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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
Q

diff diagnoses for hypothyroidism

A
  1. anemia
  2. addisons
  3. depression
  4. iodine deficiency
  5. goiter
  6. myxedema
  7. dysmenorrhea
  8. erectile dysfunction
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26
Q
A
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27
Q

PT should be wary of what with hypothyroidism?

A

CARDIOPULM
joint pain, cramps, mm weakness, fatigue, SOB
*exercise tolerance
*CTS

28
Q

what is acid reflux?

A

LOWER ESOPHAGEAL SPHINCTER doesn’t close, open too much

29
Q

signs/symptoms

A

heartburn!
regurgitation
sour taste
sore throat
nausea
hard time swallowing

30
Q

risk factors of acid reflux

A

females over 50
pregnant
obese, smokers, stressed
hiatial hernia
meds and diet

31
Q

tests to rule out acid reflux

A

esophageal pH test
x-ray

32
Q

test to rule in acid reflux

A

esophagoscopy (GO IN)
manometry (MEN GO IN)

33
Q

diff dx for acid reflux

A

cancer (long term GERD –> cancer)
esophagitis (inflammation)
IBS (pain)
peptic ulcer disease (sores in stomach)

34
Q

appendicitis is WHAT

A

inflammation due to filling with mucus, stool, parasites

*can lead to abscess, ileus, peritonitis, or death

35
Q

when do symptoms present?

A

ACUTE IN 24 HOURS
*pain RLQ, SUDDEN
*nausea, vomiting
*loss of appetite
*pain increases with pressure (cough)
*GI symptoms
*FEVER

36
Q

most common bacteria involved in appendicitis

A

E Coli
Bacteroides ssp
*can treat with antibiotics

37
Q

what are causes of appendicitis?

A

stool
appendix mass, abscess
infection agents (virus, bacteria, parasites)

38
Q

risk factors for appendicitis

A

10-30 age
men
fam hx (3x)
environmental factors (air pollution)
ethnic minorities

39
Q

diff dx for appendicitis

A

crohns

40
Q

SCREEN OUT appendicitis

A

mcBurneys (ASIS and belly button)

41
Q

tests to rule IN appendicitis

A

alavarado score (high sens, low spec but MOST CITED) eats AAS (high, med, low risk for imaging) in the AIR (over 8)

42
Q

dx tests for lab work APPENDICITIS

A

c reactive protein
WBC
procalcitonin

43
Q

imaging for appendicitis

A

CT (most used)
-enlarged
-thick
-inflammation
-appendicolith

ultrasound
MRI

44
Q

acute cholecystitis vs chronic cholecystitis

A

acute: gallstone obstructed bile duct
chronic: recurrent episodes

45
Q

acalculous cholecystitis

A

acalculous: no stones! (illness, male, trauma, burns, nutrition, bone marrow transplant)

46
Q

signs/symptoms of cholecystitis

A
  1. murphy’s sign
  2. colicky pain in RUQ/R scap/midback
  3. nausea, vomiting, bloated, fever
  4. WBC count HIGHER (12-15000)
47
Q

tests to screen OUT cholecystitis

A

ultrasound
HIDA scan
CBC
CT scan with contrast

48
Q

test to rule in cholecystitis

A

palpation RUQ
ultrasound
HIDA scan

49
Q

gold standard for cholecystitis

A

ultrasound (95% pts have gallstones)
serum lipase levels (pancreatitis, peptic ulcers)

50
Q

diff dx of cholecystitis

A
  1. MI
  2. herpatitis
  3. cholangitis
  4. appendicitis
  5. gastritis
  6. PUD, pancreatitis
51
Q

what is UTI?

A

infection of bladder/urethra
E.coli!

52
Q

signs/symptoms of UTI

A

need to pee lots, small amounts
pain
burning pee
pee is cloudy, red, brown, pink, SMELLY

53
Q

complications of UTI

A

repeated infections
kidney damage
sepsis
delirium

54
Q

diff diagnoses of UTI

A

cancer
overactive bladder
interstitial cystitis
STIs
kidney stones/infection

55
Q

tests to rule OUT UTI

A
  1. nitrite and leukocyte esterase
  2. NGAL
56
Q

tests RULE IN UTI

A

WBC
biomarkers (NGAL interleukins
eNOSE

57
Q

diagnostic tests UTI

A

urine culture
CT scan/renal ultrasound

58
Q

3 clinical tests for diabetic neuropathy

A
  1. superficial pain
  2. monofilament
  3. vibration
59
Q

signs of UMN/cord compression

A

neck/back pain
2. bad sensation/weakness
3. B&B (loss of sex ability)
4. foot drop, coordination
(hyperreflex, spasticity, clonus/babinski)

60
Q

most common cause of myelopathy in adults over 55

A

cervical spondylosis CT

61
Q

what is most effective imaging for cervical myelopathy

A

MRI (GOLD STANDARD (gadolinium contrast enhanced)

62
Q

groin hernia is what

A

bowel/ab tissue bulging through weak ab mm (inguinal or femoral)

63
Q

signs symptoms of groin hernia

A

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
Q

diff dx of groin hernia

A

lymphadenopathy/adenopathy
femoral artery aneurysm
mm strains
psoas abscess
sebaceous cist
testicle
epididymitis
hydrocele

65
Q

screen OUT groin hernia

A

herniography
CT

66
Q

RULE IN groin hernia

A

ultrasonography
MRI with valsalva

becky: Primary Care (7 decks)

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