Professional Documents
Culture Documents
Text A
Deep vein thrombosis is a part of a condition called venous thromboembolism.
Deep vein thrombosis occurs when a blood clot (thrombus) forms in one or
more of the deep veins in the body, usually in the legs.
Deep vein thrombosis can cause leg pain or swelling, but may occur without
any symptoms. Deep vein thrombosis is a serious condition because blood clots
in the veins can break loose, travel through the bloodstream, and obstruct the
lungs, blocking blood flow.
Text B
Clinical Manifestations
A major problem associated with recognizing DVT is that the signs and
symptoms are nonspecific.
Edema: With obstruction of the deep veins comes edema and swelling of the
extremity because the outflow of venous blood is inhibited
Phlegmasiaceruleadolens: Also called massive iliofemoral venous thrombosis, the
entire extremity becomes massively swollen, tense, painful, and cool to the touch.
Tenderness: Tenderness, which usually occurs later, is produced by inflammation of
the vein wall and can be detected by gently palpating the affected extremity.
The objectives for treatment of DVT are to prevent thrombus from growing and
fragmenting, recurrent thromboemboli, and post thrombotic syndrome.
Endovascular management; Endovascular management is necessary for DVT
when anticoagulant or thrombolytic therapy is contraindicated, the danger of
pulmonary embolism is extreme, or venous drainage is so severely compromised
that permanent damage to the extremity is likely.
Vena cava filter: A vena cava filter may be placed at the time of thrombectomy;
this filter traps late emboli and prevents pulmonary emboli.
Discharge and Home Care Guidelines The nurse must also promote discharge and
home care to the patient.
Text C
Heparin (Rx)
Strength Route of Recommended FIRST
Drug
Administ dosage PTT
ration
80 units/kg IV CHECK
bolus, THEN
continuous
infusion of 18
1unit/mL units/kg/hr,
2units/ OR units IV
5000 6 hours after
mL Sc/IV bolus, THEN starting
10units
100unit continuous
infusion of infusion
/mL
s/m L 1300
units/hr,
250 units/kg
OR
(alternatively,
17,500 units)
SC, THEN 250
units/kg q12hr
Drug education: The nurse should teach about the prescribed anticoagulant, its
purpose, and the need to take the correct amount at the specific times prescribed.
Blood tests: The patient should be aware that periodic blood tests are necessary to
determine if a change in medication or dosage is required.
Avoid alcohol: A person who refuses to discontinue the use of alcohol should not
receive anticoagulants because chronic alcohol intake decreases their effectiveness.
Activity: Explain the importance of elevating the legs and exercising adequately.
Text D
Questions 1-7
For each of the questions, 1-7, decide which text (A, B, C or D) the information comes from.
You may use any letter more than once
Answer each questions, 8-4, with a word or short phrase from one of the texts.
Each answer may include words, number or the both. Your answers should be correctly
spelled.
therapy is contraindicated?....................................
12. Which is the term used to describe the massive iliofemoral venous
thrombosis?..................
Complete each of the sentences, 15- 20, with a word or short phrase from one of the texts.
Each answer may include words, number or both. Your answers should be correctly
spelled
15. A major problem is associated with recognizing DVT is that the signs and symptoms
are …………………….
16.Tenderness which usually occurs later is produced by...................of the vein wall
17.In some cases, signs and symptoms of a............are the first indication.
20.The patient should be aware of periodic blood tests which are necessary to determine if a
change in.....................or dosage is required.
Questions 1-6
1. The manual informs us that;
c. In PMDD the signer names a trusted person to make health care decisions
PROTECTIVE MEDICAL DECISIONS DOCUMENT (PMDD)
The PMDD is a protective Durable Power of Attorney for Health Care which is
available from the International Task Force on Euthanasia and Assisted Suicide.
In the PMDD the signer names a trusted person to make health care decisions in
the event that the signer is temporarily or permanently unable to make such
decisions.
The PMDD, which specifically prohibits assisted suicide and euthanasia, is available in
a Multi-State version for use in most states. It is also available in state specific
versions for states where particular requirements make a state-specific version
necessary.
2. The paragraph is giving information about;
a. Types of bronchodilators
b. Uses of bronchodilators
c. Definition of bronchodilator
Bronchodilator
A bronchodilator is a substance that dilates the bronchi and bronchioles, decreasing
resistance in the respiratory airway and increasing airflow to the lungs.
Bronchodilators may be endogenous (originating naturally within the body), or they
may be medications administered for the treatment of breathing difficulties.
They are most useful in obstructive lung diseases, of which asthma and chronic
obstructive pulmonary disease are the most common conditions. Although this
remains somewhat controversial, they might be useful in bronchiolitis and
bronchiectasis. They are often prescribed but of unproven significance in
restrictive lung diseases.
3. Use of _________________ ICD is;
a. Delivers an electric shock.
b. Prevents cardiac arrest in high risk patients.
c. It is a battery powered device
Implantable Cardioverter Defibrillator (ICD)?
An ICD is a battery-powered device placed under the skin that keeps track of your
heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is
detected the device will deliver an electric shock to restore a normal heartbeat if
your heart is beating chaotically and much too fast. ICDs have been very useful in
preventing sudden death in patients with known, sustained ventricular
tachycardia or fibrillation. Studies have shown that they may have a role in
preventing cardiac arrest in high-risk patients who haven't had, but are at risk for,
life-threatening ventricular arrhythmias.
4. Overhead radiant warmers
a. Minimize the oxygen and calories of infant
Antibiotic
An antibiotic (from ancient Greek αντιF3ιοτικά antibiotiká), also called an
antibacterial, is a type of antimicrobial drug used in the treatment and
prevention of bacterial infections. They may either kill or inhibit the growth of
bacteria. A limited number of antibiotics also possess antiprotozoal activity.
Antibiotics are not effective against viruses such as the common cold or
influenza; drugs which inhibit viruses are termed antiviral drugs or antivirals
rather than antibiotics.
READING SUB-TEST : PART C
In this part of the test, there are two texts about different aspects of healthcare.
For questions 7-22, choose the answer (A, B, C or D) which you think fits best according to
the text. Write your answers on the separate Answer Sheet
After this, the virus enters an acute phase and then, in some cases, a toxic phase
that can be life threatening.
Once the yellow fever virus enters the acute phase, you may experience signs
and symptoms including: Fever, Headache, Muscle aches, particularly in your back
and knees, Nausea, vomiting or both, Loss of appetite, Dizziness, Red eyes, face or
tongue These signs and symptoms usually improve and are gone within several
days.
Although signs and symptoms may disappear for a day or two following the acute
phase, some people with acute yellow fever then enter a toxic phase. During the
toxic phase, acute signs and symptoms return and more-severe and life-
threatening ones also appear. These can include: Yellowing of your skin and the
whites of your eyes (jaundice), Abdominal pain and vomiting, sometimes of
blood, Decreased urination, Bleeding from your nose, mouth and eyes, Heart
dysfunction (arrhythmia), Liver and kidney failure, Brain dysfunction, including
delirium, seizures and coma. The toxic phase of yellow fever can be fatal.
Make an appointment to see your doctor four to six weeks before travelling to an
area in which yellow fever is known to occur. If you don't have that much time to
prepare, call your doctor anyway. Your doctor will help you determine whether
you need vaccinations and can provide general guidance on protecting your
health while abroad.
Seek emergency medical care if you've recently travelled to a region where yellow
fever is known to occur and you develop severe signs or symptoms of the
disease. If you develop mild symptoms, call your doctor.
Yellow fever is caused by a virus that is spread by the Aedes aegypti mosquito.
These mosquitoes thrive in and near human habitations where they breed in
even the cleanest water. Most cases of yellow fever occur in sub-Saharan Africa
and tropical South America.
Humans and monkeys are most commonly infected with the yellow fever virus.
Mosquitoes transmit the virus back and forth between monkeys, humans or
both. When a mosquito bites a human or monkey infected with yellow fever,
the virus enters the mosquito's bloodstream and circulates before settling in
the salivary glands.
When the infected mosquito bites another monkey or human, the virus then
enters the host's bloodstream, where it may cause illness.
You may be at risk of the disease if you travel to an area where mosquitoes
continue to carry the yellow fever virus. These areas include sub-Saharan Africa
and tropical South America. Even if there aren't current reports of infected
humans in these areas, it doesn't mean you're risk-free It's possible that local
.
populations have been vaccinated and are protected from the disease, or that
cases of yellow fever just haven't been detected and officially reported. If you're
planning on travelling to these areas, you can protect yourself by getting a
yellow fever vaccine at least 10 to 14 days before travelling. Anyone can be
infected with the yellow fever virus, but older adults are at greater risk of getting
seriously ill.
Diagnosing yellow fever based on signs and symptoms can be difficult because
early in its course, the infection can be easily confused with malaria, typhoid,
dengue fever and other viral hemorrhagic fevers.
To diagnose your condition, your doctor will likely:
Ask questions about your medical and travel history Collect a blood sample for
testing If you have yellow fever, your blood may reveal the virus itself. If not,
blood tests known as enzyme-linked immune sorbent assay (ELISA) and
polymerase chain reaction (PCR) also can detect antigens and antibodies specific
to the virus. Results of these tests may not be available for several days.
No antiviral medications have proved helpful in treating yellow fever. As a result,
treatment consists primarily of supportive care in a hospital. This includes
providing fluids and oxygen, maintaining adequate blood pressure, replacing
blood loss, providing dialysis for kidney failure, and treating any other infections
that develop. Some people receive transfusions of plasma to replace blood
proteins that improve clotting. If you have yellow fever, you may also be kept
away from mosquitoes, to avoid transmitting the disease to others.
Text 1 – Questions 7-14
13. Taking vaccine ............... days before travelling to areas where the disease is
common is recommended
A. 10 days
B. 12 days
C .14 days
D. 10-14 days
14. “It does not mean you are risk free in paragraph 8 refers to?
A. there is a greater chance of infection in some areas even though there is no
recent report of infection.
B. even though there are no current reported cases of yellow fever in some areas,
If you have signs or symptoms such as severe chest pain, fainting, sudden onset
of shortness of breath or symptoms of a stroke then taking medical assistance
is of preliminary importance. While experiencing such symptoms doesn't
always mean that you have a serious problem, it's best to get checked out
quickly. Early detection and treatment may help save your life.
An aortic dissection occurs in a weakened area of the aortic wall. Chronic high
blood pressure may stress the aortic tissue, making it more susceptible to
tearing.
You can also be born with a condition associated with a weakened and
enlarged aorta, such as Marfan syndrome or bicuspid aortic valve. Rarely,
aortic dissections may be caused by traumatic injury to the chest area, such as
during motor vehicle accidents.
Aortic dissections are divided into two groups, depending on which part of the
aorta is affected:
Type A: This is the more common and dangerous type of aortic dissection. It
involves a tear in the part of the aorta just where it exits the heart or a tear
extending from the upper to lower parts of the aorta, which may extend into
the abdomen.
Type B: This type involves a tear in the lower aorta only “ which may also extend
”
Risk factors for aortic dissection include: Uncontrolled high blood pressure
(hypertension), found in at least two-thirds of all cases Hardening of the arteries
(atherosclerosis) Weakened and bulging artery (pre-existing aortic aneurysm) An
aortic valve defect (bicuspid aortic valve) A narrowing of the aorta you're born
with (aortic coarctation)
People with certain genetic diseases are more likely to have an aortic dissection
than are people in the general population.
These include: Turner's syndrome. High blood pressure, heart problems and a
number of other health conditions may result from this disorder.
Marfan syndrome; This is a condition in which connective tissue, which supports
various structures in the body, is weak. People with this disorder often have a
family history of aneurysms of the aorta and other blood vessels. These weak
blood vessels are prone to tears (dissection) and rupture easily.
Ehlers-Danlos syndrome; This group of connective tissue disorders is
characterized by skin that bruises or tears easily, loose joints and fragile blood
vessels.
Loeys-Dietz syndrome; this is a connective tissue disorder marked by twisted
arteries, especially in the neck. People who have Loeys-Dietz syndrome are
thought to be at risk for developing aortic dissections and aneurysms.
An aortic dissection can lead to death, due to severe internal bleeding, including
into the lining around the heart (pericardial sac), Organ damage, such as
kidney failure or life-threatening damage to the intestines, Stroke, possibly
including paralysis, Aortic valve damage, such as causing the aortic valve to
leak (aortic regurgitation)
Detecting an aortic dissection can be tricky because the symptoms are similar to
those of a variety of health problems. Doctors often suspect an aortic
dissection if the following signs and symptoms are present: Sudden tearing or
ripping chest pain, Widening of the aorta on chest X-ray, Blood pressure
difference between right and left arms.
Text 2: Questions 15 to 22
D. aortic complications
C. abdomen
D. a tear