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test 2 > Common symptoms > Flashcards

Common symptoms Flashcards

1
Q

Difference between acute, persistent, chronic and subacute cough

A

Acute- less than 3 weeks
Persistent- 3 to 8 weeks
Chronic- >8weeks
Subacute- post infectious cough for 3 to 8 weeks

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2
Q

when cough lasts more than 3-6 wks what imaging should be done

A

chest radiography

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3
Q

cough lasting more than 3 weeks what is considered

A

pertussis

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4
Q

If ACE inhibitor, respiratory infection, and radiography abnormals are absent what should be expected

A

post nasal drip, GERD, Asthma

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5
Q

Dyspnea with persistant cough check for

A

HF, anemia, chronic lung disease

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6
Q

Patient with acute cough abnormal vital signs, chest dullness (on percussion) with egophony what are next two studies to perform

A

C-reactive protein (Positive if >30mg/dL) and chest xray

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7
Q

Persistant cough, no ACE-I or postinfection, what would you check? how would you check? what if that test is negative?

A

Suspect pertussis
check with polymerase chain reaction
negative PCR suspect asthma, GERD, post nasal drip

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8
Q

Step 1 therapy for asthma

A

beta 2 agonist

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9
Q

step 1 therapy for GERD

A

PPI

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10
Q

STEP 1 therapy for post nasal drip

A

therapy for allergy and chornic sinusitis

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11
Q

Early treatment of pertussis

A

macrolide antibiotics

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12
Q

Pertussis for more than 7-10 days treatment

A

Tdap, macrolide antibiotics for those at risk (wont help cough)

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13
Q

what is the difference in reflex cough and persistant cough symdromes

A

Reflex cough is when someone sees something they jsut cough

persistant cough syndromes deals with vagus/laryngeal nerve dysfunction

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14
Q

When to refer patient with cough

A

1) failure of tx to control persistent or chronic cough
2) recurrent symptoms (oto, pulm, gas)
3) adults needing Tdap FOR cocooning of at risk kids

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15
Q

How to diagnose pneumonia

A

CXR, blood levels of procalcitonin and C-reactive protein

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16
Q

Hemoptysis essential inquires

A

1) fever cough lower respiratory tract infecoin
2) smoking history
3) nasopharyngeal or gastric bleed
4) cxr, cbc, INR

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17
Q

Diagnostics tests for hemoptysis

A

CXR, cbc, renal function test, urinalysis, coagulation studies

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18
Q

young obese patient with hyperlipidemia, and smoking with chest pain, EKG depressed ST, expect

A

Acute coronary syndrome

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19
Q

Patient with chest pain, you do a TIMI and Goldman score and Troponin T, then you discharge patient why

A

TIMI 1 or less
Goldman score 1 or less
Troponin T in normal

20
Q

Patient with chest pain, you do a TIMI and HEART score and Troponin I, then you discharge patient why

A

TIMI 1 or less
Heart was 3 or less
Troponin was normal

21
Q

75y Patient comes in with palpitations, syncope, has abnormal ECG, hematocrit less than 30%, SOB, RR24, Hx of HF, should they be admitted

A

yes

22
Q

Treatment of lower extremity edema do to venous insufficiency without comorbid HF includes

A

leg elevation
compression therapy
ambulatory
NO DIURETICS ( may damage kidneys)

23
Q

normal celcius body temp range

A

36.7 (36to 37.4)

24
Q

neuroleptic malignant syndrome and serotonin syndrom cause what to occur body temp

A

hyperthermic

25
Q

treatment of neuroleptic malignant syndrome

A

dantrolene in combo with bromocriptine or levodopa

26
Q

treatment of serotonin syndrome

A

cyproheptadine or cholrpromazine , with benzodiazepine

27
Q

patient comes in with dilated pupils, sweating, diarrhea for days, shivering, headache, and confusion. reports starting new medication for mood. What would be expected, how would you treat

A

expect serotonin syndrome

treat with cyproheptadine (or chlorpromazine) and benzodiazepine

28
Q

Three common findings of weight loss of 5% over 6-12month period

A

1) cancer (30%)
2) GI disorders (15%)
3) dementia/depression

29
Q

First tests to run when significant weight loss is seen

A

cbc, tsh, urinalysis, fecal occult blood, serological test (hiv), cxr, upper gi

30
Q

when weight loss is seen, a second phase of tests to run

A

gastrointestinal (for malabsorption) and cancer screening (colonoscopy may not be adequate for symptom of weight loss only)

31
Q

When weight loss is seen along with anorexia nervosa, depression, or dementia what should be considered

A

psychological consult

32
Q

how many percentage of weight loss cases can go without specific cause

A

15-25%

33
Q

When initiating nutrition back to some one who had significant weight loss intake goal should be

A

30 to 40 kcal/kg/d

34
Q

3 common types of categories of treatment for weight loss include

A

1) appetite stimulants
2) growth hormone
3) anticatabolic agents

35
Q

appetite stimulant medications include

A 
corticosteroids,
dronabinol,  
progestational agents,
 and 
serotonin antagonists
36
Q

anticatabolic agents for treatment of weight loss include

A

hydrazine sulfate, omega 3 fatty acid, pentoxifylline, and thalidamide

37
Q

Patients with significant weight lose should be referred when

A

1) caused by malabsorption
2) anorexia nervosa or bulimia
3) persistent nutrition deficit despite adequate supplementation

38
Q

Patients with significant weight loss should be admitted when

A

1) cachexia 2nd to psych disorder
2) severe protein deficient (kwarshiorkor or marasmus)
3) severe vitamin deficient
4) electrolyte fluid replacement

39
Q

After physical assessment labs to be used for chronic fatigue diagnosis are

A 
cbc
chemistry
erythrocyte sedimentation rate
antinuclear antibodies
urinalysis
TB
Lyme serology
serum cortisol
rheumatoid factor
immunoglobin levels
Hiv antibodies
40
Q

An acute headache seen in someone who is >50 or HIV positive, especially with mental or neuro abnormals on exam requires what type of imaging

A

neuroimaging

41
Q

Patients that have acute onset of headache and are
40 or older, have neck pain or stiffness, limited neck flexion, witnessed loss of consciousness, onset during exercise, thunderclap headache should be evaluated for

A

subarachnoid hemorrhage

42
Q

If suspicion of subarachnoid hemorrhage what diagnosis tests should be done

A

CT noncontrast then CT with contrast then lumbar puncture then angiography

43
Q

urinalysis is most helpful in presentation of

A

atypical cystitis

44
Q

patient with complaints of dysuria and severe flank pain what is likely considered? requires what type of imaging

A

kidney infection, hydronephrosis,
>use renal ultrasound or ct scanning

or nephrothiasis
> CT helical scanner

45
Q

Academy of pediatrics committe on drugs states what antibiotics are safe during breast feeding

A 
ciprofloxicin
ofloxicin
trimethoprim-sulfamethoxazole(unless G6PD deficient)
amoxicillin
nitrofurantoin

test 2 (13 decks)

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