CMN 568 Final Exam Test Questions And Answers
Verified 100% Correct
What is the difference between a VTE and a PE? Risk factors for
developing? (MODULE 2)
There is no difference between pulmonary venous
thromboembolism (VTE) and pulmonary embolism (PE). A VTE is
often referred to as a PE.
Risk factors for developing a VTE/PE:
Virchow triad- venous stasis, injury to a vessel wall,
hypercoagulability
Venous stasis increases with immobility (obesity, stroke, bred
rest- esp postoperative), hyperviscosity (polycythemia), and
increased central venous pressures (low cardiac output states,
pregnancy).
Vessel damage occurs from prior episodes of thrombosis,
orthopedic surgery, or trauma.
Hypercoagulability can be caused by medications (oral
contraceptives, hormonal replacement therapy), disease
(malignancy, surgery), or may be the result of an inherited gene
defect. The most common inherited cause in white populations is
,factor V Leiden (resistance to activated protein C) For
VTE and PE: What are the diagnosis and
treatment? (MODULE 2) Diagnosis:
The gold standard diagnostic study in North America for
suspected PE is the helical CT-PA.
V/Q scan is an alternative to the CT-PA in patients in whom
contrast is contraindicated.
Pulmonary angiography- currently only used in the treatment of
acute PE or to confirm the diagnosis of chronic PE in chronic
thromboembolic pulmonary hypertension.
Treatment:
Anticoagulation is the mainstay therapy for VTE.
Thrombolytic therapy- systemic (high-risk or massive PE with low
risk of bleeding) or catheter-directed (high-risk PE with a higher
risk of bleeding; intermediate risk PE at increased risk of
hemodynamic collapse).
Mechanical pulmonary embolectomy or surgical embolectomy for
patients with contraindications to thrombolysis or failure of
thrombolysis.
Inferior vena cava filter- in patients with contraindications to
anticoagulation or patients with recurrent PE despite adequate
anticoagulation.
What can the parents of patients be taught about prevention of
SIDS? (MODULE 2)
Place your baby on their back for all sleep times.
Use a firm, flat sleep surface, such as a mattress in a crib covered
with a fitted sheet.
Keep your baby's sleep area in the same room where you sleep
until the baby is at least 6 months old.
Keep blankets, pillows, bumper pads, and soft toys out of your
baby's sleep area.
Do not cover your baby's head or allow your baby to get too hot.
,What are the risks of getting Covid, and how is it spread? What
are the current treatments for someone who has a positive test?
(MODULE 2)
COVID is spread through respiratory droplet transmissions,
including talking, singing, sneezing, and coughing. The
transmission risk of COVID is increased within higher-density
living facilities (nursing homes, homeless encampments, jails,
prisons, Native-American reservations, and certain employment
settings).
COVID + treatments and time window of initial symptom onset:
Outpatient adult, non-pregnant- Nirmatrelvir-ritonavir within 5
days (Oral), Remdesivir within 7 days (IV), Bebtelovimab within 7
days (IV), High-titer convalescent plasma within 8 days (IV),
Molupiravir within 5 days (PO).
Outpatient children and non-pregnant adolescents-
Nirmatrelvirritonavir within 5 days (PO), Remdesivir within 7 days
(IV), Bebtelovimab within 7 days (IV), Molnupiravir within 5 days
(PO).
What labs might you order for suspected:
1. Renal Disease
2. Liver Disease
3. Pancreatic Disease
4. Gall Bladder Disease
5. Thyroid Disease
If the lab substantiates the organ disease you suspect, would the
levels be increased or decreased? (MODULE 2)
1. Renal disease- BUN, Creatinine, Potassium Sodium, Chloride,
Albumin, Amylase, Calcium
, ~BUN, Creatinine, Chloride, Amylase, Calcium, and Potassium
are elevated in renal disease. Albumin and Sodium are
decreased in renal disease.
2. Liver disease- AST, ALT, Albumin, ALP, BUN, Sodium,
Bilirubin
~AST, ALT, ALP, and Bilirubin all increased in liver injury.
Albumin, BUN, and Sodium decreased in liver disease
3. Pancreatic disease- Amylase, Lipase
~Acute pancreatitis elevated Amylase and Lipase; Chronic
pancreatitis decreased amylase 4. Gall bladder disease- AST,
ALT, ALP
~All would be elevated
5. Thyroid disease- TSH, T3, T4.
~Hyperthyroidism elevated T3, T4, decreased TSH;
Hypothyroidism elevated TSH, decreased T3, T4.
How are normal lung sounds described? What is the description
of lung sounds that indicate some type of pathology? (MODULE
2)
Normal lung sounds heard over the periphery are vesicular-
gentle, rustling, heard throughout inspiration and fades in
expiration.
Normal lung sounds heard over the suprasternal notch are
tracheal or bronchial- louder, higher pitched, hallow quality, and
louder or expiration.
Adventitious breath sounds:
Wheezing- high pitched, musical, distinct whistle sound that can
indicate bronchospasm, mucosal edema, or excessive secretions.
The airway is narrowed to the point where adjacent airway walls
flutter as airflow is limited.
Rhonchi- lower pitched, snorous, gurgling quality that originates in
the larger airways when excessive secretions and abnormal
Verified 100% Correct
What is the difference between a VTE and a PE? Risk factors for
developing? (MODULE 2)
There is no difference between pulmonary venous
thromboembolism (VTE) and pulmonary embolism (PE). A VTE is
often referred to as a PE.
Risk factors for developing a VTE/PE:
Virchow triad- venous stasis, injury to a vessel wall,
hypercoagulability
Venous stasis increases with immobility (obesity, stroke, bred
rest- esp postoperative), hyperviscosity (polycythemia), and
increased central venous pressures (low cardiac output states,
pregnancy).
Vessel damage occurs from prior episodes of thrombosis,
orthopedic surgery, or trauma.
Hypercoagulability can be caused by medications (oral
contraceptives, hormonal replacement therapy), disease
(malignancy, surgery), or may be the result of an inherited gene
defect. The most common inherited cause in white populations is
,factor V Leiden (resistance to activated protein C) For
VTE and PE: What are the diagnosis and
treatment? (MODULE 2) Diagnosis:
The gold standard diagnostic study in North America for
suspected PE is the helical CT-PA.
V/Q scan is an alternative to the CT-PA in patients in whom
contrast is contraindicated.
Pulmonary angiography- currently only used in the treatment of
acute PE or to confirm the diagnosis of chronic PE in chronic
thromboembolic pulmonary hypertension.
Treatment:
Anticoagulation is the mainstay therapy for VTE.
Thrombolytic therapy- systemic (high-risk or massive PE with low
risk of bleeding) or catheter-directed (high-risk PE with a higher
risk of bleeding; intermediate risk PE at increased risk of
hemodynamic collapse).
Mechanical pulmonary embolectomy or surgical embolectomy for
patients with contraindications to thrombolysis or failure of
thrombolysis.
Inferior vena cava filter- in patients with contraindications to
anticoagulation or patients with recurrent PE despite adequate
anticoagulation.
What can the parents of patients be taught about prevention of
SIDS? (MODULE 2)
Place your baby on their back for all sleep times.
Use a firm, flat sleep surface, such as a mattress in a crib covered
with a fitted sheet.
Keep your baby's sleep area in the same room where you sleep
until the baby is at least 6 months old.
Keep blankets, pillows, bumper pads, and soft toys out of your
baby's sleep area.
Do not cover your baby's head or allow your baby to get too hot.
,What are the risks of getting Covid, and how is it spread? What
are the current treatments for someone who has a positive test?
(MODULE 2)
COVID is spread through respiratory droplet transmissions,
including talking, singing, sneezing, and coughing. The
transmission risk of COVID is increased within higher-density
living facilities (nursing homes, homeless encampments, jails,
prisons, Native-American reservations, and certain employment
settings).
COVID + treatments and time window of initial symptom onset:
Outpatient adult, non-pregnant- Nirmatrelvir-ritonavir within 5
days (Oral), Remdesivir within 7 days (IV), Bebtelovimab within 7
days (IV), High-titer convalescent plasma within 8 days (IV),
Molupiravir within 5 days (PO).
Outpatient children and non-pregnant adolescents-
Nirmatrelvirritonavir within 5 days (PO), Remdesivir within 7 days
(IV), Bebtelovimab within 7 days (IV), Molnupiravir within 5 days
(PO).
What labs might you order for suspected:
1. Renal Disease
2. Liver Disease
3. Pancreatic Disease
4. Gall Bladder Disease
5. Thyroid Disease
If the lab substantiates the organ disease you suspect, would the
levels be increased or decreased? (MODULE 2)
1. Renal disease- BUN, Creatinine, Potassium Sodium, Chloride,
Albumin, Amylase, Calcium
, ~BUN, Creatinine, Chloride, Amylase, Calcium, and Potassium
are elevated in renal disease. Albumin and Sodium are
decreased in renal disease.
2. Liver disease- AST, ALT, Albumin, ALP, BUN, Sodium,
Bilirubin
~AST, ALT, ALP, and Bilirubin all increased in liver injury.
Albumin, BUN, and Sodium decreased in liver disease
3. Pancreatic disease- Amylase, Lipase
~Acute pancreatitis elevated Amylase and Lipase; Chronic
pancreatitis decreased amylase 4. Gall bladder disease- AST,
ALT, ALP
~All would be elevated
5. Thyroid disease- TSH, T3, T4.
~Hyperthyroidism elevated T3, T4, decreased TSH;
Hypothyroidism elevated TSH, decreased T3, T4.
How are normal lung sounds described? What is the description
of lung sounds that indicate some type of pathology? (MODULE
2)
Normal lung sounds heard over the periphery are vesicular-
gentle, rustling, heard throughout inspiration and fades in
expiration.
Normal lung sounds heard over the suprasternal notch are
tracheal or bronchial- louder, higher pitched, hallow quality, and
louder or expiration.
Adventitious breath sounds:
Wheezing- high pitched, musical, distinct whistle sound that can
indicate bronchospasm, mucosal edema, or excessive secretions.
The airway is narrowed to the point where adjacent airway walls
flutter as airflow is limited.
Rhonchi- lower pitched, snorous, gurgling quality that originates in
the larger airways when excessive secretions and abnormal
