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ACNP REVIEW > Fall Final > Flashcards

Fall Final Flashcards

1
Q

Normal lipid panel values

A

Cholesterol < 200
Triglycerides < 150
HDL 50
LDL < 100

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2
Q

Moderate Intensity statins

A

Lowers LDL 30-50%, use if LDL 70-189 or < 7.5% ASCVD

Atorvastatin 10-20 mg
Simvastatin 20-40mg
Rosuvastatin 5-10 mg

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3
Q

High Intensity statins

A

Lowers LDL >50%, use if LDL >190, or high clinical ASCVD >7.5%

Atorvastatin 40-80 mg
Rosuvastatin 20-40 mg

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4
Q

Diagnostics/lab work for statin therapy

A

Baseline LFTs and CK
Lipid panel 6-8 weeks after initiating therapy,

Only recheck CK if statin induced myopathy is suspicious

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5
Q

CHADS-2 score

A 
CHF
HTN
Age >75
DM
Stroke/TIA (+2)

0-nothing, ASA; 1 ASA or warfarin; >2 wafarin

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6
Q

Stemmer’s sign

A

Sign for lymphedema
Pinch skinfold at base of 2nd toe or middle finger
If you can’t, (+) sign for lymphedema

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7
Q

Risk for DVT

A 
Pretest probability (1pt each):
active cancer
paralysis
immobility > 3days
vein tenderness
limb swelling
unilateral calf swelling
pitting edema
collateral superficial vein
-2 for alternative diagnosis likely

< 1=low; 1-2=moderate; >3 high

Management: d-dimer for low risk
venography for moderate/high risk

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8
Q

Risk for PE

A 
Pretest probability:
S/S of DVT
alternative explanation than PE
HR > 100
Immobility within 4 weeks
Prior VTE
Hemoptysis
malignancy

High >6; Mod 2-6; Low < 2

Mod/high risk= CTA

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9
Q

Bacterial Meningitis

A

S/S: fever, nuchal rigidity, altered sensorium, N/V, exaggerated DTR

Brudzinski and Kerning signs

LP: cloudy, high opening pressure >180, increased WBC (1-2k), total protein (100-500), decreased glucose < 40

Treat within 60 minutes, 3rd generation cephalosporin (Cefotaxime or Ceftriaxone plus Vancomycin)

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10
Q

Treatment of acute prostatitis

A

IV Fluoroquinolone
3rd generation cephalosporin (ceftazidime, rocephin)

S/S: rapid onset dysuria with indwelling catheter, tense/boggy/tender prostate

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11
Q

Treatment of UTI in pregnancy

A

Cephalexin 500 mg QID/BID
Nitrofurantoin 50 mg QID (avoid >36 weeks)
Ampicillin 500 mg QID
resistance 20-40% for ampicillin

Avoid sulfonamides and fluoroquinolone
Pyelonephritis use beta-lactam with/without amino glycoside

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12
Q

Treatment of urinary retention in BPH

A

Alpha blockers (-zosin) tamsuloin, alfuzosin

Second line option: 5-alpha reductase inhibitors- finasteride and dulasteride

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13
Q

Diagnosis of iron deficiency anemia

A

low MCV, low serum ferritin, low serum iron, high TIBC

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14
Q

Most common type of leukemia in older adults

A

CML

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15
Q

Significance of Auer rods

A

Seen in blasts of AML and high grade myeloproliferative syndromes

Distinguish pre-leukemia (excess blasts with Auer rods) from refractory anemia with excess blasts (no Auer rods)

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16
Q

Screening exams

A

Colonoscopy: age 50 q10 years, sigmoid q5 years
Skin: q3 years age 18-40, >40 annual
Breast: annual mammography >40
Cervical: PAP/HPV age 21 q3years, 30-65 PAP q5 years
NO specific guidelines for testicular, lung or prostate

17
Q

Reed-Sternberg cell indicated

A

Hodgkin’s Lymphoma

18
Q

Suicidal risk factors

A

Sex, Unsuccessful attempts, identified family hx, chronic illness, depression/drugs/drinking, age, lethal means

highest risk: elderly men with medical problems and no social support

19
Q

Stages of COPD

A 
COPD diagnosis: FEV1/FVC= < 0.7
FEV1: > 80% Mild
50-80% Mod
30-50% Severe
< 30% Very Severe
20
Q

Diagnosis of CAP

A 
CURB-65
Confusion
Urea > 7
RR >30
BP SBP 65

0-1= home trx; 2=hospital trx; >3= hospital or ICU

21
Q

Diagnosis of HIV

A

ELISA test first, then Western blot to confirm

22
Q

When to initiate Bactrim prophylaxis for CD4 counts

A

Initiate count < 200, discontinue when CD4 count > 200 for 3-6 months

23
Q

Stages of CKD

A

by GFR ml/min, Stage:

1: >90
2: 60-89
3: 30-59
4: 15-29
5: < 15

Neph consult at stage 3
Earliest sign of kidney damage is proteinuria

24
Q

Management of hyperkalemia

A

Kayexalate
1/2 amp of D50 with 10 unit regular insulin
10%calcium gluconate

25
Q

Compartment syndrome

A

disproportionate pain, reduced sensation, passive extension of digits causes pain

Remove constricting materials (cast, splint)

Maintain limb at level of heart

Compartment pressure >40

6 P’s

26
Q

Herberden’s and Bouchard’s nodes

A

Herberden’s: DIP joints

Bouchard’s: PIP joints

27
Q

Felty’s syndrome

A

higher risk of infection

Triad of: RA, splenomegaly, neutropenia

28
Q

Chronic vs. Acute glaucoma

A

Chronic: d/t age, nearsightedness, DM
S/S: painless, loss of visual fields, IOP 10-20, goal: improve flow or reduce aqeous (beta blockers)

Acute: due to blockage
S/S: severe pain, HA, blurry visions, halos around objects, decreased visual acuity, cloudy cornea
Trx: azetazolamide

29
Q

Treatment of Herpes Zoster

A

Acyclovir 800mg QID for 7-10days
second line: Valacyclovir 1000mg BID for 7-10 days

Rule of 50: 50 hours or less since onset, >50 years of age, more than 50 lesions

Oral steroids not effective

30
Q

Treatment of Varicella Zoster

A

Modest clinical benefit when administered within 24 hours of rash onset

Acyclovir 20 mg/kg for 5 days or 800 mg five times a day

Valacyclovir 20 mg/kg TID or 1 gram TID

Can do aluminum acetate soaks

31
Q

Conditions that require referral to Dermatology

A

conditions beyond expertise, difficult cases, to biopsy suspicious lesions, life threatening conditions

32
Q

sinusitis

A

S/S: pain/pressure worse when bending over, purulent/blood tinged nasal drainage, congest, fever, tender face

Amoxicillin- clavulanate 500 mg TID for 5-7 days
Second line: Augmentin, levofloxacin, moxifloxacin

33
Q

Otitis media

A

inflammation of inner ear, throbbing pain, hearing loss, red tympanic membrane

Trx: Amoxicillin 500 mg q12h for 5-7 days

34
Q

Otitis externa

A

decreased hearing, edema within ear canal

Trx: cortisporin otic, ciprofloxacin HC for 7 days

35
Q

Conjunctivitis

A

red/swollen eyelid, EOM intact, foreign body feeling, drainage

Trx: plymyxin 1-2 drops q2-3h for 5-7 days

Allergic: symptomatic care, antihistamines

ACNP REVIEW (32 decks)

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