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FAMILY PRACTICE NOTES > miscellaneous family practice notes > Flashcards

miscellaneous family practice notes Flashcards

1
Q

Stage hypertension

A

Pre-hypertension = 1 20–139/80–89

Stage I = 140–159/90–99
Stage II = 160+/100+

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2
Q

Herbal supplements causing hypertension

A 
Arnica
Bitter orange
ephedra = Ma–huang
ginkgo
Ginseng
guarana
licorice
senna
St. John's wort
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3
Q

Treatment of cocaine-induced hypertension

A

–Nitroglycerin
–Benzodiazepines
–Calcium channel blockers
–Labetalol (only allowable beta blocker)

do not use beta blockers as this will increase the vasoconstriction of the coronary arteries

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4
Q

initiation of pharmacologic therapy for hypertension

A

Persons <60 years of age with a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥60 years of age with a systolic blood pressure ≥150 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥18 years of age with chronic kidney disease who have a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥18 years of age with diabetes mellitus who have a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg

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5
Q

treatment for acute exacerbation of multiple sclerosis

A

steroids

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6
Q

diagnosis of serotonin syndrome

A 
increase serotoninergic activity in Central nervous system
–Neuromuscular abnormalities
–Mental changes
–Agitation
–Confusion
–Tachycardia
–elevated blood pressure
–Dry mouth
–Usually within 24 hours of starting SSRI

–May have slow horizontal nystagmus
–May have spontaneous clonus

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7
Q

treatment of serotonin syndrome

A

–diazepam to count patient
–Propanolol for hypertension
–Antidote, if needed is cyproheptadine
–Avoid HALOPERIDOL

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8
Q

positive predictive value

A

the percentage of patients with a positive test for a disease who actually
have the disease.

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9
Q

negative predictive value

A

the percentage of patients with a negative test for disease who actually do not have the disease

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10
Q

defined sensitivity of the test

A

the percentage of people who have a disease who Will get a positive result

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11
Q

define specificity

A

the percentage of people who do not have the disease and get a negative test result

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12
Q

define Gilbert’s syndrome

A

=hereditary condition with unconjugated hyperbilirubinemia
–usually normal liver enzymesan asymptomatic
–Bilirubin increases with stress, fasting, and infection

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13
Q

most likely drug involved in breast tenderness and gynecomastia

A

spironolactone

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14
Q

most common cause of death in rheumatoid arthritis

A

–coronary artery disease

Also have an increase in
––Thromboembolic events
––Infections
––Lymphoma
––Lung cancer
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15
Q

drug of choice for polynephritis

A

Cipro

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16
Q

findings in idiopathic thrombocytopenic purpura

A

thrombocytopenia which is isolated and has no other cause

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17
Q

drug of choice for pertussis

A

azithromycin

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18
Q

contraindications for ParaGard and or Mirena

A

–Mirena is preferred for most conditions

–ParaGard is preferred in the presence of severe liver disease, thromboembolic events, or liver cancer

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19
Q

prevalence of migraines

A 
–men = 10%
–Women = 20% have them
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20
Q

classification of migraine headaches with aura

A

International Headache Society Diagnostic Criteria for Migraine Headache With and Without Aura
Migraine without aura

Headache lasts 4 to 72 hours (untreated or unsuccessfully treated)

Headache has at least 2 of the following:

Aggravation by or causing avoidance of routine physical activity (e.g., walking, climbing stairs)

Moderate or severe pain

Pulsating quality

Unilateral location

During headache, at least 1 of the following:

Nausea and/or vomiting

Photophobia and phonophobia

Not attributed to another disorder

History of at least 5 attacks fulfilling above criteria

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21
Q

classification of migraine headaches without aura

A

Migraine with aura*

Aura consisting of at least 1 of the following, but no motor weakness:

Fully reversible dysphasic speech disturbance

Sensory symptoms that are fully reversible, including positive features (e.g., pins and needles) and/or negative features (e.g., numbness)

Visual symptoms that are fully reversible, including positive features (e.g., flickering lights, spots, lines) and/or negative features (e.g., loss of vision)

At least 2 of the following:

Homonymous visual symptoms and/or unilateral sensory symptoms

At least 1 aura symptom develops gradually over 5 minutes, or different aura symptoms occur in succession over 5 minutes

Each symptom lasts at least 5 minutes, but no longer than 60 minutes

Headache fulfilling criteria for migraine without aura begins during the aura or follows aura within 60 minutes

Not attributed to another disorder

History of at least 2 attacks fulfilling above criteria

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22
Q

episodic vertigo triggered by head motion

A

episodic proximal positional vertigo

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23
Q

Ménière’s disease

A 
vertigo 
tinitis
unilateral hearing loss
last 20 minutes–12 hours
Ear fullness
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24
Q

contraindications to MMR vaccine

A

–allergy to neomycin
–Immunosuppression
–Pregnancy

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25
Q

Lewy body dementia characterized by

A 
–memory deficits
–Reduced alertness
–parkinsonian features
        –rigidity 
        –Resting tremor   
        –Bradykinesia  
         –Gait disorder
26
Q

triad of normal pressure hydrocephalus

A

“wacky, wet, wobbly,”

–personality change
–Urinary incontinence
–Gait disorder

27
Q

Hashimoto’s disease

A

–most common cause of hypothyroidism
–May actually start with hyperthyroidism
–anti-thyroglobulin autoantibodies
–anti-thyroid peroxidase

28
Q

Graves’ disease in pregnancy

A

= hyperthyroidism
–Treatment with PTU (propylthiouracil)
–use beta blockers initially if thyroid storm

29
Q

differences between chalazion and hordeolum

A

chalazion = blocked oil duct

Hordeolum =infected oil duct

30
Q

Salter-Harris fracture classifications

A 
Salter I =S = slipped  epiphysis
Salter II =A= above epiphysis
Salter III =L =lower than physis
Salter IV =T = through physis
Salter V =ER =wrecked physis ( compression)
31
Q

historical features in DKA

A 
5 I's of diabetic neuropathy(history of)
–infection
–ischemia (cardiac or mesentery)
–infarction
–Ignorance (poor control)
–intoxication
32
Q

types of diabetic neuropathy

A

autonomic
–––gastroparesis, orthostasis, constipation

acute mononeuropathy
–––Cranial nerve palsy, foot drop

Distal, symmetrical,
–––Sensory > motor neuropathy

33
Q

Calcium pyrophosphate deposition disease

A

=pseudogout

34
Q

components of the tetralogy of Fallot

A

–overriding aorta
–Pulmonary stenosis
–Ventricular septal defect
–Right ventricular hypertrophy

35
Q

aortic stenosis

A 
–older patient
–history of hypertension or diabetes
–Dyspnea, syncope, chest pain
–crescendo–decrescendo murmur
–Murmur radiates to carotids
–Murmur decreases with Valsalva
36
Q

positive direct Coombs test indicates?

A

autoimmune red blood cell lysis

37
Q

what are Howell-Jolly bodies and what did they indicate

A

nucleic remnants in erythrocytes that were not filtered out by spleen
–Indicates deficient splenic activity or lack of spleen

38
Q

diagnoses of hereditary spherocytosis

A

osmotic fragility test. Spherocytes are already distended and lyse more quickly than normal cells in hypotonic solution

39
Q

characteristics of preeclampsia

A

–hypertension
–proteinuria
–20+ weeks of pregnancy

40
Q

characteristics of eclampsia

A

history of preeclampsia plus seizures
–Can occur up to 2–4 weeks postpartum
–Treated with magnesium

41
Q

earliest symptoms of magnesium toxicity

A

loss of deep tendon reflexes

42
Q

most common heart valve abnormality

A

bicuspid valve of the aortic valve

43
Q

prophylaxis for deer tick bite

A

doxycycline 200 mg, 1 dose within 72 hours a bite

44
Q

symptoms of hypoparathyroidism

A 
hypoparathyroidism causes 
–low vitamin D
–Intensity
–Seizures
–refractory heart failure
–Altered mental status
–'s stridor
45
Q

contraindications to statins

A

–pregnancy
–Breast-feeding
–Unexplained liver disease
–myopathies

46
Q

symptoms of Pancoast tumor

A 
= tumors on the apex of the lung
–arm swelling
–Horner's syndrome
–Shoulder swelling
–Atrophy of arm and hand muscles
47
Q

Horner syndrome

A

–myelosis
–ptosis
–Ahydrosis

48
Q

carcinoid syndrome symptoms

A

–tachycardia
–facial flushing
–Diarrhea

Caused by endogenous secretion of serotonin and kallikrein

49
Q

symptoms of marasmus

A

= protein-energy malnutrition

–Loss of subcutaneous fat
–Muscle wasting
–Normal hair!
–Emaciated
–Strong appetite
50
Q

symptoms of kwashiorkor

A

=protein deficiency

–poor appetite
–Edema
–Distended abdomen
–Peeling skin
–Diarrhea
51
Q

chalazion symptoms

A

–blocked meibomian oil gland
–Usually upper lid
–Nontender
–treat with warm compresses

52
Q

hordeolum symptoms

A

= stye

–Usually lower lid
–usually bacterial
–Treat with warm compresses
–Usually self drain within a week

53
Q

Henoch-Schönlein purpura

A

= acute systemic vasculitis
–primarily affects venules and arterials
–associated with palpable pruritic rash that begins in the lower extremities and extends to the abdomen
–associated with joint pain, abdominal pain and hematuria

54
Q

monitoring amiodarone therapy

A

–chest x-ray to look for interstitial pneumonitis
–Hepatic profile
–Renal profile

55
Q

Kawasaki’s disease

A 
–fever lasting for 4–5 days
–Bilateral conjunctivitis
–oral mucosal changes(strawberry tongue)
–bilateral conjunctival injection
–cervical adenopathy
–extremity changes with erythema or palm or sole desquamation
–child less than 4 years old
56
Q

developmental dysplasia of hip

A

–limited hip abduction

–more common in females
–mild laxity self-corrects
–Barlow’s maneuver attempts to dislocated hip
–Ortolani’s maneuver attempts to reduce it

After 6 months
–llimited hip adduction most important sign
–Galeazzi sign = knees flexed, feet on floor, check for knee height discrepancy

–Imaged with ultrasound
–Look for asymmetric skin creases and legs

57
Q

most common types of bone cancer in children

A

–osteosarcoma

–Ewing sarcoma

58
Q

rhabdomyolysis diagnosis

A

cause = alcohol, drugs, heat, trauma, exercise

–CPK = >5 times upper limit of normal
–hemoglobinuria with few RBCs
–hyperkalemia
–Hyperphosphatemia
–hypocalcemia

TX = IV fluids, bicarbonate, EKG

Complications =DIC, ARF, compartment syndrome

59
Q

chromosomes and Turner’s syndrome

A

45 XO

60
Q

EKG changes in various infarctions

A

Anterior wall ST elevation in leads I, AVL, and V2 to V6.
Inferior wall ST elevation in leads II, III, and AVF.
Lateral wall ST depressions in leads I, AVL, and V5 to V6.
Posterior wall ST depressions and then elevations in V1 to V3

FAMILY PRACTICE NOTES (1 decks)

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