random 3 Flashcards
What two herbal meds can help with BPH
st john’s wort and saw palmetto
st John wort can decrease effects of what meds
oral contraceptives, digoxin, hiv pts taking antiretrovirals
st john wort can increase effect of
narcotics
Ginko blob can be used for
memory/concentration, intermittent claudication/glaucoma
Risk of ginkgo biloba
bleeding, increased BP over time
What can relieve menstrual/menopausal/diabetic neuropathic pain, side effect
evening primrose; can increase epilepsy
Kava kava has what side effect
hypertension, liver damage, visual impairment, dry skin; worsen Parkinson’s; impair driving reaction time
Test for gonorrhea
NAAT; or cervical culture on modified Thayer-martin media
Discharge color of gonorrhea (women and men)
Mucopurulent, green for women, white yellow green for men
Gonorrhea tx
CTX 500mg IM x1 plus doxycycline 100 daily x 7 days to cover chlamydia, or CTX plus azithro in pregnant lady; report
How many stages of syphilis
4
what is a chancre, does it hurt
syphilis sore, painless
Primary syphilis stage sx
chancre, indurated painless ulcer at site of exposure
secondary syphilis stage sx
flu like, mucous membrane lesions, skin rash (palm and soles)
latent stage syphilis; early vs late
early: within 12 mos; late: >12 months
Tertiary syphilis; sx
10-30 years after initial infection; affects other organs- brains, nerve, heart
syphilis dx
VDRL, RPR; if positive then treponema palladium particle agglutination assay (TP-PA) or fluorescent treponema antibody absorption (FTA-ABS) to confirm
syphilis tx primary, secondary, or early; late latent, indeterminate length, or tertiary
pen G 2.4million IM; pen G 2.4 million IM weekly x 3
syphilis tx if pcn allergy
doxy or tetracycline
chlamydia sx females
postcoital bleeding, spotting, painful intercourse; vaginal discharge
chlamydia sx male
thick, cloudy, penile disrcharge
chlamydia dx
NAAT
what causes painful intercourse
PID, chlamydia, menopause, trichomoniasis
chlamydia tx
azithro 1g x 1 or doxy 100 bid x7; erythromycin, fluroquinolone
vulvovaginitis common caused by what organisms
bacteria, protozoan, and/or fungi; inflammation or infection
trichomoniasis vulvovaginitis sx, dx
smelly, frothy, yellow-green, itching, strawberry patches on cervix and vagina, painful peeing/intercourse; wet-prep with motile trichomonads
bacterial vaginosis vulvovaginitis sx, dx
fishy, watery, gray; wet prep with clue cells (squamous epithelial cells with poorly defined borders)
candidiasis vulvovaginitis sx, dx
thick, white, curd-like, erythema/pruritis, KOH shows pseudo hyphae (spaghetti and meatballs)
trichomoniasis tx
flagyl 2g x1 or 500 bid x 7
Bacterial vaginosis tx
flagyl, clindamycin cream
vaginal candidiasis tx
miconazolemonistat/clotrimazole intravag, or suppositories (BUTACONAZOLE, TERCONAZOLE)
Chancroid organism
hemophilus ducreyi, gram neg bacillus
Chancroid sx
women- asymptomatic; men: painful ulcers, unilateral bubo
What is a well established cofactor for HIV transmission
chancroid
Chancroid dx
by exclusion, painful ulcer in absence of t. pallidum and HSV; definitive made morphologically
what is a bubo
swollen inguinal lymph node
Chancroid tx
azithro 1gx1, CTX 250IM x1, or cipro 500 bid x 3
three triggers for herpes outbreak
stress, sun, cold
gold standard of herpes dx
viral culture of tissue; or PCR
herpetic whitlow
transfer of herpetic sores to other areas of body, usually fingers
Valtrex use
reducing asymptomatic viral shedding of HSV2
Heart sound in hypertension
S4, not s3
What medications can cause first dose syncope
alpha antagonists (cardura)
what HTN med can cause dizziness
CCB
What indicates SIMV intolerance
decreased SVO2, insufficient oxygen supply
Drug Treatment for PAD/PVD
Pletal
are schools covered entities under HIPAA
No
what meds are not recommended for PAD
Warfarin/aspirin
how do anticholinergics help in parkinsons
manage tremors
does medicaid vary from state to state
yes
How much protein per day?
0.8-1g/kg/day
what percentage of carbs a day
55-60%; half whole grains
how much fat a day
<30% total calories with <10% saturated fats
