Test 29 Flashcards
Depression
Patients with insomnia should be evaluated for depression. When a dx of depression is made, tx with antidepressants, rather than hypnotics, is indicated.
Hypocalcemia
Hypocalcemia can occur during or immediately after surgery, especially in patients undergoing major surgery and requiring extensive transfusions. Hyperactive deep tendon reflexes may be the initial manifestation. Hypermagnesemia, on the other hand, results in loss of the deep tendon reflexes.
MI
Reperfusion therapy with primary percutaneous intervention or fibrinolytic therapy is indicated in patients with acute ST elevation myocardial infarction (STEMI). ECG findings that are diagnostic of acute STEMI includes >1-mm (0.1-mV) ST elevation at the J point in greater than or equal to 2 anatomically contiguous leads (except V2 and V3) and new left bundle branch block.
Diabetic retinopathy
Diabetic retinopathy requires some years to develop. Poor glycemic control and blurry vision can be due to the swelling in the optical lens secondary to osmotic changes. Improving glycemic control is likely to improve the patient’s symptoms.
Research ethics
Incarcerated individuals must be given the same rights as the general population to refuse or consent to participation in medical research. However, due to the potential for exploitation, additional institutional review board oversight is necessary to avoid coercion of the incarcerated.
Rosacea
Patients with rosacea may also experience ocular symptoms. Complications frequently include a burning or foreign body sensation, blepharitis, keratitis, conjunctivitis, episcleritis, and recurrent chalazion.
Esophageal varices
In patients with cirrhosis in whom there is concern for variceal hemorrhage, IV octreotide should be initiated after stabilization and while awaiting endoscopic therapy. Octreotide is thought to decrease the elevated portal venous pressure that causes variceal formation and may stop the hemorrhage.
Esophageal varices
Nonselective beta blockers (nadolol, propranolol) can be used in the primary and secondary prevention of esophageal variceal hemorrhage, particularly in combination with endoscopic surveillance and band ligation.
