9 Flashcards by Kelly MacWhorter

sequence of meds for increasing severity of asthma

1) SABA
2) SABA + ICS
3) SABA + ICS + LABA
4) SABA + ICS + LABA + po CVS

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What is the treatment for asthma exacerbation?

Nebulizer + Steroids

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What is the role of HIDA scan in gall bladder disease?

Allows you to visualize perfusion and see whether there are blockages

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What are 3 colon genetic syndromes?

FAP, Lynch Syndrome, Peutz Jeghers

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What are the 3 main cancers associated with Lynch Syndrome (mutation in DNA mismatch?

CEO - Colorectal, Endometrial, Ovarian

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What 3 labs are helpful when diagnosing hemolytic anemia?

LDH, haptoglobin, bili

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Who should be screened for DM?

> 45 y/o, BMI > 25, HTN

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What fasting BG and A1C are pre-diabetes?

BG 100-125 and A1c 5.7-6.4

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A patient is diagnosed with DM based on A1C of 9.5 What is appropriate treatment?

If A1C > 9 then start tx with INSULIN

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What are SE of Metformin?

Lactic acidosis, Diarrhea

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SE of Sulfonylurea?

Hypoglycemia, espeically susceptible if kidney disease since renally cleared

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What is the equation for anion gap?

AG = ( Na + K ) - ( Cl + HCO3 )

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A kid has bone aches, nose bleeds and bruises. What should you be thinking of?

AML

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What are some structural causes of abnormal uterine bleeding?

PALM = Polyps, Adenomyosis, Leiomyomata, Malignancy/Hyperplasia

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What is the Rotterdam criteria for PCOS diagnosis?

Polycystic ovaries by US
Hyperandrogenism (hirsutism, acne)
Dysmenorrhea

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What does SIGECAPS stand for in depression screening?

Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor retardation
Suicidality

You are contemplating diagnosis of dementia for a patient. What sort of workup should you do to rule out other causes?

Depression screen (can look like and can be a co-morbid condition)
complete blood counts
basic chemistries
calcium
thyroid
vitamin B12 deficiency testing
folate deficiency
syphilis testing 
neuroimaging - brain MRI good place to start

3 most common causes of dementia?

Alzheimers, vascular dementia, dementia with lewy bodies

What is the name of frontotemporal dementia presenting with changes in personality, demeanor, and behavior?

Picks disease

Differentiate delirium from dementia?

Delirium symptoms fluctuate over short periods of time, whereas dementia is a gradual decline

What bedside instrument can help diagnose delirium?

Confusion Assessment Method (CAM)

Which two tests can help assess cognitive function?

MMSE, MoCA

Are the following IADLs or ADLs?
shopping

preparing meal
using the telephone
managing transportation needs
managing medications
managing finances

IADLs - skills required for independent living

What is arcus senilis?

Grayish ring around eye. Common finding in elderly, and also seen in younger patients with hypercholesterolemia

What makes up the mini-cog?

composite of the three-item recall and clock drawing

Describe the Mini-Cog.

Ask the patient to remember 3 words. Have patient draw a clock with the clock face representing 10 past 11. Then ask the patient to recall the 3 words.

Patient presents with acute worsening from baseline dementia. What is on your differential?

``` Depression Electrolyte abnormalities UTI Urinary retention URI Pain Withdrawal Acute Cerebral Vascular Event Adverse drug effects ```

What are some examples of electrolye abnormalities that can lead to delirium?

hypo or hypernatremia, hypercalcemia, hypokalemia, and metabolic acidosis

What post void residual is normal?

< 100 ml

A demented nursing home patient is having urinary incontinence. What is your ddx?

UTI or urinary retention secondary to medications or BPH with secondary overflow incontence

What is a good empirical antibiotic treatment of UTI?

Ceftriaxone and cephalexin

You place a patient with delirium on haloperidol to decrease hallucinations and agitation. What are some side effects to watch out for?

Sedation, constipation, tardive dyskinesia (involuntary spasms of the neck, tongue and lips - high doses for long periods), QT prolongation

What medications have a role in treatment of Alzheimers and symptoms?

cholinesterase inhibitors (donepezil, rivastigmine, tacrine and galantamine) Vitamin E Memantine Atypical Antipsychotics for ebhavioral disturbances - olanzapine (Zyprexa) and risperidone (Risperdal)