Top 55 dx (1) Flashcards
ABD pain GI assessment
Signs 3
inspect, auscultate, percuss, palpate
McBurney’s test - pain when pressure is released at RLQ (appendicitis)
Rosvings sign - pain in RLQ when palpation of LLQ (appendicitis)
Murphy’s sign - place hand at right costal margin, push in, breath in, pain = cholecystitis
ABD pain - pharm, labs, imaging
- acetaminophen 650 q4 hour as needed
- CBC, CMP, AST, ALT, lipase, amylase
- abd x ray
anemia pharm and non pharm, f/u
- ferrous sulfate 325 mg TID
- increase dietary intake of iron such as animal proteins, legumes, dark leafy greens, spinach
- CBC in 2-4 weeks
asthma physical exam hot spots 6
- inspect chest rise and fall, AP diameter
- palpate anterior and posterior
- T 10 posterior chest expansion
- Tactile fremitus - palmar hand, says 99; normal should be symmetrical fremitus bilaterally
- Percussion - should be low pitched hollow lung sounds
- CVA tenderness
- auscultation A & P
asthma rx
if sx <2 days/week SABA albuterol 90 mcg q4-6 hours as needed
if sx >2 <7 days/week SABA albulterol 90 mcg q4-6 hours as needed and low dose ICS budesonide 180 mcg/day
atopic dermatitis rx
OTC emollient i.e. aquaphor
hydrocortisone topical 0.2%, to affected area twice daily, as required
atopic dermatitis DD
psoriasis
shingles
Low back pain Rx
2 week trial of iburpofen 400 mg QID or acetaminophen for kidney disease, 650 mg q6H
If this doesn’t help then:
cyclobenzaprine 5 mg PO, TID, for three weeks
Low back pain non pharm, imaging, DD
- alternate hot and cold. exercise. PT
- lumbar x ray
- disc herniation, osteoporosis
Most common cause of Bell’s Palsy
HSV infection
Bell’s Palsy neuro assessment
assessment of CN 7 shows inability to wrinkle forehead, inability to close eye, asymmetry of affected side
bells palsy RX
Steroid if in the first few days of sx. Prednisone 60 mg/day for one week. If having ear pain or other discomforts then acetaminophen 650 mg q6H prn
bells palsy DD
CVA
lyme disease
tumor
BPH Rx
tamsulosin 0.4 mg once daily
BPH labs, DD
UA, PSA if life expectancy >10 years
urethral stricture, UTI, prostate cancer
Acute bronchitis s/sx
Acute onset but persistent cough, with or without sputum. Dyspnea on exertion, wheezing, rhonchi, sore thoart.
acute bronchitis Rx
sx are self limiting. can take acetaminophen for discomfort 650mg q6h prn
candida infection Rx
oral/thrush - nystatin 100,000 unts/ml 4 times daily for 14 days
vaginal - fluconazole 150 mg PO, once
candida infection DD
atopic dermatitis
tinea cruris (groin)
tinea corporis (body, ringworm)
cerumen impaction Rx
cerumenolytic called carbamide peroxide 5-10 drops BID for five days
cerumen impaction non-pharm
use cotton ball dipped in mineral oil and place in external canal for 1-20 mins once a week to decrease buildup. routine cleaning by health care professional every 6-12 months
COPD s/sx
coughing, wheezing, SOB, feeling tired, trouble sleeping, swelling in ankles, lung crackles
COPD Rx
SABA albuterol 90 mcg 2 puffs q4-6H prn
LABA formoterol 12 mcg q12H, daily
COPD labs
PFT, ABGs
common cold s/sx
fever, chills, malaise, myalgia, headache, nasal stuffiness, sore throat, nonproductive cough, fever
common cold Rx
most often none but can do acetaminophen 650 mg every 4-6 hours as needed for pain and discomfort
Cough Rx
severe, acute coughing -
dextromethorphan (Robitussin) 30 mg PO q6-8 hours, prn
benzonatate (Tessalon) 100 mg PO TID as needed
Constipation Rx
chornic, > 3 months -
psyllium (Metamucil) 1 packet/day up to three times a day
acute -
bisacodyl 5 mg PO once a day as needed up to 1 week of use
constipation non pharm
increase fiber intake to 25-35 G per day
exercise more
consume enough water, at least 64 oz daily
constipation DD
bowel obstruction
colonic ileus
colon tumor
