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my NPLEX II > board vitals > Flashcards

board vitals Flashcards

1
Q

electronystagmography

A

diagnostic test to record involuntary movements of the eye

dx for vertigo, dizziness, balance dysfunction by testing vestibular system

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2
Q

Dx for acoustic neuroma

A

MRI with gadolinium

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3
Q

BENIGN PARAOXYSMAL POSITIONAL VERTIGO

A

dizziness that comes and goes - lasts less than a min

-lack of hearing loss

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4
Q

MENIERES DZ

A

vertigo: mins to hours
hearing loss
tinnitus

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5
Q

Acoustic Neuroma

Vestibular schwannoma

A

hearing loss, tinnitus, dizziness

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6
Q

Vestibular Neuritis

A

abrupt severe dizziness

nausea/vomiting

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7
Q

Epley maneuver

A

vertigo
rotate head 45 degrees to side that causes worst vertigo
lie pt down while maintaining the head position so that head hangs over table

rotate head to 90 degrees

hold position for 30 secs or until vertigo stops

turn head to opposite side and hold again for 30 seconds

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8
Q

magnesium for:
Bromelain for:
MSM for:
CoQ10 for:

A

decrease muscle hypertonicity and associated spasm

reduce pain if inflammation present

pain relief with osteoarthritis

CoQ10: fatigue, CV disease and reduce deficiency with statin therapy

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9
Q

what test is most indicated to evaluate urethritis caused by gonorrhea or chlamydia

A

NAAT: nucleic acid amplification test

or dNA probe: but dna probe without amplification requires more invasive testing with a urethral swab

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10
Q

what is indicated to diagnose syphilis

A

dark field microscopy

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11
Q

chlamydia v. gonorrhea v. syphilis v. candida balanitis

A

chlamydia: often asymptomatic, can cause urethral inflammation, dysuria, and clear meatal discharge in men
gonorrhea: purulent meatal discharge
syphilis: hard chancre, which later becomes a painless ulcer

candida balanitis: beefy red rash and white patches on the penis with a lot of burning and itching

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12
Q

what is used to tx chlamydia

A

doxycycline

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13
Q

what is drug of choice for syphilis

A

penicillin

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14
Q

Benign prostatic hypertrophy

A

enlarged prostate on DRE
increased urination and urgency
nocturia

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15
Q

Prostatitis

A

low back pain
fatigue
dysuria
tender and BOGGY prostate

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16
Q

Prostate cancer

A

avg age 66
induration and asymmetrical nodules of prostate
fatigue, bone pain, weight loss, hematuria, hematospermia

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17
Q

Tamsulosin

A

BPH
alpha-adrenergic blocking agent

SE: dizziness, headache, rhinitis, abnormal ejaculation

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18
Q

Sildenafil

A

ED

headache, stuffy nose, and hypotension

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19
Q

Metformin

A

type 2 diabetes
insulin-sensitizing drug

SE: digestive upset,B12 deficiency, and lactic acidosis

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20
Q

Prostate HERBS

A 
Serenoa repens (saw palmetto): 5-alpha reductase inhibitor used in BPH 
*5-alpha converts diT to testosterone*

Urtica dioca: prostatic agent used in BPH

Hydrangea: BPH and prostatis
soothing demulcent for urinary tract

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21
Q

prostate size is correlated with

A

fasting glucose levels
reducing sugar intake and stabilizing blood glucose could be helpful

most helpful * limit caffeine and alcohol*

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22
Q

Acute CLOSED-angle glaucoma
v.
Acute OPEN-angle glaucoma

A

closed: medical emergency : immediate tx to prevent blindness
unilateral eye pain, blurred vision, halos around light and a dilated and unresponsive pupil

open: no eye pain
blind spots in peripheral or central vision
often affects both eyes

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23
Q

Acute conjunctivitis

A

profuse tearing
normal pupillary response
mild-burning pain
no change in vision

*eye culture could be helpful

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24
Q

Anterior Uveitis

A 
diminished vision 
moderate-severe pain 
redness
photophobia 
pupillary constriction rather than dilation
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25
Q

slit lamp

goinoscopy

A

used to estimate the width of the angle by shining light beam on the peripheral anterior chamber of the eye

*closed angle glaucoma

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26
Q

tonometry

A

measures intraocular pressure
in open-angle glaucoma

*not typically used for closed-angle

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27
Q

Amslers chart

A

macular degeneration

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28
Q

LATANOPROST

A

*open angle glaucoma
to reduce intraocular pressure

prostaglandin f2alpha analog: increases aqueous fluid outflow

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29
Q

Supplement for glaucoma after stabilized

A

quercetin

tyrosine kinase inhibitor that relaxes the trabecular meshwork tightening ciliary muscle
can prevent recurrence of glaucoma

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30
Q

tx for plantar fasciitis

A

ultrasound: decreased inflammation, breaks up adhesions and promotes healing

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31
Q

cold laser treatment

A

arthritic pain

promotes tissue healing

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32
Q

microcurrent

A

healing after injury

pain reliever

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33
Q

Lontophoresis with mag sulf

A

spasms
sprains
strains

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34
Q

herbs for uncomplicated cystitis

A

zea mays
althea officianalis
arctostaphylos uva-ursi

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35
Q

eupatorium perfolatium

A

diaphoretic and immune and digestive stimulant

affinity for repiratory and gastro system

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36
Q

vitamin A toxicity

A

hair loss, liver damage, bone loss
congenital birth defects
beta carotene safer for pregnancy

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37
Q

Actinic keratosis

A
  • can spontaneously disappear or remain stable fo years without progression
  • SCC can occur! when penetrates through dermoepidermal junction and into the dermis

60% of SCC develop from AK

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38
Q

ZOLPIDEM `

A

sedative and hypnotic

  • dont take 5-HTP (precursor for serotonin)
    can have CNS depressant effects
    drowsiness
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39
Q

Acne vulgaris

A

multiple open and closed comedones with erythema and scarring
face and back

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40
Q

Acne rosacea

A

inflammatory condition
affects middle aged adults
women

erythema and telangiectasis on the face as well as papules and pustules

central area of the face and face flushing
*alcohol aggravates

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41
Q

ISOTRETINON

A

acne, scarring

synthetic retinoid that reduces sebum reduction from sebaceous glands

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42
Q

salicylic acid

A

warts

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43
Q

Hepatoprotective and alterative herbs indicated for inflammatory and hormonal skin conditions (acne)

A

Articum Lappa
Berberis Aquifolium
Rumex Crispus (yellowdock)

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44
Q

Plantago

A

demulcent and vulnerary

indicated for dermatitis, wounds, and ulcerations but not best for acne

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45
Q

SYMPHYTUM

A

demulcent
expectorant
vulnerary
topically for wound healing

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46
Q

SOLIDAGO

A

“golden rod”

antimicrobial and anticatarrhal
upper URI and urinary tract infections

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47
Q

herpes zoster

A

50% of pts have prodrome can begin a few days, up to 3 weeks before SHINGLES vesicles become visible

prodromal symptoms include pain, burning, tickling, itching, tingling
elevated temp, lethargy, hyperesthesia

most common ddx to rule out: contact derm

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48
Q

Erythema infectiosum

A

“fifth disease”
Parvovirus b19
school-aged children

malar rash—> pink lacy rash on trunk and upper extensor surfaces

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49
Q

DECREASES risk of ovarian cancer

A

oral contraceptive use and multiple pregnancies

-decreased ovulation(?)

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50
Q

INCREASES risk of ovarian cancer

A

increased age

nulliparous repro history

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51
Q

Ovarian Cancer

A

women above 60
abdominal bloating, pelvic discomfort, firm adnexal mass

anemia due to blood loss
changes in bowel habits

  • vaginal bleeding in postmenopausal women*
    ddx: CRC and ovarian cysts
52
Q

Bisoprolol

A

beta-1 blocker
negative chronotrope for hypertension and rate control

*TAPER the medication befored/c

sudden cessation= MI, angina, or ventricular arrythmias

53
Q

DX for ovarian cancer

A

laparotomy

54
Q

Diagnostic marker for ovarian cancer

A

Serum CA-125

specific to ovarian cancer. elevated in 80% of advanced malignant tumors, however, this marker is non-specific to ovarian cancer and can also be elevated in endometriosis, inflammatory bowel disease, and several other conditions.

55
Q

TRICHOMONIASIS

A

green frothy vaginal discharge

cervical pain and inflammation

56
Q

Diagnostic for trich

A

saline wet mount

pear-shaped flagellated organisms

57
Q

tx for trich

A

metronidazole
antiparasitic and antibacterial
(gardnerella= BV)

58
Q

cyclobenzaprine

A

flexeril- muscle relaxant

59
Q

Hypericum

A

upregulation of serotonin
increasing GABA and dopamine
increase NE

60
Q

WHIFF TEST

A

10% potassium hydroxide to microscope slide with discharge

fishy odor= + = trich or BV

61
Q

flagellated organisms vs clue cells on microscopic exam

A

flagellated= trich

clue cells= BV

62
Q

what vaccine is the only immunization conventionally scheduled at birth

A

HEP B

varicella and MMR: minimum 12 months, 2nd dose at 4-6 years

meningococcal: age 4-6 : high risk

63
Q

Placenta Previa

A

painless bright red uterine bleeding without uterine cramping in late stages of pregnancy

implantation of placenta over or close to the cervical internal os

f/u with ultrasound
*hospitalization with rest

64
Q

fibrocystic breast changes

A

never been pregnant
early menarche
first birth after age 30

*US for women under 35
dif between solid or cystic lump

65
Q

what lifestyle factor is closely related to fibrocystic changes

A

caffeine

vitamin E helps and lymphatic massage of axilla

66
Q

Vitex agnus-castus

A

decreases prolactin secretion and increases progesterone

binds to dopamine receptors in the pituitary gland which decreases prolactin
=increased growth of corpus luteum

increases ratio of LH:FSH = balance progesterone to estrogen ratio

good for estrogen dominance

67
Q

lactational mastitis

A

infrequent feedinfs and breast pumps

clogged duct and nipple cracking allows bacteria in

68
Q

tx of lactational mastitis

A

CEPHALEXIN
first gen cephalosporin to target S AUREUS
breastfeeding

69
Q

budenoside

A

corticosteroid

70
Q

Rifampin

A

TB

71
Q

vancomycin

A

severe infection

72
Q

reduce re infection in lactational mastitis

A

frequent feedinfs and improved breast feeding techniques to empty the breast milk

73
Q

PHYTOLACCA AMERICANA

A

CONTRAINDICATED for topical use of mastitis
would cause mucosal inflammation and diarrhea

can take orally or remove by washing cause it can be helpdul with mastitis

74
Q

Galega officinalis and Trigonella

A

galactagogues improving secretion of milk

ok in pregnancy

75
Q

echinacea

A

anti microbial

ok in pregnancy

76
Q

varicella zoster virus

A

chickenpox
incubation 10-21 days

varicella lesions: appearance of dewdrop on a rose petal

lesions appear centrally and then spread sitally

77
Q

what is the test for varicella zoster

A

direct flourescent antibody test

rapid results

78
Q

acyclovir

A

antiviral

79
Q

clomitrazole

A

antifungal

80
Q

penicillin

A

beta-lactam antibotic

81
Q

tetracycline

A

bacteriostatic antibiotic

82
Q

Basal Cell Carcinoma

A

*most common skin cancer type
dome shaped nodule with pearly borders
recurrent bleeding and crustinf in a pt with fair skin

hx of working outdoors

83
Q

SQUAMOUS CELL CARCINOMA

A

non-healing red scaling or crusting papule or plaque that can have a rough surface

84
Q

Karposi’s sarcoma

A

malignancy
HSV 8
usually found in people with AIDs
multiple purple-black macules which grow and coalesce into nodules

85
Q

SUMATRIPTAN

A

migraine headaches
works on 5HT serotonin
**c/i in pts with ischemic heart disease due to vasoconstriction

86
Q

Pityriasis rosea

A

herald/annular patch with central clearing

christmas tree distribution of macular eruptions

papulosquamous eruption

87
Q

Pityriasis alba

A

hyperpigmented scaly 1-4 mm macules on face in children

88
Q

Classic vs Common Migraines

A

classic: *must include a visual or sensory aura with the headache
common: must include nausea/vomiting and hypersensitivity to light and noise in addition to headache

89
Q

TINEA VERSICOLOR

A

multiple coalescing pale-covered macules, usually on the torse

fungus: Malazzezia furfur : normal part of skin flora
* not contagious*

more common in teens and adults who have a lot of sebaceous secretions, diabetes, pregnancy

KOH prep=”spaghetti and meatballs”
-long curved strands of hyphae and budding yeast cells

fluoresces under Woods Lamp

90
Q

“dewdrops on rose petals”

A

chicken pox (varicella zoster)

91
Q

“chandelier sign”

A

extreme tenderness on palpation or movement of the cervix = Pelvic inflammatory disease

92
Q

“orange peel sign”

A

peau d’orange

dimpling of akin of inflammatory or cancerous breast tissue

93
Q

IMPETIGO

A

skin infection with oozing

honey-colored crusting eruptions

94
Q

TINEA CORPORIS

A

ring-worm with well-demarcated erythematous oval itchy plaques with raised edges

95
Q

SCABIES

A

itchy and highly contagious skin condition

*SARCOPTES SCABEI skin mite which lives in clothing and bedding

96
Q

THUJA (botanical)

A

strong anti-fungal topically

97
Q

TERBINAFINE

A

anti-fingal

98
Q

AZITHROMYCIN

A

macrolide antibacterial drug

99
Q

DOCUSATE

A

stool softener for constipation

100
Q

TEMEZEPAM

A

benzodiazepine for sleep and anxiety

101
Q

PACLITAXEL

A

malignant melanoma

-has been used as monotherapy as well as in combination with CARBOPLATIN

102
Q

BROMOCRIPTINE

A

ergot derivative and potent dopamine agonist used to treat hyperprolactinemia-associated dysfunctions, acromegaly, and parkinsons dz

103
Q

MALIGNANT MELANOMA

A

ABCDE
“ugly ducking” sign : one mole among many that sticks out and looks different

chronic used of steroids can actually increase risk

refer for full-thickness incisional biopsy

104
Q

Koebners response or phenomenon

A

appearance of lesions along the site of injury and can be seen in psoriasis, lichen planus, molluscum contagiosum

105
Q

Auspitz

A

punctate bleeding after scraping scales in psoriasis

106
Q

Nikolskys sign

A

Pemphigus Vulgaris

normal epidermis seperates from the basal layer when rubbed and blister forms quickly

107
Q

DERMATITIS HERPETIFORMIS

A

autoimmune skin condition associated with celiac disease, which is common with type I diabetes and other autoimmune like SLE or sarcoidosis

108
Q

what is elevated in celiac dz

A

anti-endomysial antibodies

109
Q

long-acting form of insulin

A

insulin glargine
onset 1-2 hours
has effects for 20-24 hours

110
Q

insulin aspart and insulin lispro

A

rapid-acting within 10-20 mins before meal and lasts 3 hours

111
Q

regular insulin

A

30-60 mins

lasts 5 hours

112
Q

herb that is an immune modulator with

  • affinity to the liver
  • some research supporting help with chronic HEP B
A

SCHISANDRA CHINENSIS

113
Q

risks of head and neck SQUAMOUS CELL CARCINOMA

A 
knat or tobacco chewing
tobacco smoking 
heavier alcohol consumption 
EBV 
HPV
114
Q

what is BURKITTS LYMPHOMA

A

rare EBV-associated cancer of the jaw seen mostly in African boys and those who are immunosuppressed

115
Q

Most common form of non-hodgkins lymphoma

A

diffuse large B-CELL lymphoma

116
Q

tx of psoriasis

A

hydrocortisone
oral prednisone in severe cases

vitamin D: anti-inflammatory and immune modulation

vitamin A: impt in skin conditions: cellular replication and immune function

zinc: necessary nutrient for DNA and protein synthesis : promotes normal keratinocyte production in chronic skin dz

117
Q

Berberis aquifolium

A

alterative and hepatoprotective actions

psoriasis

118
Q

Smilax

A

alterative and antipsoriatic herb used in chronic skin conditions
psoriasis

119
Q

Achillea millefolium

A

yarrow

bitter digestive stimulant
styptic

120
Q

Centella asiatica

A 
gotu kola 
vulnerary
antipruritic 
skin
brain function

*avoid in liver dz

121
Q

Calendula off

A

vulnerary
antipruritic
skin

122
Q

Matricaria recutita

A

chamomile
anti-inflammatory
anti-allergic
vulnerary

*atopic derm

123
Q

Urtica dioica

A

prostate conditions

124
Q

Symphytum officinale

A

demulcent

vulnerary

125
Q

REYES syndrome

A

rare but serious - swelling of liver and brain
children and adolescents recovering from viral infection and aspirin use
do not use aspirin during viral infection

126
Q

metabolic syndrome

A 
waist circum over 35 in 
triglycerides over 150 
hdl under 50 
glucose over 100 
blood pressure oer 130/85
127
Q

UBIQUINOL

A

co - q- 10

important for statin meds
statins inhibit enzyme HMG-CoA reductase, responsible for cholesterol biosynthesis and CoQ10 production in the mitochondria

CoQ10 can help precent adverse effects of myalgia, rhabdomyolysis in patients taking statins

my NPLEX II (28 decks)

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