NRNP 6550 Midterm Exam Questions And
Accurate Answers
Vaccinations and immunosuppression. 2 keypoints
- give inactive agents instead of live agents
- may not be as effective
live virus vaccine types
Virus:
- measles
- mumps
- polio (oral)
- rubella
- varicella
- yellow fever
- herpes zoster
Bacteria:
- typhoid
inactivated vaccine virus
Virus:
- Hep A and B
- HPV
- influenza
- polio (subq)
,- rabies
Bacteria:
- anthrax
- cholera
- diphteria
- Lyme
- meningococcus
- pertussis
- plague
- pneumococcus
- tetanus
Immunization recommendation influenza
all ages all types (pregnant, diabetes, immunocompromised, etc)
Immunization recommendation pregnancy and weakened immune system
- 1 dose Tdap
- no varicella, zoster, MMR
HIV and vaccinations
Give inactive agents when CD4 count is greater than 200 cells/ mm3
health screening 18 - 45 years
- BMI
- BP (q2years)
- at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac
,testing if LDL greater than 200 or HDL lower than 40)
- annual breast exam, females
- Pap-smear annually
health screening 45 and up
- blood glucose q3years
- 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years,
colonoscopy q10yrs)
- PSA with digital exam annually for males
- mammography q1 -2 yrs
- women 65 and up: screen for osteoporosis
top 5 leading causes of death
1. heart disease
2. cancer
3. respiratory disease
4. stroke
5. accidents
Conjunctivitis; definition
-Pink eyey
- Inflammation of conjuctiva (outer layer of eye)
Conjunctivitis: causes
Chemical, bacterial, viral, allergic, herpetic. Adenovirus most common but Haemophilus
influenzae and Streptococcus pneumoniae also very common causes in children.
Conjunctivitis: findings
inflamed
, itchy
discharge
swollen eyelid
can find gonorrhea and chlamydia in eye discharge
Conjunctivitis: management
cooling
rule out corneal abrasion
bacteria: antibiotic solution (gentamicin, neomycin)
chlamydia: oral tetracycline or erythromycin
gonorrhea: single dose ceftriaxone
herpes: refer to opthalmologist
Corneal abrasion: definition, cause, findings, treatment
dislocation of cornea - transparent membrane covering the eye foreign body/trauma
pain, redness, photophobia, diminished visual acuity ab ointment: gentamicin,
sulfacetamide, eye-patch, ophthalmologist diabetic retinopathy-definition, cause,
findings, treatment ocular retinal disease secondary to dm dm, exacerbated by smoking
and HTN -macular edema flashes of light across the path of vision, cloudy vision, black
spots, loss of vision, prolonged glucose > 130 laser therapy for macular edema,
cessation of smoking, glucose control, BP control
Retinal Detachment
definition: separation of retina and choroid
cause: trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell
findings: painless vision changes, blurred vision, light flashes, "curtain" over visual
field, bullous elevation w/o tears
tx: refer to ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma:
apply eye patch
Sudden loss of vision > will be permanent w/o rx due to abrupt blockage of retinal artery
Thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagulopathies)