deck 21 Flashcards
HIV presentation
- weight loss, oral thrush, lymphadenopathy, and ulcerative esophagitis
- esophageal disease with advanced infection
nunbullous impetigo treatment
topical mupirocin
treatment of conjunctivitis
- viruses cause 80% (usually adenovirus) so usually requires no treatment.
how to tell conjunctivitis is bacterial
- mattering and adherence of the eyelids
location of fibromyalgia trigger points
medial scapula borders + posterior neck + upper outer quadrants of gluteal muscles + medial fat pads of the knees
alopecia areata etiology
localized autoimmune reaction to hair follicles
alopecia areata course
Spontaneous recovery usually occurs within 6–12 months, although areas of regrowth may be pigmented differently. Recovery is less likely if the condition persists for longer than a year, worsens, or begins before puberty.
alopecia areata treatment
triamcinolone
preferred abx for young adult with CAP who is not sick enough to be hospitalized
azithromycin (mycoplasma coverage)
nicotine replacement + varenicline?
- leads to increase Nausea, HA, dizziness, fatigue
group for which you don’t need to treat HSIL with ablation or excision
- adolescents (HPV infection common and transient in most young women so can be observed)
risk of adenocarcinoma from Barrett’s esophagus
less than 1%
only HA type that is always unilateral
cluster
lateral epicondylitis management
- self-limiting, usually resolves within 12-18 months.
- no benefit from NSAIDS or steroids, it’s degeneration of the tendon, not inflammation
pleurisy treatment
NSAID
pleuritic chest pain workup
CXR + EKG (could be pericarditis)
use of BNP in acute heart failure
Differentiates cardiac and pulmonary disease
hemoptysis can also be due to…
effusions
catch with allopurinol
Used for prophylaxis, Can worsen acute attacks since fluctuating levels of uric acid can actually worsen inflammation
management of DVT during pregnancy
- risk of PE continues in the postpartum period
- continue treatment for 6 weeks after delivery with warfarin or LMWH
only approved DM drugs for kids
metformin and insulin
more effect on reducing HTN – dash diet or smoking?
dash diet
most effective intervention for HTN if obese
weight loss
double effect concept
- relieving suffering when death is unintended but foreseeable consequence
orthostatic proteinuria
- benign condition occurring in young people in which protein excretion is increased in the upright position but normal when patient is supine.
- diagnosed with split urine collections
test most people need for syncope workup
EKG
high risk angina features
- Angina at rest with dynamic ST-segment changes ³1 mm
- Angina with hypotension
- Angina with a new or worsening mitral regurgitation murmur
- Angina with an S3 or new or worsening crackles
- Prolonged (>20 min) anginal pain at rest
- Pulmonary edema most likely related to ischemia
USPSTF recommendation for aspirin in women
- more effective in preventing stroke than MI
- recommended for women 55-79 when benefit of stroke risk reduction outweighs GI hemorrhage
aspirin and stroke prevention evidence for men?
- low dose decreases risk of first MI, but not stroke
management of men with mild BPH
watchful waiting
spinal cord injury as VTE RF?
induces immobility
ottawa ankle rules criteria
Inability to take four steps, either immediately after the injury or when being evaluated; localized tenderness of the navicular bone or the base of the fifth metatarsal; or localized tenderness at the posterior edge or tip of either malleolus.
management of urosepsis with renal failure
1) aggressive IV fluid resuscitation
2) abx
best single angle for empiric treatment of nursing home CAP
levofloxacin (levaquin)
requirements for proxy to decide on life-sustaining therapy
A patient’s condition does not need to be terminal or irreversible to allow the removal of life-sustaining therapy.
So if on ventilator, proxy can tell you to stop it.
supplement that can have negative interaction with aspirin
ginkgo biloba (associated with serious intracereberal bleeding)
NSAIDS and MI
- all oral NSAIDS increase the risk of MI
- EXCEPT for naproxen
causes of secondary osteoporosis in men
Excessive alcohol use, hypogonadism, vitamin D deficiency, and decreased body mass index
management of RBB + left anterior hemiblock
Heart monitoring study
positive result on second but not first of 2 step TST suggests…
long-standing latent TB infection
most common cause of skin and soft-tissue infections among patients presenting to metropolitan
MRSA
nutritional intervention shown to accelerate pressure ulcer healing
adequate protein intake
- increased caloric intake will promote healing
for release of patient info, authorization must be in WRITING except for
(1) coordination of care between providers and those involved in the patient’s case (i.e., caretakers, nurses, consulting physicians); (2) arranging payment for medical services rendered; and (3) health-care operations such as evaluating a provider or system’s competency or quality.
problem with corticosteroids for obstructive lung disease
increased risk for pneumonia
med most commonly known to cause hyperthyroidism
amiodarone
DHEA efficacy as performance enhancer?
doesn’t enhance performance or muscle strength
lab to order for milky discharge from breast
prolactin
patellofemoral stress syndrome (runner’s one)
patella deviates laterally with knee extension
patellofemoral stress syndrome (runner’s one) treatment
PT
postpartum visit testing
screen fro depression
preferred initial test for patient with painless postmenopausal bleeding
1) transvaginal ultrasonography
2) if unavailable, endometrial biopsy
