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CLINDX Unit 2 UFCOM > High Yield Test Hints > Flashcards

High Yield Test Hints Flashcards

1
Q

Last unit each lecture got 5 questions. For lec 1 duff gave 5 hints, Lec 2 he gave 5, lec 3 he gave a bunch of hints & none for lec 4

A

-

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2
Q

Present with green-yellow frothy discharge, pruritis & increased pH. Treatment?

[On Test]

A

Trich –> single dose (4 pills) of metronidazole

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3
Q

What tests are generally done for trich in a primary care setting?

[On test]

A

Saline & PAP

NOT culture

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4
Q

Thin gray discharge, fishy odor & no inflammation/pruritis. Diagnosis?

[On test]

A

BV

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5
Q

Diagnostic test for appendicitis?

[On test]

A

CT

WBC can also be helpful as is elevated & has left shift

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6
Q

Diagnostic test for stones?

[On test]

A

Best is Ultrasound (for calcified)
CT if ultrasound is not diagnostic
Will also have gross or microscopic blood in urine

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7
Q

Diagnostic test for ectopic preg?

[On test]

A

Urine hcg
Ultrasound
CBC/Hematocrit (blod loss)

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8
Q

Diagnostic test for PID?

[On test]

A

PCR/Nucleic Acid Amplification Test (NAAT) for gonorrhea & chlamydia
WBC
Ultrasound for cysts

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9
Q

What are the different imaging studies & when are they used?

[On test]

A

Ultrasound for younder patients (does better with denser breasts & patients are low risk)

Mammogram screening test of choice

MRI = only for high risk patients

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10
Q

What makes a definitive diagnosis in breast cancer?

[On test]

A

Stereotactic or excisional biopsy

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11
Q

What should be at the top of the diff diagnosis if find purulent/yellow disharge from the nipple?

[On test]

A

Mastitis

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12
Q

What are risk factors for mastitis?

[On test]

A

Breast feeding (Puerperal)
Trauma (Non-Puerperal)
Piercings (Non-Puerperal) even in men

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13
Q

What organisms cause mastitis?

[On test]

A 
Staph Aureus (70%)
Strep Viridans (30%)
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14
Q

Treatment of Mastitis?

[On test]

A

Sodium Dicloxacillin (cousin of pen)
Cephalexin (Cephalosporin, give if have mild pen allergy)
Trimethoprim-sulfamethaxole (If severe allergy)
Clindamycin (If allergic to sulfa drugs & pen)

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15
Q

What is suspected when there is a bloody nipple discharge?

[On test]

A

Intraductal papilloma

Malignancy

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16
Q

Causes of Galactorrhea?

[On test]

A 
Idiopathic
Drugs (anti-psychotic)
Hypothyroidsim (TRH can increase prolactin)
Pituitary mass --> increase in prolactin
Chest wall irritation
17
Q

What things do you need to look for in a breast mass?

[On test]

A 
discharge
firm/cystic
skin changes
overlying skin changes
tenderness
18
Q

Tests for Galactorrhea?

[On test]

A

Serum prolactin & TRH

19
Q

Diagnostic test for Candida?

[On test]

A

KOH prep looking for hyphae & budding yeast

20
Q

Candida Treatment?

[On Test]

A 
Topical Miconazole (monostat) or Clotrimazole 
Single dose oral Fluconazole (Diflucan)
21
Q

How does Cushing effect growth?

[On test]

A

Growth failure

22
Q

What is the number 1 cause of Secondary Adrenal Insufficiency?

[On test]

A

Exogenous steroids = cortisone & prednisone

23
Q

What other diseases do people with Addisons usually get?

[On test]

A

50% get other autoimmune endocrinopathies , most often thyroid (25%)

24
Q

How do cortisol levels change during the day?

[On test]

A

Very high at about 7am & very low at about 11pm

Measure at morning peak for def
Measure at low point to measure excess

25
Q

Do Inferior Petrosal Sinus Sampling, then give hCRH. Plasma ACTH raise on both sides but a ton on the right side. Where is tumor?

What if ACTH level do not rise much?

[On test]

A 
In head (not ectopic)
In pituitary more so on the right side than the left

Ectopic

26
Q

What is the acute managment of hypercalcemia?

[On test]

A

Hydrate (to make pee out)

Give Lasik (induces calciuria)

Treat underlying cause

27
Q

What are the indications for surgery in hyperparathyroidism?

[On test]

A 
Symptomatic
Younger than 50
High serum Ca
High urinary Ca excretion
Low bone density
Medical monitoring may not work
Uncertain follow up
Reduce creatine clearance
Coexistent confounding disease
28
Q

What is the management of hypocalcemia?

[On test]

A

Continuous infusion of Ca (instead of bolus)

IV Mg

29
Q

If see hypothyroidism, what else should you test for?

[On test]

A 
DM
Vitiligo
Alopecia
Celiac
Inflam bowel disease
30
Q

What do you do if a child has anti-thyroid antibodies but no symptoms?

[On test]

A

Probably wont become hypothyroid

Monitor with TSH every 6-12 months
If ever have high TSH, begin treatment

31
Q

Anti-thyroid antibodies can be a sign of what? How liekly is it?

[on test]

A

thyroid cancer (but rare so dont automatically test everyone)

1 in 1000 hashimotos to cancer ratio

60-80% of thyroid cancers have Ab

32
Q

When do you do an ultrasound for suspected thyroid cancer (anti-thyroid Ab +)?

[On test]

A

Only if gland is asymmetrical or look bizarre/concerning cuz rare

33
Q

How do new borns with congenital hypothyroidism present?

[On test]

A

Mainly normal, cuz getting hormone from mom

60% jaundice
40% enlarged fontanels

34
Q

What is the goal with Levothyroxine therapy?

[On test]

A

To get in the upper half of normal range (12-20) so that when they outgrow their dose they are still in normal range

Also want greater than 50% free T4

35
Q

What test(s) should be order for suspected hyporthyroidism?

[On test]

A

Only TSH, as T3 has little value with normal TSH

36
Q

Why do we get T3 when testing for hyperthyroidism?

[On test]

A

Can get low TSH, normal T4 & isolated elevated T3 toxicosis (graves disease)

37
Q

How do you treat Thyroid Binding Globulin Deficiency?

[On test]

A

Low binding protein but free T4 is fine –> no treatment

38
Q

If a thyroid Ultrasound is suggestive of cancer, how do you proceed?

[On test]

A

NOT definitive, only do ultrasound to find additional nodules & to figure out where need to biopsy

Do a FINE NEEDLE BIOPSY

CLINDX Unit 2 UFCOM (8 decks)

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