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NP Boards > SM NP review skin, eyes, neuro, cardio > Flashcards

SM NP review skin, eyes, neuro, cardio Flashcards

1
Q

What is the difference in location from aphthous stomatitis and herpes?

A

herpes- painful vesicles outside of mouth
apthous stomatitis- inside the mouth

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2
Q

What is chronic ulcerative stomatitis (CUS)

A

autoimmune with the same lesion but larger in size but more of them with no relief. takes months to go away. treat with Plaqunil and steroids

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3
Q

What is the main difference in treatment between bullous and non bullous impetigo

A

Bullous (0 honey crust)- oral meds; Keflex
Non bullous- mupirocin ointment

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4
Q

What condition is known for starting with a Herald patch and a Christmas tree pattern?

A

Pityriasis rosea

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5
Q

How would a patient with a brown recluse spider bite present

A

Tender, deep, purple with white halo around it

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6
Q

What key words are used to describe the presentation of a patient with Rocky mountain fever? What is the treatment

A

North Carolina, tick bite, rash on soles/ palms
Doxycycline- even when pregnant

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7
Q

How can we distinguish a Lyme Disease rash

A

bull’s eye lesion

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8
Q

What is the medical term for Lyme Disease

A

Erythema migrans

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9
Q

How do we treat Lyme disease?

A

Doxycycline
If pregnant, amoxicillin

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10
Q

What is another name for Measles?

A

Rubeola

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11
Q

What are the 3 C’s associated with measles (rubeola)

A

Cough
Congestion
Conjunctivitis

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12
Q

When can babies get the MMR vaccines?

A

12 months

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13
Q

What develops in the mouth with measles?

A

Koplik spots

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14
Q

What is the most common symptom of mumps?

A

Parotitis- swelling of the glands between jaw and ear
Sialotitiasis- salivary gland stone- mass under chin while eating

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15
Q

Characteristics of actitic keratosis

A

dry, scaly lesions on sun exposed skin

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16
Q

What are characteristics of squamous cell carcinoma

A

slow growing, scaly, ulceration, more red, bleeds easily

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17
Q

What are cafe au lait spots and how are they treated?

A

Benign but more than 8 think neurofirbomatosis

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18
Q

What the mnemonic for malignant melanoma

A

A- Asymmetry
B- Board irregular
C- Color variation
D- Diameter > 6
E- evolution

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19
Q

What lesion is “pasted on” and does not need to be removed?

A

Seborrheic keratosis

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20
Q

What are key words to describe basal cell carcinoma?

A

telangiectasias (dilated small blood vessels), visible, shiny, waxy, pearly
** most common type of skin cancer **

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21
Q

How would you describe eczema?

A

flexor surface of body, itch that rashes

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22
Q

What is another term for eczema? 3 A’s?

A

Atopic dermatitis
Asthma Allergies

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23
Q

How can we recognize plaque psoiasis?

A

thick, silvery, scales

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24
Q

Auspitz Sign

A

plaques are scratched and pinpoint bleeding occurs

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25
Q

Koebner’s phenomenon

A

trauma to skin leads to plaque formation

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26
Q

How would we describe contact dermatitis? Treatment?

A

linear distribution; topical steroids’; avoid irritant

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27
Q

How would we describe shingles?

A

on a dermatone, vesicular, burning/tinglings before the rash appears

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28
Q

If the skin is still intact but non-blanchable, what stage of pressure ulcer is that

A

stage 1, foam dressing

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29
Q

What are the stereotypical signs of Scabies and treatment?

A

intensely pruritic between fingers and toes, contagious
permethrin cream
wash everything in hot water

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30
Q

How would we describe chicken poxs and when can these kids get the vaccine and go back to school?

A

various stages of healing
12 months
when all the lesions are crusted over

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31
Q

What symptoms will someone with head lice have and how do we treat it?

A

incessant puritis of scalp
permethrin for live bugs nits need to be combed out and bedding washed

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32
Q

How would you describe molluscum contagiosum?

A

indent in middle of lesion, umbilicate, dimple, flesh color, contagious, suspicious in the groin area of children

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33
Q

What are the key words for Anthrax?

A

cattle farmer, painless, ulcerated

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34
Q

What is the treatment for Anthrax?

A

1 cipro

#2 tetracyclines

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35
Q

What are the two risk factors for reoccurring hidradenitis suppurativa?

A

obesity and smoking

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36
Q

What is folliculitis?

A

skin infection of hair follicles and surrounding tissues

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37
Q

How do we treat folliculitis?

A

warm compresses, mupirocin, PCN, Keflex

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38
Q

What is the key distinguishing factor for rosacea and treatment

A

across nasal folds
metronidazole cream

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39
Q

How is the Lupus rash described?

A

malor rash, butterfly rash, spares nasal folds

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40
Q

What symptoms are consistent with Sjogren’s syndrome?

A

Very dry eyes
very dry mouth

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41
Q

How would we describe erysipleas? Treatment?

A

more superficial cellulitis
sharply defined or well demarcated boarders
superficial and reddened
PCN or Keflex

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42
Q

What are the characteristics of cellulitis

A

angry, swollen

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43
Q

What is the treatment of purulent cellulitis?
Mneumonic?

A

B: Bactrim
C: Clindamycin
D: Doxycycline

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44
Q

What is the treatment of non-purulent cellulitis?

A

Keflex, PCN

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45
Q

What is the three step treatment for acne?

A
  1. topical: benzoyl peroxide
  2. topical antibiotic
  3. Oral antibiotic: doxycycline
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46
Q

What is the three step treatment for acne?

A
  1. topical: benzoyl peroxide
  2. topical antibiotic
  3. Oral antibiotic: doxycycline
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47
Q

What is important to teach with tetracyclines?

A

sunscreen/ avoid sun

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48
Q

What is geographical tongue?

A

from spicy or hot foods
benign

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49
Q

What is leukoplakia?

A

oral hairy leukoplakia, can’t scrape off, common in HIV, refer to dentist

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50
Q

How does 5ths disease present?

A

slapped cheek rash
fever, then rash, then lacy net like all across body

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51
Q

When is 5ths disease no longer contagious?

A

when the rash appears

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52
Q

Who should be extra cautious around those with 5ths disease?

A

pregnant women

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53
Q

tinea capitis

A

head/scalp

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54
Q

tinea barbae

A

beard

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55
Q

tinea cruris

A

near groin

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56
Q

tinea pedis

A

foot

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57
Q

tinea versicolor

A

all over

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58
Q

How do we treat fungal infections?

A

topical antifungals unless more severe or reccurent

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59
Q

What is onychomycosis with treatment

A

nail bed fungal infection
treat with ORAL fluconazole

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60
Q

What is enetrobiasis?

A

Pinworm

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61
Q

How would the patient describe enterobiasis? How do you diagnose?

A

genital intently itchy at night
scotch tape test early in the morning

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62
Q

How do we treat enterobiasis

A

Mebendaozole or albendazole

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63
Q

How do we treat dog/cat bites?

A

augmentin

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64
Q

What is the #1 thing we do when a patient has an eye complaint?

A

Visual acuity

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65
Q

What does it mean to have 20/40 vision?

A

They can see at 20 feet what a person with normal eyesight can see at 40 feet

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66
Q

When is the patient considered legally blind?

A

20/200

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67
Q

What is amblyopia

A

Lazy eye

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68
Q

What usually causes amblyopia?

A

Strabismus

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69
Q

What test do we perform to asses for color blindness?

A

Ishihara chart

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70
Q

Which cranial nerves are related to the eyes?

A

II, III, IV, VI

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71
Q

How would you describe retinal arteries?

A

Arteries are light and thinner that veins
No hemorrhages or cotton wool spots
Optic disc with sharp margins and no swelling
Present red reflex

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72
Q

What are some things we don’t want to see in an eye exam?

A

Papilledema
Arteries crossing over veins

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73
Q

What is papilledema and how is it treated

A

Optic disc swelling
Refer!

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74
Q

What would we see on a fundoscopic exam of a patient with hypertension?

A

papilledema, AV nicking, copper wire arteries, flame hemorrhages

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75
Q

What would we see on a fundoscopic exam of a patient with diabetes?

A

cotton wool spots
blot hemorrhages
microaneurysm
neovascularization

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76
Q

How will a patient describe their symptoms if they are experiencing acute angle-closure glaucoma?

A

sudden eye pain, blurry vision, firm to touch, increased IOP

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77
Q

If we suspected acute angle-closure glaucoma what should we do?

A

Refer to ED for risk of permanent vision loss

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78
Q

What is the stereotypical description of retinal detachment to distinguish it from other eye conditions?

A

curtain pulled over their eye or field of vision. sudden, painless, a lot of floaters, blurred vision/ flashes of light

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79
Q

What is arcus senilis?

A

gray halo around eyes

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80
Q

What is Xanthelasema?

A

Cholesterol deposits on the eyes

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81
Q

What do you do if a patient has arcus senilis or xanthelasma?

A

Run lipid profile

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82
Q

What is pterygium?

A

benign overgrowth of conjunctiva
eye redness
crosses cornea

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83
Q

What is Pinguecula?

A

will not go over cornea

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84
Q

What is hordeolum?

A

stye; infection; staph; drainage. Warm compresses/ antibiotics

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85
Q

What is a chalazion?

A

blockage of duct
warm compresses

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86
Q

What are the characteristics of allergic conjuctivitis?

A

serous, stringy ropey drainage
starts bilaterally
notes in cervical chain

87
Q

What are the characteristics of viral conjunctivitis?

A

serous drainage
spreads from one eye to the other
lymph nodes = preauricular or submandibular

88
Q

What are the characteristics of bacterial conjunctivitis?

A

purulent drainage
spreads from one eye to the other
no lymph nodes

89
Q

What is the medical term for pink eye

A

adenoviral conjunctivitis

90
Q

What is leukocoria?

A

white reflex

91
Q

What is the description of cataracts?

A

leukocoria
no red reflex
older age
hard to drive at night

92
Q

What is the description of macular degeneration?

A

central vision loss
age
larger print to read

93
Q

What is presbyopia?

A

“my arms are too short”
hard to see things close up
starts around age 40
reading glasses

94
Q

What condition is typically associated with corneal abrasions?

A

Bells Palsy

95
Q

How do you diagnose a corneal abraison?

A

flurocein staining

96
Q

How would a patient with iritis present?

A

sensitivity to light, inflammation and swelling of iris

97
Q

What are the concerns with iritis? How do we treat it?

A

Permanent blindness/ refer to optho

98
Q

What is a subconjunctival hemorrhage and how do we treat it?

A

broken blood vessels on the sclera
resolves itself; artificial tears

99
Q

How would a patient present with a tumor headache?

A

dull, persistent headache always in the same spot
personality changes, nausea/vomiting, vision issues
order head CT

100
Q

What kind of stroke does atrial fibrillation increase the risk of

A

ischemic stroke

101
Q

What kind of stroke does hypertension increase the risk of

A

Hemorrhagic stroke

102
Q

What is BEFAST?

A

B- Balance
E- Eyes
F- Face
A- Arms
S- Speech
T- Time

103
Q

What is asphasia?

A

inability to understand or express speech

104
Q

What is receptive asphsia?

A

Wernicke’s area; cannot understand what is being said to them

105
Q

What is expressive asphsia?

A

Broca’s area; trouble expressing themselves or forming speech

106
Q

What causes Wernicke- Korasakoff Syndrome?

A

chronic alcoholism
Vitamin B1 (thiamine) deficiency

107
Q

How does a patient with a cluster head present?

A

one sided, tearing/ runny nose, occurs at the same time daily

108
Q

How would you treat this patient?

A

100% oxygen
Calcium channel blockers

109
Q

What are symptoms of temporal arteritis/ giant cell arteritis

A

1 sided, possible visual impairment, temporal pain/pulsing, increased ESR

110
Q

What is the treatment of temporal arteritis?

A

long-term steriods

111
Q

How do you make the definitive diagnosis of temporal arteritis?

A

temporal artery biopsy

112
Q

Polymyalgia rheumatica is commonly associated with what other condition?

A

temporal arteritis

113
Q

How would a patient with a hypertension headache present?

A

occipital headache, typically upon awakening

114
Q

How would you treat a patient with hypertension headache?

A

anti-hypertensives or med adjustments

115
Q

What is the most common time of day to see hypertension headache?

A

morning

116
Q

How would a patient with migraine present?

A

difficulty with lights/noise, throbbing, pulsating, nausea/vomiting, aura

117
Q

How would you treat a patient with a migraine

A

Abortive- triptans (avoid with CVD patients and pts on serotonin)

118
Q

What is the typical migraine prophylaxis

A

avoid triggers, beta blockers

119
Q

How would a patient with a tension headache present?

A

pain bilaterally

120
Q

What neurotransmitter is responsible for Parkinson’s?

A

dopamine

121
Q

What are the three main symptoms of Parkinson’s?

A
  1. bradykinesia (most debilitating)
  2. tremor
  3. rigidity
122
Q

How is Parkinson’s treated?

A

Levadopa/Carbidopa

123
Q

What is Brudzinski’s sign?

A

back of head
when you flex back of the head causes hip and knees to flex with it

124
Q

What is Kernig’s sign?

A

think knee
Can’t extend knee past 90 degrees without pain

125
Q

What disease are Brudzinski and Kernig’s sign associated with?

A

meningitis

126
Q

What are the three A’s associated with Alzheimer’s Disease?

A

Apraxia (skilled movement)
Agnosia (Recognition)
Aphasia

127
Q

What is the goal treatment of Alzheimer’s disease?

A

Slow progression

128
Q

What assessment tools can we use to assess cognitive decline

A

Mini-mental status exam

129
Q

CN1

A

olfactory- smell
S

130
Q

CNII

A

optic- visual acuity
S

131
Q

CNIII

A

oculomotor- eye movement
pupil dilation
M

132
Q

CNIV

A

trochlear- vertical eye movement
M

133
Q

CNV

A

trigeminal- facial expression and sensation
M & S

134
Q

CNVI

A

Abducens- lateral movement of eyeballs
M

135
Q

CNVII

A

Facial- taste and facial expression
M & S

136
Q

CNVIII

A

Auditory- hearing and balance
S

137
Q

CNIX

A

Glossopharyngeal- taste and swallowing
M & S

138
Q

CNX

A

Vagus- sensation in throat and viseral muscles, vocal cords, peristalsis
M & S

139
Q

CNX1

A

Accessory- head and shoulder movement
M

140
Q

CNXII

A

Hypoglossal- tongue movement
M

141
Q

What is the mnemonic for cranial nerves?

A

Oh, oh, oh to touch and feel a great vein- ah heaven
Some say marry money but my brother says big brains matter more than

142
Q

What condition is associated with cranial nerve V?

A

trigeminal neuralgia

143
Q

What are the symptoms of trigeminal neuralgia with treatment?

A

severe stabbing pain; Tegretol

144
Q

What are we concerned about with unsuccessful treatment of trigeminal neuralgia?

A

increased suicide risk

145
Q

What condition is associated with cranial nerve VII?

A

bell’s palsy

146
Q

What is a normal finding for Rinne test?

A

AC>BC

147
Q

What is a normal finding for Weber test?

A

Sound will be heard equally by both ears

148
Q

What will we see in the Weber test for conductive hearing loss?

A

think something you can see
sound lateralizes to the bad ear

149
Q

What will we see in the Weber test for sensorineural hearing loss?

A

Sound will lateralize to the good ear

150
Q

How will a patient with Meniere’s Disease present?

A

Vertigo, tinnitus, ear pressure, nystagmus

151
Q

What is our biggest concern with Meniere’s disease?

A

Permanent hearing loss

152
Q

What is the ASCVD risk cutoff for hyperlipdemia?

A

greather than 7.5%

153
Q

How often do you check lipids?

A

every 5 years unless risk factors are present

154
Q

What is the go to treatment for hyperlipidemia before medicine?

A

Lifestyle modifications

155
Q

What are the two strongest statins we can prescribe?

A

Atorvastatin (greater than 40 mg)
Rosuvastatin (greater than 20 mg)

156
Q

What are the signs of Rhabdomyolysis?

A

new muscle pain
CK level x5
Kidney failure

157
Q

What are the signs of acute drug induced hepatitis

A

Jaundice
LFTs

158
Q

What juice do we not mix with statins?

A

grape fruit juice

159
Q

Are statins safe in pregnancy

A

No

160
Q

What should we prescribe if a patient has a triglyceride over 500? What are we preventing?

A

Fenofibrate; pancreatitis

161
Q

Cullens sign

A

bruising around umbillical

162
Q

Grey Tuners sign

A

Bruising to flank

163
Q

What is your B/P goal for JNC-8?

A

less than 140/90

164
Q

When should you start treatment for HTN according to JNC8?

A

older than 60 > 150/90
Lifestyle 1st x3 months

165
Q

When should we start treatment for HTN according to AHA?

A

ASCVD risk of 10 or higher
130/80

166
Q

What is our initial plan of any new HTN?

A

lifestyle changes

167
Q

According JNC 8 we initiate BP meds sooner if the patient has these two comorbidities?

A

diabetes and CKD

168
Q

What ages with blood pressures do we start meds?

A

greater than 60= 150/90
less than 60= 140/90

169
Q

With ACE- inhibitors what labs do we want to monitor?

A

renal function and potassium (at risk for hyperkalemia)

170
Q

What are the first line HTN medications for non-black patients?

A

ACE, thiazides, CCB

171
Q

When do we change from ACE to ARB?

A

angioedema

172
Q

What is bad for thiazides?

A

Triglycerides, uric acid, glucose
but good for osteoporosis

173
Q

Are ACE good for the kidneys or bad?

A

Both; but they are renal protectant

174
Q

What are the typical side effects of CCB?

A

GERD- relaxes lower esophageal sphincter
Ankle edema/ headache

175
Q

What heart rhythm do we not give CCB

A

heart block

176
Q

What is the first line med for HTN in black patients?

A

thiazides/ CCB

177
Q

What are the three BP meds that are safe in pregnancy?

A

New Little Momma
Nifedipine
Labetalol
Methyldopa

178
Q

What are some meds we should not give to pregnant women

A

ACE
ARBS
Statins
DMARDS

179
Q

Which hypertensive medication should we use if our patient has hypertension and diabetes?

A

ACE/ ARBS (renal protectant)

180
Q

What is the preferred medication in the elderly for isolated systolic hypertension?

A

CCBS/ thiazides

181
Q

What occurs when there are variances in heart rate upon inspiration and expiration?

A

respiratory sinus arrhythmia

182
Q

What is the common population for respiratory sinus arrhythmia?

A

young healthy athlete

183
Q

What is pulsus paradoxus?

A

10 point drop in SBP upon inspiration, very serious, cardiac tamponade, status asthmaticus

184
Q

What are common diagnostic labs/tests for CHF?

A

BNP, EKG, chest xray, echo (less than 40% is diagnostic)

185
Q

When should patients be educated to follow up with you with heart failure?

A

weight gain 2kg in a day

186
Q

What heart sound is common with heart failure?

A

S3

187
Q

Where does the fluid go with right sided heart failure?

A

body

188
Q

Where does the fluid go with left sided heart failure?

A

lungs

189
Q

What meds should you avoid in heart failure due to swelling?

A

TZDs, CCBs, NSAIDS

190
Q

What two medications are patients with Afib typically on?

A

anticoagulation, beta blockers

191
Q

What is the goal INR for afib? Prostetic valve?

A

2-3
2.5-3.5

192
Q

What is the antidote for warfarin?

A

vitamin K

193
Q

What is Raynaud’s Phenomenon?

A

Decreased blood flow

194
Q

What participates Raynauds?

A

exposure to cold or stress

195
Q

How do we treat Raynaud’s?

A

CCB/ avoid triggers

196
Q

What is the mnemonic for heart valves?

A

All People Take Money
Aortic
Pulmonic
Tricuspid
Mitral

197
Q

When is hearing a split S2 not normal?

A

Inspiration and expiration

198
Q

What is heard at s1?

A

closure of AV (mitral and tricuspid)

199
Q

What is heart at S2?

A

closure of semilunar (aortic and pulmonic)

200
Q

When do we hear an S4?

A

uncontrolled HTN, and LVH

201
Q

At what grade murmur do we feel a palpable thrill?

A

Grade 4 or higher

202
Q

What mnemonic do we use for systolic murmurs?

A

MR PASS MVP
Mitral
Regurgitation

Physiological
Aortic
Stenosis
Systolic

Mitral
Valve
Prolapse

203
Q

What syndrome do we see with mitral valve prolapse?

A

Marfan Syndrome

204
Q

Which murmur radiates to the armpit?

A

Mitral regurgitation

205
Q

What murmur radiates to the neck?

A

Aortic stenosis

206
Q

What is the mnemonic we use for diastolic murmurs?

A

MS ARD

Mitral
Stenosis

Aortic
Regurgitation
Diastolic

207
Q

Diastolic =

A

Doom
Refer!

208
Q

What signs/symptoms do we see in PAD?

A

purple/hyperpigmentation
shiny skin
decreased blood flow
intermittent claudification

209
Q

What is our go to diagnostic test for PAD?

A

Ankle-brachial index
Less than 0.9= PAD

210
Q

How do we calculate ankle brachial index?

A

SBP leg / SBP arm

211
Q

What signs/symptoms might you see in chronic venous insufficiency?

A

reddish brown edematous
hyperpig

212
Q

What can chronic venous insufficiency lead to due to that pooling of blood?

A

increased risk of DVT

213
Q

Where do we refer patients with varicose veins?

A

vascular

214
Q

What are signs/symptoms of DVT?

A

swelling, calf pain, erythema

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