Top 55 dx (2) Flashcards
DM Rx
if a1c <7.5, start with lifestyle changes and monotherapy. metformin 500 mg bid, daily
DM DD
metabolic syndrome
hypothyroid
prediabetes
diarrhea Rx
if afebrile, loperamide 4 mg x 1 PO, then 2 mg PO after each loose stool
Max 16mg/day
diarrhea DD
IBS, ulcerative colitis, colon cancer
dyspepsia Rx
PPI - pantoprazole 20 mg PO daily for 8 weeks, then reevaluate
dyspepsia non pharm
lose weight
eat moderate amounts of food at each meal
avoid food/snacks within three hours of sleep
dyspepsia labs
cbc
cmp
lipase
amylase
dyspepsia DD
hiatal hernia
esophageal spasms
esophageal cancer
dysphagia Rx
none
dysphagia non pharm, imaging
swallowing rehab, speech therapy
barium swallow exam, upper endoscopy
dysphagia DD
esophageal strictures
MS
esophageal tumor
emphysema s/sx
pink puffers
severe dyspnea, normal ABGs
thin
barrel chest
dyspnea on exertion
decreased breath sounds
emphysema Rx
SABA albulterol 90 mcg 2 puffs 4-6 h prn
LABA formoterol 12 mcg 1 puff q12h daily
fibromyalgia Rx
cyclobenzaprine 5 mg PO one daily at bedtime
fibromyalgia non pharm, labs, DD
- CBT, PT
- CBC, CMP, CRP, thyroid function test
- RA, depression, polymyalgia rheumatica
fibromyalgia s/sx
soft tissue pain in muscles, ligaments, tendons
post exercise malaise
fatigue
polyarthralgia
headaches
depressed mood
appears tired
gallstones s/sx
intense, dull discomfort located in RUQ, epigastric or substernal area that may radiate to back
diaphoresis
NV
triggered by a fatty meal
post prandial pain
gallstones rx
ursodiol 8 mg/kg/day PO, divided into three dose (TID)
gallstones labs, imagina
cbc cmp amylase lipase
transabdominal US
gallstones DD
PUD
acute cholecystitis
pancreatitis
acute gout attack s/sx
pain, tenderness, erythema, swelling of affected joint
usually monoarticular, mostly big toe
excruciating pain that awakens them at night
acute gout attack rx
NSAID for pain - indomethacin 25 mg q8H PO for 5-10 days, stop med when pain stops
colchicine (kowl chuh seen) 1.5 mg PO x 1, then 0.6 mg PO 1 hour later x 1, for three days
acute gout attack non pharm
rest
elevate area
avoid triggers (alcohol)
avoid food high in purine (seafood, shellfish, turkey, bacon)
acute gout attack labs, imaging, DD
CBC CMP serum uric acid level
x ray of area
arthritis, fracture, cellulitis
ED rx
sildenafil 25 mg once daily, prn, 1 hour before anticipated sexual activity
ED non pharm, labs, imaging, DD
- reduce alcohol, tobacco, drug use; psychosexual therapy
- cbc, cmp, fasting BG to r/o DM, TSH, testosterone levels, PSA levels
- color doppler sonography to assess vascular causes
- urithritis, late stage syphilitic lesions, penile tumor
HA s/sx tension, migraine, cluster
tension - NV, bilateral pressure, bandlike pain, sleep issues, social stressors, neck arthritis, neck muscle spasms
migraine - unilateral, pulsating, episodic pain, NV, photophobia, phonophobia
cluster - periorbital, nighttime unilateral non-pulsating pain, photophobia, tearing, nasal stuffiness
HA rx
ibuprofen 400 mg PO q4-6 hours prn
prophylactic - topiramate 25 mg qHS x 1week then 50 mg/day q week
headache - bilateral pressure, bandlike pressure, neck arthritis, neck muscle spasms
tension
headache - unilateral, pulsating, episodic pain
migraine
headache - periorbital, nighttime unilateral non-pulsating pain
cluster
hematuria can be caused by
infection
menstruation
vigorous exercise
viral illness
trauma
hematuria Rx
pain - ibuprofen 400 mg PO 2-6 H prn
UTI - nitrofurantoin 100 mg PO BID 5 days
pyelonephritis - ciprofloxacin 500 mg PO BID 3 days
urethritis - doxycycline 100 mg PO BID for 7 days
hematuria non pharm, labs, imaging, DD
- heat pads, increase fluid intake, avoid coffee/soda/alcohol, encourage frequent voiding
- UA, urine microscopy, CBC CMP
- abd CT
- kidney stones, UTI, urethritis
