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Dx And Manage Acute Conditions > Final Exam ANP1 > Flashcards

Final Exam ANP1 Flashcards

1
Q

FHypoglycemia can be defined as?

A

Blood glucose <60

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2
Q

What are 9 things that can cause hypoglycemia?

A

Can occur with diagnosis of diabetes (typically type 1)
medication use
illness
skipping or delaying meals
increase in physical activity
excessive alcohol consumption
decrease in carbohydrate intake
insulin overproduction
hormone deficiencies (in children, the growth hormone).

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3
Q

What is the criteria for level 1 hypoglycemia?

A

Glucose 54-70

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4
Q

What is the criteria for level 2 hypoglycemia?

A

Glucose <54

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5
Q

What is the criteria for level 3 hypoglycemia?

A

A severe event characterized by altered mental and/or physical status requiring assistance for treatment of hypoglycemia

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6
Q

What are 5 sign/symptoms of a severe/emergent hypoglycemic event?

A

Visual disturbances, blurred vision
Confusion
Loss of consciousness
Seizures
Death

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7
Q

What are 9 sign/symptoms of a mild/moderate hypoglycemic event?

A

Hunger
Shakiness
Irritability
Anxiety
Diaphoresis
Skin Pallor
Fatigue
Arrythmia
Crying out during sleep, Nightmares

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8
Q

What are the top 5 ethnicities that are at risk for diabetes in children and adults?

A

African American
Latino
Native American
Asian American
Pacific Islander

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9
Q

What BMI are Asian Americans considered obese therefore at higher risk for diabetes?

A

> 23

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10
Q

What 3 medical conditions put you at greater risk for developing diabetes?

A

CVD
PCOS (Polycystic Ovarian Syndrome)
HIV

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11
Q

What age group would you start screening for Diabetes?

A

Over 35

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12
Q

What lipid levels would you test for diabetes?

A

HDL <35
Triglycerides >250

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13
Q

In diabetic screening for adults would you screen if the patient has a 1st or 2nd degree relative with diabetes?

A

1st degree

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14
Q

An adult that is inactive should be screened for diabetes T or F?

A

True

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15
Q

The main criteria in screening for diabetes in children is?

A

Youth that are overweight or obese

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16
Q

What are 2 screening criteria for diagnosing diabetes in children related to family history?

A

Maternal history of GDM
1st or 2nd degree relative with diabetes

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17
Q

What are 4 medical conditions associated with a need for screening children for diabetes?

A

Acanthosis nigricans
HTN
PCOS
Small for gestational age birth weight

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18
Q

At what age or stage should you screen children for diabetes?

A

10 or onset of puberty, whichever comes first.

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19
Q

How often should you repeat screen for diabetes in children if their first screening is normal?

A

3-year intervals, more often if BMI increases

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20
Q

What are the HgbA1C values for non-diabetic, pre-diabetic, and diabetic?

A

non-diabetic <5.7
prediabetic 5.7-6.4
diabetic > or = to 6.5

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21
Q

What are the FBS values for non-diabetic, pre-diabetic, and diabetic?

A

non-diabetic <100
prediabetic 100-125
diabetic > or = 126

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22
Q

What are the 2 hour glucose tolerance test values for non-diabetic, pre-diabetic, and diabetic?

A

non-diabetic <140
prediabetic 140-199
diabetic > or = 200

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23
Q

What is the random blood sugar for diabetic?

A

> or = 200

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24
Q

To make a definitive diagnosis of diabetes you need to have?

A

2 positive tests or 1 positive lab and be symptomatic

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25
Q

Treatment of severe/emergent hypoglycemia includes?

A

IV D50 (Dextrose 50g)
IM or SQ Glucagon 0.5-1mg
Monitor LOC
Continuous infusion of glucose
Food if tolerated

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26
Q

Treatment of mild/moderate hypoglycemia includes?

A

Eat or drink 15 grams of glucose or carbohydrates (1/2 cup of soda, juice, 1 tablespoon of honey, sugar)
Recheck glucose level in 15 minutes, if still low then repeat 15 grams of glucose or carbohydrates
Repeat steps until glucose level returns to normal
Eat snack if next meal is more than an hour away

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27
Q

What is necessary to prevent recurrence of hypoglycemia?

A

To determine and treat the underlying etiology

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28
Q

How are most children diagnosed with diabetes?

A

The initial presentation of DKA

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29
Q

Define Diabetic Ketoacidosis

A

High levels of blood acids called ketones are produced.

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30
Q

What are 9 contributing factors in diabetic ketoacidosis?

A

Illnesses
surgeries
infections
medications
illicit drug use
pregnancy
bleeding disorders
ischemic incidents

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31
Q

What signs/symptoms in DKA are severe/emergent?

A

Deep, rapid breathing (Kussmaul respirations)
Tachycardia
Hypotension, orthostatic
Alteration of consciousness, decreased alertness

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32
Q

What signs/symptoms in DKA are considered moderate?

A

Fruity breath odor
Abdominal pain
Nausea and vomiting
Headache
Muscle stiffness or aches
Flushed face

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33
Q

What signs/symptoms in DKA are considered mild?

A

Frequent urination
Excessive thirst
Dry skin and mouth

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34
Q

Testing for Severe/emergent or moderate DKA includes?

A

Point of care blood glucose testing
Urinalysis
Electrocardiogram
CBC
CMP or electrolytes

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35
Q

Testing for mild DKA includes?

A

Point of care blood glucose testing
Urinalysis
Complete blood count
Compete metabolic panel

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36
Q

What is a characteristic that applies to type 1 diabetes (DM1)?

A

Significant hyperglycemia and ketoacidosis results from lack of insulin

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37
Q

Heredity and obesity are major risk factors for which type of DM?

A

DM2

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38
Q

You consider prescribing insulin glargine (Lantus) because of its:

A

extended duration of action

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39
Q

The onset of lispro (Humalog) occurs in

A

less than 30 mins.

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40
Q

You see an obese 25 year old male with acanthosis nigricans and consider ordering

A

ESR

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41
Q

Hemoglobin A1C best provides information on glucose control over the past:

A

64-90 days

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42
Q

In caring for a diabetic patient, how often should you obtain a urine microalbuminuria measurement?

A

Yearly

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43
Q

T or F In Alcoholic ketoacidosis significant hyperglycemia is present?

A

False

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44
Q

A patient with alcoholic ketoacidosis is at risk for developing?

A

Torsades de Pointes

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45
Q

Treatment for alcoholic ketoacidosis in Severe/moderate emergencies includes?

A

IV fluids, dextrose and saline solutions
Thiamine before dextrose in alcoholic patients
Potassium replacement
Phosphate replacement
Magnesium replacement

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46
Q

Name 17 symptoms that can be see with hypothyroid disease.

A

Fatigue
Increased sensitivity to cold
Constipation
Dry skin
Weight gain
Puffy face
Hoarseness
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Thinning hair
Slowed heart rate
Depression
Impaired memory
Enlarged thyroid gland (goiter)

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47
Q

Myxedema Coma symptoms include? (6)

A

Hypothermia
Variable blood pressure, hypotension when advanced
Bradycardia
Hypoventilation
Peripheral edema
Mental status change, coma

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48
Q

Low TSH High T4

A

Hyperthyroidism

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49
Q

High TSH low T4

A

Primary Hypothyroidism

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50
Q

Low TSH Low T4

A

Secondary Hypothyroidism

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51
Q

Thyroid (T4) replacement medications and usual dose range?

A

Synthroid (brand)
Levoxyl
Levothyroid
Unithiroid
generic levothyroxine for all
75-125mcg of levothyroxine

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52
Q

What disease is a common cause of hyperthyroidism?

A

Graves Disease

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53
Q

Excess circulating hormone from the thyroid gland resulting in hyperfunction is considered?

A

Primary Hyperthyroidism

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54
Q

Excess production of thyroid releasing or thyroid stimulating hormones in the hypothalamus and pituitary is considered?

A

Secondary Hyperthyroidism

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55
Q

Name 16 signs and symptoms of Hyperthyroidism.

A

Unintentional weight loss
Tachycardia
Arrhythmia
Palpitations
Increased appetite
Nervousness, irritability, anxiety
Tremors
Sweating
Changes in menstrual patterns
Increased sensitivity to heat
Changes in bowel habits, frequent bowel movements
Enlarged thyroid gland (goiter)
Fatigue, muscle weakness
Difficulty sleeping
Skin thinning
Fine, brittle hair

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56
Q

Name 18 signs and symptoms of Thyroid Storm.

A

Agitation
Change in alertness, consciousness
Seizure
Confusion
Diarrhea
Abdominal pain
Jaundice
Increased temperature
Tachycardia, palpitations
High systolic/low diastolic
Arrhythmia
Elderly:
Congestive heart failure
Atrial fibrillation
Restlessness
Shaking
Sweating
Weakness
Fatigue

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57
Q

Excess circulating thyroid hormone originating from any source is known as?

A

Thyrotoxicosis

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58
Q

A rare hypermetabolic state induced by excessive release of thyroid hormones that is acute, severe, and life threatening is known as?

A

Thyroid Storm

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59
Q

What is the most common precipitating cause of thyroid storm?

A

Infection

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60
Q

Treatment for Hyperthyroidism which is usually ordered by the Endocrinologist includes?

A

Anti-thyroid medication
Radioactive iodine
Beta blockers
Surgery, thyroidectomy

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61
Q

Hypothyroidism most often develops as a result of:

A

Autoimmune thyroiditis

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62
Q

Physical exam findings in patients with Graves’ disease include:

A

Eyelid Retraction

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63
Q

Thyroid stimulating hormone is released by the:

A

Anterior lobe of the pituitary

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64
Q

TSH of 24; free T4 of 3 is indicative of

A

Hypothyroid

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65
Q

TSH of <0.15; free T4 of 79 is indicative of

A

Hyperthyroid

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66
Q

Chronic, insufficient production of the hormones cortisol and aldosterone from the adrenal gland is known as?

A

Adrenal Insufficiency (Addison’s Disease)

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67
Q

Primary insufficiency is caused by?

A

Intrinsic adrenal gland dysfunction

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68
Q

Secondary insufficiency is caused by?

A

Inadequate adrenocorticotropic (ACTH) production due to hypothalamic-pituitary dysfunction.

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69
Q

What condition can be caused by a sudden withdrawal of oral steroids?

A

Adrenal Crisis

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70
Q

What is adrenal crisis?

A

An acute life threatening condition where there is a reduction of cortisol production.

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71
Q

What are 12 signs and symptoms of Adrenal insufficiency?

A

Extreme fatigue
Weight loss and decreased appetite
Darkening of the skin (hyperpigmentation)
Low blood pressure, even fainting
Salt craving
Low blood sugar (hypoglycemia)
Nausea, diarrhea or vomiting (gastrointestinal symptoms)
Abdominal pain
Muscle or joint pains
Irritability
Depression or other behavioral symptoms
Body hair loss or sexual dysfunction in women

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72
Q

What are 9 signs and symptoms of Adrenal Crisis?

A

Severe weakness
Confusion, delirium
Pain in lower back or legs
Severe abdominal pain, vomiting and diarrhea, leading to dehydration
Reduced consciousness or delirium
Low blood pressure
Circulatory collapse
Dehydration
High potassium (hyperkalemia) and low sodium (hyponatremia)

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73
Q

What is the treatment for Adrenal Insufficiency?

A

Hydrocortisone - Cortisol replacement

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74
Q

Which of the following is a mineralocorticoid?
A. Cortisol
B. Aldosterone
C. Insulin
D. Hydrocortisone

A

B. Aldosterone

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75
Q

A 40 year old man presents to the ED in acute adrenal crisis, and is experiencing nausea, vomiting, hypotension. Cyanotic and confused. Treatment is an injection of:
A. Epinephrine
B. Insulin
C. Adrenaline
D. Hydrocortisone

A

D. Hydrocortisone

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76
Q

Signs and symptoms of Hypercalcemia?

A

Increased thirst
Bone Pain
Muscle weakness
confusion
fatigue
upset stomach
nausea /vomiting
Constipation

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77
Q

A condition in which one or more of your parathyroid glands become overactive and release (secrete) too much parathyroid hormone (PTH) is known as?

A

Hyperparathyroidism

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78
Q

SIGECAPS Pneumonic

A

Sleep: insomnia or hypersomnia
Interest: reduced, with loss of pleasure
Guilt: often unrealistic
Energy: mental and physical fatigue
Concentration: distractibility, memory disturbance, indecisiveness
Appetite: decreased or increased
Psychomotor: retardation or agitation
Suicide: thoughts, plans, behavior’s.

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79
Q

What are the rules of 7’s in Major Depressive Disorder (MDD)?

A

1 in 7 persons with MDD commit suicide
70% of suicides have seen a PCP within 6 weeks
7th leading cause of death

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80
Q

Name 8 disorders that may cause depression.

A

CHF
Diabetes
Anemia,
Asthma
Hypothyroidism
Menopause
Chronic Diseases
Cancer

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81
Q

Name 6 drugs that may cause depression.

A

Antihypertensives
Corticosteroids
Hormones (progesterone and prednisone)
Antianxiety (Valium)
Birth Control Pills
GI (Reglan)

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82
Q

Criteria for diagnosis of major depressive disorders per DSM-V

A

Must have 5+ of following symptoms during two weeks (must include either depressed mood or anhedonia) in addition to:

Weight loss/gain
Increase/decrease in sleep
Increase/decrease psychomotor activity
Loss of energy
Feeling of guilt
Decreased ability to concentrate
Suicidal ideation/suicidality

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83
Q

DIGFAST pneumonic

A

Distractibility - poorly focused, multitasking
Insomnia - decreased need for sleep
Grandiosity - inflated self esteem
Flight of Ideas - complaints of racing thoughts
Activity - Increased goal directed activities
Speech - pressured or more talkative
Thoughtlessness - risk taking behaviors (sexual, financial, travel, driving)

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84
Q

What psychiatric medication can cause a rash that can lead to Stevens-Johnson Syndrome?

A

lamotrigine (Lamictal)

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85
Q

7 Common Disorders That May Cause Anxiety

A

Hyperthyroidism
Asthma
Alcoholism
Hypoglycemia
Delirium
Cardiac arrhythmia
MVP

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86
Q

5 Drugs That May Cause Anxiety

A

Amphetamines
Caffeine
Steroids
Appetite Suppressants
Drugs (street)

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87
Q

Criteria for diagnosis of schizophrenia per DSM-V

A

2+ symptoms must be present for one month and at least one must be 1., 2. or 3.:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Disorganized behavior
5. Negative symptoms

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88
Q

A screening tools that is used at every office visit for depression.

A

PHQ-9

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89
Q

A screening tools that is used for anxiety (General Anxiety Disorder), PTSD, Panic Disorder, Social Phobia.

A

GAD-7

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90
Q

A patient presents with symptoms ranging from Mild depression to Hypomania what type of bipolar is this?

A

Cyclothymia

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91
Q

A patient presents with symptoms ranging from major depression to Hypomania what type of bipolar is this?

A

Bipolar Type 2

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92
Q

A patient presents with symptoms ranging from Major depression to Mania what type of bipolar is this?

A

Bipolar Type 1

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93
Q

Name 5 SSRI’s used to treat depression.

A

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil, Pexeva)
Sertraline (Zoloft)

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94
Q

What are some side effects associated with SSRI’S?

A

Nausea
Agitation
Sexual Dysfunction
Weight Gain
Insomnia
Hyponatremia

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95
Q

What SSRI is linked to the risk of dementia?

A

Paroxetine

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96
Q

What SSRI has a high risk of causing QTc prolongation?

A

Citalopram

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97
Q

What SSRI has an increased risk of problematic withdrawals and is harder to wean a person off of?

A

Paxil

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98
Q

Trazodone name 5 side effects.

A

Nausea (5-HT)
Priapism (α1)
orthostatic hypotension
headache
blurred vision

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99
Q

Circumscribed area of change in normal color, with no skin elevation or depression; may be any size is a?

A

Macule

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100
Q

Solid, raised lesion up to 0.5 cm in greatest diameter is a?

A

Papule

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101
Q

Similar to papule but located deeper in the dermis or subcutaneous tissue is a?

A

Nodule

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102
Q

What is the first line treatment for pyelonephritis?

A

Fluroquinolone to include

Ciprofloxacin 500 mg po BID X 7 days
Levofloxacin 750 daily x 7 days

2nd line is Bactrim DS 1 BID x 10-14 days

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103
Q

What assessment finding can you expect in a patient with pyelonephritis?

A

Positive CVAT

104
Q

Signs and symptoms of pyelonephritis can include (7)

A

UTI
Fever
Chills
Nausea
Vomiting
Back or Flank Pain
Hematuria

105
Q

Pyelonephritis usually presents at what age range in women?

A

18-40 years

106
Q

Preferred treatment for UTI includes

A

Macrobid 100 mg BID x 5 days (best for pregnant women)
Bactrim DS 1 BID x 3 days

107
Q

The preferred treatment for Epididymitis is?

A

Rocephin 500 mg IM x 1 and
Doxycycline 100 mg po bid x 10 days

Males >35 having anal sex Rocephin 500mg IM x 1 and
Levaquin 500 mg po x 10 days

Scrotal elevation and NSAID’s

108
Q

What are 2 scrotal conditions that have a positive cremasteric reflex?

A

Epididymitis
Torsion of appendix of testis

109
Q

This scrotal condition has a negative cremasteric reflex.

A

Testicular torsion

110
Q

In males <35 years old the most common pathogen is?

A

Chlamydia and Gonorrhea

111
Q

What condition appears with a blue dot as a Key feature?

A

Torsion of appendix of testis

112
Q

Which scrotal condition has a gradual onset of pain?

A

Acute Epididymis

113
Q

Which scrotal condition is associated with trauma?

A

Testicular torsion

114
Q

Which scrotal condition presents with nausea and vomiting?

A

Testicular torsion

115
Q

Which scrotal condition presents with fever and dysuria?

A

Acute Epididymis

116
Q

What is the preferred imaging study for scrotal pain?

A

Testicular ultrasound

117
Q

What is the leading cause of acute scrotal pain in children?

A

Torsion of appendix of testis

118
Q

The 3 most common pathogens in acute prostatitis.

A

E. Coli
Pseudomonas
Klebsiella

119
Q

What STI presents as a single painless lesion 10-21 days after being infected?

120
Q

The preferred treatment for syphilis is?

A

Penicillin shot 2.4 g

121
Q

The most common STI in the USA?

122
Q

In women the most common pathogen that causes Bartholin gland abscess is?

123
Q

First line treatment for Chlamydia is?

A

Doxycycline 100 mg BID x 7 days

124
Q

What is the most common pathogen in female UTIs?

125
Q

Is E. coli a gram negative or gram positive bacteria?

126
Q

What is the treatment of the female UTI?

A

Bactrim DS 1 tab PO BID x 3 days or Macrobid 100mg PO BID x 5 days.

127
Q

After how many UTIs would you refer your patient to the urologist?

A

3 infections in a 6 month period

128
Q

What is a telltale symptom of vulvovaginitis?

A

External burning

129
Q

How does atrophic vaginitis present?

A

Thin, dry, pale mucosa

130
Q

What findings will present and in what population is significant for interstitial cystitis?

A

UTI symptoms but UA is negative and seen in middle aged women

131
Q

What are the 4 pathogens associated with pyelonephritis?

A

E. coli, Klebsiella, Proteus mirabilis, Enterobacter

132
Q

What is the second most common disorder in children?

133
Q

Name 4 clinical presentations of UTI in infants.

A

Fever, irritability, failure to thrive, loss of appetite

134
Q

How can UTIs present in toddlers?

A

abdominal pain

135
Q

What are two congenital malformations in children that can lead to UTIs?

A

dysplastic kidney and hydronephrosis

136
Q

What is a major structural abnormality associated with UTI and kidney damage?

A

Vesicoureteral reflux (VUR)

137
Q

What is the treatment for an uncomplicated UTI in pediatrics?

A

Cephalexin 50mg/kg/day PO divided TID or Bactrim 4-5 mg/kg PO BID for 7-10 days

138
Q

What are 3 pathogens that make up most of the vaginitis infections?

A

Trichomonas vaginalis, Candida, and bacterial vaginosis (BV)

139
Q

What are 5 complaints in vaginitis?

A

Vaginal itching, discharge, burning, painful intercourse, or foul odor

140
Q

What are 3 pathogens responsible for cervical infections?

A

Chlamydia, Gonorrhea, Herpes Simplex Virus

141
Q

What is a tell-tale sign of BV?

A

Fishy odor (positive Whiff test)

142
Q

In diagnosing BV, what is seen on microscopy?

A

Clue cells

143
Q

What is the pH in BV, trich or atrophic vaginitis?

144
Q

What is the color of discharge seen in BV?

A

thin white/grey

145
Q

What is the treatment for BV?

A

Flagyl 500mg PO BID x 7 days or Flagyl vaginal cream 1 applicator vaginally nightly for 5 days

146
Q

What is the pathogen responsible for yeast vaginitis?

147
Q

What is the main complaint of yeast vaginitis?

A

vaginal itching

148
Q

What does the discharge look like in yeast vaginitis?

A

white and curdy

149
Q

How does yeast vaginitis present on microscopy?

A

Budding/branching (spaghetti and meatballs)

150
Q

What is the treatment of yeast vaginitis?

A

Diflucan 150 mg PO once or may repeat in 4-7 days OR Monistat OTC and start probiotics

151
Q

What is the classic look of testicular torsion on ultrasound?

A

snail sign or whirl pool sign

152
Q

What are 5 signs of BPH?

A

Frequency, hesitancy, nocturia, urgency, and weak stream

153
Q

Is dysuria present in BPH?

154
Q

Is hematuria present in BPH?

155
Q

What age group has the highest incidence for BPH?

A

Greater than 80 years old

156
Q

What would be performed to assess the prostate size or presence of a nodule?

A

Digital rectal exam (DRE)

157
Q

What diagnostic tests will be performed for BPH?

A

PSA, U/A with culture, BUN, Creatinine, post void residual

158
Q

At what point do you consult urology for BPH?

A

Failure of treatment, age < 45 or abnormal DRE

159
Q

What two classes of medications are used to treat BPH?

A

Alpha blockers and 5 alpha-reductase inhibitors

160
Q

What would you educate your patient about when taking meds for BPH?

A

They can cause hypotension so they must be cautioned about sudden position changes and adequate hydration

161
Q

In what age group are most testicular cancer cases seen?

A

20-34 years old

162
Q

What are 4 risk factors of testicular cancer?

A

Positive FH, cryptorchidism (undescended testicle), HIV, or previous testicular cancer in the other testicle.

163
Q

What are 6 signs and symptoms of testicular cancer?

A

hard lumps or nodules
change in testicle appearance
scrotal swelling
dull ache in lower abdomen or scrotum
feeling of heaviness or pain
gynecomastia

164
Q

What test would you encourage your male patient to perform in regards to testicular cancer?

A

Monthly testicular exam

165
Q

What is the clinical presentation of gynecomastia?

A

breast tissue swelling

166
Q

Does gynecomastia mean a patient has breast cancer?

A

No, but breast cancer must be ruled out.

167
Q

What are 5 causes of gynecomastia?

A

Testicular tumors, breast cancer, cirrhosis, malnutrition, and drugs

168
Q

What is an example of a medication that can cause gynecomastia?

A

spironolactone

169
Q

What is the treatment for gynecomastia?

A

Stop offending drugs

170
Q

What is hypospadius?

A

Congenital anomaly of the male urethra resulting in the ventral placement of the urethral opening

171
Q

In testicular cancer, is the nodule painless or painful?

172
Q

What are 10 patient complaints in testicular cancer?

A

weight loss, fever, nausea, vomiting, abdominal pain, SOB, headaches, lumbar pain, bone pain, and unilateral leg swelling

173
Q

What are the three stages of syphilis?

A

Primary, secondary, and tertiary

174
Q

What 2 body systems does tertiary syphilis affect?

A

Cardiovascular and nervous systems

174
Q

How does secondary syphilis present?

A

If untreated, about 2 months after exposure a nonpruritic, maculo-papular rash involving palms and soles with generalized lymphadenopathy.

175
Q

What is the diagnostic tests for syphilis?

176
Q

What does Gardasil protect against?

A

A vaccine for HPV

177
Q

What is the most common STD in young adults?

178
Q

What is Peyronie’s disease?

A

Curvature of the erect penis caused by fibrous scar tissue

179
Q

Do you need to obtain a urethral swab to test for gonorrhea or chlamydia?

A

No, you can perform a urine test

180
Q

What is the treatment for gonorrhea?

A

Rocephin 500 mg IM once

181
Q

What STD causes non-gonococcal urethritis (NGU)?

182
Q

Are males or females more likely to have complicated UTIs?

183
Q

Name 4 acute urinary symptoms that need to be evaluated?

A

Hematuria, dysuria, proteinuria, or incontinence

184
Q

What are 5 common causes of acute kidney injury?

A

Volume depletion, nephrotoxin exposure, urinary obstruction, profound diarrhea and over diuresis

185
Q

What are 4 risk factors for nephrolithiasis?

A

Genetics, low fluid intake, high oxalate intake, and prior bariatric surgery

186
Q

What is the clinical presentation of nephrolithiasis?

A

severe flank pain, abdominal pain, nausea, vomiting and hematuria

187
Q

Name 6 rashes that always present with itching.

A

Atopic dermatitis, urticaria, insect bites, scabies, chickenpox, and pediculosis

188
Q

Name 4 rashes that may itch.

A

Psoriasis, impetigo, tinea, and pityriasis rosea

189
Q

Name 3 rashes that never itch.

A

Warts, vitiligo, nevi

190
Q

What does the term cetripetal mean when describing a rash?

A

Spreading towards the center

191
Q

What does the term centrifugal mean when describing a rash?

A

Spreading outward from the center

192
Q

What does the term caudal mean when describing a rash?

A

Spreading downward

193
Q

Name some ways to classify rashes.

A

Whether or not it itches, how it spreads, if there is pain or burning, known exposures or triggers, new soaps, lotions, meds, clothing, detergents or any recent travel. Also note initial presentation or any illnesses at the time.

194
Q

What is the signature look for fifth’s disease?

A

Slapped cheeks

195
Q

What are characteristics of Rubeola (Measles)?

A

Erythematous, maculopapular rash that begins on the face and spreads to the body.

196
Q

What are characteristics of Scarlett fever?

A

Fine erythematous rash that blanches. Sandpaper feel. Neck, axillary folds, and groin have Pastia’s lines (petechiae)

197
Q

What childhood rash presents with a strawberry tongue?

A

Scarlet fever

198
Q

A scarlet fever rash presents after which bacterial infections?

A

Strep pharyngitis

199
Q

What is another name for measles?

200
Q

Describe the appearance of Koplik’s spots.

A

Gray and white, grainy dots on red base on buccal mucosa opposite lower molars, 2 days before rash appears

201
Q

What disease is associated with Koplik’s spots?

202
Q

What two pathogens causes impetigo?

A

S. aureus and Strep pyogenes

203
Q

What virus causes hand-foot-and-mouth disease?

A

Coxsackievirus A16

204
Q

Describe the appearance of chicken pox.

A

Rash begins along hairline of face with crusted vesicles, then over trunk, and extremities are last.

205
Q

Describe impetigo.

A

Honey-colored crusts from vesicles or pustules that rupture. Bullous or pustular forms.

206
Q

Describe hand-foot-and-mouth disease.

A

painful mouth ulcers followed by painful white vesicles with surrounding eythema on fingers, palms, toes, and soles.

207
Q

Describe shingles.

A

clustered vesicles surrounded by an erythematous base with discrete lesions that later crust.

208
Q

What is another name for hydradenitis suppurative?

A

perifolliculitis

209
Q

What gland is affected in hydradenitis suppurative?

A

Apocrine glands

210
Q

What is the most common pathogen to cause hydradenitis suppurative?

A

staph aureus

211
Q

What is the antibiotic of choice for hydradenitis suppurative?

212
Q

What two pathogens cause osteomyelitis?

A

S. Aureus or strep pyogenes

213
Q

What two pathogens cause cellulitis?

A

S. aureus and group A beta-hemolytic strep

214
Q

What antibiotics can be used to treat cellulitis?

A

Keflex, e-mycin, dicloxacillin. May also give a dose of cefazolin or ceftriaxone

215
Q

What parts of the body are affected by intertrigo?

A

under breasts, inner thighs, axilla, and perianal areas

216
Q

What is the treatment for Lyme disease?

A

Doxycycline/tetracycline 100 mg BID x 14-21 days

217
Q

What is a classic sign of Dengue fever?

A

Retro-orbital pain

218
Q

What part of the body is affected by a rash in Rocky Mountain Spotted Fever?

A

Wrists and ankles also involving the palms and soles

219
Q

Where on the body are scabies typically found?

A

Axillae, webs of fingers and toes or groin

220
Q

What antidepressant does not cause sexual dysfuction?

A

Bupropion (Wellbutrin)

221
Q

What are some presentations of serotonin syndrome?

A

Rapid onset that progresses from diarrhea, restlessness, agitation, hyperreflexia, to later symptoms of seizures, hyperthermia, uncontrolled shivering and muscle rigidity and ultimately it can lead to delirium, coma, CV collapse and death

222
Q

What is the treatment for serotonin syndrome?

A

Immediate cessation of offending drug and supportive care (may include benzos)

223
Q

What is the only FDA approved antidepressant for the treatment of bulimia?

A

Fluoxetine (prozac)

224
Q

If a patient is at high risk of suicide, what class of meds would you avoid?

A

tricyclics

225
Q

What are your first line of drugs for panic attacks or OCD?

A

SSRI/SNRI– fluoxetine, paroxetine, or sertraline

226
Q

What medication can be given to increase appetite?

A

Mirtazapine

227
Q

What SSRI is safe for use while pregnant?

A

Sertraline (zoloft)

228
Q

What medications can cause dyspepsia?

A

ASA, NSAIDs, antibiotics, DM meds, antihypertensives, cholesterol meds, pysch meds, anti parkinson meds, steroids, estrogen, digoxin, iron, and opiods

229
Q

What are 8 causes of dyspepsia?

A

PUD, GERD, gastric cancer, gastroparesis, lactose intolerance, malabsorptive problems, parasites, and pancreatic CA and chronic pancreatitis

230
Q

What are 7 critical signs of dyspepsia?

A

N/V, hematemesis or melena, weight loss, persistent vomiting, severe pain, dysphagia

231
Q

What disorder experiences relief of symptoms with food?

A

PUD (peptic ulcer disease)

232
Q

Describe dyspepsia.

A

Gnawing or burning epigastric or upper abdominal pain that occurs with an empty stomach, alcohol intake or stress

233
Q

What stressors can cause dyspepsia?

A

domestic violence, anxiety, home or school problems, prior psychological problems

234
Q

What is the treatment for H pylori?

A

combination of antisecretory meds (omeprazole or lansoprazole) and antibiotic.

235
Q

What is the most common cause of lower GI bleeding?

A

diverticulosis

236
Q

What are some symptoms of diverticulitis?

A

Sudden, localized abd pain, fever, elevated WBC and ESR, n/v/d or constipation, guarding or rebound pain, rectal bleeding, flatulence or gas

237
Q

What is the gold standard test for diverticulitis?

A

Contrasted abdominopelvic CT

238
Q

How would the abdomen present in a patient with diverticulitis?

A

Rigid or distended with tympanny. Could also be tender, firm, mass in left side. Decreased bowel sounds or increased if obstructed.

239
Q

What are two assessment tests that can be performed to support the diagnosis of diverticulitis?

A

iliopsoas test and obturator sign

240
Q

What is the antibiotic treatment for diverticulitis?

A

Flagyl 500 mg PO Q8 hours and ciprofloxacin 500 mg PO BID for 7 to 10 days.
Alternative is levofloxacin 750 mg daily along with Flagyl
Alternative is Augmentin 875/125 PO TID or Septra DS BID along with Flagyl

241
Q

Elevation of skin occupying a relatively large area in relation to height

242
Q

Circumscribed elevation of skin containing purulent fluid of variant character

243
Q

Circumscribed, elevated, fluid containing lesion less than 0.5 cm in diameter

244
Q

Circumscribed, elevated, fluid containing lesion more than 0.5 cm in diameter

245
Q

Child present to the office with a fever greater than 101.3 for 5 days with no know reason. What could this be indicative of?

A

Kawasaki’s Disease

246
Q

Name other criteria for diagnosing Kawasaki’s Disease:

A

Conjunctivitis
Cervical lymphadenopathy
Swollen hands and feet
Red palms and soles
Strawberry tongue with rough red spots
mucositis (very red swollen cracked lips)
Peeling of fingers and toes
Irritability and fussiness
vomiting
diarrhea
abdominal pain
cough
headache
runny nose
joint pain

247
Q

What is the Gleason score used for?

A

Prostate Cancer tissue grading

T=tumor tissue size
N= amt of nodal involvement
M= spread (metastasis) within the pelvic region

Each letter is associated with a number as well

248
Q

Most common pathogen in Epididymitis:

A

< 35ys of age: Chlamydia trachomatis and Neisseria gonorrhoeae
Older males: E. Coli, Pseudomonas, & other coliform bacteria

249
Q

For the lungs the x-ray film has to show what?

A

The Apex to the costophrenic.

250
Q

X-ray of the cervical spine needs to show what areas?

251
Q

What view for an x-ray is best for the cervical spine?

252
Q

Visualization of long bones which view do you want on your x-ray?

A

AP, lateral, and oblique

253
Q

What would you do for a long bone injury in the pediatric population?

A

Refer to Ortho

254
Q

For determining a foreign body in soft tissue, what test is the best?

A

Ultrasound

Dx And Manage Acute Conditions (2 decks)

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