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NURP 423 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

First line treatment for hyperthyroidism

A

Radioactive iodine (recommended for patients > 40)

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2
Q

Second line treatment for hyperthyroidism

A

Antithyroid Drugs (PTU & methimazole)

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3
Q

Third line treatment for hyperthyroidism

A

Surgery

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4
Q

First line treatment for hypothyroidism

A

Only treatment is replacement of thyroid hormone – levothyroxine (Synthroid)

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5
Q

Lab values for hyperthyroidism

A

TSH - decreased

Free T4 - increased

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6
Q

Lab values for hypothyroidism

A

TSH - increased

Free T4 - decreased

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7
Q

Treatment for hyperthyroidism in pregnancy

A

Radioactive iodine contraindicated and in lactation.

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8
Q

What is the blood test to check vitamin D level?

A

25-hydroxyvitamin D (25OHD)

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9
Q

What level indicates vitamin D deficiency?

A

< 30

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10
Q

What level indicates vitamin D toxicity?

A

< 150

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11
Q

Signs of vitamin D toxicity

A

anorexia, weight loss, polyuria, arrhythmias, increased calcium level

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12
Q

People at risk for inadequate vitamin D absoprtion

A

gastric bypass, IBD, liver disease, cystic fibrosis, celiac, Crohn’s, ulcerative colitis

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13
Q

What do you need to monitor when treating a hyperthyroid patient with PTU?

A

Monitor CBC during first 3 months of therapy to avoid fatal agranulocytosis

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14
Q

What S&S should a patient taking PTU report?

A

Sore throat and fever

Obtain CBC and stop drug if WBC is low

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15
Q

Treatment for hypothryoidism

A

Synthroid

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16
Q

What does the parathyroid do?

A

Regulates calcium and phosphate metabolism

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17
Q

What causes pernicious anemia?

A

Vitamin B12 deficiency due to lack of intrinsic factor

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18
Q

Treatment of pernicious anemia

A

Vitamin B12 (cyanocobalamin) IM

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19
Q

What condition increases the risk of pernicious anemia?

A

Gastric bypass surgery

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20
Q

What do you check and when after start of treatment for iron deficiency anemia

A

CBC, HGB, HCT

2 weeks after start of therapy

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21
Q

VTE prophylaxis in pregnancy

A

LMWH

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22
Q

Lab test to monitor Heparin

A

PTT

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23
Q

Lab to monitor coumadin

A

PT

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24
Q

What thrombolytic agent would you use for someone with renal failure?

A

Coumadin

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25
Antidote for heparin
Protamine sulfate
26
What is OLDCART
``` Onset Location Duration Characteristics Aggravating factors Alleviating factors Treatment ```
27
Two biggest side effects from narcotics
Respiratory depression & constipation
28
Treatment of choice for neuropathic pain?
gabapentin/neurontin
29
What vital sign should you monitor with use of narcotics
Respiratory rate & BP
30
What is the use for marijuana?
Nausea and vomiting in patients receiving chemo
31
Which form of marijuana has no CNS side effects?
CBD
32
What is safest pain reliever?
Tylenol (but it is not an anti-inflammatory)
33
What is a burst of steroids?
Steroid use for 5 days (greater than that, taper off)
34
First line tx for RA
Methotrexate and folic acid
35
What are drug/drug interactions for NSAIDs and what would you monitor?
ACE/ARB | Monitor for bleeding, GI, decreased kidney fx -- GI bleed and renal failure
36
What effects do steroids have on bone health?
Can cause osteoporosis | Give calcium & vit d
37
Teaching for biophosphates?
Take medicine while sitting up and drink a full glass of water
38
First line treatment of OA
Tylenol
39
MOA of tylenol
Inhibits COX which results in decreased prostaglandin synthesis
40
Recommended dose of tylenol
4 grams/day | Chronic alcohol 1800-2000 mg/day
41
When is celebrex contraindicated?
allergy to sulfonamides
42
When is tramadol contraindicated?
Hx of seizures -- lowers seizure threshold
43
How should you stop tramadol?
Taper medication dose d/t potential to induce serotonin syndrome
44
MOA of capsaicin
depletion of substance P
45
When is maximum effect seen with capsaicin
2-4 weeks
46
When are intra-articular steroids useful?
When an effusion is present and there are clear signs of local inflammation
47
What is safest for OA patients with renal failure?
Capsaicin (no absolute contraindications with this med)
48
Most common AE of corticosteroids?
cataracts, glaucoma, glucose intolerance, osteoporosis (effect calcium absorption)
49
Contraindications to methotrexate
Pregnancy, breastfeeding, leukopenia
50
Labs to be monitored during methotrexate therapy
CBC q4weeks | BUN, creatinine, LFTs q3 months
51
TNFI (tumor necrosis factor inhibitors)
End in -mab
52
When is golimumab (Simponi) indicated?
Only in combination with methotrexate
53
When will patient see response to TNFI?
Within days to weeks
54
What test should you do before started TNFI?
tuberculin skin test or interferon gamma release assay
55
Labs to monitor with TNFI
CBC and LFTs
56
With what medication should you avoid live vaccines
TNFIs
57
What do steroids put patient at risk for?
Obesity and infection
58
First line treatment for chronic gout
Xanthin oxidase inhibitors (allopurinol)
59
When will serum urate levels begin to drop with allopurinol
2 weeks
60
How often should serum urate levels be checked
q2-5 weeks
61
Common AE of allopurinol
GI (take with food), rash, arthralgias
62
MOA of allopurinol
Decrease uric acid levels by selectively inhibiting xanthine oxidase
63
First line treatment for acute gout
Short courses of NSAIDs, corticosteroids, or colchicine
64
MOA of colchicine
Inhibits activation, degranulation, and migration of neutrophils to the area of a gout attack
65
SE of colchicine
GI (diarrhea most commonly)
66
Ditropan SE
QT prolongation and risk for torsades de pointes
67
Alpha-adrenergic blockers (flomax) MOA
relax smooth muscle of prostate and bladder neck without interfering with bladder contractility, decreasing bladder resistance to urinary outflow
68
5-a-reductase inhibitors MOA
specifically blocking 5-a-reductase (enzyme that activates testosterone in prostate) and impairs growth of prostate
69
What med to give prosthetic valve
Warfarin
70
What med to give for biological valve
aspirin
71
What is the difference in OA vs RA
RA-inflammatory markers, symmetric | OA-non-inflammatory, asymmetric
72
Serum urate to dx gout
> 6.8
73
What other med should be taken with longterm use of NSAIDs?
PPI or H2 blocker
74
Adjuvant pain meds
Gabapentin and tramadol
75
What med affects PSA?
5-AR (should reduce up to 50%)
76
BBW for NSAIDs
Potential for CV events and GI bleeding
77
First line tx UTI in pregnancy
Nitrofurantoin (1st and 2nd trimesters)
78
MOA opioids
Bind to opioid receptors in CNS (mu, kappa, delta) with analgesic effect primarily with mu

NURP 423 (2 decks)

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