9 Flashcards
sequence of meds for increasing severity of asthma
1) SABA
2) SABA + ICS
3) SABA + ICS + LABA
4) SABA + ICS + LABA + po CVS
What is the treatment for asthma exacerbation?
Nebulizer + Steroids
What is the role of HIDA scan in gall bladder disease?
Allows you to visualize perfusion and see whether there are blockages
What are 3 colon genetic syndromes?
FAP, Lynch Syndrome, Peutz Jeghers
What are the 3 main cancers associated with Lynch Syndrome (mutation in DNA mismatch?
CEO - Colorectal, Endometrial, Ovarian
What 3 labs are helpful when diagnosing hemolytic anemia?
LDH, haptoglobin, bili
Who should be screened for DM?
> 45 y/o, BMI > 25, HTN
What fasting BG and A1C are pre-diabetes?
BG 100-125 and A1c 5.7-6.4
A patient is diagnosed with DM based on A1C of 9.5 What is appropriate treatment?
If A1C > 9 then start tx with INSULIN
What are SE of Metformin?
Lactic acidosis, Diarrhea
SE of Sulfonylurea?
Hypoglycemia, espeically susceptible if kidney disease since renally cleared
What is the equation for anion gap?
AG = ( Na + K ) - ( Cl + HCO3 )
A kid has bone aches, nose bleeds and bruises. What should you be thinking of?
AML
What are some structural causes of abnormal uterine bleeding?
PALM = Polyps, Adenomyosis, Leiomyomata, Malignancy/Hyperplasia
What is the Rotterdam criteria for PCOS diagnosis?
Polycystic ovaries by US
Hyperandrogenism (hirsutism, acne)
Dysmenorrhea
What does SIGECAPS stand for in depression screening?
Sleep Interest Guilt Energy Concentration Appetite Psychomotor retardation Suicidality
You are contemplating diagnosis of dementia for a patient. What sort of workup should you do to rule out other causes?
Depression screen (can look like and can be a co-morbid condition) complete blood counts basic chemistries calcium thyroid vitamin B12 deficiency testing folate deficiency syphilis testing neuroimaging - brain MRI good place to start
3 most common causes of dementia?
Alzheimers, vascular dementia, dementia with lewy bodies
What is the name of frontotemporal dementia presenting with changes in personality, demeanor, and behavior?
Picks disease
Differentiate delirium from dementia?
Delirium symptoms fluctuate over short periods of time, whereas dementia is a gradual decline
What bedside instrument can help diagnose delirium?
Confusion Assessment Method (CAM)
Which two tests can help assess cognitive function?
MMSE, MoCA
Are the following IADLs or ADLs?
shopping
preparing meal using the telephone managing transportation needs managing medications managing finances
IADLs - skills required for independent living
What is arcus senilis?
Grayish ring around eye. Common finding in elderly, and also seen in younger patients with hypercholesterolemia
What makes up the mini-cog?
composite of the three-item recall and clock drawing
Describe the Mini-Cog.
Ask the patient to remember 3 words. Have patient draw a clock with the clock face representing 10 past 11. Then ask the patient to recall the 3 words.
Patient presents with acute worsening from baseline dementia. What is on your differential?
Depression Electrolyte abnormalities UTI Urinary retention URI Pain Withdrawal Acute Cerebral Vascular Event Adverse drug effects
What are some examples of electrolye abnormalities that can lead to delirium?
hypo or hypernatremia, hypercalcemia, hypokalemia, and metabolic acidosis
What post void residual is normal?
< 100 ml
A demented nursing home patient is having urinary incontinence. What is your ddx?
UTI or urinary retention secondary to medications or BPH with secondary overflow incontence
What is a good empirical antibiotic treatment of UTI?
Ceftriaxone and cephalexin
You place a patient with delirium on haloperidol to decrease hallucinations and agitation. What are some side effects to watch out for?
Sedation, constipation, tardive dyskinesia (involuntary spasms of the neck, tongue and lips - high doses for long periods), QT prolongation
What medications have a role in treatment of Alzheimers and symptoms?
cholinesterase inhibitors (donepezil, rivastigmine, tacrine and galantamine)
Vitamin E
Memantine
Atypical Antipsychotics for ebhavioral disturbances - olanzapine (Zyprexa) and risperidone (Risperdal)
