Leik chp 1 exam info Flashcards

1
Q

A patient with an elevated WBC count accompanied by ______ and the presence of ________ most likely has a serious bacterial infection

A

neutrophilia (>70%) bands (“shift to the left”)

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2
Q

__________ is defined as the ability of a test to detect a person who has the disease.

A

Sensitivity

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3
Q

__________ is defined as the ability of a test to detect a person who is healthy (or to detect the person without the disease)

A

Specificity

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4
Q

A ______ study follows a group of people who share some common characteristics to observe the development of a disease over time (ex. the Framingham Nurses’ Health Study)

A

cohort

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5
Q

Trauma to ________ ________ will result in an anterior nosebleed

A

Kiesselbach’s plexus

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6
Q

The diagnostic or gold-standard test for sickle cell anemia, glucose-6-phosphate dehydrogenase (G6PD) anemia, and alpha or beta thalassemia is the ___________ ____________.

A

hemoglobin electrophoresis

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7
Q

Distinguishing between first- and second-line antibiotics:
A 7 year-old child with acute otitis media (AOM) who is treated with amoxicillin returns in 48 hours without improvement (complains of ear pain, bulging tympanic membrane). The next step is to discontinue the amoxicillin and start the child on a second-line antibiotic such as _____________ ___(frequency) x ____ days

A

amoxicillin-clavulanate BID x 10 days

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8
Q

Alternative antibiotics for PCN-allergic patients:
If pt has a gram-positive infection, the possible alternatives are __________, ____________, or _______ with gram-positive activity such as levofloxacin or moxifloxacin

A

macrolides, clindamycin, or quinolones

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9
Q

If a patient has an infection that responds well to macrolides (azithromycin, clarithromycin, erythromycin), but she thinks she is “allergic” to erythromycin (symptoms of nausea or GI upset), inform her that she had an adverse reaction, not a true allergic reaction (hives, angioedema) and switch her from erythromycin to _____________

A

azithromycin (usually a Z-Pack)

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10
Q

If a patient fails to respond to the initial medication, _____ _________ _______
Ex. A pt with COPD is Rx’d Atrovent for dyspnea. On follow-up, the patient complains that his symptoms are not relieved. The next step would be to Rx an albuterol inhaler or to prescribe a combination inhaler.

A

add another medication (follow the steps of the treatment guideline)

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11
Q

Disease states on the exam are usually presented in their full-blown “classic” textbook presentations. Ex. In the case of acute mono, the patient will most likely be a teen presenting with the classic triad of ________, ___________, and _______________. If the patient is older, but has the same signs and sx, it is still mono.

A

sore throat, prolonged fatigue, enlarged cervical nodes

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12
Q

Ethnic background may give a clue for some diseases. Ex: ______ thalassemia is more common among Southeast Asians (Filipinos). _________ thalassemia is more common among Mediterranean people.

A

Alpha - Southeast Asians

Beta - Mediterranean

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13
Q

On the exam, no asymptomatic or “borderline” cases of disease states are presented. For ex. - In real life, most patients with iron-deficiency anemia are asymptomatic and do not have either ______ or ______-______ nails. On the exam, they will probably have those clinical findings plus the other findings of anemia.

A

pica

spoon-shaped

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14
Q

Become familiar with lupus or systemic lupus erythematosus (SLE). Ex. A ___ rash is present in most patients with lupus. These patients should be advised to avoid or to minimize _________

A

malar (butterfly)

sunlight

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15
Q

Become familiar with polymyalgia rheumatica. Ex. First-line treatment for PMR includes ______-_____ ______.

A

Long-term steroids. Long term, low-dose steroids are commonly used to control symptoms (pain, severe stiffness in shoulders and hip girdle)

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16
Q

Polymyalgia rheumatica patients are also at higher risk for _______ _______.

A

Temporal arteritis

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17
Q

Some conditions need to be evaluated with a radiologic test. Ex. Damaged joints: order _______ first, but _____ is the gold standard.

A

x-ray

MRI

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18
Q

The abnormal eye findings in diabetes (diabetic retinopathy) and hypertension (hypertensive retinopathy) should be memorized. Learn to distinguish each one.
Ex. Diabetic retinopathy: ______, ______ ______ _____, __________

A

neovascularization, cotton wool spots, microaneurysms

19
Q

The abnormal eye findings in diabetes (diabetic retinopathy) and hypertension (hypertensive retinopathy) should be memorized. Learn to distinguish each one.
Ex. hypertensive retinopathy: ________ _______, _______ or ______ _______ ________

A

AV nicking, silver or copper wire arterioles

20
Q

Become knowledgeable about physical exam “normal” and “abnormal” findings. Ex. When checking DTRs in a patient with severe sciatica or diabetic peripheral neuropathy, the ankle jerk reflex (Achilles reflex) may be ______ or ________. Scoring: 0
1
2
3
4

A
absent
hypoactive
Scoring: 0 - Absent
               1 - hypoactive
               2 - normal
               3 - hyperactive
               4 - clonus
21
Q

There are only a few questions on benign or physiologic variants.
Ex. A benign S4 heart sound may be auscultated in some ________ patients.

A

elderly

22
Q

There are only a few questions on benign or physiologic variants.
Ex. _______ ________ and ________ _______ may be seen during the oral exam in a few patients.

A

Torus palatinus

fishtail uvula

23
Q

Know the preferred and/or first-line drugs used to treat some diseases. Ex. _____ or ________ are the preferred drugs to treat hypertension in diabetics and patients with mild to moderate renal disease because of their renal-protective properties.

A

ACEI

ARBs

24
Q
When meds are used in the answer options, they will be listed either by name (generic and brand name) or by drug class alone. 
Ex. Instead of using generic/brand name of ipratropium (Atrovent), it may be listed as a drug class (\_\_\_\_\_\_\_\_\_\_\_\_)
A

anticholinergic

25
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. Penicillin: ___________, __________

A

amoxicillin

penicillin VK

26
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. macrolide: ___________
___________
____________

A

erythromycin
azithromycin
clarithromycin

27
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. cephalosporins: First gen: _______
2nd gen: _________, ________
3rd gen: _______, _____, _______

A

1st: Keflex
2nd: Cefaclor, Ceftin
3rd: Rocephin, Suprax, Omnicef

28
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. Quinolones: ____________, ___________

A

ciprofloxacin

ofloxacin

29
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. Quinolones with gram-positive coverage:
________
________
________

A

levofloxacin
moxifloxacin
gatifloxacin

30
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. Sulfa: __________
____________

A

trimethoprim-sulfamethoxazole (Bactrim, Septra)

nitrofurantoin (Macrobid)

31
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. tetracyclines _________
_________
___________

A

tetracycline
doxycycline
minocycline

32
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. NSAIDS

A

Ibuprofen

naproxen

33
Q

Most of the drugs mentioned in the exam are the well-recognized drugs.
Ex. COX-2 inhibitor: _________

A

Celecoxib (Celebrex)

34
Q

Category ____ drugs are allowed for pregnant or lactating women

A

B - pick Tylenol instead of NSAIDS

35
Q

Avoid _________ and _______ drugs during the third trimester due to increased risk of hyperbilirubinemia

A

nitrofurantoin and sulfa drugs

36
Q

The preferred treatment for cutaneous anthrax is _______ ____ mg orally ______ for _______ days

A

Cipro 500 mg BID for 60 days

37
Q

The preferred treatment for cutaneous anthrax when a patient is allergic to Cipro is _________ _____ mg _____

A

doxycycline 100 mg BID

38
Q

Cutaneous anthrax is / is not contagious.

A

is NOT. It comes from touching fur or animal skins that are contaminated with anthrax spores.

39
Q

Stages of change or “decision” theory (Prochaska):

A
precontemplation
contemplation
preparation
action
maintenance
40
Q

health theorists: Alfred Bandura

A

self-efficacy

41
Q

health theorists: Elisabeth Kubler-Ross

A

grieving

42
Q

Ex of Freud: If a small child expresses a desire to marry a parent of the opposite sex, the child is in the ______ stage and the child’s age is about _____ to _____ years

A

Oepidal

5 to 6 (preschool to kindergarten)

43
Q

Starting at the age of about ______ years, most children can understand abstract concepts (early abstract thinking) and are better at logical thinking. For ex, when performing the Mini-Mental State Exam, when the NP is asking about “proverbs”, the NP is assessing the patient’s ability to understand ______ ________.

A

11

abstract concepts