deck 17 Flashcards
antidepressant that can induce modest weight loss
bupropion
preventive measures paid for by medicare
pneumococcal vaccine, influenza vaccine, annual mammography, and a Papanicolaou test every 3 years.
conditions that produce a reactive lymphocytosis
- viral infections
- EBV, mono, CMV, HSV, HIV
movement type that increases pine from spinal stenosis
Extension that increases lumbar lordosis decreases the cross-sectional area of the spinal canal, thereby compressing the spinal cord further. Walking downhill can cause this. Spinal flexion that decreases lordosis has the opposite effect, and will usually improve the pain, as will sitting.
med contraindicated in cirrhotics
NSAIDS (can increase risk of bleeding by further impairing platelet function. ALSO decrease blood flow to the kidneys and can increase risk of renal failure in cirrhotics)
ASPIRIN is NOT AN NSAID
…
NSAIDS affect on the heart?
- can increase CV morbidity, worsen HF, increase BP, and increase ischemia/MI
best test for psychogenic seizures
vEEG
rosacea management
Management includes avoidance of precipitating factors and use of sunscreen. Oral metronidazole, doxycycline, or tetracycline also can be used, especially if there are ocular symptoms. These are often ineffective for the flushing, so low-dose clonidine or a nonselective β-blocker may be added.
prognostic factor that suggests no recovery in post-MI comatose patient
myoclonic status epilepticus at 24 hours
2 conditions that account for 90% of hypercalcemia
Primary hyperparathyroidism
Malignancy
familial hypocalciuric hypercalcemia labs
- moderate hypercalcemia + low urinary calcium excretion
- PTH can be normal or mildly elevated
drugs that can cause SJS
- Allopurinol
- antibiotics, antiepileptics, and NSAIDs. Of these, antibiotics are the most common alleged cause of
Stevens-Johnson syndrome.
acute adult asthma exacerbation albuterol method
MDI
conversion aphonia
voice hoarseness/lose of voice after stressful event
PFTs with vocal cord dysfunction
- Normal expiratory portion but a flattened inspiratory phase.
posterior tibial tendonopathy presentation
Pain + swelling posterior to medial malleolus + no injury + pain with inversion and plantar flexion
posterior tibial tendonopathy management
immobilization in a cast boot for 3 weeks
hiccups lasting more than a couple days management
- work up cause –>
feature of diverticular bleeding and angiodysplasia
PAINLESS
Ischemic colitis presentation
abdominal pain + CV RF’s + bloody diarrhea
Heparin-induced thrombocytopenia management
D/C heparin + start non-heparin anticoagulant such as argatroban or desirudin
lichen planus presentation
pruritic + symmetrically distributed papular lesions + violaceous flat-topped papules
lichen planus treatment
high-potency topical corticosteroids (clobetasol)
hip impingement presentation
Gradually worsening anterolateral hip joint pain + sharply accentuated when pivoting laterally on affected hip or moving from a seated to standing positon. + pain with internal rotation.
OTC med commonly associated with serotonin syndrome
dextromethorphan
lab to order to rule out adrenal insufficiency
morning serum cortisol
PMR criteria for diagnosis
- bilateral shoulder or hip stiffness and aching for at least 1 month
- ESR should be over 40
first line for fatty liver disease
healthy diet, weight loss, exercise
med to reduce secretions that causes least CNS effects
glycopyrrolate
clinical relevance of frequent PVCs
linked to acute MI + sudden death
management of patients with frequent PVC’s + cardiac risk factors
CAD evaluation
radial head fracture management
- posterior splint + repeat radiograph in 1-2 weeks (ensure alignment)
management of post-procedure wound (after skin biopsy)
- petrolatum
- evidence recommends against use of topical antibiotics (can aggravate open wounds, hindering wound-healing process. also significant risk of developing contact dermatitis).
alternative therapy with good evidence for low back pain
acupuncture
management of sudden sensorineural hearing loss
oral corticosteroids
other indicator of active infection in hep b
elevated ALT
management of painful subacute thyroiditis
prednisone
patient with pyelo and persistent fever/flank pain
- perinephric abscess
- order CT
most common feature of IBS
abdominal pain (more common that constipation or diarrhea)
vertigo with increased due to increased pressure think
perilymphatic fistula (between middle and inner ear)
female athlete triad
amenorhea + osteoporosis + disordered eating
diverticulosis management
- increased dietary fiber intake
management of v fib after electrical defibrillation and CPR fail…
vasopressor (epi or vasopression) then if that fails –> amiodarone
gold standard for diagnosis of renal colic/stones
CT
features of malignant nodules
size greater than 10 mm, irregular border, “ground glass” appearance, either no calcification or eccentric calcification, doubling time of 1 month to 1 year
management of asymptomatic aortic stenosis
watchful waiting
genetic component of psoriasis?
yet
levo management during pregnancy
uptitrate
caveat about surgery for rotator cuff tears
- has to be done in less than 6 weeks, or muscle atrophy will reduce benefit
- ## most effective in young, active patients
med for all patients with HF due to systolic dysfunction
ACEI
