Module 8 Part 3

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Headache & Dizziness
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1

Papilledema: What is it?

*Swelling of optic disc*

2

Papilledema: S/s

H/A, N/V, May have vision problem ie. double vision

3

Papilledema: Causes & Tx

-increase ICP, Brain tumor, Cerebral trauma, Meningitis, Ecephalitis

Tx: Depends on cause

4

Aneurysm: 3 types

  1. Saccular/Berry Aneurysm
    1. Congenital Abnormality
    2. Rupture MC cause of acute subarachnoid hemorrhage
  2. Fusiform Aneurysm
    1. Arteriosclerotic Changes
  3. Dissecting Aneurysm
5

Aneurysm: S/s

Asymptomatic until rupture usually

6

Pituitary Adenoma: What & Where? Cause?

Mostly benign tumors @ anterior pituitary

Cause: DNA Mutation

7

Pituitary Adenoma: S/s

-Tumor compress on nl pituitary gland= failed gland= hypopituitarism

-Depend on which hormone involved

-Hyperactivity or nothing, N/V, HA, Visual Changes

8

Pituitary Adenoma: Tx

-Surgery: Remove pituitary= Hormone replacement

-Radiation Therapy=Hormone replacement

-Drug therapy

9

Pituitary Adenoma: Most common hormone involved @ Anterior Pituitary gland

  1. Prolactin: Galactorrhea
  2. ACTH: Cushing's Disease
  3. GH: Acromegaly
10

Cushing's Syndrome: S/s

-Obesity: fat deposit@midsection, upper back, behind shoulders(hump) & Face "Moon Face"

-Striae: Abs, thigh, arm, breast,

-Skin: Thinning, fragile, bruise easily

-Slow healing of bites, cuts & infections

-Acne

-Women: Thicker visible body hair & irregular-no menstrual periods

11

Cushing's Syndrome: Physiology 2 ways

  1. Adrenal Gland= Zona faciculata make too much cortisol
  2. Secondary Hyperthyroidism= too much ACTH usually b/c of tumor
12

Hypertension: What is considered HTN?

Whats Pre-HTN?

*BP >140/90*

Pre-HTN: >120/80 & <139/79

13

Hypertension: Cause

- increase age, African Americans, Diabetics

-Atherosclerosis=Arterial wall disorder=coronary artery can lead to heart attack

-Anxiety/stress

-Increase Na= Na in blood, H2O follows= too much in vessels

- Kidney disorder: Aldosterone & Renin= Vasoconstrictors

14

Hypertension: S/s

-Asymptomatic

-H/A, Blurred vision, Arrhythmias/chest pain, nose bleed

-Risk for=Atherosclerosis, Aeurysm, heart failure, stroke, vision loss (hypertensive Retinopathy), Metabolic Syndrome, Cognitive Function

15

Hypertension: Testing

Clinical

R/O above disorders

16

Hypertension: Tx 8 meds

Diuretics, ACE inhibitors, ARB, Ca Blockers, Direct Vasodilators, Alpha1 Blocker, Alpha2 Agonist, Beta Blockers

17

Diuretics

Increase Urine Output & decrease fluid volume

18

ACE Inhibitors

Block formation of Angiotensin 2 = vasodilation

19

ARB

Angiotensin 2 Receptor Blocker

Prevent Angiotensin 2 from reaching receptors = vasodilation

20

Ca Channal Blockers

Black Ca channel in arterial SM = Vasodilation

21

Direct Vasodilators

Act on SM of arteriols = vasodilation

22

Alpha1 Blockers

Inhibit Sympathetic activation in arteriols = vasodilation

23

Alpha2 Agonist

decrease sympathetic impulses fron CNS to heart and arteriols = vasodilation

24

Beta Blockers

decrease HR & Myocardial contractility = decrease cardiac output

25

Arrhythmia: What?

*irregular cardiac rhythm*

26

Arrhythmia: Causes

*Structural

-Electrolyte or homone imbalance (Na&K, TH)

-Stress to heart=Heart disease, HTN

-Caffiene, Drugs (lots of them)

- Postural Orthostatic Tachycardia Arrhythmia (Stand up too fast)

27

Arrhythmia: S/s

-"Skipped beat", "Fluttering" sensation

chest pain, Dissiness, Syncope (LOC), Asymptomatic

28

Arrhythmia: Testing

-EKG, Hormones, Chemistry panel, 24 hr holter monitor or event monitor

29

Wolf Parkinson White Syndrome (WPW): What?

**Abnormal conduction pathways leading to arrhythmia**

30

Wolf Parkinson White Syndrome (WPW): What happens to the ventricles?

Preexcites ventricles preventing them to fill all the way

31

Wolf Parkinson White Syndrome (WPW): AV Node

"Pause button"

AV Node gets bypassed preventing ventricles to fully fill

32

Wolf Parkinson White Syndrome (WPW): Delta Wave

Ventricle recieved signal too early

QRS start too early & Widens

33

Wolf Parkinson White Syndrome (WPW): Delta wave - what happens to PR interval?

PR interval shortens

34

Wolf Parkinson White Syndrome (WPW): Accessory pathway mode fo transportation

Skips Bundle of Hiss and Perkinji fibers going straight to Bundle of Kent

35

Wolf Parkinson White Syndrome (WPW): Tx

-Beta Blocker (decrease HR)

-Ca Channel Blocker

-Massage carotid arteries

-Diving reflex: Cold water shock to face

-Deep Breathing