adult hemoglobin levels
males = 14-18g/dL females = 12-16 g/dL
adult serum glucose levels
<100 mg/dL
adult hematocrit levels
males 37%-49%
females 36-46%
adult cholesterol levels
120-200mg/dL
vary with age and gender
children and adolescent desirable LDL-D values
<110 mg/dL
adult desirable LDL-C cholesterol levels
<130 mg/dL
desirable HDL-C levels
men= 35-65 mg/dL women = 35-80 mg/dL
triglyceride levels for ages 20-65
<150 mg/dL
serum albumin levels
3.5-5.5 g/dL
obesity
due to caloric excess refers to weight more than 20% above ideal body weight or BMI of 30-39.9. causes are complex and multifaceted; genetic, social, cultural, pathologic, physiological, and physiologic factors are implicated. regardless of cause, the underlying problem is usually imbalance of caloric intake and caloric expenditure. visceral protein levels are normal, anthropometric measures are above normal
what are the anthropometric measures for obesity?
weight >120% standard for height
BMI >30
TSF >10% standard
waist to hip ratio >1.0 men and >.8 women
BMI 40+ is morbid obesity or extreme obesity
anthropometric measures for marasmus
weight less than 80% standard for height
TSF <90% standard
mid-upper arm muscle circumference less than 90% standard
marasmus
protein-calorie malnutrition. due to inadequate intake of protien and calories or prolonged starvation. anorexia, bowel obstruction, cancer cachexia, and chronic illness are among the clinical manifestations leading to marasmus. characterized by decreased anthropometric measures. visceral protein levels may remain within normal ranges
laboratory findings for obesity
serum cholesterol 200 mg/dL
serum triglycerides >250 mg/dL
kwashiorkor
protein malnutrition. due to diets high in calories but contain little or no protein. decreased visceral protein levels but adequate anthropometric measures. They may therefor have a well-nourished or even obese appearance
marasums/kwashiorkor mix
due to prolonged inadequate intake of protein and calories such as severe starvation and severe catabolic states. muscle, fat, and visceral protein wasting. individuals have usually undergone acute catabolic stress such as major surgery, trauma, or burns in comination with prolonged starvation or have AIDS wasting. associated with the hightest risk for morbidity and mortality
anthropometric measures of kwashiorkor
weight >100% standard for height
TSF 100+ standard
laboratory findings with kwashiorkor
serum albumin <3.5 g/dL
anthropometric measures for marasums/kwashiorkor mix
weight 70+% standard
TSF less than 80% standard
MAMC less than 60% standard
laboratory findings for marasmus/kwashiorkor mix
serum albumin <2.8 g/dL
pigmented keratotic scaling lesions resulting from a deficiency of niacin. these lesions are especially prominent in areas exposed to the sun such as hands, forearms, neck, and legs
pellagra
dry, bumpy skin associated with vitamin A or linoleic acid deficiency. linoleic acid deficiency may also result in eczematous skin, especially in infants
follicular hyperkeratosis
deficiency of vitamin c. gums are swollen, ulcerated, and bleeding due to vitamin C-induced defects in oral epithelial basement membrane and periodontal collagen fiber synthesis
scorbutic gums
sign of riboflavin deficiency
magenta tongue
sign of vitamin D and calcium deficiency in children and adults
rickets
foamy plaques of the cornea that are a sign of vitamin A deficiency. Severe depletion may result in conjunctival xerosis and progress to corneal ulceration and, finally, destruction of the eye
bitot’s spots
annular
circular. begins in center and spreads to periphery (tinea corporis or ringworm)
confluent
lesions run together (uticaria/hives)
discrete
distinct, individual lesions that remain seperate
gyrate
twisted, coiled spiral, snakelike
linear
scratch, streak, line, or stripe
zosteriform
linear arrangement along a unilateral nerve route (herpes zoster)
grouped
clusters of lesions (contact dermititis)
target
iris, resembles the iris of eye, concentric rings of color in the lesions
polyciclic
annular lesions grow together (psoriasis)
macule
solely a color change, flat and cicumscribed, of less than 1cm. Freckles, hypopigmentation, petechiae, measles, scarlet fever
patch
macules that are larger than 1cm. mongolian spot, vitiligo, cafe au lait spot
nodule
solid, elevated, hard or soft, larger than 1cm. may extend deeper into the dermis than papule.
tumor
larger than a few cm in diameter, firm or soft, deeper into dermis; may be benign or malignant
papule
something you can feel caused by superficial thickening in the dermis (mole, wart)
plaque
papules coalesce to form surface elevation wider than 1cm. plateu like, disk shaped lesions
wheal
superficial, raised, tansient, erythematous; slightly irregular shape due to edema (mosquito bite, allergic reaction)
uticaria
hives. wheals coalesce to form extensive reaction, intensely pruritic
vesicle
elevated cavity containing free fluid, up to 1cm; a blister. clear serum flows if wall is ruptured (herpes simplex, early varicella, herpes zoster, contact dermatitis
bulla
larger than 1cm diameter; usually single chambered; superficial in epidermis; it is thin walled, so it ruptures easily (friction blister, burns, contact dermititis)
cyst
encapsulated fluid-filled cavity in the dermis or sub q layer, tensely elevating skin
pustule
turbid fluid (pus) in the cavity. circumscribed and elevated (impetigo and acne)
crust
thickened, dried-out exudate left when vesicles/pustules burst or dry up. color can be red-brown, honey, or yellow depending on the fluids ingredients (scab after abrasion)
scale
compact, desiccated flakes of skin, dry or greasy, silvery or white, from shedding of dead excess keratin cells
fissure
linear crack with abrupt edges extends into dermis, dry or moist
erosion
scooped out but shallow depression, superficial; epidermis lost; moist but no bleeding; heals without scar because erosion does not extend into the dermis
ulcer
deeper depression extending into the dermis, irregular shape. may bleed; leaves scar when heals (stasis ulcer, pressure sore)
excoriation
self-inflicted abrasion; superficial; sometimes crusted; scratches from intense itching
scar
after a skin lesion is repaired normal tissue is lost and replaced with connective tissue (collagen) this is permanent fibrotic change
lichenification
prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss
atrophic scar
the resulting skin level is depressed with loss of tissue; a thinning of the epidermis (striae)
keloid
a hypertrophic scar. the resulting skin level is elevated by excess scar tissue, which is invasive beyond the side or original injury. may increase long after healing occurs. looks smooth, rubbery, and clawlike and has a higher incidence among blacks
stage I pressure ulcer
intact skin appears red but unbroken. localized redness, skin will not blanch. dark skin appears darker but does not blanch
stage II pressure ulcer
partial-thickness skin erosion with loss of epidermis or the dermis. superficial ulcer looks shallow like an abrasion or open blister with a red-pink wound bed
stage III pressure ulcer
full-thickness pressure ulcer extending into the sub q tissue and resembling a crater. may see sub q fat but not muscle, bone or tendon
stage IV pressure ulcer
full-thickness pressure ulcer involves all skin layers and extends into the supporting tissue, exposed muscle, tendon or bone, and may slough or eschar
what is the order of colors of a bruise?
red-blue or purple blue-purple blue-green yellow brown to disappearing
hyperthyroidism
goiter. exophtalmos. symptoms include nervousness, fatigue, weight loss, muscle cramps, and heat intolerance; signs include tachycardia, shortness of breath, excessive sweating, fine muscle tremor, thin silky hair and skin, infrequent blinking, and a staring appearance
myxedema
hypothyroidism. a deficiency of thyroid hormone, when sever, causes a nonpitting edema or myxedema. puffy, edematous face, especially around the eyes, coarse facial features, dr skin and dry, coarse hair and eyebrows
Bell’s palsy
lower motor neuron lesion producing cranial nerve VII paralysis, which is almost always unilateral. has a rapid onset and its cause is currently thought to be the herpes simplex virus. complete paralysis of one side of the face. usually presents with smooth forehead, wide palpebral fissure, nasolabial fold, drooling, and pain behind the ear
stroke
upper motor neuron lesion. an acute neurological deficit caused by an obstruction of a cerebral vessel. paralysis of lower facial muscles and upper half of face is not affected. person is still able to wrinkle the forehead and close the eyes