deck 19 Flashcards
USPSTF lung cancer screening recommendation
Annual screening for lung cancer with low-dose computed tomography (LDCT) in adults 55–80 years of age who have a 30-pack-year smoking history and
currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has
not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability
or willingness to have lung surgery (B recommendation).
standard treatment for symptomatic MM patients
autologous stem cell transplantation
standard treatment for asymptomatic MM patients
none
corticosteroid injection for back pain evidence?
none without radicular signs or symptoms
other standard of management for chronic back pain
multidisciplinary rehab program (physician + psychologist, social worker, or vocational)
side effects of inhaled corticoseroids
- candidate infection of oropharynx
- hoarseness
- increased risk of developing pneumonia
inhaled corticosteroids use for COPD
- don’t reduce mortality or affect long-term progression of COPD
- do reduce number exacerbations and rate of decline in QOL
group you don’t need to vaccinate for hep A
- immigrants from developing countries like India (prevalence is so high that virtually everyone is infected and immune and infection confers lifelong immunity)
minimum daily intake of vitamin d for infants and children
400 IU
initial management of c diff associated diarrhea
stop antibiotic. don’t start metronidazole until stool is positive for toxins
how to reduce pressure ulcers
1) elevate head to less than 30 degree to reduce shearing forces
2) can use topical antibiotics for up to 2 weeks
best screening test for mobility/fall risk
“get up and go test”
abx for epidydimitis in under 35
CTX + doxycycline
alk phos elevated in conditions affecting what?
bones, liver, small intestine, placenta
other biochemical who’s elevation localizes alk phos elevation to the liver
5-nucleotidase (commonly done)
most common causes of nephrotic kidney disease
1) primary kidney disease – membranous nephropathy and focal segmental glomerulosclerosis
2) DM
finding almost universally present with peritonsillar abscess
trismus (difficulty opening mouth)
management of occult fracture of scaphoid bone
thumb spica splint
most common SE of varenicline
nausea
circumflex occlusion causes changes in leads
I, AVL, V5, and V6
LAD occlusion causes changes in
V1, V6
RCA occlusion causes changes in
II, III, AVF
muscle strength grading
The inability to contract a muscle is scored as 0. Contraction
without movement constitutes grade 1 strength. Movement with the effect of gravity neutralized is grade
2 strength, while movement against gravity only is grade 3 strength. Movement against gravity plus some
additional resistance indicates grade 4 strength. Normal, or grade 5, strength is demonstrated by movement
against substantial resistance.
features of successful weight loss
low-fat diet rich in complex
carbohydrates, eat breakfast daily, weigh themselves at least once a week, and are physically active for
60–90 minutes a day.
proctalgia fugax
- These consist of episodic, sudden, sharp pains in the anorectal area lasting several seconds to minutes. The diagnosis is based on a history that fits the classic picture in a patient with a normal examination.
hair loss following pregnancy called
telogen effluvium
other osteoporosis RF’s
Asian ethnicity, low body weight
handbone fracture that typically occurs with hyperextension of the wrist
triquetral fractures
med used for most SVT
adenosine
genital warts treatment
chemical treatments are more effective on soft, moist, nonkeratinized genital lesions, while physical ablative treatments are more effective for keratinized lesions
HPV serotypes associated with genital warts
6 AND 12
effect of aspirin on bleeding times and why
single aspirin can effect bleeding time for 5 days because aspirin is the only med that inhibits platelet for entire life of platelet by acetylene cyclooxygenase
management of child 12 years or younger with nasal polyps
CF until proven otherwise
post-thrombotic syndrome (PTS)
- complication of acute DVT
- chronic pain + swelling + skin changes
- 1 in 3 patients with DVT
- significantly reduced with compression stockings
steroids for croup?
single dose of dexamethasone
acute phase proteins secreted by liver
albumin, transferrin
med for PMS during luteal-phase
spironolactone
retinal vein occlusion presentation
- sudden painless loss of vision or distortion of vision
- tortuous and dilated retinal veins
how to reduce risk of exercise-induced hypoglycemia with insulin
non exercised injection site for insulin administration.
diverticulitis presenting as a LLQ mass?
Can happen because can present as an abscess.
other findings in diverticulitis
fever, fatigue, weight loss, diarrhea
drugs causing drug-induced vasculitis
sulfonamides, allopurinol, thiazides, phenytoin, penicillins
skin biopsy in drug-induced vasculitis
eosinophilia
management of mild small-vessel vascultiis
supportive
asthma attack management
1) albuterol
2) if continued –> oral corticosteroids
problem with benadryl in older people
- high association with falls
meds frequently associated with falls in older adults
benzodiazepines, antidepressants, antipsychotics, antiepileptics, anticholinergics, sedative hypnotics, muscle relaxants, and cardiovascular medications
how to reduce risk of contrast-induced nephropathy
1) hydrate with isotonic sodium bicarb infusion or isotonic saline
2) low-osmolar or iso-osmolar contrast media
how to approach PE testing
1) determine pretest probability –> if low then get a d-dimer
