Review for exam Flashcards
Extrapyramidal symptoms
Disordered dopaminergic regulation of movement usually caused by antipsychotic drugs. Include:
- involuntary movement
- tremors
- tardive dyskenesia
- stooped posture
Treated with anticholinergics
Anticholinergic side effects
- confusion/delirium
- dry mouth/eyes
- blurred vision
- headache
- anxiety
Examples of anticholinergics
Benadryl, TCAS, MAOIS, unisom
Treatment for genital herpes
Valcyclovir
Treatment for syphillis
Penicillin G
Treatment for gonorrhea
Ceftriaxone
Treatment for chlamydia
Doxycycline
Treatment for BV
Metronidazole
Treatment for Trichomoniasis
Metronidazole
Treatment for syphilis
PCN G
Marfan syndome
Connective tissue disorder characterized by being tall, thin, with long limbs, curved spine and flexible joints
Vaccinations at 2, 4, 6 months of age
RV, Dtap, Hib, PCV, IPV,
Ped vaccine at birth
Hep B
Vaccnations at 12 months
Hib, PCV, IPV, MMR, varicella, hep a
When is hep b vaccine given?
Birth, 1-2 months, 6-18 months
15 month vaccine
Dtap
When are flu and covid given?
Yearly starting age 6 months
Vaccines age 4-6
Dtap, IPV, varicella, MMR
When is Hep A given?
12 months and 18 months
SDOH Healthy People
- economic stability
- Education access/quality
- Healthcare access/quality
- Neighborhood/built environment
- Social/community context
CKD stage 1
GFR >90
CKD stage 2
GFR 60-89
CKD stage 3a
GFR 45-59
CKD stage 3b
GFR 30-44
CKD stage 4
GFR 15-29
CKD stage 5
GFR < 15
Ankylosing spondylitis
Chronic inflammatory disorder where the bone extends over the joint space. Pain may start at the neck and progress down. Often affects sacroilieac joint.
Bamboo spine on xray
Loss of ROM
Management of ankylosing spondylitis
Managed by rheumatology
Antibiotics for MRSA
- Bactrim
- Clindamycin
- Doxycycline
Gram positive bacteria
- Staph (clusters)
- Strep (chains)
- enterococci
Gram negative bacteria
- E coli
- proteus
- klebsiella
- h pylori
- pseudomonas
HBsAG
Hep B surface antigen. Tells you if you have an active infection.
(INFECTION)
Anti-HBc
Hep b core antibody. Tells you if you have been exposed to Hep B currently or in the past.
(EXPOSURE)
Anti-HBs
Hep b surface antibody. Positive if immune (immunization or previous exposure)
(IMMUNITY)
Causes of SIADH
Tumors, some drugs (SSRIs and antipsychotics)
Treatment for SIADH
Treat source
- fluid restriction
- diuretics
SIADH
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Body produces too much ADH which causes retention of fluid and severe hyponatremia
Diabetes insipidus
Inadequate ADH secretion (or inadequate renal response).
S/S DI
Polyuria, polydypsia. Large volumes of dilute urine with low specific gravity (less than 1.005),
Treatment for DI
Desmopressin
Used to replace the missing ADH lowering the amount of urine made by the body
Chovtek sign
Tap on the facial nerve for movement. Sign of hypokalemia.
Trousseau sign
Carpopedal spasm (inbending of wrist) caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.
PTH hormone
Moves CA out of the bone into the serum
Calcitonin
Moves CA out of the serum and into the bone
Cushing’s syndrome
Excess cortisol commonly from an adrenal tumor.
Diagnostics for Cushings syndrome
24 hour urine free cortisol
Dexamethasone suppression test
Midnight salivary cortisol
Adrenal Insufficiency
Adrenal glands do not produce adequate amounts of cortisol. Can also happen if steriods are discontinued suddenly.
S/S of addison’s
- feeling cold, fatigue, weight loss, hypotension, lethargic, cognitive impairment, low urine output
Diagnostics for adrenal insufficiency
Early AM cortisol level
Pheochromocytoma
Catecholamine producing tumor of the adrenal glands. Causes increase in catecholamines (epinephrine, norepinephrine, dopamine)
Paroxysmal symptoms (tachy, brady, hypo/hypertensive)
Diagnostics for pheochromocytoma
24hour urine
MIBG gold standard
Hyperglycemic hyperosmolar syndrome (HHS)
Complication of T2D where patient doesn’t keep up with insulin needs over time and results in very high BS >600 and high sodium levels in the urine (hyperosmolality). Causes severe dehydration. usually presents in the elderly
- no acidosis or ketones present
Causes of HHS
- infection
- inadequate insulin intakeT
Treatment for HHS
IV insulin (stop when therapeutic) and IV fluids
DKA
Caused by DM1, usually new onset in previously undiagnosed person.
GLucose >500
Polyuria, polyphagia, polydipsia, weight loss
High level of ketones and fruity breath
Treatment for DKA
IVF
IV insulin drip
Potassium correction (will look high but actually low)
Metabolic syndrome
Insulin resistance syndrome which includes 3/5 of the following:
- Waist circumference >40 men, >35 in women
- HTN >130/80
- Triglycerides >150
- HDL <40 male, <50 female
- hyperglycemia
Leads for inferior MI
II, III and AVF
Leads for septal MI
VI, V2
Leads for anterior MI
V3, V4
Leads for lateral MI
V5, V6
S1 valves
MOTIVATED
mitral
AV
tricuspid
S2 valves
APPLES
aortic
pulmonic
semilunar
S3 gallop
Indicates HF or CHF
Sounds like “Kentucky”
S4 gallop
Indicates resistance and stiffness of the left ventricle.
Sounds like “tennessee”
AAA triad
Abdominal pain
Abdominal distention
Hemodynamic instability
