Content 3 Flashcards
(148 cards)
1
Q
Loss of hearing that gradually occurs as individuals grow older
A
Presbycusis
2
Q
Natural loss of accomodative capacity with age
A
Presbyopia
3
Q
Tx of bacterial conjunctivitis and corneal abrasion due to excessive contact use
A
Ciprofloxacin, gentamycin or ofloxacin
4
Q
Weber test in sensorineural loss
A
Louder in unaffected ear
Meniere disease
5
Q
Rinne test in sensorineural loss
A
No change
6
Q
Rosenbaum test
A
Tests for near vision
7
Q
Immediate goal of placement of myringotomy and tube placement in children with recurrent AOM
A
Allow removal of suppurative and mucoid material, releasing the pressure
8
Q
Visualization of floaters usually due to
A
Syneresis
Degenerative changes in the vitreous humor
9
Q
When should child achieve 20/20
A
By age 4
10
Q
Use of nasal decongestants >every 3 hours for >3 weeks is a risk factor for
A
Rhinitis medicamentosa
3 days in a row is maximum recommended time
More than that can cause rebound congestion
11
Q
Microtia
A
Small ears
12
Q
Most common cause of sensorineural hearing loss
A
Presbycubis
13
Q
Allen test
A
Vision screening using picture cards
For children aged 2.5-3
14
Q
PE finding in a patient with mumps
A
Orifice of Stensen’s duct appears red
15
Q
Leading cause of blindness in people aged 20-60
A
Diabetic retinopathy–a progressive microangiopathy with small vessel damage and occlusion
16
Q
S/S acute angle closure glaucoma
A
Halos around lights, severe eye pain and redness, N/V, HA, blurred vision, conjunctival injection, cloudy cornea, mid-dilated pupil, increased IOP
17
Q
Gold standard for dx strep throat
A
Throat culture
18
Q
In older adults, the most common cause of decreased visual functioning
A
Cataract formation
19
Q
Trachea deviates towards the affected side in
A
Large atelactasis or fibrosis
20
Q
Trachea deviates towards the unaffected side in
A
Aortic aneurysm, unilateral thyroid lobe enlargement, pneumothorax
21
Q
Drugs safe to use with perforated TM
A
Cipro + Dexamethasone (Ciprodex Otic)
Do not use <6 months
22
Q
Abnormal corneal light reflex suggests
A
Improper alignment of the eyes
23
Q
A smooth tongue may be due to
A
Vitamin deficiency
24
Q
What is CI when a patient has a suspected foreign body in the ear
A
Flushing with water
25
Normal artery:vein ratio in the eye
2:3
26
Asian man about to take allopurinol for gout, what should be screened for
HLA-B*1501 gene
| -Increased risk of SJS and toxic-epidermal necrolysis when taking the medication
27
1st line therapy for fibromyalgia
TCA--amitriptyline
28
Polymyalgia rheumatica
Inflammatory disease of unknown etiology that affects people >50 years
Tx: prednisone for 3 days
29
Patent ductus arteriosus s/s
Continuous murmur, bounding apical pulse, respiratory distress
Tx: indomethacin
30
Carcinoid tumor
Neuroendocrine tumor characterized by flushing, diarrhea, wheezing due to tumor secretion of histamine, serotonin, prostaglandins
31
Cor pulmonale
Right heart fsailure
32
Peutz-jeghers syndrome screening
Screen for GI cancer beginning at age 12 in patienrts who have GI symptoms
33
Triad of nephritic syndrome
hypertension, peripheral edema, renal insufficiency
| Labs: proteinuria, UA RBC and RBC casts
34
Nephrotic syndrome
Hypotension
| Labs: heavy proteinuria, hypoalbuminemia, hyperlipidemia, UA lipiduria
35
CN 3 palsy suggests
Cerebral aneurysm
36
Tx travelers diarrhea in pregnant woman
Azithromycin
37
Adverse effect of methadone
Can cause QT interval prolongation that can cause torsades de pointes
38
Tx of idiopathic hypercalciuria
Thiazide diuretic--decrease urinary calcium excretion
39
Murmur of carditis due to rheumatic fever
Apical holosystolic murmur
40
SE of donepezil
Cholinesterase inhibitor--increases cholinergic transmission
| SE: diarrhea
41
1st line therapy for neuropathic pain due to DM
Pregabalin and duloxetine
42
Characteristics of hypertrophic cardiomyopathy
LV hypertrophy, ejection murmur, S4 gallop, dyspnea, angina, syncope, rapid upstroke of carotid arterial pulse
43
Characteristics of aortic stenosis
LV hypertrophy, ejection murmur, S4 gallop, dyspnea, angina, syncope
44
How long does troponin stay elevated after MI
10 days
45
How long does CK remain elevated after MI
36-48 hours
46
Nitroglycerine tablet storage instructions
If in open bottle, throw away after 3 months
If in unopen bottle, good for 1 year
Sensitive to light, mositure and heat
47
Precautions related to fluoroquinolone therapy
Do not give <18 years old
Do not give to pregnant women
Hypoglycemia and hyperglycemia may occur
Anorexia/nausea may occur
48
Heightened vagal tone can cause
Hypotension, bradycardia, slowing of AV conduction
49
Subclavian steal syndrome
Caused by atherosclerotic narrowing of subclavian artery proximal to vertebral artery
Causes unequal BP in 2 arms
50
Heightened vagal tone responsible for vasovagal faint is commonly caused by
Transient bradycardia, sinus arrest, or AV block
51
Meconium ileus in newborn is usually due to
CF
| Can also be caused by Hirschsprung disease
52
Congenital cytomegalovirus is manifested by
Petechiae, jaundice, intracranial calcifications, hearing loss, seizures
53
Classic presentation of intussusception
Sudden onset of intermittent, severe, crampy, progressive abdominal pain, accompanied by constant crying and drawing up of the legs towards abdomen
54
SGLT2 inhibitors are associated with increased risk of
Amputation
55
Common cause of recurrent cellulitis in patient who has undergone venectomy
Tinea pedis
56
Adverse effects of SSRIs
Sexual dysfunction, drowsiness, weight gain, anxiety, dizziness, insomnia
57
Difference between emphysema and chronic bronchitis
Emphysema: normal oxygenation and normal pulmonary artery pressure and normal ventilation
58
Paradoxical pulse is classic sign of
Pericardial tamponade
59
Most common cause of inherited thrombophilia
Factor V leiden mutation-- increases risk of DVT and pulmonary embolism
60
Underlying systemic diseases that can cause carpal tunnel
hypothyroidism, DM, acromegaly, RA, amyloidosis
61
Smokers weigh on average ____ than non-smokers
5-10ib less
When they quit, 80% gain weight
Weight gain is caused by replacing cigarettes with food
62
What medications lead to a decreased response to the tB skin test
Steroids and other immunosuppressive agents
63
Most common reason for a chronic cough in children
Postinfection
64
Main cause of CAP
Strep pneumoniae
| Followed by mycoplasma pneumoniae, h. influenzae, staph aureus
65
What should be considered in all adult onset asthma
Occupational asthma
66
What deficiency is noted in a lot of people with COPD
Vitamin D
67
What percent of people who smoke 1 pack of cigarettes per day have a cough?
40-60%
68
Most notable manifestatio of tongue cancer
Hoarseness of the voice
69
What is effective in tx of pneumonia, atelactasis, and CF
Chest physiotherapy
70
X ray finding of croup
Tapered symmetric subglottic narrowing, or steeple sign, on AP view
71
Secondary pneumothorax usually due to
COPD
72
1st line therapy for GOLD 1 COPD
Beta 2 agonists
73
Most common cause of persistent cough in children of all ages
Recurrent viral bronchitis
74
3 D's of epiglottitis
Drooling, dysphagia, distress
75
2 most prevalent organisms constituting the normal flora of oropharynx
Streptococci and staphylococci
76
Unexplained nocturnal cough in adult should suggest
CHF
77
Bacteria in TSS
Staph aureus
78
Requirements for home oxygen
PaO2 <55mmHg or O2 sat <85%
79
Normal adult thorax shape
Elliptical
80
Acid-base disturbance that occurs due to aspirin overdose
Respiratory alkalosis
| Due to direct stimulation of respiratory center in the medulla, which causes increase in pH and decrease in PaCO2
81
Hamman's sign
Auscultation sound at the mediastinum in the presence of mediastinal crunch
Present with emphysema or pneumomediastinum
82
Trachea deviation in pleural effusion
Unaffected side
| Due to fluid displacing pleural space
83
CAP in alcoholic usually due to
Pneumococcus (usually streptococcus pneumoniae)
84
Which TB medication should not be taken by pregnant women
Pyrazinamide
85
Peaked T wave that may progress into widening of QT interval due to
Hyperkalemia
86
U waves, ST depression and T wave flattening due to
Hypokalemia
87
Prolongation of QT interval
Hypocalcemia
88
Occlusion of which artery usually results in damage to inferior wall of left ventricle
Right coronary artery
89
Roos test
Assesses for thoracic outlet syndrome
-If pain or paresthesias are present when the client positions his/her shoulders in abduction and external rotation of 90 degrees
90
Most common causes of mitral stenosis
Endocarditis, rheumatic heart disease, calcific mitral valve disease
91
CHADS2 score
For A fib stroke risk
CHF, hypertension, age, diabetes, history of TIA or stroke
>2=anticoagulation
92
Hypertensive retinopathy
End organ damage
| AV nicking + cotton wool spots
93
Diagnosis of acute aortic dissection best made with
CT angiography of the chest or transesophageal echo
94
Auscultation of aortic valve is best performed using which side of stethoscope
Diaphragm
95
Pleuritic chest pain, diffuse ST segment elevation, PR depression, leaning forward
Pericarditis
96
High pitched diastolic murmur, widened pulse pressure, laterally displaced PMI
Aortic regurigitation
97
Low pitched diastolic rumble heard best at the cardiac apex
Mitral stenosis
98
Scooping of ST segment and T wave inversion and QT shortening due to what toxicity
Digoxin
99
Digoxin toxicity first manifests as
N/V, abdominal pain, HA, diarrhea, loss of appetite, low heart rate, palpitations
100
Initial tx of viral pericarditis
NSAIDs + colchicine
101
Next step in management of HF if decreased sensitivity to loop diuretics and spirinolactone combination
Metolazone
102
Target BP >60 years
<150/90
103
What should be performed in all patients with suspected hypertrophic cardiomyopathy
Transthoracic echo
104
Harsh crescendo-decrescendo systolic murmur heard best at left upper sternal border
T wave inversion
Hypertrophic cardiomyopathy
105
Systemic hypotension, jugular venous distention, muffled heart sounds
Cardiac tamponade
106
Weak carotid pulse with slow upstroke
Aortic stenosis
107
MVP characterized by
Elongation of chordae tendinae and enlarged valve leaflets
| Ballooning of the cusps into the atrium occurs during systole
108
Education if someone is using the BBT method
Avoid unprotected intercourse from the beginning of the menstrual cycle until the BBT has been elevated for 3 days
109
What is an associated sx with stress incontinence
Recurrent cystitis
110
Most common G U dysfunction occuring after a transurethral resection of the prostate
Retrograde ejaculation
111
Pt education regarding using podophyllum for warts
Wash off after 1-2 hours to prevent tissue being destroyed
112
Sx of Prostate CA vs BPH
Same sx but with prostate CA, sx progress more rapidly
113
Stein-Leventhal syndrome
PCOS
114
Who would rarely develop prostate cancer
Someone who received a orchiectomy before puberty as prostate cancer is androgen dependent
115
Mobiluncus species causes
BV
116
Most common sx expressed by women with PMS
Fatigue
117
Most common scrotal disorder in adolescents
Testicular torsion
118
MOA of 5-alpha reductase inhibitors
Induce apoptosis and atrophy as well as reduce action of androgens in the prostate
119
CI to IUD
Heart disease--susceptible to bacterial endocarditis
| Heavy bleeding
120
ED most common cause
Organic--mostly vascular
121
Co-factors for HIV transmission
Chancroid, genital herpes, syphilis
122
What medications may diminish the effectiveness of OCP
Antibiotics, antacids, anticonvulsants
123
Conditions outside of the scrotum that may present with scrotal pain
AAA, inguinal herniation, pancreatitis, renal colic, peritonitis, intraperitoneal hemorrhage, plyarteritis nodosa
124
Bacteria in TSS
Staph aureus
125
Epithelial cells with bacteria adherent to the cell wall giving a stippled, granular appearance
Clue cells
| in BV
126
Fibroids during pregnancy
1/3 will increase in first trimester; may result in miscarriage, preterm labor, abruptio placentae, C-Section
127
Most common cause of gross hematuria in men
Bladder infection
128
Genital exam position for a patient with severe spasticitiy
Knee-chest position
129
What position is the uterus if the cervix is located on the anterior vaginal wall
Anteverted
130
Labs to rule out causes of ED
FBS, Lipids, TSH, testosterone
131
How long may you leave the nuva ring out ?
3 hours
132
Fibromyalgia dx
11/18 tender trigger points including occiput, low cervical, trapezius, supraspinatus, second rib, lateral epicondyle, gluteal, greater trochanter, knee
133
Spurling maneuver
Assesses nerve root compression of the neck
134
Which nerve root involvement for decreased sensation in lateral leg and web of great toe
L4/L5
135
Most common cause of cauda equina syndrome
Herniated lumbar intervetebral disk
136
Roos test
Assesses for thoracic outlet syndrome
-If pain or paresthesias are present when the client positions his/her shoulders in abduction and external rotation of 90 degrees
137
Reiters syndrome
Reactive arthritis
COnjunctivitis, nongonococcal urethritis, arthritis
"cant see, cant pee, cant climb a tree"
138
Thompson test
Used to dx achilles tendon rupture
139
Baker's cyst
Build up of synovial fluid behind the knee
140
What causes articular cartilage destruction in RA
Lysosomal degradation due to leukocytes producing lysosomal enzymes
141
Ankylosis
Stiffness or immobility in a joint due to bones fusing
142
Tx adhesive capsulitis
Moist heat application, use of analgesics, gentle stretching
143
Gelling
achiness and stiffness that occurs in RA
144
Dupuytrens contracture
Nodular thickening of the palmar facia that draws the fingers inward to the palm
145
Functional vs structural scoliosis
Functional: apparant with standing and disappears with forward bending
Structural: fixed
146
Allen test
Assesses patency of radial and ulnar arteries and the arterial arch
147
Largest joint in the body
knee
148
Pain elicited with finkelsteine test
Indicates Quervains tenosynovitis
