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Boards Review Final > Board review 1 > Flashcards

Board review 1 Flashcards

1
Q

Bloody diarrhea, bowel incontinence, fever, sensation of incomplete emptying, continuous inflammation of mucosa

A

UC

Dx made by colonoscopy

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2
Q

Insulin shock sx

A

Nausea, slurred speech, sweating, tremors

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3
Q

When pt experiences myopathy after use of a statin

A

Discontinue the statin until sx subside and then restart at the same or lower dose

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4
Q

Where can USPTF guidelines be found

A

The guide to clinical preventative services and the national guideline clearing house website

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5
Q

6 month language milestones

A

Babbling, responding to name, using sounds to express joy and frustration

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6
Q

3 month language milestones

A

Smiling, turning head towards noise, imitation of sounds

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7
Q

12 month language milestones

A

Respond to no, say dad and mama, respond to simple requests, try to imitate spoken words

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8
Q

18 month language milestones

A

Several words, 2-4 word sentences, follow simple commands, point to pictures when prompted

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9
Q

Preferred agent to tx htn in pregnancy

A

labetalol, long acting nifedipine or methyldopa

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10
Q

early diastolic murmur heard best at 3rd or 4th left intercostal space near sternal border

A

Aortic regurgitation

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11
Q

Risk factors for placental abruption

A

hypertension, prior C section, smoking

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12
Q

Apley grind test

A

For meniscal injury
with the patient lying prone with the knee in 90 degree flexion, place pressure on the heel with one hand while rotating the lower leg externally and internally; if pain or a click is felt it is positive

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13
Q

Mcmurray test

A

for meniscal injury; place one hand along the joint line and the other hand on the lateral side of the knee to stabilize the joint and provide valgus stress while the other hand rotates the leg externally while extending the knee (medial meniscus test); stabilize medial knee in fully flexed position while internally rotating the leg as the leg is extended (lateral meniscus test)

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14
Q

Lachman test

A

used to assess for ACL and PCL tear; patient knee placed in 20-30 degree flexion; place anterior force on the proximal tibia

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15
Q

PSA screening

A

Between 55 and 69 should have opportunity discuss risks vs benefits

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16
Q

Sx ischemic heart disease

A

Angina, arm pain, dyspnea with stress or exertion

If reproducible with exertion, relieved by rest or nitroglycerine and not getting worse: stable

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17
Q

Meds for sx managament of IHD

A

Nitroglycerine, beta blockers, CCB, ranolazine

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18
Q

Rivaroxaban

A

Inhibits Xa blood coag factor
Initial tx of DVT
3-6 months

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19
Q

Renal papillary necrosis

A

coagulative necrosis of the renal medullary pyramids and papillae; form of nephropathy due to impairment of blood supply; diffuse necrosis; associated with analgesic abuse, pyelonephritis, sickle cell hemoglobinopathies, tuberculosis, alcoholic cirrhosis, renal transplant ejection, radiation, diabetes
Labs: urine RBC + elevated BUN and Cr

Think DM and chronic NSAID use

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20
Q

Glomerulonephritis labs

A

Urine RBC and red cell casts

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21
Q

Cystitis labs

A

Urine nitrites, leukocyte esterase and bacteria

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22
Q

Pyelonephritis labs

A

High counts of urine WBC and bacteria

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23
Q

Statins MOA

A

Inhibit HMG CoA reductase, which converts HMG CoA to mevalonic acid

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24
Q

Orlistat

A

Inhibits pancreatic lipase

Tx of obesity

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25
Q

Cholestyramine MOA

A

Binds to bile acids

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26
Q

Ezetimibe MOA

A

Reduces cholesterol absorption in the small intestine

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27
Q

Leukemia with lowest survival rate in adults

A

AML

Followed by ALL

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28
Q

In children, which leukemia has highest remission rate

A

ALL

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29
Q

Hypercalcemia with suppressed PTH should raise concern for

A

Malignancy

Order CT

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30
Q

Why is chronic constipation common in elderly

A

as we age, the rectum enlarges, which decreases the strength of rectal contractions

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31
Q

Loss of corneal reflex suggests a problem with

A

CN5

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32
Q

CN 10

A

Swallow and gag reflex

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33
Q

Gemfibrozil MOA

A

Increase expression of lipoprotein lipases; results in decrease of LDL and VLDL
May increase gallstone production and billiary disease

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34
Q

1st line tx for fibromyalgia

A

Aerobic exericse

If not responsive: TCAs, SNRI, pregabalin

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35
Q

Prednisone dosing in pediatrics

A

1-2mg/kg/day for 3-6 days

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36
Q

Achalasia

A

Loss of ganglion cells in myenteric plexus; causes a loss of neurons containing NO resulting in incomplete relaxation of lower esophageal sphincter

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37
Q

Cause of carbuncles and hidradenitis suppurative

A

Staph

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38
Q

Cause of cellulitis and erysipelas

A

Strep

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39
Q

Latex allergy has cross reactivity with

A

Kiwi, banana, peach, avocado, chestnut, fig, bell pepper, tomato, white potato

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40
Q

Most common method of suicide

A

Gunshot

Second: suffocation/hanging

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41
Q

Black cohosh

A

tx hot flashes

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42
Q

Echinacea

A

Boosts immunity

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43
Q

Saw Palmetto

A

BPH

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44
Q

Gingko Biloba

A

Memory

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45
Q

SSRIs can induce

A

Mania

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46
Q

Role of NPs developed in

A

1960s

First program in Colorado

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47
Q

Hmong culture

A

Disrespectful to make eye contact; not expected for woman to shake hands

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48
Q

Patient on vegan diet should take what vitamin

A

B12

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49
Q

What med is safe for pregnant bipolar patients

A

Clonazepam

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50
Q

What abx can cause hemolysis in patients with G6PD deficiency

A

Bactrim and Macrobid

Tx UTI with cephalosporin instead

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51
Q

Consider G6PD deficiency if

A

Jaundice, dark urine, back pain or abdominal pain in response to infection, ingestion of fava beans or taking certain meds

52
Q

MOA of tetracyclines

A

Bind to 30S and 50S subunits

53
Q

MOA of sulfonamides

A

Inhibits folic acid synthesis of bacteria

54
Q

MOA of penicillins

A

Bactericidal and inhibits bacterial cell wall synthesis

55
Q

MOA of fluoroquinolones

A

Inhibits DNA synthesis by inhibiting DNA gyrase and topoisomerase enzymes

56
Q

Small urinary stones tx

A

oral hydration, pain control, alpha blockers for anti spasm, CCB to help pass stones
AVOID steroids

57
Q

Stones >5mm

A

Need urologic consult and surgical removal

58
Q

What anti-diabetic drugs are weight neutral

A

DPP4 inhibitors– gliptins

Acarbose

59
Q

Which anti-diabetic drugs cause weight gain

A

Sulfonylureas

TZDs

60
Q

Which anti-diabetic drug cause weight loss

A

GLP-1 agonist

Metformin

61
Q

Opioids available in short acting formulation

A

Oxycodone, tramadol, hydromorphone, morphine

62
Q

MOA macrolides

A

Bacteriostatic by binding to 50S subunit

Inhibitors of P450 system

63
Q

Chronic use of PPI can cause

A

Osteoporosis due to decreased calcium absorption

64
Q

Tx enuresis

A

1st: positive reinforcement
2nd: Desmopressin
3rd: imipramine

65
Q

Neonatal alloimmune thrombocytopenia

A

Due to maternal antibodies from platelet incompatibility

Can lead to severe bleeding

66
Q

Clotrimazole

A

Used orally to treat thrush of intravaginally for candida

67
Q

1st line agent to treat vaginal candidiasis

A

Fluconazole

68
Q

Blood smear shows fragile lymphocytes that appear to have been flattened

A

CLL

Most common cause of generalized lymphadenopathy in older adult

69
Q

Leukemia that presents with pancytopenia and fever

A

AML

70
Q

Leukemia that presents with splenomegaly, anemia, elevated WBC, no lymphadenopathy

A

CML

71
Q

Cancer that presents with anemia, bone pain, hypercalcemia, renal insufficiency

A

Multiple myeloma

72
Q

Dabigatra and apixaban are CI in

A

kidney impairment with Cr clearance <15

73
Q

Dalteparin

A

Low molecular weight heparin

Preferred tx for VTE in pregnancy

74
Q

Tx Shigella

A

Bactrim

75
Q

Tx C Diff

A

Metronidazole

76
Q

Tx Giardia

A

Metronidazole

77
Q

Which abx may increase INR when taking Warfarin

A

Cipro + Bactrim

-Use Macrobid for UTI nstead

78
Q

SE prednisone

A

Hyperglycemia, osteoporosis, psychosis if >20mg/day, A Fib

79
Q

Mainstay tx COPD exacerbations

A

Prednisone

40mg/day for 5 days

80
Q

Bupropion MOA

A

Dopamine and NE inhibitor

CI in bulimia and anorexia

81
Q

Potency of topical steroids

A 
MOST
Clobetasol
Betamethasone
Fluocinolone
Hydrocortisone 
LEAST
82
Q

Common SE metoclopramide

A

Drowsiness, anxiety, insomnia, EPS

83
Q

Tx sinusitis with penicillin allergy

A

Doxycycline

84
Q

Onset of benzos

A

Most rapid: diazepam
Second: Lorazepam
Third: Clonazepam

85
Q

Enoxaparin

A

Low molecular weight heparin

Used to treat PE in outpatient setting

86
Q

3 tx regimens for H. Pylori

A

 Quadruple therapy with PPI, bismuth, tetracycline and metronidazole for 10 days
 Triple therapy with clarithromycin, PPI and amoxicillin or metronidazole for 14 days
 Triple therapy with levofloxacin, PPI and amoxicillin for 14 days

87
Q

Nicotinic acid MOA

A

Reduces synthesis of VLDL in the liver, which leads to decreased LDL production

88
Q

1st line agent for tobacco cessation

A

Verenicline

89
Q

Metolazone

A

Thiazide diuretic used in conjunction with a diuretic to reduce edema and volume overload in HF patients

90
Q

8 stages of kotters change process

A 
	Create sense of urgency
	Build a guiding coalition
	Form strategic vision and initiatives
	Enlist a volunteer army
	Enable action by removing barriers
	Generate short term wins
	Sustain acceleration
	Institute change
91
Q

Beneficence

A

Obligation to prevent harm, promote good and help the patient; advocate for the patient and act with compassion

92
Q

Non-maleficence

A

Avoidance of harm or act of protecting a patient from harm

93
Q

Type 1 hypersensitivity reaction

A

IgE mediated; hives, flushing, angioedema, swelling, airway issues, wheezing, anaphylaxis

94
Q

Type 2 hypersensitivity reaction

A

IgG mediated

Several days after exposure; thrombocytopenia, neutropenia, hemolytic anemia,

95
Q

Type 3 hypersensitivity reaction

A

Serum sickness, vasculitis, localized reactions

96
Q

Type 4 hypersensitivity reactions

A

T cell activation, mild to life threatening cutaneous patterns

97
Q

Suspect what with fluctuating muscle weakness and normal reflexes

A

Myasthenia gravis
Acetylcholine receptor antibodies present
Order electromyography

98
Q

Reflexes in MS

A

Abnormal

99
Q

GLP1 agonists CI in

A

Hx medullary thyroid carcinoma

100
Q

Ham Bang culture

A

Based on balance between yin and yang and balance of fire, earth, metal, water, wood

101
Q

Mesothelioma

A

Cancer affecting membrane that lines lungs and abdomen

Asbestos exposure in 70-80% cases

102
Q

Vietnamese culture

A

Relies on younger family members for decision making

Eye contact disrespectful

103
Q

SE valproic acid

A

Thrombocytopenia, spontaneous gingival hemorrhage or acute stomatitis
Black box warning for hepatotoxicity and pancreatitis

104
Q

Carbamazepine black box warnings

A

Severe derm reactions, aplastic anemia and agranulocytosis

105
Q

Phenytoin SE

A

Gingival hypertrophy, coarse facial features, increased hair growth
Black box warning for CV risks with rapid IV infusion

106
Q

SE SSRI

A

Weight gain, sexual dysfunction, diarrhea, insomnia, dry mouth, headache, blurred vision

107
Q

Most common obstructive cause of amenorrhea

A

Imperforate hymen
Absence of menses despite cyclic pattern of symptoms; combined with vaginal distention
Order translabial/transperitoneal US

108
Q

L2-L3 disk herniation

A

Weakness of hip flexion

109
Q

L3-L4 disk herniation

A

Weakness of knee extension and diminished patellar reflex

110
Q

L4-L5 disk herniation

A

Weakness of dorsiflexion and difficulty in heel walking

111
Q

L5-S1 disk herniation

A

Achilles reflex diminished, plantar flexion weakness

112
Q

Welcome to Medicare assessment for functional ability

A

Hearing impairment, activities of daily living, fall risk, home safety

113
Q

Swiss cheese model

A

systems approach, not a person approach, to understanding errors; posits that humans are fallible and errors are to be expected, even in the best organizations

114
Q

Argatroban, Dabigatran, Bivalirudin

A

Inhibitors of throbin

115
Q

Type 1 DM is characterized by

A

T lymphocytic infiltration and destruction of B islet cells of the pancreas

116
Q

Type 2 DM characterized by

A

Amyloid deposition within B cells of pancreas

117
Q

Which med recommended to reduce the incidence of developing HFpEF and improve symptoms of hypertension and edema in patients with CKD

A

Chlorthalidone

118
Q

Signs of B12 deficiency

A

Glossitis, positive Babinski, positive Romberg

119
Q

Which hypertensive med can increase risk of ED

A

Hydrochlorothiazide

120
Q

Which med can cause priapism

A

Trazodone

121
Q

Which 2 diabetic meds together carry an absolute hypoglycemia risk

A

GLP-1 agonist and sulfonylurea

122
Q

Tx pinworms (enterobius vermicularis)

A

Mebendazole

123
Q

Anogenital itching, discomfort, dyspareunia, painful defecation, dysuria, genital bleeding

A

Lichen Sclerosus

Tx: Clobetasol

124
Q

Flagyl MOA

A

Damages bacterial DNA through production of toxic free radical metabolites

125
Q

Meds that stimulate GI motility

A

Dopamine receptor agoists (metoclopramide), guanylate cyclase-C agonists, macrolide antibiotics

126
Q

Myerson’s signs

A

Patient unable to resist blinking with tapping on the area between the nose and eyebrows
Found in PD

Boards Review Final (4 decks)

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