia? Tachycardia, HTN tremor, irritability, pallor, sweating, headache, seizure, dizziness, visual disturbance, loss of consciousness, mental dullness, confusion, amnesia. What is a precaution with diabetic patients prior to exercise? A pregluclose level less than 100 mg/dl may require added carbohydrate ingestion before starting activity. What is the function of the parathyroid gland? Controls the amount of calcium in a person's blood. Does this by demineralizing bones. Increases calcium reabsorption from kidneys and small intestine. What are some clinical signs of hyperparathyroidism? Hypercalciuria, Ca2+ in blood volume, kidney stone formation (nephrolithiasis), Osteopenia, osteoporosis and increased Fx risk. What is hypothyroidism? Too little thyroid hormone being produced. Leads to low calcium levels in the body. What are some S/S of hypothyroidism? Increased neuromuscular irritability (tetany); painful muscle spasms, thin, patchy hair; brittle nails; dry, scaly skin, parathesias. What is edema? Abnormal excessive accumulation of serious fluid in connective tissue What is lymphedema? Accumulation of fluid in an extremity of body part as a result of damage or loss of the lymphatic vessels. Typically in the distal LE. What is primary lymphedema? congenital condition with abnormal lymph node or lymph vessel formation What is secondary lymphedema? Injury to the lymph system, blocked, dissected, fibroses, damage, etc.