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1
Q

What two herbal meds can help with BPH

A

st john’s wort and saw palmetto

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2
Q

st John wort can decrease effects of what meds

A

oral contraceptives, digoxin, hiv pts taking antiretrovirals

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3
Q

st john wort can increase effect of

A

narcotics

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4
Q

Ginko blob can be used for

A

memory/concentration, intermittent claudication/glaucoma

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5
Q

Risk of ginkgo biloba

A

bleeding, increased BP over time

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6
Q

What can relieve menstrual/menopausal/diabetic neuropathic pain, side effect

A

evening primrose; can increase epilepsy

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7
Q

Kava kava has what side effect

A

hypertension, liver damage, visual impairment, dry skin; worsen Parkinson’s; impair driving reaction time

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8
Q

Test for gonorrhea

A

NAAT; or cervical culture on modified Thayer-martin media

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9
Q

Discharge color of gonorrhea (women and men)

A

Mucopurulent, green for women, white yellow green for men

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10
Q

Gonorrhea tx

A

CTX 500mg IM x1 plus doxycycline 100 daily x 7 days to cover chlamydia, or CTX plus azithro in pregnant lady; report

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11
Q

How many stages of syphilis

A

4

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12
Q

what is a chancre, does it hurt

A

syphilis sore, painless

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13
Q

Primary syphilis stage sx

A

chancre, indurated painless ulcer at site of exposure

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14
Q

secondary syphilis stage sx

A

flu like, mucous membrane lesions, skin rash (palm and soles)

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15
Q

latent stage syphilis; early vs late

A

early: within 12 mos; late: >12 months

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16
Q

Tertiary syphilis; sx

A

10-30 years after initial infection; affects other organs- brains, nerve, heart

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17
Q

syphilis dx

A

VDRL, RPR; if positive then treponema palladium particle agglutination assay (TP-PA) or fluorescent treponema antibody absorption (FTA-ABS) to confirm

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18
Q

syphilis tx primary, secondary, or early; late latent, indeterminate length, or tertiary

A

pen G 2.4million IM; pen G 2.4 million IM weekly x 3

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19
Q

syphilis tx if pcn allergy

A

doxy or tetracycline

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20
Q

chlamydia sx females

A

postcoital bleeding, spotting, painful intercourse; vaginal discharge

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21
Q

chlamydia sx male

A

thick, cloudy, penile disrcharge

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22
Q

chlamydia dx

A

NAAT

23
Q

what causes painful intercourse

A

PID, chlamydia, menopause, trichomoniasis

24
Q

chlamydia tx

A

azithro 1g x 1 or doxy 100 bid x7; erythromycin, fluroquinolone

25
Q

vulvovaginitis common caused by what organisms

A

bacteria, protozoan, and/or fungi; inflammation or infection

26
Q

trichomoniasis vulvovaginitis sx, dx

A

smelly, frothy, yellow-green, itching, strawberry patches on cervix and vagina, painful peeing/intercourse; wet-prep with motile trichomonads

27
Q

bacterial vaginosis vulvovaginitis sx, dx

A

fishy, watery, gray; wet prep with clue cells (squamous epithelial cells with poorly defined borders)

28
Q

candidiasis vulvovaginitis sx, dx

A

thick, white, curd-like, erythema/pruritis, KOH shows pseudo hyphae (spaghetti and meatballs)

29
Q

trichomoniasis tx

A

flagyl 2g x1 or 500 bid x 7

30
Q

Bacterial vaginosis tx

A

flagyl, clindamycin cream

31
Q

vaginal candidiasis tx

A

miconazolemonistat/clotrimazole intravag, or suppositories (BUTACONAZOLE, TERCONAZOLE)

32
Q

Chancroid organism

A

hemophilus ducreyi, gram neg bacillus

33
Q

Chancroid sx

A

women- asymptomatic; men: painful ulcers, unilateral bubo

34
Q

What is a well established cofactor for HIV transmission

A

chancroid

35
Q

Chancroid dx

A

by exclusion, painful ulcer in absence of t. pallidum and HSV; definitive made morphologically

36
Q

what is a bubo

A

swollen inguinal lymph node

37
Q

Chancroid tx

A

azithro 1gx1, CTX 250IM x1, or cipro 500 bid x 3

38
Q

three triggers for herpes outbreak

A

stress, sun, cold

39
Q

gold standard of herpes dx

A

viral culture of tissue; or PCR

40
Q

herpetic whitlow

A

transfer of herpetic sores to other areas of body, usually fingers

41
Q

Valtrex use

A

reducing asymptomatic viral shedding of HSV2

42
Q

Heart sound in hypertension

A

S4, not s3

43
Q

What medications can cause first dose syncope

A

alpha antagonists (cardura)

44
Q

what HTN med can cause dizziness

A

CCB

45
Q

What indicates SIMV intolerance

A

decreased SVO2, insufficient oxygen supply

46
Q

Drug Treatment for PAD/PVD

A

Pletal

47
Q

are schools covered entities under HIPAA

A

No

48
Q

what meds are not recommended for PAD

A

Warfarin/aspirin

49
Q

how do anticholinergics help in parkinsons

A

manage tremors

50
Q

does medicaid vary from state to state

A

yes

51
Q

How much protein per day?

A

0.8-1g/kg/day

52
Q

what percentage of carbs a day

A

55-60%; half whole grains

53
Q

how much fat a day

A

<30% total calories with <10% saturated fats

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