ClinMed_test3 Flashcards
(127 cards)
1
Q
Define Medical emergency
A
An injury or illness that is acute and poses an immediate risk to a person’s life or long term health
2
Q
Name the ABCDEFGHI in medical emergency
A
Airway Breathing Circulation Disability Exposure
3
Q
What to do in a case of Airway
A
Make sure they have patent airway.
Not busting out the epinephrine
4
Q
What is the leading cause of morbidity and mortality in the US
A
Acute myocardial infarction (Heart attack)
5
Q
Heart attack In men vs heart in chicks
A
Men-Levine Sign
Females - heartburn, SOB, back pain, vomiting.
6
Q
Name the two types of acute stroke
A
Ischemic - most common(perform carotid bruit-looking for plaques). There is blockage
Hemorrhagic(Bleeding in the brain)
7
Q
What should u check if pt reports had a severe stroke?
A
Check VF
8
Q
What does the FAST protocol consist of
A
Face - smile
Arms - raise them
Speech - say a sentence
Time- call 911
9
Q
Define Orthostatic Hypotension
A
A sudden drop in BP when you change position. This can happen if you stand up too fast, get dehydrated, or take certain medicines, such as ones for high BP
10
Q
T/F
Fever will always be present before a seizure
A
False
It can present itself afterwards.
11
Q
What is the trt of choice for anaphylaxis?
A
Epinephrine
12
Q
What is the goal for ppl suffering from seizures
A
Prevent secondary injury
13
Q
What is the cause of seizure
A
Spontaneous epilepsy, drugs, metabolic disorders (hypoglycemia), rapidly increasing fever, brain tumor aneurysm med withdrawal, stroke
14
Q
how often do u need to inject epinephrine in a pt suffering from anaphylaxis
A
`5 to 15 mins
15
Q
what are some signs seen with anaphylaxis
A
Angioedema
Urticaria
hypotension
Bronchospasm
16
Q
Name possible trt for anaphylaxis
A
Steroids
Antihistamines
Beta-adrenergics (epinephrine, albuterol)
17
Q
what is the best place to insert epipen
A
Rectus femoris site
18
Q
What is the entity for cluster headaches?
A
Horner’s syndrome
19
Q
Where is the pain on Horner’s syndrome
A
Facial pain radiating to the ipsilateral eye
20
Q
Name the worst HA of your life
A
Can be subarachnoid bleed
21
Q
Retrobulbar
A
Pain on eye mvts
No retinopathy.
22
Q
Name the evidence for a person with end organ damage
A
Chest pain
Severe HA
Nausea, vomiting
23
Q
Define Hypertensive emergency
A
Severe HTN + End Organ Damage
24
Q
How do you prepare for emergencies?
A
Staff training
Community resources
Office equipment
25
What is the leading cause of death in the US
CVD-cardiovascular disease
There are diff types of the disease.
CAD-coron art disease!!!!!
26
Name the top two Cardiovascular disease leading to death
Coronary heart disease akak coronary artery disease-coronary arteries is blocked.
Stroke
27
Name some uncontrollable factors for Cardiovascular disease (CVD)
Sex
Race
Age
Hereditary
28
Name some controllable factors for Cardiovascular disease (CVD)
```
Physical activity
Obesity
Smoking
Stress and anger
Diabetes
High blood pressure(biggest risk)
high blood cholesterol
```
29
Brittle diabetic
Their A1C is hard to control due to other factors like metabolic syndrome
30
T/F
| Risk of cardiovascular disease double for every increase of 20 points over 115
True
31
name the most common type of heart disease?
Coronary heart disease aka Coronary artery disease
32
Define acute coronary syndrome
Umbrella term used to cover any grp of clinical symptoms compatible with acute myocardial ischemia
33
T/F
| Woman are 5X more likely to die from cardiovascular disease than from breast cancer
True
34
Define angina pectoris
Uncomfy pressure, fullness, squeezing or pain in the center of the chest.
35
List the pts most likely to present w/o chest pain
```
Elderly
Diabetes
Neuropathy
Stroke
Female
Non-white
CHF
```
36
What is the most common time of day for MI
| Common day of week?
6am to 12pm
| Monday
37
Name the drug used as preventative care for CAD
Aspirin.
It thins the blood.
Side effects: Subconj Heme
38
List the medical management of CAD
```
Aspirin-antiplatelet
Anticoagulants
Beta blockers
Thrombolytics
Nitrates
Morphine
ACEI's
```
39
INR values
Less than 2 = too thin
2-3 = normal
More than 3 = too thick
40
What is the most common immediate cause of death in a myocardial infarction?
Arrhythmia
41
What should u suspect if u witness a roth spot heme?
Suspect endocarditis
Diabetes
HTN
Vascular
42
What is the white spot found in the center of the roth spot heme
CWS
Lymphoma
Septic Emboli
43
What are the top two things leading to bacterial endocarditis
Tooth extraction
| Brushing teeth
44
Osler nodes
Small painful ischemia on the palm of the hand or feet
45
What do osler nodes indicate
Thrombocytopenia
| Inflammatory disease
46
Diff b/w osler nodes and Janeway lesions
Janeway are Painless
| Osler are painful
47
What kind of hypersensitivity rxn is Janeway lesion
Type III
| Need to r/o Syphillis
48
Where do splinter hemes appear
| What condition
Petech heme on inf plap conj or conj
| Bacterial endocarditis
49
Name the most common arrhythmia that requires trt
Atrial Fibrillation
50
TQ: signs and symptoms of CHF
```
Periph Edema
Pulmonary Edema
SOB
Dyspnea or exterion/exercise intolerance
Paroxysmal nocturnal dyspnea
Orthopnea
```
51
Medical management for CHF
```
Diuretics
ACEI's or ARBS
Beta Blockers
Aldosterone receptor antagonists
Digoxin
```
52
Look up Marfan Disease
Okee
53
Signs of Margan disease
```
Reduced upper to lower body seg
Arm span exceeding ht
Arachnodacyl of fingers and toes with pos thumb and wrist signs
Scoliosis
Dilation of the Aorta
Aortic dissection
Ectopia lentis
Dural ectasia
```
54
Function of the normal kidney
Major waste management plant of the body
1. Filters and excretes metabolic waste products
2. Excretion of nitrogenous wastes
3. Detoxifies and eliminates toxins
4. Regulates red blood cell production
5. BP regulation
6. Keep the acid/base concentration of your blood constant
7. Regulates fluid and electrolyte balance
55
Name the two parts to a nephron
Glomerulus
| Tubules
56
What does Blood Urea Nitrogen(BUN) represent
Reflects excretory capacity of kidney.
| It is the final breakdown product of protein
57
What is the normal value of BUN
10-20 mg/dl
58
What is creatinine
Product of skeletal muscle metabolism.
| Freely filted by glomerulus, not reabsorbed; minimally secreted by tubules.
59
Name the 2things that effect Creatinine
Age
| Muscle mass
60
T/F
| Creatinine clearance gives an accurate estimation of GFR
False
| Overestimation
61
what is the normal GFR for men and woment
Males: 130 ml/min
Women: 120 mL/min
62
define Prerenal ARF
Reduced renal perfusion due to volume depletion and/or decreased perfusion.
Biggest cause is dehydration
63
What is the biggest cause of Pre-renal ARF
| TQ
```
Dehydration
Others:
volume loss(bleedg)
heart failure
shock
liver disease
```
64
What is post-renal ARF
Any obstruction to urinary outflow from renal calyces and pelvis to urethral meatu.
OBSTRUCTION-THIS IS PAINFUL
THIS IS AN EMERGENCY
65
How many pts die from ARF
50%
66
What are the ocular findings in ARF
```
Uveitis
Ocular Muscle paralysis
Hollenhorst crystals
Roth spots in endocarditis
Lupus retinopathy
```
67
Lupus retinopathy and kidney?
U will see acute lupus nephritis.
| Biggest cause of death in pts.
68
Name the two conditions that cause CKD
Diabetes
| HTN
69
Define Chronic Kidney disease
Presence of markers of kidney damage for three months.
70
Name some ocular disorders in CKD
Band K
Calcium deposits in conj, hyperemia
HTN retinopathy
Cranial nerve involvement: nystagmus, miosis, pupillary, EOM palsy
71
Name the three trt options for renal disease
1. Hemodialysis
2. Periotneal Dialysis
3. Kidney transplantation
72
Name the indications for dialysis
```
A E I O U
A; intractable metabolic acidosis
E: electolyte imbalance, esp hyperkalemia
I: intoxications
O: overhydration
U: uremia
```
73
What is the most common renal tumor in childhood?
Wilms tumor
| 95% before age 10
74
What is
| WAGR
Wilms Tumor
Aniridia
GU anomalies
Mental retardation
75
Name the 7 types of primary lesions
```
Macule
Papule
Plaque
Hives
Nodule
Vesicle
Bulla
```
76
Name the 9 secondary lesion
```
Crust
Scale
Erosion
Ulcer
Fissure
Atrophy
Scar
Lichenification
Excoriation
```
77
What is another name for actinic keratosis
Pre-cancer to squamous cell carcinoma
78
Where is actinic keratosis usually found
On skin exposed areas
79
Is actinic keratosis progressive
Not really.
| It is slowly growing, can take yrs to develop unless immunocompromised.
80
Which skin condition may develop a horn like texture
Actinic keratosis
81
How to trt actinic keratosis
1. Burning
2. Curettage and electrodesiccation
3. Excision
4. Cryotherapy
5. 5-FU and Imiquimod: creams
82
What happens to the skin during therapy for actinic keratosis with 5-FU
As abnormal cells are eradicated, skin becomes redder, crusts and peels.
83
Name the three types of skin cancers
Basal Cell Carcinoma
Squamous Cell Carcinoma
Malignant Melanoma
84
T/F Basal cell carcinoma spreads throughout the body
False
85
Are basal cell carincoma curable
Yes; high cure rate.
| But, there is a 20-40% chance of developing another case.
86
Name the skin cancer that accounts for 80% of new skin cancer cases
BCC
87
Can squamous cell carincoma spread?
claro que si
88
How to treat BCC and SCC
Surgical excision
Mohs sx
5 FU, Imiquimod cream
Radiation therapy
89
What is the worst skin cancer
Malignant Melanoma
| 80% of skin cancer deaths
90
Is malignant melanoma curable?
Si
91
What are the ABCDE of Melanoma
```
Asymmetry
Border
Color
Diameter >6mm
Elevation
```
92
What is superficial spreading melanoma
It grows as small plaque for 6 to 24 months and then develops nodule.
It is highly invasive.
93
What are some lab studies to include when diagnosing a possible skin cancer
```
Liver function test
Dermoscopy
Wood's lamp
CBC w/ diff
Pet Scan
```
94
Prognosis of melanoma sizes
Less than 1mm have good prognosis
| Lesion that are greater than 3mm have guarded prognosis
95
Managment of melanoma
Excision
Lymph node dissection
Examination and lab screening for metastasis
Trt for metastatic dz usually unsatisfactory
96
What is allergic contact dermatitis
A delayed hypersensitivity rxn caused by contact with an allergen
97
Management of eczematous dematitis in all stages
```
Topical steroids
Immunomodulators
IM seroids
Antihistmaines
Antibiotics
Lubrication
```
98
What is eczema herpeticum
Disseminated HSV
Painful, umbilicated pustular vesicals
Fever, malaise, lymphadenopathy
Significant morbidity and mortality
99
What is molluscom contagiosum caused by
Pox virus.
| Dome shaped papules with central plug and umbilication
100
What kinds of pts does molluscum occur in
Children
Young adults
Immunocompromised pts
101
Which pathogen causes impetigo
Staph aureus
102
Describe impetigo
Pustular vesicles with straw colored discharge
103
Trt of impetigo
Self limiting
Systemic antibiotic
Topical Bactroban ung - TID for ten days
104
What is Dermatomyositis
Acquired, idiopathic connective tissue disease.
| Charact by proximal muscle weakness, rash on eyelids, scalp.
105
Pathognomonic features of dermatomyositis
Heliotrope rash
| Gottron's papules
106
What is the name of the sign that is on the tip of the nose in Zoster
Hutchingson's sign.
| Means there are ocular complications
107
Management of zoster
Antiviral agents: valtrex, famvir, acyclovir
Prednisone
Anti staphy Abs
Oc lubs
108
Can nevus of ota cause glaucoma
Si
| Up to 10%
109
What is syringoma
Benign adnexal neopaslm
| Formed by well diff ductal elements
110
What is a Hidrocystoma
Cystic lesion of either the apocrine or eccrine sweat glands
111
What is xanthoma
Lipid deposit in the skin and tendons
112
Xanthelasma -
yellowish plaques on the eyelids.
| 50% have normal cholesterol but higher LDLs
113
Rosacea-Derm findings
```
Facial erythema
Telangiectasia
Red papules
Pustules
Sebaceous gland hypertrophy
Rhinophyma
```
114
Trt of Rosacea
```
Oral tetracyline, doxycycline
Oral erythromycin
Topical metronidazole
Isotretinoin
Lid hygient
Ats
Topical steroids
```
115
Rosacea - Complications
Corneal scarring
COrneal perforation
Bleph
COnjunctivitis
116
What is seborrehic dermatitis
Common, chronic, inflammatory dermatitis
Associated with overgrowth of yeast Pityosporum ovale
Face, scalp, presternal, upper back.
117
Trt of seborrheic dermatitis
```
Sodium sulfacetamide
Metronidazole
Ketoconazole shampoo
Tar shampoo
Topical steroids
Immunomodulators (elidel and protopic)
```
118
Psoriasis
Lifelong and characterized by chornic, recurrent exacerbations and remissions that can be emotionally and physically debilitating `
119
Pesudoxanthoma elasticum in the eye?
Angioid straks
120
Define metabolic syndrome
Group of risk factors that occur together and increase the risk for coronary artery disease and stroke
121
Name some risks for AMD
```
Age
Genetics
Gender
Smoking
Sunlight exposure
High levels of LDL and low levels of HDL
High BMI
```
122
What percentage of AMD cases are linked to Dry AMD
90%
| 10% = Wet AMD
123
T/F
| BMI of 30 or higher was associated with a twofold higher risk of AMD
True
124
T/F
| Obese men were 2x more likely to have dry AMD
true
125
T/F
| Genetics plus higher BMI increased risk of AMD almost sixfold
True
126
What was the Diabetes Prevention Program
Modest wt loss through dietary changes and increased physical activity could prevent or delay the onset of type II diabetes in study participants by 58%.
127
What did the ARIC and cardiovascular health study find?
Obese persons were found to have a nearly four-fold increased risk of retinal vein occlusion
