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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
Cholestyramine MOA
Binds to bile acids
26
Ezetimibe MOA
Reduces cholesterol absorption in the small intestine
27
Leukemia with lowest survival rate in adults
AML | Followed by ALL
28
In children, which leukemia has highest remission rate
ALL
29
Hypercalcemia with suppressed PTH should raise concern for
Malignancy | Order CT
30
Why is chronic constipation common in elderly
as we age, the rectum enlarges, which decreases the strength of rectal contractions
31
Loss of corneal reflex suggests a problem with
CN5
32
CN 10
Swallow and gag reflex
33
Gemfibrozil MOA
Increase expression of lipoprotein lipases; results in decrease of LDL and VLDL May increase gallstone production and billiary disease
34
1st line tx for fibromyalgia
Aerobic exericse | If not responsive: TCAs, SNRI, pregabalin
35
Prednisone dosing in pediatrics
1-2mg/kg/day for 3-6 days
36
Achalasia
Loss of ganglion cells in myenteric plexus; causes a loss of neurons containing NO resulting in incomplete relaxation of lower esophageal sphincter
37
Cause of carbuncles and hidradenitis suppurative
Staph
38
Cause of cellulitis and erysipelas
Strep
39
Latex allergy has cross reactivity with
Kiwi, banana, peach, avocado, chestnut, fig, bell pepper, tomato, white potato
40
Most common method of suicide
Gunshot | Second: suffocation/hanging
41
Black cohosh
tx hot flashes
42
Echinacea
Boosts immunity
43
Saw Palmetto
BPH
44
Gingko Biloba
Memory
45
SSRIs can induce
Mania
46
Role of NPs developed in
1960s | First program in Colorado
47
Hmong culture
Disrespectful to make eye contact; not expected for woman to shake hands
48
Patient on vegan diet should take what vitamin
B12
49
What med is safe for pregnant bipolar patients
Clonazepam
50
What abx can cause hemolysis in patients with G6PD deficiency
Bactrim and Macrobid | Tx UTI with cephalosporin instead
51
Consider G6PD deficiency if
Jaundice, dark urine, back pain or abdominal pain in response to infection, ingestion of fava beans or taking certain meds
52
MOA of tetracyclines
Bind to 30S and 50S subunits
53
MOA of sulfonamides
Inhibits folic acid synthesis of bacteria
54
MOA of penicillins
Bactericidal and inhibits bacterial cell wall synthesis
55
MOA of fluoroquinolones
Inhibits DNA synthesis by inhibiting DNA gyrase and topoisomerase enzymes
56
Small urinary stones tx
oral hydration, pain control, alpha blockers for anti spasm, CCB to help pass stones AVOID steroids
57
Stones >5mm
Need urologic consult and surgical removal
58
What anti-diabetic drugs are weight neutral
DPP4 inhibitors-- gliptins | Acarbose
59
Which anti-diabetic drugs cause weight gain
Sulfonylureas | TZDs
60
Which anti-diabetic drug cause weight loss
GLP-1 agonist | Metformin
61
Opioids available in short acting formulation
Oxycodone, tramadol, hydromorphone, morphine
62
MOA macrolides
Bacteriostatic by binding to 50S subunit | Inhibitors of P450 system
63
Chronic use of PPI can cause
Osteoporosis due to decreased calcium absorption
64
Tx enuresis
1st: positive reinforcement 2nd: Desmopressin 3rd: imipramine
65
Neonatal alloimmune thrombocytopenia
Due to maternal antibodies from platelet incompatibility | Can lead to severe bleeding
66
Clotrimazole
Used orally to treat thrush of intravaginally for candida
67
1st line agent to treat vaginal candidiasis
Fluconazole
68
Blood smear shows fragile lymphocytes that appear to have been flattened
CLL | Most common cause of generalized lymphadenopathy in older adult
69
Leukemia that presents with pancytopenia and fever
AML
70
Leukemia that presents with splenomegaly, anemia, elevated WBC, no lymphadenopathy
CML
71
Cancer that presents with anemia, bone pain, hypercalcemia, renal insufficiency
Multiple myeloma
72
Dabigatra and apixaban are CI in
kidney impairment with Cr clearance <15
73
Dalteparin
Low molecular weight heparin | Preferred tx for VTE in pregnancy
74
Tx Shigella
Bactrim
75
Tx C Diff
Metronidazole
76
Tx Giardia
Metronidazole
77
Which abx may increase INR when taking Warfarin
Cipro + Bactrim | -Use Macrobid for UTI nstead
78
SE prednisone
Hyperglycemia, osteoporosis, psychosis if >20mg/day, A Fib
79
Mainstay tx COPD exacerbations
Prednisone | 40mg/day for 5 days
80
Bupropion MOA
Dopamine and NE inhibitor | CI in bulimia and anorexia
81
Potency of topical steroids
``` MOST Clobetasol Betamethasone Fluocinolone Hydrocortisone LEAST ```
82
Common SE metoclopramide
Drowsiness, anxiety, insomnia, EPS
83
Tx sinusitis with penicillin allergy
Doxycycline
84
Onset of benzos
Most rapid: diazepam Second: Lorazepam Third: Clonazepam
85
Enoxaparin
Low molecular weight heparin | Used to treat PE in outpatient setting
86
3 tx regimens for H. Pylori
 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
Nicotinic acid MOA
Reduces synthesis of VLDL in the liver, which leads to decreased LDL production
88
1st line agent for tobacco cessation
Verenicline
89
Metolazone
Thiazide diuretic used in conjunction with a diuretic to reduce edema and volume overload in HF patients
90
8 stages of kotters change process
```  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
Beneficence
Obligation to prevent harm, promote good and help the patient; advocate for the patient and act with compassion
92
Non-maleficence
Avoidance of harm or act of protecting a patient from harm
93
Type 1 hypersensitivity reaction
IgE mediated; hives, flushing, angioedema, swelling, airway issues, wheezing, anaphylaxis
94
Type 2 hypersensitivity reaction
IgG mediated | Several days after exposure; thrombocytopenia, neutropenia, hemolytic anemia,
95
Type 3 hypersensitivity reaction
Serum sickness, vasculitis, localized reactions
96
Type 4 hypersensitivity reactions
T cell activation, mild to life threatening cutaneous patterns
97
Suspect what with fluctuating muscle weakness and normal reflexes
Myasthenia gravis Acetylcholine receptor antibodies present Order electromyography
98
Reflexes in MS
Abnormal
99
GLP1 agonists CI in
Hx medullary thyroid carcinoma
100
Ham Bang culture
Based on balance between yin and yang and balance of fire, earth, metal, water, wood
101
Mesothelioma
Cancer affecting membrane that lines lungs and abdomen | Asbestos exposure in 70-80% cases
102
Vietnamese culture
Relies on younger family members for decision making | Eye contact disrespectful
103
SE valproic acid
Thrombocytopenia, spontaneous gingival hemorrhage or acute stomatitis Black box warning for hepatotoxicity and pancreatitis
104
Carbamazepine black box warnings
Severe derm reactions, aplastic anemia and agranulocytosis
105
Phenytoin SE
Gingival hypertrophy, coarse facial features, increased hair growth Black box warning for CV risks with rapid IV infusion
106
SE SSRI
Weight gain, sexual dysfunction, diarrhea, insomnia, dry mouth, headache, blurred vision
107
Most common obstructive cause of amenorrhea
Imperforate hymen Absence of menses despite cyclic pattern of symptoms; combined with vaginal distention Order translabial/transperitoneal US
108
L2-L3 disk herniation
Weakness of hip flexion
109
L3-L4 disk herniation
Weakness of knee extension and diminished patellar reflex
110
L4-L5 disk herniation
Weakness of dorsiflexion and difficulty in heel walking
111
L5-S1 disk herniation
Achilles reflex diminished, plantar flexion weakness
112
Welcome to Medicare assessment for functional ability
Hearing impairment, activities of daily living, fall risk, home safety
113
Swiss cheese model
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
Argatroban, Dabigatran, Bivalirudin
Inhibitors of throbin
115
Type 1 DM is characterized by
T lymphocytic infiltration and destruction of B islet cells of the pancreas
116
Type 2 DM characterized by
Amyloid deposition within B cells of pancreas
117
Which med recommended to reduce the incidence of developing HFpEF and improve symptoms of hypertension and edema in patients with CKD
Chlorthalidone
118
Signs of B12 deficiency
Glossitis, positive Babinski, positive Romberg
119
Which hypertensive med can increase risk of ED
Hydrochlorothiazide
120
Which med can cause priapism
Trazodone
121
Which 2 diabetic meds together carry an absolute hypoglycemia risk
GLP-1 agonist and sulfonylurea
122
Tx pinworms (enterobius vermicularis)
Mebendazole
123
Anogenital itching, discomfort, dyspareunia, painful defecation, dysuria, genital bleeding
Lichen Sclerosus | Tx: Clobetasol
124
Flagyl MOA
Damages bacterial DNA through production of toxic free radical metabolites
125
Meds that stimulate GI motility
Dopamine receptor agoists (metoclopramide), guanylate cyclase-C agonists, macrolide antibiotics
126
Myerson's signs
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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