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Flashcards in CNM Purple Thin Book Study Questions 2013 Deck (104)
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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

maintenance/relapse prevention



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?

stool softeners
osmotic laxatives


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:

inhibit absorption


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

Hgb electrophoresis


test which is very effective at distinguishing types of hemoglobin in a blood sample

Hgb electrophoresis


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)


meds used for abortive or analgesic therapy of acute migraines

codeine-containing products
ergotamine preparations