Test 1 - Created June 24 Flashcards
results of B12 deficiency
dementia, subacute combined degeneration; intramedullary hemolysis, ineffective erythropoiesis
standardized mortality ration equation
observed number of deaths/expected number of deaths; used in occupational studies
risk for long-term survivors of Hodgkin lymphoma
cardiovascular issues; radiation leads to fibrosis -> MI, restrictive CMP with diastolic dysfn, contstrictive pericarditis, valve issues, conduction defects
eye exam with central retinal artery occlusion
pale fundus with “cherry red spot”
eye exam with central retinal vein occlusion
fundus with retinal hemorrhages and optic disc edema
eye exam with retinal detachment; see floaters
vitreous hemorrhage and marked elevation of retina
eye exam with vitreous hemorrhage
decreased red reflex; visible hemorrhage
eye exam with optic neuritis
optic disc edema
eye exam with DM eye changes
neovascularization; possible hemorrhage
triad in Meniere’s disease
periodic vertigo, unilateral hearing loss, tinnitus
steps in root cause analysis
- collect data 2. causal flow chart 3. root causes 4. recommendations and changes 5. measure results
equation for (+) likelihood ratio
sensitivity / (1 - specificity) OR TP/FP
equation for (-) likelihood ratio
(1 - sensitivity) / specificity OR FN/TN
tx for lactational mastitis
dicloxacillin or cephalexin; IV vanc if MRSA risk factors; continue to breastfeed
subclinical hypothyroidism: when to treat
TSH > 10; TSH 4.5-10 with elevated TPO Ab’s or sxs/goiter
Lyme tx in pregnant woman
14-21 days of amoxicillin or cefuroxime
tx of NSTEMI
NA-BASH (nitrates, ASA, BBs, anti-plt with -grel), statin, heparin); likely get “NA” en route; give “AH”; hold off on BS until later
tx of STEMI
meds the same but need cardiac cath and revascularization within 90 minutes STAT
adjustment disorder with depressed mood
onset w/in 3 mo. of stressor; marked distress and/or functional impairment
illness anxiety disorder
excessive concern about having or developing a serious, undiagnosed general medical disease; concerns persist > 6 mo.; patients tend to have multiple (-) workup’s
normal stress response
not excessive or out of proportion to severity of stressor; no significant functional impairment
somatic symptom disorder
worry about symptoms; physical symptoms persist over time
presentation of chronic prostatitis and workup
> 3 mo. of dysuria, pelvic pain, and/or pain during ejaculation; workup = U/A and UCx to r/o UTI; U/A will show >20 leukocytes
treatment for chronic prostatitis
alpha blockers, Abx, anti-infl., and/or psychotherapy; give 6 wks of FQN or TMP-SMX if bacterial
presentation of acute prostatitis
similar to chronic with dysuria and pelvic pain BUT has high fever and dirty urine; prostate is warm, edematous, tender; UCx shows E.coli or Proteus
presentation of lithium toxicity; level for toxicity; common drugs that cause it; treatment
N/V/D, slurred speech, confused, tremors, ataxia; > 1.5; thiazides, ACE-i, NSAIDs; lithium levels, IVF, hemodialysis if bad
presentation of neuroleptic malignant syndrome; drugs that cause it
fever, extreme rigidity, autonomic instability, AMS; antipsychotic meds
presentation of serotonin syndrome; drugs that cause it
myoclonus, hyperreflexia, hyperthermia, tachycardia, confusion, tremors; multiple serotonin drugs
treatment for Paget’s disease
give if sxs, involves wt-bearing bones, or neuro involvement; bisphosphonates (activity against osteoclasts, the problem in Paget’s)
reasons why subchorionic hematoma can occur; complications down the road
reasons: infertility tx, anticoag., uterine anomalies, recurrent pregnancy loss; complications: spont. abortion, abruptio placentae, pPROM, PTD, PreE, IUGR, IUFD
when placenta accreta more likely to occur
prior Csections (implants over scar)
when placenta previa more likely to occur
h/o of prior Csection, multiparity, multiple babies (twins), prior placenta previa
when to do basal-bolus insulin in hospital
T1DM, T2 if they did it prior, T2 poor controlled by SS, new DM pt
when to do sliding scale insulin in hospital
T2 well controlled with diet and/or oral meds before admission; may need to add basal
when to do insulin infusion insulin in hospital
T1 who aren’t eating and whose bG is poorly controlled with subcut; T1 perioperatively or during labor; hyperglycemic emergencies
stress incontinence and tx
leakage w/ cough, sneeze, laugh, lifting; urethral hypermobility, intrinsic sphincter def., or (+) urine stress test on PE; LS modification, pelvic floor exercises, pessary, urethral sling surgery
urge incontinence and tx
sudden, overwhelming, or frequent need to urinate; LS modification, bladder training, antimusc. meds (oxybutynin, tolterodine)
overflow incontinence and tx
constant dribbling of urine, incomplete bladder emptying, decr. perineal sensation on PE; intermittent cath, correct etiology if possible; may be from DM, spinal injury, MS or may be taking antihistamines and making it worse
