Key Points Flashcards

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1
Q

screen for metabolic syndrome and EPS

A

Antipsychotics

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2
Q

great for anxiety and depression. BBW SI in kids. Dont stop abruptly

A

SSRIs

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3
Q

Most likey SSRI to cause sexual dysfucntion

A

(Partoxetine (paxil)

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4
Q

sense of risk or harm; disturbing thoughts and images with compulsion that is done to reduce the anxiety about the obsessions

A

OCD

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5
Q

Tx for OCD

A

Tx: SSRI and CBT

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6
Q

When does USPSTF say to start screening for substance abuse?

CAGE vs. AUDIT?

A

18 for substance use/ abuse . CAGE,

AUDIT (14 years old and up )

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7
Q

Meds for active alcohol withdrawal

A

Librium, ativan, valium

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8
Q

(can’t use if taken opioids in last week). Can drink on this med . helps with alcohol cravings

A

Naltrexone

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9
Q

Meds to help with alcohol cravings

A

Naltrexone
Acamprosate
Disulfiram (antabuse)

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10
Q

Vitamin supplementation for alcoholics

A

B12
Thiamine
Folic acid
Magnesium

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11
Q

What might labs show in alcoholic pt

A

low platelet count
increased MCV
elevated AST and ALT
hypertriglyceridemia

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12
Q

Delayed attainment of milestones; concern for social interactions; reaction to loud noises; language impairment (not a specific sign); repetitive behaviors (lining up toys, not ok with messing up line)

A

ASD

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13
Q

Screening tools for ASD. Ages to use?

CHAT =
MCHAT =
CAST=

A

CHAT 18-24 mos
MCHAT Toddlers
CAST over age 3

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14
Q

WHat is necessary for dx of ASD?

What else to look for?

A

Sx have to be present since age 1

Check lead levels

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15
Q

When can you dx ADHD

A

not before age 4

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16
Q

lanugo, peripheral edema (low albumin), amenorrhea, BMI <18.5
At risk for osteoporosis/osteopenia

A

anorexia

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17
Q

proteinuria, low albumin, high lipids, peripheral edema, periorbital edema

DM #1 cause in adults
ED
Chronic condition, not curable. Tx recurrence with corticosteroid

A

nephrotic syndrome

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18
Q

often occurs after strep infection. Hematuria

Tx often supportive, abx if needed, diuretics. Hospital if severe.

A

Glomerulonephritis

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19
Q

> 150mg/day → caused by exercise, can indicate renal disease and/or HTN

A

Proteinuria

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20
Q

30-150mg protein in urine /day → early sign renal disease, esp in diabetics

A

Microalbuminuria

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21
Q

How to tx Proteinuria?

A

Tx: ACEi or ARB. control HTN and DM; may need Na and protein restricted diet

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22
Q

What do bence jones proteins in urine indicate

A

multiple myeloma

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23
Q

Painless hematuria…

A

think bladder CA. Smoking increases risk

24
Q

3 or more RBCs per high-power field

A

hematuria

25
Q

Persistent if occurs on 2 or more occasions
Can be exercise induced
DDx: meses, UTI, renal disease, stone (urolithiasis) Bladder CA
False positives: semen, vit c supplements

A

hematuria

26
Q

If hematuria present with protein …

A

refer to nephrologist

27
Q

prostate nontender, rubbery, smooth, can’t feel median sulcus

A

BPH

28
Q

How to treat BPH

A

Tx: alpha blocker at bedtime to combat drop in BP (terazosin, doxazosin)
TURP, prostatectomy

Alpha blockers= relax the muscle of the prostate and bladder neck, which allows urine to flow more easily

29
Q

super tender, boggy prostate

Presents as infection (chills, fever, pain, blood in urine or semen, urinary sx)

A

Prostatitis

30
Q

How to tx Prostatitis?

A

Tx: bactrim 1 tab BID for 6 weeks OR cipro 500mg BID x 6 wks

31
Q

asymmetric, nodular, hard prostate

A

Prostate CA

32
Q

PSA if >4 and no signs of prostatitis if PSA increased >0.75 in one year OR nodule on DRE

A

refer to urology!

33
Q

How to tx incontinence

A

anticholinergics (Detrol, oxybutynin (Ditropan), pseudoephedrine

34
Q

Kidneys can’t get rid of phosphate which then binds to calcium and lowers serum ca levels and parathyroid releases more parathyroid hormone, and causes renal hyperparathyroidism
Elevated calcium and phos (as well as BUN/creat, low GFR)
Avoid NSAIDs
Monitor for anemia
Vit d supplements

A

CKD

35
Q

look for CV disease, psychological issues
Tx: PDE5i - don’t take w/ nitrates
Common SE of ssris, snris, tcas

A

Erectile Dysfunction

36
Q

chronic w/ exacerbations and remissions, often chronic LBP that wakes pts up in middle of the night. Pain otherwise worse in the morning

A

Ankylosing Spondylitis

37
Q
(+) HLAB27
Needs regular visits to ortho and cardio 
NO glucocorticoids
NSAIDs and refer to rheum for biologics
PT
A

Ankylosing Spondylitis

38
Q

pain worse at night, limping, palpable mass

A

Bone tumor

39
Q

most common bone tumor

A

osteoscarcoma

40
Q

2nd most common bone tumor… often in leg with palpable mass

A

Ewing sarcoma

41
Q

Benign bone tumor

A

Osteochondroma

42
Q

Tx plan for possible bone tumor

A

Diag: x-ray first, then biopsy

43
Q

Bone tumors in adults are usually bone marrow =

A

multiple myeloma

44
Q

joint extremely tender, warm, red, swollen, decreased ROM

HCTZ (and other diuretics) compete with uric acid transporter, resulting in increased uric acid levels

A

gout

45
Q

Acute gout tx

A

Acute: NSAIDs and colchicine; corticosteroids for subsequent attacks

46
Q

Chronic/ maintenance tx of gout

A

allopurinol (can cause increase in flares so start anti-inflammatory at same time- indomethacin, colchicine, naproxen)
Hydrox
Low purine diet (avoid, meat , seafood, alcohol)

47
Q

can lead to osteomyelitis if not treated. IMMEDIATE ER (IV ABX)
ACUTE onset pain, red, swollen, warmth to one joint
never give corticosteroid!

A

Infectious/Septic Arthritis

48
Q

progressive, more than 6 wks
Limp, multiple joints, may have rash
ANA (+)
Immediate referral to rheumatologist (biologics, DMARDs, NSAIDs)

A

JRA

49
Q

T-score ≤ -2.5

OR T score <-1 and > -2.5 and ≥2% & 10-yr major fracture risk 20% or 3% hip fracture risk

A

Osteoporosis

50
Q

osteonecrosis of jaw; risk of esophagitis. Can cause pathologic fracture. Need drug holiday every 5 yrs for 3-5 years

A

Bisphosphonates

51
Q

Lifestyle changes for osteoporosis

A

Weight bearing exercise, stop smoking, decrease alcohol and caffeine, calcium, vit d, limit steroid use

52
Q

asymmetric arthritis

Trendelenburg gait

A

Osteoarthritis

53
Q

difference between
Heberden nodes and
Bouchard nodes

A

Heberden nodes - distal
Bouchard nodes - proximal

Bouchard before Heberden

only found in OA not RA

54
Q

Tx of Osteoarthritis

A

acetaminophen, NSAIDs, Tramadol (Ultram), consider topical NSAIDs for pts over 75 (lidocaine patches); exercise

55
Q

new onset severe temporal HA, jaw claudication, vision changes

A/w polymyalgia rheumatica
Temporal artery usu tender and thick

A

GCA

56
Q

tx of GCA

A

: prednisone 1mg/kg daily (max 60mg daily) for at least one month, then taper and remain on prednisone for 2-3 years. Low dose aspirin

57
Q

Swollen, tender joints, BILATERAL, w/ systemic sx

A

Rheumatoid arthritis