SAM 2020 Flashcards by Cleo Hung

risk factors of plantar fasciitis

Body mass index > 27 kg per m2
Excessive running
Intrinsic foot and calf muscle tightness
Leg length discrepancy
Occupations requiring prolonged standing or walking
Pes cavus (high arch)
Pes planus (excessive foot pronation)
Reduced ankle dorsiflexion
Sedentary lifestyle

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management of plantar fasciitis

stretching of the plantar fascia
ice packing
massage
nonsteroidal anti-inflammatory drugs

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ddx (skeletal conditions) of plantar fasciitis

skeletal causes: 
acute calcaneal fracture 
bone tumor 
Calcaneal apophysitis (Sever disease)
calcaneal stress fracture 
spondyloarthropathies

soft tissue condition: 
Achilles tendinitis
Tarsal tunnel syndrome
Fat pad contusion
Plantar fibroma
Retrocalcaneal bursitis

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antihypertensive safe for breastfeeding

labetalol
extended release nifedipine
methyldopa
captopril
enalapril

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Modifiable risk factors of CRC

obesity
sedentary lifestyle
diet high in processed meat or calories
excessive EtOH intake
excessive smoking
control diabetes

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hereditary conditions causing increased CRC

Familiar noncancerous polyposis

Lynch syndrome

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topical treatment for rosacea

topical metronidazole
topical azelaic acid
topical ivermectin

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definition of significant weight loss in elderly

reduction of 5% weight in 1 months or

reduction of 10% in 6 months

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Etiology of elderly weight loss

side effect of meds or treatment (C/T, R/T, dialysis)
malignancy
CHF, COPD, CKD
pain
wandering, dementia, or psychiatric conditions
emotional or psychological problem (anxiety, depression, delusions)
impaired cognitive or physical functions
GI disease (malabsorption, GERD, constipation, N/V)
Endo: hypo- hyper- thyroidism, hyperparathyroidism, hypoandrenalism
oral health: poorly fit denture, diseased mucosa
swallowing disorder
loss appetite or early satiety
social factors: isolation, poverty, food prep access

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instructions of loperamide for traveler’s diarrhea

Do not take it with dysentery (diarrhea with blood)

- seek medical attention if no improvement in 24-48 hrs

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20) classic symptoms of Meniere disease

vertigo attack
unilateral hearing loss
tinnitus
aural fullness

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treatment (pharm and non-pharm) for Meniere disease

dietary salt restriction
stress reduction
betahistine
diuretics

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reproducible vertigo symptoms with certain head movement

Meniere disease attacks are not reproducible by specific head movements

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driving instructions for patient diagnosed with Meniere disease

people with MD can drive provided they have enough warning before attacks (drop attacks)
should not drive if experiencing Drop Attacks (Tumarkin otolith crisis)

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Causes of chronic non-bloody diarrhea +/- weight loss

IBS
IBD
malabsorption (celiac, lactose intolerance)
chronic infection (esp. immunocompromised pt): bacterial, mycobacterial, parasitic

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Risk factors for torsade include the following

Congenital long QT syndrome
Female gender
Acquired long QT syndrome (causes of which include medications and electrolyte disorders such as hypokalemia and hypomagnesemia)
Bradycardia
Baseline electrocardiographic abnormalities
Renal or liver failure

Risk factors for torsade include the following

Medications causing QT prolongation

anti-arrhythmic

amiodarone
Quinidine

anti-depressant

Fluoxetine (SSRI)
TCA (amitriptyline)
Doxepin
Venlafaxine

antibiotics

quinolone (Levofloxacin)
macrolide (Clarithromycin)

anti-psychotics
- Haloperidol

Medications causing QT prolongation

anti-arrhythmic

amiodarone
Quinidine

anti-depressant

fluoxetine (SSRI)
TCA (amitriptyline)
doxepin
venlafaxine

antibiotics

Levofloxacin
macrolide (clarithromycin)

anti-psychotics
- haloperidol

triptan

Medications causing QT prolongation

anti-arrhythmic

amiodarone
Quinidine

anti-depressant

fluoxetine (SSRI)
TCA (amitriptyline)
doxepin
venlafaxine

antibiotics

Levofloxacin
macrolide (clarithromycin)

anti-psychotics
- haloperidol

triptan

Causes of secondary Raynaud phenomenon

mixed connective tissue disease (85%)
systemic sclerosis (scleroderma) - 90%
systemic lupus erythematosus
rheumatoid arthritis
Sjögren syndrome
polymyositis

treatment of primary Raynaud phenomenon

Conservative:  - LSM 
avoidance of precipitating factors 
use of gloves
education
warming of the affected body part
cessation of vasoconstricting agents such as nicotine

PHARM: 
calcium channel blocker treatment; nifedipine is the usual choice
Topical nitroglycerin (1% or 2%) has been found to help if applied locally

secondary Raynaud phenomenon

Conservative measures: less effective

- Pharmacologic options for secondary Raynaud phenomenon: including calcium channel blockers and prostacyclin analogues

how to differentiate primary and secondary Raynaud phenomenon

nail fold capillary changes under Nailfold dermatoscopy

antibiotics choice for simple MRSA skin infection (not perineal, not peri-rectal, no paronychia)

- Septra (TMP/SMX) | - clindamycin

Oral antibiotic options for treating skin and soft-tissue infections in patients with community-associated MRSA

- clindamycin - trimethoprim/sulfamethoxazole (TMP/SMX; Bactrim, Septra) - tetracycline (doxycycline or minocycline [Minocin]) - linezolid (Zyvox)

risk factors of skin MRSA infection

``` recent antibiotics use contact sports group housing low SES IVDU ```

Who should not be prescribed tetracyclines ? List TWO patient populations.

- pregnant women | - children under 8 years

When considering the treatment plan for this patient

- monotherapy NOT recommended - limit antibiotic use to shortest possible duration - concomitant treatment with topical agents

What are the cardinal symptoms of ADHD? List FOUR

- inattention - impulsiveness - hyperactivity - forgetfulness - distractibility - poor academic performance - behavioural problems

You want to obtain a more detailed history of this patient so you inquire about the mother’s pregnancy with the patient. What are the prenatal risk factors for this condition? List TWO

- smoking during pregnancy - prenatal alcohol exposure - low birth weight

Which comorbidities are often associated with ADHD

- oppositional defiant disorder - tic disorder - substance use disorder - anxiety - depression - Autism Spectrum Disorder (ASD) - learning disorders - intellectual disability - prematurity

What are some other differential diagnoses to consider for this condition (ADHD)? List THREE.

- oppositional defiant disorder (ODD) - tic disorder - substance use disorder - anxiety - depression - learning disorders - sleep disorders

What is the GREATEST risk factor for ADHD? List ONE.

family history

What are the TWO first-line interventions for ADHD?

- amphetamine | - methylphenidate

What should all patients be screened for prior to taking this medication? State ONE thing.

- risk factors for sudden cardiac death

What are the most common diagnoses and factors on history associated with spontaneous pneumothorax? List THREE.

- asthma - emphysematous bleb - tobacco use - congenital abnormality

You read in his discharge note from the hospital that he suffered a small pneumothorax. He was managed with conservative measures. In the case this had been a larger pneumothorax, what other treatments might have been required? List TWO.

- chest tube placement/drain/catheter placement (Accept any one) - surgical repair

The parents would like to discuss the consequences of this event for their child’s health. What is the MOST common complication following a pneumothorax? List ONE.

- recurrence