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[2a] A ⼀ Step 2 OD USLME > ✅F4 (PSYCH/EYE/DERM/BIOSTAT/TOX/Rx) > Flashcards

✅F4 (PSYCH/EYE/DERM/BIOSTAT/TOX/Rx) Flashcards

2
Q

PTSD dx requires sx > 1 month

PTSD sx [3 days -1 month] duration = ⬜

A

[Acute Stress Disorder]

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3
Q

[Normal Grief Bereavement] overlaps [Major Depressive Disorder]

Name 4 major qualities of NGB that distinguishes it from MDD

A
  • aIn [Normal Grief Bereavement]:*
    1. if Patient wishes to die it’s only to join the deceased*
    1. visual/auditory hallucinations of deceased person is normal*
    1. [sadness (Triggered by reminders) ➜ PRESENTS IN “WAVES” and ⬇︎ Intensity over time]*
    1. NO PERVASIVE SUICIDALITY*
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4
Q

Diagnostic criteria for [Adjustment disorder with depressed mood] - 3

A
  1. [≤ 4 SIGECAPSS] within 3 mo. of acute stressor (EXCLUDING BEREAVEMENT) that –>
  2. functional impairment
  3. NOT 2/2 more specific disorder

Tx = CBT

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5
Q

Diagnostic criteria for [Adjustment disorder with depressed mood] - 3

A
  1. [≤ 4 SIGECAPSS] within 3 mo. of acute stressor (EXCLUDING BEREAVEMENT) that –>
  2. functional impairment
  3. NOT 2/2 more specific disorder

Tx = CBT

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6
Q

[Normal Grief Bereavement] overlaps [Major Depressive Disorder]

Name 4 major qualities of NGB that distinguishes it from MDD

A
  • In [Normal Grief Bereavement]:*
    1. if Patient wishes to die it’s only to join the deceased*
    1. visual/auditory hallucinations of deceased person is normal*
    1. [sadness (Triggered by reminders) ➜ PRESENTS IN “WAVES” and ⬇︎ Intensity over time]*
    1. NO PERVASIVE SUICIDALITY*
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7
Q

PTSD dx requires sx > 1 month

PTSD sx [3 days -1 month] duration = ⬜

A

[Acute Stress Disorder]

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8
Q

Buspirone

MOA

________________

indication

A

Buspirone = [5HT1α R partial agonist]

________________

GAD

________________

[slow onset] and [lacks muscle relaxant/anticonvulsant properties]

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9
Q

Describe Trichotillomania is

________________

what’s a serious complication of this?

A

compulsive Hair pulling DO in which pt attempts to stop pulling hair out of scalp, eyebrows and eyelashes BUT CAN’T!

________________

Possibly ➜ trichophagia (swallowing hair) which ➜ bowel obstruction

Related to OCD and has ⬆︎morbidity in those with hx or fam hx of OCD

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10
Q

Diagnostic clinical criteria for Generalized Anxiety Disorder consist of a ≥6 month time period of ≥3 out of 6 major sx

What are the 6 GAD major sx?

A

waTCHERS

Worry / Anxiety that –>

  1. Tension in muscles
  2. Concentration ⬇︎
  3. Hyperarousal IRRITABILITY
  4. Energy ⬇︎
  5. Restlessness/on edge
  6. Sleep ∆
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11
Q

Patients with postpartum depression can be treated with ⬜ or ⬜ antidepressant and can continue to breastfeed

A

Sertraline ; Paroxetine

these have the lowest/undetectable levels in breast milk

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12
Q

This condition ( ⬜ ) is common in ⬜

A

[Tinea Corporis trichophyton] ; [atheletes who participate in contact sports]

pruritic but nontender rash with central clearing and raised borders

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13
Q

[Pressure decubitus Ulcers] require local wound care, repositioning and pain/nutrition control

How are shallow ulcers managed?
_________________

How are Full-Thickness ulcers managed?

A

s: [occlusive or semipermeable dressings to maintain moist wound environement]

FT: DEBRIDEMENT OF DETIALIZED TISSUE

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14
Q
  • Patients with OCD can experience Obsessions, Compulsions or both*
  • ________________*
    a. define Obsessions
    b. Give 4 examples

________________

c. define Compulsions

A

Obsession = Recurrent intrusive anxiety-causing urges or thoughts about..

([killing/unwanted taboo urges], fear of arm, contamination, symmetry/bad luck)

_______________

Compulsion = rituals/behavioral response used to combat the obsessions (> 1h/day or causing significant distress)

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15
Q

Patients with OCD can experience Obsessions, Compulsions or both

Tx for OCD -2

A

[SSRI high dose]

+

[(Exposure & Response prevention) CBT]
_________________
+/- [TCA clomiporamine] and antipsychotic augmentation

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22
Q

cp for Carbon Monoxide poisoning?-3

________________

Dx?

A
  1. PINK SKIN
  2. GI distress
  3. HA

________________

Dx = [Carboxyhemoglobin levels: ABG]

________________

This can present very similarly to [Cyanide tox (also [PINK SKIN BUT with bitter almond breath)] and [Methemoglobinemia tox (BLUE SKIN)] so be careful!

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23
Q

toxicity of what 2 substances causes PINK SKIN?

A

{Carbon Monoxide tox ➜ [PINK SKIN]}

________________

{CYanide tox ➜ [PINK SKIN with Yucky BITTER ALMOND BREATH]}

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26
Q

Houses built before what year ⬆︎ risk for lead poisoning?

A

1978

false positives occur so be sure to confirm with venous blood draw!

27
Q

Antidote for CYanide toxicity - 3

A

“CYanide poisoning, Needs Smoke Help”

  1. Nitrites (induces methemoglobinemia)
  2. [Sodium thiosulfate]
  3. HydroxoCobalamin

________________

empircally treat smoke inhalation pts for CYanide tox!

28
Q

This type of study (known as ⬜ ) can only provide what type of information?

A

[ecologic correlational study] ;

population-level information

29
Q

[mild 32-35C hypOthermia]

management
_________________

sx? (5)

A

m: passive external warming

(remove wet clothes, blankets)
_________________

30
Q

[Moderate 28-32C (or unresponsive mild) hypOthermia]

management
_________________

sx? (5)

A

(warmed IVF, heated blankets, warm baths, forced hot air)

_________________

31
Q

[SEVERE <28C (or unresponsive Moderate) HYPOTHERMIA]

management
_________________

sx? (3)

A

(WARM PERITONEAL LAVAGE, WARM HUMIDIFIED O2)
_________________

32
Q

tPA MOA

A
33
Q

a child, brought in by their grandmother needs non-emergent care

What are the guidelines for this?

A

For minors, in NON-emergent situations, informed consent should be obtained from parent or legal guardian (written > verbal) before intervention
_________________
if 911 situation: consent does NOT need to be obtained before intervention (as long as reasonable attempts to contact parent/legal guardian are made)

34
Q

What is the purpose of [Home Health Services]?

HHS = PT/OT/wound care

A

allows patients that are both [infirmed (weak in health)] and [homebound**] to receiveskilled care at home
_________________

  • **homebound = ≥1 of*
  • -[uses mobility device (wheelchair/cane/walker)]*
  • -can only leave home with assistance*
  • -leaving home medically contraindicated*
35
Q

What does overlapping [Standard Error of Measurement] suggest?

A

suggest a non-statistically significant difference (two data sets are similar)

36
Q

In the Kaplan-Meier survival curve graph, ≥2 study groups can be compared and are associated with p-value

What does p-value delineate?

A

p ≥ 0.05

means

the study groups are NOT statistically different

38
Q

What are the components of [Root Cause Analysis]? -5

A

DCRSA

  1. Data Collection
  2. [Causal Factor flow chart] (main steps leading up to event that, if eliminated, could have prevented or reduce adverse event)
  3. Root Cause (reason behind each causal factor)
  4. Solutions recommended (for each root cause)
  5. Assessment (assess success of Recommendations)
39
Q

Kava Kava is a supplement used for (⬜2)

What is its major side effect?

A

anxiety / insomnia
_________________
[LIVER FAILURE weeks after starting it]

40
Q

Tx for Somatic Symptom disorder

A

Regularly scheduled Med visits (Goal: Improve functionality)

DO = preocupation with unexplained (but proven to be benign) medical sx

41
Q

Somatic Symptom disorder clinical presentation

A

excessive thought and behavior toward ≥1 unexplained (but proven to be benign) SYMPTOM

42
Q

What is Functional Neurological Symptom Disorder?

________________

tx?

A

unexplainable neurological symptoms 2/2 emotional stressors

________________

EDUCATION about the Disorder!

AKA CONVERSION DISORDER

43
Q

Describe the difference between Factitious Disorder and Malingering

A

F = Falsifying Sx or injury just for Fun (NO obvious external reward)
_________________

M = Falsifying Sx or injury for Monetary/External Reward

44
Q

Explain the blackbox warning regarding antidepressants and Bipolar Depression

A

ALL ANTIDEPRESSANTS carry risk of inducing mania (especially in bipolar patients)

and tx for this is d/c antidepressant

45
Q

Explain what the [Principle of Beneficence and Nonmaleficence] means for Doctors

A

Doctors have ethical duties to prioritize patient global well being (beneficence)

while also [AVOIDING (either directly or indirectly by inaction) causing unwarranted patient harm] (nonmaleficence)

(ie so…DOCTORS must EXPLICITY and clearly state recommendations against or in support) Patient autonomy does NOT extend to the recommendations by the Doctor

46
Q

What are the guidelines regarding Sterilization

A

THE PATIENT THEMSELF has to freely consent to sterilization and legal guardians/appointed health care decision-makers CAN NOT consent on patient’s behalf

Involuntary sterilization (especially in retarded patients) is unethical

47
Q

etx? | Tx?-2

A

Papular urticaria = INSECT BITES➜ [1cm pruritic papules with pale halos] 2/2 [Type 4 delayed hypersensitivity rxn] ➜ spontaneous resolution in months

________________

[2nd gen H1 blockers (cetirizine/loratidine)] + [Topical CTS]

48
Q

Clinical Presentation of of Anterior Uveitis(4)
_________________

A

(C**a**LEB)

Constricted pupil / ANTERIOR UVEITIS/ Limbus erythema / Eye pain / Blurred vision

49
Q

What is the treatment for ASA toxicity? (2)
_________________

MOA for this tx?

A

[IV NaHCO3] ➜ [HemoDialysis (if severe)]
_________________

[IV NaHCO3] Alkalinizes Blood and Urine ➜ basic blood/urine environment ➜ deprotonation of Salicylates ➜[Salicylate ion] inability to be reabsorbed into CNS or into [blood from renal tubules] ➜ [⇪ salicylate ion excretion]

severe = cerebral/pulmonary edema | renal failure

50
Q

This condition is known as ⬜. How is it characterized?

It is a/w ⬜ and can be triggered by what?

A

Porphyria Cutanea Tarda (Nonpainful blisters with increased fragility of dorsal hand +/- facial hypertrichosis & hyperpigmentation)

; Hepatitis C ; [ethanol or estrogen]

[2a] A ⼀ Step 2 OD USLME (21 decks)

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