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Winland Brown Review Book > Content 3 > Flashcards

Content 3 Flashcards

1
Q

Loss of hearing that gradually occurs as individuals grow older

A

Presbycusis

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2
Q

Natural loss of accomodative capacity with age

A

Presbyopia

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3
Q

Tx of bacterial conjunctivitis and corneal abrasion due to excessive contact use

A

Ciprofloxacin, gentamycin or ofloxacin

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4
Q

Weber test in sensorineural loss

A

Louder in unaffected ear

Meniere disease

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5
Q

Rinne test in sensorineural loss

A

No change

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6
Q

Rosenbaum test

A

Tests for near vision

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7
Q

Immediate goal of placement of myringotomy and tube placement in children with recurrent AOM

A

Allow removal of suppurative and mucoid material, releasing the pressure

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8
Q

Visualization of floaters usually due to

A

Syneresis

Degenerative changes in the vitreous humor

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9
Q

When should child achieve 20/20

A

By age 4

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10
Q

Use of nasal decongestants >every 3 hours for >3 weeks is a risk factor for

A

Rhinitis medicamentosa
3 days in a row is maximum recommended time
More than that can cause rebound congestion

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11
Q

Microtia

A

Small ears

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12
Q

Most common cause of sensorineural hearing loss

A

Presbycubis

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13
Q

Allen test

A

Vision screening using picture cards

For children aged 2.5-3

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14
Q

PE finding in a patient with mumps

A

Orifice of Stensen’s duct appears red

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15
Q

Leading cause of blindness in people aged 20-60

A

Diabetic retinopathy–a progressive microangiopathy with small vessel damage and occlusion

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16
Q

S/S acute angle closure glaucoma

A

Halos around lights, severe eye pain and redness, N/V, HA, blurred vision, conjunctival injection, cloudy cornea, mid-dilated pupil, increased IOP

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17
Q

Gold standard for dx strep throat

A

Throat culture

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18
Q

In older adults, the most common cause of decreased visual functioning

A

Cataract formation

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19
Q

Trachea deviates towards the affected side in

A

Large atelactasis or fibrosis

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20
Q

Trachea deviates towards the unaffected side in

A

Aortic aneurysm, unilateral thyroid lobe enlargement, pneumothorax

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21
Q

Drugs safe to use with perforated TM

A

Cipro + Dexamethasone (Ciprodex Otic)

Do not use <6 months

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22
Q

Abnormal corneal light reflex suggests

A

Improper alignment of the eyes

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23
Q

A smooth tongue may be due to

A

Vitamin deficiency

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24
Q

What is CI when a patient has a suspected foreign body in the ear

A

Flushing with water

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25
Q

Normal artery:vein ratio in the eye

A

2:3

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26
Q

Asian man about to take allopurinol for gout, what should be screened for

A

HLA-B*1501 gene

-Increased risk of SJS and toxic-epidermal necrolysis when taking the medication

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27
Q

1st line therapy for fibromyalgia

A

TCA–amitriptyline

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28
Q

Polymyalgia rheumatica

A

Inflammatory disease of unknown etiology that affects people >50 years
Tx: prednisone for 3 days

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29
Q

Patent ductus arteriosus s/s

A

Continuous murmur, bounding apical pulse, respiratory distress
Tx: indomethacin

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30
Q

Carcinoid tumor

A

Neuroendocrine tumor characterized by flushing, diarrhea, wheezing due to tumor secretion of histamine, serotonin, prostaglandins

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31
Q

Cor pulmonale

A

Right heart fsailure

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32
Q

Peutz-jeghers syndrome screening

A

Screen for GI cancer beginning at age 12 in patienrts who have GI symptoms

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33
Q

Triad of nephritic syndrome

A

hypertension, peripheral edema, renal insufficiency

Labs: proteinuria, UA RBC and RBC casts

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34
Q

Nephrotic syndrome

A

Hypotension

Labs: heavy proteinuria, hypoalbuminemia, hyperlipidemia, UA lipiduria

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35
Q

CN 3 palsy suggests

A

Cerebral aneurysm

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36
Q

Tx travelers diarrhea in pregnant woman

A

Azithromycin

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37
Q

Adverse effect of methadone

A

Can cause QT interval prolongation that can cause torsades de pointes

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38
Q

Tx of idiopathic hypercalciuria

A

Thiazide diuretic–decrease urinary calcium excretion

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39
Q

Murmur of carditis due to rheumatic fever

A

Apical holosystolic murmur

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40
Q

SE of donepezil

A

Cholinesterase inhibitor–increases cholinergic transmission

SE: diarrhea

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41
Q

1st line therapy for neuropathic pain due to DM

A

Pregabalin and duloxetine

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42
Q

Characteristics of hypertrophic cardiomyopathy

A

LV hypertrophy, ejection murmur, S4 gallop, dyspnea, angina, syncope, rapid upstroke of carotid arterial pulse

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43
Q

Characteristics of aortic stenosis

A

LV hypertrophy, ejection murmur, S4 gallop, dyspnea, angina, syncope

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44
Q

How long does troponin stay elevated after MI

A

10 days

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45
Q

How long does CK remain elevated after MI

A

36-48 hours

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46
Q

Nitroglycerine tablet storage instructions

A

If in open bottle, throw away after 3 months
If in unopen bottle, good for 1 year
Sensitive to light, mositure and heat

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47
Q

Precautions related to fluoroquinolone therapy

A

Do not give <18 years old
Do not give to pregnant women
Hypoglycemia and hyperglycemia may occur
Anorexia/nausea may occur

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48
Q

Heightened vagal tone can cause

A

Hypotension, bradycardia, slowing of AV conduction

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49
Q

Subclavian steal syndrome

A

Caused by atherosclerotic narrowing of subclavian artery proximal to vertebral artery
Causes unequal BP in 2 arms

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50
Q

Heightened vagal tone responsible for vasovagal faint is commonly caused by

A

Transient bradycardia, sinus arrest, or AV block

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51
Q

Meconium ileus in newborn is usually due to

A

CF

Can also be caused by Hirschsprung disease

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52
Q

Congenital cytomegalovirus is manifested by

A

Petechiae, jaundice, intracranial calcifications, hearing loss, seizures

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53
Q

Classic presentation of intussusception

A

Sudden onset of intermittent, severe, crampy, progressive abdominal pain, accompanied by constant crying and drawing up of the legs towards abdomen

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54
Q

SGLT2 inhibitors are associated with increased risk of

A

Amputation

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55
Q

Common cause of recurrent cellulitis in patient who has undergone venectomy

A

Tinea pedis

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56
Q

Adverse effects of SSRIs

A

Sexual dysfunction, drowsiness, weight gain, anxiety, dizziness, insomnia

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57
Q

Difference between emphysema and chronic bronchitis

A

Emphysema: normal oxygenation and normal pulmonary artery pressure and normal ventilation

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58
Q

Paradoxical pulse is classic sign of

A

Pericardial tamponade

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59
Q

Most common cause of inherited thrombophilia

A

Factor V leiden mutation– increases risk of DVT and pulmonary embolism

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60
Q

Underlying systemic diseases that can cause carpal tunnel

A

hypothyroidism, DM, acromegaly, RA, amyloidosis

61
Q

Smokers weigh on average ____ than non-smokers

A

5-10ib less
When they quit, 80% gain weight
Weight gain is caused by replacing cigarettes with food

62
Q

What medications lead to a decreased response to the tB skin test

A

Steroids and other immunosuppressive agents

63
Q

Most common reason for a chronic cough in children

A

Postinfection

64
Q

Main cause of CAP

A

Strep pneumoniae

Followed by mycoplasma pneumoniae, h. influenzae, staph aureus

65
Q

What should be considered in all adult onset asthma

A

Occupational asthma

66
Q

What deficiency is noted in a lot of people with COPD

A

Vitamin D

67
Q

What percent of people who smoke 1 pack of cigarettes per day have a cough?

A

40-60%

68
Q

Most notable manifestatio of tongue cancer

A

Hoarseness of the voice

69
Q

What is effective in tx of pneumonia, atelactasis, and CF

A

Chest physiotherapy

70
Q

X ray finding of croup

A

Tapered symmetric subglottic narrowing, or steeple sign, on AP view

71
Q

Secondary pneumothorax usually due to

A

COPD

72
Q

1st line therapy for GOLD 1 COPD

A

Beta 2 agonists

73
Q

Most common cause of persistent cough in children of all ages

A

Recurrent viral bronchitis

74
Q

3 D’s of epiglottitis

A

Drooling, dysphagia, distress

75
Q

2 most prevalent organisms constituting the normal flora of oropharynx

A

Streptococci and staphylococci

76
Q

Unexplained nocturnal cough in adult should suggest

A

CHF

77
Q

Bacteria in TSS

A

Staph aureus

78
Q

Requirements for home oxygen

A

PaO2 <55mmHg or O2 sat <85%

79
Q

Normal adult thorax shape

A

Elliptical

80
Q

Acid-base disturbance that occurs due to aspirin overdose

A

Respiratory alkalosis

Due to direct stimulation of respiratory center in the medulla, which causes increase in pH and decrease in PaCO2

81
Q

Hamman’s sign

A

Auscultation sound at the mediastinum in the presence of mediastinal crunch
Present with emphysema or pneumomediastinum

82
Q

Trachea deviation in pleural effusion

A

Unaffected side

Due to fluid displacing pleural space

83
Q

CAP in alcoholic usually due to

A

Pneumococcus (usually streptococcus pneumoniae)

84
Q

Which TB medication should not be taken by pregnant women

A

Pyrazinamide

85
Q

Peaked T wave that may progress into widening of QT interval due to

A

Hyperkalemia

86
Q

U waves, ST depression and T wave flattening due to

A

Hypokalemia

87
Q

Prolongation of QT interval

A

Hypocalcemia

88
Q

Occlusion of which artery usually results in damage to inferior wall of left ventricle

A

Right coronary artery

89
Q

Roos test

A

Assesses for thoracic outlet syndrome
-If pain or paresthesias are present when the client positions his/her shoulders in abduction and external rotation of 90 degrees

90
Q

Most common causes of mitral stenosis

A

Endocarditis, rheumatic heart disease, calcific mitral valve disease

91
Q

CHADS2 score

A

For A fib stroke risk
CHF, hypertension, age, diabetes, history of TIA or stroke
>2=anticoagulation

92
Q

Hypertensive retinopathy

A

End organ damage

AV nicking + cotton wool spots

93
Q

Diagnosis of acute aortic dissection best made with

A

CT angiography of the chest or transesophageal echo

94
Q

Auscultation of aortic valve is best performed using which side of stethoscope

A

Diaphragm

95
Q

Pleuritic chest pain, diffuse ST segment elevation, PR depression, leaning forward

A

Pericarditis

96
Q

High pitched diastolic murmur, widened pulse pressure, laterally displaced PMI

A

Aortic regurigitation

97
Q

Low pitched diastolic rumble heard best at the cardiac apex

A

Mitral stenosis

98
Q

Scooping of ST segment and T wave inversion and QT shortening due to what toxicity

A

Digoxin

99
Q

Digoxin toxicity first manifests as

A

N/V, abdominal pain, HA, diarrhea, loss of appetite, low heart rate, palpitations

100
Q

Initial tx of viral pericarditis

A

NSAIDs + colchicine

101
Q

Next step in management of HF if decreased sensitivity to loop diuretics and spirinolactone combination

A

Metolazone

102
Q

Target BP >60 years

A

<150/90

103
Q

What should be performed in all patients with suspected hypertrophic cardiomyopathy

A

Transthoracic echo

104
Q

Harsh crescendo-decrescendo systolic murmur heard best at left upper sternal border
T wave inversion

A

Hypertrophic cardiomyopathy

105
Q

Systemic hypotension, jugular venous distention, muffled heart sounds

A

Cardiac tamponade

106
Q

Weak carotid pulse with slow upstroke

A

Aortic stenosis

107
Q

MVP characterized by

A

Elongation of chordae tendinae and enlarged valve leaflets

Ballooning of the cusps into the atrium occurs during systole

108
Q

Education if someone is using the BBT method

A

Avoid unprotected intercourse from the beginning of the menstrual cycle until the BBT has been elevated for 3 days

109
Q

What is an associated sx with stress incontinence

A

Recurrent cystitis

110
Q

Most common G U dysfunction occuring after a transurethral resection of the prostate

A

Retrograde ejaculation

111
Q

Pt education regarding using podophyllum for warts

A

Wash off after 1-2 hours to prevent tissue being destroyed

112
Q

Sx of Prostate CA vs BPH

A

Same sx but with prostate CA, sx progress more rapidly

113
Q

Stein-Leventhal syndrome

A

PCOS

114
Q

Who would rarely develop prostate cancer

A

Someone who received a orchiectomy before puberty as prostate cancer is androgen dependent

115
Q

Mobiluncus species causes

A

BV

116
Q

Most common sx expressed by women with PMS

A

Fatigue

117
Q

Most common scrotal disorder in adolescents

A

Testicular torsion

118
Q

MOA of 5-alpha reductase inhibitors

A

Induce apoptosis and atrophy as well as reduce action of androgens in the prostate

119
Q

CI to IUD

A

Heart disease–susceptible to bacterial endocarditis

Heavy bleeding

120
Q

ED most common cause

A

Organic–mostly vascular

121
Q

Co-factors for HIV transmission

A

Chancroid, genital herpes, syphilis

122
Q

What medications may diminish the effectiveness of OCP

A

Antibiotics, antacids, anticonvulsants

123
Q

Conditions outside of the scrotum that may present with scrotal pain

A

AAA, inguinal herniation, pancreatitis, renal colic, peritonitis, intraperitoneal hemorrhage, plyarteritis nodosa

124
Q

Bacteria in TSS

A

Staph aureus

125
Q

Epithelial cells with bacteria adherent to the cell wall giving a stippled, granular appearance

A

Clue cells

in BV

126
Q

Fibroids during pregnancy

A

1/3 will increase in first trimester; may result in miscarriage, preterm labor, abruptio placentae, C-Section

127
Q

Most common cause of gross hematuria in men

A

Bladder infection

128
Q

Genital exam position for a patient with severe spasticitiy

A

Knee-chest position

129
Q

What position is the uterus if the cervix is located on the anterior vaginal wall

A

Anteverted

130
Q

Labs to rule out causes of ED

A

FBS, Lipids, TSH, testosterone

131
Q

How long may you leave the nuva ring out ?

A

3 hours

132
Q

Fibromyalgia dx

A

11/18 tender trigger points including occiput, low cervical, trapezius, supraspinatus, second rib, lateral epicondyle, gluteal, greater trochanter, knee

133
Q

Spurling maneuver

A

Assesses nerve root compression of the neck

134
Q

Which nerve root involvement for decreased sensation in lateral leg and web of great toe

A

L4/L5

135
Q

Most common cause of cauda equina syndrome

A

Herniated lumbar intervetebral disk

136
Q

Roos test

A

Assesses for thoracic outlet syndrome
-If pain or paresthesias are present when the client positions his/her shoulders in abduction and external rotation of 90 degrees

137
Q

Reiters syndrome

A

Reactive arthritis
COnjunctivitis, nongonococcal urethritis, arthritis
“cant see, cant pee, cant climb a tree”

138
Q

Thompson test

A

Used to dx achilles tendon rupture

139
Q

Baker’s cyst

A

Build up of synovial fluid behind the knee

140
Q

What causes articular cartilage destruction in RA

A

Lysosomal degradation due to leukocytes producing lysosomal enzymes

141
Q

Ankylosis

A

Stiffness or immobility in a joint due to bones fusing

142
Q

Tx adhesive capsulitis

A

Moist heat application, use of analgesics, gentle stretching

143
Q

Gelling

A

achiness and stiffness that occurs in RA

144
Q

Dupuytrens contracture

A

Nodular thickening of the palmar facia that draws the fingers inward to the palm

145
Q

Functional vs structural scoliosis

A

Functional: apparant with standing and disappears with forward bending
Structural: fixed

146
Q

Allen test

A

Assesses patency of radial and ulnar arteries and the arterial arch

147
Q

Largest joint in the body

A

knee

148
Q

Pain elicited with finkelsteine test

A

Indicates Quervains tenosynovitis

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