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Medical Elomda??

The document discusses various types of pain, including acute and chronic pain, their characteristics, and the pain assessment tools used to evaluate them. It also covers surgical procedures, the importance of informed consent, anesthesia types, and postoperative complications. Key points include the physiological processes of pain and the role of nursing management in both preoperative and postoperative care.

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mondysherif131
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17 views49 pages

Medical Elomda??

The document discusses various types of pain, including acute and chronic pain, their characteristics, and the pain assessment tools used to evaluate them. It also covers surgical procedures, the importance of informed consent, anesthesia types, and postoperative complications. Key points include the physiological processes of pain and the role of nursing management in both preoperative and postoperative care.

Uploaded by

mondysherif131
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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NE EN aan) ee 3 sudden/ waent A usualy due to injury, surgery, or an a “accident bre infection [Resolves as healing occur eypoeele Few gaa > r oO Lasts beyond the normal healing period 5 Fa isso eae ue (usually >3-6 months), Itcan be | e persistent or intermittent. sudden “eigen f Ra 3g 7. we ouvjl cu Acuk pain:. sudden Lurgenl £ severe = Iw Cela Chk anty mild Acute bb Dw lt candassbs alas Tis 10 uu Cl We as Wait SNe Hascly dial Surgical NUring differently’ Byeveryone. lad | Aye Gi or a Cable Gruss thew 260 yy SNS os wee cay bots be Fe pain subjective derta| Fe pain subjective derta| objective ——} usually ue to injury, surgery, oF al el accident =o» infection [Resolves as healing occurs) oe i ° Lasts_beyond the normal healing period o Ws bev = bur is} (usually>3-6 orth. Itcan be persistent or intermittent. @B sudden “urgent gg evil oro pea / spina ~ Acule pain:. sudden £urgenl £ severe eas Iw Chie hls ante mild. aa in cules is» J —3/Acute Is Peploaaest fa Ww ewe Nie Hisc'y nou <2) ey do > Blo pase ©” 'epelvis/mlestin/ chest /Absomen. evve) Ae | ceplor) GZ Io . | Inction, often Thejpain pathway consists of four main processes: oo iabeti a clabese leceplor. Ak poll atu lu Il ey ransmission:} Pain signals travel from the site of injury to the (tal cord and brainc£ yl Ap) w) uw YI) popepay Cro CLD lerprets pain and processes the emotional Ain Wool asi,. = yu cas factors, with o> i we "Choy cele hinl" Call 3 Sa Percepfion di aust) is - % Endorphins. ar RR ag | | /A4 Paindaig ye 8 888tyd 3) 5 es SEEN ieee - pt fal tage aw si0 vO aewsie yp) * eae ) ®| 9, Newrepathic pain (Nevve) a Pamege Nociceplive pain Cveceplor) ed pe. [Brewopenie Pain| caused by nerve damage or dysfunction, often “7; Na : es aa shooting, or electric shock-like (e.g. diabetic Be it NS ect Ce 7 neuropathy, sciatica). Nyy O Psychogenic PainjPain influenced by Psychological factors, with \y > no clear physical cause. ws Cue V5 vis o» x aoa so yalf : op eo. <= oor” ee ec “ cae u 1-3 +o ms ~~ : : foe tal Chronic pain ea, i ipocste : Police OVA Ee Us iD Chronic episodic pain: a 0 ER OVS Cp . * Pain that occurs sporadically over an extended period of time is episodic pain. * Pain episodes last for hours, days, or weeks. Examples are v Coal f leet As chores calls ews 4 [Pisedic Migs. OT ¢ . ~ JHU Caio [pis pny I ® PEM UH bay Eel ae ‘ ‘ “= svoury, ae 1 aIQ8 ag 9 ANE odo, 9 Bute sadgy a 7 TE mm oe mele 2 —— ee Sade Joyeg-3uoy, <— syuaned jequaa-uou “(s1wak €2) uaup} PWWM SD Grey Fo e—y, ea eqsome’ liad soy ame anita (Cla a TICS aap matching mcs Pain assessment tools There are various tools that are designed to assess the level of 3 — pain. The most used tools are: 9 ~==== 5 1-Visual Analog Scale (VAS). AY dig > WEI psp to oe 8 2- Numerical Rating Scale (NRS). , de so Cro Cosy [7 3- Wong-Baker Faces Pain Scale. Aly! 51 satstuc tec a So 5 iv Sa os Cools Sut Zed 6 3 los ELonis put jo 4- McGill Pain Questionnaire (MPQ =z 5- Brief Pain Inventory (BPI). — a : un: caAyl - ais 9 Aby> ees LH 040 ; / 93> a Cpl rele { - o\Based on etiot logy Damage of receptor. ou =_ lay Dit——— 7 Pain: Due to activation of nociceptors (pain S = receptors) in response to noxious stimuli. Sli fay ee fesiose % i “ oy) (@ Somatic Pain:) STN or throbbing (@.g., bone = ny PL Hy [5 Jy 90 pul WO OSU sy fracture, skin injury). muscle joint Iskin. US lol yu) y ] Viscera Poorly localized,| deep, dull, or cramping (e.g., aa abdominal pain in appendicitis). bla 2 (ao UI Ce puiva a) ; Caerls CrrPoeic spc ul Jc yp 7 : - pa © pelvis /infestin/ chest / Abdomen. er le . hl lhl ltt ee IG a oF. y oog¢h => —7 eaais HS —7 zails (—— Gr wt Td3LS (ete &t) . sdais OHM Suipeas ajeas uleg — (A9PPe’T JUsUIOSeUR UIE OHM*"’ ae iC Pima <6 geist: 7" : NAsTds (Analgesics) ati +] WHO Pain Management Ladder ae By yg oud "9 Dun g, wie ? nado go ge, tt ) Pain iS” a. _ A-Subiacs've/ Cry 3 If ansed due to Bae 5 oe cours SPotadiCally Wey On Peniod oF tire iS: Reberred P. Pain i be feit in the Shae | en ny (T/F) neuyofathic Parw NWOCICEPAVE Pain Le Based of EHalogy Sermo PaIAT WiSCera}—Pain — > PSyLhogenic er x 2) Physielogy of Pain ( £ Pain ain Pathway) — CO “Hransducton— —__ @ Fyapsnais$ion——__— travel Lp ona $e Injury te 4 brain iS i= ‘int A} aS such C) PercePton yy ogni ee Factors inLjwencin® a ee So A3e Gender @ Gwbtiona | Stare - —Q on ON lo) Pain ASSe>S ment essay or | list) PRR SF — pp —_=>=-— 5 ~iminy Precip ig Galt? podiaton>? Severity, ey D unith scale use2S_éCorinan Faces —__ _and_is ei ued for Children oe “eldeng, 0 RIV, — wong-Baker Faces 7] YVAS i sexe + a @Dinat is the Scale assessé>_ = A based | en 3 bmernti0r08 hehe “EFFEC: _ ce ee ee a ee Ee ond -b 7 eee eee! =a Owen of the Pollowing that ASESS Bolin 1A 5 thing mood ere [oa -. — SEE en shi p—______ *yBPT By MP —e nes DN RS _ _ Adale & vho_ Can Communicate. —>. WNRS VA - Children (SZ “ah non verbal wong Sqe Vi —Chronié Pain fakents —» BP | pat) Pain assessment. tools : © Visual Analog scale VAS) (fumervical Rating § cole (WRS) NCI faces Pain scale. Ain Questi ionnas re (MPO) rie F Paw | inventory ¢ p oT. rs ig a Staight Jo ates a A) aM evi Cal RATING FONE = Cee ef |@ what is Ehe Cons of | NiSual Analog scale % —_ re _____B) | 26 useful ia Hon and __ thi “Tailor, eer stan kd C) Time Consuming Q wich ecole iS the + Pahents? JD WHO Pain manag D tf Pati Heat aces tn Pain Seale a 4 veSul fois} u Ly yn laa hich W | —_ Spon td “se 2 xy steP 4 By step 2 -onter3 Pa tieut Contra led Eaalges ia — _ Oe eee ee en ™ Discuss assessments needed i in needed in immediate and laier postoperative as at ae wi Identify the postoperative compli y <7 Types of surgery «Leo jst a> = Diagnostic (e.g| breast lump biopsy’ ja Palliative (to reduce pain and/or other symptoms e.g., debulking to relieve bowel compression in a patient with ive (e.g., Cleft lip and palate repair and breast {loos f constructions are examples of reconstructive surgery .Q1Y3 uo ja / it (an organ/s, tissue or group of cells are removed ve ere from one person (the donor) and transplanted into another - Person (the recipient), or moved from one site to another in the same person ; Obsessed <—A po Oo x ld OLS cal Ge 5l nr Coos Sul é : NaEaO = Rae _ aero a Seg so Wq st =~ yperatiye is a term used to the entire span of surgery, what occurs before, during, after the actual operation. Ce my) coll. ous? RR pee ee Types of surgery ™ Surgical procedures ai : — : Ssyhas tO J> is affected by the client’s age, general health, ally elective surgery and has live complications. E.g., re commonly grouped according to: SASH / e200 ANON / Cavs yall yas js ky nutritional od Isp ; oho 4. Chsiimecisevisis!"able" = Se ps i311 Types of surgery Abst o> [gle a IMMediate M>FLyalyy ” DLs” AV Ce yt are commonly grouped according to: NCy: \ Gb sintlas ys aes CS J99 sad ; “| en life-savin; intervention, normally it ! decision to operate. Eg. intestinal obstructio oe 4- Urgent, ob be Sully esdauull /', eli lust}! Gyio> j Intervention for acute onset or clinical. deter tioration of life, limb or organ. survival; for fixation of multiple fractures, i d for relief of pain or other distréssing symptoms. Normally it occurs he ony Ib. appendectomy, eno a of hours of decision to wagpovslog ) be Aes IU lective: Cp Las! “Shall Jeary all Ecidlaltyt : al procedure planned or booked in advance of Toutine admission to ithin a planned time that suits patient, hospital and staff. late, or urgent; example, Ula Ue ce/ —a76N7 YI when the patient is transferred to the operating table admitted to the{ POST Anesthesia care unit(PACU) Cie yell Su pou Lois tay 1H LSS BUS Vy> uv cas luation at home, or is discharged to a rehabilitation lete) Informed Consent Prior to any surgical procedure, informed consent is required from the patient o1 legal guardian. yy the physician; such its, and alternatives. A signed form, Swittessed by a nurse is evidence that consent has been obtained, And each nurse must be familiar with hospital policies and laws regarding surgical consent forms. e receiving any preoperative CAs = Uy o0ts) bs he nurse is responsible for ensuring] that signed consent form is in the atient’s chart before the © lent goes to the operating room (OR). == i cle ee eas ees Out intravenous (IV) fluids and other lines and DY). eesti uml Me Ghali Los ie Sy js5 Lee Exeremey — 7 jie romote circulation and reduce the of forming a thrombus in the veins. C2411. =e * Antiembolism stockin / ™ Leg exercises help pi tisk gs help prevent thrombi by Compressing superficial ye ‘ins and capillaries redirecting | Z blood to larger and deeper veins, where it flows more : ao toward the heart, / : AeSing =e ae Bee SY) cep 1) ay 9s pe) ils wl i =. N = Intraoperative Phase Surgical team Preparation of supplies and equipment on the f sterile field, Sate : Provision of appropriate sterile instrumentation, vist the surgeon by controlling bleeding, dling and cutting tissue sutures during the ‘ocedure. : > -\\Responsible for accounting for all sponges, dles, and instruments at the close of surgery th circulating nurse to prevent foreign bodies being left inside the client. Deep Breathing and Coughing exercise ~~) - Deep breathing is a form of seus ventilation that opens and fills small Deep ™ Coughing exercise is a nz the airways. IRR Intraoperative Phase Surgical team ™ Responsible for creating a safe environment | ™ Managing the activities outside the sterile field. — ™ Ensuring surgical specimens are identified and place ip’ the right media. Accompanies patient to the Tecovery room. yaw Anesthesia ™Is the use of loss, the C S of 0 SI ‘SS ™Factors that influence the Sthesia used include: Age. asd] ™ Health status. UGH type of ™ Medication and surgical history . wall ast ™ Surgical to be performed Calott sho Ul S =~ pool Types of Anesthesia * ely ou as > Administered by IV or inhalation E '™ It affects the Praia wvellagthe entire body. Sl WI / Cr pls SJ at / — 3 ® Loss of all sensation and consciousness ® Loss of protective reflexes > Block awareness centers in brain Nursing management in the postanesthetic care unit ning a patent airway: = The nurse applies oxygen, and assesses respiratory rate and depth, oxygen saturation, They semiconscious patient} should be p. side, with thd face slightly down. |A pillow isCnod placed, iV which allows the free entry of air in and out of the lungs. Nursing management in the postoperative nie A ‘ Ce bsslass tie 22p4su sSlals we postoperative phase: Copalsu & Souulsnits y - Cpr aa iy oy) a | Nursing manasement in the nnct Types of Anesthesia } | Regional anesthesia — is yally su) ® local anesthetic injection(Spinal anesthesia) ™ Surface or topical. Cus | | ™ Local nerve infiltration, A er j > oO = A ° I \ AEE MSDS, WOUNG Cranage devices). Post Operative Complication Respiratory complications: -It’s the obstruction of one or more pulmonary arterioles by an embolus — originating some where in the venous — or in the right side of heart. yeumonia: <> se yy ell quently occurs in the post surgical patient as the result of failure to and the lungs sufficiently , fluid accumulates in the lungs and an santas process is begun. — — IS 9c My) Shr Y Atciectasis: - Lung collapsed due to obstruction of a bronchial tube by a plug of eae Jolsallcyo © > ewer nell > Lees Si By Gate? me ——~Lt fAR/ si... & _ € response of the body to a decrease in the circulating volume of blood, tissue perfusion impaired, cellular hypoxia and death. —= — s (DVT). Occur ir{pelvic vein|or in lower extremities, and it’s common after hip surgery. = Post Operative Complication — ee ee = Abdominal distention: SS i / ™ Is common after abdominal surgery . / ® Handling of the abdominal contents cause a loss of normal peristalsis for 24 to in partial or complete impairment to the forward flow of intestinal — LPoCHvat/auys olsIAl ros -/ Urinary Retention. Cs \ i J Urinary tract Infection Cc ry as Post Operative Complication Infection — aimee? = Ev Ae fation SG {_ Wound 21 (seps ~)~ Dehiscenc oh ™ Wound dehiscence: . 2zlclay 5 evade oll — > Is an opening of the wound edges. \ \))__™ Is characterized by the protrusion of loop of bowel Through the incision. slsolil Jj en Ce cals (20 marks) Part I: Multiple-Choice Questions 1. What does COPD stand for? a) Chronic Obstructive Pulmonary Disease b) Chronic Oxygen Pulmonary Disorder #4 Continuous Obstructive Pulmonary Disease d) Continuous Obstructive Pulmonary Disorder. 2. Which of the following conditions is included in COPD? a) Chronic bronchitis b) Emphysema oth a and b d) Asthma 3. The primary characteristic of COPD is ........++++ a) Fully reversible airflow limitation ‘rogressive and irreversible airflow limitation. ¢) Temporary airway inflammation d) Sudden onset of symptoms 4. Which of the following is a common cause of COPD? a Cigarette smoking b) Regular exercise c) High-fiber diet d) Drinking water 5. The main function of cilia in the bronchial tubes is to: a) Produce mucus b Move mucus out of the airways c) Absorb oxygen d) Trap dust particles ee = a etry? 6, What does FEV-1 measure in spirom: ‘a) The total lung capacity The amount of air exhaled inf second 2 The amount of oxygen in the bloo eo 4) The elasticity of the lungs z x tion of atveoti walls? erized by the destruc 7. Which condition is characte ‘a) Chronic bronchitis ‘Emphysema ‘c) Asthma d) Pneumonia 8, Which stage of COPD is characterized by FEV-1 < 30%? a) Stage 1 b) Stage 2 c) Stage 3 A Stage 4 9. Which of the following ‘Alpha-1 antitrypsin deficiency ‘p) High cholesterol c) Diabetes d) Hypertension is a genetic factor that can lead to COPD? 10. Which machine is used to help COPD patients breathe during sleep? CPAP b) MRI c) ECG d) Ultrasound 11. What is the primary purpose of a pullectomy? To remove a bulla and improve airflow b) To replace a damaged lung c) To reduce inflammation in the airways d) To increase mucus production 12. What is the term for pneumonia that develops in a patient who has for more than 48 hours? a) Community-acquired pneumonia (CAP) Ye Hospital-acquired pneumonia (HAP) onia jated pneumonia of the following is : in (CAP)? * €8™Mon causative agent of community pseudomonas aeruginosa reptococcus pneumoniae « cherichia coli @) Klebsiella species 14. What is the a) Diarrhea b) Rapidly rising fever « c) Hypertensic 4) Bradycardia Primary clinical manifestation of pneumonia? 15. Which of the follo f pneumonia? 2) Pleural offre” wing is a complication of p) b) Hypertension ©) Hyperglycemia 4) Osteoporosis Auton 16. What is the primary diagnostic tool for identifying structural dist pneumonia? a) Blood test b) Chest X-ray c) Sputum culture + 4) Tuberoulin skin test : 17. Which of the following is a common symptom of tuberculosis? a) An initial dry cough b) Hypertension c) Dyspnea d) Weight gain 18. What is the primary treatment for tuberculosis? a) Short-term antibiotic therapy b) Long-term antimicrobial therapy * c) Antiviral medications 4) Antifungal medications 19. Which of the following is a common complication of tuberculos a) Lymphadenopathy « b) Pneumothorax c) Hyperglycemia d) Osteoporosis — F ~ onin MANAZEN,,, 20. The primary purpose of chest physiotherapy In pneume Wy a) Reduce fever Loosen and mobilize secretions ©) Increase blood pressure d) Treat bacteremia. tor as a 23 | Tuberculosis can only infect the lungs. 24 | Pneumonia is always treated with antiviral medications. 25 l Tuberculosis is a viral infection. FA 6 [Smoking cessation can increase the progression of COPD. 2 '7 | Patients with COPD often experience shortness of breath. — term exposure to air pollution can contribute to COPD. 7 F (cars can be completely cured with proper medication. 32 | Pneumonia can be classified as lobar or bronchopneumonia based on location. LZ TT] Oxygen therapy is never used in COPD treatment. : Pneumonia is characterized by the consolidation of lung tissue. 33 | Pneumonia is more common in children than in adults. iS IRIN] eB | COPD is more common in men than women. el The resolution stage of Pneumonia involves complete healing of lung tissue. Good hack Aesist. Prof. Zeina Gamal MISR UNIVERSITY NCR a TECHNOLOGY exe of Nursing Day & Dateof Exam: Saturdsy- 9/4/2025. Time: 930 ae 11S am Exam Type: Quiz? * Model No= c Total Questar 35 ———— Total Seore: 3 Part I: Multiple-Choice Questions (20 marks) 1, What does CPAP stand for? a) Cutaneous Pulmonary Airway Pressure b) Chronic Pulmonary Airway Pressure ¢) Continuous Positive Airway Pressure d) Complete Positive Airway Pressure 2. What is the most common lung function test used to diagnose COPD? a) Chest X-ray b) Spirometry ¢) Blood test 4) CT scan 3. What is the primary characteristic of COPD? a) Fully reversible airflow limitation b) Temporary airway inflammation ¢) Sudden onset of symptoms d) Progressive and irreversible airflow limitation 4. Which of the following is a symptom of COPD? a) Increased appetite b) Shortness of breath ¢) Weight gain d) High energy levels 5. The primary purpose of bronchodilators used in COPD management is to: a) Reduce inflammation b) Relax the muscles around the airways ¢) Increase mucus production d) Cure the disease Page Lofa —— 6. What does forced vital capacity (FVC) measure in spirometry? a) The largest amount of air patient can breathe out 'b) The amount of air exhaled in 1 second ¢) The amount of oxygen in the blood d) The elasticity of the lungs 7. Which condition is characterized by the destruction of alveolar walls? a) Chronic bronchitis b) Asthma c) Emphysema ) Pneumonia 8 Which stage of COPD is characterized by FEV-1 30-49%? a) Stage 1 b) Stage 2 ©) Stage 3 4) Stage 4 9. Which of the following is a long-acting bronchodilator? a) Atrovent b) Serevent ©) Advair 4) Esteourt 10. Which machine is used to help COPD patients breathe during sleep? a) MRI b) ECG c) Ultrasound d) BIPAP 11. The primary purpose of a bullectomy is to: a) Remove a bulla and improve airflow b) Replace a damaged lung ¢) Reduce inflammation in the airways d) Increase mucus production 12, Pneumonia that develops in hospitalized patients for less than 48 hours is defined as? a) Community-acquired pneumonia (CAP) b) Hospital-acquired pneumonia (HAP) ¢) Aspiration pneumonia d) Ventilator-associated pneumonia Pag a) Streptococcus pneumoniae b) Escherichia coli ¢) Klebsiella species 4) Pseudomonas aeruginosa 13. The common e: agent of community-acquired pneumonla (CAP) is: | 14, The primary clinical manifestation of pneumonia include which of the following? a) Diarrhea b) Rapidly rising fever c) Hypertension 4) Bradycardia 15. Which of the following is a complication of pneumonia? | a) Pleural effusion 'b) Osteoporosis ¢) Hypertension 4) Hyperglycemia 16. The primary diagnostic evaluation for identifying structural distribution in pneumonia? a) Chest X-ray b) MRI ©) CT scan 4) Bronchoscopy 17. Which of the following is a common symptom of tuberculosis? a) An initial dry cough ) Hypertension ¢) Dyspnea 4) Weight gain 18. What is the primary treatment for tuberculosis? ) Long-term antimicrobial therapy b) Antiviral medications «) Short-term antibiotic therapy ) Antifungal medications 19. The primary purpose of chest physiotherapy in pneumonia management a) Reduce fever ) Loosen and mobilize secretions ¢) Increase blood pressure d) Treat bacteremia \: 0. Which of the following is a common complication of tuberculosis? a) Pneumothorax ) lymphadenopathy c) Hyperglycemia 4) Osteoporosis Part Il: True and False: (15 Marks) Circle (A) if answer is correct and Circle (B) if the answer is False COPD is more common in women than men. A lung transplant is never an option for COPD patients. 23 | Pulmonary rehabilitation is an important part of COPD management. 24 | Chronic bronchitis and emphysema are included in COPD. alba can be completely cured with proper medication. 26 | Smoking cessation can slow down the progression of COPD. 27 | Patients with COPD often experience short breathing. [8 ‘Oxygen therapy is never used in COPD treatment. 29 | Tuberculosis is a viral infection. 30 | Pneumonia can be classified based on location as lobar or bronchopneumonia. 31 | Long-term exposure to air pollution can contribute to COPD. a r 32 | Pneumonia is characterized by the consolidation of lung tissue. 33 | Pneumonia is more common in children than in adults. 34 | Tuberculosis can only infect the lungs. | 35 ‘| The resolution stage of pneumonia involves complete healing of lung tissue. Good fuck Aesiat Pref. Letnes Genel Pages ea te aot Lage chaing point awe r ener, MISR UNIVERSITY Conoge of Nuvsings ‘Spring 202470075 Sem pring eee ea Day & Date af Bxami Saturday. 26/4025 Timer 9:30 am-=11:30 am 1 “Total Questions: SS TrotatSeorer 8S Student name: hii, Student 1D: ST (20 marks) Part I: Multiple-Choice Questions 1. What is the primary characteristic of diabetes mellitus? a) Low blood glucose Po Bligh blood glucose ‘) Excessive insulin production d) Low glucagon levels 2. Which cells in the pancreas produce insulin? a) Alpha cells b) Beta cells c) Delta cells d) Fcells 3. Type 1 diabetes is caused by: a) Insulin resistance b) Autoimmune destruction of beta cells ©) Obesity 4) Viral infection only 4. The most common type of diabetes worldwide is: a) Type 1 b) Type 2 c) Gestational 4) Latent, 5. Gestational diabetes typically occurs during: a) Childhood b) Pregnancy c) Old age d) Adolescence 6. A fasting blood glucose level that indicates diabetes is: a) > 100 mg/dL b)> 126 mg/dL c)> 140 mg/dL. d) > 200 mg/dL | 7 MbAte renects avernge Mos | d) Pancreatic polypeptide vod glucose levels? oft lassic symptoms polyphagia are classic SY >) Diabetes mellitus ¢) Hypertension 16 itt eesti NOT seed 8) Reinopay iephropath a eer ay mi [Serpe meen i sdifiable risk factor for coronary 11. Which of the following is considered a modifial 2) Age |b) Family history ©) Gender 4) Smoking 12, First-line medication for acute angina is: 8) Metformin b) Nitroglycerin ©) Atorvastatin @) Heparin 13, Atherosclerosis primarily involves buildup of: a) Calcium only b) Fats, cholesterol, and other substances ¢) Red blood cells a) Platelets 14. Which layer of the arterial wall is first damaged in atherosclerosis? a) Adventitia b) Media 6) Intima 4) Elastic lamina 15. Foam cells in pla #) Endothelial cells b) Macrophages that i ©) Neutrophils ) Platelets 16. Complete occlusion of a coronary artery for >20-45 minutes leads to: a) Reversible ischemia ) Myocardial infarction ©) Angina pectoris 4) Vasospasm Page 2. ith diabetes? \que formation are derived from: gested oxidized LDL 18, What is the term for pain caused by myocardial ischemia? a) Suprapubic b) Angina ©) Epigastrie ) Palpitation 19, The two main coronary arteries are: a) Pulmonary and aortic b) Right coronary and left coronary ) Circumflex and anterior descending 4) Carotid and subclavian 20. Increased urination refers to: a) Polyuria b) Polydipsia ¢) Polyphagia 4) Peripheral Part I: True and False: (10 Marks) Circle (A) if answer is correct and Circle (B) if the answer is False 1 21_| Type 2 diabetes is always insulin dependent 22_| Prediabetes is diagnosed when fasting glucose is 100-125 mg/dL. 23_| Insulin pumps are only used for type 2 diabetes 724 | Gestational diabetes increases the risk of developing type 2 diabetes later. 25_| Metformin is a first-line treatment for type 1 diabetes. 26 _| Exercise improves insulin sensitivity. 27 | Atherosclerosis is the buildup of fats, cholesterol, and other substances in and on the artery walls. 28 | ECG is a diagnostic tool that records the electrical activity of the heart. 29__| Angina always radiates to the right leg. '30_[ Smoking is a nonmodifiable risk factor. Part 3: Matching (5 marks) Select from column A the appropriate sentence of column B A 31_| High-Density Lipoprotein 32 | Electrocardiogram (ECG) 33 | Coronary Artery Bypass Grafting Surgery (CABG) B @) Bad cholesterol ) Chest pain ©) Good cholesterol 34 | Low-Density Lipoprotein @) Open-heart surgery 35 | Angina e) Records heart rhythm Good ack Hassist. Prof Zeinab Gamal MISR UNIVERSITY Fo sCENcr, @ TECHNOLOGY College of Nersing arse fealSersea Nester TT Course CodeasdNez_NURDOE ‘ ‘Semester: Spring TOTS, Dav & DateofEsam: Saterday. 2642025 “Timez 9:30 am0-1130 am Exam Trp ‘Qi: Model Noz 5B “Toral Question= 35 “Toral Score: 3s Student name: Student ID: @0 marks) Part I: Multiple-Choice Questions 1. Which cells in the pancreas produce insulin? a) Alpha cells b) F cells ©) Delta cells. 4) Beta cells 2. Type 1 diabetes is caused by: ‘a) Autoimmune destruction of beta cells b) Insulin resistance ©) Obesity 4) Viral infection only 3. Gestational diabetes typically occurs during: 2) Childhood ) Pregnancy ©) Old age 4) Adolescence 4, What is the primary characteristic of diabetes mellitus? a) Low blood glucose b) High blood glucose (Hyperglycemia) ©) Excessive insulin production 4) Low glucagon levels 5. The most common type of diabetes worldwide is: a) Type! b) Type 2 ©) Gestational 3 d) Latent. 6. HbAle reflects average bload glucose levels over: a) | week b) J month ¢) 3 months 4) 6 months Page 10f3. 7. A fasting blood glucose level that indicates diabetes is: a)> 100 mg/dL. b)> 126 mg/dL c)> 140 mg/dL. d)> 200 mg/dL, 8, Which hormone a) Glucagon b) Insulin c) Somatostatin d) Pancreatic polypeptide 9. Polyuria, polydipsia, and polyphagin are elnssie symptoms of: 1) Hypothyroidism b) Anemia ¢) Hypertension 4) Diabetes mellitus 10, Which of the following is considered a modifiable risk factor for CAD? a) Age b) Smoking ¢) Gender 4) Family history 11, Which complication is NOT associated with diabetes? a) Retinopathy b) Osteoporosis c) Nephropathy 4) Peripheral neuropathy 12. First-line medication for acute angina is: a) Metformin b) Heparin c) Atorvastatin 4) Nitroglycerin 13, Foam cells in plaque formation are derived from: a) Endothelial cells b) Macrophages that ingested oxidized LDL c) Neutrophils 4) Platelets 14, Which layer of the arterial wall is first damaged in atherosclerosis? a) Adventitia b) Media ©) Elastic lamina 4) Intima 15, Atherosclerosis primarily involves buildup of: a) Calcium only b) Platelets ©) Red blood cells 4) Fats, cholesterol, and other substances 16. Complete occlusion of a coronary artery for >20-45 minutes lends to: a) Myocardial infarction b) Reversible ischemia ) Angina pectoris 4) Vasospasm es blood glucose levels? Page 2013, | 48. What is the term for pain caused by myocardial ischemia? | 3) Suprapubic ®) Angina ©) Epigastic 4) Palpitation 19. The two main coronary arteries are: a) Pulmonary and aortic b) Circumflex and anterior descending ) Right coronary and left coronary ) Carotid and subclavian 20. Which type of angina is relieved by rest and nitrates? a) Unstable b) Prinzmetal ©) Stable d) Silent °) Part ‘rue and False: Circle (A) if answer is correct and Circle (B) if the answer is False (10 Marks) 21 | Type | diabetes is always insulin-dependent. l 22_| Prediabetes is diagnosed when fasting glucose is more than 126 mg/4L. 23 _| Insulin pumps are only used for type 2 diabetes. 724_| Smoking is a nonmodifiable risk factor. 25 | Atherosclerosis is the buildup of fats, cholesterol, and other substances in and on the artery _ | walls, 26_| ECG is a diagnostic tool that records the electrical activity of the heart. 27_| Metformin is a first-line treatment for type 1 diabetes. 28 _| Exercise improves insulin sensitivity. ‘ [29 | Angina always radiates to the right leg. 30 | Gestational diabetes increases the risk of developing type 2 diabetes later. Part 3: Matching Sclect from column A the appropriate sentence of column B (5 marks) A | B 31_|Polyua ‘@)_Lowers blood sugar 32_| Polydipsia b) Autoimmune origin 33_| Insulin ©) Lifestyle-related 34_| Type 1 DM a) Excessive thirst 35__[Type2DM ) Frequent urination Goodluck Rastat. Prof, Lainab Gamal Page 3 of 3

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