Cases 26-30 Flashcards
USPSTF guidelines for prostate screening
discussion to start PSA at 55 - 69
If a patient ops for flex sigmoidoscopy instead fo colonoscopy, how frequent should they get one?
every 5 years
If a patient ops for FOB or FIT instead fo colonoscopy, how frequent should they get one?
every year
What should be ordered in a patient who is fatigued?
CBC
ESR
TSH
What does HEEADSSS stand for?
Home
Education/Employment
Eating
Activities
Drugs
Sexuality
Suicide/Depression
Safety/Violence
In a patient with testicular pain, if a cremasteric reflex is absent what could be the cause?
testicular torsion
What is does the blue dot sign indicate?
torsion of a testicular appendage
What is Prehn sign?
physical lifting of the testicle relieves the pain caused by epiddidymitis
(not relieved in testicular torsion)
Regarding testicular torsion, what is the percent of teticular viability after 6 hours of scrotal pain?
90%
Regarding testicular torsion, what is the percent of teticular viability after more than 12 hours of scrotal pain?
50%
Regarding testicular torsion, what is the percent of teticular viability after more than 24 hours of scrotal pain?
10%
Do Guidelines for Adolescent Preventative Services (GAPS) address diabetes prevention?
nah
What is the most common malignancy affecting men between 15 and 35yo?
testicular cancer
What is the most common type of testicular cancer?
Germ cell (seminoma)
What is the difference between acute and chronic bronchitis?
Acute: productive cough lasting 1-3 weeks
Chronic: Productive cough lasting for at least 3 months for the past 2 years
Name 4 classic COPD PE findings
Increased anterioposterior diameter of the chest
decreased diaphragmatic excursion
wheezing (often end expiratory)
Prolonged expiratory phase
What happens to height of the larynx in COPD
Often decreases
What cells are involved in COPD?
Macrophages, T killer cells, and neutrophils
When do the major benefits of smoking cessation occur?
within the first year of quitting
What are the GOLD grades for COPD?
Based on CAT scores, how should group B, C, and D be treated?
Therapy for GOLD group B
In addition to a short acting beta agonist (SABA) for symptoms, patients in group B should be given a long acting beta agonist (LABA) or long acting anti-muscarinic antagonist (LAMA). Eventually, if symptoms worsen, they may be given both a LABA and LAMA.
Therapy for GOLD group C
In addition to a SABA, LABA, and LAMA, patients in group C should be given an inhaled corticosteroid (ICS).
Therapy for GOLD group D
In symptomatic COPD patients whose FEV1 is < 50% of predicted and severity of dyspnea and exacerbations is high, it is recommended that inhaled corticosteroids (ICS) be added to LABA bronchodilator treatment and/or LAMA. The addition of a glucocorticoid may increase the risk of pneumonia. Roflumilast, a Phosphodiesterase-4 inhibitor, can be substituted or added to the LAMA/LABA/ICS combinations. A SABA, ipratroprium, or can be used as needed. The cost of many of these inhalers can be a barrier to use. Oxygen therapy is indicated if room air oxygen saturations < 88%.
What is the gold standard for diagnosing COPD?
PFT
In pulmonary function testing, either a FEV1/FVC ratio less than the 5th percentile, or less than 70%, confirms a diagnosis of COPD.
Name 5 treatments that are used to treat alzheimer’s
Cholinesterase inhibitors
Vit E
Memantine
Respite
Atypical antipsychotics
What tool has evidence support in diagnosing delirium?
Confusion Assessment Method (CAM)
