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FNP 2015 Comprehensive Final Part 1 22:30 - end

Terms in this set (29)

At what week of gestation are male and female reproductive organs differentiated?
8th Week
(until then they appear the same)
The primary hormonal determinant of sex differentiation in the fetus at eighth week of gestation is:

a) estrogen
b) progesterone
c) growth hormone
d) testosterone
d) testosterone
Name the hormone linked to obesity and early puberty
Leptin
What is primary site of cervical dysplasia or cervical cancer?
Where cervical columnar epithelium meet the squamous epithelium of vagina known as the TRANSFORMATION ZONE
The pair of glands that lie posterior to the urinary bladder in the male are:
Seminal Vesicles
What glands in females lie in the posterior aspect of the introitus?
Bartholin Glands
What is NOT a common characteristic of aging in the male reproductive system?
A reduced sperm count
Dysmenorrhea is due to
Prostaglandins

Treat with: NSAIDS 3 days before period starts and will alleviate pain
Primary cause of cervical cancer is:
HPV
Symptoms of BPH (main symptom)
Weak urinary flow bc compression of urethra
What pathology has the sudden onset of malaise, back pain, perineal pain, fever, chills, dysuria, nocturia, and urinary retention?
Bacterial Prostatitis
Cross-fit is a common cause of _______. Change in the Creatinine Kinase level is one of the most clinically useful measurements to diagnose this.
Rhabdomyolysis
A primary defect in the loss of articular cartilage.
Osteoarthritis
Most malignant type of soft tissue tumor in children is called:
Rhabdomyosarcoma
Types of Seizures
1) PARTIAL:

Simple partial:
--common with cerebral lesions
--rarely lasts > 1 minute
--NO LOC**
--motor symptoms often start in a single muscle group and spread to entire side of body
--parasthesias, flashing lights, vocalizations, hallucinations common

Complex partial:
--any simple partial seizure followed by IMPAIRED LOC**
--may have aura, staring, or automatisms such as lip smacking and picking at clothing

2) GENERALIZED:

Absence (petite mal):
--sudden arrest of motor activity with blank stare
--commonly discovered in children/adolescents
--begins and ends suddenly

Tonic-clonic (grand mal)
--may have an aura
--begins with tonic contractions
--usually lasts 2-5 minutes
--incontinence may occur
--followed by postictal period

Status Epilepticus:
--series of grand mal seizures of > 10 minute duration
--most uncommon and life-threatening
Conditions that lead to neck stiffness with resistance to flexion:
1) meningitis
2)sub-arachnoid hemorrhage
A patient collapses when they hear bad news, what type of syncope?
Vasovagal
When assessing a patient with lower back pain, ask if pain is unilateral or bilateral. Bilateral indicates what?
Muscular pain
Describe gonococcal arthritis?
Medscape:

History
The clinical presentation of disseminated gonococcal infection (DGI) is typically divided into a bacteremic form and a septic arthritis form. Approximately 60% of patients present with symptoms consistent with the bacteremic form, and the remaining 40% present with symptoms of more localized infection. Although each form presents with its own symptom complex, the overlap can be considerable. The time from initial infection to initial manifestations of disease ranges from 1 day to 3 months.[1]

Bacteremic form
In the bacteremic form (arthritis-dermatitis syndrome), symptoms are typically present 3-5 days before diagnosis.[6]

Migratory arthralgias are the most common presenting symptom in persons with DGI and are usually polyarticular. The arthralgias are typically asymmetric and tend to involve the upper extremities more than the lower extremities. The wrist, elbows, ankles, and knees are most commonly affected. Symptoms resolve spontaneously in 30-40% of cases or evolve into a septic arthritis in 1 or several joints.

Pain may also be due to tenosynovitis. The tenosynovitis of DGI is asymmetric and most commonly occurs over the dorsum of the wrist and hand, as well as over the metacarpophalangeal joints, ankles, and knees. Diffuse involvement of fingers can result in dactylitis.[1]

The rash associated with the bacteremic form of DGI may be overlooked by patients because it is painless and nonpruritic and consists of small papular, pustular, or vesicular lesions.

Nonspecific constitutional symptoms may include myalgias, fever, and malaise.

Septic arthritis form
Joint symptoms begin within days to weeks of gonococcal infection.[6] Patients may experience pain, redness, and swelling in 1 joint (or sometimes multiple joints), most commonly in a knee, wrist, ankle, or elbow
What kind of questions should the ANP use while obtaining patient history?
Open-ended
Term for pain that has no apparent underlying cause
Idiopathic pain
Pain of a crushed finger or a heart attack; a pain with a cause resulting from normal tissue injury. Either SOMATIC or VISCERAL
Nociceptive pain
Non-nociceptive pain; the result of trauma or disease of nerves and leads to long term plastic changes along somatosensory pathways from the periphery to cortex and abnormal processing of sensory information by the PNS and CNS
Neuropathic pain
Arises from connective tissue, muscle or bone, and skin and is either sharp and well localized (A fibers) or dull, aching, and poorly localized (C fibers)
Somatic pain
Refers to pain in internal organs and abdomen and is transmitted by sympathetic afferents; it is poorly localized because of the lesser number of nociceptors in the visceral structures
Visceral pain
Also called psychalgia, is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors. Headache, back pain, or stomach pain are some of the most common types of this pain.
Psychogenic pain
Percussion sounds
-Tympanic, drum-like sounds heard over air filled structures during the abdominal examination
-Hyperresonant (pneumothorax) said to sound similar to percussion of puffed up cheeks.
-Normal resonance/ Resonant the sound produced by percussing a normal chest.
-Impaired resonance (mass, consolidation) lower than normal percussion sounds.
-Dull (consolidation) similar to percussion of a mass such as a liver.
When performing a breast exam you notice that one breast is larger than the other. Is this a normal finding?
Yes
Abnormal findings while performing the breast exam would include:
Nipple discharge
Dimpling
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