2 Flashcards
Low Abdominal pain male pct. with severe pain in lower abd area bilaterally. On digital rectal exam there is increase tenderness. (2 differential dx)
prostatitis and appendicitis
Lower abdominal pain in McBurney’s point
appendicitis pathognomonic
Uninsured 53 yr old male Pt with 4 months with diarrhea, his 2 younger brothers have had Hx of Colon Cancer. His charity Medicaid is pending. What does the NP do
refer for colonoscopy
27 yr old male with diarrhea 1st test
Occult blood test, CBC, Ova and Parasites
At age 20?
Lipid screening
Management of hyperlipidemia [obese child with family history of cardio vascular dx
(1st 3 assessments = BMI, lipid profile, immunizations)
Gout and HTN-Medication of choice
Losartan. NEVER Thiazides
68 yrs old male Pt who smoked for 20 yrs and stopped 5 yrs ago with clinical signs and symptoms of COPD (management):
spirometry
Tx of pharyngitis due to streptococcus
PENICILLIN V
Uncomplicated UTI Dx and management
Bactrim 3 days
Pneumonia
Tactile fremitus INCREASED
Hematology (G6PD), Sickle cell
(Primary prevention is counseling)
Woman with postmenopausal vaginal bleeding (what to do)
Endometrial Bx
Woman with cervical lesion (Colposcopy, cryotheraphy, excision of tissue, determination of HPV)
HPV, COLPOSCOPY, Leep
Mother go with a 13 y/o girl to the NP; mother ask why she has to administer the HPV vaccine (Use of HPV vaccine)
Prevents cervical cancer and Genital warts. Strains 6,11,16,18
Which primary intervention decreases risk for herpes zoster by 66%:
varicella vaccine in childhood
Metronidazole (Side effect, effect with alcohol)
Vomiting.
Asthma ( stages according to spirometry) Clinical presentation and FEV1 DE 80-60%
PERSISTENT MODERATE
Asthma exacerbation (tx)
ADD INHALED CORTICOSTEROID
Infant (2y/o) with Bronchiolitis symptoms with family Hx of asthma (differential dx:
Bronchiolitis, asthma, foreign object)
3 y/o with murmur grade IV, heard in the pulmonary area, radiated all over the precordium: Dx
Septal Atrial Communication
- woman with systolic Murmur in the apex that radiated to axilla
MR
Causes of anemia in a kid of 1-2 y/o:
Excess of whole milk
Complications of Kawasaki (causes):
vasculitis
(25 y/o man with generalized rash in the palms and soles of the hands and generalized lymphoadenopaties)
Secondary Syphilis
Acne - Inflammatory lesions
Topical antibiotics
Moderate papular or when topical tx has been inadequate
Oral antibiotics (takes 6-8 weeks to note improvement)
Closed comedones
Benzoyl peroxide often in combination with topical antibiotics
Significant inflammation
Tretinoin gel (Is photosensitizing, takes 6 weeks to note improvement)
Cystic acne that does not respond to other therapies
Isotretinoin (Accutane) Course of 4-6 months, then 2 months off.
COC
Decreased androgen and sebum production (takes 3 months to see improvement)
Kid with gynecomastia what to tell the parents
It is transitory
14 y/o Gynecomastia and sexual retardation, small testes long neck, long arms, tall
Klinefelter’s
Asymmetric development of . the breast in a girl (what to tell the parents
NORMAL
Woman smoker, multiple partner, did not use seat belt what is the first advice of primary prevention you should give to this lady
QUIT SMOKING
