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Ccs Flashcards

1
Q

Intususception-STAT

A

Exam: rectal, genital, abd
Supportive care: NPO, bowel rest, IV access, fluids, analgesics, antiemetics
NGT decompression, abd X-ray, surgery consult, u/s, CBC, bmp
Barium enema
Ward->bed rest, urine output
F/u, preventive care, counsel

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2
Q

Ruptured AAA-STAT

A

IV access, BP monitor, cardiac monitor, pulse oximetry, ECG
IV fluids, morphine, phenergan
Pre op: PTT, PT/INR, type and cross, NPO, bed rest
ICU
Abx (cefazolin), repair AAA
Cancel NPO, regular diet, re evaluate

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3
Q

Acute bacterial rhinosinusitis

A

No imaging needed
Abx, analgesics, NS irrigation, topical steroids
If allergic to augmentin, foxy/flouro

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4
Q

Acute chole

A

CBC, BMP, LFTs, blood cultures, amylase, lipase, abd x ray, abd u/s, pre op labs
Assessing clinical status: order interval history, focused physical exam

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5
Q

Sigmoid volvulus

A

GI for sigmoidoscopy and rectal tube

If complications-surgery

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6
Q

Ovarian cancer

A

Stage: LFTs, UA, colonoscopy, mammogram, Pap smear, CA 125, CXR
Pre op (laparotomy): PT/INR, PTT, ECG, NPO
Cefazolin before, DVT prophylaxis
Surgery: gyn onc
Follow up with onc

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7
Q

Whenever patient follows up

A

Interval history and exam

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8
Q

Polymyalgia rheumatica

A

CBC, BMP, ESR, ANA, RF, CPK, TSH
Taper steroids later, GI ppx, calcium, vitamin D, baseline DEXA

Follow up: ESR, CRP, CBC

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9
Q

Temporal arteritis f/u

Treatment

A

ESR, CRP, CXR, CBC

Aspirin and steroid

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10
Q

Fever with AMS

A

Complete infectious work up, all the CSF studies

Oxygen (thinking of something happening in brain)

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11
Q

Turner

A

First diagnose with karyotype analysis
Then FSH, LH, TSH, bmp, glucose, lipids, renal, pelvic u/s, echo, bone scan, hearing test
Consult ophtho, psych, nutrition
Give estrogen-progestin, growth hormone, vitamin d, calcium

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12
Q

Essential htn

A

Obtain CBC, BMP, UA, lipids, ECG
2 more measurements before diagnosis (3 month periods)
Lifestyle interventions in between, then meds at 3rd visit
F/u in 6 weeks

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13
Q

Diverticulitis

A

Get UA, blood cultures, abdominal CT
Repeat CT if no improvement in 2-3 days
Colonoscopy in 2-6 weeks
Inpatient: IV zosyn

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14
Q

Fall

A

FULL exam

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15
Q

Child abuse differential

A

Check for coagulopathy
Psych consult
Rib fracture: analgesics, incentive spirometer, chest PT

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16
Q

Menopause

A

Hormone replacement unless clots/breast cancer
If <45 yo->TSH, prolactin, FSH, UPT
Calcium, vitamin d, exercise, preventive health

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17
Q

DVT treatment

A

PT/INR, Fobt before
Lovenox+ warfarin
CBC on day 3 and 5 (HIT)
Pt/INR every day

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18
Q

Suspected cancer

A

Admit to hospital for staging, pre op, prophylactic antibiotics

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19
Q

Strep pneumo meningitis

A

DEXA

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20
Q

Before starting lithium

A

BUN, creatinine, calcium, TFTs, CBC, ECG, B-HCG

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21
Q

Mania

A

Suicide contract

Psychotherapy

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22
Q

General approach

A
  1. Standard ER (IV access, monitors)
  2. Symptoms
  3. CBC, BMP
  4. Diagnosis
  5. Diff
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23
Q

Septic arthritis

Fluid studies

A

IV abx, blood cultures, arthrocentesis->arthroscopy

Culture, gram stain, cytology, glucose, crystals

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24
Q

OCP in dysfunctional uterine bleeding

A

Low estrogen, low progesterone

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25
Q

ALL trauma patients

A

Emergency ABCDE before complete physical exam
Labs: LFTs, lipase/amylase, UA, ABG, Uds, blood ethanol, hcg, ECG, spine x Ray, chest x Ray, abd CT
If surgery needed->immediately after exam

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26
Q

Splenic rupture

A

Serial exams, CBC q6hours, BP monitor

27
Q

Diagnosis

A

Admit or not.

28
Q

Suspected cancer

A

Think about every organ.

29
Q

Constipation diff

A

Electrolytes, cancer, hypothyroidism

TSH, FOBT

30
Q

Asthma exacerbation test

A

PEFR every hour

If <40%-admit

31
Q

Croup

A

CBC, neck x Ray, humidified Air, dexamethasone oral, inhaler epinephrine
No need to admit if not severe enough

32
Q

Hemophilia

A 
bleeding time, PT, PTT, LFTs
Factor 8, 9, 11
Transfer to ward or ER 
Give deficient factor 
Monitor PTT and factor 8 till within normal level 
Consult genetics 
Avoid aspirin and contact sports
33
Q

ACS

A

Stat oxygen, IV access, cardiac monitoring, EKG, ASA, nitro before exam
FOBT before heparin drip
LFTs, echo
*ST depressions in unstable angina->cath
Risk reduction on discharge

34
Q

Choking

A

Rigid bronchoscopy

CXR and neck x Ray

35
Q

Panic disorder

A

Emergency orders like ACS + glucose

Get U/A and UDS

36
Q

Pre op labs

A

PT/INR, PTT, NPO, fluids

Antibiotics before

37
Q

TIA

A

Aspirin stat before CEA

If afib-> apixaban/warfarin

38
Q

COPD exac

A

PEFR, ABG, EKG

As patient improves, transfer to ward, P.O. steroids, MDI nebs, walk test before leaving

39
Q

Breast mass

A

U/s: simple cyst-> reassure, complex->FNA
Solid:
Mammogram
F/u: every 3 months for a year

40
Q

Htn emergency

A 
CT Head before Nitroprusside 
ICU, arterial line, NPO, urine output 
DBP goal 100-105
CXR, UA to check for end organ damage 
Lipid profile
41
Q

Outpatient depression

A

Start SSRI, do not wait for all labs to come back.

F/u: every week for 6-8 weeks

42
Q

Candida tests

Treatment

A

Vaginal PH, wet mount, gram stain, Pap smear, gc culture, u/a
Counseling: patient ed, safe sex, no alcohol
Miconazole, clotrimazole (topical), fluconazole (PO)

43
Q

Alzheimer’s

A

Vitamin E, donepezil + olanzapine

44
Q

UC management

A

Mesalamine, loperamide, dicyclomine, dietary consult

45
Q

Pregnant UTI

A

Confirm eradication with f/u culture in a week

46
Q

Pregnant

A

Blood type, Rh type, atypical antibody titer, Pap smear, u/a, urine culture, rubella ab, RPR, Hep B surface antigen, HIV, chlamydia, prenatal vitamins, iron sulfate, folic acid
F/u in a month

47
Q

Ectopic pregnancy treatment

A

Stable, hcg<5000, <3 cm-methotrexate
Consult ob-gyn
LFTs, pt/INR, blood type
If mtx->f/u in 4 days to check b-hcg

48
Q

IBS

A

Complete physical exam
ESR, tsh, Fobt, stool studies, stool fat
Treatment: diet (high fiber, lactose free), reassurance, education, behavioral therapy, biofeedback
Dicyclomine for pain

49
Q

Rheumatoid arthritis

A

Consider arthrocentesis
Prednisone + methotrexate
PT/OT

50
Q

DKA

A

Serum osmolality, serum ketones
Potassium, check phosphorus
Add glucose once <250
BMPs and ABGs q2h

51
Q

ACS antibiotics

A

Azithromycin, cefuroxime

Exchange transfusion

52
Q

Anaphylaxis

A

IM epi, glucagon if on beta blockers
Steroids, diphenhydramine, ranitidine, albuterol
Outpatient RAST testing
Medical alert bracelet

53
Q

GI bleed in office

A

FOBT,

H. Pylori-clarithromycin, amoxicillin, ppi

54
Q

Hypothyroidism

A

Check lipids

55
Q

Tea and toast diet

A

Folic acid, not necessarily b12 deficiency
If giving folic acid, five iron as well
Thiamine, MVI in alcoholic
Rec count as follow up

56
Q

Tea and toast diet

A

Folic acid, not necessarily b12 deficiency
If giving folic acid, five iron as well
Thiamine, MVI in alcoholic
Rec count as follow up

57
Q

TSS

A

Clindamycin

58
Q

Pancreatitis

A

Get RUQ U/s to rule out gallstone panc

If dilated CBD, ERCP

59
Q

Hepatitis f/u

A

PT, INR, notify health department

60
Q

Brady

A

EKG, echo, trop
Transcutaneous pacing
Cards for transvenous

61
Q

Rhabdo

A

Electrolytes, sodium bicarbonate?

62
Q

TB

A 
Get LFT, uric acid, eye exam before meds
Isoniazid, pyrimethamine, pyrazinamide, ethambutol, 
rifampin
AFBs till negative 
LFTs
63
Q

Minimal change disease

A

Lasix+ albumin

Prednisone

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