Clinic Flashcards
How to know when to give an osteopenic pt a bisphosphonate?
Calculate risk of fracture w/ FRAX calculator
-gives 10 year fracture risk taking into account: age, height, weight, hx of fracture or corticosteroid use, smoker
Fosamax
Fosamax = brand name for alendronate
-bisphosphate
Name of the strongest statin
(a) What is the next strongest?
Statins
Strongest = rousuvastatin (crestor)
(a) one of the stronger = atorvastatin (lipitor)
Describe the typical ankylosing spondylitis patient
Pt under 40 yoa w/ pain for 3+ mo that improves w/ exercise
-pain started gradually and is worse in the morning (morning stiffness)
What is sciatica?
(a) Clinical presentation
(b) Most common etiology
Sciatica = condition of leg pain going down the leg from the lower back
(a) Sharp/burning pain that radiates posteriorly or laterally down the leg (usually down to the foot or ankle)
- often associated w/ numbness or paresthesia
(b) 90% cases caused by spinal disk herniation compressing lumbar or sciatic nerve root
Lumbar disk herniation
(a) most common symptom
(b) diagnostic physical exam maneuver
Lumbar disk herniation
(a) Almost all pts present w/ sciatica = leg pain that radiates down from the lower back
(b) Straight leg test- pt lies supine and you raise straight leg 30-90 degrees and reproduce pain
Characteristic finding of spinal stenosis
Spinal stenosis typically presents w/ neurogenic claudication = pain in legs after walking
Most common location of lumbar disk herniation
Lower lumbar nerve roots: L5 and S1
What determines the overall tx regimen of Hepatitis C
Tx varies by the different genotypes (strains) of the virus
-most common is genotype 1
Describe the general tx of Hep C
Generally 12 weeks to treat chronic (not active/acute) Hep C of antivirals
-no longer use interferon or ribavarin
Bunch of dif drugs => chose depending on provider coverage and side effect profile
Syphilis
(a) Organism
(b) Incubation period
(c) Describe primary syphilis
- Findings
- Duration
Syphilis
(a) Treponema pallidum
(b) Primary syphilis develops on average 4 weeks after exposure
(c) Primary syphilis comprises of a chancre at the site of infection
- lasts about 3 weeks
- Chancre = ulcerative, often painless, lesion
- often painless and small => usually doesn’t come to medical attention
Syphilis
(a) Primary
(b) Secondary
(c) Tertiary
Syphilis
(a) Primary = chancre- ulcerative sore usually on mouth or genitals
(b) Secondary = typically rash involving hands and soles
- fever, headache, malaise
- anorexia, diffuse lymphoadenopathy
(c) Tertiary = gummas (non-cancerous soft growths), neurological, cardiac features
Define latency period in syphilis
Latency (in general) = infected as supported by serologic evidence, but asymptomatic at the time
Most common presentation of ocular syphilis
Posterior uveitis (as part of secondary syphilis) -pt presents w/ decrease in visual acuity
Describe what it means to say that anti-Smith is very specific, but not very sensitive
Very specific but not very sensitive:
So if pt has anti-Smith it is practically pathognomonic for SLE (aka very specific), but only 15% of SLE pts have +anti-Smith (not very sensitive)
SpPin and SnNout
