Midterm Flashcards
Daytime symptoms >2 but <7 days per week.
Nocturnal awakenings 1-2 per month.
Minor interference with activities.
Exacerbations treated with OCS > or = to 2 in 6 months or > or = to 4 episodes of wheezing lasting more than a day in a year + risk factors for persistent asthma.
These are symptoms of what level of asthma in children <4 years old?
Mild Persistent asthma in children <4 years old.
Antibiotics will not help in what ear condition?
Otitis media with effusion (OME)
What comorbid conditions are associated with asthma?
GERD
Sinusitis
Rhinitis
Obesity
Step 1 treatment of intermittent asthma in Children 4-11 years old.
SABA as needed
Step 1Treatment for Intermittent asthma children <4 years old?
No daily treatment however a short course of daily ICS at the beginning of a respiratory tract infection.
What is the duration of the common cold?
1 week
Step 5 treatment of asthma in Children 4-11 years old
Preferred: Daily high dose ICS-LABA and SABA as needed
Alternative: Daily high dose ICS plus LTRA and SABA as needed
Add-On Therapy: A biologic agent (eg: omalizumab, mepolizumab) is an additional option for patients > or = 6 years of age.
Daytime symptoms < or = to 2 days per week.
Nocturnal awakenings < or = to 2 per month.
No interference with activity
Normal FEV1 and FEV1/FVC
Exacerbations < or = to 1 per year
These are symptoms of what level of asthma in children 4-11 years old.
Intermittent
Step 6 treatment of Severe Persistent asthma in adolescents and adults.
High dose ICS-LABA daily consider LAMA as substitute for LABA or as add on therapy if not done previously.
Oral glucocorticoids titrated to optimize asthma control and minimize adverse effects.
Possible addition of asthma biologics.
What are the most common first line abortive therapies for migraines?
NSAID’s and Triptans
This can be used as a reasonable alternative for treatment of Otitis Externa if the tympanic membrane is intact?
Cortisporin
There is NO documented role for decongestants or antihistamines in children for what ear condition?
Otitis Media with Effusion (OME)
What condition presents with severe eye pain, foreign body sensation, tearing, and photophobia?
Corneal Ulcers (Contact Lens Users)
What disease presents with gradual onset, low grade or no fever, non-productive cough, fatigue, person continues to work or go to school.
Atypical pneumonia
3 most common pathogens that cause ear infections.
Streptococcus pneumonia
Haemophilus influenzae
Moraxella catarrhalis
What is the most common (CAP) Community Acquired Pneumonia organism?
Strep Pneumonia
What are the five risk factors included in metabolic syndrome?
Abdominal obesity
High Blood Pressure
Elevated Blood Sugars
Elevated Triglycerides
Low HDL Levels
Symptoms all day
Nocturnal awakening nightly
Need for SABA several times per day
Extreme limitation in activity
FEV1 <60% predicted
Exacerbations > or = to 2 per year
These are symptoms of what level of asthma in adolescents and adults.
Severe Persistent asthma
Daytime symptoms < or = to 2 days per week.
No nocturnal awakenings.
No interference with activities.
Exacerbations treated with OCS < or = to 1 time per year.
These are symptoms of what level of asthma in children <4 years old?
Intermittent asthma children <4 years old.
Defined as a recent onset of headache with no prior history of similar episodes.
Acute Headache
What are the components of diagnosing dyslipidemia?
History, Family History, Medical and surgical
Exam which includes obesity
Arcus
Milky serum
Xanthomas (tendons, eye lids, knees)
5 Risk factors for Bell’s Palsy include:
DM
HTN
Toxins
Infections (Herpes, HIV, Shingles, Lyme disease, EBV)
Ischemia
What type of eye drops should be avoided?
Garamycin
What is the incubation period for COVID?
Approx. 14 days with most cases occuring 4-5 days post exposure.
What condition presents with a sudden flash of light before vision loss, veil or curtain over the eye, and sudden onset of floaters.
Retinal Detachment
Refer to ED
What are the two most important biomarkers identified for predicting major cardiovascular events?
BNP
Urinary Albumin to Creatinine Ratio
What is the gold standard test for Pneumothorax?
Chest X-Ray
Step 4 treatment of Severe Persistent asthma in adolescents and adults.
Combination medium dose ICS-formoterol daily and 1-2 inhalations as needed up to 12 inhalations per day.
Alternative:
Medium dose ICS-LABA daily or medium dose ICS+LAMA daily and SABA as needed
or
Medium dose ICS daily + LTRA or zileuton and SABA as needed
Step 5 Treatment of Severe Persistent Asthma that is poorly controlled and treatment for severe persistent asthma not effective children <4 years old.
Preferred: Daily high dose ICS-LABA
Alternative: Daily high dose ICS + LTRA
What is the treatment for bronchitis?
Supportive treatment this is viral condition
What is one of the most important causes of asthma exacerbations?
Viral URI
What is the treatment for Bell’s Palsy?
10 day course of oral corticosteroids and 10 day course of Acyclovir
Step 4 Treatment of Severe Persistent Asthma children <4 years old.
Preferred: Daily medium does ICS-LABA
Alternative: Daily medium dose ICS + LTRA
Step 2 Treatment of Mild Persistent Asthma children <4 years old.
Preferred Treatment is daily low dose ICS
Alternative is a daily LTRA (Leukotriene)
True or False: Most cases of Acute bronchitis are bacterial
False
What blood pressure meds would be started for heart failure?
Ace Inhibitors
Diuretics
What are red flags in headache presentation?
Persistent, severe, sudden onset, “different” than the usual one
Patient states worse headache of my life.
Thunderclap
What ear condition requires urgent referral to the ER for immediate treatment?
Mastoiditis (a bacterial infection of the mastoid process).
Low back pain 2nd to common problems is?
Spondylogenic back pain
Risk factors for a Pneumothorax
Blunt trauma to chest
COPD
cystic fibrosis
Thin male age 15-30 (spontaneous)
True or False: Headache that is present in the morning but gets worse as the day progresses is due to ICP?
False
True or False: Migraines can be progressive so treating early in life can increase future quality of life.
True
What are the 4 levels of asthma?
Intermittent
Mild Persistent
Moderate Persistent
Severe Persistent
Hearing loss resulting fromtraumatic ruptureof the tympanic membrane accompanied by vertigo, persistent bleeding, or profuse clear otorrhea requires?
Semi Urgent Referral
What is the most important factor in the pathogenesis of Otitis Media (OM)?
Abnormal function of the Eustachian tube.
What are 8 important questions to ask regarding past medical history for a patient with asthma?
**History of ER visits
**Hospitalizations
***Intubation or mechanical ventilation
**Need for systemic or oral corticosteroids
Age of onset
Cough that is worse at night
Pattern of symptoms
Precipitating factors (smoking, exercise, environment, weather changes)
What medication can be used in the treatment of all stages of asthma children <4 years old?
SABA as needed
This condition is not caused by herpes simplex virus.
Herpetiform Aphthous Ulcers
What is the strongest identifiable predisposing factor for developing asthma?
Atopy (IgE mediated response)
In children with MEE (Middle Ear Effusion) remember
signs of acute inflammation are necessary to differentiate AOM from OME.
Step 2 treatment of Mild Persistent asthma in adolescents and adults.
Low dose ICS daily and SABA as needed
or
Low dose ICS-SABA
or
Low dose ICS + SABA given together as needed
Alternative: Daily LTRA or SABA as needed
Antibiotic treatment for pneumonia in patients with no comorbidities <65 years old, non-smoker or non-drinker.
1st line: Amoxicillin + a macrolide or doxycycline
2nd line: Cephalosporin + a macrolide or doxycycline
3rd line: Fluoroquinolone
Step 6 Treatment of Severe Asthma that is poorly controlled children <4 years old.
Preferred: Daily high dose ICS-LABA + OCS
Alternative: Daily high dose ICS + LTRA and OCS
Name some patient’s symptoms with a PE.
Most common sudden onset with sudden dyspnea
2nd most common presentation is hemoptysis, SOB & chest pain w/inspiration, wheezing, tachypnea, restlessness, and apprehension (SENSE OF DOOM*)
Chest pain
Gripping stabbing pain
Moderate to severe pain
Pain radiates to neck or shoulder
What are the 2 most informative biomarkers for predicting major cardiovascular events
BNP
Urinary albumin to creatinine ratio
Which type of headache has tender points?
Tension
What are the five components in diagnosing and treating hypertension?
Epidemiology
H&P
Diagnosis
Lifestyle Prescription
Pharmacology
True or False Temporal/giant cell arteritis should be immediately referred to the emergency department?
True
Classification of headaches
Acute
Acute recurrent (episodic)
Chronic nonprogressive
Chronic progressive
The most helpful diagnostic tool for evaluation of seizures by neurology?
EEG (electroencephalogram)
Name the 9 risk factors that would warrant a referral for immediate imaging for suspected TBI.
Age <2
Recurrent Vomiting
Loss of consciousness
Sever injury mechanism
Severe or worsening headaches
Amnesia
Non-frontal scalp hematoma
GCS <15
Clinical suspicion for skull fracture
What blood pressure meds would be started for DM?
ACE Inhibitors
Preventative therapy for cluster headaches include
Beta Blockers
Calcium Channel Blockers
What 3 patient statistics are needed to figure an asthma plan and peak flow?
Gender
Age
Height
What are the 2 most common presentations with a PE?
Most common sudden onset with sudden dyspnea
2nd most common presentation is hemoptysis, SOB & CHEST PAIN w/inspiration, wheezing, tachypnea, restlessness, and apprehension (SENSE OF DOOM*)
Define asthma
A chronic inflammatory disorder of the airways
Daily symptoms
Nocturnal awakening >1 a week but not daily
Need for SABA daily
Some limitation in activity
FEV1 60% to 80% predicted
Exacerbations > or = to 2 per year
These are symptoms of what level of asthma in children 4-11 years old.
Moderate Persistent
You should never use a tongue depressor in patient’s suspected of having this condition due to risk of laryngeal obstruction?
Epiglottitis
What are the 2 most common pediatric headaches
Migraine
Tension
What is the treatment for Cholesteatomas?
Refer to ENT for Surgical Incision
What type of headache presents with unilateral, pm pain, lacrimal tearing, waxes and wanes, and can be treated with 100% oxygen
Cluster Headache
Symptoms throughout the day
Nocturnal awakenings >1 per week
Need for SABA several times per day
Extreme limitation in activity
Exacerbations treated with OCS > or = to 2 in 6 months or > or = to 4 episodes of wheezing lasting more than a day in a year + risk factors for persistent asthma.
These are symptoms of what level of asthma in children <4?
Severe Persistent Asthma children <4 years old.
What are the 4 components of asthma management?
Component 1: Routine monitoring of symptoms and measuring lung function
Component 2: Patient education: create a partnership between patient and provider
Component 3: Control of environmental factors & comorbid conditions that affect asthma
Component 4: Medication
If an itchy maculopapular skin rash appears when treating a patient suspected of having strep throat with Amoxicillin or Augmentin what should you do?
Stop the antibiotics as they may have Mono
Name 7 uncomplicated drug classes to treat HTN.
Diuretics
Beta Blockers
Specific
Alpha Blockers
ARB’S
Calcium Channel Blockers
ACE Inhibitors
What type of headache presents with jaw claudication and pain when the temporal artery is tapped that the patient should be referred to the EMERGENCY ROOM.
Temporal arteritis
What is the most common reason for low back pain?
Lumbosacral Strain
What condition presents with eye pain and visual changes with rainbow colored halos and is an EMERGENCY?
Acute angle glaucoma
What eye exam should be done before referring a patient to an ophthalmologist?
Visual Acuity
What disease presents with sudden onset, sick, toxic, fever, productive cough, myalgia, and anorexia.
Bacterial pneumonia
In regards to children with asthma what is the biggest concern regarding lung development?
Inhibition of lung growth
What disease presents with frequent sudden waves of coughing, hard to catch breath when coughing, may vomit when coughing
Acute Bronchitis
What are the cardinal symptoms of Acute Bronchitis
Cough lasting 1-3 weeks with or w/o productive sputum
Acute onset in absence of clinical symptoms of pneumonia (afebrile, no rales, no sign of consolidation, no tachypnea)
Cough can last 2-6 weeks.
Step 1 treatment of intermittent asthma in adolescents and adults.
SABA as needed
What bacteria causing pneumonia is common in smokers
H. Fluenza
Three types of Cholesteatoma are?
Congenital
Primary acquired
Secondary acquired
Name 4 Viral Rhinosinusitis most common causes
Rhinoviruses
Adenoviruses
Influenza viruses
Parainfluenza
Step 4 treatment of intermittent asthma in Children 4-11 years old
Preferred: Daily and as needed medium dose ICS-formoterol
Alternative: Daily medium dose ICS-LABA and SABA as needed or Daily medium dose ICS plus LTRA and SABA as needed
True or False: Febrile seizures are common in adults.
False
What are 7 common triggers for migraines.
lack of sleep
stress
dehydration
chocolate
aged cheese
wine
menses
Duration of treatment for Acute Bacterial Rhinosinusitis (ABRS)?
typically 7-10 days but depending on pt hx and severity may need up to 14 days
First line treatment for most patients with acute bacterial rhinosinusitis (ABRS) relates to its safety, efficacy, low cost, and narrow microbiologic spectrum is?
Amoxicillin 875 mg PO BID
Marked redness of the tympanic membrane without bulging is unusual in?
AOM
Daytime symptoms >2 or <7 days per week.
Nocturnal awakenings 3 to 4 per month.
Minor interference with activity
Normal FEV1 and FEV1/FVC
Exacerbations > or = to 2 per year
These are symptoms of what level of asthma in children 4-11 years old.
Mild Persistent
A clinical diagnosis of AOM can be made in children with either:
Bulging of the tympanic membrane (Pneumatic otoscopy is not necessary in children with bulging of the tympanic membrane)
Perforation of the tympanic membrane w/acute purulent otorrhea if acute otitis externa has been excluded.
The most common pathogens in Otitis Externa (OE) Swimmers Ear are?
S. aureus (Staphylococcus aureus)
P. aeruginosa (Pseudomonas aeruginosa)
Patient presents with sudden onset of fever, fatigue, aches, cough, sore throat - flu or common cold?
Flu
Treatment for Flu must begin within?
48 hours after symptoms begin.
Group A beta-hemolytic streptococci (GABHS), causes 5% to 36% of cases of?
Acute Bacterial Pharyngitis
Step 2 treatment of intermittent asthma in Children 4-11 years old
Preferred: Daily low dose ICS and SABA as needed
Alternative: Daily LTRA and SABA as needed
Patient presents with low grade fever, runny nose, otherwise mild symptoms - flu or common cold?
Common cold
What type of seizures are not predictive or related to epilepsy?
Febrile Seizures
Back pain that is caused by depression is?
Psychogenic back pain
Step 6 treatment of intermittent asthma in Children 4-11 years old
Preferred: Daily high dose ICS-LABA plus OCS and SABA as needed
Alternative: Daily high dose ICS plus LTRA and OCS and SABA as needed
Add-On Therapy: A biologic agent (eg: omalizumab, mepolizumab) is an additional option for patients > or = 6 years of age.
Daily symptoms
Nocturnal awakenings 3-4 per month
Daily SABA use
Some activity limitation
Exacerbations treated with OCS > or = to 2 in 6 months or > or = to 4 episodes of wheezing lasting more than a day in a year + risk factors for persistent asthma
These are symptoms of what level of asthma in children <4?
Moderate Persistent Asthma children <4 years old.
True or False Headaches due to increased ICP may present with pain that is worse in the AM & improves as the day progresses?
True
What 7 studies are ordered to diagnose Dyslipidemia?
Fasting fractionated lipid profile (including apolipoproteins)
Metabolic panel
CBC
UA (kidney disease)
Thyroid
LFT
EKG
What are 7 key indicators in diagnosing asthma?
Wheezing current or recent
Nighttime cough
Wheezing or cough after exercise
Wheezing or cough or chest tightness after exposure to airborne allergens
Colds “go to the chest” or take over 10 days to clear
Sxs improve with asthma meds
Labs may show neutrophils, lymphocytes
At what age do 1/3 of childhood migraines stop?
25 years old
Symptoms throughout the day
Nocturnal awakening most nights
Need for SABA several times per day
Extreme limitation in activity
FEV1 <60% predicted
FEV1/FVC below normal
Exacerbations > or = to 2 per year
These are symptoms of what level of asthma in children 4-11 years old.
Severe Persistent
Acronym OPQRST
O - Onset
P - Provocation & Palliation
Q - Quality
R - Region & Radiation
S - Severity
T - Timing
What are 6 red flags in childhood headaches that would warrant a referral to a neurologist?
Vomiting (esp at night or first thing in the AM), diplopia, ataxia, dysphagia, focal neurologic signs or decline in neuro function.
What is the duration of the flu?
2-5 days
Bacterial Rhinosinusitis most common causes
S. pneumoniae is isolated in approx. 20% to 43% of aspirates.
H. influenzae in 22% to 35%.
M catarrhalis in 2% to 10%
Staphylococcus aureus in 10%
Streptococcus pyogenes 3%
Step 3 treatment of Moderate Persistent asthma in adolescents and adults.
Preferred: Combination low dose ICS-formoterol daily and 1-2 inhalations as needed up to 12 inhalations per day.
Alternative: Medium dose ICS daily and SABA as needed
or
Low dose ICS-LABA combination daily or low dose ICS + LAMA daily or low dose ICS + LTRA daily and SABA as needed
or
Low dose ICS daily + zileuton and SABA as needed
Is a corneal ulcer considered an emergency?
Yes it is an ophthalmologic emergency, refer to ED.
What blood pressure meds would be prescribed post MI?
Beta Blockers (non ISA) and ACE with systolic dysfunction
True or False: NP’S can prescribe steroid eye drops for a patient as needed.
False
Daytime symptoms < or = to 2 days per week.
Nocturnal awakenings < or = to 2 per month.
Normal FEV1.
Exacerbations < or = to 1 time per year.
These are symptoms of what level of asthma in adolescents and adults.
Intermittent
A hallmark symptom of Cholesteatoma is?
Painless otorrhea (either recurrent or unremitting).
The most common cause of infection in corneal ulcers is due to which 3 bacteria?
Pseudomonas
Staphylococcus
Streptococcus
Back pain that is due to penetrating ulcers, pancreatitis, and renal, prostate or uterine disease is called?
Viscerogenic back pain
Antiepileptic Drugs
phenytoin
carbamazepine
phenobarbital
primidone
valproic acid
ethosuximide
clonazepam
What mouth condition may warrant hospitalization that you would want to consult with a physician and will probably send to ER?
Peritonsillar Abscess
The gold standard test for step throat is a?
Throat Culture
What condition presents with acute onset of severe eye pain, photophobia, tearing, and blurred vision in one eye.
Herpes Keratitis
Back pain that is caused by Sciatic neuritis 2nd to DM, tumor pain usually more pronounced at night (Mult. Myeloma) is called?
Neurogenic back pain
Requires expeditious referral to an otolaryngologist for further evaluation, audiometry, and possible therapy with high-dose corticosteroids.
Sudden idiopathic sensorineural hearing loss
Difficulty understanding spoken words suggests what type of hearing loss?
Sensorineural hearing loss
Childhood migraines that stop can relapse at what age range?
30-50 years old
Antibiotic treatment for pneumonia in patients with comorbidities >65 years old, smoker or drinker.
1st line: Amoxicillin-clavulanate + a macrolide or doxycycline
2nd line: Cephalosporin + a macrolide or doxycycline
3rd line: Fluoroquinolone
What cranial nerve is affected in Bell’s Palsy?
CN 7
What are the two leading causes of death in the US?
Heart Disease and CVA
True or False Headaches persistently in occipital region warrants attention?
True
Abrupt onset of hearing loss with complaints of a unilateral “blockage” (i.e., hearing loss), with a H&P that is normal and unrevealing the NP should suspect?
Sudden idiopathic sensorineural hearing loss
Step 5 treatment of Severe Persistent asthma in adolescents and adults.
Preferred: Medium to high dose ICS-LABA + LAMA daily and SABA as needed
Alternatives:
Medium high does ICS-LABA daily or high dose ICS+LTRA daily and SABA as needed with possible addition of asthma biologics
Daily symptoms.
Nocturnal awakenings >1 nights per week.
FEV1 60-80% predicted.
Exacerbations > or = to 2 per year.
Some activity limitation.
Daily need for SABA.
These are symptoms of what level of asthma in adolescents and adults.
Moderate Persistent asthma
Daytime symptoms > 2 but < 7 days per week.
Nocturnal awakenings 3-4 nights per month.
FEV1 Normal Range.
Exacerbations > or = to 2 per year.
Minor interference with activities.
These are symptoms of what level of asthma in adolescents and adults.
Mild Persistent asthma
In those over 50 years of age, which is a more important risk factor for heart disease: systolic or diastolic elevation?
Systolic
Severe Acute Otitis Media presents with the presence of?
Moderate to severe otalgia or fever equal to or higher than 39 degrees C/102.2 degrees F.
What are the Peak Flow zones?
Controlled (green zone) >80% of predicted personal best.
Not well controlled (yellow zone) 60-80% of predicted personal best.
Very poorly controlled(red zone) ,60% predicted personal best.
Step 3 treatment of intermittent asthma in Children 4-11 years old
Preferred: Daily and as needed low dose ICS-formoterol
Alternative: Daily medium dose ICS and SABA as needed or Daily low dose ICS-LABA or low dose ICS plus LTRA and SABA as needed
What are some of the different causes of seizures? Name 4
Hypoglycemia
Hypoperfusion
Drug or Alcohol overdose or withdrawal
Head Trauma
In regards to adults with asthma what is the biggest concern regarding the lungs?
Inhibition of lung function
What can be used to detect corneal abrasions?
Fluorescein drops or strips and a Wood’s lamp
Name 2 atypical bacterial pneumonias
Mycoplasma
Chlamydia
What is the gold standard test for a PE?
CT angio
What type of back pain is caused by AAA, PAD with claudication?
Vascular back pain
A thick muffled voice “Hot Potato Voice” is representative of?
Acute epiglottitis and peritonsillar abscess
Name the 4 types of medications for asthma.
SABA
LABA
Leukotriene Modifiers
Steroids (inhaled or oral)
What is the leading cause of morbidity and mortality word wide?
Pneumonia
True or False Distinguishing primary cause for secondary cause is crucial for determining proper treatment of a Headache?
True
Name 3 Adult Acute Rhinosinusitis Symptoms
Purulent nasal drainage
Nasal Obstruction
Facial pain-pressure-fullness
What is the gold standard test for diagnosing coronary artery disease.
Coronary Angiography (cardiac cauterization)
A headache that occurs several times a month with intervening symptom free intervals is?
Acute recurrent (episodic)
Gold Standard for Asthma?
Spirometry
Step 3 Treatment of Moderate Persistent Asthma children <4 years old.
Daily low dose ICS-LABA
or
Daily low dose ICS + LTRA
or
Daily medium dose ICS
What is the gold standard test for dx Pneumonia
Chest X-ray
Mono is caused by what virus?
Epstein Barr
What condition presents with acute onset of erythematous swollen eyelid with proptosis (bulging of the eyeball), limited EOM’s, and severe pain in affected eye.
Orbital Cellulitis
What type of medication should you NOT give for migraines or headaches?
Opoids
True or False Consult or refer to neurology if feel there is serious pathology, or you are unsure?
True
What are some risk factors for PE?
s/p surgery Prolonged bed rest
Older Age
Air travel, Immobilization by a cast, as above bed rest
Cancer
COVID19 infection
Prior DVT
Venous stasis from CHF or venous insufficiency
Thrombophilia (Factor V Leiden, antiphospholipid syndrome, estrogens via OCP, pregnancy)
Patient presents with a sore throat that resolves in 1-2 days would you think Flu or Common cold?
Common cold
What condition presents with a barking cough at night and is relieved with humidity?
Croup
In 90% of individuals with Low Back Pain symptoms will resolve without any treatment in how many days?
30
A patient present’s with one or all of these symptoms Bladder/Bowel dysfunction, LE muscle weakness, LE neuro deficits (Saddle anesthesia) what would you consider?
Possible Cauda Equina Syndrome
This is a medical emergency.
Woman of childbearing age with:
1 sided abdominal pain w/ or w/o shoulder pain
C/o dizziness, fainting
Irregular bleeding or spotting after light menstrual period
What condition could this be?
Ectopic pregnancy
Pain that is defined as activity intolerance due to lower back or back related leg symptoms for 3 months or less is?
Acute low back
Which physical examination maneuver used to assess the integrity of the anterior cruciate ligament in a suspected anterior cruciate ligament (ACL) injury?
Lachman’s test
The drawer test can be performed in diagnosing what knee injury?
Posterior cruciate ligament
With patient laying supine, hips flexed at 45 degrees, knee flexed to 90 degrees, foot flat on the table, examiner gently pulls tibia forward to observe how far the tibia moves. What test is this?
Drawer test
Patient supine with knee flexed 20-30 degrees, grasp femur in one hand tibia in the other, perform an anterior posterior motion of the knee by displacing the tibia on the femur, grade the motion from 0-4+, grade the ligament as firm marginal or stiff. What test is this?
Lachman’s test
What are 5 risk factors for foot pain?
Obesity
Occupation
Sports with running or jumping
Sudden change in activity levels
Limited ankle dorsiflexion less than 10 degrees (within normal limits is 20 degrees)
What are the 7 Subjective elements of an office visit?
Chief Complaint
History of Present Illness
System Review
Past medical/surgical, family, and/or social history
Allergies
Current Medications
Immunizations
What are the 5 domains of Social Determinants of Health
Economic Stability
Education Access and Quality
Health Care Access and Quality
Neighborhood and Built Environment
Social and Community Context
What is the most common pathogen seen in Otitis Externa?
Staphylococcus Epidermidis
Staph. aureus & pseudomonas are the 2-2nd. most common
What are 3 prophylactic agents for migraine headaches?
Beta Blockers
Antiepileptics
Tricyclics Antidepressants
What are 5 characteristics of Retinal Detachment.
New onset light flashes
Floaters
Veil or curtain being pulled down
Not red or painful
Unilateral
What are 8 characteristics of Angle Closure Glaucoma
Acute onset eye pain
Redness with Ciliary Flush
Hazy cornea
Sluggish reactive pupil
Photophobia
Headache
Nausea and/or vomiting
Change in baseline vision
On dilated eye exam for Angle Closure Glaucoma what is the expected finding?
Glaucomatous Cupping
What is Acute Glaucoma also known as?
Angle Closure Glaucoma (ACG)
What are the 4 characteristics of Anterior Uveitis?
Rapid onset of unilateral dull painful red eye
Discomfort radiating to temple and periorbital area
Vision change
pupil constricted, non reactive, and irregularly shaped
What is Anterior Uveitis also know as?
Iritis
What is a major difference in clinical presentation between ACG and Uveitis?
In ACG the pupil is dilated and sluggish where as in uveitis the pupil is constricted, nonreactive, and irregularly shaped.
What are the 5 criteria on the Centor Scale for Group A Strep Testing (GAS)?
Age 3-14
Tonsillar swelling or exudate
Tender/swollen anterior cervical lymph nodes
Fever greater than 38 d. C. or 100.4 F
Absence of cough
Score of 2+ needed to test
Each are worth 1 point
