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CMN 568 > final memorize > Flashcards

final memorize Flashcards

1
Q

anemia:
levels
risks

A

H/H <11/33 in 1st and 3rd trimester
H/H <10.5/32 in 2nd

intrauterine growth restriction
preterm labor

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2
Q 
ASTHMA SEVERITY:
Intermittent
symptoms
wake's
SABA use
activity
A

S: <2days/week
W: 0-4y 0 / >5y 2/month
SABA: <2 d/wk
A: none

SABA prn

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3
Q

Flu antivirals

A

start w/in 48 hours
DOC: Tamiflu

Relenza - no asthma, must be >7y/o

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4
Q

LABA example

A

Salmeterol

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5
Q

6 month vision screening

A

cover test (what for movement of eye after cover is removed)

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6
Q

folic acid recommendations

A

History/family hx neural tube defect - 4mg/day several months before pregnancy

insulin Diabetes / seizure meds (depakote, carbamazepine) - 1mg/day

others - 0.4mg/day 1 month before pregnancy

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7
Q

ibuprofen pediatric dosage

A

5-10 mg/kg q6-8h
max 40mg/kg/day

must be >6 months

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8
Q

What organism most commonly causes otitis externa?

A 
Pseudomonas aeruginosa
(staph aureus and staph epidermis are also frequent causes, fungi common in DM and immunocompromised)
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9
Q

viral croup:
agent
s/s

A 
parainfluenza virus (RSV)
s/s: steeple sign
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10
Q

AOM treatment?

A

1st line: Amoxicillin

2nd line: Augmentin or ceftriaxone (taken amoxicillin in last 30 days or doesn’t improve - might be H.influenza)

PCN rash - ceftriaxone, cefdinir, cefuroxime, cefpodoxime

PCN allergy - bactrim, macrolide(azithromycin), clindamycin

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11
Q

What is the first line medication for allergic rhinitis in adults?

A 
Intranasal corticosteroids
(oral antihistamines are useful but may cause drowsiness, nasal anticholinergics are useful for vasomotor rhinitis, decongestants may help w/ stuffiness but do not address inflammation)
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12
Q

ZIKA dx

A

culture

-can be found in semen up to 69 days after symptom onset

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13
Q

10 day old with staccato cough, tachypnea, and conjunctivitis. Most likely organism?

A

Chlamydia trachomatis can be passed to the infant during birth if the mother has an infection. The presenting symptoms are tachypnea, a staccato cough and conjunctivitis in a young baby

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14
Q

Pneumonia vaccines

A

PCV13:
all >65 y/o
19-64 if immunosuppressed , renal figure, CA, cochlear implant, CSF leak

PPSV 23:
all >65 y.o
19-64, 1 dose: smoke, chronic disease, DM, ETOH, long term facility
2 doses 5 yrs apart: HIV, CA, immunocompromised

give PCV13 first then wait 1 year before PPSV23

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15
Q

fetal movement onset

A

18-20 wks primiparous

14-18 wks multigravida

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16
Q

COPD Group C

A

> 2 moderate exacerbations, >1 hospital admit

LAMA

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17
Q

AOM must have to diagnoses?

A

bulging TM and middle ear effusion

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18
Q

Empiric treatment for 42 yr old with CAP, no comorbidities, no recent antibiotic use, allergic to azithromycin.

A

She has no risks for antibiotic resistance, so we would use either a macrolide or tetracycline. Since she is allergic to azithromycin (macrolide), tetracycline (Doxycycline) would be appropriate. They are not in the same class.

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19
Q

kids & adults oral corticosteroid dosage

A

KIDS: 1-2 mg/kg/day single or divided BID

ADULTS: 40-60mg/day single of divided BID

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20
Q

med for uncomplicated cystitis

A

bactrim and macrobid

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21
Q

fundal height

A

8 wks - just at pubic symphysis
16 was - midpoint between pubic symphysis and umbilicus
20 wks - at umbilicus
18-34 weeks - match gestational age in weeks
after 26 weeks - may not match b/c baby defended

grand multis may not measure correctly d/t thinning of uterus and poor uterine support

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22
Q

ASTHMA CONTROL:
not well controlled

symptoms
wake's
SABA
activity
oral med exacerbations
A 
symptoms >2/wk
wake's
0-4: >1/mth
5-11: >2/mth
>12: 1-3/wk
SABA: >2/wk
activity: some
oral med exacerbations: 
0-4: 2-3/yr
>5: >2/yr
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23
Q

Blepharitis treatment

A

eyelid hygiene

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24
Q

COPD Group D

A

> 2 moderate exacerbations, >1 hospital admit

LAMA
OR
LAMA/LABA
OR ICS+LABA if eos >300

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25
Q

celiac disease diet NOs

A

wheat, rye, barley

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26
Q

endometritis meds

A

clindamycin
gentamicin
(IV)

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27
Q

Pre-eclampsia definition

A

BP >140/90 on 2 occasions 4 hours apart plus 1 of:

  • proteinuria
  • thrombocytopenia
  • renal insufficiency
  • impaired liver fx
  • pulmonary edema
  • cerebral/vision sx
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28
Q

ASTHMA CONTROL:
poorly controlled

symptoms
wake's
SABA
activity
oral med exacerbations
A 
symptoms: throughout day
wake's
0-4: >1/wk
5-11: >2/wk
>12: >4/wk
SABA: several a day
activity:very limited
oral med exacerbations:
0-4: >3/yr
>5: >2/y
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29
Q

AOM most common pathogen

A

strep pneumo

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30
Q

acute otitis externa:
S/S
treatment

A

s/s: acute onset of severe ear pain, can’t see into ear (swollen)

use wick for Abx (fluoroquinolone)

if can’t see TM d/t swelling give Ciprodex (safe if TM perforated)
-Cortisporin if can see TM NOT perforated

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31
Q

acute cystitis meds in pregnancy

A

cefpodoxamine
amoxiciilin-clavulante
fosfomycin
nitrofurantoin (until 38 weeks)

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32
Q

Bronchiolitis testing & tx

A

don’t do RSV swab (doesn’t dictate tx)
don’t give meds (no steroids, albuterol, abx)
Tx if severe ill - ribovirin if immunocompromised

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33
Q

pregnancy initial labs

A 
CBC
Rh/antibody
RPR/VDRL
HIV
Hep B surface antigen
rubella/varicella titers
UA
Pap/HPV
GC/Chlamydia
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34
Q

suspect w/ painless bleeding after 24 weeks

A

placenta previa

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35
Q

McBurneys

A

RLQ (appendicitis)

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36
Q

optimal glucose levels

A

fasting 70-95
1 hr postprandial <130-140
2 hr postprandial <120

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37
Q

COPD dx

A

spirometry

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38
Q 
ASTHMA SEVERITY:
SEVERE PERSISTENT
symptoms
wake's
SABA use
activity
A

S: throughout day
W: 0-4y >1/wk / >5y 7x/wk
SABA: several/day
A: very limited

0-4y: medium dose ICS
5-11: medium dose ICS + LABA (+oral med)
>12: medium dose ICS + LABA OR high dose ICS + LABA

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39
Q

CURB-65

A 
admission tool for CAP:
Confusion
Urea (BUN >7)
BP (<90/60)
Age >65
0=outpt
1-2=admit
3-4=ICU
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40
Q

high dose IIV3 and IIV4

A

give to >65

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41
Q

AOM watchful waiting criteria

A

6mth-2y: all ABx (except unilateral w/o otorrhea may observe)

> 2y:
Abx - otorrhea w/ AOM or AOM (uni or bi) w/ severe symptoms
may wait: bilateral or unilateral w/o otorrhea

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42
Q

What are the side effects of tiotropium?

A

Tiotropium is an anticholinergic long-acting bronchodilator. Anticholinergic medications can cause urinary retention. Caution is needed if Rx to a male with BPH

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43
Q

depression SSRI in kids

A

prozac

44
Q

vision screening: referral reason

A

absent red reflex

2 line discrepancy

45
Q

PP hemorrhage meds

A

oxytocin
methergine
prostin

46
Q

viral croup: tx

A

mild-moderate: supportive, 1 dose dexamethasone, DC if symptoms resolve <3hrs

moderate-severe: humidified O2, racemic epi - if recurrent epi admit

47
Q

CAP: adults vs kids agents

A

adults: bacterial
kids: viral (RSV, parainfluenza, influenza A/B)

48
Q

Review the choice of antibiotics for strep pharyngitis if mono may also be present. Are there any antibiotics that you should AVOID?

A

amoxicillin

use cephalexin, azithromycin, clindamycin

49
Q

Treatment of uncomplicated cystitis?

A

Monurol, Macrobid, Bactrim

50
Q

mastitis meds

A

cephalosporins
erythromycin
dicloxacillin

bactrim if MRSA

51
Q

appendicitis imaging & earliest sign

A

CT

periumbilical pain that moves to RLQ

52
Q

Epistaxis treatment plan

A

direct pressure 15 minutes
tilt head forward
topical decongestant (Afrin)

53
Q

COPD Group B

A

0-1 moderate exacerbations, no hospital admit

LABA or LAMA

likely to have comorbidities
may need 2 bronchodilators

54
Q

pediatric tylenol dosage

A

10-15 mg/kg q 4-6h

max 5 dose, 4g

55
Q

HTN meds contraindicated pregnancy

A

ACE ARBS

-prils

56
Q

Bronchiolitis S/S

A

<2y/o, hx prematurity

starts as URI

57
Q

ADA gestational diabetes screening

A 
1 step:
8 hour fast >92
75g OGTT:
1 hr >180
2 hr > 153

-takes 1 abnormal-

58
Q

What medication is recommended for the treatment of urticaria (rash & itching) in a 3 yr old?

A

antihistamine

59
Q

GDM treatments

A

(1) diet

(2) insulin
or hypoglycemic agent - metformin, glyburide

60
Q

invasive genetic testing

A

> 35y/o of family hx

  • chorionic villous sampling 10-13 wks by transabdominal or transvaginal
  • amniocentesis 15-20 wks
61
Q

most accurate way to obtain temp, what value is fever

A

rectal

>100.4

62
Q

asymptomatic bacteriuria in pregnancy meds

A

beta lactic: PCN and cephalosporins
-amoxicillin, amoxicillin-clavulante, cephalexin, cefpodoxine

  • fosfomycin (single dose tx)
  • nitrofurantoin in 2nd trimester

5-14 days, repeat cx 1-2 weeks after tx

63
Q

What is the first line treatment for mania

A

Valproic acid

64
Q

AOM amoxicillin dosage

A

80-90mg/kg divided BID

-max 2000mg/day

65
Q

ACOG gestational diabetes screening

A

2 step:
(1) 50g non fasting GCT
1hr >130-140
-abnormal proceed to OGTT-

(2) 100g OGTT
fasting >95
1hr > 180
2 hr > 155
3 hr > 140
-take 2 abnormals-
66
Q

determine risk of GABHS

A 
center criteria:
fever >100.4
tender anterior cervical adenopathy
lack of cough
exudate

2: strep test
3: PCN

67
Q

Zika wait time

A

men - 6 months after symptoms or exposure

women - 8 weeks after symptoms or exposure

68
Q

diverticulitis where is pain?

A

LLQ pain

69
Q

Myopia vs. Hyperopia

A

M: nearsighted (distance blurred)

H: farsighted

70
Q

pertussis tx

A

works best in early disease
azithromycin
clarithromycin
erythromycin >1m/o

71
Q

Obtruator

Rovsing

Iliopsoas

A

O: RLQ pain on internal rotation of right hip

R: push LLQ pain RLQ

I: extension R hip pain RLQ

72
Q

allergic rhinitis tx

A

non sedating antihistamines

Mast cell stabilizers

73
Q

CAP causes/tx

A

adults - bacterial S. pneumoniae

tx:
macrolide (azithromycin/doxycycline)

> 65, comorbidity, recent abx 90 days- resp. fluoroquinolones (moxifloxacin) OR macrolide + b-lactam (amoxcil)

74
Q

severe chronic HTN meds pregnancy

A

1st - methyldopa, labetalol, nifedipine

2nd - diuretics

75
Q

HTN types delivery goals

A

chronic - 38-40 weeks
gestational - 37 weeks
pre-eclampsia - 37 weeks
severe pre-eclampia - strive for >34 weeks

76
Q

Pertussis 3 stages

A

(1) catarrhal (7days-3wks): runny nose, low-grade fever, mild cough (URI)
(2) paroxysymal (1-10wks): whooping cough worse @ night
(3) convalescent (7days-3 weeks): gradual recovery

77
Q

retinal detachment: S/S

A

curtain, floaters/flashers

78
Q

What is a FDA approved medication for the prevention of migraines in a 15 year-old?

A

Topirimate

79
Q

S/S: acute closed angle glaucoma

A

sudden onset
halos around lights
pupil dilated and unreactive to light

80
Q

recombinant influenza vaccine (RIV4)

A

give to >18 w/ egg alley

81
Q

PE s/s

A

sudden shortness of breath
tachycardia
anxious

82
Q

Aneuploidy Screening

A

(1) stepwise
11 wks - 13/6 weeks - US measurement of fetal nuchal translucency + serum PAPP-A and BHCG
15 wks - 18 wks - maternal AFP (open neural tube defect)

(2) quadruple screening (15-20 wks, ideal 16-18)
- maternal AFP
- BHCG
- unconjugated estriol
- inhibin

83
Q

PUPPS when & tx

A

3rd trimester - 2 weeks PP

topical steroids
antihistamines
sarna lotion

84
Q

GAD med

A

benzo

85
Q 
ASTHMA SEVERITY:
MODERATE PERSISTENT
symptoms
wake's
SABA use
activity
A

S: daily
W: 0-4y 3-4/mth / >5y >1x/wk
SABA: daily
A: some

0-4y: medium dose ICS
5-11: medium dose ICS + oral med
>12: low dose ICS + LABA OR medium dose ICS (+oral med)

86
Q

Baloxavir (Xofluza) is approved for which patients?

A
  • Balozavir is approved by the FDA for treatment of acute uncomplicated influenza within 2 days of illness onset in people 12 years and older. The safety and efficacy of baloxavir for the treatment of influenza have been established in pediatric patients 12 years and older weighing at least 40 kg. Safety and efficacy in patients less than 12 years of age or weighing less than 40 kg have not been established. One oral dose is given.
  • Dose: Weight 40-79kg: 40mg po x 1 dose
  • Weight > 80kg: 80mg po x 1 dose
  • CDC does not recommend use of baloxavir for treatment of pregnant women or breastfeeding mothers.
  • CDC does not recommend use of baloxavir for chemophylaxis
87
Q

Asthma and LABA

A

never give alone to Asthma patient - slow acting so can’t use as rescue

88
Q 
ASTHMA SEVERITY:
MILD PERSISTENT
symptoms
wake's
SABA use
activity
A

S: >2days/week
W: 0-4y 1-2x/mth / >5y 3-4x/month
SABA: >2 d/wk
A: minor

low dose ICS

89
Q

iron teaching

A

continue 3 months after iron levels normal
take on empty stomach w/ OJ

beef, liver, beans, whole grains, nuts, dark leafy greens

90
Q

prenatal weight gain

A

underweight BMI <18.5: 28-40lbs
normal BMI 18.5-24.9: 25-35lbs
overweight 25-29.9: 15-25lbs
obese >30: 11-20lbs

91
Q

epiglottitis: S/S

A

drooling
sudden high fever
tripod

92
Q

pregnancy UTIs do not give

A 
fluorquinolones
tetracyclines
3T: sulfonamide (jaundice)
1T: trimethoprim (folic acid antagonist)
after 38 weeks - nitrofuratoin (anemia)
93
Q

Live attenuated influenza vaccine (LAIV4)

A

mist
2-49
healthy

NOT pregnant, healthcare, close contact w/ high risk, kids<18 taking ASA, cochlear implant, CSF leak, 2-4y w/ asthma, antiviral w/in 48 hrs

94
Q

COPD Group A

A

0-1 moderate exacerbation, no hospital admit

bronchodilator

95
Q

Antibiotic of choice to treat CAP that covers mycoplasma pneumonia

A

A macrolide, like azithromycin, is used to treat CAP when you suspect Mycoplasma pneumonia.

96
Q

ASTHMA CONTROL:
well controlled

symptoms
wake's
SABA
activity
oral med exacerbations
A 
symptoms <2/wk
wake's
0-4: <1/mth
5-11: <2/mth
>12: <2/mth
SABA: <2/wk
activity: none
oral med exacerbations: 0-1/yr
97
Q

Treatment of viral CAP in children

A

The most common causes of CAP in children are viruses, but clinical exam, CXR and lab work can not reliably distinguish between viral and bacterial CAP. Therefore, we usually treat with empiric antibiotics to cover for possible co-existent bacterial pneumonia. Amoxicillin is the drug of choice. You also give supportive care and anti-viral medication if the test positive for influenza

98
Q

Empiric treatment of CAP in 39 yr old, smoker, alcoholism and chronic liver disease

A

This patient has comorbidities that make use of a fluoroquinolone or a combination of macrolide plus beta-lactum the recommended treatment. Moxifloxacin was the only fluoroquinolone listed and there were no combination regimes listed

99
Q

Which are stimulant laxatives?

A

Bisacodyl

100
Q

CAPS: kids treatment

A

bacterial: amoxicillin
viral: abx usually indicated, if flu + give tamiflu

101
Q

Sinusitis Abx

A

10-14 days w/o improvement

amoxicillin or Augmentin

102
Q

What is a complication of Pseudotumor Cerebri?

A

Vision loss

103
Q

acute pyelonephritis med

A

cipro

104
Q

prenatal visit schedule

A

<28 weeks - every 4 weeks
28-26 weeks - every 2 weeks
36-40 weeks - every week

105
Q

What is a FDA approved medication for acute migraine in child >12 years-old?

A

Almotriptan

CMN 568 (10 decks)

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