Bronze Review Flashcards
(208 cards)
1
Q
If a patient has a fever, chills, nausea, rash on forearms and ankles, palms, and soles of feet after hiking or camping in the mountains
A
-Rocky Mountain spotted fever
2
Q
How do you treat RMSF
A
-Doxycyline
3
Q
Middle age lady has been out in the yard, long grass, has target bulls eye rash what is the likely diagnosis
A
- lyme
- Erythema migrains
4
Q
Middle-aged man notes a lesion on arm with irregular borders, different colors, with some black. What is the likely diagnosis?
A
-melanoma
5
Q
Slivery white scales on an erythematous base that are pruritic
A
-psoriasis
6
Q
Koebner phenomenon
A
when there is a trauma and a scab forms but psoriatic plaque forming over top
7
Q
Auspitz sign
A
If you take a psoriatic plaque and it starts pinpoint bleeding
8
Q
Mom brings in 5 year old child. Child is complaining of itching, mostly at night, interdigital burrowing happening
A
scabies
9
Q
What tx or instructions do you give for scabies
A
- permethrain cream
- treat close contacts
- wash everything in VERY hot water
10
Q
Atopic triad is
A
- allergies
- asthma
- atopic dermatitis
11
Q
Mom brings in 10-year-old child, who is scratching his leg, notes a ring with central clearing that is pruritic
A
-tinea corporis
12
Q
Actinic keratosis is the precursor
A
SCC
13
Q
Where do you usually see actinic keratosis
A
- sun-exposed area
- face
- nose
- ears
14
Q
Actinic keratosis is
A
-a dry, pink, raised lesion
15
Q
How do you treat actinic keratosis
A
5-FU cream
Cryotherapy
16
Q
What is the gold standard for diagnosing skin lesions
A
-punch biopsy
17
Q
Black or tan lesion that looks pasted on the skin, waxy, wart-like
A
seborrheic keratosis
18
Q
What is cellulitis
A
- A skin infection
- Reddened
19
Q
If you have a patient with diabetes and cellulitis you are concerned for:
A
-osteomyelitis
20
Q
PAD presentation
A
- intermittent claudication (feels better at rest, painful when walking)
- feels better when dangling
- shiny
- hairless
- no edema
21
Q
What is the test for PAD
A
ABI
22
Q
What is an ABI diagnostic level for PAD
A
<0.9
23
Q
What is 1 thing PAD patients must do?
A
-STOP smoking
24
Q
Venous insufficiency presentation
A
- edema
- discoloration: leg is red/purple/dark
- varicose veins
25
What is happening in varicose veins and what is the risk associated with this?
- Blood is pooling
| - risk for DVT
26
Erysipelas treatment
-penicillins (usually dicloxacillin)
27
Erysipelas
-well-demarcated rash on the face, like cellulitis of the face
28
If you have inflamed/infection skin you would consider
Keflex/Cephalosporins/Penicillin
29
Mastitis treatment and education
Keflex or Penicillin
| -educate to continue to breastfeed
30
What is the treatment of MRSA
BCD
- Bactrim
- Clindamycin
- Doxycycline
31
If your patient is pen allergic, what medications would you give
Macrolide (ie. Azithromycin)
32
Whats the most common skin cancer
BCC
33
What does BCC look like
- Pearly
- Waxy
- Ulcerated center
34
Patient presents at 7 years old with a dome-shaped lesion, belly button looking, white plug, umbilication
-Molluscum contagiousum
35
If you see molluscum contagiosum in the genital region of children you need to
-consider abuse and report
36
The maculopapular vesicular rash starts on the trunk and spreads to heads, pruritic
Varicella (chickenpox)
37
Patients with varicella can return to regular activities when
lesions have crusted over
38
Acne 1st line treatment
-Topicals (Benzoyl Peroxides)
39
Acne that is not improved by topicals you will next implement
-Oral antibiotic (Tetracyclines)
40
If acne is not improved by topical or oral antibiotics, then you want to consider
-refer to derm for accutane
41
If patient is experiencing skin irritation from acne treatments suggest
- decrease frequency
| - sun safety
42
Honey crusted lesions
Impetigo
43
How is impetigo treated
Mupirocin (Bactroban)
"iMpetigo and Mupirocin"
44
Scarlet Fever or Scarletina rash
sandpaper rash
45
Herald patch that starts on truck that then turns into a Christmas tree pattern
-pityriasis rosacea
46
1st-degree burn
| and treatment
- redness, stinging and burning
| - cold water, ice, topical burn cream or gel
47
2nd-degree burn and treatment
- partial-thickness
- redness
- blisters form** (BUZZWORD)
- pain
- tx: Silver, abx ointment, don't pop blister
48
3rd-degree and treatment
- full-thickness
- painless
- go to ED
49
Rule of 9's in burns adults
- Chest 18%
- Back 18%
- Arms: 9% each
- Head (front and back)= 9%
- Legs: 18% each
- Perineum 1%
50
Rule of 9's in burns children
- Head (front and back) 18%
- Back 18%
- Chest 18%
- Arms 9% each
- Legs 13.5% each
- perineum 1%
51
Marijuana lowers ____ count
sperm count
52
Cocaine can cause ____ bleed
nosebleeds
53
Macular degeneration is a loss of ____ vision
Central
54
Patient presents with eye pain, cloudy cornea, tearing, halos what is the dx and mgmt
- acute angle closure
| - "close the door" get them to the ER
55
What should the intraocular eye pressure be?
8-21
56
Patient presents saying they are seeing floater, flashes and like someone has closed the curtain on their vision
-retinal detachment
57
A cauliflower-like growth in the ear and the management
Cholesteatoma; refer to ENT
58
Ulceration on the inside of cheek or lip
-stomatitis
There is viral and apthous
-viral is multiple
-apthous is just 1
59
Optic disc that is swollen with blurred edges what is this?
-Papilledema
60
What is the underlying disease process in papilledema?
-Hypertension
61
When the artery in the eye crosses over the vein this is called
AV nicking; decreased blood flow to the eye; can have blurry vision or diplopia
62
AV nicking is seen in
hypertension
63
Whats the first thing to do if you have a patient present with a visual complain
-visual acuity
64
Koplik spots are associated with
Measles (Rubeola)
65
Measles presents with ___ and the 3 c's
Fever +
- conjunctivitis
- cough
- coryza
and koplik spots
66
sensorineural hearing loss is always categorized y a ____ because conductive is simply a blockage
drug or otoxic drug
67
Meniere's disease presents with
- vertigo
- tinnitus
- N/V
- nystagmus
- hearing loss
68
Weber lateralizes to ____ in conductive hearing loss
affected ear in conductive hearing loss
69
Rinne in the affected ear will be ____ in conductive
BC > AC
70
Weber lateralizes to ____ in sensorineural hearing loss
opposite ear
71
Rinne will be ____ in sensorineural loss
Normal
72
First line treatment for otitis media is
amoxicillin
73
If patient has had an antibiotic within 30 days and has OM treat with
Augmentin
74
What is the main organism that causes OM
-Strep pneumo
75
OME is treated with
decongestant
76
How is OE treated
Corticosporin drops
77
Xanthelasma is
Lipid deposits around the eye
78
Allergic Conjunctivits presents like
- bilaterally
- tearing
* *Stringy mucous
79
Bacterial Conjunctivitis presents like
- unilateral can go to bilateral (cross contamination)
- profuse tearing
- a lot of excuadte
- yellow crusted
80
What is the test for mono
- mono
| - heterophile
81
Viral conjunctivitis presents like
- unilateral but can go to bilateraly
- a little tearing
- not a lot of exudate
82
Mono presents with
- fatigue
- pharyngitis
- cervical lymphadenopathy
- enlarged spleen
83
Mono patients can return to physical activity
when spleen is no longer enlarged ~`4-6 weeks; check by ultrasound
84
Viral rhinitis first-line treatment is
intranasal corticosteroid spray
85
You can only use afrin for ___ days otherwise patients will experience
3 days or less; rhinitis medicamentosa
86
Mitral Regurgitation
- Systolic
| - Harsh, loud, blowing
87
Mitral Stenosis
- Diastolic
| - soft, blowing
88
What murmur radiates to the axilla
-Mitral Regurge
| MR wants to be the head but hes not
89
When will you hear S3
- pregnancy
| - CHF
90
When will you hear S4
- elderly
| - left ventricular hypertrophy
91
What is the treatment for ISH
-CCB
92
An EKG with a prolonged PR interval is
A 1st degree block
93
An EKG with no P wave is
atrial fibrillation
94
Thiazides benefits and AE
-stimulates osteoclasts good in osteoporosis
- Hyperglycemia
- Hyperuricemia
- Hypertriglycerides
95
Metabolic sydrome
Have at least
- Hypertension
- DM
- Hyperlipidemia
- Waist circumference >40 in men; >38 in women
96
What is the presentation with endocarditis
- fever
- chills
- osler nodes (only on 1 digit)
- janeway lesions (on palms)
- Splinter hemorrhages on the finger nails
97
Asthmatic patient presents with a BP drop of 10mmHg or more on inspiration
-pulsus paradoxus
98
If a patient has diabetes what is 1st line for hypertension
ACEi or ARBs (renal protective)
99
If a patient has BPH and hypertension what would you give
Hytrin
100
What is 1st line in Raynaud's
CCB
101
In a patient with GERD and hypertension what medication do you not want to give?
CCB
102
Would you give CCB to a patient with CHF?
No
103
In patients with gout or kidney stones what hypertensive medications would you not want to give
Thiazide diuretics
104
What hypertensive medication is contraindicated in COPD
Beta Blockers
105
If you put a patient on a statin you need to avoid ___ juice
Grapefruit juice
106
Group A COPD minimally symptomatic low risk of exacerbations treatment
SABA or in combination with SAMA
107
Group B COPD more symptomatic but low risk of exacerbations
LAMA or LABA or SABA PRN
108
Group C COPD minimally symptomatic but high risk for exacerbation
LAMA is first line; SABA for sx relief
109
Group D COPD
Refer
110
If a COPD patient has poor symptom relief with a SAMA (ipratropium) then you should add
SABA
111
Intermittent asthma 1st line treatment
SABA
112
Mild asthma 1st line treatment
low dose ICS
113
Moderate asthma 1st line treatment
low dose ICS + LABA
114
Mod to Severe asthma 1st line
Med dose ICS = LABA
115
GINA Stepwise approach to asthma
- Step 1 (Sx <2x/mth): Low dose ICS- formoterol PRN
- Step 2: (sx >2x/mth but less than daily) Low dose ICS-Formeterol daily
- Step 3 (sx daily, waking with asthma 1x/wk or more) low dose ICS + LABA, or med dose ICS + Laba or low dose ICS + LTRA
- Step 4: Refer
116
CURB-65
-Confusion
-Urea (>19.6)
-Respiratory (>30)
-Blood pressure >90/60
Age >65
117
If you hear a bruit you should consider the following diagnosis
- renal vascular hypertension
| - renal vascular stenosis
118
A TB test induration of 5mm is + in
HIV; Immunocompromised; recent exposure
119
A TB Test induration of 10mm is + in
Migrant farmers; healthcare workers and immigrants
120
If you find a single nodule on a thyroid it is more likely to be ____ than multinodular
malignant
121
An A1C >9 you should
start basal insulin
122
Addison disease presents like
- hyperpigmentation (bronzing skin)
- Salt craving
- thin
- low cortisol levels
- low sodium (sodium follows cortisol)
- High potassium (has inverse relationship with sodium)
123
Cushing presents like
- obesity
- buffalo hump
- fatigued
- high cortisol levels
- High sodium levels
- Low potassium
124
Dawn phenomenon management
manage with night time insulin
125
Somgyi phenomenon management
- is a dip and it goes back up think backwards S
- manage by giving them a snack before bed
- decrease nighttime insulin
126
Currant jelly stools and sausage shape mass
-Intussception
127
Projectile vomiting and olive shape mass
-pyloric stenosis
128
Pencil thin stools signify
-descending colon cancer
129
CKD labs will show
- Hyperkalemia
- Elevated Creatinine
- eGFR will be low
130
Urge
Stress
Overflow
Functional
Incontinence
- Urge: Strong urges to go, need to go now
- Stress: Increased intra-abdominal pressure
- Overflow: Difficulty emptying the bladder (think BPH)
- Functional: Inability to make it to the bathroom (think like disability or injury)
131
Child with uti consider ordering
U/S
132
Pyelonephritis key finding in the UA
- Nitrates +
| - WBC with casts***
133
glomeurlonephritis key finding in the UA is
RBC casts
| and proteinuria
134
Trigeminal nerve is cranial nerve #
5
135
Which cranial nerves control occular movement
3,4,6
136
Shoulder shrugs is cranial nerve
8
137
Cranial nerve ___ is indicated in bells palsy
7
138
Cranial nerve ___ is smell
1 (1 nose)
139
What is the treatment for cluster headache
100% O2 at 12L x 15 minutes
140
What can you use to prophylactically treat a migraine
propranolol
141
What are abortive treatment for migraines
Triptans
142
How do you dx fibromyalgia
-need 11 out of 18 tender points for 3 months
143
Subarchnoid hemorrhage what is the key finding
-WORSE HEADACHE OF MY LIFE
144
Subdural hemorrhage the neuro exam is ____ and how do you dx
Positive; CT
145
What labs will you order to distinguish between Dementia and Delirium
CBC, CMP, TSH, UA, Folate and B12
146
Alzhemiers
Lewy Body
Vascular
- Alzhemiers: affects frontal lobe think loss of executive function
- Lewy body : mimics parkinsons; postural tremors, instability
- Vascular: mimics alzheimers but due to a vascular event (like after a stroke)
147
Shoulder, hip, pelvic girdle pain, elevated ESR/CRP what is this
polymyalgia rheumatica
148
How is polymyalgia rheumatica treated?
High dose steroid
| can be up to 9-12 months
149
If polymyalgia rheumatica patient has sudden vision loss what do they likely have
-temporal arteritis
150
What is gold standard for sickle cell and thlassemia
hemoglobin electrophoresis
151
Bicep tendon rupture presents with
- arm pain
| - big bulge
152
What is 1st line treatment for OA
Acetaminophen
153
What is 1st line for osteoporosis
Bisphosphonates
154
Symmetrical joint swelling, takes a while to get moving in the morning >1 hr, morning stiffness
RA
155
What is 1st line treatment for RA?
NSAIDs
156
Shin splint education
RICE, anti-inflammatory
157
Burning and numbness between 3/4th metatarsal
Morton's neuroma
158
Vit D is recommended at ____ units for those 19-70
600 units
159
How much calcium is recommended per day
1200
160
Atypical antipsychotics
Risperdal
Zyprexa
Seroquel
161
With atypical antipsychotics you need to check
- weight
- BMI
- blood glucose
162
Serotonin syndrome presents like
- high fever
- hyperreflexia
- tachycardia
- muscular ridgidity
163
What is the #1 reason men stop taking psych meds
ED
164
What is the #1 reason women stop taking psych meds
Weight gain
165
Herbal treatment for anxiety and sleep
Kava Kava
166
Acute prostatitis presents like
- Suprapubic and perineal pain
- flu like symptoms
- warm and boggy prostate
167
The prostate exam on a patient with BPH
- firm
| - symmetrically enlarged
168
If you just wanted to shirk the prostate you can use
Proscar
169
If you want to use a natural herb for BPH
Saw palmetto
170
Ectopic pregnancy presents with
- spotting
- jarring movements are painful
- hypotensive
171
What is natural estrogen treatment
- Black cohosh
- Isoflavone
- soy beans
172
In postmenopausal bleeding you will need to order
- transvaginal ultrasound
| - endometrial biopsy
173
LSIL management
- 21-24: watching and repeat in 12 months
| - 25+: colposcopy
174
HSIL
Colposcopy for everyone
175
Suspected galactorrhea order
Prolactin
176
What is 1st line treatment for UTI
Macrobid
177
Screening tests for syphillis
VDRL
| RPR
178
What is the confirmation test for syphilis
FTA-ABS
179
5ths disease or erythema infectiosum is caused by
parvovirus B19
180
Slapped cheek, lacy rash is
5th's disease or erythema infectiosum
181
Positive signs of pregnancy
you verified these !!
- Fetal Heart Tones
- Ultrasound
182
Probable signs of pregnancy
- Hegars sign
- Chadwicks
- Urine pregnancy tests
183
Presumptive signs of pregnancy
(verified by mom)
- fetal movements
- weight gain
- nausea/vomiting
- breast tenderness
184
Fundus above symphilis pubis occurs at
12 Weeks
185
Fundus at the umbilicus
20 weeks
186
Give rhogam at ____ and ____
28 weeks and 72 hours
187
What test, tests mom and baby antibodies
Coombs
188
When there is a traumatic delivery, or there is a resulting cephalohematoma then you should consider that the baby is at risk for
-Elevated bilirubin levels
189
Where will you see jaundice first
-sclera
190
Where will you see cyanosis 1st
-mouth/mucous membranes
191
When do anterior fontanelles close
15 to 18 months
192
Posterior fontanelle closes at
2-3 months
193
If you see white eye when trying to elicit red reflex
-leukocoria
194
Neuroblastmoas do they cross the midline
Yes
195
Babies weight doubles at ____ months and triples at _____
6 months and triples at 1 year
196
Legg-Calve-Perthes (avascular necrosis or osteonecrosis)
+ Trendelenburg test
197
What cardiac finding in marfans
MVP click
198
Klinefelter's syndrome
- wider hips
- smaller penis
- smaller testicles
- softer features
- worry is infertility
199
Turner's
-ovarian failure (concern is infertility)
-webbed neck
-
200
If your parents are heterogeneous for sickle cell what is the percent chance you will have it
25%
201
At 2 months babys are expected to
Coo
202
At 4 months babys are expected to
Smile spontaneously
Babble
Hands to mouth
203
At 6 months babys are expected to
Sit up
204
At 9 months babys are expected to
Wave bye
| Try and feed self
205
At 12 months babys are expected to
Stand and walk
Use a sippy cup
Can say 2-4 words (mama, dada)
Know their name
206
A 2 years old they can
speak 2-3 word sentences
understand simple directions
running, active
No
207
At 3 year old they can
- speak in 3-5 word sentences
- stranger can understand them
- Can copy a circle and throw a ball
- Ride a tricycle
208
At 4 years old they can
- Draw a cross
| - Playing mom and dad
