Women's Health/Primary care COMPS Flashcards
general anxiety disorder
persistent excessive incapacitating worry, associate with 3 or more symptoms – restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance.
panic disorder
intense, brief, acute anxiety, associate w/ 4 or more symptoms – palpitations, sweating, tremblings, SOB, choking sensation, chest pain, abdominal distress, dizziness, derealization, fear of losing control, fear of dying, paresthesia, chills/hot flashes,
Buspirone
anti-anxiety agent, nonbenzodiazepine
s/e : nausea, dizziness, HA, restlessness, DO NOT use with MAOIs or Cytochome P450 effect.
Depression
presence of at least 5 symptoms for 2 weeks and presence of the 1st or 2nd symptoms
sad or depressed mood most of the day, every day
loss of interest in usual activities
fatigue, weight gain/loss, sleep disturbance, difficulty concentrating, feelings of worthlessness/guilt, psychomotor retardation/agitation, suicidal ideation
SSRI
fluoxetine, sertraline, paroxetine, citalopram, escitalopram
first choice for depression
Fibromyalgia
widespread pain for more than 3 months and pain on palpation in at least 11 or 18 selected tender points
management: low impact exercise, hot/cold therapy, massage, biofeedback, hypnotherapy, strength training. mild analgesics SSRI & SNRI: Duloxetine pregabaline tramadol
HTN
BP 140/90 or higher dx before pregnancy, before 20 weeks GA, or after 12 weeks postpartum.
management of HTN
stable mild CHTN can be co-managed with physician
Diuretics should not be used in pregnancy
1st choice antihypertensives include labetalol or hydralazine
fetal surveillence: monitor for IUGR, NSTs, AFI/BPP
intermittent asthma
mild asthma
> 2days/week
night wakening: 3-4x/month
interference with ADLs: minor
treatment: low dose ICS
moderate asthma
daily
night wakening: >1x /week
interference with ADLs: some
treatment: low dose ICS & LABA or medium-dose ICS
severe asthma
throughout the day
night wakening : often 7x/week
interference with ADLs: extreme
treatment: high dose ICS & LABA and possibly oral corticosteroid.
stye
abrupt onset
normal vision, red and tender eyelid, boil-like lesion on eyelid
treatment: warm compresses
chalazion
non-abrupt onset, may of history of occurrence
normal vision, non tender cyst
warm compresses, may need I & D
refer
Blepharitis
hx of allergy or other dermatologic condition
normal vision, conjunctival inflammation, eyelash loss
treatment: eyelid hygiene (baby shampoo BID) send eye culture, antibiotics based on culture results
allergic conjunctivitis
watery eyes
diffuse redness, tearing
antihistamines, eye drops
bacterial conjunctivitis
exposure to others with similar complaints
sudden onset, diffuse redness, purulent d/c
treatment: antibiotics
viral conjunctivitis
current URI, exposure to other with similar symptoms
diffuse redness, blurry vision, tearing, clear watery discharge.
treatment: cool compresses.
retinal detachment
spots before eyes, flashes of light, sudden loss of vision, no pain or redness
loss of portion or whole vision field
refer to ophthalmologist
acute otitis media
fever, tinnitis, vertigo
external ear canal wnl, tympanic membrane BULGING, red, opaque
treatment: antibiotic
Otitis media with effusion
fullness in ear, tinnitus on affected side, hearing loss
external ear wnl, tympanic membrane bulging
referral if not heal
bulgin myringitis
possible serous or bloody d/c, hearing loss, tinnitus
intra-epithelial fluid pockets of tympanic membrane
referral to ENT
TMJ
feeling of ear fullness, tinnitus, dizziness, pain with eating
ear exam wnl, click with opening mouth, palpation of joint produces pain
discuss lifestyle management options
otitis externa
pruritis of outer ear, pinna pain, prolonged water exposure
external ear lots of d/c, edema and redness of canal, tympanic membrane clear & not bulging
treatment: antibiotics if bacterial is suspected
