Test 3

Question 1

what does oncogene activation do?

Answer 1

leads to excessive amounts of cyclins and uncontrolled cell growth

Question 2

labs for dehyration

Answer 2

BUN will be elevated, creatinine won’t

Question 3

fever in cancer patients

Answer 3

99.0

Question 4

SIADH happens commonly in which cancer?

Answer 4

lung

Question 5

treatment of spinal cord compression

Answer 5

• often palliative
• high dose corticosteroids decrease swelling and reduce compression
• high-dose radiation
• surgery
• external back or neck braces

Question 6

s/s of hypercalcemia

Answer 6

fatigue, loss of appetite, n/v, constipation, polyuria, severe muscle weakness, loss of deep tendon reflexes, paralytic ileus, dehydration, ECG changes

Question 7

treatment of hypercalcemia

Answer 7

• oral hydration is usually adequate

- glucocorticoids, calcitonin…

Question 8

Tx of superior vena cava syndrome

Answer 8

• O2, corticosteroids, diuretics

- high-dose radiation therapy, rarely surgery, stent placement

Question 9

tumor lysis syndrome

Answer 9

large numbers of tumor cells are destroyed rapidly, resulting in intracellular contents being released into the blood stream faster than they can be eliminated
-potassium and purines

Question 10

Tx of tumor lysis syndrome

Answer 10

• prevention through hydration

- drug therapy: allopurinol, diuretics, kayexalate

Question 11

albumin level that shouldn’t go to surgery

Answer 11

lower than 3.8

Question 12

A1C normal level

Answer 12

4-6.5… definitely should be lower than 7

Question 13

diabetes insipidus originates in the

Answer 13

posterior pituitary gland

Question 14

diagnostics for diabetes insipidus

Answer 14

vasopressin test: when given, symptoms go away

Question 15

diagnostics for diabetes mellitus

Answer 15

• fasting 8 hr glucose of 126 or more

- random or casual glucose of 200 or more

Question 16

rapid acting name

Answer 16

aspart

lispro

Question 17

short acting name

Answer 17

regular

Question 18

intermediate acting name

Answer 18

NPH

lente

Question 19

long acting name

Answer 19

glargine

Question 20

what does A1C measure?

Answer 20

• the amount of glycosylated hemoglobin as a percentage of total hemoglobin
• e.g., A1C of 7% means that 7% of the total hemoglobin has glucose attached to it

Question 21

labs for hypoparathyroidism

Answer 21

-serum PTH

Question 22

treatment of hypoparathyroidism

Answer 22

• increase serum Ca+ to 9 to 10 mg/dL
• calcium gluconate IV
• Pentobarbital to decrease neuromuscular irritability
• administration of parathormone
• quiet environemnt, low draft, no sudden movement
• high Ca+ diet and low in phosphorus
• Vitamin D

Question 23

secretion of growth hormone happens where?

Answer 23

anterior pituitary gland

Question 24

disease if excess GH is secreted before the epiphesial plates close

Answer 24

gigantism

Question 25

disease if excess GH is secreted after epiphesial plates close

Answer 25

acromegaly

Question 26

steriostatic radiation

Answer 26

occlude blood vessels feeding the tumor, thereby starving it

Question 27

disease of hyposecretion of growth hormone

Answer 27

dwarfism

Question 28

treatment of dwarfism

Answer 28

-biosynthetic GH at bedtime until they are 14 or 16

Question 29

Cushings disease is caused by

Answer 29

hyperfunction of adrenals... too much steroid release

Question 30

labs for cushings

Answer 30

-dexamethasone suppression test

Question 31

Addisonian crisis s/s

Answer 31

shock; hypotension; rapid, weak pulse; rapid resp rate; pallor; extreme weakness

Question 32

Tx of Addisonian crisis

Answer 32

immediate IV administration of fluids, glucose, and electrolytes, especially sodium; replace missing hormones; vasopressors; recument position with legs elevated

Question 33

tx of graves disease

Answer 33

- radioactive 131I therapy - PTU and methimazole - Na+ and potassium iodine solutions - dexamethasone - beta blockers

Question 34

thyroid storm s/s

Answer 34

- high fever - extreme tachy - altered neuro: delirium psychosis, somnolence, coma

Question 35

tx of thyroid storm

Answer 35

- reduce temp and HR and recent ventricular collapse - O2 - IV fluids containing dextrose - PTU or methimazole - hydrocortisone to treat shock - iodine to decrease output of T4 - Propanolol and dig to reduce CV symtoms

Question 36

s/s myxedema coma

Answer 36

diminished LOC, hypothermia without shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis

Question 37

tx of myxedema coma

Answer 37

- ventilatory support - thyroid and adrenocortical hormones, fluids, and glucose - gradual rewarming

Question 38

hypercalcemic crisis

Answer 38

- serum Ca+ >13 mg/dL | - neuro, CV, and kidney symptoms that can be life threatening

Question 39

tx of hypercalcemic crisis

Answer 39

- rapid rehydration with isotonic fluids to maintain output of 100-150 mL/hr - Calcitonin

Question 40

DKA is characterized by...

Answer 40

- hyperglycemia - ketosis (fruity breath) - acidosis (respirations) - dehydration (BUN abnormal, creatinine normal)

Question 41

s/s DKA

Answer 41

- early: lethargy/weakness | - late: dehyration, abdominal pain, vomiting, kussmaul respirations

Question 42

Tx of DKA

Answer 42

- hydration with NS - insulin drip (always regular) - K+ replacement (ONLY when they're hydrated) - O2 - check glucose q30 min x2 or 4 when hanging drip, then qh - change IV to contain D5NS or D5 1/2NS when BG reaches 250 - stop IV when insulin drip reaches 200

Question 43

dif between HHS and DKA

Answer 43

in HHS: - increased serum osmolality - absent/minimal ketone bodies

Question 44

tx of HHS

Answer 44

- same as DKA but greater fluid replacement: - IV fluids, insulin therapy, electrolytes - once stable, attempt to detect underlying cause

Question 45

what interferes with sensing hypoglycemia

Answer 45

beta blockers

Question 46

treatment of hypoglycemia

Answer 46

- Always treat ABC's first - them 15mg CHO once able to swallow (orange juice, soda, lifesavers, lowfat milk) - repeat if BG is still