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3 p exam > 3p > Flashcards

3p Flashcards

1
Q

episodic headache occurring several times daily for 4-6 weeks with extended relieve for 6-12 months occurs mostly in men

A

cluster headaches

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2
Q

Produced by ovaries & placenta

responsible for enlargement of uterus, breast & genitals

A

estrogen

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3
Q

maintains endometrium for implantation
inhibits uterine contractility, preventing abortion
promotes secretory ducts of breast for lactation

A

progesterone

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4
Q

influences thyroid gland size, activity & increases HR

increases basal metabolic rate by 23% during pregnancy

A

thyroxine (T4)

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5
Q

used in pregnancy test to determine pregnancy state

stimulates progesterone & estrogen by corpus luteum to maintain pregnancy until pregnancy takes over

A

human chorionic gonadotropin (HCG)

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6
Q

produced by placenta

affects glucose & protein metabolism

A

human placental lactogen (hPL)

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7
Q

produced by anterior pituitary gland

causes pigmentation of skin to darken

A

melanocyte stimulating hormone (MSH)

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8
Q

produced by corpus luteum & placenta

inhibits uterine activity

A

relaxin

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9
Q

prepares breast for lactation

A

prolactin

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10
Q

produced by posterior pituitary gland
stimulates uterine contraction
after birth, helps keep uterus contracted
stimulates milk ejection reflex during breast feeding

A

oxytocin

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11
Q

“Patient states,” Amenorrhea, N/V, increased urinary frequency, excessive fatigue, breast tenderness

A

presumptive signs (subjective)

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12
Q

“Provider sees & feels,” softening, darkening of cervix, uterine softening, enlargement, ballottement, positive pregnancy test

A

probable signs (objective)

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13
Q

“Testing reveals”, fetal heart rate detected, fetal outline & movements

A

positive signs (diagnostic)

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14
Q

prompted by hormonal changes
preparation for lactation
estrogen & progesterone cause proliferation in ducts & glandular tissue
12 oz increase in breast weight over term of pregnancy
during pregnancy, breast skin thins & striae develops
alveoli become progressively distended

A

breast changes during pregnancy

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15
Q

solid organ becomes thin- walled & hollow
wall thickens from 10 mm to 25 mm in first 16 weeks
thins to 5-10 mm by term
Hegar’s sign = uterus bends in anterior direction on lower uterine segment
fundus rises out of the pelvis and enlarges 1 cm weekly
uterine souffle’ = maternal arterial blood arriving into the placenta

A

uterine

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16
Q

increased levels of progesterone & relaxin soften pelvic floor ligaments & muscles
further stretched by the gravid uterus & vaginal delivery
contributes to urinary/ fecal incontinence, hemorrhoids, dyspareunia & uterine prolapse

A

pelvic floor changes

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17
Q

increased production of sweat & sebaceous glands
increasing levels of melanocyte- stimulating hormone causes linea nigra
striae gravidarum (stretch marks)

A

skin changes

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18
Q

flatus, constipation diminished bowel sounds from slow peristalsis
decreased intestinal contractility from displacement, fluid reabsorption changes & increased progesterone levels
dyspepsia in pregnancy aggravated by displacement of abdominal organs, increased progesterone alters esophageal sphincter & gastric tone

A

GI changes

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19
Q

heart displaced upward
supine hypotension
cardiac output increases 30-50%
blood volume peaks 30-34 weeks, increases 30-50%, 1110-1600 mL
75% increase is plasma red blood cell volume increases

A

cardiovascular changes

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20
Q

respiratory congestion from increased edema of pharynx & larynx
5% reduce lung capacity from increased chest wall circumference & decreased chest compliance
30% increase in oxygen consumption compromising respiration in those with chronic asthma, obesity or smoking

A

respiratory changes

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21
Q

maintains electrolyte & acid - base balance, regulates increase in blood & extracellular fluid volume, excretes maternal & fetal waste products & conserves essential nutrients
kidneys are displaced & increase in size
effects of progesterone decrease bladder tone

A

renal changes

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22
Q

effects of progesterone, estrogen and relaxin on ligaments & joints. relaxation of pelvic structures
posture shifting center of balance
gait changes, sciatica, discomfort of the symphysis pubis & stretching/ pain of uterosacral & cardinal ligaments

A

muscloskeletal/ neuro changes

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23
Q

thyroid enlargement
pituitary gland increases by factor of 3
basal metabolic rate increase 20-25%
insulin resistance, obesity greater risk for gestational diabetes
increased prolactin & oxytocin
emotional/ irritability hormone shifts
decreased attention span, decreased concentration & memory lapse
sleep alterations
corneal edema, plugged ears, reduced hearing & vertigo

A

endocrine changes

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24
Q

Naegele’s rule

A

1st day of LMP + 7 days - 3 months + 1 year = estimated due date

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25
Q

Rh- mom receives Rhogam when?

A

@ (7 months) 28 weeks & 72 hours post delivery

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26
Q

food to avoid during pregnancy

A

unpasteurized foods, beverages & raw meats

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27
Q

genetic & fetal screening done in 1st trimester

A

cystic fibrosis, sickle cell, autosomal recessive, down’s syndrome
abnormal finding warrant further diagnostic testing = aminocentesis

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28
Q

cessation of menstruation for at least 12 months

A

menopause

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29
Q

perimenopausal period

A

2-8 years prior to LMP

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30
Q

early postmenopausal period

A

1st 5 years following menopause

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31
Q

late postmenopausal period

A

6+ years after the LMP

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32
Q

anticholinergic antimuscarinic agents oxybutynin (Ditropan), toterodine (Detrol), fesoterdin (Toviaz), darfenacin (Enablex) & solifenacin (Vesicare)

A

used for urge incontinence

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33
Q

tricyclic antidepressants imipramine (Tofranil) and mirabegron (Myrbetriq)

A

used for urge incontinence

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34
Q

alpha - adrenergic agonist (ephedrine & pseudoephedrine (Sudafed) and duloxetine

A

used for stress incontinence

35
Q

trauma, testicular Ca, enlarged veins in the scrotum, inflammation of the testes (orchitis), swelling due to increased fluid (hydrocele), hernia, infection/ inflammation of epididymis (epididymitis) & CHF cause

A

scrotal edema

36
Q

common in newborns usually disappears w/o treatment by age 1

37
Q

torsion of spermatic cord = ED

A

occurs in young males p exercise, Sx required

38
Q

test for torsion of spermatic cord

A

cremasteric reflex ( gentle stroke of inner thigh) triggers elevation of the ipsilateral testicle

39
Q

lab test for syphilis

40
Q

painless sore indicates what STI

41
Q

tx for syphilis

A

PCN G 2.4 million units single dose + prednisone x 3 days

42
Q

STD painful sore caused by H ducreyi

43
Q

tx for chancroid

A

azithromycin 1 g single dose or rocephin 250 mg IM single dose

44
Q

what medications for BPH relax the muscles of the prostate & neck of bladder

A

alpha blockers

45
Q 
Alfuzosin (Uroxatral)
Doxazosin (Cardura)
Prazosin (Minipress)
Silodosin (Rapaflo)
Tamsulosin (Flomax)
Terazosin (Hytrin)
A

Alpha blockers

46
Q

meds that shrink the prostate & prevent additional growth

A

5- alpha reductase inhibitors (5-ARIs)

47
Q

Dutastride (Avodart)

finasteride (Proscar)

A

5-alpha reductase inhibitors (5-ARIs)

48
Q

meds that improve prostate symptoms by increasing flow rate

A

Phosphodiesterase 5 inhibitors (PDE5 inhibitors)

49
Q

Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
Avanafil (Stendra)

A

Phosphodiesterase 5 inhibitors (PDE5 inhibitors)

50
Q

normal pediatric growth percentile range

A

> 5th % & < 95th %

51
Q

newborn

52
Q

infant

A

1-12 months

53
Q

newborn average weight

A 
7.5 lbs
loses 5-8% of body weight
gains back by 10-14 days
doubles by 4-6 months
triples by 12 months
54
Q

newborn reflexes

A

indicate neurological well being, begin to dissipate in 1st few months except for sucking & Babinski

55
Q

rooting, sucking, moro/ startle, grasping, babinski

A

newborn reflexes

56
Q

anterior fontanels closes

A

@ 18 months

57
Q

posterior fontanels closes

A

@ 2-3 months

58
Q

newborn pulse & resp

A 
p = 120-170
r = 30-80
59
Q

6 year pulse/ resp

A 
p = 75-115
r = 16-20
60
Q

17 year old pulse/ resp

A 
p = 60-100
r = 12-20
61
Q

hemoglobin increase

A

may indicate dehydration or intravascular hemolysis

62
Q

decreased Hgb

A

may indicate anemia, sickle cell, thalassemia, hemorrhage or hyperthyroidism

63
Q

Hct increased

A

may indicate polycythemia, dehydration or erythocytosis

64
Q

Hct decreased

A

may indicate anemia, hemorrhage, hyperthyroidism, leukemia, cirrhosis

65
Q

MCV increased > 100

A

macrocytic anemias = folic acid or Vit B12

66
Q

MCV decreased < 80

A

microcytic anemias = Fe deficiency, thalassemia, lead poisoning & anemia of chronic diseases

67
Q

test for cystic fibrosis

A

chloride test

68
Q

first trimester screening for Down’s or trisomy 18

A

nuchal translucency and triple screen (AFP-3 test)

69
Q

nuchal translucency

A

measures the amount of fluid accumulation behind baby’s neck

70
Q

Throbbing pain behind one eye photophobia, phonophobia N/V in adults females. aggravated by red wine, aspartame, menstruation and stress

A

migraine w/o aura

71
Q

Throbbing pain behind one eye photophobia, phonophobia, halos, scotoma, scintillating lights, N/V in adults females. aggravated by tyrosine

A

migraine w/ aura

72
Q

bilateral “band like” pain, continuous dull pain may last a day, may be accompanied by spasms of trapezius muscles happens in adults aggravated by stress

A

muscle tension headache

73
Q

intense & very brief, sharp stabbing pain, one cheek in older adults & elderly aggravated by cold food, cold air, talking touch, chewing

A

trigeminal neuralgia

74
Q

prophylactic tx for headaches

A 
propranolol (inderal)
tricyclic antidepressants (TCA) = Amitrptyline (Elavil)
75
Q

CN I (1)

A

Olfactory = smell

76
Q

CN II (2)

A

Optic = visual field (Snellen)

77
Q

CN III, CN IV, CN VI (3,4,6)

A

Oculomotor = EOM

78
Q

CN V (5)

A

Trigeminal= sensory nerves to face

79
Q

CN VII (7)

80
Q

CN VIII (8)

A

Acoustic = whisper test

81
Q 
CN IX (9)
CN X (10)
A 
Glossopharyngeal = open mouth yawn
Vagus = uvula & gag reflex
82
Q

CN XI (11)

A

Spinal accessory = shoulder shrug

83
Q

CN XII (12)

A

Hypoglossal = stick out tongue move from side to side

3 p exam (2 decks)

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