Test 8 Flashcards
Smoking cessation
Varenicline is the most effective pharmacologic intervention for smoking cessation; combination of varenicline with nicotine replacement therapy increases it’s effects even further, without serious adverse effects. Combination therapy is associated with mild adverse effects, such as nausea, insomnia, and mild skin reactions.
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Foreign body ingestion
Any sharp object in the esophagus should be removed emergently by flexible endoscopy.
Ear trauma
Blunt trauma to the ear can cause an auricular hematoma, which is a collection of blood between the perichondrium and cartilage of the outer ear. Prompt evacuation of the hematoma is required to avoid complications of infection, avascular necrosis, and permanent cauliflower ear deformity.
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Androgenic steroids
Anabolic-androgenic steroids are used to improve physique and athletic performance but are associated with numerous adverse effects, including mood and behavior changes. Findings may include acne, hirsutism, bilateral temporal hair loss, voice deepening, gynecomastia, clitoromegaly, testicular failure, ovarian dysfunction, hepatic dysfunction, altered lipid profiles, and erthyrocytosis.
Patient confidentiality
The genetic information nondiscrimination act prevents insurers and employers from requiring or requesting genetic testing results from their participants or employees. If an employer already has genetic testing information, the law prevents the employer from using the information to discriminate against the employee.
SIADH
Hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by low serum osmolality (<275 mOsm/kg H2O), inappropriately high urine osmolality (>100 mOsm/kg H2O), and high urine sodium concentration (>40 mEq/L) in the setting of clinical euvolemia. PNA and a # of psychiatric medications (eg, selective serotonin reuptake inhibitors, carbamazepine, valproic acid) are common precipitants of SIADH.
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Decision making capacity
Patients with decision-making capacity have the right to refuse medical tx. When there is concern that a patient does not understand the consequences of refusing tx, a formal assessment of decision-making capacity is indicated.
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Infectious Mononucleosis
Epstein-Barr virus infectious mononucleosis is typically a self-limited illness treated with supportive care and nonsteroidal anti-inflammatory drugs. Sx generally resolve within weeks (other than fatigue, which persists for months). Antimicrobial therapy is not indicated.
Airway obstruction may develop during the course of infectious mononucleosis, with signs such as difficulty breathing, tachypnea, and inability to swallow. Although corticosteroids are not indicated in the classic self-limited cases of infectious mononucleosis, they are indicated in cases in which severe complications (airway obstruction, overwhelming infection, aplastic anemia, thrombocytopenia) develop.
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PID
Having multiple sexual partners is associated with the highest increase in risk for PID. Other risk factors include being age 15-25, previously having PID, inconsistently using barrier contraception, and having a partner with a sexually transmitted infection.
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Sickle cell
Acute sickle hepatic crises (vaso-occlusion) can present during pregnancy with fever, nausea, vomiting, right upper quadrant pain, and elevated transaminases. Vaso-occlusive episodes are more common in pregnancy and are associated with an increase in maternal and fetal morbidity.
Vitamin b12 deficiency
HY
The 3 main components of autoimmune metaplastic atrophic gastritis (AMAG), which is associated with pernicious anemia, are glandular atrophy, intestinal metaplasia and inflammation. Atrophy affects mainly the gastric body and fundus. Typically, little changes are observed in the gastric antrum.
