Adult Flashcards
What do cotton wool spots on eye exam indicate?
hypertension
What is the most & second most frequently used topical antibiotic for acne?
Clindamycin & Erythromycin
What is the most common skin cancer?
basal cell carcinoma
yellow plaques as a result of fat build up under the skin, usually near the inner canthus of the eye; hyperlipidemia is the underlying cause
Xanthelasma
What condition? Wickham’s striae with purplish flat bumps, painful sores in & around the mouth or on the genitals, itching
lichen planus
What antibiotics for anthrax?
penicillin, cipro, or doxycycline
4 labs diagnostic of DM
fasting sugar >=126 ; random sugar >= 200 w/ signs of hyperglycemia ; sugar >= 200 2 hours after glucose load ; HgbA1C >= 6.5
Hyper- or Hypothyroidism? Grave’s disease
Hyperthyroidism
Hyper- or Hypothyroidism? Hashimoto’s thyroiditis
Hypothyroidism
What condition? “Fast” ; “Overdrive” ; “keep your foot on the gas pedal, go to your grave”
hyperthyroidism (Grave’s disease)
Hyper- or Hypothyroidism? Thyroid crisis
hyperthyroidism
Hyper- or Hypothyroidism? Myxedema coma
hypothyroidism
What medication is important to avoid in a thyroid crisis?
ASA - can exacerbate problem
What is the cure for hyperparathyroidism?
parathyroidectomy
Hyper- or Hypoparathyroidism? Increased calcium, Decreased phosphorus
hyperparathyroidism
Hyper- or Hypoparathyroidism? Decreased calcium, Increased phosphorus
hypoparathyroidism
What is the management for hypoparathyroidism?
calcium carbonate ; Vitamin D ; daily PTH hormone in severe cases
Cushing’s or Addison’s? too much steroids
Cushing’s
Cushing’s or Addison’s? not enough steroids
Addison’s
Cushing’s or Addison’s? hyperglycemia, hypernatremia, hypokalemia
Cushing’s
Cushing’s or Addison’s? hypoglycemia, hyponatremia, hyperkalemia
Addison’s
Duodenal or Gastric ulcer? relief of pain with eating
duodenal
Duodenal or Gastric ulcer? pain worsens with eating
gastric
3 steps of management of PUD
H2 receptor antagonist at bedtime –> H2 BID –> PPI
What is the therapy for H. Pylori eradication?
2 antibiotics plus either a PPI or bismuth
What does IgM and IgG mean in hepatitis?
IgM = “immediate” or active disease ; IgG = “gone” or recovered/chronic disease
Acute vs. Chronic Hep C, serology will be the same, so what test differentiates between the 2?
PCR testing. PCR + for acute and - for chronic
Diverticulitis - where will the abdominal pain be?
LLQ
deep pain on inspiration while fingers are placed under the right rib cage
Murphy’s sign
What does positive Murphy’s sign mean?
cholecystitis
Gold standard test for cholecystitis
ultrasound
What condition? high pitched, tinkling bowel sounds
bowel obstruction
Ulcerative colitis: what is the hallmark symptom, what test is diagnostic, and what is the management?
bloody diarrhea ; sigmoidoscopy ; Mesalamine (Canasa) suppositories or enemas for 3-12 weeks & hydrocortisone suppositories and enemas
Thin, “ribbon” stools sign of what?
late sign of colon cancer
RLQ pain when pressure is applied to the LLQ
Rovsing’s sign
What medication is the mainstay of treatment for chronic bronchitis and emphysema?
inhaled ipratropium bromide (Atrovent) or sympathomimetics
Pregnant women with pertussis should get what and when to prevent transmission?
Tdap in 3rd trimester
What condition? frothy yellowish-green discharge, “strawberry patches” on cervix and vagina
trichomonas
Which condition? normal saline mixture shows clue cells
bacterial vaginosis
Which condition? KOH mixture shows pseudo hyphae
candidiasis
What is a primary cause of dysmenorrhea?
high levels of prostaglandin
What is the treatment for dysmenorrhea?
prostaglandin synthetase inhibitors (PGSIs) - ibuprofen, naproxen, indomethacin
Abnormal uterine bleeding is usually the result of what?
endocrine dysfunction
Name the PALM-COEIN mnemonic for evaluation of abnormal uterine bleeding.
Polyps, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial causes, Iatrogenic causes, Not yet classified
What is the hormonal therapy for patients with menopause with and without a uterus?
No uterus = estrogen therapy ; With uterus = estrogen + progestogen (to protect against endometrial cancer)
___ score is number of standard deviations around the mean bone density for race and gender
T score
____ score compares the patient with the population adjusted for gender, age, and race
Z score
DEXA scan results for normal, osteopenia (low bone mass), and osteoporosis
T score - normal (> -1.0), osteopenia (-1.0 to -2.5), osteoporosis (below - 2.5)
What media is used for a cervical culture of N. gonorrhoeae?
Thayer-Martin
What condition uses a papnicolaou or Tzanck stain?
herpes
What medication can be used for herpes prophylaxis/suppression therapy, such as to help decrease transmission to partner?
valacyclovir
Is lymphogranuloma venereum associated with painful or painless vesicles/ulcers?
painless
What condition? shiny flesh-colored to pearly-white papules
molluscum contagiosum
What is the treatment for molluscum contagiosum?
“wait & see” or cyroanesthesia with liquid nitrogen
What stage of syphilis? painless chancre, indurated ulcer
primary
What stage of syphilis? flu-like symptoms, skin rash on palmar/plantar surfaces
secondary
What stage of syphilis? seropositive, but asymptomatic
latent
What stage of syphilis? multi-system involvement
tertiary
What serological tests for syphilis?
VDRL/RPR or treponemal tests
What conditions are reportable to the health department?
HIV, TB, GCS (Gonorrhea, Chlamydia, Syphilis)
What is the treatment for syphilis?
benzathine penicillin G
Low MCV, High MCV, or Normocytic? iron deficiency anemia & thalassemia
low MCV (microcytic)
Low MCV, High MCV, or Normocytic? B12 or folate deficiency, alcoholism, liver failure, and drug effects
high MCV (macrocytic)
Low MCV, High MCV, or Normocytic? anemia of chronic disease, sickle cell disease, renal failure, blood loss, and hemolysis
normocytic
What lab value is normocytic?
mean corpuscular volume (MCV) 80-100
What lab value is normochromic?
mean corpuscular hemoglobin concentration (MCHC) 32%-36%
What lab tests can distinguish between iron deficiency anemia and thalassemia?
TIBC and ferritin - IDA will have low ferritin and high TIBC (TIBC is high b/c ferritin is low) ; thalassemia is normal TIBC and ferritin
What is the treatment for thalassemia?
none for mild/moderate ; for severe forms RBC transfusion/splenectomy
What is the management for polycythemia?
phlebotomy, aspirin, referral
What condition? excessive levels of iron, joint pain, pain in knuckles of pointer & middle fingers
hemochromatosis
What condition? pancytopenia with circulating blasts
acute lymphocytic leukemia (ALL)
What is the most common leukemia in adults?
chronic lymphocytic leukemia (CLL)
What condition is lymphocytosis the hallmark sign of?
chronic lymphocytic leukemia (CLL)
What condition? philadelphia chromosome seen in leukemic cells
chronic myelogenous leukemia (CML)
What is required to confirm the diagnosis of leukemia?
bone marrow aspiration
How is Hodgkin’s disease differentiated from non-Hodgkin’s disease?
presence of Reed-Sternberg cells
What condition? Reed-Sternberg cells
Hodgkin’s disease
What is used to confirm diagnosis of lymphoma?
biopsy & histopathologic examination
Knee “locking” is usually indicative of what?
meniscal tear or loose bodies
What condition? positive McMurray’s test
medial meniscal injuries
positive McMurrary (M&M) equals what?
medial meniscal (M&M) injury
an audible click when the knee is raised slowly with one foot externally rotated (knee is flexed and then quickly straightened)
McMurray’s test (positive = medial meniscal injury)
What condition? positive Lachman’s test
ACL or PCL tear
What does “LL” mean for the Lachman test?
“Lachman Ligament” - meaning Lachman tests for ACL or PCL tears
What condition? Apley’s grind test
medial or lateral collateral ligament damage and/or meniscus injury
Sprain: ligaments or tendons?
ligaments
Strain: ligaments or tendons?
tendons
What condition? positive Tinel’s sign and Phalen’s test
carpal tunnel
chronic memory impairment due to severe vitamin B deficiency (due to alcohol abuse)
Korsakoff syndrome
What valvular disease? radiates to base or left axilla
mitral regurgitation
What valvular disease? radiates to the neck
aortic stenosis
“Ms. Ard and Mr. Ass”
Mitral Stenosis/Aortic Regurgitation = Diastolic murmur … Mitral Regurgitation/Aortic Stenosis = Systolic murmur
