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Step 3 CCS > CCS > Flashcards

CCS Flashcards

1
Q

UTI

A

Urine HCG
UA
Urine culture
Tx: bactrim/nitrofurantoin

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2
Q

Pregnancy

A 
Pregnancy Test
Pelvic Ultrasound for dating
1st trimester labs:
GC/CT
HIV
RPR
CBC
BMP
Type and Screen
Rh
Antibody
UA and culture
Hep B Surface antigen
Rubella titer
Prescribe: Prenatal vitamins, iron supplementation, folic acid, counseling
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3
Q

Ulcerative Colitis

A

Diagnosis: Sigmoidoscopy, Rectal biopsy, ESR, stool O/P, stool leukocyte, stool culture, PT/PTT
Tx: Mild - Topical mesalamine, treat diarrhea/pain with loperamide, dicyclomine Mod - oral mesalamine, consider steroids, consider azathioprine, Severe - Hospitalize, Consider surgery

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4
Q

Ectopic Pregnancy

A

Dx: Beta-HCG, Transvaginal ultrasound, Surgical workup (PT/PTT, Type and cross, blood group, Rh status), GC/CT
Tx: Methotrexate

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5
Q

IBS

A

Dx: CBC/BMP, TSH, FOBT, ESR, Stool workup (O/P, leukocyte, culture)
Tx: Diet modification, Dicyclomine, loperamide, amitriptyline

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6
Q

Depression

A

Dx: CBC, BMP, TSH, B12
Tx: SSRI, Counseling

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7
Q

Vaginitis

A

Dx: Vaginal PH, Wet mount, gram stain, Pap smear, GC/CT, U/A
Tx: Yeast - fluconazole/clotrimazole, BV - Metronidazole, Trich - Metronidazole

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8
Q

Dementia

A

Dx: CBC/BMP, LFT, TSH, Vitamin B12, CT
Tx: Aricept, vitamin E, atypical antipsychotic for psychotic sx, can add on memantine

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9
Q

COPD Exacerbation

A

Dx: Peak flow, CBC/BMP, CXR, ABG, EKG
Tx: Albuterol, ipratropium, PO steroids, consider antibiotics i.e. Doxy (outpatient) Levaquin (inpatient)

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10
Q

Breast Lump

A

Dx: Mammography, Ultrasound, FNA automatically, counseling

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11
Q

Hypertensive Emergency

A

Dx: Look for evidence of end organ damage (CBC, BMP, ECG, head CT, UA)
Tx: Transfer to ICU, Art line for monitoring, Oxygen, pulse ox, nitroprusside (1), labetalol (2),

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12
Q

Foreign Body Aspiration

A

Dx: CXR, Neck X-ray, bronchoscopy
Tx: Oxygen, pulse ox, bronch

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13
Q

Panic Attack

A

Lots to rule out! Dx: ECG, Trop, CXR, CBC, BMP, Urine drug, glucose, TSH, UA
Tx: Oxygen, benzo

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14
Q

Immediate stabilization options

A

Oxygen, pulse ox, head elevation, Cardiac monitoring, BP monitoring, IV access

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15
Q

TIA

A

Dx: CBC, BMP, Glucose, ECG, head CT, carotid Doppler, echo, lipid panel, A1C
Tx: IV access, aspirin, Carotid endarectomy, counseling

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16
Q

PID

A

Dx: Pelvic Exam, GC/CT swab, gram stain swab, pelvic ultrasound, blood cultures, UA, Urine culture, urine HCG, HIV, RPR
Tx: IV cefoxitin, IV doxycycline (24 hours), morphine, saline, NPO, Tylenol

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17
Q

Hemophilia

A

Dx: CBC, INR/PTT, bleeding time, BMP, LFT. Then Factor VIII, IX, or XI
Tx: Replace missing factor, trend levels

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18
Q

Unstable Angina/MI

A

First: IV Access, pulse ox, oxygen, aspirin, nitroglycerine, ECG, cardiac monitoring, BP monitoring
Dx: Cardiac enzymes, CBC, BMP, LFT, lipid profile, INR/PTT, Echo, Card consult, Catheterization
Tx: Add on heparin, metoprolol, eptfibatide, simvastatin

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19
Q

Croup (barking cough)

A

First: oxygen, pulse ox
Dx: CXR, neck X-ray, CBC, BMP
Tx: Dexamethasone, Racemic Epi

20
Q

Asthma Exacerbation

A

First: Head Elevation, Oxygen, Pulse Ox, cardiac monitoring, ECG
Dx: CXR, Peak flow, ABG, CBC, BMP
Tx: Salmbuterol, ipatroprium, oral or IV steroid based on severity
Monitor: Peak flow

21
Q

Constipation

A

Dx: FOBT, TSH, CBC, BMP, Mag, Phos
Tx: Fiber, senna, docusate

22
Q

Appendicitis

A

Dx: CBC, BMP, LFT, FOBT, Abdominal X-ray, abdominal ultrasound, UA, PT/INR, PTT
Tx: NPO, IV access, NS, Morphine, antiemetics, Cefoxitin!!!, surge consult, laparoscopy

23
Q

Joint Infection

A

Dx: Joint aspiration, joint X-ray, synovial culture/gram stain/cell count. CBC, BMP, Blood culture, INR/PTT
Tx: IV vanc and ceftriaxone. Joint arthroscopy if fluid can’t be removed. Ortho consult. IV access, IV morphine, counseling

24
Q

Dysfunctional Uterine Bleeding

A

Dx: GYN exam, CBC, prolactin, TSH, Ferritin, GC/CT, INR/PTT, urine HCG, Consider endometrial biopsy, pelvic ultrasound, LFTs
Tx: OCs, Iron sulfate

25
Q

Pericarditis

A

Dx: ECG, troponin, CBC, BMP, CXR, echo, amylase/lipase, ESR, CK-MB, blood cultures
Tx: NSAID + colchicine, consider steroid if refractory, consider pericardiocentesis

26
Q

Trauma

A

First: C-spine immobilization, oxygen, pulse ox, IV access, NS, BP/Cardiac monitoring
Dx: Full physical, CBC, BMP, LFTs, CXR, Abdominal CT/Ultrasound (depending on stability), ABG, ECG, Spine x-ray, type and screen, UA, INR/PTT, urine pregnancy test, amylase/lipase, urine drug screen
Tx: Supportive unless requiring splenectomy, IV analgesia/anti-emetics, foley, surgical consult

27
Q

Cellulitis

A

Dx: Blood culture, CBC, BMP, X-ray, wound culture
Tx: Outpatient: Clinda; Inpatient: IV access, NS, elevation, Vanc (MRSA) or Cefazolin-> Keflex, PO analgesic

28
Q

Gout

A

Dx: Joint aspiration, Uric acid, CBC, BMP, ESR, INR/PTT, X-ray
Tx: Indomethacin, consider colchicine if can’t tolerate NSAIDS

29
Q

AIDS with PCP

A

Dx: ELISA followed by western blot then CD4 and viral load, CBC, BMP, CXR, Sputum culture, pulse ox, ABG, LDH,
Tx: Bactrim + steroids, oxygen, vaccinations, HAART i.e. Efavirenz/Tenofovir/Emtricitabine

30
Q

Renal Cell Carcinoma

A

Dx: CBC then iron studies (ferritin, transferrin, TIBC), INR/PTT BMP, LFTs, UA, cystoscopy, abdominal CT, chest CT, FOBT
Tx: Nephrectomy (pre-op care i.e. Cefazolin, type and cross, NPO)

31
Q

Duodenal Ulcer

A

First: IV Access, oxygen, Cardiac/BP monitoring, ECG
Dx: CXR or AXR, CBC, BMP, FOBT, amylase, lipase, UA
Tx: Laparoscopy (NPO, PPI, NG tube, INR/PTT, Type and cross, NS), IV Zosyn

32
Q

Turner Syndrome

A

Dx: Full exam, Karyotype, FSH, LH* CBC, TSH, BMP, Psych consult for IQ, hearing test, skeletal survey, renal ultrasound, pelvic ultrasound, echo, fasting glucose, lipid profile, UA
Tx: Calcium, vitamin D, OCs, growth hormone, diet, ophthalmology consult

33
Q

Essential HTN

A

Dx: CBC, BMP, LFTs, UA, lipid, ECG. Then have return in 1 month for repeat BP
Tx: start with lifestyle management. If no change in 3-5 month period start on medication management. ACE if standard. CCB if AA

34
Q

Diverticulitis

A

Dx: FOBT, Abdominal CT, CBC, BMP, LFTs, UA, Blood culture
Tx: Zosyn -> augmentin. NS, NPO, morphine, anti-emetics. Colonoscopy 3 weeks post recovery.

35
Q

Child abuse

A

Dx: Skeletal Survey, consider ophthalmologic exam, if bruising CBC, INR, PTT, bleeding time
Tx: CPS Consult, Psych consult, admit, DO NOT RETURN HOME

36
Q

Menopause

A

Dx: FSH, prolactin if worried, CBC
Tx: Counseling, estrogen/progestin replacement

37
Q

DVT

A

Dx: admit to ED if PE findings present, Dopplers, d-dimer, CBC, BMP
Tx: LMWH if Cr normal, Warfarin, will need CBC on day 3 to r/o HIT, INR daily until therapeutic, oxycodone

38
Q

PE

A

First: Oxygen, pulse ox, IV, ECG, cardiac monitor
Dx: CBC, D-dimer, CT spiral, INR/PTT, BMP, CXR, ABG, Cardiac enzymes
Tx: LMWH, Warfarin, discontinue pro-clotting meds (OCs)

39
Q

Colon Cancer

A

Dx: CBC with appropriate workup, FOBT, Colonoscopy (don’t forget mechanical bowel prep), UA, BMP, ESR, TSH, stage with CXR and abdominal CT, CEA**
Tx: Hemicolectomy, pre-op orders antibiotics include cipro + metronidazole

40
Q

Bipolar

A

Dx: CBC, BMP, UA, Urine Drug Screen, TSH,
Tx: Atypical antipsychotic + lithium*****, suicide contract, psych consult, admit

41
Q

Bacterial Meningitis

A

Dx: CBC, BMP, Blood culture, Head CT, Vanc + ceftriaxone, LP, UA, CXR CSF gram stain, cell count, glucose, protein, culture, antigens
Tx: Vanc + ceftriaxone, consider gent if gram neg, Dexamethasone for likely s pneumo, NPO, IV, NS, antipyretics

42
Q

Cryptococcal Meningitis

A

Dx: CBC, BMP, Blood culture, Head CT, LP, UA, CXR CSF gram stain, cell count, glucose, protein, culture, antigens + cryptococcal antigen, India ink, fungal culture (Test for everything with AIDS)
Tx: Amphotericin B, flucytosine

43
Q

HCV Meningitis

A

Dx: CBC, BMP, Head CT, Blood Culture, LP with CSF PCR, CXR, UA, INR/PTT, Urine Culture
Tx: NPO, NS, IV acyclovir

44
Q

Giant Cell Arteritis

A

Dx: CBC, BMP, ESR, Temp artery biopsy, UA, CXR, head CT, blood culture
Tx: Oral steroid, if vision loss - IV steroid. With steroids need: PPI, Vitamin D, calcium. Monitor ESR, CBC*

45
Q

Polymyalgia Rheumatica

A

Dx: CBC, BMP, ESR, CXR, ANA, RF, CPK, TSH
Tx: Oral steroid, With steroid: PPI, Calcium, Vitamin D
Monitor: ESR, CRP, CBC, Focused Exam

46
Q

Ovarian Torsion

A

Dx: CBC, BMP, Pelvic Ultrasound, CXR, UA, Urine culture, Blood culture, urine HCG
Tx: Laparoscopy, IV access, NS, anti-emetics, analgesia, with pre-op NPO, INR/PTT, Cefazolin

47
Q

Ovarian Carcinoma

A

Dx: CBC, BMP, TSH, LFTs, CXR, Pelvic Ultrasound, UA, Colonoscopy, Mammography, Abdominal CT for staging, CA-125 pre-op
Tx: Laparotomy with preop orders (ECG, Type and cross, INR/PTT, NPO, IV access, NS)

Step 3 CCS (1 decks)

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