Part 1 Flashcards
Medicine
The art and science of diagnosis, treatment, and prevention of disease, a drug or remedy for illness
Illness
An abnormal process in which aspects of social, physical, emotional, or intellectual condition or function of a person are diminished or impaired, with general term for impairment being disease, and specific illness being considered disease or disorders
3 major bacterial classifications based on shape
Cocci, bacili (rod), spirilla
What type of infection is poliomyleitis?
Viral
What type of infection is meningitis?
Bacterial or viral
What type of infection is pneumonia?
Viral or bacterial
What type of infection is typhoid fever?
Bacterial
What type of infection is malaria?
Protozoa
What type of infection is trichomoniasis?
Protozoa
2 leading causes of death in US
1) heart disease
2) cancer
Name of machine that produces an electrocardiogram
Electrocardiograph
Radiopaque
Substances that do not permit the passage of x rays
Radiolucent
Substances that readily permit passage of x rays
a.c. abbreviation
before meals
Centigrade is equivalent to
Celsius
What angle is sub-q injections given at?
45 degrees (beneath skin but above muscle)
Typical mL range of sub-q injections
0.5-2mL
Angle of an IM injection administration
90 degrees
Typical mL range of IM injections
3-5 mL
Intradermal injection angle of administration
10 degrees
Brady or tachyphasia
Slow or fast manner of speech
Frontal/coronal plane
Divides body into front (ventral) and back (dorsal) portions
Sagittal Plane
Divides the body into left and right sides with a vertical line
Transverse plane
Divides body into upper and lower portions with a horizontal line
Caudal
Toward tail direction
Cephalad
Toward head direction
Lateral recumbent position
Laying down on side
Most BP meds should be continued up to day of surgery except for these 2 classes which should be held 24 hours before
ACE and ARBs
Ballottement test (patella tap test)
Test for knee effusion, with pt laying supine, examiner uses one hand to push downward on the top of the knee then with the other hand taps the knee, if it bounces back after tapping this indicates a positive for significant joint effusion
prolia (denosumab) drug type, administration, use
Monoclonal antibody administered once via 60mg subQ injection into upper arm, thigh, or stomach area every 6 months for up to 5 or so years to treat osteoporosis, typically a 2nd line option
Evenity indication, administration, contraindications
new bone density medication for initial therapy in patients with very high fracture risk such as T score <-3, or <-2.5 with fragility fracture history, given as a 210mg once monthly subQ injection that is then often switched to prolia. Contraindicated in MI and stroke pts
if a patient has osteopenia managed with conservative measures and a subsequent fragility fracture then now they need….
Treatment with bone density medication
HSV laryngitis treatment
vocal cord surgery
Levothyroxine brand names (2)
levoxyl or synthroid
Chiari malformation definition and number of types and primary diagnosis
Group of disorders characterized by anatomic abnormalities of cerebellum, brainstem, craniocervical junction, with displacement of the cerebellum into the spinal canal. 4 types. Diagnosed via neuroimaging typically MRI or CT of the brain
Budd chiari syndrome definition and type 1 vs type 2
Hepatic venous outflow obstruction, type 1 is obstruction 2/2 thrombosis or phlebitis vs type 2 is compression 2/2 malignancy often
fuch’s dystrophy definition
Fluid build up in the clear layer (cornea) on the front of the eye typically affects both, causing your cornea to swell and thicken, often manifesting as glare, blurred or cloudy vision, and eye discomfort typically starting in 30’s-50’s, if advanced enough and not responsive to conservative measures requires corneal transplant surgery
solifenacin drug class, use, dosing
anticholinergic agent used for overactive bladder treatment, dosed at 5mg once daily and if tolerated up to 10 mg once daily
Xyzal generic name, drug class and function
Levocetirizine, 2nd gen H1 antihistamine, allergy treatment and prevention
tums (calcium carbonate) dosing
500-1250 calcium carbonate per tablet or per 5-10mL, typically 1-4 tablets or 5-10 mL for PRN episodes of GERD < or =1 episode per week, max dose 8 g/day
indomethacin dosing schedule for gout
50 mg TID within 24/48 hrs of onset, may reduce as symptoms improve and discontinue 2-3 days after resolution of flare, typical course is 5-7 days
colchicine interacts with some drugs in this class
antiarrhythmics
chantix dosing schedule
Days 1-3 0.5 mg once daily. Days 4-7 0.5 mg twice daily. Day 8 onward 1 mg twice daily
Opzelura (ruxolitinib) definition
Nonsteroidal cream for treatment of vitiligo and eczema
qsymia generic name
phentermine and topiramate
cosentyx (secukinumab) definition
Biologic interleukin monoclonal antibody for treatment of psoriasis and ank spondy
Brilinta (Ticagrilor) drug class
blood thinner antiplatelet P2Y12 antagonist
curb-65 score
Assessment of pneumonia severity to help determine need for inpatient vs outpatient treatment, Confusion
bUn >19mg/dL
Respiratory rate >30/min
BP <90 systolic and/or <60 diastolic
age >65
All negative outpatient, 1 point likely outpatient 2 points consider outpatient with close follow up vs inpatient, etc.
zaleplon brand name, drug class, indication and dosing
sonata, nonbenzodiazepine benzo receptor agonist, insomnia, 5-10 mg before bed up to 20 mg max
veozah (fezolinetant) drug class, function, and monitoring parameter
neurokinin 3 receptor antagonist, once daily med to treat vasomotor symptoms of menopause, LFT’s need monitoring cannot be >2 upper limit of normal
prampipexole drug class and use
Dopamine agonist, used for parkinson and alternative agent for RLS
jardiance generic name, drug class, and conditions it treats (3)
Empagliflozin, SGLT 2 inhibitor, type 2 DM, heart failure, and CKD
Spravato generic name and drug class and function
esketamine, NDMA receptor antagonist, used intranasally applied in a psych office for treatment resistant depression, used alongside a regular antidepressant
Ankle catching and locking sensation should often make you consider imaging looking for what?
An osteochondral lesion
demerol generic name, drug class
Meperidine, opioid
januvia generic name, drug class, function
Sitagliptin, DPP-4 inhibitor, type 2 diabetes treatment not used with GLP-1’s in addition to metformin or as monotherapy
test of cure for chlamydia
not warranted all the time, 4 weeks at least after and normal retest is 3 months
sulindac drug class
NSAID
HEART Score (MACE)
Used in patient’s with symptoms suggestive of ACS, includes
History suspicious or not
EKG
Age
Risk factors (other vascular disease, personal or family hx, HTN, DM, HLD, smoker, obesity)
Troponin (initial)
myrbetriq generic name, drug class and function and dosing and adverse effect
Mirabegron, B3 agonist, used for OAB 25 mg initially can titrate up to 50 mg after 4-8 weeks, urinary retention (otherwise much better tolerated)
detrol generic name, drug class, function, dosing, adverse effects
Tolterodine, anticholinergic agent, treatment of overactive bladder, 2 mg twice daily immediate release, dry mouth, headaches, dizziness,
First line osteoporosis treatment drug class
Bisphosphonates (alendronate, ibandronate, risedronate)
A chiari II malformation is often found prenatally or at birth because….?
It is almost always associated with a myelomeningocele and will cause symptoms such as dysphagia, arm weakness, stridor, or aspiration.
Type 1 Chiari malformation
Defined due to descent of the cerebellar tonsils measured below the level of foramen magnum. Can be asymptomatic and managed conservatively with monitoring if without myelomengingocele accompanying. If does have myelomeningocele debated on treatment if needed.
Do Chiari malformations commonly cause mental or cognitive delay?
No
Doxepin drug class and function and dosing
tricyclic antidepressant, most often used for insomnia 3 to 6 mg 30 min before bed
quantiferon gold definition
An IGRA used for TB screening particularly useful in patients with hx of BCG vaccine
farxiga generic name, drug class, and functions (3)
Dapagliflozin, SGLT 2 inhibitor, type 2 DM, CKD, and HF
Coricidin ingredients (2 with an alternative) and function
Either dextromethorphan or acetaminophen and chlorpheniramine which is a 1st gen antihistamine, used for either cough or cold without having impact on BP like sudafed (pseudoephedrine)
soma generic name and function
Carisoprodol, skeletal muscle relaxant
Indomethacin 2 contraindications
Heart disease (specifically s/p CABG) and hx of peptic ulcer disease
Janumet is a combo med of these two meds (and what classes are these 2 meds)
Sitagliptin (DPP-4 inhibitor) and metformin (biguanide)
List some of the common muscle relaxers
cyclobenzaprine, methocarbamol, baclofen, metaxalone, carisoprodol, and tizanidine
Chlorpheniramine drug class and function
first gen H1 antihistamine, used for allergies
Sanguinous definition
containing blood
In vitro vs in vivo
in a test tube or artificial environment vs in a living organism
Autologous transfusion
Where blood is removed from a donor and stored for a period before being returned to their circulation
Autologous graft
Transfer of tissue from one site to another on the same body
Homologous graft/allograft
Tissue removed from a donor for transplantation to a recipient of the same species
Mediastinum
The space between the lungs in the chest cavity
schlerotherapy
injection of a chemical solution directly into a varicose or spider vein causing vein walls to thicken, swell, and seal shut stopping the flow of blood resulting in fading away of the varicose vein after a few weeks
Thymus location
In chest slightly above heart, anterior mediastinal cavity
Glottis
Vocal apparatus of the larynx, consists of the vocal folds and openings between them that the epiglottis covers
Cheyne-Stokes respiration and what is it often seen in
Abnormal pattern of respiration characterized by alternating periods of apnea and deep, rapid breathing often seen in heart failure
Hypercapnia
excess CO2 in the body
pneumoconiosis
Any disease of the lung caused by chronic inhalation of dust in either occupational or environmental origin
3 regions of the stomach
1) Cardiac regions
2) Fundus
3 Pylorus
Prepuce
Fold of skin that forms a retractable cover over the clitoris, foreskin of the glans penis equivalent in male
Can men get trichomoniasis?
Yes, but they are often asymptomatic carriers and it often spontaneously resolves, urethritis is most common symptom
Trichomoniasis testing in men
NAAT, penile swab only
phimosis treatment
gentle stretching and betamethasone cream twice daily on the foreskin for 4-8 weeks
Chancre vs canker sore
chancre is the first phase of syphilis, a characteristically painless sore, a canker sore is an aphthous ulcer
condyloma acuminata
anogenital warts
Hallux
referring to big toe
Syndactly
Congenital anomaly marked by webbing between adjacent digits
DMARDs abbreviation and definition
Disease modifying antirheumatic drugs, modify the course of inflammatory conditions such as rheumatoid arthritis, slowing progression of disease
2 parts of the deincephalon
thalamus and hyopthalamus
of pairs of spinal nerves that arise from the spinal cord
31 (8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal)
Cerebral palsy definition
Motor function disorder caused by permanent, nonprogressive brain defect present at birth
pediculosis definition
Infestation by human lice
Primary type of anticoagulant used for protein C or S deficiency?
Vit K antagonists and LMW heparin, simply because of lack of data on DOAC but depends on the specific patient
Centor score
A calculator to determine the likelihood of strep pharyngitis including age, exudate, lymphadenopathy, temp, cough presence or absence
fluorquinolones are contraindicated in what condition of the cardiovascular system?
Anyeurysm
When to check serum testosterone on a male pt who injects weekly?
8-10am 24-48 hours after last dose.
Is proximal or distal bicep tendon tear more common?
Proximal
oral potassium and anticholinergics
contraindicated because it slows gastric emptying which can ulcerate or damage the abdominal wall
normal cap refill
<3 seconds
azelastine drug class and use
2nd gen antihistamine used exclusively in nasal spray form
bisocodyl (ducolax) use and dosing
either bowel cleanse as an enema single dose or oral constipation 5-15 mg once daily
dementia = __+__
memory impairment + impairment of 1 other cognitive function sufficiently severe enough to cause impairment in social or occupational performance
3 groups of meds for dementia
ssri, donezepil (aricept) and memantine (namenda)
diverticulitis imaging of choice
with contrast CT
amitryptiline side effects
constipation and weight gain
gilbert’s syndrome, dubin johnson syndrome, rotor syndrome, and crigler najjar syndrome differences
1) Gilbert’s is benign indirect bilirubin elevation in absence of other abnormal LFT often found incidentally occasionally might see subtle jaundice at times but requires no treatment
2) Dubin Johnson is benign direct bilirubin predominant elevation in absence of other abnormal LFT’s might see jaundice at times of illness or stress but again requires no treatment, no itching and what separates it from the very similar rotor syndrome is the mechanism only. Dubin Johnson is impairment of excretion, rotor is impairment of hepatic storage.
4) Crigler Najjar is rare autosomal recessive disorder of severe unconjugated hyperbilirubinemia that can result in severe bilirubin induced neurologic dysfunction, normally screened for in newborns to prevent rapid progression to kernicterus and neurologic injury
is aspirin use ok for kidneys for antiplatelet effect? What about as an analgesic
yes, a baby aspirin has no impact. As an analgesic it can be associated with AKI in high doses
hold blood thinners how many days prior to surgery
10
hippocampal diffusion restriction on MRI seen with
TGA
oxygen concentrator vs cpap
Different functions, one concentrates pure o2 from the air while the other just pushes airway open, supplemental o2 has NOT been shown to help sleep apnea.
Tibial plateau fracture common mechanism of injury, complications, diagnosis, treatment
heavy force blow lateral tibia most commonly, acute compartment syndrome most dire, x rays and if equivocal then CT or MRI, orthopedic consult within first 48 hours if any angulation
Bicep anatomy
Distal attachment point on the radial tuberocity (bicep aponeurosis) but there is a division then with the distal short HEAD that attaches directly onto the scapula corocoid process and this almost never tears, then there is a proximal long HEAD that commonly ruptures wrapping sideways around the humerous onto the supraglenoid tubercle of the scapula
Example of an anticholinergic drug
oxybutynin
Oxygen concentrator vs oxygen tank
Oxygen concentrator is unlimited without need for refill
