Random Flashcards
Causes of hypovolemic hyponatremia
- Diuretics, mineralocorticoid deficiency (no aldosterone to reabsorb salt/water), ACE inhibitors (affects RAAS)
What are institutional bylaws
Institutional rules that provide further qualifications/restrictions on role of healthcare staff (beyond national guidelines)
What are MRTs and function
Team assembled to deal with emergency situations (like RRT or institutional disasters
Inverse relationship of K+ and pH
- Increase of pH by 0.1 = decrease in K+ by 0.6
Inverse relationship of Ca and pH
- Acidemia increases ical, alkalemia decreases ical (alkalosis increases protein binding, which decreases ical
Hypercalcemia drug tx
- Calcitonin or NS with loop diuretics
Stocking glove syndrome/paresthesia is a sign of
- Respiratory alkalosis
Normal anion gap metabolic acidosis causes
- Renal tubular acidosis, diarrhea, DKA recovery
Tx of metabolic alkalosis if IVF tx is contraindicated
- Acetazolamide
VonWillebrand tx
- DDAVP
ITP drug tx
- High dose corticosteroids to elevate blood count, IVgamma globulin (preferred over steroids in HIV), maybe plt TF
Ddx ITP from SLE? (both have thrombocytopenia)
- bone marrow aspiration
Mainstay tx of COPD
- inhaled ipratropium bromide (Atrovent)
Sx of sarcoidosis and drug tx
- Velcro rales, nonproductive cough
- Corticosteroids
Heparin gtt rate for PE (and coumadin)
- 80u/kg bolus then 18u/kg/hour for PTT 1.5-2 x normal, bridge coumadin to INR 2-3
CXR findings for viral pneumonia
- Bilateral interstitial infiltrates
Iodine uptake in graves vs subacute thyroiditis
- Graves: high ; subacute thyroiditis: low
Hyperthyroid drugs
- Methimazole/tapazole and PTU
Med to avoid in thyroid storm
- ASA
Skin symptoms in addisons
- Hyperpigmentation in knuckles, diffuse tanning and freckles
Causes of SIADH
- SAH, small cell lung cancer
Drug cause of DI
- Lithium
Urine assay in pheochromocytoma
- Catecholamines, metanephrines (>2.2), VMA (>5.5), and creatinine
Clotting in SLE – what lab?
- Antiphospholipid antibodies (hypercoagulable)
Tx for giant cell arteritis
- Prednisone
May thurner syndrome
- Compression of L common iliac vein by overlying R common iliac artery ->DVT
Pericarditis EKG changes
- STE in all leads and PR segment depression
Pericarditis drug tx
- NSAIDs, corticosteroids only if NSAIDs fail
Dxs with night sweats in adults
- Menopause, TB, HIV/AIDs, leukemia, endocarditis
Osler nodes
- Red nodules in distal phalanges, endocarditis
Splinter hemorrhages
- Linear, subungual splinter appearing, SLE
Janeway lesions, seen when
- Small, not painful macules on palms and soles (endocarditis, syphilis)
What dxs causes lesions on palms and soles
- Syphilis and endocarditis (Janeway lesions)
Roth spots
- Small retinal infarcts, white in color, encircled by areas of hemorrhages, endocarditis
What might cause OHTN in elderly
- Baroceptors become less sensitive
- Decreased cardiac reserve
Top 5 killers in adults in US
- CVD (CAD-MI), cancer, accidents, lower respiratory disease (asthma/COPD), stroke
Single best predictor of functional impairment
- Impaired cognition
Pneumonic for MMSE
- ORArL 2 3 R W D
Amaurosis fugax
- Ipsilateral monocular blindness
Percentage of ischemic CVAs vs hemorrhagic
- 80 percent ischemic
Indication for CEA
- > 70-80% stenosis in symptomatic patients
3 Hs that increase risk for IICP
- Hypotension, hypoxemia, hypercapnia
Lab finding in MG
- Acetylcholine receptor antibodies
What dxs can cause stocking glove syndrome
Respiratory alkalosis, GB
Kernig’s sign
- Hamstring pain/spasm with neck flexion
Brudinski’s sign
- Flexion of head -> legs flex at hips and knees
Battle’s sign
- Bruising behind ear at mastoid process
Racoon eyes
- Basilar skull fx
When are steroids used in SCI
- Blunt trauma, not penetrating trauma
Myerson’s sign is also what abnormal reflex?
- Globellar reflex – tapping over nose bridge causes sustained blink response
Dopamine agonists that mimic dopamine
- Ropinorole, rotigotine, pramipexole
MAOB inhibitors to prevent dopamine breakdown
- Selegiline, rasagiline, safinamide
3 med options for UTI
- Macrobid (nitrofurantoin); Bactrim (TPX-SMX DS), or monurol (Fosfomycin)
Avoid which abx in UTI if resistance > 20%
- Bactrim (tpx-smx ds)
3-drug regimen in kidney stones
- Opioid, Toradol (NSAID), reglan
BBW of reglan
- Permanent tardive dyskinesia (extrapyramidal symptoms)
3 principles of instruction
- Mentoring/coaching, role modeling, counseling
Single best predictor of health status
- Health literacy
Average reading level, and grade level health information should be written at
- 8th grade, no higher than 6-8
how can AGANCP be ready for future mass casualties
pre enroll in organizations
Meaningful use
using EMR to improve healthcare, reduce disparities, engage pts/family, improve care coordination, maintain privacy
General mental health assessment tool
Patient stress questionnaire
Depression screening, how many sx, points
PHQ-9, 9, 0-3 ( 3 = almost every day), 0-27 points (q4 minimal, mild, mod, mod/severe, severe)
anxiety screening tool, score for mild/mod/severe and GAD
GAD-7, 5-9 = mild, +4… GAD = equal or greater than 10
Positive CAGE score
2 or more
When to use BPI pain screening tool
Survey for pain from chronic diseases - severity, impact on ADLs
Four features of CAM-ICU, assessment of ?; frequency of assessment
acute onset of MS changes, inattention, disorganized thinking, altered LOC; delirium; q day of shift
Geriatric assessment tool for dementia/delirium
MMSE
Clock drawing test assesses for? scoring
Score 1-6, equal to or greater than 3 = cognitive deficit
Depression assessment tool for geriatric, score that suggests depression
Geriatric depression scale 5/15 = suggests depression
ADL functional assessment for geriatric; # of functions
Index of independence in ADL (Katz index of ADL); bathing, dressing, toileting, transferring, continence, feeding
Gait and immobility/fall risk tool; scoring for risk of fall
Get up and go test; 3/5 indicates risk of falling (normal to severely abnormal)
Pain assessment tool in geriatrics; # of behaviors observed
Pain assessment in advanced dementia scale; 5: breathing, negative vocalization, facial expression, body language, consolability (0-2 each, 10 total)
Life expectancy of DME
3 years
Purpose of assistive devices
maintain improve function and independence