Elaine Shared "Med Surg Exam 3" - 81 Picmonics

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Med Surg Exam 3

Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Tacrolimus (Prograf) Overview
Mechanisms
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Transplant Rejection
Atopic Dermatitis
Considerations
Increased Lymphoma Risk
Avoid Grapefruit Juice
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1 min
Tacrolimus (Prograf) Side Effects
Nephrotoxicity
Neurotoxicity
GI Distress
Infection
Hypertension
Hyperkalemia
Hyperglycemia
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1 min
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
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2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
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1 min
Kidney Transplant
Indications
End Stage Renal Disease (ESRD)
Considerations
Selective Candidacy
Close Compatibility
Immunosuppressants
Monitor for Rejection
Monitor for Infection
Monitor Urine Output
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2 mins
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
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2 mins
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
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1 min
Tricuspid Regurgitation
Holosystolic
Blowing Murmur
Radiates to Right Sternal Border
Enhanced by Inspiration
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1 min
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Mitral Regurgitation
Characteristics
Holosystolic
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
Expiration
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1 min
Hypertrophic Cardiomyopathy Mechanisms
Pathophysiology
2/3 Autosomal-Dominant
1/3 Sporadic Type
Mutation in Gene for Sarcomere Protein
Cardiac Myosin Binding Protein C
Asymmetric Septal Hypertrophy
Outflow Tract Obstruction
Diastolic Dysfunction
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2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
Signs and Symptoms
Sudden Death Of Young Athlete
Heart Failure
Angina
Arrhythmias
Syncope
Harsh Systolic Ejection Murmur
S4 Heart Sound
Treatment
Beta Blocker
Non-dihydropyridine Calcium Channel Blocker
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2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Onset: 1 Hour
Peak: 10 - 24 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treated Aggressively
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2 mins
Cardiac Enzyme Evaluation: Myoglobin
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 1 - 4 Hours
Peak: 12 Hours
Return to Normal: 24 Hours
Considerations
Elevation After 24 Hours: Reinfarction
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2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 4-8 Hours
Peak: 12-24 Hours
Return to Normal: 2-3 Days
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1 min
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min

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