deck 26 Flashcards

1
Q

How to reduce HF admissions

A

good evidence that case management interventions led by a heart failure specialist nurse reduce heart failure readmissions, all-cause readmissions, and all-cause mortality. Case management interventions include home care, telephone calls, patient education, self-management, and face-to-face visits. It is not possible to say which specific interventions were optimal, but telephone follow-up was a common component in most of these trials. Multidisciplinary interventions may also be effective.

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2
Q

management of acute low back pain

A

Nonbenzodiazepine muscle relaxants such as cyclobenzaprine are beneficial for the relief of acute low back pain for the first 7–14 days after the onset of symptoms. Patient education, physical therapy, and the application of ice or heat may also help.

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3
Q

respiratory infection in which antibiotic therapy be initiated immediately upon diagnosis

A

Epiglottitis

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4
Q

intrapartum prophylaxis of GBS in penicillin-allergic patients

A

cefazolin

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5
Q

initial treatment of crohn’s

A

prednisone

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6
Q

when to use TNF agents for Crohn’s

A

Anti-TNF agents such as infliximab should be considered in patients with moderate to severe Crohn’s disease who do not respond to initial corticosteroid or immunosuppressive therapy, but these are not recommended for initial treatment.

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7
Q

how to differentiate grief from depression in terminally ill patients

A

The key clinical feature in distinguishing the two conditions is in the pervasiveness of symptoms in depression, particularly the loss of pleasure or interest in all activities. Episodic feelings of guilt, anxiety, and helplessness, and even thoughts of wanting to die can and do occur with grief reactions, but these feelings are not constant and over time the symptoms gradually wane. Terminally ill patients with major depression feel helplessly hopeless all the time, but they often respond to and significantly benefit from antidepressant medication (SOR A).

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8
Q

NSAIDS and liver disease

A
  • fine for mild liver disease, but should be avoided in all patients with cirrhosis (due to risk of precipitating hepatorenal syndrome)
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9
Q

acetaminophen and liver disease

A

toxic in high doses, but can be used safely in dosages o 2-3 g/day

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10
Q

USPSTF HIV recommendation

A

all adults age 65 years and under be screened for HIV regardless of RFs

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11
Q

next step if ABI’s don’t correlate with clinical evidence of peripheral vascular disease

A

vascular imaging with MR or CT arteriography

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12
Q

high risk exposure areas to asbestos

A

individuals who worked in construction trades or as boilermakers, shipyard workers, or railroad workers, as well as U.S. Navy veterans.

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13
Q

silicosis exposures

A

sandblasters, miners, persons who have worked with abrasives, and several other occupations.

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14
Q

phenazopyridine

A

Chemical which, when excreted into the urine, has a local analgesic effect. It is often used to alleviate the pain, irritation, discomfort, or urgency caused by urinary tract infections, surgery, or injury to the urinary tract.
- Phenazopyridine is prescribed for its local analgesic effects on the urinary tract. It is sometimes used in conjunction with an antibiotic or other anti-infective medication at the beginning of treatment to help provide immediate symptomatic relief.

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15
Q

signs of infection in wounds

A
  • periwound induration, cellulitis extending greater than 2 cm beyond margin, increased temp, pain on palpation, drainage from site,
  • lymphangitis
  • increase in ulcer size
  • odor
  • pain intensity
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16
Q

treatment of ankle sprain

A

Lace-up ankle support

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17
Q

most effective prevention of acute mountain sickness

A
  • slow ascent

- acetazolamide or dexamethasone can also be used for prevention and treatment

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18
Q

signs of end-stage acute mountain sickness

A

ataxia + altered mental status

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19
Q

what to avoid with AMS

A

alcohol consumption

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20
Q

myocardial changes with age

A
  • collagen and mass both increase with age (increase in collagen may play a role in decreasing LV compliance)
21
Q

how to improve EF in systolic HF

A

spironolactone (reduces all cause mortality and improves EF)

22
Q

med contraindicated with systolic HF

A

Verapamil (negative inotrope, associated with worsening HF + increased risk of adverse cardiovascular events)

23
Q

term for gynecomastia in fat people + presentation

A
  • pseudogynecomastia (just due to increased fat deposition secondary to obesity)
24
Q

gynecomastia presentation

A

palpable glandular tissue in nipple/areolar region in a concentric mass.

25
Q

sulfonylurea most likely to cause hypoglycemia

A

glyburide

26
Q

for what condition is extracorporeal shock wave therapy used for for shoulder pain?

A

calcific tendinitis of the rotator cuff

27
Q

pharmacotherapy for BPD?

A

nothing available

28
Q

beta blocker contraindicated in pregnancy

A
  • metoprolol (associated with fetal growth restriction)
29
Q

drug generally used for HTN in pregnancy

A

labetalol

30
Q

most common cause of acute infectious endocarditis

A

staphylococcus aureus

31
Q

treatment of hypoactive sexual desire disorder in women (not interested in sex and it bothers them)

A
  • topical testosterone, in either patch or gel form)
32
Q

treatment for diarrhea-predominant IBS

A

SSRIs or TCAs

33
Q

treatment of jarisch-herxheimer reaction

A

reassurance + antipyretics

34
Q

ADA recommendation on diabetes screening

A

Testing for diabetes mellitus should be considered in all asymptomatic adults who have a BMI ≥25 kg/m2 and have one or more additional risk factors such as physical inactivity, a first degree relative with diabetes, a high-risk ethnicity, hypertension, hyperlipidemia, or polycystic ovary syndrome. In asymptomatic patients with no risk factors, screening should begin at age 45.

35
Q

side effect more likely with aromatase inhibitors than tamoxifen

A

myalgais and noninflammatory arthralgia

36
Q

myelodysplastic syndrome labs

A

Myelodysplastic syndrome is a hematologic malignancy with a predisposition to leukemic transformation. It can present with findings of anemia, thrombocytopenia, neutropenia, or any combination of these. Anemia occurs in 80%–85% of patients and is typically macrocytic.

37
Q

management of hospitalized pt with low-risk peptic ulcer bleeding

A

d/c same day as endoscopy and on oral PPI

38
Q

initial imaging modality to diagnose stress fractures

A

plain radiograph

39
Q

treatment of mallet fracture

A

splint DIP joint in extension for 8 weeks

40
Q

first line therapy for stress and urge urinary incontinence

A

Conservative therapies such as behavioral therapy, including bladder training and lifestyle
modification

41
Q

antidepressant of choice for patient with limited lifespan

A

methylphenidate (ritalin)

42
Q

treatment of bell’s palsy

A

corticosteroids

43
Q

entity legally responsible for notifying patient results of mammogram

A

facility

44
Q

heatstroke vs. heat exhaustion

A

Heatstroke is a much
more severe condition than heat exhaustion. Evidence of central nervous system dysfunction is evidence of heatstroke rather than heat exhaustion, even if other symptoms are not severe and point to heat exhaustion. Heatstroke is a medical emergency.

45
Q

caveat about GERD cough

A

can be otherwise asymptomatic

46
Q

management of cerebellar hemorrhage

A

neurosurgery consult

47
Q

BNP level that rules out HF

A

less than 100

48
Q

treatment of choice for menorrhagia due to endometrial hyperplasia without atypia

A

medical therapy with pro gestational drugs (progestins convert the proliferative endometrium to a secretory one, causing withdrawal bleeding and regression of hyperplasia) - usually with cyclic oral medroxyprogesterone or levonorgestrel IUD

49
Q

treatment of traveler’s diarrhea

A

cipro