Quiz 37 Flashcards
Early drug reaction allergic effect.
Anaphylactic reactions result from a massive release of histamine and start with pruritus around the mouth, on the scalp, and on the palms and soles; flushing of the face and neck, with rhinitis and conjunctivitis; angioedema of the oral mucosa, especially of the pharynx and larynx; severe urticaria; dyspnea and bronchospasm (especially in known asthmatics); and hypotension.
Which one of the following is true regarding the treatment of generalized anxiety disorder?
Cognitive-behavioral therapy has been shown to be at least as effective as medication for treatment of generalized anxiety disorder (GAD), but with less attrition and more durable effects. Many SSRIs and SNRIs have proven effective for GAD in clinical trials, but only paroxetine, escitalopram, duloxetine, and venlafaxine are approved by the FDA for this indication. Benzodiazepines have been widely used because of their rapid onset of action and proven effectiveness in managing GAD symptoms.
A 25-year-old female kindergarten teacher comes to your office for evaluation of a cough she
has had for 2 weeks. The preceding week she had symptoms of rhinorrhea, mild malaise,
low-grade fever, and lacrimation. She reports that episodes of coughing are so severe that
vomiting is induced. She was evaluated at a walk-in clinic 1 week ago and was diagnosed with
bronchitis. Treatment with hydrocodone cough syrup and amoxicillin has not helped. On
examination she has mild rhinorrhea and injected conjunctivae, but her lungs are clear. A chest
radiograph is normal and her laboratory results reveal a mild lymphocytosis.
Which one of the following is the most appropriate next step in the management of this patient?
Whooping cough has reemerged over the past few years. The initial catarrhal stage is manifested by
nonspecific symptoms similar to those of a viral upper respiratory illness. This stage is usually 1–2 weeks
in duration, and the patient is highly contagious. The paroxysmal stage is manifested by severe coughing
spells that occur in paroxysms and may be followed by the inspiratory whoop (much more likely in
children). Post-tussive emesis is another classic sign. There are no characteristic findings on examination
other than signs induced by extreme coughing. The CDC recommends both a nasopharyngeal culture and
polymerase chain reaction testing to confirm the diagnosis.
Azithromycin helps to stop infectionativity
A 57-year-old female on dialysis for end-stage renal disease develops chronic, severe
generalized pain. Which one of the following opioids is preferred for management of her pain?
A. Codeine
B. Fentanyl
C. Hydrocodone
D. Morphine
Fentanyl and methadone are the preferred opioids for use in patients with end-stage renal disease (SOR
C). Fentanyl is metabolized in the liver and has no active metabolites.
pharyngitis stept throat probablility
Most episodes of pharyngitis are caused by viral rather than bacterial infections.
One point each is assigned for (1) absence of cough, (2) swollen, tender anterior cervical nodes, (3) temperature >38.0°C (100.4°F), and (4) a tonsillar exudate and swelling. One point is added for patients between the ages of 3 and 14 years, and a point is subtracted for patients over the age of 45.
Score of 2 or higher should get should get rapid antigen test or throat culture
Screening for colon cancer would be recommended for which one of the following patients?
A 40-year-old female whose mother was diagnosed with colon cancer at age 54
A history of a first degree relative diagnosed with colon cancer before age 60 predicts a higher lifetime incidence of colorectal cancer (CRC) and a higher yield on colonoscopic screening. The overall colon cancer risk for these persons is three to four times that of the general population. Screening should consist of colonoscopy, beginning either at age 40 or 10 years before the age at diagnosis of the youngest affected relative, whichever comes first.
HA1C to glucose
A rough guide for estimating average plasma glucose levels assumes that an 1cof 6.0% equals an average glucose level of 120 mg/dL. Each percentage point increase in 1c is equivalent to a 30-mg/dL rise in average glucose. An HbA1cof 7.0% is therefore roughly equivalent to an average glucose level of 150 mg/dL, and an HbA1c of 8.0% translates to an average glucose level of 180 mg/dL.
Anxiety attack blood gas
The elevated pH, normal oxygen saturation, and low pCO2 are characteristic of acute respiratory alkalosis, as seen with acute hyperventilation states. In patients with a pulmonary embolism, pO2 and pCO2 are decreased, while the pH is elevated, indicating the acute nature of the disorder.
