Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAC > NAC > Flashcards

NAC Flashcards

1
Q

Ottawa foot x-ray rules

A

Ottawa foot rules:
1) 5th meta tarsal tender
2) navicular tender
3) inability to weight bare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ottawa ankle rules

A

To determine neccessity for ankle x-ray
1) lateral mall tenderness
2) medial mall tenderness
3) inability to weight bare <4 steps

Ottawa foot rules:
1) 5th meta tarsal tender
2) navicular tender
3) inability to weight bare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ankle & foot exam

A

Inspect (SEADS) - front & back, can you walk for me?

Palpate
- temp
- achilles
- both malleoli & anterior joint line
- med/lateral ligaments
- 5th metatarsal & navicular
- feel all bones in foot up to metatarsal head
- check pulses (DP & PT)

ROM
- active: can you dorsi, plantar, inversion eversion and toes too?
- passive: allow me to

POWER:
- against resistance

Special tests:
- talar tilt (calcaneo-fibular ligament)
- talar drawer (talo-fibular ligament)
- squeeze test (if no movement of foot = +) - testing achilles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe talar tilt, talar drawer test & squeeze test?

A

ankle tests:

  • talar tilt (calcaneo-fibular ligament)
  • talar drawer (talo-fibular ligament)
  • squeeze test (if no movement of foot = +) - testing achilles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is most commonly sprained ligaments in ankle?

A

High sprain - inferior tibulo-fibular

Low sprain - anterior talo-fibular ligament (ATFL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gout risk factors & causes

A
  • high purine (red meats, organ meats, seafood, HFCS)
  • alcohol (beer)
  • meds (HCTZ, loop diuretics, aspirin, chemo drugs, contrast dye)

Issues with purine metabolism - either under excreter (90%) or over producer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gout ix & tx

A

Sx:
- acute: v painful, tender, no pressure, high fever
- chronic: tophi & arthritis

Ix:
- CBC (high WCC), serum uric acid
- synovial fluid analysis (neg birefringent & needle crystals) r/o septic arthritis & gram stain/culture
- x-ray or ultrasound or CT to see deposits

tx:
- acute: NSAIDs or steroids or colchicine
- prevention: allopurinol or XO inhibitors or febuxistat (+/- NSAIDS or steroids for 3-6 months?)
- avoid high purine foods and alcohol, switch meds as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Asthma diagnosis

A

sx: SOB, wheeze, tightness, cough worse at night, FHX

PFTs - FEV1/FVC <70% w bronchodilator reversal >12% (after 20 mins)

XRAY - r/o cancer or infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Asthma outpatient mx

A

Education (env control, avoid triggers, asthma action plan, technique & priming inhaler, peak flow meter)

Technique - breathe out fully, breathe in fully & hold 10 sec, out –> shake puffer & wait 1 min before next puff (prime by spraying 4 puffs if new or >2weeks since use)

Inhalers:
- <2x/week: salbutamol 1-2puffs q4-6h PRN
- >2x/week (not daily): salb qid + low dose ICS 1 puff bid (Flovent)
- daily: LABA + med dose ICS (combo - Advair mod dose or Symbicort high dose)
- still uncontrolled: add LABA, LRTA, high dose ICS, oral steroids, consider omalizumab (anti IgE if >12yo)

If using SABA > 4x/day, >2x/week, 1night/week or 2nights/month –> increase

COMBOS:
- Advair (250mg steroid + LABA)
- Symbicort (400mg + LABA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are your ICS Asthma inhalers called?

A

ORANGE: Flovent (fluticasone propionate) - 125mcg, 250mcg, 500mcg

BROWN: Pulmicort (budesonide) - 100mcg, 200mcg, 400mcg

PURPLE: ADVAIR (LABA-ICS COMBO)

WHITE & RED: SYMBICORT (COMBO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Inhaler colours

A

Blue: salbutamol (SABA) & salmeterol (LABA)

Green: Atrovent (SAMA)

Orange: Flovent (ICS)

Brown: Pulmicort (ICS)

Purple: Combo Advair

White/red: Symbicort combo

Singulair: tablets
Spiriva: handheld (COPD) - LAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ER Asthma Attack Mx

A

SOB, diaphoretic, dyspneic, tachypneic (RR > 30), HR > 120, SpO2 <90%, tripod, PEF < 50%, difficulty talking, cyanotic, reduced consciousness, absent breath sounds, bradycardia & hypotensive = ER!!!

  • Assess ABCs (ABG, peak flow, intubate?)
  • O2 > 94%
  • Brochodilators (salbutamol + atrovent) 4 puffs q15mins x 3
  • Steroid (50mg po pred or IV)
  • Fluids
  • If unresponsive - Mg, ICU, consider other causes (anaphylaxis, foreign body etc)
  • discharge w inhalers, 5d steroids, fu with GP in 5 days, safety plan (return if inhaler use <2h, sx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Asthma history

A

EVENT - OCD, meds, symptoms, 911, admitted, intubated, discharge meds?

Asthma HX (recently increase puffer times, attacks at night)

Triggers
- infections, meds (aspirin, BB), exercise, cold air, pollen/dust
- indoor - smoke, pets, fabrics, perfume, for, mold, construction
- stress

PMH & FH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Meds that can worsen asthma

A

Beta-blockers (non-specific) & aspirin

Ace can cause a cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

COPDE Mx

A

Increased SOB, purulence, volume

  • Mx ABCs (if dec LOC & ABG - consider ventilation)
  • O2 88-92
  • nebulized broncho (sal & atrovent x 3)
  • steroids x 5d (PO or iV)
  • antibiotics if 2/3 criteria

Antibiotics:
- outpt: levo 750mg PO q24h x 5d or amox 1000mg PO tid /clarithro 500mg PO bid
- inpt/immuno/group home: azithro 500mg IV q24h x 5d + ceft 1g IV q24h
- pseudo sens or recent Ab/Cx piptaz 3.375g IV q6h
- MRSA Vanc 1g IV q24h

Discharge:
- inhalers
- 5d course steroids
- antibiotics
- post rehab for exercise tolerance
- O2 if needed (PaO2 < 55 or cor pulm with <60)
- vaccines
- smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

COPDE Antibiotic Protocol

A
  • outpt: levo 750mg PO q24h x 5d or amox 1000mg PO tid /clarithro 500mg PO bid
  • inpt/immuno/group home: azithro 500mg IV q24h x 5d + ceft 1g IV q24h
  • pseudo sens or recent Ab/Cx piptaz 3.375g IV q6h
  • MRSA Vanc 1g IV q24h
17
Q

Inhaler mx for COPD

A

Short acting Ventolin (q6h PRN) & Atrovent (1-2 q6h)

Long acting bronchodilator
- LABA (Serevent) +/- Atrovent
- LACA (Spiriva) –> stop atrovent (both cholinergic)

ICS- LABA combos:
- Advair
- Symbicort

18
Q

Blood sugar targets in DM

A

HBA1c < 7
Fasting sugar 4-6
BP < 130/80
LDL < 2
TG < 1.5
TC/HDL < 4

DM:
HBA1c > 7
Fasting sugar > 7
Random glu + sx > 10
GTT > 11.1

Pre-DM:
Fasting sugar 6.1 - 6.9
GTT 7.8 - 11

19
Q

DM diagnosis

A

DM:
HBA1c > 6.5%
Fasting sugar > 7
Random glu + sx > 10
GTT > 11.1

Pre-DM:
Fasting sugar 6.1 - 6.9
GTT 7.8 - 11

20
Q

Pre-DM diagnosis

A

Pre-DM:
HbA1c 5.8 - 6.4%
Fasting sugar 6.1 - 6.9
GTT 7.8 - 11

DM:
HBA1c > 6.5%
Fasting sugar > 7
Random glu + sx > 10
GTT > 11.1

21
Q

Normal blood sugar

A

HBA1c <5.7%
Fasting sugar 3.9 - 5.5

22
Q

Chlamydia treatment

A

100mg doxy BID x7d or 1g azithro

test of cure if suboptimal treatment, pre-pubertal or pregnant or sx

complications:
- PID, infertility, ectopic pregnancy, chronic pelvic pain, Fitz Hugh Curtis (liver ix), neonatal conjuctivitis/pneumonia, reactive arthritis

23
Q

Tx for gonorrhoea

A

1x ceftriaxone 250mg IM + azithro 1g

24
Q

Most common bacterial & viral STIs in Canada

A

bacterial - chlamydia

viral - HPV

25
Q

oncogenic vs. warts strains of HPV

A

HPV 16 & 18 - onco

HPV 6 & 11 - genital warts

26
Q

Herpes clinical picture

A

prodromal itch, burning, tingling

7-10d shallow ulcers with small vesicles, inguinal LAD, fever with first eruption, subsequent are shorter, less severe and less frequent

Tx: acyclovir, famcidovir and valacyclovir 7-10d & 5d for recurrent & suppressive therapy if q2months

Transmission - avoid sex from onset of prodrome until lesions completely healed (within 3 weeks) –> bc vesicle, opens, crusts over

27
Q

syph treatment & stages

A

primary (under a month) - ulcer & LAD & negative test

secondary (2-6mo) - malaise flu like + maculopap rash soles/palms/trunk

latent - no signs but labs

tertiary - neuro & cardiac (aneurysm, dilated aortic root, tabes, paresis)

penicillin 2.4mill units IM single dose unless prolonged latent or tertiary

28
Q

PID sx & treatment

A

lower abdominal pain, N/V, discharge, fever > 38.3, dysuria

cervical motion tendernes, uterine & adnexal tenderness, high ESR/CRP, lab dx of c/g, TV us or MRI showing thickened fluid filled tubes/free fluid

chronic - pelvic pain, dyspareunia

tx: 2 weeks of antibiotics

29
Q

Anorexia DSM 5 Dx

A
  • energy restriction causing SEVERELY low body weight
  • intense fear of weight gain
  • lack of perception/awareness of severity

mild: >17 BMI
mod: 16-17
severe: <16
extreme: <15

30
Q

Bulimia DSM 5 Dx

A

Binge eating (discrete episodes 2hrs eating more than others would) + compensatory behaviour

1x/week for at least 3 months

31
Q

Criteria for anorexia admission

A
32
Q
A

NAC (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions