2 Flashcards
hematuria can be seen with
kidney stones
bladder cancer
acute pyelonephritis
first-line medication for tinea unguium?
oral terbinafine
Emphysema presents with
shortness of breath minimal cough decreased heart and lung sounds pursed-lip breathing use of accessory muscles
Chronic bronchitis is characterized by
productive cough
wheezing
coarse crackles
A patient with a cluster headache should be initially treated with
100% oxygen @12L + intranasal 4% lidocaine
Puncture wounds of the foot may become infected with _____________ by the foam material from sneakers.
P. aeruginosa
gram negative
increased ICP (Cushing’s triad)
increased SBP
increased pulse
decreased respirations
What is used to treat the initial symptoms of mild allergic conjunctivitis?
OTC antihistamine/mast cell stabilizer
topical steroid strengths range from _ (least potent) to _ (very potent)
7; 1
First imaging to assess for any neural tube defects
US
Where do you hear vesicular breath sounds?
in the lower lobes
Where do you hear bronchial breath sounds?
at the second and third intercostal spaces
Where do you hear tracheal breath sounds?
over the trachea
Kawasaki’s usually occurs in children under what age?
5 years
range of estradiol associated with perimenopause is
30 to 400 pg/mL
FSH >30 mIU/mL is indicative of
decreased ovarian function
AMH level of <0.5 ng/mL is associated with
perimenopause
Dicyclomine (Bentyl)
anticholinergic and antispasmodic
decreases fecal urgency and pain associated with diarrhea
Lubiprostone (Amitiza)
chloride channel activator
treatment of IBS with constipation in adults
Alosetron (Lotronex) is administered for
IBS associated with diarrhea
Patients with PMR are treated with______________.
oral corticosteroids
One of the hallmarks of the disorder is the dramatic improvement of symptoms after starting treatment with oral prednisone.
classic sign of allergic rhinitis is a
transverse nasal crease (allergic salute)
Also may see clear nasal discharge and under-eye circles from vasodilation and/or lack of sleep from sneezing and itchiness
balanoposthitis
penile gland and foreskin are inflamed. A reddened, moist macular lesion is present on the prepuce
candida infections, are commonly associated with the use of antibiotics and are the most common identifiable infectious etiology associated with balanoposthitis
Primary tx for de Quervain’s
Ice + NSAIDs
rash appears either as a single expanding red patch or as a central spot surrounded by clear skin that is in turn ringed by an expanded red rash
bull’s-eye lesion of Lyme dz
test used to assess for inflammation and the presence of bacteria in the lower urinary tract, findings that are associated with symptoms of chronic prostatitis
Meares–Stamey 2-glass
Periumbilical to RLQ pain occurs more frequently in ______, while LLQ is more classically associated with ____________.
Crohn’s; ulcerative colitis (UC)
Avoid triptans in patient with hx of
MI
penopubic epispadias
urethral meatus is found near the pubic bone
bladder sphincter is shaped more like a horseshoe than a ring, it does not close all the way. Because of this, urine leaks out.
In boys with epispadias, the penis tends to be
broad, short, and curved up
penile epispadias, the urinary meatus is found along the______. In penopubic epispadias, it is found _________.
shaft; on or near the pubic bone.
suppurative otitis media
TM bulges & ruptures spontaneously through a small perforation in the pars tensa
discharge usually present
Dx usually made with direct visualization of TM via otoscope
TM = red and swollen, and may be retracted or bulging
Decreased mobility of TM as measured by tympanogram
postherpetic neuralgia
s/p Shingles
Shingles lasts about 3-5 weeks, but neuralgia can last months
sensation of burning, throbbing, sharp pain, and aching at the site of the outbreak
Tx w/ gabapentin
patient should first be examined for acute renal failure with _______ and then ____ or ___________.
24-hour creatinine level; MRI, intravenous pyelogram (IVP)
Hepatitis A virus typically is transmitted by the
fecal–oral route
commonly by consuming food contaminated by infected food handlers
Hepatitis B can be transmitted by
IV drug use, unprotected sex, or blood transfusion
Hepatitis C can be transmitted by
unprotected sex or contaminated needles.
________ can reactivate during treatment for hepatitis C and cause serious liver problems.
Hepatitis B
first-line antibiotic treatment for an infant with pertussis are
macrolides
MS patient with intermittent or new vision loss should see a __________. because the patient may have __________.
neurologist; optic neuritis
contact lens keratitis
Often d/t sleeping with contact lenses
eye pain, redness, excessive tearing, and a lesion on the cornea
Topical antibiotics are the first line of treatment
Antiretroviral regimens for HIV often have black box warnings for severe hepatomegaly and HBV exacerbation. What do we do?
monito liver enzymes and cholesterol
tell patients to follow low-fat diet
patient with HIV for follow-up of initial antiretroviral treatment regimen that is working
f/u PVL should be completed in 4 to 8 weeks
f/u CD4 in 3 months.
Multiple bacteria in a urine sample is indicative of
a contaminated sample
highest sensitivity/specificity for kidney stones
noncontrast CT
syphilis
condylomata lata = wartlike papules are found in the inguinal area
rash on palms and soles of feet
Step 1: RPR or VDRL
Step 2: if those are positive, confirm with FTA-ABS, MHA-TP
tests ordered for suspected infection with HIV
HIV-1/ HIV-2 antibody and P24 antigen tests (combination assay)
Miliary TB
found in children under age 5 and the elderly
seen on x-ray with milia seed patterns
Reactivated TB noted on XR by
lesions, nodules, and cavitation
Latent TB
when bacteria is in the lymph nodes and is not infectious.
XR shows calcification and fibrosis.
Pleural TB
in the pleural space and is very contagious
it is indicated by a mass with obtuse angles on x-ray
ventricular gallop
S3 heart sound
S3 heart sound is heard
during early diastole
At what age should healthy full-term infants be screened for anemia?
9 to 12 months
infants have enough iron stores to last 4 to 6 months after birth
It is important to monitor _______________ when administering theophylline (Theo-Dur).
serum concentration
Scoliosis spinal curvature of >40 degrees requires
surgical intervention with a Harrington rod
Scoliosis spinal curvature between 5 and 20 degrees should
be monitored for changes
Scoliosis spinal curvature between between 20 and 40 degrees need
Bracing
Healthy women (age 18–65 years) dx with UTI may be treated with a ___-day treatment plan
3
Hydrochlorothiazide can cause __________ suppression, leading to __________
bone marrow
neutropenia
Uncomplicated acute diverticulitis can be treated on an outpatient basis if the provider educates the patient on the treatment plan:
take Augmentin as ordered and report fever to HCP immediately so that the patient can be evaluated for abscesses, peritonitis, or sepsis
Once the acute diverticulitis episode resolves, the patient should
maintain a high-fiber diet with supplemental psyllium fiber
avoid laxatives long term
stool softener can be added to the regime, if necessary
groups of papules and vesicles (not bullae) on a red base that rupture and become crusted; along dermatome
typical shingles rash
Pityriasis versicolor, formerly known as tinea versicolor,
Dx by clinical appearance and a sample of the skin scrapings placed on a KOH wet mount, which reveal short hyphae and budding cells
oral fluconazole (Diflucan) is the primary prescribed treatment for widespread infection
Why do infants have an increased risk of CNS toxicity and sensitivity to pharmacologic agents that act on the brain?
infant’s blood–brain barrier is not fully developed for several months
AV nicking and copper wire/ silver wire arterioles are signs of
hypertensive retinopathy
ventricular hypertrophy affects the heart
stroke damages the brain.
noncommunicating hydrocele
occurs when the sac closes normally around the testicle during development, but the body does not absorb the fluid inside it.
common in newborns and usually disappears without treatment by 1 year of age.
Surgery is recommended for a _________hydrocele (when the sac ___________)
communicating
does not seal
Zollinger–Ellison syndrome is a
neuroendocrine tumor that leads to gastrin hypersecretion and multiple peptic ulcer formation
ADA A1C goal for most pregnant pts
< 6%
ADA A1C goal for most adults with T2DM
< 7%
ADA A1C goal for older patients
< 8%
