Knowlege Check

1. CC: “I keep been having tremendous chest and arm indisposition for the departed 2 hours and I consider I am having a benevolence invasion.”HPI: Mr. Hammond is a 57-year-old African American hardy who presents to the Emergency Department following a while a foremost expostulation of chest indisposition that radiates down his left arm. He states that he launched having indisposition divers hours ago and says the indisposition “it feels love an elephant is sitting on my chest”. He rates the indisposition as 8/10. Nothing has made the indisposition amend or worse. He denies any foregoing incident of chest indisposition. Denies disgust, dyspnea, or lightheadedness. He was loving 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the indisposition.Lipid panel reveals Entirety Cholesterol 324 mg/dl, noble inobservance lipoprotein (HDL) 31 mg/dl, Low Inobservance Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis peculiarity is an intelligent auxiliary deference myocardial infarction.1 of 2 Questions:Why is HDL considered the “good” cholesterol?

QUESTION 21. CC: “I keep been having tremendous chest and arm indisposition for the departed 2 hours and I consider I am having a benevolence invasion.”HPI: Mr. Hammond is a 57-year-old African American hardy who presents to the Emergency Department following a while a foremost expostulation of chest indisposition that radiates down his left arm. He states that he launched having indisposition divers hours ago and says the indisposition “it feels love an elephant is sitting on my chest”. He rates the indisposition as 8/10. Nothing has made the indisposition amend or worse. He denies any foregoing incident of chest indisposition. Denies disgust, dyspnea, or lightheadedness. He was loving 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the indisposition.Lipid panel reveals Entirety Cholesterol 324 mg/dl, noble inobservance lipoprotein (HDL) 31 mg/dl, Low Inobservance Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis peculiarity is an intelligent auxiliary deference myocardial infarction.2 of 2 Questions:Explain the role inflammation has in the product of atherosclerosis.

QUESTION 31. A 45-year-old dowager following a while a fact of systemic lupus erythematosus (SLE) presents to the Emergency Locality (ER) following a while expostulations of penetrating retrosternal chest indisposition that worsens following a while profound exhalationing or untrue down. She reports a 3-day fact of low-grade ferment, listlessness and says she feels love she had the flu. Corporeal exam reveals tachycardia and a pleural rubbing rub. She was diagnosed following a while intelligent pericarditis.
Question:
What does the Advanced Practice Registered Foster (APRN) own as the consequence of the pleural rubbing rub?

1 points   QUESTION 41. A 15-year-old pubescent hardy succeeds to the clinic following a while his parents following a while a foremost expostulation of ferment, disgust, vomiting, indisposed localized abdominal indisposition, arthralgias, and “distended lymph nodes”. States he has felt “lousy” for a stranger weeks. The ferments keep been as noble as 102 F. His parents sentiment he had the flu and took him to an Urgent Care Center. He was loving Tamiflu® and sent abode. He says the Tamiflu didn’t appear to is-sue. States had a scorn pointed throat a stranger weeks ago and attributed it to the flu. Corporeal exam orthodox lean future man who appears to be dissatisfied but not intelligently ill. Subsequent pharynx reddened and tonsils 3+ following a whileout exudate. + former and subsequent cervical lymphadenopathy. Tachycardic and a new onslaught 2/6 noble-pitched, crescendo-decrescendo systolic eviction whisper auscultated at the left sternal rim. Rapid strep +. The resigned was diagnosed following a while intelligent rheumatic benevolence illness (RHD).
Question:
Explain how a decisive strep trial has agentd the resigned’s symptoms.

QUESTION 51. The APRN sees a 74-year-old fleshy fehardy resigned who is 2 days shaft-op following undergoing left solidty hip renovation. The resigned has had austere shaft op disgust and vomiting and has been unqualified to go to corporeal therapy. Her mucus membranes are dry. The resigned says she feels love the skin on her left leg is too fast. Exam reveals a distended, stretched, and red colored calf. The resigned has a duplex ultrasound which reveals the influence of a profound venous thrombosis (DVT).Question:Describe the factors that could keep contributed to the product of a DVT in this resigned interpret how each of the factors could agent DVT.

QUESTION 61. A 45-year-old dowager is 10 days foothold shaft unfair imbecile bowel resection for Crohn Illness and has been recuperating at abode. She suddenly develops austere insufficiency of exhalation, becomes imbecile, and her respect exigency drops to 80/40 mmHg (foregoing readings ~130/80s mmHg). The pulse oximetry is 89% on locality air. The APRN suspects the resigned conversant a colossal pulmonary embolus.
Question:
Explain why a great pulmonary embolus interferes following a while oxygenation.
  QUESTION 71. A 45-year-old dowager is 10 days foothold shaft unfair imbecile bowel resection for Crohn Illness and has been recuperating at abode. She suddenly develops austere insufficiency of exhalation, becomes imbecile, and her respect exigency drops to 80/40 mmHg (foregoing readings ~130/80s mmHg). The pulse oximetry is 89% on locality air. While indetermination for the Emergency Medical Service (EMS) to get, the APRN places EKG leads and the EKG demonstrates fair ventricular filtrate.
Question:
Explain why a great pulmonary embolism agents fair ventricular filtrate.
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QUESTION 81. A 12-year-old maid is brought to the Emergency Locality (ER) by her dowager following a while expostulations of insufficiency of exhalation, wheezing, tachypnea, tachycardia, and a non-productive cough. The dowager states they had justeous succeed from a droop festivity where the solid lineage enjoyed a hayride. The symptoms began shortly following they left the festivity but got amend a stranger hours following they returned abode. The symptoms began anew encircling 6 hours delayedr and appear to be worse. The dowager states there is no fact of allergies or many respiratory transmitted. The branch is up to limit on all vaccinations. The branch was diagnosed following a while asthma. The foster practitioner interpreted to the dowager that her branch was exhibiting symptoms of asthma, and probably had an future asthmatic confutation and a delayed asthmatic confutation.
Question 1 of 2:
Explain future asthmatic confutations and the cells legitimate for the confutations.

QUESTION 91. A 12-year-old maid is brought to the Emergency Locality (ER) by her dowager following a while expostulations of insufficiency of exhalation, wheezing, tachypnea, tachycardia, and a non-productive cough. The dowager states they had justeous succeed from a droop festivity where the solid lineage enjoyed a hayride. The symptoms began shortly following they left the festivity but got amend a stranger hours following they returned abode. The symptoms began anew encircling 6 hours delayedr and appear to be worse. The dowager states there is no fact of allergies or many respiratory transmitted. The branch is up to limit on all vaccinations. The branch was diagnosed following a while asthma. The foster practitioner interpreted to the dowager that her branch was exhibiting symptoms of asthma, and probably had an future asthmatic confutation and a delayed asthmatic confutation.Question 2 of 2:Explain delayed asthmatic confutations and the cells legitimate for the confutations.

QUESTION 101. A 64-year-old man following a while a 40 pack/year fact of cigarette smoking has been diagnosed following a while emphysema.  He asks the APRN if this resources he has COPD.Question 1 of 2:Explain the pathophysiology of emphysema and how it relates to COPD.

QUESTION 111. A 64-year-old man following a while a 40 pack/year fact of cigarette smoking has been diagnosed following a while emphysema.  He asks the APRN if this resources he has COPD.Question 2 of 2:Explain the pathophysiology of continuous bronchitis and how it relates to COPD.

QUESTION 121. Mr. Jones is a 78-year-old yeoman who presents to the clinic following a while a foremost expostulation of ferment, chills and cough. He to-boot reports some dyspnea. He has a fact of fair policyd CVA, COPD, dyslipidemia, and HTN. Current medications understand atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol. He reports further use of his albuterol recover inhaler.
Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO2 on locality air 86% and on O2 4 L nasal canula 94%. CMP WNL, WBC 18.4. Corporeal exam reveals lean, unquiet yeoman following a while moderate hemiparesis on left policy due to CVA. HEENT WNL negative for diminished gag reflex and encumbered loftiness of the uvula, CV-HR 108 RRR following a whileout whispers, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals coalition in fair inferior lobe. He was diagnosed following a while fraternity adscititious pneumonia (CAP).Question:
Patient was hypoxic as evidenced by the low PaO2. Interpret the pathologic processes that agentd this resigned’s hypoxemia.

1 points   QUESTION 131. A 64-year-old dowager following a while tolerably austere COPD succeeds to the pulmonary clinic for her quarterly checkup. The APRN reviewing the chart notes that the resigned has past 5% of her association consequence gone her decisive mark. The APRN questions the resigned and resigned admits to not having abundantly of an passion and she to-boot admits to detriment some meals beagent it “takes too abundantly is-sue” to belie and use dinner.
Question:
The APRN owns that COPD has a pernicious property on resigneds. Interpret why resigneds following a while COPD are at risk for malnutrition.

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