Question dissection and analysis Flashcards
what is the normal hemoglobin range for males and females?
Males: 13-17.5 g/dL
Females: 12-16 g/dL
what is the normal hematocrit range for males and females?
Males: 40-50%
Females: 35-45%
what is the normal range for MCV?
80-100 fL
what is the normal range for RDW?
greater than 14.5% (>14.5)
what is the normal range for platelet count?
less than 150,000/mm3 (increased risk of bleeding, disseminated intravascular coagulation)
what is the normal range for reticulocytes?
0.5%-1.5% of red cells (increase acute bleeding), starting treatment for vitamin deficiencies (iron, B12, folate), acute hemolytic episodes
what is the normal total WBC?
4,500 to 11,000
what is the normal band forms? (immature white blood cells)
greater than 5% (increase severe bacterial infections), also called “shift to the left”
what is the normal range for eosinophils?
greater than 3% (increase in allergies, parasitic diseases, cancer)
A TSH greater than 5.0 mU/L indicates what?
hypothyroidism
A TSH less than 0.4 mU/L indicates what?
hyperthyroidism
In iron deficiency anemia, the serum ferritin and serum iron levels, TIBC and RDW will be what?
Serum ferritin and serum iron levels will be decreased
TIBC and RDW will be elevated.
in alpha or beta thalassemia trait or minor, the following results are found:
serum ferritin and serum iron levels, TIBC?
Serum ferritin and serum iron levels will be normal
TIBC will be normal
what is the gold standard test to diagnose any anemia involving abnormal hemoglobin (e.g. thalassemia, sickle cell) ?
hemoglobin electrophoresis
what is the RDW?
RDW is a measure of the variability in size of red blood cells.
what is the most common anemia in the world?
iron deficiency anemia, rule out first before ordering a hemoglobin electrophoresis
what is deprescribing?
the process of adjusting the dose of a medication down to the minimum effective dosage or stopping it when it is no longer needed. helps decrease polypharmacy, especially in the geriatric population.
what is pharmacogenomics?
how your genes affect how you respond or do not respond to a drug.
what is pharmacokinetics?
the process by which a medication is absorbed, distributed, metabolized, and eliminated by the body.
what is a half life?
the amount of time it takes for a drug concentration to reduce to half of its original dose.
what is the first pass metabolism or effect?
when an oral drug reaches the stomach, it goes to the small intestine, then to portal circulation where it is metabolized by the liver. after the liver has metabolized the drug, it is released to the systemic circulation where it can reach the target organs.
what is the only vaginal condition with an alkaline pH?
Bacterial vaginosis
For a patient that has Bacterial vaginosis, the microscopy slide will show what?
very few WBCs and a large number of clue cells.
According to the Infectious diseases society of America (IDSA) and the American thoracic society (ATS) treatment guidelines, what is the first line treatment for uncomplicated community-acquired pneumonia?
Macrolides
Azithromycin (Z-paK)
what is a side effect of hydrochlorothiazide?
hyperuricemia and hyperglycemia
what is the most common cause of cancer death ?
lung cancer
what is the most common type of skin cancer?
basal cell skin cancer
what is the most common cancer in females?
breast cancer
what is the most common cancer in males?
prostate cancer
what is the skin cancer with the highest mortality?
melanoma
what is the most common gynecological cancer?
uterine/endometrial cancer
what is the second most common gynecological cancer?
ovarian cancer
is breast cancer classified as a gynecological cancer?
NO
what is torus palatinus?
it is a bony growth on the midline of the hard palate of the mouth.
what is this called? “ The tongue has multiple fissures and irregular smoother areas on its surface that make it look like a topographic map. The patient may complain of soreness on the tongue after eating or drinking acidic or hot foods
geographic tongue
what is the USPSTF breast cancer screening guideline?
Start at age 50 years and then every 2 years until the age of 74 yrs.
what is the strongest risk factor for ovarian cancer (or breast cancer) ?
genetic predisposition.
Having BRCA 1 or BRCA 2 mutations and positive family hx.
what is the age for baseline mammogram testing according to USPSTF?
at age 50 years
what is the screening recommendation for breast cancer in women ages 75 and older?
insufficient evidence
what is the cervical cancer screening recommendation?
Baseline pap smear (cytology) only starting at age 21 then every 3 years after.
DO Not Screen younger than 21.
what is the cervical cancer interval screening recommendation?
Screen every 3 years until age 65 OR at age 30-65, screen every 5 years using HPV testing alone or in combination with cytology (co-testing)
what is the lung cancer recommendation for people with a 30 pack year hx of smoking or quit smoking up to 15 years previously?
ages 55 to 80 with a 30 pack year hx of smoking or quit smoking up to 15 years previously.
ANNUAL screening with LOW-DOSE CT SCAN.
what is the recommendation for women who have had a hysterectomy (no cervix) ?
DO NOT SCREEN (if no hx of precancer or cervical cancer)
what is the prostate cancer recommendation screening?
aged 55-69 years, PSA based screening should be indivdualzied, if older than 70 years–do not screen
What is the recommendation for testicular cancer screenings?
routine screening is not recommended
what is the colorectal cancer baseline screening recommendation?
baseline screening recommended starting at age 45.
screening from 45 to 75.
what is the colorectal cancer interval screening recommendation for:
colonoscopy
FOBT (fecal occult blood test)
sigmoidoscopy
colonoscopy, every 10 years
sigmoidoscopy, every 5 years
fecal occult blood test, yearly
what is the recommendation for skin cancer?
Current evidence is insufficient to assess benefits/harms of visual skin exam.
education: educate fair-skinned people to avoid sunlight (10a-3pm) and use sunblock greater than SPF 15.
what are the USPSTF recommendations for tobacco smoking?
Ask all adults about tobacco use, advise them to stop smoking, and provide behavioral interventions/pharmacotherapy (if not pregnant) for smoking cessation.
what is the Abdominal aortic aneurysm USPSTF recommendation?
one-time screening (men aged 65 to 75) for cigarette smokers or those who have quit.
screening test is ultrasound of the abdomen.
how many tanner stages are there?
there are 5
Tanner stage I for girls
prepubertal pattern
Tanner stage 2 for girls
Breast bud and areola start to develop
Tanner stage 3 for girls
Breast continues to grow with nipples/areola (one mound/no separation)
Tanner stage 4 for girls
Nipples and areola become elevated from the breast (a secondary mound)
Tanner stage 5 for girls
adult pattern
tanner stage 1 for boys
prepubertal pattern
tanner stage 2 for boys
tests and scrotum start to enlarge (scrotal skin starts to get darker/more rugae)
tanner stage 3 for boys
penis grows longer (length) and tests/scrotum continue to become larger
tanner stage 4 for boys
penis becomes wider and continues growing in length (testes are larger with darker scrotal skin and more rugae
tanner stage 5 for boys
adult pattern
Potatoes, apricots, and brussels sprouts have a high amount of what?
potassium
aged cheese, red wine and chocolate have high amount of what?
tyramine
Corn, rice, potatoes, quinoa, tapioca, soybeans are examples of what?
Gluten free diet
wheat bread, nuts (almonds, peanuts, cashews), some beans have a good source of what?
Magnesium
Patients who are on anticoagulant therapy should avoid what?
leafy green vegetables (kale/collard greens, spinach, cabbage, broccoli) and cooking with canola oil (high in vitamin K).
what is the treatment for anaphylaxis?
given an injection of epinephrine 1:1000 dilution 03. to 0.5 mg IM state, then call 911. Repeat dose in 5 minutes in case of poor response.
Admin epinephrine IM, 100% oxygen by face mask, an antihistamine (benadryl) and H2 antagonist such as ranitidine, bronchodilator (albuterol), and systemic glucocorticoids (prednisone)
what are the first line drugs for depression?
SSRIs
What type of effect do TCAs have? Dry mouth, sedation, arrhthymias, confusion, urinary retention
Anticholinergic effects
A skin rash that has both color and texture (small papules or raised skin lesions–the color ranges from red to bright pink)
maculopapular
Maculopapular rash in a lace-like pattern resembles what?
fifth disease
Maculopapular rashes with papules, vesicles, and crusts resembles what?
varicella zoster, herpes simplex
Maculopapular rashes that are oval shaped with a herald patch resemebles what?
pityraisis rosea
vesicular rashes on an erythematous base resembles what?
herpes simplex, genital herpes
Think of scabies if you see excoriated pruritic rashes that are located where?
in the finger webs and penis until proven otherwise
the rash of scarlatina has what signs and symptoms?
sandpaper-like texture, accompanied by a sore throat, strawberry tongue, and skin desquamation (peeling) of the palms and soles.
where is the best location to auscultate for S3 heart sound?
mitral area
The mitral area is also called what?
the cardiac apex
what position allows the practitioner to hear the mitral area?
the left lateral recumbent position–it brings the apex closer to the wall
SSRIs are first line treatment for depression and what else?
OCD, GAD, PD, social anxiety disorder, PTSD, premenstrual mood disorder.
examples of SSRIS:
Citalopram (celexa), escitalopram (lexapro), fluoxetine (prozac), sertraline (zoloft), and paroxetine (paxil)
When using the CAGE questionnaire, what is considered a positive result?
2 out of the 4 questions right is suggestive of alcohol abuse
What does the CAGE questionnaire stand for?
Cut down?
Annoyed when comments about your drinking?
Guilty about your drinking?
Early morning drinking?
what are the symptoms of rocky mountain spotted fever?
dog/wood tick bite, red rash on both wrists and ankles that spreads centrally with involvement of the palms and the soles).
systemic symptoms: high fever, headache, myaglia, nausea
what is the treatment of rocky mountain spotted fever?
doxycycline 100 mg orally or by iV for a minimum of 7 days or longer
What is emergent to know about Rocky moutain spotted fever?
RMSF can cause death if not treated within the first 8 days of symptoms
what diagnosis is associated with erythema migrans rash stage?
early lyme disease
what is considered ITP?
platelets less than 30,000
what is the iniital treatment for ITP?
glucocorticoids
what is the second highest cause of mortality among adolescents and young adults in this country? what is the first cause?
2nd cause suicide
1st cause is MVC
serum creatinine is affected by what?
age, gender, ethinicity (higher with african background) and other factors.
the BUN is what?
a waste product of the protein from foods that you have eaten. if you eat more protein before the test, it will increase.
dehydration will elevate BUN
