Flashcards in CNM Purple Thin Book Study Questions 2013 Deck (104)
Cancer screening recommendations from American Cancer Society on mammograms
Women age 40 or older should have annual mammograms continuing for as long as the woman is in good health
Cancer screening recommendations from American Cancer Society on Paps
Age 21-29, q 3 yrs if wnl
Age 30-39 q 5 yrs if wnl (with HPV testing)
Age 40+ ...
Cancer screening recommendations from American Cancer Society on fecal occult blood testing FOBT
shoudl be conducted annually starting at age 50
Cancer screening recommendations from American Cancer Society on sigmoidoscopy/colonoscopy
Starting at age 50
sigmoidoscopy q 5 yrs -OR-
colonoscopy q 10 yrs -OR-
double-contrast barium enema q 5 yrs -OR-
CT colonography q 5 yrs
CDC recommendations for 65 yr old
Influenza should be given annually.
All immunocompetent individuals 65 or older should be immunized once with pneumococcal vaccine (one-time revax if vax 5 or more years previously and less than 65 at time).
Adults should receive Td booster vax q 10 yrs.
Herpes zoster vax rec for individuals age 60+.
Fat intake recommendations from AHA
Total fat 25-35% of total daily caloric intake
Saturated fats <1% tdci
Where are trans fats found?
in products that contain partially hydrogenated fat
as well as in meat and whole-fat dairy products
One strategy for replacing saturated fats with unsaturated fats
Replace meats with veg alternatives (eg beans) or fish
Will reduce cholesterol content
Sat fat v cholesterol content in peanut butter
low in cholesterol
high in saturate fat
Five stages of Thranstheoretical Model for Change
antidepressant which is helpful in smoking cessation (likely due to effect on neuroal uptake of dopamine, prolonging action of nt)
Weight gain NOT a s/e
Start bupropion 1-2 wks before quit date so blood levels of med will be satbilized.
Bupropion is C/I in sz disorder and eating disorders
Criteria for dx of IBS
Continuous or recurrent sx, for at least 3 months of:
abdominal pain or discomfort relieved with defecation -OR- associated with a change in frequency or consistency of stool
Must also have irregular pattern of defecation at least 25% of time with =3/+ of:
altered stool frequency/form/passage, passage of mucus and bloating, or feeling of abdominal distention
Typical IBS does NOT waken individual nor does it result in significant weight loss
Physical activity generally does not cause an increase in severity of sx.
Regular physical exercise may be beneficial
Appropriate treatment for both diarrhea and constipation IBS
increasing dietary fiber, which will result in a bulkier stool.
Bulk forming agents such as psyllium husk fiber and methylcellulose can also be used.
What laxative types are ok occasionally for pt with constipation IBS?
What type of laxatives should be avoided as much as possible in someone with constipation-predominant IBS?
Avoid stimulant laxatives
26 yr old with abrupt-onset diarrhea that began 24 hours ago; has had approx 6 loose stools without noticeable blood; mild abdominal cramps, neg nausea, neg fever.
Acute diarrhea. Usually self-limiting.
Maintain oral hydration rich in electrolytes.
Restart foods slowly as toleated with clear liquids and then carbs.
Resume protein and fats last.
Stool culture may be indicated if sx persist and/or fever/bloody stools.
32 yr old. 3-month hx intermittent burning retrosternal pain that radiates to her back.
Sx noted 30-60 minutes after meal; relieved quickly with antacids. PE and VS wnl.
GERD gastroesophageal reflux disease
sx include intermittent nature,
association of relief with antacids
Usually colicky, constant, in RUQ
Deep inspiration usually causes severe pain and splinting of repirations (Murphy's sign)
If gastric irritation with ingestion of iron supplement on empty stomach (recommended):
Ingest with food to reduce irritation.
Try another preparation.
Increase slowly from small dose.
Antacids for gastric irritation while taking iron supplement:
to increase iron absorption
take iron supplement with vit C
test to determine iron stores
serum ferritin level (major storage protein)
Is located in serum [ ] directly r/t iron stores
test of choice for distinguising bt carrier and affected state of sickle cell
test which is very effective at distinguishing types of hemoglobin in a blood sample
Is Sickledex a screening or diagnostic test
screening test for SCA/SCT; must be confirmed with Hgb electrophoresis
When to migraine HA usually begin
adolescence or early adulthood, though they can occur in young children
where are migraines usually located?
sx of migraine HA
can last up to 72 hours
often accompanied by nausea and photophobia
what is indicated for preventive therapy of migraine HA that come 2 or more x/mo?
beta-adrenergic blocking agents (propranolol)