Random Flashcards
Can lactose intol pt have yogurt?
Yea! Fermented milk with live cultures have b galactosidase which is well tolerated in pts
What are the most common adverse inhospital events?
In surgery pts- wound inf, bleed, dvt
In medicine pts- most common is adverse DRUG event like hypoglycemia, abx, narcotics 5-7% hospitalized
Falls only make up 1-2%
Hospital inf makes up 4%
Pressure ulcers up to 5%
Restless leg syndrome needs only one lab test. What is it?
Ferritin bc often assoc w IDA
Tx of restless leg syndrome
If mild then decr caffeine and alcohol, incr mentally stim activities
If severe then dopamine agonists like pramiprexole or ropinorole
Main side effect of GINGKO? Why is it used?
Bleeding and plt dysfunction by inh platelet activating factor.
Used as memory booster bc incr cerebral blood flow and may be effective for alzheimers and claudication
Medicare coverage- parts a to d?
A- inpt, SNF, hospice
b- outpt, obs
C - medicare advantage allows u to also enroll in private insurance
D - prescriptions
When to refer to bariatric surgery?
Failed diet, behavior, medical therapy
Bmi>35 and comorbidies or bmi>40
Antidote to organophosphate poisoning (cholinergic receptor) causing constricted pupil, salivation, wheezing,sweats, drooling
Atropine (antimuscarinic) and pralidoxime (cholinesterase inh)
Injestion of fish causing flushing, headache, palpitations, abd cramps, diarrhea
Scromboid poisoning due to improperly stored seafood causing histamine release
Vs pufferfish causing neuro symp
Acute vision loss in one eye without pain? What do u see on eye exam?
crao
On exam with pale fundus and a cherry red spot. Tx to decr intraocular pressure with massage and acetazolamide
Va optic neuritis- vision loss with eye pain that worsens with movement. On exam with optic disc edema
Vs crvo similar but not due to embolism. On exam w dilated veins, diffuse hemorrhage, sic swelling
Ams, basilar crackles, bradypnea, pupils 2 mm
Opioid intox esp in setting of renal injury. Normal pupil size 4 mm
Ams, basilar crackles, bradypnea, pupils 2 mm
Opioid intox esp in setting of renal injury. Normal pupil size 4 mm
Narcolepsy treatment
Modafinil (nonaddicting stimulant) . Take scheduled naps during day.
Daytime sleeping, cataplexy (lows of muscle tone with stress or argument), hypnagogic hallucination.
How do u tx the cataplexy?
Snri like venlafaxine or ssri or tca to treat cataplexy
Primary amenorrhea, bl inguinal hernias, breasts without pubic hair
Androgen insensitivity - XY. vagina ends in blind pouch.
Va klinefelter is XXY looks like male with small testes and gynecomastia
A drug test is a urine what test? Immunoassay or chromatography?
Immunoassay
Uses and side effects of: Gingo and gingseng Saw palmetto St johns worts Kava Licorice! Black cohosh Horse chestnut
Gingo and gingseng for memory but incr risk of bleed
Saw palmetto for bph but incr risk bleed
St johns wort for depression/insomnia but interefere w lots drugs and also cause htn crisis
Kava for anxiety and insomnia causes severe liver dmg!!!
Licorice cause htn
Black cohosh for pms and menopause cause hypotension
Horse chestnut for venous stasis cause bleed
The best predictor of a pt suffering from back pain returning to work is: Depreasion Job satisfaction Stress Patients expected recovery time
Pts expected recovery time which doctors should help pts figure out!
Sudden onset hyperglycemia in setting of TPN is due to
Sepsis
Injestion causing bradycardia, miosis, wheezing, skin flushing? What is best way to dx?
Utox
Rbc cholinesteraae
Organophos poisoning - dx w rbc cholinesterase
Bacterial conjunctivitis untreated can lead to..
Tx? And for how long?
Keratitis!! Inflammation of cornea which is more srs and in contact lense wearers
Vs endopthalmitis is more serious and deep inf in vitreous and aqueous humor- maybe due to eye injury or surgery
Tx is erythromycin ointment! Only reserve oxacin for contact lens wearer!! Tx for 24 hrs before pt returns to school to decr transferring
How long before a viagra taking pilot can drive a plane?
6 hrs due to blue green color distortion
Before can start peritoneal dialysis in pt with apckd, need additional img. What kind?
Cscope be incr risk of diverticulosis
Could have prevented fall in >65 yo on klonipin and exercises regularly if: stength training/gait exercise vs avoid benzo
Avoid benzo. This pt is active and no instability.
Which is most common cancer w sjogrens disease?
B cell nonhodgkin lymphoma
How to preserve donor organ?
Euvolemic NORMOTENSIVE and normothermic!!! Not hypothermic
Overdose accidental on antifreeze. Antidote?
Fomepizole only!! Dont need to combine w ethanol!
Antifreeze is ethylene glycol. Also methanol can receive fomepizole.
If homeless person is intoxicated on thay then u can give just ethanol
Are you allowed to precribe ur friends adderall? What do u say?
Altho id like to help i am UNCOMFORTABLE prescribing for someone i am not treating
It is generally unethical BUT not always ie if emergency and thus u r allowed to!!
Opioid withdrawal tx
Methadone - only if pt adherent and will be monitored outpt
Clonidine is alpha agonist good too
Laser or dermabrasion to remove tattoo from 10 yrs ago side effect
Scar or skin discoloration
Removing it doesnt matter on how long ago it was placed
If woman says sex life not pleasurable ask
Does ur hubs have erectile dysf?
Or tell sometimes menopause can make more difficult
Menopause bc of vag dryness and dyspareunia
