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dg and rx > dg and rx > Flashcards

dg and rx Flashcards

1
Q

esophageal stuff

A

dg- manometry, esophagogram, barium esophageogram
rx- depends on which one

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2
Q

extra order in infectious stool testing

A

stool PCR

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3
Q

splenic rupture in EBV

A

first vol rescus, then ct abdominal WITH contrast to see what ruptured and where. consult surgery for exploratory lap or splenectomy.

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4
Q

hepatic adenoma

A

ct with contrast! which will show well demarcated and PERIPHERALLY ENHANCED mass. rx- less than 5cm or asympto= stop OCPs. >5cm or symptomatic-resection. high chance of malignancy so serial follow ups and alpha fetoprotein needed.

now, focal nodular will have scarring AND DIFFUSE uniform!!! enhancement

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5
Q

hirschprung

A

abdo usg, air or water enema, then abdomen X-ray to make sure no rupture.

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6
Q

mesenteric ischemia

A

order amylase phosphate ABG. look for metabolic acidosis. dg- ct or mr angiography depending on kidney function.

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7
Q

gastric emptying

A

EGD, upper endoscopy, then nuclear empty

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8
Q

hematochezia

A

if unstable, can be upper bleed so EGD. if stable- colonoscopy

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9
Q

GERD

A

just give PPIs. endoscopy if long time since >5 yrs ds bcz risk of Barrett esophaguse malignancy or also if alarm simps! ph monitor if pPPIs not working.

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10
Q

malabsorption symtoms

A

don’t forget stool osmotic gap. inc in lactulose and celiac

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11
Q

celiac

A

iron, folate, vit d, DEXA scan, give pneumococcal vaccine due to hyposplenism

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12
Q

toxic megacolon

A

abdo xray!!! can also see for rupture. DONT DO COLONOSCOPY! rx- medical management with STEROIDS! if perforation hasn’t occurred. if it has, surgery consult.

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13
Q

pancreatitis

A

acute- lipase amylase. chronic- mrcp or abdo ct. you’ll see hallmark pancreases calcifications and dilated ducts. rx. Pain management- TCA, NO morphine.bcz no opioid use in pancreas stuff. will make it worse! pregablin will work. amytriptylline pancreases enzymes, small meals, no alcohol smoking.

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14
Q

SAH

A

ct no contrast, then LP if nothing found. xanthochromia is PERSISTENTLY or elevating counts of RBCs. if declines- its traumatic tap.. then angiography to find the source of bleeding!

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15
Q

any headache red flags

A

MRI with contrast!!! WITH contrast

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16
Q

transverse myelitis

A

motor weakness, bladder bowel simps, sensory deficit, treat with glucocorticoids.

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17
Q

TIA

A

MRI> ct. more sensitive to detecting small ischemia which causes the transient attacks. then CT or MR angiography to find the source artery. carotid USg. and echo to find embolic source! also give anti platelet therapy! aka aspirin, clopidogrel!

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18
Q

sarcoidosis

A

exclude TB, chest xray, ophtho consult, esr and cry for arthritis, check calcium!, ACE, lyme serology, check for HSM!!- then do biopsy of skin or LN.

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19
Q

frontotemporal dementia

A

clinical but do ct to rule out other shit. rx- behavior mod and SSRI. survival 8-10 years. another extra- can also develop ALS type simps with hypo and hyper reflex

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20
Q

l5 radiculopathy

A

lateral shin and dorsal foot

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21
Q

femoral nerve entrapment symps

A

decreased knee jerk, sensaiton loss over anterior thigh, leg and foot. all medial. quad muscle weakness.

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22
Q

obturator nerve

A

medial inner thigh

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23
Q

lewy body dementia rc

A
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23
Q

lewy body dementia rx

A

melatonin for sleep bcz dec REM cycle. Dopamine cuz parkinsonsim and rivastigmine for alzeihemrs. if pyschotic symps are severe, quietapine (2nd gen) w less s/e.

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24
Q

narcolepsy

A

polysomnography!

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25
Q

narcolepsy

A

modafinil or any stimulants- methylphenidate. but nonpharm is equally impt- sleep hygiene counsel. daytime naps!.

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26
Q

cataplexy rx

A

venlafaxine which is a SNRI, but can also use TCA, SSRIs, and sodium oxybute.

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27
Q

perinauds syndroma

A

loss of upward gaze and ataxia! headache due to obstruction. some tumours can also secrete bhcg!!!! which can cause precocious puberty.

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28
Q

cluster headaches rx

A

ox2 for current but if no response or partial response- sumatriptan. then verapamil or topiramate (anticonvulsants) to prevent.

29
Q

b12 deficiency

A

vibration sense but also corticospinal leading to hyperreflexia and spastic paresis. and ataxia aka romberg sign positive

30
Q

wilsons ds

A

5-35 years of age

31
Q

hemolytic orders

A

ldh, haptoglobin, pblood smear, liver orders, pt, ptt, bilirubin. reticulocyte count, mcv.

32
Q

NPH

A

ct scan head- ventriculomegaly. LP for relief. definite rx- venticuloperitoneal shunting. so all fluid that keeps collecting in head goes to peritoneum to be peed out etc.

33
Q

multiple sclerosis

A

mri brain to see white lesions, csf to see oligoclonal bands.rx- methylprednisone . oral if no eye symps. IV if optic neuritis. then beta interferon or glatiremer interferon for ch maintenence. baclofen for spazzing. gabapentin for neuropathic pain.

34
Q

thiamine

A

give even if suspicion bcz not all 3 symps of wernickes are always present and its a dire problem so give right away! could be live saving! check for korsakoff by doing MRI to see the mammillary bodies.

35
Q

als spared symps

A

sensory, bladder and bowel.

36
Q

stroke didnt get tpa

A

then give aspirin.

37
Q

TIA vs stroke

A

tia symps resolve so just give aspirin and clopidogrel. not tpa.

38
Q

cholestatic cirrhosis orders

A

alp, mitochondirial antibodies, MRCP, C ANCA antibodies,

39
Q

wilsons

A

ceruloplamsmin, urinary cu, genetic test.

40
Q

hematochromotosis

A

ferritin, transferrin, genetic test.

41
Q

hep b rx

A

tenofovir

42
Q

alzeihmers rx

A

rivastigmine, donepezil.

43
Q

parkinsons rx

A

pramipexole, ropinarole, carpidopa, l dopa, amantadine, entacapone.

44
Q

chest pain and SOB orders

A

chest xray, troponins, BNP, echo, d dimer, chest ct, echo

45
Q

cough extra orders

A

pefr, elisa for hiv, tb tests, neck xray, chest xray, PEFR< sputum orders.

46
Q

abdominal pain

A

FAST us, us abdo, tranvag us. abdo xray, abdo ct, barium enema, endoscopy,

47
Q

back pain

A

prostate US, xray spine,

48
Q

stool extras

A

clostridium dif. p anca, sweat test

49
Q

bleeding

A

factor 8 and 9, ristocetin, von willebrands factor, platelet antibody, pt ptt,

50
Q

vaginal extras

A

KOH prep, HPV dna, cervical bx if needed, colposcopy

51
Q

constipation order

A

docusate

52
Q

diarrhea

A

loperamide

53
Q

severe body pain

A

ketorolac

54
Q

chest pain meds

A

aspirin and NG

55
Q

ADMIT orders- ADMITCO nemonic

A

activity, diet, meds, ina and outs (urine), temp bp vitals, compression stockings, OMEPRAZOLE.

56
Q
A
57
Q

COPD orders!!

A

albuterol, ipratropium, levofloxacin, methylprednisone!

58
Q

rhabdo orders

A

urine myoglobin, cpk,

59
Q

iv drug use rx

A

pip tazo, ceftriaxone, vanco.

60
Q

back pain referral

A

physical therapy!

61
Q

meningitis emperic orders

A

dexamethasone, ceftriaxone, vanco, tylenol for fever.

62
Q

suspect overdose orders

A

emergency orders then glucose, thiamine, naloxone, d5. intubate.

63
Q

pill overdose rx

A

urine tox, serum alc, serum salicylate, serum aceta, serum tca, sodium bicarb

64
Q

cholecystitis orders

A

pip tazo for infection, morphine, zofran for nausea.

65
Q

PCP orders

A

bactrim, hospitalize, ldh, infec disease consult!!!

66
Q

HIV order dont forget

A

torch antibodies and then NOTIFY PUBLIC DPT

67
Q

pregnant mom orders

A

pelvis US then transvag US, fetal doppler to see how the baby is doing, 24 hour protein, pt ptt cross rh esp if c section needed.

68
Q

pre eclamspia early esp before 33 weeks

A

betamethasone, mg sulfate, hydralazine, labetalol, COMPLETE BED REST, consult gyne

69
Q

streptococcus orders

A

stretolysin, anca antibodies, c3 c4, anti glomerular antibodies, ANA, cryoglobulin.

70
Q

cystic fibrosis rx

A

iv antibx for strep pneump and psuedomonas, chest physiotherapy, panc enzymes, vitamins.

dg and rx (1 decks)

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