deck 7 Flashcards
common cause of folate deficiency
alcohol abuse
Rule for spacing out Pap smears
if 3 normal in a row, then can space out to every 3 years
Pap smears for vaccinated patients?
no change. not known at this time.
management of persistent stiffness post ankle sprain
Physical therapy
most common melanoma type
superficial spreading
melanoma that grows quickly and invasive is probably
nodular melanoma
most common type of melanoma in AA’s/Asians. Found under finger and toenails
acral lentiginous melanoma
definition of microscopic hematuria
3 or more RBCs/HPF
gross hematuria workup
- can’t assume it’s exercise-induced (although commonly is)
- UA + culture + imaging of upper urinary tract by CT
management of thyroid cancer detected during pregnancy
observe until after pregnancy is complete
TSH/T4/T3 in hyperthyroid state
low TSH, High T4/T3
early decels due to…
fetal head compression
variable decels due to..
cord compression
late decels due to…
uteroplacental insufficiency
most common cause of hypercalcemia in the ambulatory patient…
hyperparathyroidism
primary hyperparathyroidism is mostly caused by…
adenoma (benign tumor) of parathyroid glands
hypercalcemia workup
measure PTH –> 24 hour urinary calcium excretion (differentiates between primary hyperparathyroidism and familial hypocalciuric hypercalcemia)
hypercalcemic patient with suppressed PTH suggests…
malignancy until proven otherwise (suggests that some process is causing calcium to be released from bone or absorbed from the gut despite suppressed PTH. This happens when tumors produce a hormone that mimics the active site of the PTH molecule, particularly in respect to the bone and renal effects, but that have no counter regulatory mechanism for suppression when calcium levels rise).
leading cause of severe vision loss in the lederly
age-related macular degeneration (AMD)
efficacy of CPR
15%
caveat about sputum
color of sputum is not diagnostic of presence of a bacterial infection
most common presentation of acute bronchitis
cough productive of purulent sputum
pneumonia features
- prolonged fever
- signs of consolidation on pulmonary exam
when to investigate pneumonia vs. bronchitis
abnormal vitals + findings suggestive of pulmonary consolidation
inflammation/infection of nasal mucosa
rhinosinusitis
strep throat findings
- abrupt onset of sore throat and fever
- tonsillar and/or palatal petechiae
- tendeer cervical adenopathy
- absence of cough
mono vs. GAS
mono –> retrocervical or generalized adenopathy + HSM
trismus
pain with chewing
rapid strep test vs. throat culture
rapid strep more specific but less sensitive than throat culture
natural course of otitis media
- most cases resolve spontaneously
indications for treatment of otitis media
- prolonged, recurrent, or severe symptoms
frequency and complications of otitis media?
- uncommon
- mastoiditis, bacterial meningitis, brain abscess, subdural empyema
tonsillopharyngeal exudate does not differentiate viral and bacterial pathology
okay
step up therapy for asthma
SABA –> add low-dose ICS –» low-dose ICS + LABA –> medium dose ICS + LABA –> high-dose ICS + LABA AND consider omalizumab for patients who have allergies –> high-dose ICS + LABA + oral corticosteroid
aspirin for primary prevention
…
PPSV indication
1) adults 65 years of age or older
2) smokers
3) adults with serious long-term health problems
