Leik 2 Flashcards
visual fields by confrontation is used to evaluate for
peripheral vision
A tonometer is used to evaluate
glucoma
What causes condylomata acuminata?
genital warts
HPV
What findings are consistent with syphilis?
painless chancre
maculopapular rash of palms and soles
lymphadenopathy
condylomata lata
When evaluating for coarctation of the aorta, the BP in the ____ is higher than in the ____
higher in the arms than in the legs
The NP is reviewing a patient’s lab results and notes a normal ferritin, high serum iron, elevated TIBC, normal MCHC, & abnormal hemoglobin electrophoresis….what diagnosis is most likely?
Thalassemia
What diagnosis is most likely?
low ferritin
decreased serum iron
elevated TIBC
decreased MCHC
normal hemoglobin electrophoresis
iron deficiency anemia
Patients on atypical antipsychotics are at risk for:
obesity
hyperglycemia
T2DM
hyperlipidemia
The acronym TORCH stands for:
Toxoplasma gondii
Other infections
Rubella
CMV
Herpes
The anti-hepatitis C virus (HCV) test of a 60 y/o F is positive. What test is a appropriate for f/u?
HCV RNA
anti-HCV detects antibodies but cannot distinguish between active and previous HCV infection
Treatment for acne
1st:
2nd:
3rd
4th
1st topical agents
2nd Retin-A 0.25%
3rd Tetracycline oral
4th Accutane
When does an infant triple it’s birth weight?
12 months
What are adverse effects of atypical antipsychotics
orthostatic hypotension
sedation
EX zyprexa, Seroquel, Risperdal
Characteristics of Osgood-Schlatter disease
pain over the tibial tuberosity with palpation of a bony mass over the anterior tubercle of one or both knees
What do you prescribe for a patient with acute epididymitis most likely caused by chlamydia/gonorrhea as well as the probability of enteric organisms obtained by men who practice anal sex?
Ceftriaxone IM AND ofloxacin orally BID x10days
CN IX
glossopharyngeal
CN X
vagal
CN XI
spinal accessory
CN XII
hypoglossal
Which of the following antibiotic regimens is recommended as 1st line tx for CAP in patients with no comorbidities?
doxycycline 100mg PO BID
For patients with comorbidity and CAP what’s the treatment?
Beta-lactam AND macrolide or doxy
OR
monotherapy with fluoroquinolone
What are the hematologic changes with pernicious anemia?
hypersegmented granulocytes
elevated MCV
decreased cobalamin
elevated MCHC
The first permanent teeth erupt at 6 years…what’s the first teeth?
First molars
how to determine fundal height
after 20 weeks gestation fundal height in cm = number of weeks gestation
What are people with PMR at high risk for?
giant cell arteritis (temporal arteritis)
A 5 y/o pt is up-to-date on immunizations. He has not had chickenpox. What following immunizations are indicated on this visit?
DTaP
IPV
MMR
varicella
The Tdap is reserved for patients older than ____ years
11 years
a 40 y/o man c/o severe stabbing pains behind his left eye for the past 2 days. They are accompanied by nasal congestion and rhinorrhea, which is clear in color. The pt denies pharyngitis and fever. What condition is most likely?
cluster headache
What are symptoms of a cluster headache? 5
-excruciating, unilateral pain
-orbital or supraorbital
and/or temporal pain
-Attack ranges from 15mins to 3+hrs
The following symptoms on one side of the face
-Ptosis (drooping eyelid)
-Miosis (pupil constriction)
-lacrimation
-rhinorrhea in
What are symptoms of trigeminal neuralgia (tic douloureux)
unilateral headache from compression or inflammation of the trigeminal nerve (CN5)
What causes infectious mono?
how to make clinical diagnosis?
what will labwork show?
EBV
Dx:
-fever
-pharyngitis
-lymphadenopathy lasting 1 to 4 weeks
Lab:
-Elevated WBC
-Increased lymphocytes
->10% abnormal lymphocytes
-positive monospot test
An elderly man is diagnosed with conductive hearing loss in the left ear by the NP. What is the expected result when performing a Rinne test on this patient?
BC > AC
normal Rinne: AC > BC
Erythromycin ___ (inhibits or induces) the CYP450 system…what drugs should be avoided
inhibits
Avoid: Theophylline, coumadin, valium
What medication increases the risk of bleeding for patient’s receiving coumadin?
bactrim
sucralfate
Losartan
Lasix
Bactrim
What would you expect on a wet mount slide ofa patient diagnosed with BV?
A large # of squamous epithielial cells who surfaces and edges are coated with large #s of bacteria along with a few leukocytes
Dx of BV
3 out of 4 Amsel criteria
1) white, thick adherent discharge
2) pH >4.5
3) positive whiff test (mixed with KOH)
4) clue cells >20%
A pt is diagnosed with acute strep pharyngitis. Her throat is bright red with no tonsillar exudate, and clear mucus on lower nasal turbinates. The UA shows a large amount of WBCs & is positive for nitrites. The patient has a sulfa allergy and thinks she is also allergic to penicillins. Whats the best treatment?
augmentin
Levaquin
Bactrim
Clarythromycin
This patient has strep pharyngitis and a UTI
Give Levaquin treats UTI and strep
pt is allergic to augmentin and bactrim
What is the most common site for female breast cancer?
Tail of Spence
The upper outer quadrant of the breast
An elderly women was found on the floor after she passed out. Shes been ordered an EKG and xray. What labs would you order next?
UA
electrolytes
glucose
H and H
Blood glucose
An adult patient’s lab work reveal macrocytosis and reticulocytopenia. You will evaluate for…
alcoholism
thalassemia
hypothyroidism
liver disfx
thalassemia
these findings are associated with vit B12 deficiency
Thalassemia is a hemolytic anemia that causes excessive destruction of RBCs
A 76 y/o male with a history of CVD presents with hyperlipidemia…what intensity statin do you prescribe?
Moderate intensity
This is because the patient is >75 years with ASCVD
if he was less than 75 then he would be prescribed a high intensity statin like atorvastatin or rosuvastatin
What is the most common type of cancer in young children?
acute lymphoblastic leukemia (ALL)
malignancy of bone marrow
The Somogyi effect is characterized by what?
high fasting blood glucose in the morning caused by the secretion of glucagon by the liver
-nocturnal hypoglycemia
What is secondary prevention and secondary prevention activities?
Detecting disease at an early stage to halt or slow its progression
All screening and lab tests (mammography, pap smears etc) are secondary activities
What foods do you recommend for a patient with folic acid deficiency?
Liver
dark leafy vegetables
beans
pasta
breads
cereals
The ELISA and Western blot test are used to detect what?
HIV antibodies only
How does malignant neuroleptic syndrome present?
high fever
muscular rigidity
BP changes
urinary incontinence
AMS
how does acute serotonin syndrome present?
sudden onset high fever
muscular rigidity
clonus
uncontrolled shivering
AMS
A patient with normocytic hemolytic anemia who has electrophoresis results of hemoglobin S with a 20% concentration of hemoglobin F has what??
sickle cell anemia
What is tertiary prevention?
Any type of rehab for a particular condition
-swimming
-cardiac rehab
-speech therapy
Koilonychia is associated with what condition?
“spoon-shaped nails”
iron deficiency anemia
What medication is a treatment option for BPH and htn?
Terazosin (Hytrin)
what is bipolar II characterized by?
not associated with impairment of social function and able to maintain work and family requirements
what is bipolar I characterized by?
significant impairment with social function and work life
what is schizoaffective disorder characterized by?
schizophrenia and major depression
Roseola infantum
cause
onset
rash course
Cause: herpes
Onset: 6 months to 2 years
Rash: maculopapular that first appear on trunk then spread to extremities
Fever»_space;» rash
What lab value is elevated in ETOH abusers?
Serum GGT
What drug class is recommended for the treatment of postherpetic neuralgia?
Tricyclic antidepressants
anticonvulsants
Hand food mouth disease
cause
tx
Cause: Coxsackievirus
Tx: symptomatic
What part of the DTaP vaccine causes a fever?
pertussis component
