FM Case Files 1-5 Flashcards
An intervention designed to prevent a disease before it occurs
Primary Prevention
An intervention intended to reduce the recurrence or exacerbation of a disease
Secondary Prevention
Pulmonary difficiency that presents earlier in life:
- May or may not be associated with smoking
- Episodic exacerbations w/ return to normal baseline
Asthma
Pulmonary insufficiency that tends to present in midlife or later, is usually the ruslt of a long history of smoking and
is a slowly progressive disorder.
An airway obstruction that is not fully reversible, usually progressive, and is a/w Chronic bronchitis,
Emphysema, or Both
COPD
Cough and Sputum production on most days for at least 3 months during at least 2 consecutive years
Chronic Bronchitis
Shortness of breath caused by the Enlargement of
Respiratory Bronchioles and Alveoli caused by
Destruction of Lung Tissue
Emphysema
Pathologic changes
- Mucous gland hypertrophy w/ hypersecretion
- Ciliary dysfunction
- Destruction of Lung parenchyma
- Airway remodeling
Pathologic changes of COPD
A disease of INflammation of the airways, lung tissue, and vasculature.
COPD reversibility is defined as an increase in
FEV1 of greater than _____% or ______ mL.
COPD reversibility is defined as an increase in
FEV1 of greater than _12_% or _200_ mL.
COPD: FEV1 / FEV < 0.70
Management of Stage I COPD
Management of Stage I COPD
- β2-agonists (Albuterol)
- Anticholinergics (Ipratropium)
Management of Stage II COPD
Management of Stage II COPD
- long-acting β2-agonists (Salmeterol)
- Anticholinergics (Tiotropium)
- Oral Methylxanthines (Aminophylline, Theophylline)
Management of Stage III and IV COPD
Management of Stage III and IV COPD
- Inhaled Steroids
- Fluticasone
- Triamcinolone
- Mometasone
- Stage IV - long term oxygen therapy
- Only therapy shown to decrease mortality
- At least 15 h/d
For patients who develop COPD at a young age;
consider?
α1-Antitrypsin deficiency
Most Gout attacks occur between:
- ___ and ___ years in men
- ___ and ___ years in women
Most Gout attacks occur between:
- _30_ and _50_ years in men
- _50_ and _70_ years in women
These types of diuretics may induce Hyperuricemia
and cause Gouty attacks
Thiazide diuretics
Characteristics of Monosodium Urate Crystals
(MSU Crystals)
- Needle like appearance
- Strong Negative Birefringence
Characteristics of:
Calcium Pyrophosphate dehydrate crystals
- Rod-shaped
- Rhomboid
- Weakly Positive Birefringence
Characteristics of:
Calcium Hydroyapaptie crystals
- Cytoplasmic inclusions
- Seen on Electron microscopy
- Non-birefringent
Characteristics of:
Calcium oxalate crystals
- Bipyramidal appearance
- Strongly Positive Birefringences
- A/w End-stage Renal disease
Condition of excess uric acid leading to deposition of MSU crystals in joints, especially the Great toe (Metatarsophalangeal joint) - Podagra
Gouty Arthritis
Condition of joint pain and inflammation due to
Calcium Pyrophosphate dehydrate crystals in the Joints
Pseudogout
Laboratory tests that may be abnormal in RA?
Laboratory tests that may be abnormal in RA?
- Rheumatoid Factor (RF)
- Anti-citrullinated protein antibody (anti-CCP)
- More specific than RF
- Elevated Erythrocyte Sedimentation Rate (ESR)
- Elevated C-reactive protein (CRP)
- Anemia
- Thrombocytosis
- LOW Albumin (correlates w/ severity of disease)
Treatment for Acute Gout Attacks?
(3) Acute
(2) Maintance
- Colchicines
- NSAIDs
- Glucocorticoids
- Maintance therapy
- Probenecid - increases urinary excretion of Uric acid
- Allopurinol - reduces the production of Uric Acid
Rx therapy for RA?
- NSAIDs
- Glucocorticoids
- Disease-modifiying antirheumatic drugs (DMARDs)
- Sulfasalazine
- Methotrexate
- Anticytokines
- Infliximab
- Etanercept
- Topical analgesics
Definition for Advanced Maternal Age?
- Pregnant woman who will be 35 years or beyond at the estimated date of delivery (EDD)
Increased managment a/w Pregnancies
- Diabetes
- Asthma
- Thyroid disease
- Hypertension
- Lupus
- Thromboembolism
- Seizures
High-risk Pregnancies
What is Naegele’s Rule for estimating EDD?
- From the First day of the Last-Menstrual Period (LMP)
- Sustract 3 months
- Add 7 days
- Reliable if:
- Date is certain
- Last menstrual period was normal
- No contraceptive use in past 1 year
- No bleading since the LMP
Prenatal Visit Plan?
Prenatal Visit Plan:
- Every 4 weeks until 28-week gestation
- Every 2 weeks from 28- to 36-week gestation
- Every week from 36 until delivery
When can you use Amniocentesis
or Chorionic Villus Sampling (CVS)
Screening?
- Amniocentesis
- 15 week gestation
- 0.5% risk of Spontaneous abortion
- CVS
- 10- to 12- week gestation
- 1% to 1.5% risk of Spontaneous abortion
When do you screen for Gestational Diabetes?
24 to 28 weeks gestation
w/ a 1-hour 50g Glucose challenge test
> 140 mg/dL is Abnormal
> 200 mg/dL –> Gestational diabetes
Follow up with a 3-hour Glucose Tolerance Test (GTT)
after a overnight fast and 100g Glucose load
Reduction or Loss of Vision in One eye from lack of use
Amblyopia
Term for Ocular Misalignment
Stabismus
- The child focuses on an object with both eyes and the examiner covers one eye
- Strabisumus is suggested when the uncovered eye deviates to focus on the object
Definition of a Failure to Thrive child?
- Weight below the 3rd or 5th percentile for Age
OR
* Decelerations of Growth that have crossed two major percentailes in a short period of time
Child Car Seat guidlines?
- A child should sit in a rear-facing car seat until the child is both 1 year old and weighs at least 20 lbs.
- A child older than 1 year and between 20 and 40 lbs should use a Forward-facing car seat
- A child that weighs more than 40 lbs, the child may use a Booster-type seat along with the Lap shoulder seatbelts
- A child can stop using the booster when the child can sit with his or her back squarely against the bakc of the seat with the legs bent at knees over the front of the seat, approx. 4 ft. 9 in. ~ 8 to 12 y.o.
- No child in the front seat unless they are 13 y.o.
