Boards review 3 (hard) Flashcards by Jade Molyneux

Chronic hemolytic anemia

Bone marrow production of erythrocytes is increased; need to supplement with folic acid

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Specific lab test for SLE

Anti-double stranded DNA antibodies

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Divalprex

Long time to recurrence of mania in bipolar patient

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Ventilation is most closely linked with

systemic arterial PaCO2

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Emergent tx of variceal bleeding

Prophylactic antibiotics, octreotide administration, endoscopic procedure

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Tx systolic HF in pregnant patients

Labetalol, hydralazine, loop diuretics, nitrates

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myopia increases risk of

retinal detachment

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Tx cocaine-induced myocardial ischemia

Nitrates, verapamil, diltiazem, aspirin

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Women who have neurofibromastosis type.1 have increased risk of

breast cancer development

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Preferred initial test for dx CF

DNA analysis

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CI to placement of urinary catheter

Gross hematuria after pelvic trauma

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Loss of DTR in the knee is most likely due to

femoral nerve involvement

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Dx test for CO poisoning

Systemic arterial carboxyhemoglobin level

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Adenomyosis is associated with

Diffuse enlargement of uterus

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Klebsiella infection is increased in what kinds of patients

Immune compromised–DM, malignancy, COPD, renal disease, long term steroids

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Risk factors for pseudomonas

Bronchiectasis due to CF, structural lung abnormalities, contaminated healthcare equipment

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Which bacteria is someone with sickle cell more susceptible to

HIB, E coli, staph, salmonella (all encapsulated bacteria)

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Vertebrobasilar artery insufficiency

Subclavian steal syndrome

Unequal BP in arms

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Low voltage on ECG due to

Hypothyroidism

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Silicone embolism presents as

Petechial rash, hypoxemia, fever, altered consciousness

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Granular casts are a sign of

Acute tubular necrosis of the kidney

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WBC casts + eosinophiluria

Interstitial nephritis

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Polycystic kidney disease increases risk of

Cerebral aneurysm

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Ombudsman

person who acts as an intermediary between the patient and an organization; represents the patient and works in the best interest of the patient

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Durable power of attorney

Health care decisions

Power of attorney

Can make all decisions

HIPAA passed in

1966

Claim based policy

 If NP changes job, they are not covered by malpractice insurance if it dates back to even when they had a job

Occurrence based policy

 Malpractice policy that is not affected by job changes or retirement

Medicare coverage

 Automatic at age 65 if you paid the premiums when you were working  Also covers person with end stage renal disease at any age

Medicare Part A

* Pays for inpatient hospitalization, hospice care, home health care, skilled nursing facility * Does not pay for nursing homes or retirement homes

Medicare Part B

* Outpatient * Voluntary; monthly premiums * Lab tests covered, durable medical equioment, CT scans, etc

Medicare Part D

Prescriptions

Medicaid

 Low income individuals; children, pregnant women, parents, seniors, individuals with disabilities

Borrelia Burgdorferi

Lyme disease

Stage 1 Lyme disease

Erythema migrans

Stage 2 Lyme disease

 Months later  Rash may appear with multiple lesions with arthalgias, myalgia, HA, fatigue  Heart block and bell palsy may occur

Stage 3 Lyme disease

 1 year after initial infection |  Joint pain, memory problems, depression, neuropathy

Preferred tx for alcohol withdrawal sx when concomitant hx of hepatic disease

Lorazepam

What can be used to tx tachy and tremor of alcohol withdrawal

Clonidine

Campral

Does not cause unpleasant effects when drinking

If pt has G+ infection and is allergic to penicillin

Give azithromycin or clindamycin

Screening test for temporal arteritis

ESR

Sensitivity

True positive

Specificity

True negative

What does trauma to Kiesselbachs plexus cause

anterior nosebleed

Alpha thalassemia more common among

Asians

Neovascularization, hard exudates, cotton wool spots, microanuerysms

Diabetic retinopathy

AV nicking, silver/copper wire arterioles

Hypertensive retinopathy

Tx cutaneous anthrax

Cipro for 8 weeks | If allergic, give Doxy

Tx Barret esophagus

High dose PPI for lifetime

Cutaneous larva migrans

Hook worm rashes shaped like red raised wavy lines; red and very pruriitc Tx: Ivermectin or Albendazole

Buergers disease

Ischemic changes and gangrene of the hands and fingers

How much iron do menstruating women lose

2mg/day

Highest B/C failure rate

Cervical cap

Most common sx of toxoplasmosis

Headache

Atrial gallop

Major risk of RBC transfusion

Cytomegalovirus infection

Liver flap

nonrhythmic flapping of the wrists and hands associated with hepatic encephalopathy, uremia and respiratory acidosis

Risk factors for renal cancer

Tobacco use and analgesic abuse

Prostatodynia

Sx of prostatitis but without infection

Glucosamine sulfate

Natural supplement that can be used for OA

Long and narrow face with prominent forehead and chin and large ears

Fragile X

ECG of therapeutic levels of digoxin

Cupped ST segments

Risks for pancreatitis

Gallstones, excessive ETOH, elevated triglycerides, thiazide diurtics, blunt abdominal trauma

Labs in pancreatic cancer

amylase not effected | May have elevated total and direct bilirubin and alkaline phosphatase

PE of MVP

May have pectus excavatum or scoliosis

Aortic stenosis leads to

LVH

Hypertrophic cardiomyopathy

Murmur gets louder when standing

Who may have a benign split of S2

Young athletes

Early finding in chronic renal failure

Persistent proteinuria

Edema, urinary RBC casts, proteinuria, hypertension

Glomerulonephritis

WHen does Cr clearance increase

With age, in men, and with hypertension

most common incontinence in elderly

urge

Functional urinary incontinence occurs with

Delirium, fecal impaction, manual dexterity, immobility

How much protein loss in the urine indicates significant glomerular disease

>3.5g | Requires kidney biopsy

What meds can cause hematuria

ACEI, NSAIDs and aminoglycosides

Risk factors for urinary tract cancer

Obesity, smoking, asbestos

Most common cause of acute renal failure

Acute tubular necrosis

Osmolality in azotemia

Increased in pre-renal | Decreased in intra-renal

BP in coarctation of aorta

Higher in arms than in legs

AV valves

Mitral + Tricuspid

SL valves

Aortic + pulmonic

Where is split S2 best heard

2nd ICS, RSB

Carotid stenosis puts pt at risk for

Stroke and CAD

Ranson's criteria

``` For admission for pancreatitis  Age >55  WBC >!6,000  Glucose >200  Base deficit >4  LDH >350  AST >250 ```

Onset of sx after food poisoning with staph

1-4 hours

Onset of sx after food poisoning with salmonella

12-24

Minimal dehydration

<3% body weight

Moderate dehyrdation

3-9% body weight

Severe dehydration

>9% body weight

Enterobiasis infection

Pinworms | Perform scotch test early in the morning for several days

Tx Giardia

Metronidazole

Labs in liver failure

Low BUN, high ammonia