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SMNP Review > Missed > Flashcards

Missed Flashcards

1
Q

Subungual melanoma S/S

A

longitudinal brown or black band in the nail

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2
Q

What is Koilonychia?

A

curved spoon-shaped nail often with soft or flared ends, which can occur in patients with iron deficiency anemia

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3
Q

Actinic Keratosis S/S

A

red, pink, or brown and a rough, yellow scale is common. Leads to SQC.

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4
Q

Lithium Toxicity

A

N/V, tremors, confusion, slurred speech

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5
Q

Mastitis Tx

A

Dicloxacillin

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6
Q

Fifth Disease S/S

A

Flushed cheeks, lacy maculopapular rash

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7
Q

Fifth Disease Return to School

A

After rash appears (no longer contagious)

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8
Q

McMurray Test

A

Click is meniscus tear

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9
Q

Cataract Chnages

A

Bilatersl loss distance vision and night driving difficulty, foggy/cloudy vision

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10
Q
A
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10
Q

slipped capital femoral epiphysis

A

displacement of the proximal femoral epiphysis through the growth plate. Slater Harris Type 1 Positive Trendelenburg Test.

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11
Q

Infantile Hemangioma s/s

A

lesion started out flat and small but appears to be growing. The physical exam is significant for a slightly raised, lobulated, soft, and compressible lesion that is bright red. Dilated capillaries are visible

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12
Q

Infantile Hemangioma Tx

A

Only if interferes with vital function (promprnaolol). Otherwise goes away over years

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13
Q

Infective Endocarditis S/S

A

Splinter Hemorrhage
Roth Spots (Retinal hemorrhages with a white center)
Osler nodes are painful, red-purple lesions on the hands and feet

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14
Q

Orbital Cellulitis

A

infection of the contents of the orbit of the eye but not the globe. It presents with eye pain, erythema, edema, conjunctival swelling, and difficulty controlling eye movement. ED!!!

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15
Q

Finkelstein Test

A

Flexion of the thumb within curled fingers combined with ulnar flexion of the wrist causes Pain. DeQuaverian

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16
Q

5th Disease

A

low-grade fever and progresses into the development of a rash. The rash classically appears as a slapped cheek rash on the face and a lacy, reticular rash on body

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17
Q

Morton Neuroma

A

Morton neuroma (B) presents as a pain at the ball of the foot and numbness to surrounding toes.

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18
Q

COPD under age 45

A

Patients under the age of 45 with airflow obstruction should be tested for alpha-1 antitrypsin deficiency. inherited disorder that can cause COPD and affect the liver and skin

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19
Q

Turner Syndrome

A

X chromoseom deletion
Women Only - short stature / neck / no puberty sex change
Low dose estrogen therapy
Pregnancy possible but high risk

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20
Q

Temporal Arteritis

A

Vasculitis unknown cause of larger vessels. Fever, fatigue, headache, tenderness of scalp and jaw. Need steroids and referral ASAP.

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21
Q

Polymyalgia Rhuematica

A

chronic system infmlammatory unknown cause. Stiff and ache in shoulder girdle, pelvic girdle, neck. Elevated ESR, CRP. Occurs often the Temporal Arteritis.

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22
Q

Katz Index

A

Toileting
Bathing (except one area)
Dressing (except shoe tying)
In/Out of bed

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23
Q

Sialolithiasis

A

salivary gland stone. pain/swelling of face and jaw pain when salivating. Foul taste / smell.

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24
Q

PEricarditis causes

A

Lupus, Gout, Flu, Epstein-barr, rhuematoid arthritis

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25
Q

aphthous stomatitis

A

canker sore
inside of the mouth on the oral mucosa, shallow, painful. idocaine mouthwash might help with the pain and can also shorten healing time.

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26
Q

Ovarian CA risks

A

Early menarche, nulliparity, and late menopause are also risk factors for ovarian cancer. Orla contraceptive use may protect.

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27
Q

Seborrheic keratosis

A

Seborrheic keratoses present as well-demarcated, oval lesions with a stuck-on or wart-like appearance. They most commonly develop on the trunk, arms, and face.

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28
Q

Hidradenitis suppurativa

A

chronic inflammatory skin condition caused by follicular occlusion in intertriginous areas,
antibiotics, such as topical clindamycin, may be prescribed to reduce symptoms

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29
Q

Enterobiasis

A

intestinal infection caused by pinworms. The most common symptom of enterobiasis is perianal pruritus noted primarily at night

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30
Q

Ankle-Brachial index

A

divide the highest ankle SBP of the leg by the highest arm SBP from either arm. Normal ABI is 1–1.3. A diagnosis of borderline PAD based on an ABI is 0.9–1. Any patient with an ABI < 0.9 is considered to have PAD

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31
Q

Diabetic Retinopathy

A

new small blood vessels
Tiny red dots (microanyurism)
Cotton wool spots

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32
Q

JNC 8th HTN

A

pharmacologic treatment should begin when a patient is < 60 years old and has a systolic blood pressure > 140 mm Hg or diastolic blood pressure > 90 mm Hg

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33
Q

vesicoureteral reflux

A

1 - ureter
2 - ureter and collecting system
3 - ureter and dilates partly
4 - dilates ureter and collecting
5 - dilates with intrakidney or twisting
Refer all 3+
ABX for 1/2 if UTI hx or not toilet trained

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34
Q

Common Downs associated issues

A

Hypothyroid
Leukemia
Strabismus

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35
Q

Bowel sounds in Bowel Obstruction

A

Early - High Pitched
Late - Absent

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36
Q

Oral Combined Contraceptive Contraindications

A

Current cancer or history of breast cancer
Migraine with aura
35+ and smoker

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37
Q

AOM common causes

A

H. influenzae
Strep pnuemoniae
M. catarrhalis

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38
Q

idiopathic thrombocytopenic purpura

A

acute episode following a viral infection. It is seen most frequently in children ages 3 to 5. Clinical manifestations include a sudden onset of mucocutaneous bleeding, ecchymosis, and petechiae

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39
Q

Acyclovir S/E

A

GI Effects
Acute kidney injury
Headache
Dizziness, malaise

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40
Q

B12 Def. Causes

Diet

A

Diet (vegan, ETOH)
PPI long term
Metformin long term
Crohn’s / malabsorb
Gastric reduction
Pancreas insuff.

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41
Q

galactorrhea

A

bilateral milky nipple discharge
usually benign origin
Med causes - antidepressant / antipsych
Check prolactin level
Elevated prolactin - refer for MRI if no medicine cause

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42
Q

Macular Degeneration

A

Loss of central vision
Line distortion
Chronic and progressive, no treatment

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43
Q

Macular Degen Risk Factors

A

alcohol abuse
smoking
high fat diet
high red meat idiet
HTN
Obesity

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44
Q

Low MCV with High MCH

A

Only cause is congenital sperocytic anemia (very rare)

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45
Q

Sarcoidosis

A

chronic condition that causes collections of inflammatory tissue, which are called granulomas. Sarcoidosis is a systemic disease and can present in multiple body systems but most commonly occurs in the lungs. This is considered a type of restrictive lung disease,

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46
Q

condylomata acuminata

A

genital warts
treat with TCA, wash area

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47
Q

Iritis

A

ocular inflammation of the iris and often presents with acute changes in vision, photophobia, eye pain, and hyphema. Refer

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48
Q

HIV test

A

Enzyme linked immunoassay (HIV1/2 Immunoassay).
If positive then NAT (Differentiation test)

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49
Q

Sensorineural loss

A

tuning fork lateralizes to good ear

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50
Q

Conduction loss

A

tuning fork lateralizes to bad ear
BC>AC or BC=AC

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51
Q

Addison Findings

A

Hyponatremia
Hyperkalemia
Elevated BUN
Hypoglycemia

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52
Q

Genu Varum

A

Bow legs
normal resolves by 2 y/o

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53
Q

pansystolic murmur

A

A pansystolic murmur that radiates to the axilla likely indicates mitral regurgitation. The best placement to assess the mitral valve is at the apex of the heart. All mitral murmurs, diastolic or systolic, can best be heard at the apex.

54
Q

Otosclerosis

A

Otosclerosis is an abnormal bony remodeling of the inner ear bones, frequently the footplate of the stapes bone. It is a form of conductive hearing loss and will need surgery

55
Q

scarlet fever s/s

A

fever, sore throat, malaise, headache, and loss of appetite. The rash associated with scarlet fever develops 1–2 days after sore throat onset. It is a blanchable and erythematous rash that diffusely spreads to the face, neck, trunk, and extremities. The patient’s skin may feel like sandpaper due to small erythematous papules that also develop. Patients may also present with an erythematous tongue with a strawberry appearance.

56
Q

Roseaca

A

chronic skin condition that presents as a reddened, centrofacial rash. Education regarding sun protection including sunscreen, sun avoidance, and protective hats, should be included in this patient’s plan of care.

57
Q

Hyperparathyroid

A

gastrointestinal, kidney, musculoskeletal, neurologic, and cardiovascular. Common symptoms include anorexia, nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, bone pain, fatigue, decreased concentration, depression, and cardiac dysrhythmias.

58
Q
A
59
Q

Thiazide Diuretic Benefits

A

Stimulates osteoblasts, decrease calcium secretion. Good choice in women at risk of osteoporosis

60
Q

Thiazides avoided in:

A

Elevated total cholerterol
Gout patients
Diabetes

61
Q

Common cause of otits externa

A

Psuedomonas aeruginosa
Treat with ofloxacin drops

62
Q

Long term H2 blocker use

A

Risk for thrombocytopenia
Get a CBC

63
Q
A
64
Q

Cholesteatoma

A

white, keratinized skin growth noted behind an intact tympanic membrane (B) that often resembles a cauliflower. Patients should be referred to ENT for removal

65
Q

Medicare B covers:

A

outpatient
medical equipment
Flu, Pmnuemonia, HepB, and Covid vaccines

66
Q

MMSE scores

A

Low = bad
24+ normal
20-23 mild
13-19 moderate
12 or less severe

67
Q

Tdap recommendations

A

10+ since last - get it
5+ years and dirty wound - get it
less than 5 and dirty wound - no
less than 10 non-dirty - no

68
Q

CN III, IV, VI

A

O - III - blink/focus
T - IV - down, out, in
A - VI - outward

69
Q

retinal artery occlusion

A

cherry red sport and pale, swollen retina. Sudden painless vision loss.

70
Q

Fenofibrates

A

start if Triglycerides > 500

71
Q

Med for alzheimers

A

Donepezil

72
Q

facial shingles rash

A

facial shingles rash can lead to a complicated form of shingles called herpes zoster ophthalmicus - shingles reactivation in the fifth cranial nerve. Refer! Blindness risk!

73
Q

Blisters on TM

A

Bullous myringitis. Tx with augmentin

74
Q

Auspitz sign

A

Auspitz sign (A) is a classic clinical finding in plaque psoriasis. It occurs when an area of plaque is removed and small, pinpoint bleeding occurs.

75
Q

sausage shaped abdominal mass

A

intussusception

76
Q

asthma controlled by medium or low dose daily ICS

A

Moderate persistent

77
Q

Family Hx of Breast CA - Screenings

A

Annual mammo
Genetic testing
Breast exam
Consider MRI

78
Q

Who is at risk for alpha-thalassemia?

A

Southeast asian

79
Q

Who is at rick for beta-thalassemia?

A

Mediterrian

80
Q

Toprimate is not good for patients with:

A

Anorexia
Major Depression

81
Q

Risk factors for gall bladder”

A

obesity
inactivity
oral contraceptive
female sex
rapid weight cycling
pregnancy
hormone therapy

82
Q

pulmonary TB tx

A

rifampin
isoniazid
pyrazinamide
ethambutol
(RIPE therapy)

83
Q

DTaP risk

A

fever

84
Q

Fibromyalgia Dx

A

3 months
Pain index 7+
Fatigue
No other explanation

85
Q

rare congenital anomaly that involves the dislocation or hyperextension of one or both knees

A

genu recurvatum

86
Q

systolic murmur with crescendo-decrenscendo and radiation

A

Aortic stenosis

87
Q

mid-systolic click with late systolic murmur at apex

A

mitral valve prolapse

88
Q

high-pitched holosystolic murmur at apex

A

mitral regurgitation

89
Q

high-pitched blowing diastolic murmur at left sternal border

A

aortic regurgitation

90
Q

HTN and GERD

A

CCBs worsen GERD

91
Q

Folliculitis v. HS

A

painful, erythematous pustules on the skin. But HS is usually in higher BMI and in skin folds.

92
Q

Measles

A

Measles presents initially with fever, cough, congestion, and conjunctivitis. Approximately 3–5 days after the onset of symptoms, patients will develop a rash

93
Q

Duchenne muscular dystrophy (DMD)

A

inherited condition in which the muscles become progressively weaker over time. Onset of weakness typically occurs at around 2 to 3 years of age.
cognitive function. Large calf muscles, waddling gait.

94
Q
A
95
Q

iron def. in babies

A

full-term infants are born with enough iron stores to prevent iron deficiency anemia for approximately 4–6 months after birth. Therefore, it is most common to see iron deficiency anemia develop between 6 and 24 months (

96
Q

Cushing disease

A

Pituitary caused hypercotisolism. central obesity, a moon face due to the thickening of facial fat, a buffalo hump dorsocervical fat pad, red-purple abdominal striae, hirsutism, and acne. Cushing disease is diagnosed by a measurement of > 100 mcg of cortisol in the urine in a 24-hour period. Surgical removal of tumor is needed.

97
Q

AHA/ACC Hypertension Guide

A

<120/<80 is normal
Pre - 120-129
Stage 1 - 130-139 or 80-89
Stage 2 - 140+ or 90+

98
Q

Fragile X syndrome

A

congenital genetic disorder associated with neurological, cognitive, and behavioral deficits. Physical findings may include poor growth, seizures, joint hyperlaxity, sleeping problems, obesity, short stature, strabismus, long narrow face, teeth crowding, and large prominent ears. Behavior and cognitive findings may include intellectual difficulties, language delays, autism, anxiety, and aggression.

99
Q

atopic dermatitis

A

also known as eczema and is characterized by intensely pruritic, erythematous papules or vesicles with crusting and exudation. Patients with atopic dermatitis often have other atopic conditions, such as seasonal allergies or asthma.

100
Q

Hemochromatosis

A

inherited disorder leading to iron overload. DM, skin darkening, arthirits can occur. Treated with phlebotomy.

101
Q

Echinacea

A

used for immune boost and asthma. Cannot replace rescue inhaler!

102
Q

Allopurinol labs

A

Cr and Liver
Uric acid for effectiveness

103
Q

Most common cause of pnuemonia

A

Strep pneumoniae

104
Q

Cholesteatoma can damage what CN?

A

CN VIII - Facial

105
Q

copper intrauterine devices specific complications

A

heavy menstrual bleeding and menstrual pain

106
Q

Keloid v Hypertrophic Scar

A

Keloids extend beyond the original scar.
HS confined to original scar

107
Q

JNCC 8 HTN

A

start meds at 140/90 or more

(AHA is different)

108
Q

Diabetic Retinopathy S/S

A

Cotton wool spots
neovascularization
microaneurysms

109
Q

HRT Contraindications

A

Endoimetriosis
DVT / PE
Vaginal bleeding

110
Q

Agnosia

A

impairment in the ability to understand information in relation to the five senses

111
Q

turner syndrome risks

A

hearing loss, infertility, hypertension, osteoporosis, and kidney abnormalities

112
Q

UTI and on coumadin

A

Bactrim will interfere with coumadin

113
Q

When to step down on asthma?

A

FEV has improved and stable for 2-3 months

114
Q

Mastitis still pain after Tx

A

Refer for ultrasound/mammo

115
Q

Meconium ileus cause

A

think cystic fibrosis

116
Q

Allergic rhinitis symptoms

A

cobblestoning on the posterior pharynx
infraorbital edema
allergic shiners
loss of taste and smell
upper lip transverse crease

117
Q

Digoxin Toxicity

A

green-yellow halos
confusion
V Tach
N/V/D

118
Q

Vaginal bleed in post-menopause

A

Endometrial Cancer. Refer.

119
Q

Headache every AM in same spot, worsens with activity

A

Brain tumor

120
Q

Heart sound only heard at base of heart

A

S2

121
Q

Auscultate a split S2

A

At pulmonic during inspiration (2nd ICS left)

122
Q

Measles S/S

A

Koplik spots
Corzya
Cough
Congestion

123
Q

Thiazides do what?

A

Increase BGL
Increase uric acid
increase triglycerides
lower potassium

124
Q

Other causes of increased BUN

A

HF
GI Bleed
Liver Issues

125
Q

Laxative for elderly

A

Colace (docusate)

126
Q

UTI in first trimester

A

Augmentin is best choice

127
Q

Uterus height 16 weeks

A

Halfway between symphis pubis and umbilicus

128
Q

Prophylactic ABX for rheumatic heart disease history helps:

A

future episodes of rheumatic heart fever

129
Q

PKU diagnosis in newborn

A

Refer to metabolic specilaists right away, then later consider genetic testing

130
Q

Atrial Septal Defect finding

A

Wide fixed split S2

131
Q

You suspect pyloric stenosis -

A

ED refer right away, don’t ultrasound

132
Q

Sunken fontanelles in infants, even if all else is normal, should

A

be referred to the ED right away

133
Q

Kawasaki Disease

A

fever lasting ≥ 5 days and 4 of:
high-grade fever, bilateral conjunctivitis;
oral mucosal changes, such as injected or fissured lips or a “strawberry tongue”; a variable rash;
and changes in the extremities, such as redness or swelling of the palms or soles and peeling skin near the nails. Additionally, cervical lymphadenopathy is usually on one side and > 1.5 cm

SMNP Review (8 decks)

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