Top 55 dx (1)

Question 1

ABD pain GI assessment
Signs 3

Answer 1

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

Question 2

ABD pain - pharm, labs, imaging

Answer 2

1. acetaminophen 650 q4 hour as needed
2. CBC, CMP, AST, ALT, lipase, amylase
3. abd x ray

Question 3

anemia pharm and non pharm, f/u

Answer 3

1. ferrous sulfate 325 mg TID
2. increase dietary intake of iron such as animal proteins, legumes, dark leafy greens, spinach
3. CBC in 2-4 weeks

Question 4

asthma physical exam hot spots 6

Answer 4

1. inspect chest rise and fall, AP diameter
2. palpate anterior and posterior
3. T 10 posterior chest expansion
4. Tactile fremitus - palmar hand, says 99; normal should be symmetrical fremitus bilaterally
5. Percussion - should be low pitched hollow lung sounds
6. CVA tenderness
7. auscultation A & P

Question 5

asthma rx

Answer 5

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

Question 6

atopic dermatitis rx

Answer 6

OTC emollient i.e. aquaphor

hydrocortisone topical 0.2%, to affected area twice daily, as required

Question 7

atopic dermatitis DD

Answer 7

psoriasis
shingles

Question 8

Low back pain Rx

Answer 8

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

Question 9

Low back pain non pharm, imaging, DD

Answer 9

1. alternate hot and cold. exercise. PT
2. lumbar x ray
3. disc herniation, osteoporosis

Question 10

Most common cause of Bell’s Palsy

Answer 10

HSV infection

Question 11

Bell’s Palsy neuro assessment

Answer 11

assessment of CN 7 shows inability to wrinkle forehead, inability to close eye, asymmetry of affected side

Question 12

bells palsy RX

Answer 12

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

Question 13

bells palsy DD

Answer 13

CVA
lyme disease
tumor

Question 14

BPH Rx

Answer 14

tamsulosin 0.4 mg once daily

Question 15

BPH labs, DD

Answer 15

UA, PSA if life expectancy >10 years
urethral stricture, UTI, prostate cancer

Question 16

Acute bronchitis s/sx

Answer 16

Acute onset but persistent cough, with or without sputum. Dyspnea on exertion, wheezing, rhonchi, sore thoart.

Question 17

acute bronchitis Rx

Answer 17

sx are self limiting. can take acetaminophen for discomfort 650mg q6h prn

Question 18

candida infection Rx

Answer 18

oral/thrush - nystatin 100,000 unts/ml 4 times daily for 14 days
vaginal - fluconazole 150 mg PO, once

Question 19

candida infection DD

Answer 19

atopic dermatitis
tinea cruris (groin)
tinea corporis (body, ringworm)

Question 20

cerumen impaction Rx

Answer 20

cerumenolytic called carbamide peroxide 5-10 drops BID for five days

Question 21

cerumen impaction non-pharm

Answer 21

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

Question 22

COPD s/sx

Answer 22

coughing, wheezing, SOB, feeling tired, trouble sleeping, swelling in ankles, lung crackles

Question 23

COPD Rx

Answer 23

SABA albuterol 90 mcg 2 puffs q4-6H prn
LABA formoterol 12 mcg q12H, daily

Question 24

COPD labs

Answer 24

PFT, ABGs

Question 25

common cold s/sx

Answer 25

fever, chills, malaise, myalgia, headache, nasal stuffiness, sore throat, nonproductive cough, fever

Question 26

common cold Rx

Answer 26

most often none but can do acetaminophen 650 mg every 4-6 hours as needed for pain and discomfort

Question 27

Cough Rx

Answer 27

severe, acute coughing -

dextromethorphan (Robitussin) 30 mg PO q6-8 hours, prn

benzonatate (Tessalon) 100 mg PO TID as needed

Question 28

Constipation Rx

Answer 28

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

Question 29

constipation non pharm

Answer 29

increase fiber intake to 25-35 G per day
exercise more
consume enough water, at least 64 oz daily

Question 30

constipation DD

Answer 30

bowel obstruction
colonic ileus
colon tumor