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NP Boards > SM NP review psych, respiratory, endo, musc > Flashcards

SM NP review psych, respiratory, endo, musc Flashcards

1
Q

What are some common screening tools for depression?

A

PHQ-2
PHQ-9

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2
Q

Why do most patients stop their psych medications at home?

A

sexual dysfunction and weight gain

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3
Q

How long can it take to see effects of antidepressants

A

4-6 weeks, then increase dose or switch meds. always double check compliance and underlying causes

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4
Q

How long will your patient be on SSRI>

A

taper off after 6 months

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5
Q

What is depression commonly treated with?

A

SSRI, SNRI

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6
Q

What herbal supplement can be used?

A

St John’s Worts (increases risk of serotonin syndrome)

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7
Q

What do we tell patients about GI complaints related to antidepressants?

A

They will go away in a few weeks

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8
Q

How do we approach suicidal ideation?

A

very straightforward, educate, ask for plan

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9
Q

Which SSRI should we avoid in the elderly?

A

Prozac (long half life)

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10
Q

What are some other medications that be given for depression?

A

TCAs- Nortitlyine

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11
Q

Which two antidepressants are safest in the elderly?

A

Zoloft and Lexapro

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12
Q

Which SSRI is most sedating?

A

Paxil

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13
Q

Which SSRI would likely be avoided in anxious patients?

A

Prozac

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14
Q

What do we need to consider before we prescribe an atypical antipsychotic?

A

Zyprexa, seroquel
weight gain and increased lipids increased glucose

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15
Q

What signs and symptoms would we see in bipolar?

A

phases between mania and depression

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16
Q

What is bipolar treated with

A

Lithium
Side effect: hypothyroidism

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17
Q

What signs/symptoms would you see with PTSD?

A

night mares, hypervigilance, exaggerated startle, flashbacks, insomina

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18
Q

What is PTSD commonly treated with

A

SSRIs

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19
Q

What is seasonal affective disorder

A

changing of seasons effects the patient’s circadian rhythm treated with sunlight

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20
Q

What is the most predominant symptom of asthma

A

cough

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21
Q

How do we know if treatment is successful

A

peakflows

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22
Q

What is the FeV1 with airflow limitation

A

decreased

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23
Q

What are the stages of asthma

A

intermittent, mild, moderate, severe

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24
Q

What medication do we never give alone?

A

LABA

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25
Q

What is the cornerstone of our treatment for asthma

A

Low dose inhaled corticosteriods (decrease mortality)

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26
Q

What three things impact peak flow?

A

height
age
gender

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27
Q

What is the go to treatment for acute asthma attacks

A

ICS + LABA

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28
Q

Common low dose ICS and LABA

A

budesonide-formoterol (Symbicort)

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29
Q

Steps of asthma treatment

A
  1. ICS-LABA PRN
  2. L-ICS daily
  3. ICS - LABA daily
  4. Referral
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30
Q

How do we diagnose COPD?

A

FEV1/FVC ratio less than 0.70 or 70%

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31
Q

What do we expect to see in COPD

A

barrel chest, clubbing of fingers, chronic cough, percussion –> hyperresonant

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32
Q

Group A treatment of COPD

A

Bronchodilator (SABA or LABA)

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33
Q

Group B treatment of COPD

A

LABA or LAMA long acting bronchodilator

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34
Q

Group C treatment of COPD

A

LAMA

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35
Q

Group D treatment of COPD

A

LAMA or combo (ICS-LAMA)

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36
Q

What signs and symptoms do we expect with pneumonia

A

cough, fever, chills, rhonchi, wheezes, tactile fremitis

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37
Q

How will you decide treatment for pneumonia with no comorbidities or recent antibiotic use

A

M- macrolide
A- amoxicillin
D- doxycycline

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38
Q

How will you treat pneumonia with comorbidities or antibiotic use in last 90 days

A

fluoroquinolones or Augmentin + macrolide

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39
Q

What is the CURB 65 criteria

A

C- Confusion
U- Urea- BUN > 19
R- Respiratory rate > 20
B- Blood pressure < 90/60
Age>65
2 points = consider admission
3 points= must be admitted

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40
Q

Where is TB seen in the lungs?

A

Upper lungs

41
Q

When is >5 mm diagnostic for TB

A

CD4>200, HIV, immunocompromised, immigrant with exposure

42
Q

When is >10mm diagnostic for TB

A

immigrant, healthcare worker

43
Q

When is >15 mm diagnostic for TB

A

general public

44
Q

How do you confirm TB diagnosis

A

Sputum culture

45
Q

Why must we always treat strep throat with antibiotics

A

scarlet fever, rheumatic fever

46
Q

Why can we not treat a patient with strep and mono with Amoxicillin

A

Morbiliform rash; use macrolide or sporin

47
Q

What is the key finding of peritonsillar abscess

A

deviated uvula

48
Q

Most cases of bronchitis are

A

nagging cough
95% viral

49
Q

Do we treat bronchitis with antibiotics?

A

no unless it is pertussis to reduce how contagious it is

50
Q

What signs and symptoms do we expect to see with sinusitis

A

recurrence of symptoms
tooth ache
hurts bending down

51
Q

What do we treat sinusitis with

A

Augmentin/ Amoxicillin

52
Q

What is our screening tool for thyroid disorder

A

TSH

53
Q

If TSH is high and T3/T4 are low

A

Hypothyroidism

54
Q

First line meds for hypothyroidism

A

Levothyroxine

55
Q

First line medication for hyperthyroidism

A

Beta blockers
tapazole
PTU

56
Q

What is the parathyroid’s purpose in the body

A

calcium and phosphorus
high calcium think malignancy

57
Q

Somogyi Effect

A

dip in the middle of the night before it rises in the morning

58
Q

Dawn phenomenon

A

blood glucose steadily increases all night

59
Q

When do you screen for diabetes

A

45; q 3 years unless you have BMI > 30, family hx, PCOS

60
Q

How we diagnose T2DM?

A

Hemoglobin A1C > 6.5
fasting glucose
random glucose

61
Q

Which medications are most notorious for hypoglycemia? Cardioprotective?

A

SGLT2 inhibitors
GLP1 agonist

62
Q

When do we discontinue metformin

A

GFR less than 30

63
Q

What do you expect to see in Addison’s?

A

decrease cortisol, hyperpigmentation, increased potassium

64
Q

What are safety concerns with Addison’s?

A

Emergency kit of steriods

65
Q

What do we expect to find in cushings?

A

increased cortisol, decreased potassium, moon face, trunkal obesity, purple striae

66
Q

How do we diagnose Lupus?

A

anti-nuclear steriod test and symptoms

67
Q

What organ can Lupus really affect

A

Kidneys

68
Q

How can you diagnose osteoporosis?

A

DEXA scan
-2.5 or below

69
Q

How do you diagnose osteopenia?

A

-1- -2.5

70
Q

How do we prevent osteoporosis?

A

calcium & vitamin D
weightbearing exercise

71
Q

What are the risk factors associated with osteoporosis?

A

use of Depo
long term steriods
long term PPI
smoking

72
Q

What are some treatment options for osteoporosis?

A

Bisphosphonates (-dronate)

73
Q

What is a good medication to give to a patient with osteoporosis and hypertension

A

Thiazides

74
Q

Heberden’s node

A

joint closest to the tip of the fingers

75
Q

Bouchard’s

A

Closet to the hands

76
Q

Characteristics of RA

A

can begin at any age
faster onset
bilaterally
stiffness > 1 hour
systemic symptoms
Bouchard’s nodes
Swan neck deformity

77
Q

Characteristics of OA

A

Occurs with age
Slower onset
unilateral
stiffness < 1 hour
no systemic symptoms
Heberdens and Bouchards nose

78
Q

What would you see on a Xray for arthritis

A

joint space narrowing

79
Q

What are treatment options for arthritis

A

DMARDS

80
Q

What are some common signs/symptoms of ankylosing spondylitis

A

lower back up to her neck
autoimmune inflammatory disease

81
Q

What does ankylosing spondylitis look like on an xray

A

bamboo spine

82
Q

When does a scaphoid fracture/ navicular fracture show up on an X-ray? How is it treated?

A

2 weeks
thumb spica cast

83
Q

Phalen’s

A

backwards prayer hands

84
Q

Tinel’s

A

tap the inner wrist

85
Q

How would a patient describe Morton’s Neuroma

A

“pebble in their shoe between 3rd and 4th toe with numbness and tingling”

86
Q

Lateral epicondylitis

A

painful and inflamed tendon on outer elbow

87
Q

medial epicondylitis

A

Golfer’s elbow

88
Q

McMurray Test

A

Meniscus

89
Q

Apley test

A

Meniscus

90
Q

Continued knee popping

A

Meniscus

91
Q

Lachman test

A

ACL

92
Q

Anterior drawer test

A

ACL

93
Q

Valgus

A

MCL

94
Q

Varus

A

LCL

95
Q

What is a positive straight leg test

A

reproduction of pain between 30-70

96
Q

L4 pain:

A

squat and rise exam knee jerk diminished

97
Q

L5 Pain:

A

heel walking numbness at big toe

98
Q

S1 painL

A

walk on toes absent ankle jerk

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