Final exam new material Flashcards

1
Q

What level of Hgb is considered anemia?

A

Men: 13.6
Women: 12

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2
Q

Iron deficiency anemia: Labs

A

Low Hgb
Low MCV, MCH
Low reticulocytes
High RDW

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3
Q

Thalassemia: Labs

A

High RBC
Low Hgb
Low MCV
Normal RDW

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4
Q

Vit B12 and folate labs

A

Low Hgb
Elevated MCV
Elevated RDW
Low reticulocyte

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5
Q

What type of anemia is methylmalonic acid elevated in?

A

B12

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6
Q

What type of anemia is homocysteine elevated in?

A

B12 & Folate

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7
Q

Anemia of chronic disease: Labs

A
Low Hgb
Low reticulocytes
Normal MCV
Elevated RDW
Elevated TIBC
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8
Q

What platelet level defines thrombocytopenia?
What level is there a risk of bleeding with surgery/trauma?
What level is there a risk for spontaneous bleeding?

A

Less than 150k
50k
10k

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9
Q

How do you manage lab levels with thrombocytopenia?

A

Recheck immediately if less than 50k
Recheck in 1-2 weeks if 50-100
Recheck in 1-2mo if 100-150

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10
Q

Name the condition:
Lack of iris color, hematuria, hypertension
unilateral abd mass that does not cross the midline (displaceable and painless)

A

Wilms Tumor

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11
Q

What type of WBC is most prevalent in leukemia?

A

Blasts (immature WBCs)

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12
Q

What are the B symptoms of lymphoma?

A

unexplained wt loss of 10% or greater of body weight in 6 months prior to dx
unexplained fever > 38
drenching night sweats

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13
Q

What type of lymphoma are B symptoms most common in?

A

Hodgkin lymphoma

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14
Q

What type of lymphoma are reed-sternberg cells most common in?

A

Hodgkin lymphoma

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15
Q

Where does Hodgkin vs. non-Hodgkin lymphoma begin and where do they metastasize to?

A

Hodgkin: starts in cervical lymph nodes; mets to liver, spleen
Non-Hodgkin: starts in intestinal lymph nodes; mets to CNS and bone marrow

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16
Q

When would the FNP perform a chest x-ray while working up acute bronchitis?

A

If respiratory distress s/s present - tachypnea, tachycardia; high fever

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17
Q

Definition of acute bronchitis

A

cough with or without sputum production persisting past 7 days

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18
Q

Atypical presentation of pneumonia

A

prodrome of headache and sore throat; dry cough

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19
Q

Typical presentation of pneumonia

A

fever, chills, malaise, productive cough

rales, consolidation

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20
Q

CURB 65 criteria

A
Confusion?
BUN > 19
RR > 30
BP (SBP < 90, DBP < 60)
65 or older?
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21
Q
Management of pneumonia
Previously healthy, no recent antibiotic use
Atypical
Significant comorbidities
If suspect MRSA (recent abx use)
Peds
A

Previously healthy, no recent antibiotic use: macrolide or doxycycline
Atypical: Macrolide
Significant comorbidities: Macrolide + Augmentin or respiratory fluoroquinolone (levofloxacin, moxifloxacin)
If suspect MRSA (recent abx use): vancomycin or linezolid
Peds: amoxicillin 1st line if presumed bacterial

22
Q

Name the condition:
Sudden onset pleuritic chest pain, dyspnea
Tachycardia, tracheal deviation, hypotension

A

Pneumothorax

23
Q

How does the FNP manage a pneumothorax?

A

Observation if asymptomatic/primary and < 2-3cm
Refer all patients to pulmonologist
Hospitalize if symptomatic or large pneumo
ALL tension and secondary pneumo need hospitalization
No air travel until after complete resolution

24
Q

Name the condition:

Dyspnea, tachypnea, pleuritic chest pain

A

Pulmonary embolism

25
Q

What are the Geneva score cut-offs for probability of DVT?

A

0 - 3 points indicates low probability (8%)
4 - 10 points indicates intermediate probability (29%)
11 points or more indicates high probability (74%)

26
Q

Causes of URI vs. Croup vs. Bronchiolitis

A

URI: rhinovirus
Croup: parainfluenza virus
Bronchiolitis: RSV

27
Q

Tx for moderate-severe croup sx

A

Dexamethasone

28
Q

Screening guidelines for prostate cancer

A

Shared decision making starting at 55-age 69 with PSA & optional DRE

29
Q

Prostatitis tx

Acute vs. STI concern vs. chronic bacterial

A

acute: fluoroquinolone
STI concern: ceftriaxone + doxy
chronic: fluoroquinolone or bactrim

30
Q

What are considerations for patients taking PDE5 inhibitors for ED?

A

Make sure they are not high risk for CVD

If erection longer than 4 hours need to go to the ER

31
Q

What condition is the Prehn sign associated with?

A

Epididymitis - pain partially relieved by elevating the scrotum

32
Q

Tx for epididymitis

A

Sexually active men: Ceftriaxone + doxycycline

If enteric organisms: Levofloxacin x 10 days

33
Q

Tx for uncomplicated UTI

A

Nitrofurantoin or fosfomycin or Bactrim

34
Q

Tx for complicated UTI:

Men, pregnant women, upper UTI sx

A

Men: Bactrim, Nitrofurantoin or augmentin
Pregnant women: cephalexin, amoxicillin, augmentin
Complicated: Levofloxacin or cipro

35
Q

Tx of urethritis

A

If unable to r/o gonorrhea: Ceftriaxone + doxycycline
Nongonococcal: doxycycline or azithromycin
Azithromycin if pregnant

36
Q

Name the condition:
Persistent widespread pain - deep ache, throbbing, intense and persistent; generalized burning and tingling
Sleep issues, fatigue, emotional distress
Need to test point tenderness over many spots

A

Fibromyalgia

37
Q

Tx for acute gout attacks vs. prevention

A

Acute: NSAIDs, colchicine, corticosteroids
Prevention: allopurinol

38
Q

What lab is most sensitive for RA?

A

Anti-CCP

39
Q

What condition is a/w heberden and bouchard nodes?

A

OA

40
Q

Is OA or RA aggravated by activity?

A

OA

41
Q

Is OA or RA a/w extended morning stiffness?

A

RA

42
Q

What part of the body does PMR affect?

A

shoulder girdle, neck and pelvic girdle

43
Q

What does PMR respond well to?

A

low dose corticosteroids

44
Q

What is the presentation of giant cell arteritis?

A

head pain, jaw pain, vision problems

45
Q

What part of the body does ankylosing spondylitis affect?

A

SI joint and spine - low back pain

46
Q

What labs are elevated in ankylosing spondylitis?

A

inflammatory markers (CRP, ESR)

47
Q

What is first line for ankylosing spondylitis?

A

NSAIDs

48
Q

What is a classic sign of psoriatic arthritis?

A

sausage digits, enthesitis, nail changes

49
Q

What are the s/s of SLE?

A

fatigue, malar rash, joint pain

50
Q

What labs are indicated for SLE?

A

ANA (not specific)

Anti-Sm and anti-dsDNA autoantibodies

51
Q

What referral needs to be made for patients taking hydroxychloroquine?

A

opthalmology

52
Q

What color rash is often present in JIA?

A

salmon-colored