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becky: Primary Care > FINAL REVIEW > Flashcards

FINAL REVIEW Flashcards

1
Q

tests to rule in DVT
tests to rule out DVT

A

rule IN: WELLS, CONSTANS
rule OUT: D-dimer, doppler

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2
Q

5 diff dx for DVT

A
  1. lymphedema
  2. lipedema
  3. thrombophlebitis
  4. gout
  5. cellulitis
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3
Q

what is endometriosis

A

chronic inflammatory disease of endometrial tissue OUTSIDE UTERUS

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4
Q

3 types of endometriosis

A
  1. peritoneal
  2. deep infiltrating
  3. ovarian
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5
Q

etiology theories of endometriosis

A

hormonal/immune system
backflow

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6
Q

signs/symptoms of endometriosis

A

pain
infertility
issues with periods
fatigue
depression/anxiety
nausea/bloating
ASYMPTOMATIC

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7
Q

screens to RULE IN and RULE OUT endometriosis

A

RULE OUT: clin history
RULE IN: pelvic exam

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8
Q

diff dx of endometriosis

A

cervical stenosis
anovulation
pelvic muscle issues
cancer

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9
Q

dx test

A

laparoscopy (GOLD STANDARD)
-ultrasound
-MRI
-lab work

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10
Q

what is HERPES ZOSTER?

A

viral infection caused by VARICELLA ZOSTER VIRUS
*dormant in DRG
*reactivated as rash/blisters in dermatomal pattern (1 or 2-3 dermatomes)

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11
Q

signs of HERPES ZOSTER

A

pain/itching/tingling in rash
*stripe of blisters/vesicles on ONE SIDE OF BODY or FACE
*fever, headache, chills, tummy issues

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12
Q

etiology of herpes zoster: how does it spread?

A

respiratory droplets or blister contact

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13
Q

reactivation triggered by:

A

age
stress
immunocompromised
chicken pox
women
fam HX

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14
Q

what is a common complication of herpes zoster?

A

post-herpetic neuralgia

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15
Q

diff diagnosis of HERPES ZOSTER

A
  1. contact dermatitis (rash_
  2. impetigo (blisters)
  3. cellulities (infection of skin, red)
  4. eczema herpeticum (vesicular lesions)
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16
Q

gold standard for diagnosis herpes zoster

A

PCR VZV test!
(also clin diagnosis screen (100% sensitivity) and DFA (specificity))

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17
Q

hypothyroidism is WHAT

A

thyroid gland does not make T4 due to thyroid or pituitary

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18
Q

primary/overt hypothyroidism has

A

high TSH, low T4

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19
Q

central/secondary or 3rtiary hypothyroidism has

A

lowish TSH and low T4

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20
Q

subclinical hypothyroidism has

A

high TSH but normal T4

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21
Q

severe hypothyroidism can lead to ____

A

myxedema coma
(hypothermia, lethargy, slow HR, altered mental)

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22
Q

primary hypothyroidism can be due to

A
  1. hashimotos
  2. low iodine
  3. radiation
  4. thyroidectomy
  5. medication
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23
Q

secondary hypothyroidism is due to

A

pituitary
tumor or sheehan’s syndrome

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24
Q

how to diagnose hypothyroidism

A

2 step blood test
1. check TSH (high?)
2. check T4 (low?)

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25
diff diagnoses for hypothyroidism
1. anemia 2. addisons 3. depression 4. iodine deficiency 5. goiter 6. myxedema 7. dysmenorrhea 8. erectile dysfunction
26
27
PT should be wary of what with hypothyroidism?
CARDIOPULM joint pain, cramps, mm weakness, fatigue, SOB *exercise tolerance *CTS
28
what is acid reflux?
LOWER ESOPHAGEAL SPHINCTER doesn't close, open too much
29
signs/symptoms
heartburn! regurgitation sour taste sore throat nausea hard time swallowing
30
risk factors of acid reflux
females over 50 pregnant obese, smokers, stressed hiatial hernia meds and diet
31
tests to rule out acid reflux
esophageal pH test x-ray
32
test to rule in acid reflux
esophagoscopy (GO IN) manometry (MEN GO IN)
33
diff dx for acid reflux
cancer (long term GERD --> cancer) esophagitis (inflammation) IBS (pain) peptic ulcer disease (sores in stomach)
34
appendicitis is WHAT
inflammation due to filling with mucus, stool, parasites *can lead to abscess, ileus, peritonitis, or death
35
when do symptoms present?
ACUTE IN 24 HOURS *pain RLQ, SUDDEN *nausea, vomiting *loss of appetite *pain increases with pressure (cough) *GI symptoms *FEVER
36
most common bacteria involved in appendicitis
E Coli Bacteroides ssp *can treat with antibiotics
37
what are causes of appendicitis?
stool appendix mass, abscess infection agents (virus, bacteria, parasites)
38
risk factors for appendicitis
10-30 age men fam hx (3x) environmental factors (air pollution) ethnic minorities
39
diff dx for appendicitis
crohns
40
SCREEN OUT appendicitis
mcBurneys (ASIS and belly button)
41
tests to rule IN appendicitis
alavarado score (high sens, low spec but MOST CITED) eats AAS (high, med, low risk for imaging) in the AIR (over 8)
42
dx tests for lab work APPENDICITIS
c reactive protein WBC procalcitonin
43
imaging for appendicitis
CT (most used) -enlarged -thick -inflammation -appendicolith ultrasound MRI
44
acute cholecystitis vs chronic cholecystitis
acute: gallstone obstructed bile duct chronic: recurrent episodes
45
acalculous cholecystitis
acalculous: no stones! (illness, male, trauma, burns, nutrition, bone marrow transplant)
46
signs/symptoms of cholecystitis
1. murphy's sign 2. colicky pain in RUQ/R scap/midback 3. nausea, vomiting, bloated, fever 5. WBC count HIGHER (12-15000)
47
tests to screen OUT cholecystitis
ultrasound HIDA scan CBC CT scan with contrast
48
test to rule in cholecystitis
palpation RUQ ultrasound HIDA scan
49
gold standard for cholecystitis
ultrasound (95% pts have gallstones) serum lipase levels (pancreatitis, peptic ulcers)
50
diff dx of cholecystitis
1. MI 2. herpatitis 3. cholangitis 4. appendicitis 5. gastritis 6. PUD, pancreatitis
51
what is UTI?
infection of bladder/urethra E.coli!
52
signs/symptoms of UTI
need to pee lots, small amounts pain burning pee pee is cloudy, red, brown, pink, SMELLY
53
complications of UTI
repeated infections kidney damage sepsis delirium
54
diff diagnoses of UTI
cancer overactive bladder interstitial cystitis STIs kidney stones/infection
55
tests to rule OUT UTI
1. nitrite and leukocyte esterase 2. NGAL
56
tests RULE IN UTI
WBC biomarkers (NGAL interleukins eNOSE
57
diagnostic tests UTI
urine culture CT scan/renal ultrasound
58
3 clinical tests for diabetic neuropathy
1. superficial pain 2. monofilament 3. vibration
59
signs of UMN/cord compression
neck/back pain 2. bad sensation/weakness 3. B&B (loss of sex ability) 4. foot drop, coordination (hyperreflex, spasticity, clonus/babinski)
60
most common cause of myelopathy in adults over 55
cervical spondylosis *CT*
61
what is most effective imaging for cervical myelopathy
MRI (GOLD STANDARD (gadolinium contrast enhanced)
62
groin hernia is what
bowel/ab tissue bulging through weak ab mm (inguinal or femoral)
63
signs symptoms of groin hernia
Visible bulge in the inguinal area that goes away when LYING SUPINE and applying mild pressure. Increased pain or bulge with activity or cough. Discomfort that can progress to intense pain if not treated. Burning sensation that may radiate down the leg. More obstruction = more symptoms overtime.
64
diff dx of groin hernia
lymphadenopathy/adenopathy femoral artery aneurysm mm strains psoas abscess sebaceous cist testicle epididymitis hydrocele
65
screen OUT groin hernia
herniography CT
66
RULE IN groin hernia
ultrasonography MRI with valsalva

becky: Primary Care (7 decks)

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