deck 16 Flashcards
most common cause of abnormal liver tests
NAFLD/metabolic syndrome
in patients with severe CAP, urine should be tested for…
legionella and pneumococcus
best intervention for low back pain without sciatic involvment
Resumption of physical activity as tolerated
other association with sexual abuse
functional GI disorders
screening test in routine prenatal care
HIV screening
earliest and most specific sign of autism
delayed attainment of social skill milestones
chronic neck pain with radicular symptoms imaging
c spine series
PE initial treatment
LMWH, unfractionated heparin, or fondaparinux for at least 5 days
when can PE meds be stopped
INR has been greater than 2.0 for at least 24 hours
cardiovascular changes associated with aging
decreased cardiac output, maximum heart rate, and stroke volume, as well as increased systolic and diastolic blood pressure.
other physio changes with ageing
decreases in nerve conduction, proprioception and balance, maximum O2 uptake, bone mass, muscle strength, and flexibility
respiratory changes with aging
increase in residual lung volume and a decrease in vital capacity
CENTOR criteria
Tonsillar exudates
Tender anterior cervical lymphadenopathy
Absence of cough
History of fever
interpreting CENTOR criteria
4 = treat with abx 3 = test and treat with positive 0-1 = analgesics + supportive care
long term prognosis in HSP depends on involvement of what?
renal involvement
DM drugs that help people lose weight
metformin incretin mimetics (exenatide)
tenderness in pes anserine bursitis is located…
medial aspect of proximal tibia
pes anserine bursitis treatment
NSAIDS + PT + corticosteroid injection
alternative meds for IBS
- peppermint oil
- Restriction of fermentable, poorly absorbed carbohydrates is beneficial, including fructan (found in wheat and onions), sorbitol, and other such alcohols.
postcholecystectomy pain w/ jaundice think…
retained common duct stone
USPSTF recommendation on breast exams
don’t do it (evidence suggests leads to more additional imaging and biopsies with no gains in BC detection or reduction)
other criteria for gastric bypass surgery
- weight loss by nonoperative means
- eval by dietitian + mental health professional before surgery
best test for renovascular HTN
duplex doppler US (contrast can damage kidneys so can’t do CT angio)
renovascular HTN
condition in which high blood pressure is caused by the kidneys’ hormonal response to narrowing of the arteries supplying the kidneys.
1st line for pregnancy associated N/V
doxylamine + B6
initial warfarin dose in elderly or in patients with HF, liver disease, or h/o recent surgery
5 mg
2 most impt interventions for symptomatic arterial vascular disease
1) walking program
2) stop smoking
best med for symptomatic arterial vascular disease
cilostazol
features of polycythemia vera
- elevated hematocrit
- splenomegaly
- thrombocytosis
- leukocytosis
- low serum ego
treatment of mild recurrent c diff
metronidazole again
multiple c diff recurrences treatment
metronidazole + vancomycin
diabetes diagnostic criteria
hemoglobin A1c level ≥6.5% be used to diagnose diabetes mellitus. Other criteria include a fasting plasma glucose level ≥126 mg/dL, a random glucose leve l≥200 mg/dL in a patient with symptoms of diabetes, or a 2-hour oral glucose tolerance test value ≥200 mg/dL.
osteoporosis screening
1) All women older than 65
2) all men older than 70
3) men and women 50-70 with RF’s –> FH, falls, inactivity, low vitamin D or calcium,
alcoholic ketoacidosis classic setting
- patient who has been binge drinking and eating nothing
-
treatment of alcoholic ketoacidosis
NS + thiamine/glucose
initial treatment of grade 2 ascites (visible with abdominal distention)
Spironolactone + salt restriction
initial treatment of grade 3 ascites
large-volume paracentesis
biceps tendon rupture presentation
present with a visible lump in the upper arm following an audible, painful “pop.” The injury typically results from application of an eccentric load to a flexed elbow. Risk factors for biceps tendon rupture include age >40, deconditioning, contralateral biceps tendon rupture, a history of rotator cuff tear, rheumatoid arthritis, and cigarette smoking. Weakness in forearm supination and elbow flexion may be present. The biceps squeeze test and the hook test are both sensitive and specific for diagnosing the condition.
serpiginous beach rash
hookworm called cutaneous larva migrant
acute bacterial sinusitis diagnosis
- symptom duration of at least 10 days before starting abx
boxer’s fracture
fracture of 5th metacarpal head
boxer’s fracture manage
ulnar gutter splint
guttate psoriasis often triggered by…
group a strep infection
most common RF for frozen shoulder
DM
frozen shoulder presentation
middle aged patient with stiffness + restricted motion + severe pain
differences between men and women that can affect pharmacokinetics
1) GI transit time is slower in women, reducing absorption (means women should also wait longer after eating before taking meds that shouldn’t be taken on an empty stomach)
2) Women secrete less gastric acid than men
3) women typically have higher fat stores than men
4) women have lower GFRs
target glucose level in critically ill patients
- 140-180.
- just want to avoid hypoglycemia
recommended duration of dual anti platelet therapy following placement of drug-eluting stent
1 year
management of intrahepatic cholestasis of pregnancy
ursodiol
why do we give abx for pertussis infections?
- reduces infectivity. no effect on disease duration or severity.
management of blisters with frost bite
- leave non-tense blisters intact. Aspirate tense or bleeding blisters.
frost bite management
- rewarm in whirlpool bath with mild antiseptic
- analgesics
caveat about BC screening
Breast cancer screening has resulted in an increase in the diagnosis of localized disease without a commensurate decrease in the incidence of more widespread disease. Unfortunately, it cannot predict which of the discovered cancers are more aggressive, and cannot accurately detect premalignant lesions. The decrease in the mortality rate of breast cancer is due both to earlier detection and better follow-up medical care.
