deck 28 Flashcards
high risk areas for basal cell recurrence
High-risk locations include the “mask” areas of the face, which include the central face, eyelids, eyebrows, periorbital area, nose, lips (cutaneous and vermilion), chin, mandible, preauricular and postauricular skin/sulci, temple, and ear. Other high-risk sites include the genitalia, hands, and feet. Moderate-risk locations include the cheeks, forehead, scalp, and neck. All other areas, including the trunk and extremities, are low-risk areas.
how to figure out infection in intertrigo not responding to conservative measures
Wood’s light examination, KOH preparation, and exudate culture
how enhance healing in acute anal fissure
-diltiazem, nifedipine, nitroglycerin ointment
drugs that dilate the internal sphincter
best med for treating resistant HTN
- spironolactone
- longer-acting diuretic such as chlorthalidone also recommended, particularly in cases with normal renal function.
differentiating between severity of alcohol withdrawal
Withdrawal can be divided into four levels of severity: minor, major, seizures, and delirium tremens. Minor alcohol withdrawal is characterized by tremor, anxiety, nausea, vomiting, and/or insomnia 6–24 hours after the patient’s last drink. Major withdrawal occurs 10–72 hours after the last drink and can include the signs and symptoms of minor withdrawal, as well as visual and auditory hallucinations, diaphoresis, tachycardia, and elevated blood pressure. Alcoholic seizure generally occurs within 2 days of the last drink and may be the only sign of withdrawal, although approximately one-third of these patients will progress to delirium tremens.
defining clinical feature of delirium tremens
delirium
feature of delirium tremens not commonly seen with other forms of withdrawal
fever
best meds for treatment of HF when standard treatment with diuretics, beta blockers, and an ACE inhibitor are insufficient to control symptoms
hydralazine + isosorbide denigrate (particularly effective in African Americans with Class III or IV HF)
main use of atropine in ACS
sinus bradycardia with hypotension
best initial choice for chronic opioid therapy
Morphine is the best first choice for chronic potent opioid therapy (SOR B). It is reliable and inexpensive,
and equivalent doses can be easily calculated if the patient must later be switched to another medication.
Transdermal fentanyl and hydromorphone are reasonable second-line choices; however, they are not
recommended as first-line therapy because they are expensive and can produce tolerance relatively quickly
(SOR B). Methadone is another second-line option and tolerance is usually less of a problem. It is
inexpensive and long-acting but also has unique pharmacokinetics. It has a very long elimination half-life,
and its morphine-equivalent equianalgesic conversion ratio increases as dosages increase.
therapies for moderate carpal tunnel syndrome with the longest symptom relief
local corticosteroid injections
typical diastolic HF patient
elderly person who has systolic HTN, LVH, and normal EF
only FDA-approved oral treatment for acne rosacea
doxycycline
principles of patient-centered medical home
Comprehensiveness: Most preventive, acute, and chronic care for individual patients can be performed
at the PCMH. Patient Centered: The PCMH provides care that is relationship-based, with an orientation toward the whole
person. Coordination: The PCMH coordinates care for patients across all elements of the health care system. Accessibility: The PCMH works to provide patients with timely access to providers. Quality: The PCMH continuously works to improve care quality and safety.
target uric acid level to prevent gout
5 to 6 mg/dL
management of ICD when patient doesn’t want intense healthcare
- deactivate it (shocks can be painful and distressing to caregivers/family members)
long QT associated with
polymorphic ventricular tachycardia, including torsades de pointes, and sudden cardiac death
treatment of long QT
p-blockers and implanted cardioverter defibrillators
treatment of mild plaque psoriasis
Topical corticosteroids, vitamin D analogs, and tazarotene are
effective treatments for mild psoriasis (SOR A).
med that can be used for IBS
citalopram
highest risk groups for influenza complications
highest risk include children under the age of 2 years, pregnant women (including women less than 2 weeks post partum), adults over the age of 65, the morbidly obese (BMI >40 kg/m2), and Native or Alaskan Americans
