deck 6 Flashcards
tylenol, NSAID?
NO
tylenol generic name
acetaminophen
ibuprofen is…
advil
motrin is…
ibuprofen
dyslipidemia algorithm
- if LDL-C not achieved or statin not tolerated –> don’t add nonstatin lipid-lowering drug.
- whether to treat with statin really depends on estimating patient’s underlying CVD risk rather than lipid levels.
rales are also called
crackles
rhonchi is another term for…
wheezing
description for lung findings
no wheezing, rales, rhonchi.
rhonchi sound
rattling, signifies pathology in bronchi
gastroparesis presentation
erratic glucose control + nonspecific GI complaints
BP and cholesterol goals for diabetic patients
- BP less than 140/90
- ## moderate intensity statin therapy or high-intensity statin therapy if 10-year cardiovascular risk is greater than 7.5%
aspirin indications for diabetic patients
MI history, stroke or TIA, PAD, claudication, or angina
recommendation for HbA1c measurements
q6 months
other labs to order in diabetics annually
- lipid panel
- spot urine test for albuminuria
- annual foot exam
- annual funduscopis exam
how to differentiate dysuria from STD vs. UTI
abrupt onset –> UTI
- probability of UTI increases significantly if no discharge or irritation.
gradual –> STD
order a UA for healthy woman wit acute cystitis?
order a culture only if complicating factors (unclear ddx, pregnant, med intolerance, underlying complication)
factor that should make you reconsider UTI ddx
absent pyuria
treatment for uncomplicated cystitis/UTI
empiric bacterium x 3 days
low back pain management
conservative management with
1) return to normal activities, exercise
2) weight control
3) acetaminophen or NSAID
drugs to avoid with low back pain management
muscle relaxants and opioids (CNS SE’s and addiction potential)
radiculopathy management
anticonvulsants (gabapentin)
CAGE questionnaire
Have you ever felt you needed to Cut down on your drinking?
Have people Annoyed you by criticized your drinking?
Have you ever felt Guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?
interpreting CAGE questionnaire
1-2 mean should investigated further
depression screen
“Over the past 2 weeks, have you felt down, depressed, or hopeless?”
“Over the past 2 weeks, have you felt little interest or pleasure in doing things?”
most effective treatment for insomnia
CBT
treatment for depression + pain syndrome
SNRI
headache algorithm
red flags? –> no then are criteria for episodic migraine met? Yes, manage as migraine, No. Rest on page 313.
headache red flags
- focal neuro deficits
- papilledema
- fever
- nick stiffness, meningeal signs
- TTP or diminished pulse over temporal artery
- diastolic greater than 120
- decreased visual acuity
- new onset after age 50
- worst headache o life
- progression or fundamental change in headache pattern
- triggered by exertion, sexual activity, or valsalva maneuver
migraine mnemonic
Pulsatile quality, One day duration (can last up to 3 days), Unilateral in location, N/V, Disabling intensity
- 3 or more is 90% predictive of migraine
migraine treatment
mild –> NSAID or acetaminophen
severe –> triptan
triptan contraindications
1) ischemic vascular disease
2) uncontrolled HTN
what to tell people about HA meds
don’t take more than 2-3 days per week to avoid medication-overuse (rebound) HA’s
5 R’s to motivate patients unwilling to quit smoking
1) Encourage patient to think of Relevance of quitting smoking to their lives.
2) Assisst patient in identifying the Risks of smoking
3) Assist the patient in identifying the Rewards of smoking cessation
4) Discuss with patient Roadblocks or barriers to attempting cessation
5) Repeat the motivational intervention at all visits
