Midterm review questions Flashcards

1
Q

Name 3 types of headaches and describe how they differ

A

Tension type headache: is bilateral and is often chracterized by pressing or tightening. Not caused by exercise
Migraine: unilateral and is often chracterized by throbbing and can cause you to have nausea and vomiting. Caused by exercise

MOH: medication overuse headache is caused by the overuse of migraine medication. Caused by acetaminophen and NSAID. Can occur in both tension type headache and migraine.

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2
Q

What severe reaction can occur with acetaminophen and when it is likely to occur?

A

Hepatotoxicity with overdose or alcohol use

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3
Q

Name two contraindications for the use of NSAIDs

A

Pregnancy (third trimester), renal failure, peptic ulcer, bleeds

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4
Q

Name 4 red flags where a patient with fever should be referred to a physician?

A

Less than 6 months old, new medication, had surgery, new rash, child is irritation or in distress

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5
Q

What is the MOA of an antipyretic> will it work in absence of fever?

A

Decrease prostaglandin which causes decrease thermogularly set point
No it will not because antipyretic’s do not lower body temperature

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6
Q

Two types of allergic rhinitis

A

Intermittent and persistent

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7
Q

Two goals of therapy for allergic rhinitis

A

Prevent symtoms by avoiding exposure to allergens
Alleviate signs and symptoms produced by the allergic reponse
Minimize adverse reactions of treatment
Improve quaility of life

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8
Q

Which medications are recommended for allergic rhinitis in pregnacy?

A

-second generation antihistamines
-first-generation antihistamines
-Topical decongestants
-Cortiosteroids

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9
Q

How does influenza and the common cold differ?

A

Common cold
Caused by many viruses
Sore throat usually resolving in a few days, Nasal congestion, rhinorrhea, Sneezing and cough, Fever in children but less common in adults
Symptoms peak at 2-4 days and begin to resolve by day 7 with cough sometimes lingering for 3 weeks
Usually self-limiting

Influenza
caused by influenza A and/or B virus
Fever, myalgia, headache, malaise and chills, sore throat, nonproductive cough and rhinitis
Viral shedding before symptoms show, usually lasts 5-7 days but shedding may continue for 7 days or longer after onset of symptoms
Complications include pneumonia and even death

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10
Q

What could be recommended for fever, aches & pain due to influenza?

A

Acetminophen or ibuprofen

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11
Q

What could be an optimal therapy for an adult patient with aches & pain, congestion and a runny nose and no allergies or comorbidlities?
What adverse effects could be expected?

A

Acetaminophen for the pain and aches and a decongestants for the congestion and runny nose
Decongestants can increased blood pressure and may cause rhinitis medicaments if used more than 3-5 days.
Acetaminophen can cause nausea and vomiting and can cause hepatotoxicityin high doses.

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12
Q

Name 3 non-pharmacologic therapies for cough?

A

Hydration, humidifiers, avoiding irritants

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13
Q

Name two antitussive agents and their side effects and interactions?

A

Codeine can cause drowsiness/sedation
Interaction: CNS depressants

Dextromethorphan can cause occasional dizziness
Interaction: SSRIs/ MAOI

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14
Q

What are expectorant?

A

Expectorants are protussives (make cough more effective)
guaifenesin enhances cough by promoting clearance of airway secretions.

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15
Q

how can impacted ear wax be prevented?

A

-external opening canbe cleaned with washcloth
- Discourage cotton-tipped applicators to clean ears
- instillation of olive oil, light mineral oil, hydrogen peroxide

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16
Q

What are 3 monitoring points for otitis externa?

A

-Symtoms relief should occur as soo wax expelled
-Initially, hearing loss or fullness may exacerbate due to swelling of wax
-if irritation of the canal occurs, use of the product should be discontiuned.

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17
Q

Name 3 potential complication of N&V?

A

esophageal rupture, dehydration, malnutrition, dental cariers, hypokalemia

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18
Q

Name an anticholinergic and an antihistamines used for N&V and describe their main side effect?

A

Anticholinergic: Promethazine (restnessless)
Antihistamines: Benadryl (Sedation)

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19
Q

Example of each laxative?

A

Bulking agents: Bran
Emollient: Docusate
Osmotic: Polyethylene gel
Stimulant: Bisacodyl

20
Q

What 3 types of enemas are available for bowel cleansing?

A

Phospahte, bisacodyl, mineral oil

21
Q

What is opioid induced constipation and which laxatives could you use for this condition?

A

Decreased GI motility, increased intestinal fluid absorption, increased anal sphincter tone and decreased anorectal sensitivity to distention due to opioid use
Stimulant laxatives mainstay with rescue enemas or bisacodyl suppositories used PRN not exceeding 3 days. Commonly require combination of both osmotic and stimulant. Either lactulose and PEG also may be used but may cause nausea. Avoid bulk-forming agents since they may cause impaction

22
Q

6 red flags for diarrhea?

A

watery stool, blood in stool, pregnacy, fever, constant cramping, vomiting and nausea

23
Q

Name a bulk forming agent and an antimotility agent used for diarrhea

A

Bulk forming agent: Psyllium
Antimotility: Attapulgite

24
Q

What products could be appropriate for diarrhea in pregnancy?

A

Metamucil/psyllium
ORT

25
Q

What is GERD?

A

Occurs when stmach acid repeatedly flows back into the tube connecting your mouth and stomach.
Heartburn is the most common symptom of GERD

26
Q

Name 3 salts used as antacids?

A

sodium bicarbonate, calcium carbonate, Magnesium

27
Q

Define what is an H2RA, provide 4 examples and compare their effectiveness?

A

H2 recetor antagonist reduced gastric acid by inbiting the h2 recetor.
Cimetidine, famotidine, nizatidine, yantidine

H2 recetor antagonist are not as effective as PPI but have a rapid onset of action

28
Q

What is a PPI, provide 6 examples and compare their effectiveness vs each other and H2RAs?

A

Proton pump inhibitors (PPIs): Effectively block acid by irreversibly binding to and inhibiting proton pump

Dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole (magnesium/sodium) and rabeprazole
More effective than H2-RAs and provide rapid relief of symptoms
PPIs similar symptom relief, mucosal healing, tolerability, and safety at equivalent dose

29
Q

What are hemorrhoids and how are they classified?

A

Common condition characterized by rectal bleeding, pain, and itching
They can be classified as internal, external, or mixed
Internal hemorrhoids should not cause pain, unless complications since no nerves
External hemorrhoids can cause pain, since area well innervated
Mixed is when internal and external hemorrhoids coexist

30
Q

4 non-pharmacological therapies for hemorrhoids?

A

fiber supplement, hemorrhoideectomy, sitz bath, sclerotherapy

31
Q

What is an astringent and what symptoms can they relieve?

A

Astringents promote dryness of the skin, Cause coagulation (clumping) of proteins in cells lining of the anal canal.
Effective for mild symptoms help relieve burning, itching, and pain.

32
Q

What is the main goal of diabetes management?

A

Primary goal maintain health and avoid acute/long-term complications

33
Q

What is CGM and FGM. How do they differ

A

Bloodless glucose meters becoming more common among patients requiring frequent BG monitoring. Both systems require a sensor, a tiny electrode inserted subcutaneously, which monitors glucose levels.
Continuous Glucose Monitoring (CGM): Readings are transmitted continuously to a meter, insulin pump, or smartphone where readings displayed, and from which alarms can be customized for high and low values.
Flash Glucose Monitoring (FGM) sensor: Automatically stores glucose readings every 15 minutes for up to 8 hours until the information can be reviewed. Sensor is scannable for instant review by passing meter/phone within 4 cm of the sensor. Allow for regular and discreet monitoring without lancing and strips. Does not utilize alerts, users responsible for scanning to gain glucose status.

34
Q

List 4 patients who many benefit from regular blood glucose testing?

A

-Any patient with type 1 dabetes or type 2 on insulin
-Any patient not achieving glycemic control
-Pregnacy women with diabetes
-Patients starting new medication known to cause hyperglycemia
-Patients newly diagnosed with diabetes

35
Q

What’s important to remember when insulin administration devices?

A

Thats all pens & cartidges are not interchangeable

36
Q

Risk factors for hemorrhoids?

A

Constipation, diarrhea, pregnancy, advanced age spinal cord injury, physical exertion

37
Q

Pharmacologic therapy of hemorrhoids?

A

Astringents
hydrocortisone
protectants glycerine
white petrolatum
vasoconstrictors

38
Q

What symptoms may patients complain about with hemorrhoids?

A

itching, swelling,burning, bleeding, potentially pain

39
Q

What are 2 important preventative measures for hemorrhoids?

A

-Avoid constipation
-Don’t remain on toilet for more than 1-2 minutes & avoid strining

40
Q

what is the best non-pharmacological therapy for pregnancy & breastfeeding?

A

-Calcium-containing
-Magnesium

41
Q

What is Gerd caused by?

A

Abnormalities in the esophagus, lower esophageal spincter and stomach

42
Q

What is dyspepsia caused by?

A

Identifiable abnormalities such as chronic peptic ulcers disease (PUD), gerd & gastric or esophageal cancer

43
Q

what are the 3 main symptomatic treatements for rhinosinusitis?

A

Nasal saline irrigation
Decongestants (topical and systemic)
Analgesics

44
Q

What is the difference between conductive and sensorineural hearing loss?

A

Conductive: sound is prevented from gaining access to inner ear due to a variety of causes
Sensorineural: invloves dysfunction of inner ear, cochlea, auditory nerve and or central nerve lesion

45
Q

What is seborrheic dermatitis?

A

An inflammatory, erythematous, greasy, scaling eruption

46
Q

What are some risk factors of dandruff?

A

HIV-AIDS, CNS disorders, depression, mood disorders, genetics, comorbid diseases, environmental factors, stress, sweat, lack of sleep, diet