MT Flashcards
1
Q
Associated with morbid obesity and can be associated with the CNS
A
Central sleep apnea
2
Q
Periods of apnea due to mechanical or functional blockage of flow
A
Obstructive sleep apnea
3
Q
___ people with sleep apnea are obese
A
2/3
4
Q
Losing weight can help improve symptoms of sleep apnea both subj and obj
A
Increased lung volume
Decreased pharyngeal collapse
5
Q
What sleeping position can help with symptoms of sleep apnea
A
Side lying
6
Q
Avoid ___ for sleep apnea
A
Alcohol
7
Q
CPAP can help reduce
A
Hypertension which improves quality of life, reduces depression and MVA
8
Q
Surgical options for sleep apnea
A
Removal of nasal polyps
Correcting deviated septum
Removing tonsils, adenoids, or the uvula
9
Q
Restless leg syndrome
A
Iron supplementation is beneficial
65 mg of elemental iron given 1-3 times daily as needed
10
Q
Other drugs for RLS
A
Alpha 2 delta drugs which affect calcium channels
Neurontin (gabapentin)
Lyrica (pregablin)
Gabapentin enacarbil (horizant)
11
Q
Thiazolidinones classification
A
Actose
12
Q
Attaches to nuclear receptors in the cells to cause an increase in production of cellular proteins that facilitate glucose transport
A
Actose
13
Q
Side effects of actose
A
Can worsen CHF Stomachache pain Blurred vision Chest pain Swelling
14
Q
Classification biguanides
A
Metformin
15
Q
Does NOT increase insulin production
Helps to bind insulin to insulin receptors and potentate insulin activity
A
Metformin
16
Q
Used to treat type 2 diabetes
A
Metformin
17
Q
Side effects metformin
A
Abdominal pain
Nausea and vomiting
May interfere with the absorption of folic acid and B12 or amino acids
Patient may complain of metallic or bitter taste
18
Q
Metallic or bitter taste
A
Metformin side effect
19
Q
Insulin drugs
A
Novolog (RCA) Lantus (RCA) Humulin Novolin Lletin 2 Humalog (RCA)
20
Q
RCA
A
Recombinant human analogs extracted from pork
21
Q
RCA lower blood sugar by
A
Increasing peripheral uptake in muscles na dfat
22
Q
Promotes conversion of glucose to glycogen
A
RCA
23
Q
Most common cause of dementia in the US
A
Alzheimers
24
Q
Accounts for 65-75% of all dementia cases in US
A
Alzheimer’s
25
Women with this tend to live longer than men
Alzheimer’s
26
Alzheimer’s accounts for ___ in lost productivity
100 billion
27
Accumulation of senile plaques in the cerebral cortex and subcortical gray
Alzheimer’s
28
Plaques contain ___ and are made of ____
Beta amyloid and neurofibrillary tangles
Tau protein
29
Depression is a risk factor for
Alzheimer’s
| Low vitamin D levels
30
___ can help prevent dementia but insignificant for alzheimer’s
Estrogen
31
Smoking increases the risk for
Alzheimers
32
Hippocampal atrophy may be predicative in for conversion to
Alzheimer’s
33
Management alzheimre’s
Early and correct diagnosis are important
cannot be cured
Cognitive and behavioral problems may be managed medically
Cognitive probelms are treated with cholinesterase inhibitors such as tacrine (cognex) and donepeezil (aricept)
34
Inhibit the degeneration of acetylcholine at the synaptic cleft
Cholinesterase inhibitors
35
Disease altering strategies alzheimer’s
Ginko blioba
Vit E
NSAIDs
36
Elderly account for __ of prescription drug purchases and ___ of non-prescription
30%
| 40%
37
__ of the elderly must take at least one drug a day to perform ADLs
40%
38
Many medical physicians rely on medications to achieve treatment goals because
It cuts down on time and there is immediate patient satisfaction
39
The patient seeks care from multiple physicians and will ____ info on other prescriptions they’re taking
Forget or purposefully omit
40
The patient will take a friends and faimly members medications because
They feel they have the same symptosm
41
Erectile dysfunction most common cause
Diabetes
42
Risk factors for ED
CV disease
Metabolic syndrome
Smoking
Age
43
Age ED
52% higher in 40-72
| Prevalence is 50-70
44
ED drugs
Viagra
Cialis
Levitra
45
Side effects ED drugs
Orthostatic hypotension
Headaches
Flushing of the skin
Avoid grapefruit adn limit alcohol intake while taking these meds
46
Selective cyclic guanisine monophodiesterase inhibitor
Cialis
47
Cialis side effects
```
HA
Dizziness
Abdominal pain
Chest pain
Myalgias
```
48
Phosphodiesterase 5 inhibitor
Causes vasodilation in corpus cavernous
Levitra
49
Side effects of levitra
```
Facial edeam
Postural hypotension
Palpations
MI
Angina
Gout
Dermatitis
```
50
Causes vasodilation in corpus cavernous in effect with nitric oxide
Viagra
51
Side effects viagra
Facial edema, postural hypotension, palpations, MI angina, gout, dermatitis
52
Enzyme blocker for phosphodiesterase type 5 causing increase in blood flow to penis
Levitra(vardenafil HCL)
53
Side effects levitra (vardenafil HCL)
HA
Indigestion
Flushing
Stuffy nose
54
OA nutritional supplements
Glucosamine and chondroitin
55
Those with knee ligament or meniscal injury’s demonstrated a higher risk for developing
Degenerative changes earlier
56
Nutrition for OA
Glucosamine 1500 mg and chondroitin sulfate 1200 mg divided into 4 servings
57
If someone is trying to become active they should start with
Low impact or no weight
58
Possible reduction in breast pain
100-400 IU/day
No side effects
Vitamin E
59
Cofactor in production of dopamine
400-1000 IU/day
High dosage may cause diarrhea
Magnesium
60
Used to treat anxiety and as a sleep aid
2-3 g taken 1-3x/day
Should only use freash
Not taken while prego or as sleep enhancers
Valerian
61
Works synergistically with 5 HTP also an anti-inflammatory and has analgesic properties
St. Johns wart
62
3x daily up to 600 mg 3x/day
| Taken with 5 HTP reduce the 5 HTP dose to 100 mg/day
St. Johns wart
63
Side effects st. Johns wart
Possible stomach irritation, tiredness, HA, restlessness
64
Possible decrease in menstrual cramping
40 mg/day throughout cycle, 100mg/2 hours as peeded during menses
High dose may cause diarrhea
Magnesium and vit B6
65
Relieves cramping
200 mg/day, 100mg/day every 2-3 hours during cramps
Not effective unless taken 7-10 days prior to menstrual flow
Niacin
66
Side effects niacin
Flushing effect
HA
Stomachache
67
800-1000 IU/day
| Taken for 3 months to determine effectiveness
Vit E
68
May reduce symptoms of hot flashes
| 1200 mg and 1200 mg of bioflavonoid hesperidin
Vit C
69
Side effects vit C
Diarrhea
| High levels of vit C can deplete body of copper
70
Adaptogenic effect on female hormonal system
Dong quai
71
3-4g/day
Not recommended for prego or lactating
May cause sensitivity to light
Dong quai
72
Endometriosis is found in an estimated ___ of reproductive age women
15-20%
73
Mainly found in age 25-29
| Laproscopy id definitive dx
Endometriosis
74
Classic triad endometriosis
Dysmenorrhea
Dyspareunia
Infertility
75
3rd most common gynecologic cancer
Cervical cancer
76
Considered an STD
Average age is 50
First sign is usually painful intercourse
Cervical cancer
77
5 year survival rate for early stage and late stage cervical cancer
80-90%
| 15%
78
Mainly in 60-65 age
Increased risk with HPV history
Poorly differentiated lesions that have spread = 15-20% 5 year survival
Small differentiated lesions 5 year survival = 70%
Vaginal cancer
79
2nd most common gynecologic cancer
Ovarian cancer
80
Cuases more deaths than the rest
| Seen in areas where there is a high fat intake
Ovarian cancer
81
Ovarian cancer 5 year survival
5-40%
82
___ of women have advanced cases at time fo dx for ovarian cancer
75%
83
Geriatric cancer seen in women over 70
Vulvar cancer
84
Only 3-4% of all gynecologic cancers
Vulvar cancer
85
Most common presentation vulvar cancer
Palpable often visable vulvar lesions with pruritis
86
5 year survival widespread and local
15%
| 90%
87
Most common discharge
Candidiasis
88
Accounts for 15-20% of all vaginal infections
Candidiasis
89
Causes extreme pruritus especially at night
Candidiasis
90
Gardnerella accounts for 50-60% of vaginal infections
Bacteral vaginosis
91
Accounts for 15-20% of all vaginal infections
Trichomoniasis
92
Foudn when pH of vagina gets more alkaline
Trichomoniasis
93
Tubal disease infertility
20%
94
Endometriosis infertility
5-10%
95
Male factors infertility
20-25%
96
Unexplained infertility
30%
97
___ of asymptomatic cancer can be caught on normal breast exams
50%
98
Women 50 or older account for ___ of breast cancer cases
70%
99
Mutations in BRACA 1 gene have a higher risk for
Developing cancer
100
___ of women over 40 who are multiparous after age 30 account for 16% of new breast cancer cases each year
21%
101
Survival rate breast cancer
60%
102
Most recurrences develop within
2-6 years
103
Risk factors breast cancer
Family hx
Previous hx
Benign breast disease
Menstrual relationship before 12 or menopause after 55
Giving birth after age 30 for first time
Mutation of BRACA 1 gene inc lifetime risk by 85%
104
Types breast cancer
Non-invasive
| Invasive
105
Account for 10% of breast cancers
Comedo is aggressive
Non comedo is slower growing over longer periods of time
Non invasive
106
Ductal carcinoma accounts for 80% of cases
| Lobular carcinoma accounts for 10% of cases
Invasive
107
Staging breast cancer 1
Lesion less than 2 cm and no lymph involvement
108
Intermediary stage iwht small lesions with lymph node enlargement or larger lesions without lymph node involvement
Stage2
109
Larger than 5 cm, with lymph involvement
Stage3
110
Metastasis
Stage 4
111
Self imposed weight loss due to distorted body image
Anorexia nervosa
112
Majority anorexia are
Affluent white females 85%
113
Weight is 15% below expected normal
Intense fear of gaining weight even though underweight
Distorted sense of self
Absence of at least 3 consecutive menses
Anorexia
114
Binge purge cycle in effort to avoid weight gain
Bulimia nervosa
115
Seen in about half of AN patients
Bulimia
116
Seen in about 20% of college students
Bulimia
117
```
Parotid or salivary gland swelling
Bruising of knucklesa
Pharyngitis from reflux of gastric acid
Dental erosions
Conjunctival hemorrhages from retching
Problems may arise from hypokalemic hypochloremic metabolic acidosis
```
Bulimia
118
Women are twice as likely as men to be affected
Incontinence
119
Incontinence affects about ___ of older males
30-50%
120
Bone loss in early menopause
5-10%/decade
| 1-5%/year
121
Risk factors osteoporosis
```
White or asian background
Early menopause
Lean body habitus
Lack of exercise
Glucocorticoids, loop diruretics, warfarin
Heavy alcohol consumption
Smoking
Low calcium intake
High homocysteine levels
```
122
X-rays can only detect osteoporosis once ___ of bone has been lost
30-50%
123
Most sensitive for osteoporosis
Single and dual photon absorptiometry (SPA, DPA)
| DEXA is now the tool of cohice
124
Supplementation osteoporosis
1000mg premenopausal
1500mg post menopausal
For elderly consider vit D
