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AANP > Do or Die > Flashcards

Do or Die Flashcards

1
Q

what category are ACEI/ARBs in 2nd & 3rd trimesters?

A

C & D respectively

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2
Q

which abx prolong QT?

A

macrolides -mycin

quinolones -floxacin

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3
Q

what is a major SE of quinolones?

A

tendon rupture

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4
Q

HIV increases risk of what with abx use?

A

sulfa-related Steven’s Johnson syndrome

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5
Q

ASA suppresses platelet function for how long?

A

irreversibly x7 days

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6
Q

ASA should not be used in which patient population?

A

<16 years old (Reye syndrome)

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7
Q

which abx is used to treat MRSA infection?

A

Bactrim

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8
Q

S. aureus infection is treated with which abx?

A

doxycycline

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9
Q

how should you treat severe poison ivy?

A

14-21 days of oral steroids

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10
Q

which abx interfere with warfarin?

A

erythromycin
clarithromycin
sulfa

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11
Q

which vaccines are considered live vaccines?

A 
MMR
Flumist
rotavirus
varicella
zoster
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12
Q

parameters for mammograms?

A

50-74 years old, every 2 years

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13
Q

parameters for pap smear?

A

21-65 years old, every 3 years

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14
Q

parameters for colonoscopy?

A

50-75 years old, every 10 years

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15
Q

parameters for pneumovax?

A

one time at age 65

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16
Q

parameters for Tdap?

A

one time, then Td booster

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17
Q

normal Rinne test (VIII)?

A

AC > BC

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18
Q

otitis external treatment?

A

cortisporin drops

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19
Q

which vitamin is a teratogenic?

A

high-dose vitamin A

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20
Q

major SE of cholesteatoma?

A

erodes bones of the face damaging CN VII; need abx & debridement

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21
Q

pinguicula

A

yellow triangular thickening (outer cornea)

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22
Q

chalazion

A

“bead” in the upper eyelid

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23
Q

pterygium

A

yellow triangular thickening (inner cornea)

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24
Q

foods that have increased levels of vitamin K?

A

mayo
canola
soy bean

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25
Q

what is a common SE of minocycline?

A

vertigo, dizziness

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26
Q

features of mitral regurg (blood regurg in the L atrium)?

A

holosystolic murmur, blowing quality

usually grade II-III

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27
Q

MR s/s?

A 
decreased cardiac output
DOE
CP
orthopnea
syncope
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28
Q

valves of the heart

A

tricuspid- R atrium & R ventricle
pulmonary- R ventricle & pulm artery
mitral valve- L atrium & L ventricle
aortic valve- L ventricle & aorta

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29
Q

blood flow through the heart

A 
SVC
R atrium
R ventricle
pulmonary artery
pulmonary vein
L atrium
L ventricle
aorta
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30
Q

areas of the heart

A 
aortic
pulmonic
Erb's
tricuspid
mitral
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31
Q

common form of HTN target organ damage?

A

LVH

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32
Q

when do you hear an S3 heart sound?

A

systolic dysfunction

HF

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33
Q

when do you hear an S4 heart sound?

A

diastolic dysfunction
poorly-controlled HTN
recurrent MI

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34
Q

immediate intervention is anaphylaxis in primary care?

A 
ABCs
supine position
EMS
IM epi
benadryl, ranitidine
IV access, O2 monitoring
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35
Q

stages of change

A 
precontemplation
contemplation
preparation
action
maintenance/relapse
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36
Q

recommendation for breast ca screening?

A

mammogram annually at age 45 to 54 (then biennially)

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37
Q

recommendation for colorectal screening?

A

colonoscopy every 10 years beginning at age 50

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38
Q

recommendation for lung ca screening?

A

people at high-risk 55-74 annual LDCT

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39
Q

finasteride (PROSCAR, PROPECIA) falls into which category?

A

X

5-alpha reductase inhibitor

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40
Q

what does specificity mean?

A

DO NOT have a disease

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41
Q

what is the most common cause of otitis media?

A

pseudomonas

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42
Q

Rocky Mtn Fever presentation

A

103-105 fever

petechiae (start on hands/feet)

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43
Q

Rocky Mtn Fever treatment

A

doxycycline

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44
Q

Remeron is good for which population and why?

A

elderly

appetite stimulant

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45
Q

what score on the MMSE qualifies for dementia?

A

<24

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46
Q

what does CURB-65 stand for?

A 
confusion
BUN >7
RR >30
SBP <90, DBP <60
age >65
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47
Q

what is Korsakoff-Wernicke?

A

B1 deficiency (chronic)

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48
Q

what is the least sedating antihistamine making it OK for elderly?

A

claritin

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49
Q

which oral antidiabetic is not good for the elderly?

A

glyburide

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50
Q

when should osteoporosis screening begin?

A

age 65

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51
Q

who should receive Flumist?

A

2-49 years ONLY

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52
Q

at what age can you receive the shingles/zoster vaccine?

A

age 60

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53
Q

acute closure glaucoma s/s

A

acute, severe eye pain
HA
n/v

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54
Q

when someone has senile arcus you should…

A

screen for cataracts

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55
Q

gastroparesis is a contrindication for what?

A

Exenatide (Byetta)

Glucagon-Like peptide 1 receptor

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56
Q

PCOS is a risk factor for what?

A

DMII

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57
Q

abnormal lab values in hyperthyroid?

A

decreased TSH, increased free T4

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58
Q

what medication should be avoided in BPH?

A

elavil

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59
Q

what is 1st line treatment for cellulitis?

A

dicloxacillin
PCN allergy- macrolides (Clinda)
? of MRSA- Bactrim

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60
Q

what abx should be used for bites?

A

Augmentin

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61
Q

what is hidradenitis suppurativa?

A

A chronic skin condition featuring lumps in places such as the armpits or groin.

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62
Q

how do you treat hidradenitis suppurativa?

A

Augmentin (S. aureus)

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63
Q

how do you treat impetigo?

A

keflex

macrolides (Clinda)

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64
Q

what is impetigo?

A

highly contagious, causing red sores on the face

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65
Q

what are the s/s of meningitis?

A 
sudden onset sore throat
cough
fever
HA
stiff neck
photophobia
changes in LOC
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66
Q

what is recommended for meningitis prophylaxis?

A

rifampin

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67
Q

how is meningitis treated?

A

IV rifampin and vancomycin

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68
Q

s/s of Lyme disease?

A 
erythema migrans (bulls-eye)
flu-like symptoms
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69
Q

treatment of Lyme disease?

A

doxycycline

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70
Q

what medication is used to treat varicella and shingles?

A

acyclovir

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71
Q

how do you identify tinea infections?

A

KOH slides

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72
Q

how are tinea infections treated?

A

-azoles

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73
Q

what is the identifying symptom in Measles?

A

Koplik spots- white, with red base

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74
Q

mneumonic MOTIVAED

A

mitral, tricuspid- AV valves

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75
Q

mneumonic APPLES

A

aortic, pulmonic- semilunar valves

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76
Q

a split S2 heart sound signifies what?

A

normal when heard on inspiration

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77
Q

MR. ASH

A

systolic murmurs
MR- left, radiates to apex & axilla
AS- right, radiates, noisy

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78
Q

MS. ART

A

diastolic murmurs
MS- apex, “snap”, low-pitch
AR- right, high-pitch, “blowing”

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79
Q

CHADS2

A 
CHF
HTN
age
diabetes
stroke/TIA
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80
Q

why are CCBs used in a-fib?

A

rate control

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81
Q

what does paroxysmal atrial tachycardia look like on an EKG?

A

peaked QRS, P waves

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82
Q

when does paroxysmal atrial tach occur?

A

carotid massage

straining

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83
Q

what is the 1st line antihypertensive in DM?

A

ACE/ARB

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84
Q

when should an ACE/ARB never be used?

A

pregnancy

renal artery stenosis

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85
Q

what is the first line med for HTN in men with BPH?

A

-zosin

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86
Q

when should thiazides not be used?

A

sulfa allergy

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87
Q

what do you see on an exam in a patient with diabetic retinopathy?

A

microaneurysms
cotton wool spots
neovascularization
floating spots in visual field

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88
Q

what defines NYHA class II?

A

ordinary physical activity = DOE, fatigue

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89
Q

aside from HTN, when are CCBs used?

A

Raynauds

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90
Q

what is the first line treatment in COPD?

A

inhaled anticholinergics and/or LABA

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91
Q

what are the inhaled anticholinergics?

A 
Ipratropium bromide (Atrovent®) 
Tiotrpium Bromide (Spiriva®)
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92
Q

what are the LABAs?

A 
Foradil
Serevent
Brovana
Perforomist
(-terol)
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93
Q

what are the SABAs?

A

-buterol

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94
Q

s/s of acute CAP?

A

green-rust colored sputum

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95
Q

how do you treat acute CAP (no comorbidities)?

A

macrolide (Clarithro, Azithro)

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96
Q

how do you treat acute CAP (comorbidities)?

A

levaquin

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97
Q

how do you treat atypical PNA (gradual onset)?

A

macrolides

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98
Q

how do you treat acute bronchitis?

A

symptom management

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99
Q

what are the absolute contraindications for oral contraception?

A 
My- migraine with aura
C- CAD/CVA
U- undiagnosed bleeding
P- pregnant
L- liver
E- estrogen-dependent tumor
T- thrombus
S- smoker >35
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100
Q

s/s of acute pancreatitis?

A

+Cullen
+Gray-Turner
epigastric pain that radiates to back

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101
Q

s/s of acute diverticulitis?

A

LLQ pain
rebound pain
+Rovsings

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102
Q

s/s of acute appendicitis?

A

RLQ pain
+psoas
+obturator
+McBurney’s

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103
Q

s/s of acute cholecystitis?

A

RUQ pain
pain radiates to R shoulder
+Murphy’s

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104
Q

how do you treat an H. pylori infection?

A

clarithromycin
amoxicillin
PPI

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105
Q

how do you treat diverticulitis?

A

cipro with Flagyl

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106
Q

treatment for C. diff?

A

Flagyl

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107
Q

what does it mean when you are HBsAg +?

A

+ virus, infections

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108
Q

what does it mean when you are anti-HBS +

A

immune

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109
Q

what does lone GGT elevation mean?

A

alcoholism

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110
Q

what is a contraindication to using fluoroquinolones?

A

<18 years old

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111
Q

what do you use to treat UTIs?

A

Bactrim

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112
Q

what signifies a UTI (on lab test)?

A

> 10,000 of ONE organism

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113
Q

how do you treat acute pyelonephritis?

A

recephin

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114
Q

what tests are used to test for meningitis?

A

Kernig (flexion hip & knee)

Brudzinski (flexion of neck)

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115
Q

cranial nerves

A 
olfactory
optic
occulomotor
trochlear
trigeminal
abducens
facial
acoustic
glossopharyngeal
vagus
spinal
hypoglossal
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116
Q

tensions HA is?

A

bilateral

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117
Q

s/s of cluster HA?

A

tearing

nasal congestion

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118
Q

treatment of cluster HA

A

high-dose oxygen

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119
Q

when are MCHC and MCH decreased?

A

iron-deficiency anemia

thalassemia

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120
Q

when is TIBC increased?

A

iron-deficiency anemia

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121
Q

when is ferritin decreased?

A

iron-deficiency anemia

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122
Q

when do you see a normocytic anemia?

A

chronic illness

autoimmune d/o

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123
Q

what do pernicious, folate and B12 anemias have in common?

A

megoblastic RBCs

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124
Q

blepharitis is most common in?

A

fair-skinned people

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3
4
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125
Q

which diagnostic test finds ca ONLY and not polyps?

A

fecal immunochemical test

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126
Q

what does stridor sound like?

A

high-pitched

harsh on inspiration

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127
Q

what is not elevated in pancreatic ca?

A

amylase

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128
Q

what is tinea cruris?

A

jock itch

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129
Q

how do you treat duodenal ulcers?

A

antimicrobial therapy

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130
Q

what vital signs represent shock?

A

HR >100, BP <80, RR >24

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131
Q

Osler nodes and Janeway lesions are indicative of what?

A

bacterial endocarditis

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132
Q

what is vasogenic shock

A

anaphylaxis

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133
Q

how do you treat osteamalacia?

A

calcium & vitamin D

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134
Q

what is the first-line diagnostic testing in ED?

A

serum glucose
TSH
lipid panel

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135
Q

how do you identify nephrotic syndrome?

A

proteinuria
hypoalbuminemia
increased glomerular permeability
edema

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136
Q

how do you treat pernicious anemia?

A

B12 for life

137
Q

what is Fifth’s disease?

A

erythematous, macular rash on the cheeks & ears

“slapped cheek”

138
Q

what is autoimmune thyroiditis?

A

when the body sees the thyroid gland and hormones (TSH, T3, T4) as a threat

139
Q

iron absorption decreases with?

A

antacids
H2
fluoroquinolones

140
Q

S1 heart sound indicates what?

A

mitral stenosis

141
Q

nitroglycerin can have what SE?

A

headaches

142
Q

what are the low-potency topical corticosteroids?

A

hydrocortisone 2.5%
flucinolone 0.01%
triamcinolone 0.025%
desonide (Desowen)

143
Q

what is a normal T4 in the elderly?

A

8.1

144
Q

what do you see on eye exam wth hypertensive retinopathy?

A

AV nicking

copper & silver wire arterioles

145
Q

how frequently should you test for DMII after age 45?

A

every 3 years

146
Q

what is Korsakoff’s syndrome?

A

chronic thiamine deficiency

147
Q

s/s of pulmonary embolus?

A 
SOB
friction rub
tachycardia
tachypnea
pleuritic chest pain
chest discomfort
148
Q

what does increased ICP look like on exam?

A

optic disc swollen with blurred edges

149
Q

who is high risk for prostate ca?

A

African American- begin to screen at age 40

150
Q

when should you begin screening for prostate ca?

A

50 yo

151
Q

what are the risk factors for endocarditis?

A

h/o
cardiomyopathy
bicuspid aortic valve

152
Q

BRATY diet

A

bananas, rice, applesauce, toast, yogurt

153
Q

what is a hordeolum?

A

stye

154
Q

when do you see respiratory alkalosis?

A

pulmonary embolus

155
Q

when do you see respiratory acidosis?

A

obstructive lung disease
sleep apnea
Guillain Barre syndrome

156
Q

what can cause gouty arthritis?

A 
thiazides
ASA
niacin
cyclosporine
alcohol
157
Q

how do you treat an HPV lesion?

A

trichloracetic acid

158
Q

how do you treat AOM in PCN allergic?

A

clarithromycin

159
Q

Katz Index

A

0-6, lower the score the higher the function

160
Q

what causes a gastric ulcer

A

NSAIDs

steroids

161
Q

which type of ulcers have a higher risk of malignancy?

A

gastric

162
Q

how do you treat uncomplicated PNA?

A

macrolides

doxycycline

163
Q

s/s of angle-closure glaucoma?

A

rapid onset
eye pain
blurred vision
halos

164
Q

what increases susceptibility of gastroenteritis?

A

increased age
poor physical
gastric surgery

165
Q

open-angle glaucoma?

A

increased cup to disc ratio

166
Q

how do you diagnose meningitis?

A

CSF culture

blood, throat cultures

167
Q

what puts someone at an increased risk for UTI?

A

low lactobacilli colonization

168
Q

s/s of TB?

A

fever
dry cough
malaise

169
Q

what is pseudogout?

A

calcium pyrophosphate deposition

170
Q

what is the first line treatment for AOM?

A

amoxicillin

171
Q

causes of chronic blood loss?

A

erosive gastritis
menorrhagia
GI malignancy

172
Q

causes of reduced RBC production?

A

nutritional deficit
anemia of chronic disease
bone marrow suppression
reduced erythropoietin production (chronic renal failure)

173
Q

what medications can cause reduced RBC production?

A

chronic PPI use

metformin

174
Q

microcytic

A

MCV <80

175
Q

normocytic

A

MCV 80-96

176
Q

macrocytic

A

MCV >96

177
Q

normochromic

A

MCHC 31-37

178
Q

hypochromic

A

MCHC <31

179
Q

Normal RDW

A

11.5-15%

180
Q

normocytic, normochromic with normal RDW is etiology of?

A

acute blood loss

ACD

181
Q

microcytic, hypochromic with elevated RDW is etiology of?

A

IDA

182
Q

what test confirms IDA?

A

Ferritin

183
Q

microcytic, hypochromic with normal RDW is etiology of?

A

alpha or beta thalassemia

184
Q

who is at risk for alpha thalassemia?

A

asian, african

185
Q

who is at risk for beta thalassemia?

A

african
mediterranean
middle eastern

186
Q

macrocytic, normochromic with elevated RDW is etiology for?

A

pernicious anemia
B12 deficiency
folate deficiency

187
Q

normal hgb?

A

12-14

188
Q

normal hct?

A

36-43

189
Q

iron supplements should be taken…

A

on an empty stomach

190
Q

what is the most common type of anemia in childhood, pregnancy, elderly and in women during reproductive years?

A

IDA

191
Q

acute rhinosinusitis (ARS) is caused by?

A

allergens, environmental irritants or infection

can last up to 4 weeks

192
Q

acute bacterial rhinosinusitis (ABRS) is caused by?

A

secondary infection following viral URI

193
Q

first-line treatment for ABRS?

A

augmentin

doxycycline in PCN allergy

194
Q

in conductive hearing loss, the Weber test lateralizes to….

A

affected ear

195
Q

how do you treat sensorineural hearing loss?

A

hearing aids or implants

196
Q

in conductive hearing loss, the Rinne test….

A

BC >AC

197
Q

s/s of allergic rhinitis (AR)?

A

nasal congestion
rhinorrhea
sneezing
intraocular and/or nasal itching

198
Q

what is the controller therapy for AR?

A 
intranasal corticosteroids (Flonase, Nasacort)
LTM (Singulair) as an add-on if not adequately controlled
199
Q

what is the reliever therapy in AR?

A

2nd gen oral antihistamines (loratadine, cetirizine)

200
Q

when should a patient be referred to opthamology?

A

eye triad: red, painful eyes with new-onset vision changes

201
Q

what is macular degeneration?

A

central vision loss

202
Q

open-angle glaucoma is identified as?

A

peripheral vision loss

203
Q

what test is used for early detection of macular degeneration?

A

Amsler grid

204
Q

what is presbyopia?

A

hardening of the lens resulting in close vision problems

205
Q

what is anosmia?

A

diminished sense of smell

206
Q

what is presbycusis?

A

difficulty with conversation in a noisy place

207
Q

suppurative conjunctivitis treatment?

A

cipro-, levo-, moxi

208
Q

otitis externa treatment?

A

mild: acetic acid with propylene glycol and hydrocortisone
moderate: drops with cipro and hydrocortisone

209
Q

malignant otitis externa treatment

A

PO cipro

210
Q

exudative pharyngitis treatment?

A

pCN V

211
Q

what does actinic keratosis look like?

A

red or brown, scaly, often tender

212
Q

how do you treat actinic keratosis?

A

5-fluorouracil
5% imiquimod
topical diclofenac

213
Q

which type of skin carcinoma is most common?

A

basal cell

214
Q

which type of skin carcinoma is more likely malignant?

A

squamous cell

215
Q

how is scabies treated?

A

permethrim lotion

216
Q

what are mid to higher potency corticosteroids used in contact dermatitis therapy?

A

triamcinolone 0.1%

clobestasol 0.05%

217
Q

when >20% of BSA is affected with contact dermatitis, how should it be treated?

A

prednisone PO

218
Q

s/s of brown recluse spider bite?

A

red, white and blue

219
Q

treatment for MSSA?

A

dicloxacillin

cephalexin

220
Q

what is the topical treatment for impetigo?

A

mupirocin

221
Q

what is the treatment for nonpurulent cellulitis, erysipelas, and impetigo?

A

PCN VK
Keflex
dicloxacillin
clinda

222
Q

what are the characteristics of first degree burns?

A

superficial
red, painful, dry
no blisters

223
Q

what are the characteristics of second degree burns?

A

superficial partial thickness or deep partial thickness
red, blistered
swollen, painful (maybe)

224
Q

what are the characteristics of third degree burns?

A

full thickness

white or charred

225
Q

rule of 9s

A

1%: genitalia, palmar aspect of hand
9%: head & neck, upper limbs,
18%: lower limbs
36%: trunk

226
Q

treatment of 2nd degree burns?

A

bacitracin
silvadene
bactroban

227
Q

s/s of hypothyroidism?

A 
thick, dry skin
hyporeflexia
thoughts too slow
weight gain
constipation
menorrhagia
easily chilled
228
Q

s/s of hyperthyroidism?

A 
smooth, silky skin
hyperreflexia
mind racing
weight loss
frequent, low volume, loose stool
oligomenorrhea
heat intolerance
229
Q

common causes for hypothyroidism?

A

hashimotos
RAI treatment
lithium, amiodarone, interferon

230
Q

lab values with hypothyroidism?

A

increased TSH

decreased T3 & T4

231
Q

when should TSH be checked after starting levothyroxine?

A

8 weeks of therapeutic therapy

232
Q

how should levothyroxine be taken?

A

with water on an empty stomach
same time every day
do not take within two hours of iron, calcium, aluminum, magnesium

233
Q

at what point should hypothyroid be treated?

A

TSH >5

234
Q

what is the treatment for hyperthyroid?

A

beta-blocker (tremor & tachycardia)
PTU
RAI

235
Q

what is the role of parathyroid hormone?

A

appropriate body calcium levels

236
Q

clinical presentation for primary hyperparathyroidism?

A

moans, groans, stones and bones… with psychic overtones

237
Q

a thunderclap HA is suggestive of what?

A

subarachnoid hemorrhage

238
Q

what are the abortive medications used in migraine HA treatment?

A

triptans

ergots

239
Q

what are the prophylactic medications used in migraine treatment?

A

beta blockers
tricyclic antidepressants (-triptyline)
depakote, topiramate, sodium valproate
butterbur, feverfew, CoQ10, riboflavin

240
Q

which medication is used in the treatment of cluster HAs?

A

lithium

241
Q

which lab tests are used when there is suspected temporal arteritis?

A

CRP

ESR

242
Q

treatment for temporal arteritis?

A

high-dose systemic steroids (6 months-2 years) until biopsy

243
Q

what can be taken to help reduce the risk of developing cataracts?

A

antioxidants (E & C)

244
Q

what would you expect to see on CSF eval of someone with bacterial meningitis?

A

WBC median count of 1200 cells/mm3 of CSF with 90 – 95% neutrophil
reduced CSF glucose amount below the normal level of about 40% of the plasma level
an elevated CSF protein level

245
Q

what EKG findings are associated with digoxin toxicity?

A

AV heart block

246
Q

what are the triad of responses known as Cushings response seen in neurologic deterioration?

A

widened pulse pressure
bradycardia
irregular respiratory pattern

247
Q

most cost-effective method of diagnosing H. pylori infection is?

A

stool antigen testing

248
Q

how do you establish the diagnosis of GERD?

A

s/s of heartburn & regurg

DO NOT perform endoscopy, barium, H. pylori

249
Q

when is an endoscopy warranted?

A 
dysphagia
odynophagia (painful swallowing)
unintended weight loss
hematemesis
melena 
chest pain
choking
250
Q

what is recommended treatment for the presumptive diagnosis of GERD?

A

PPI

once/day, before the first meal

251
Q

other than pharmacologic, what are recommendations in GERD treatment?

A

head of bed elevation
avoidance of meals 2-3 hours before bed
weight loss
avoiding food that can trigger reflux (chocolate, caffeine, alcohol, acidic foods)

252
Q

in which disease processes to you expect to see leukocytosis?

A

appendicitis
pyelonephritis
bacterial pneumonia

253
Q

s/s of duodenal ulcer?

A 
intermittent upper abd pain
epigastric burning, gnawing pain
relief with foods, antacids
tender at the epigastrium
slightly hyperactive bowel sounds
254
Q

s/s of erosive gastritis?

A

NSAID use
intermittent nausea, burning pain limited to upper abd
worse with eating
hyperactive bowel sounds

255
Q

s/s of diverticulitis?

A

intermittent LLQ pain
fever, cramping, nausea
4-5 loose stools/day
negative Blumberg’s

256
Q

what are acute disease markers of hep A infection?

A

HAV IgM

elevated hepatic enzymes

257
Q

what are the acute disease markers for hep B?

A 
HBV core IgM ab (earliest to become positive)
HBsAg (always growing)
HBeAg (extra contagious)
elevated hepatic enzymes
IgM anti-HBc +
258
Q

what are the chronic disease markers for hep B?

A

HBsAb (Bye)

259
Q

what markers indicate that you are still susceptible to hep B?

A

HBsAg negative
anti-HBc negative
HBsAb negative

260
Q

what are the acute markers for hep C?

A

anti-HCV +
HCV viral RNA
elevated hepatic enzymes

261
Q

what are the chronic markers for hep C?

A

anti-HCV present
HCV viral RNA
normal to slightly elevated hepatic enzymes

262
Q

what indicates that hep C was present in the past?

A

HCV RNA absent

anti-HCV present

263
Q

what are symptoms of acute hepatitis infections?

A 
fever
fatigue
loss of appetite
n/v
abdominal pain
gray-colored BM
joint pain
jaundice
264
Q

what are the preferred antimicrobials in s. pneumoniae CAP?

A

doxycycline
azithro-, clarithro-, erythro
standard dose amox

265
Q

what are the preferred antimicrobials in s. pneumoniae CAP with risk for DRSP?

A

HD amox

moxi-, levo-, gemi-

266
Q

what are the preferred antimicrobials in h. influenzae CAP?

A 
cephalosporins
augmentin
macrolides
respiratory fluoroquinolones
doxycycline
267
Q

in which population is h. influenzae common?

A

tobacco-related lung disease

268
Q

what are PE findings with consolidation in PNA?

A

dullness
increased tactile fremitus
bronchial or tubular breath sounds
late inspiratory crackles

269
Q

what are PE findings with pleural inflammation (pleurisy) in PNA?

A

sharp, localized pain, worse with deep breathing/movement/cough
audible pleural friction rub (inspiration & expiration)

270
Q

treatment of acute bronchitis d/t respiratory tract virus?

A

Atrovent
albuterol
short course of oral steroid

271
Q

treatment of acute bronchitis d/t bacterial pathogens?

A

macrolide

doxycycline

272
Q

clinical presentation of active TB?

A 
cough
unexplained weight loss/anorexia
fever
night sweats
hemoptysis
chest pain
fatigue
273
Q

what diagnostic tool is used to make the diagnosis of asthma and COPD?

A

spirometry

274
Q

what diagnostic tool is used for monitoring asthma?

A

peak flow meter

275
Q

what would you expect to find of PE during acute asthma or COPD flare?

A 
hyperresonance
decreased tactile fremitus
wheeze (expiratory first, then inspiratory)
low diaphragms
increased AP diameter
276
Q

what are the most common COPD symptoms?

A

chronic cough
chronic sputum
activity intolerance
progressive over time

277
Q

in GOLD 1, mild COPD, what is the expected FEV1?

A

> 80%

278
Q

in GOLD 2, moderate COPD, what is the expected FEV1?

A

50%-80%

279
Q

in GOLD 3, severe COPD, what is the expected FEV1?

A

30-50%

280
Q

in GOLD 4, very severe COPD, what is the expected FEV1?

A

<30%

281
Q

treatment recommendations for GOLD 1-2?

A

low risk/less symptoms: SAMA or SABA PRN

low risk/more symptoms: LAMA or LABA on set schedule

282
Q

treatment recommendations for GOLD 3-4?

A

high risk/less symptoms: ICS + LABA (or LAMA) on set schedule
high risk/more symptoms: ICS + LABA (or LAMA) on set schedule

283
Q

in addition to bronchodilator use, what would be used in COPD exacerbation?

A

prednisone 40 mg/d 5-10 days

consider adding ICS

284
Q

in absence of risk factors, when should screening for DM occur?

A

age 45 (repeated at least at 3 year intervals)

285
Q

which lab values are indicative of DM?

A

fasting plasma glucose >126
random >200 with symptoms (pols)
2 hr OGTT >200
A1c >6.5%

286
Q

what is a normal A1c?

A

<5.6

287
Q

what is a normal fasting plasma glucose?

A

<100

288
Q

what is a normal peak postprandial (1-2 hr post meal) plasma glucose?

A

<140

289
Q

thiazolidinediones (Actos, Avandia) should not be used in which patient population?

A

HF- edema risk

should not be used with insulin or nitrates

290
Q

which medications are the sulfonylureas?

A

glipizide
glyburide
glimepiride

291
Q

GLP-1 agonists (Byetta, Victoza) should not be used in which patients?

A

gastroparesis

severe renal impairment or ESRD

292
Q

what are the short-acting, rapid-acting insulins?

A

Humalog

Novolog

293
Q

what are the regular insulins?

A

Humulin R

Novolin R

294
Q

what are the long-acting insulins?

A

Levelmir

Lantus

295
Q

what are the intermediate-acting insulins?

A

Novolin N

Humulin N

296
Q

what are the components of metabolic syndrome?

A 
large waistline
HLD
low HDL
HTN
high glucose
297
Q

what is the BP goal in patient with DM and/or CKD?

A

<140/<90

298
Q

BP goal in patients >60 with no DM or CKD?

A

<150/<90

299
Q

what labs should be monitored with diuretic use?

A

Na
K
Mg

300
Q

when is aldosterone most often use?

A

HF

301
Q

what are the effects of statin therapy?

A

decrease LDL 18-55%

increase HDL 5-15%

302
Q

what is the most frequent cause of HF?

A

systolic LV dysfunction

303
Q

PE findings in genital herpes (HHV-2)?

A

painful ulcerated lesions

lymphadenopathy

304
Q

PE findings in chlamydia?

A

irritative voiding symptoms
mucopurulent discharge
large number of WBCs
cervicitis common

305
Q

treatment of chlamydia?

A

azithro

306
Q

PE findings in gonorrhoeae?

A

purulent discharge
irritative voiding symptoms
large number of WBCs

307
Q

treatment of gonorrhoeae?

A

ceftriaxone one-time dose + azithro one-time dose

308
Q

PE findings in trichomoniasis?

A 
dysuria
itching
vulvovagnial irritation
frothy, cervical petechial hemorrhages
alkaline pH
large number of WBCs
309
Q

treatment of trichomoniasis?

A

Flagyl one-time dose

310
Q

PE findings in syphilis?

A

chancre, firm, round, painless genital and/or anal ulcers with clean base and indurated margins

311
Q

PE findings in genital warts (HPV)?

A

verruca-form lesions

312
Q

treatment of genital warts?

A 
podofilox
liquid nitrogen
cryoprobe
trichloroacetic acid
topical imiquimod (external only)
313
Q

PE findings in PID?

A 
irritative voiding symptoms
fever
abdominal pain
CMT
vaginal discharge
increased risk of ectopic pregnancy and/or infertility
314
Q

treatment of PID?

A

ceftriaxone one-time dose + doxycycline x14 days with out without Flagyl

315
Q

treatment of acute, uncomplicated UTI in nonpregnant woman?

A

Bactrim

316
Q

acute bacterial prostatitis PE findings?

A 
irritative voiding symptoms
suprapubic, perineal pain
fever
tender, boggy prostate
leukocytosis
317
Q

treatment of acute bacterial prostatitis in <35 yo?

A

ceftriaxone one-time dose + doxycycline x10 days

318
Q

PE findings in prostate ca?

A

nodular, firm, nontender prostate

319
Q

treatment for urge incontinence?

A 
detrol
ditropan
VESIcare
enablex
toviaz
320
Q

paraphimosis

A

retracted foreskin that cannot be brought forward to cover the glans

321
Q

varicocele

A

“bag of worms”

322
Q

hydrocele

A

collection of serous fluid that causes painless scrotal swelling, easily recognized by transillumiation

323
Q

phimosis

A

foreskin cannot be pulled back to expose the glans

324
Q

cryptorchidism

A

testicle located in inguinal canal or abdomen

325
Q

opportunistic conditions for which there is no effective therapy?

A

cryptosporidiosis
microsporidiosis
progressive multifocal leukoencephalopathy

326
Q

testing for HIV

A

ELISA

then Western blot to confirm

327
Q

SIGECAPS (depression)

A 
sleep
interest
guilt
energy
concentration
appetite
psychomotor
suicide
328
Q

WATCHERS (GAD)

A 
worry
anxiety
tension in muscles
concentration difficulty
hyperarousal
energy loss
restlessness
sleep disturbance
329
Q

SSRIs (most to least energizing)

A 
fluoxentine
sertraline
citalopram
escitalopram
paroxetine
330
Q

SNRIs

A

venlafaxine
duloxetine
desvenlafaxine

331
Q

SDRI

A

Wellbutrin

332
Q

which SSRi has the longest half life?

A

fluoxetine (84 hours)

333
Q

FINISH (antidepressant discont. syndrome)

A 
flu-like symptoms
insomnia
nausea
imbalance
sensory disturbances
hyperarousal
334
Q

medications used to slow AD?

A

vitamin E 1000

or selegiline

335
Q

mild to moderate stage treatment of AD?

A

donepezil
rivastigmine
galantamine

336
Q

moderate to severe AD treatment?

A

Namenda

337
Q

treatment of agitation in AD?

A

risperidone (if environmental manipulation fails)

338
Q

medications with significant anticholinergic effect?

A

amitriptyline
doxepin
oxybutynin

339
Q

mneumonic for anticholinergic effects

A 
dry as a bone
red as a beat
mad as a hatter
hot as a hare
can't see
can't pee
can't spit
can't shit

AANP (1 decks)

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