Crash Course Flashcards
1
Q
What is the other name for canker sores
A
Apthous Stomatitis
2
Q
What is the primary difference of location between apthous stomatitis and herpes
A
AS is typically inside the mouth while herpes is usually outside mouth/on lips
3
Q
Ideal timeframe to begin treatment for oral herpes
A
48-72 hours
4
Q
What is a chronic form of apthous stomatitis?
A
chronic ulcerative stomatitis (CUS)
5
Q
What causes chronic ulcerative stomatitis
A
it is an autoimmune disorder but can be caused by lichen planis
6
Q
What is the difference between CUS and apthous stomatitis
A
CUS lesions are larger in size and number and can take weeks to months to resolve
7
Q
How to treat CUS
A
oral steroids and hydroxyfluroquin
8
Q
What is keratosis pilaris commonly called
A
“chicken skin”
9
Q
How to treat keratosis pilaris
A
emollients and moisturizers
(this condition is commonly outgrown)
10
Q
What is the classic look of impetigo?
A
Honey crusted or yellow tinged lesions
11
Q
What are the two most common bacterial causes of impetigo?
A
-Strep pyogenes
-Staph aureus
12
Q
How to treat bollous impetigo
A
must have oral abx (keflex, dicloxacillin, doxy)
13
Q
How to treat non-bollous impetigo
A
topical mupuricin ointment (bactroban)
14
Q
What has a classic “christmas tree” pattern with a “herald patch”
A
Pityriasis rosea
15
Q
Treatment for pityrasis rosea?
A
it usually self resolves
16
Q
What does a brown recluse spider bite look like
A
-Deep purple spot with white halo around it
-VERY tender
17
Q
How to treat rocky mountain spotted feaver
A
doxycycline
(even if pregnant or a kid)
18
Q
When/where does the rash develop after a bite in rocky mt spotted fever
A
Starts 3-5 days after initial s/s and starts on palms and soles initially
19
Q
What is erythema migrans
A
lyme disease
20
Q
What does the rash of erythema migrans look like
A
“bulls eye” lesion
21
Q
How to treat erythema migrans or lyme disease
A
1st- doxycycline
2nd- amoxicillin if pregnant or allergy to doxy
22
Q
What is the other name for measles
A
Rubeola
23
Q
What are the three distinguishing signs or symptoms of rubeola (measles)
A
“The three C’s”
-Cough
-congestion
-conjnctivitis
24
Q
When does the rash develop in rubeola (measles)
A
3-5 days after the “3 C’s”
25
What are the oral lesions in rubeola (measles) and what do they look like
-Koplik spots
-Look like grains of sand with a red halo
-starts 3-5 days after the 3 c's with the rash
26
How to prevent rubeola (measles)
vaccination at 12mo (live vax)
27
What is the most common symptom of mumps?
parotid gland swelling
"mumps with a jaw bumps"
28
Describe atinic keratosis
-dry, scaly lesion
-sun exposed area
-pink, yellow, tan, pale, brown in color
29
Treatment for atinic keratosis
-- 5-FU (fluroicil)
-- cryotherapy
30
What does actinic keratosis commonly lead to if untreated
squamous cell carcinoma
31
Describe squamous cell carcinoma
-red, scaly "crusty
-Bleeds easily
-sun exposed area
32
How to diagnosis squamous cell carcinoma
-biopsy
33
What do cafe au laid spots look like
-flat areas of darkened skin
34
if the patient has more than 6-8 cafe au lait spots, what other dx needs to be considered
-neurofibromatosis
35
What skin condition is usually described as "stuck on" brown spots
seborrheic keratosis which is benign
36
Describe basal cell carcinoma
-Telangiectasias (visible vessels)
-Shiny, waxy, pearly
37
Most common type of skin cancer
Basal Cell
(most common spice)
38
What to do if we suspect basal cell carcinoma
-Biopsy and refer to derm for removal
39
What is the other name for eczema
Atopic dermatitis
40
Describe atopic dermatitis
-flexor surfaces
-The itch that rashes
41
How to treat atopic dermatitis
-Emollients
-Topical steroids
42
What are the three a's that commonly come together (atopic triad)
-atopic dermatitis
-asthma
-allergies
43
Describe plaque psoriasis
-Thick silvery scales
-Auspitz sign
-Koebner's phenomenon
44
What is Auspitz sign
When plaque psoriasis lesions are scratched and pinpoint bleeding occurs
45
What is Koebner's phenomenon
When trauma to the skin produces new lesions in plaque psoriasis pts
“Koby is always hurting himself”
46
How to treat plaque psoriasis
-topical steroids
-coal tar
-derm referral
47
When to start acyclovir for shingles
within 48-72 hours
48
How to treat contact dermititis
-topical steroids
-avoid irritant
49
Describe shingles
-follows across a dermatome
-vesicular
-proceeded by burning/tingling
50
Describe stage one pressure ulcer
Skin is intact but non-blanching
51
How to treat stage one pressure ulcer
Foam dressing- cushions the area
52
When is a pressure ulcer unstageable
when you cant see the wound bed
53
When is eschar on heels good?
-no s/s of infection
-seals out bacteria in DM pts
54
S/S of scabies
-Very itchy (everyone in house)
-Marks between fingers
55
How to treat scabies
Treat everyone with permethrin cream and wash everything in HOT water
(treat x2 often needed)
56
What is varcella
chicken pox
57
How is varcella often described
"lesions in various stages of healing"
58
When can kids with varcella return to school
when all lesions have crusted over
59
When is the varcella first given
at 12mo (live)
60
S/s of head lice
-itching of scalp day and night
61
Lice treatment
-Permethrin cream kills live ones
-Comb nits/eggs out
-wash everything in HOT water
62
Describe a molluscum contagiosum lesion
-flesh colored
-indent in the middle of lesion (umbillicated)
63
How to treat molluscum contagiosum lesions
-they self resolve
-consider sexual abuse if in the genital region on a kid
64
Describe antrax lesion
-ulcerated
-black
-painless
65
who might you see anthrax in
cattle farmers
66
how to treat anthrax
1st- ciprofloxacin
2nd- tetracyclines (doxy)
67
Risks of hidradenitis suppurativea
-obesity
-smoking
-genetics
68
Common areas for hidradenitis suppurativa
-groin
-thighs
-axilla
-breast folds
69
How to treat HS
Mild- warm comprsses
Severe- I&D, culture
Abx if infection is suspected
70
What is folliculitis
infection of the hair follicle plus surrounding skin
71
How to treat folliculitis
-Usually self resolves
-Warm compresses
-topical mupuricn ointment (bactroban)
-oral abx if severe (keflex, pcn)
72
Describe the rosacea rash
A facial rash that does NOT spare the nasal fold
(you dont spare your nose when smelling a rose)
73
How to treat rosacea
Metronidazole gel
74
Describe lupus rash
"mallar rash" or butterfly rash that does spare the nasal folds
75
What symptoms are consistent with sjogren's syndrome
-dry eyes and mouth
76
what is erysipelas
a more superficial form of cellulitis
77
Describe erysipleas
-sharply defined/well demarcated borders
-superficial redness
78
How to treat erysipleas
-keflex
-PCNs
79
How to treat purulent cellulitis
(could be MRSA)
-Bactrim
-Clindamycin
-Doxycycline
80
How to treat non-purulent cellulitis
-Keflex
-PCNs
81
First line acne treatment
-Topical benzynol peroxide
82
Second line acne treatment
-topical abx (clindamycin)
-Topical retinoids (tretoinin)
83
Third line acne tx
oral abx (doxy)
84
4th line acne tx
-derm referral
85
What is the black box warning associated with isotretoinin
YOU CANNOT GET PREGNANT
86
What must you wear with tetracyclines?
SUNSCREEN
87
what can cause a geographical tongue
Spicy/hot foods
88
Can you scrape off oral candidiasis
yes
89
What disease causes "slapped cheeks"
Fifth's disease
90
How do pts with fifth's disease present
-Fever first
-Slapped cheeks rash
-lacy, net-like rash across body
91
When is a pt with fifths disease no longer contagious
when the rash APPEARS
92
Who needs to stay away from those with fifths disease?
pregnant people- fetal demise and miscarrage
93
what is enterobiasis
pin worms
94
s/s of enterobiasis
very itchy genital region at night
95
how to treat enterobiasis
mebendazole, abendazole
OTC pyrental pamoate
96
How to dx enterobiasis
scotch tape test
97
Abx for animal bites
augmentin
98
What is amblyopea
"lazy eye"
99
What is 20/200 vision
legal blindness
100
First step with any pt that comes in with a visual complaing
test acuity
101
what usually causes amblyopea
strabismus
102
what tests for color blindness
-anomaloscope
-ishihara chart
103
What cranial nerves are associated with the eye
II
III
IV
VI
104
CN II
optic- visual acuity
105
CNIII
oculomotor- focus
106
CNIV
trochler- downward and inward mvts
107
CN VI
abducens- outward mvt and side to side mvt
108
Which are lighter on fundoscopic exam arteries or veins
retinal arteries are thinner and lighter than veins
109
Describe a normal optic disc
-Sharp margins
110
What is papillidema
swelling of the optic disc- refer!
111
What fundoscopic exam findings are associated with HTN
-Papilledema
-AV nicking
-copper wire arteries
-flame hemmorrhages
112
What fundoscopic exam findings are associated with DM
-cotton wool spots
-blot hemorrhages
-microanurysms
-neurovascularazation
113
What are copper wire arteries on fundoscope
when the arteries look red
114
what is AV nicking on fundoscope
when an artery crosses a vein causing it to bulge at the intersection
115
what is neovascularization on fundoscope
formation of new tiny blood vessels
116
Describe the S/S of acute angle-closure glaucoma
-sudden SEVERE pain
-blurred vision
-eye feels firm (tonometry with increased IOP)
117
What is someone with acute angle glaucoma at risk of
blindness- refer to ED
118
Describe typical description of a retinal detachment
-"curtain being pulled over eye"
-Painless
-Frequent flashes/floaters/blurred vision
119
What are pts with retinal detachment at risk of
blindness- refer to ED
120
What is arcus senilis
grey halo around iris
121
What is xanthelasma
-yellow patches near corner of eye
122
When is xanthelasma considered benign
in old folks
123
how does cholesterol concerns present in the eye
-arcus senilis
-xanthelasma
124
What is the med term for pink eye
edenoviral conjuctivitis
125
Where is a pterygium
-encroaches on the corneaa
126
Where is a pinguecula
does NOT extend into the cornea
127
What is a chalazion and how to treat
-A blocked duct
TX: Warm compress
128
what causes a horeolum and how to treat
-Caused frequently by staph
-TX: warm compresses and abx
129
Which type of conjunctivitis starts bilaterally
allergic
130
Which type of conjunctivitis will have cervical lymphadenopathy
allergic
131
which type of conjunctivitis has serous and stringy drainage
allergic
132
Which type of conjunctivitis has purulent drainage
bacterial
133
Which conjunctivitis has preauricular and submandibular lymphadenopathy
viral
134
which type of conjunctivitis has no w`1
bacterial
135
what is leukoria
white reflex
136
when might you see leukoria
with cataracts
137
what is presbyopia and when does it usually begin
age related vision loss starting after 40
They will often state "my arms are too short"
138
What eye concern is often associated with bells palsey
corneal abrasions because they cannot close their eye- LUBE!
139
how to dx a corneal abrasion
-florascene stain
-tonometry if we need to R/O AAG
140
How would a pt with iritis present
-eye pain that is light sensitive
-poor visual acuity
-inflammation and swelling of the iris
141
how to treat iritis
refer! risk for blindness
142
How would a patient present with a cranial tumor
-dull persistent headache that is always in the same spot
-N/V
-Vision changes
-Behavioral/personality changes
143
How to DX cranial tumor
head CT
144
When will symptoms of a TIA vs Stroke dissapear
within one hour
145
What causes wernicke-korsakoff syndrome
-alcoholism related B1 vitamin deficiency (thiamine)
146
Which type is wernickes
receptive
147
which type is broca's
expressive
148
Evaluation of stroke pts
"BE FAST"
-balance
-eyes
-face
-arm
-speech
-time
149
Describe a cluster headache presentation
-one sided
-tearing/runny nose
-occurs around same time daily
150
Cluster HA tx
-100% 02
-CCBs (verapimil)
-Imatrex?
151
How to definitively dx temporal arteritis
bx
152
What can temporal arteritis lead to
blindness
153
What is temporal arteritis also called
giant cell arteritis
154
Describe temporal arteritis s/s
-One sided HA
-possible visual impairment
-temple pain/pulsing
-increased ESR on bloodwork
155
Tx or giant cell arteritis
long term oral steroids
156
What condition is commonly associated with giant cell?
polymyalgia rheumatica
157
Describe a HTN HA
-occipital HA
-typically present upon awakening
158
How to tx HTN HA
-change or add meds
159
Describe migraine s/s
-difficulty with noise and light
-trobbing/pulsating
-N/V
-aura prior
160
What are the migrane abortive meds and who are they contraindicated in
-triptans
-Contraindicated in pts with uncontrolled HTN and those taking SSRIs
161
Which neurotransmitter is the issue with parkinsons
dopamine
162
What are the three main symptoms in parkinsons
-bradykanesia (most debilitating)
-tremors
-ridigity
163
What is the main tx of parkinsons
levodopa/carbadopa
164
Which two tests are helpful to dx meningitis
-brudzinski's
-Kernig's
165
Positive brudzinski's
"B=Back of head"
Flexing back of head causes knees and legs to also flex
166
positive kernig's
"K=Knee"
-Cant extend knee past 90 degrees without severe pain
167
What are the three "A"s associated with alxheimers
--Apraxia- inability to carry out skilled movements
--Aphasia
--Agnosia- inability to name objects/people
168
What is the overall goal of alzheimers tx
-slow progression
169
What tool is most often used to assess alzheimers
MMSE
170
CN order mnemonics
oh oh oh to touch and feel a great vein, ah heaven
171
CN function mnemonic
some say marry money but my brother says big brains matter more
172
Which nerve is associated with trigeminal neuralgia
the trigeminal- CN V
173
S/S of trigeminal neuralgia
-severe stabbing pain in the face (so severe that these folks are at risk of suicide)
174
First line treatment for trigeminal neuralgia
-tegretol (carbamazepine)
-Is an anticonvulsant
175
which CN is associated with bells palsey
CN VII
176
which two test assess CN VIII
Rinne and weber
177
Normal Rinne finding
air is 2x longer than bone conduction
178
Abnormal rinne finding
Bone conduction is longer than air
179
Normal weber finding
no lateralization to either ear
180
abnormal Weber finding
lateralization to either ear
181
S/S of meinere's disease
-vertigo
-tennitus
-ear pressure
-nystagmus
182
Biggest concern with minere's disease
risk for permanent hearing loss
183
Why do most pts stop SSRI/SNRI
-sexual dysfunction
-wt gain
184
What supplement can be used to treat depression
St Johns wart
185
When is St Johns wart contraindicated
with any other serotonin meds!
186
S/S of serotonin syndrome
-shivering
-shaking
-seizures
-tachy
-aggitation
187
What to do in no change in PHQ after starting SSRI 4-6 weeks ago
increase dose or look for other cause
188
Advise if N/V on SSRI/NRI
GI symptoms usually self resolve in a few weeks
189
When to try to taper off SSRI/NRI
Stay on for at least 6mo when well controlled
190
How to approach suicidal ideation
-be straight forward
-Ask about plan and refer for 72 hour hold if they do
191
Which SSRI should be avoided in the elderly and why
-Fluoxetine (prozac) because it has a very long half-life
- Tticyclics- anticholinergic SEs
192
Why are TCAs not first line for depression
Lots of anticholinergic SEs
(doxepin, nortriptyline, amitriptyline)
193
Which two antidepressants are safest in the elderly
-Sertraline
-Escitalopram
Both have safe SE profiles
194
Which SSRI is most sedating
Paxil (paroxetine)
195
Which SSRI should be avoided in an anxious patient and why
Fluoxetine (prozac)- it can produce jitteriness
196
Biggest SEs of ziprexa and seroquel?
-Wt gain
-Increase hyperlipedemia
-Get a lipid, BG and wt prior to initiating
197
Describe the two phases of bipolar
Mania- no sleep, impulse issues, over excitement
Depression- lack of motivation
198
What is commonly used to treat bipolar
Lithium
199
what is the therapeutic range for lithium
0.5-1.2
200
What are some issues with lithium
-Very narrow therapeutic range
-Long term SEs
-Induces hypothyroidism with long term use
201
S/S of PTSD
-nightmares
-hypervigilance
-exaggerated startle
-flash backs
insomnia
202
first line tx for PTSD
SSRIs but poorly researched
203
Tx for seasonal affective disorder
more light
204
Which enzyme pathway is responsible for why we cant give SSRI with st. johns wart
CYP3A4
205
Which pathway impacts an asian's ability to metabolize pain meds and reduce their effectiveness
CYP2C19
206
What is the ASCVD risk cutoff for initiating a statin
7.5%
207
Normal total cholesterol
<200
208
Normal HDL
40-60
209
Normal LDL
<100
210
Normal triglycerides
<150
211
How often to check lipids if no risk factors present
Q5y
212
How often to recheck lipid after initiating statin
Q1-3m then yearly
213
Which two HMG CoA reductase inhibitors can be high intensity
atorvastatin and rosuvastatin
214
S/S to watch for with statins
-new muscle pain (check CK, stop statin, can lead to acute renal failure)
-S/S of jaundice (draw LFT)
215
What dietary thing to avoid with statins
grapefruit juice
216
When should you be concerned with triglycerides
when it is over 500
217
When triglycerides are over 500, what to tx and why
fenofibrate to prevent pancreatitis
218
JNC8 HTN goal
<140/90
219
When to initiate treatment in those older than 60? for the JNC8
>150/90
220
Goal for AHA/ACC
<130/80
221
Stage 1 HTN treatment with ASCVD cutoff for AHA at
10%
222
ACE monitoring
-Renal function: GFR, BUN, Creat
-K+ (at risk for hyperkalemia)
-Watch for angioedema and cough
223
When do we switch to an ARB
when they fail an ACE (me)
224
TZD is bad for who?
-DM (increase BG)
-Gout (increases uric acid)
-Hyperlipidemia (increases triglycerides)
225
Which pt is a thiazide particularly good for?
those with osteoporosis because it stimulates osteoblasts and Ca+ retention
226
Typical SE of CCB
-ankle edema
-HAs
-Worsens GERD symptoms (relaxes sphincter)
227
Renal protective antiHTN
ACEi
228
What BP meds are safe in pregnancy
"New Little Momma"
-Nifedipine
-Labetaolol
-Methyldopa
(do not give ACE, ARB, Statins, Methotrexate)
229
What are the two most common causes of CKD
HTN and DM
230
What is ideal for isolated systolic hypertension in the elderly
(caused by stiffening of blood vessels)
CCB because it relaxes the smooth muscle
(Apparently Tzds as well)
231
What is it called when there is a variance in inspiration and expiration?
respiratory sinus arrhythmia
232
In what population is respiratory sinus arrhythmia common in
-Associated with young and healthy people
-Doesnt need treatment
233
What is pulsus paradoxus
When there is a 10+pt drop in systolic BP upon inspiration
-EMERGENCY as it can indicate a cardiac tampanaude or status asthmaticus
234
Why are CCBs not recommended in HF?
decreases the force of contraction
(they should also DC NSAIDS as it increases Na+ retention)
235
Diagnostic HF labs/tests
-BNP
-EKG
-CXR- cardiomegaly
-Echo- measures EJ
236
what is the ejection fraction in those with HF
<40 is HF
237
What kind of sound will you hear with HF
S3 (associated due to fluid overload)
(also heard in pregnancy)
238
Why are TZDs and CCBs not used in HF?
both cause edema
239
When should a HF pt call you with increased weight
if they gain more than 2kg per day
(increase/add a diuretic)
240
Why avoid NSAID with HF?
Encourages Na+ retention
241
A fib is the 1# risk for what
clot, stroke
242
Describe ekg of a-fib
irregularly irregular with NO P wave
243
What two meds will a chronic A-fibber be on
-Anticoags- stroke prevention
-BBlocker for rate control
244
Normal INR for those not on antigcoag
around 1
245
Therapeutic INR on warfarin
2-3
246
Antidote for warfarin
Vitamin K
247
When to give Vitamin K
-Active bleeding
-INR over 10
248
How to treat raynaud's?
-CCB (relaxes small vessels)
-Avoid triggers (cold, stress)
249
Order of valve
Aortic
pulmonic
tricuspid
mitral
250
What makes the S1 sound
-Closure of the mitral and tricuspid valves (AV)
251
What makes an S2 sound
Closure of the semi-lunar valves: aortic and pulmonic
252
Which is the only sound heard at the base of the heart
S2
253
When is the S3 heard
in cases of fluid overload like HF and Pregnancy
254
When is an S4 heard
In uncontrolled HTN with left ventricular hypertrophy
255
When is a split S2 NORMAL
-on INSPIRATION only
Abnormal if heard on inspiration and expiration (REFER)
256
nemonic for systolic murmurs
"Mr. Peyton Manning As MVP"
257
nemonic for diastolic murmurs
"ARMS"
258
What are the systolic murmurs
"MR"- Mitral Regurgitation
"Peyton Manning"- Physiologic Murmur
"AS" - Aortic stenosis
"MVP"- mitral valve prolapse
259
What are the diastolic murmurs
"ARMS"
AR- aortic regurgitation
MS- mitral stenosis
260
Three steps for murmurs
1) systolic or diastolic
2) WHERE
3) associated symptoms
261
Which type of murmurs radiate?
ONLY SYSTOLIC
262
Which murmurs are worst
diastolic = Doom
263
Which murmur radiates to the neck
Aortic stenosis (is systolic, closest to neck)
264
Which murmur radiates to the arm pit
Mitral regurgitation (is systolic and close to the arm)
265
What grade of murmur will have a palpable trill?
Grade 4
266
S/S of intermittent claudication and what disease is it associated with
- Pain relieved with rest and dangling
-Associated with PAD
267
S/S of PAD
-purple/hyperpigmented legs
-shiny legs
-Toe ulcerations
268
Diagnostic test for PAD
Ankle bracheal index of < 0.9
Ankle/arm=ABI
269
Biggest risk factor for PAD
smoking
270
Treatment for PAD and intermittent claudication
continue to walk
271
s/s of venous insufficiency
-red/brown color legs
-edema
272
what are chronic venous insufficiency pts at risk for?
DVT due to poor venous return and blood pooling
(get doppler and D-dimer)
273
Most common asthma symptom
cough
274
Order of asthma severity
-intermittent
-mild
-moderate
-severe
275
How to measure treatment success in asthma
-peak flow monitoring
-success is not based on rescue inhaler use
276
Which asthma med do we NEVER give alone and why
-LABAs
-They MUST always be combined with an ICS!!!! risk for sudden death
277
What three things impact peak flow
"HAG"
-height (largest predictor in adults)
-age
-gender
(peds considers weight as well)
278
What is NOW the cornerstone of asthma treatment
low lose ICS (budesonide)
279
What is NOW the preferred rescue inhaler?
ICS with LABA?????????
280
Ending for all bronchodialators?
"-terol" (like albuterol!)
281
Ending for ICS
"-ide" (budesonide)
"-sone" (fluticasone)
282
Treatment foe intermittent asthma
ICS+LABA PRN
(PRN rescue med)
283
Tx for mild asthma
Low dose ICS daily
+ ICS/LABA rescue
284
Tx for moderate asthma
ICS/LABA daily
or
ICS and monalucast
ICS/LABA= budesonide/fomotrol
285
COPD is a combo of what two diseases
chronic bronchitis
emphysema
286
How to Dx COPD
FEV1/FVC of less than 0.7 or 70%
287
s/s of COPD
-barrel chest
-clubbing of fingers
-chronic cough
-hyperresonance
288
Treatment groups for COPD
A, B, C, D
289
Medication flow for COPD meds
SABA, LABA, LAMA, COMBO
A- SABA
B- LABA
C- LAMA
D- LAMA or combo (lama-ICS)
290
What should you be concerned about if a pt with COPD loses weight??
-investigate for lung CA
-Could also be that they are just burning so many calories from work of breathing
291
Antibiotics for PNE in healthy, outpt adults
"MAD"
-Macrolide (azithromycin)
-Amoxicillin
-Doxycycline
292
s/s of PNE
-Cough/ronchi/wheezing
-Fever
-Chills
-Increased tactile fremitus
293
Treatment for PNE with comorbidities or Abx in the last 90 days
-Respiratory fluoroquinolones (levofloxacin)
or
-Augmentin (amoxacillin clavulanic acid) plus a macrolide (azithromycin)
CIPRO IS NOT A RESPIRATORY FLUOROQUINOLONE
294
What are the CURB criteria and how many points send the pt to the hospital
-Confusion
-Urea (BUN) >19
-Respiratory rate over 20-30
-BP <90/60
-Age over 65
Each is one point, admit if over 3
295
Where will you see infiltrates for TB
upper lobes
(lower in PNE)
296
At what induration on the TB skin test is positive for those with HIV, exposed, or immunocompromised?
>5mm
297
At what induration on the TB skin test is positive for immigrants
>10mm
298
At what induration is considered positive for TB in the general/healthy population
>15mm
299
How to confirm TB
-sputum cultures
300
When does HIV turn to AIDES
when CD4 is less than 200
301
Untreated strep can lead to what
-rhumatic fever
-glomularnephritis
302
How to treat strep
PCN
303
How to treat mono
Symptom management
304
When can a pt with mono go back to sports
-get spleen US first
305
Why cant we treat a pt with strep and mono with amoxicillin?
PCN plus mono= morbilliform rash
-you can use Pen VK though
-Can also use macrolide or cephalosporin
306
Key findigs in peritonsillar abcess
-large, erythematous, tonsil
-DEVIATED UVULA
307
most common cause of peritonsillar abcess
strep
308
What to do with a pt with a peritonsillar abcess?
-send to ED/ENT for drainage they can lead to sepsis and airway blockage
309
most common cause of bronchitis
viral
310
symptoms of bronchitis
chronic, nagging cough
311
when to treat bronchitis
only if it is pertussus
Macrolides erythromycin, clarithromycin, and azithromycin* are preferred for the treatment
312
What can chronic sinus infections lead to
nasal polyps
313
S/S of sinusitis
-recent URI (7-10 days ago)
-Recurrence of symptoms
-pain when bending over
-unilateral toothache
314
how to treat sinusitis
-amoxicillin or augmentin to prevent periorbital cellulitis
315
Allergic rhinitis treatment
1st- intranasal corticosteroids
2nd- antihistamines
316
normal TSH
0.5-5.0
317
how often to recheck TSH after starting medicaiton
4-8 weeks
318
Cardiac rate control for hyperthyroidism
BBlockers
319
1st trimester antithyroid drug
-PTU
320
2nd trimester antithyroid drug
-Tapazole
321
Three antithyroid drugs
-PTU
-Methimazole
-Tapazole
322
what does the parathyroid do
keeps Ca+ and Phosphorous levels balanced
323
CA and phos in hyperparathyroid
- increased CA and decreased Phos
324
Ca and phos in hypoparathyroid
-decreased Ca and phos
325
what is smogyi effect
(dip and rebound sugars)
There is a dip in the middle of the night and rises in the AM
326
management of somogyi effect
-change night insulin dosing
-take a snack
-dont exercise before bed
327
Dawn phenomenon
Blood glucose steadily rises all night due to an increase in nighttime hormones
common in kiddos going through a growth spurt
328
ADA DM screening reccomendations
start at age 45 and q3y but those with risks should be screened earlier
329
A!C diagnostic for DM
6.5
330
max dose per day of metformin
2000-2550 per day (depends on which type)
331
What can long term metformin lead to
B12 deficiency
332
SE of metformin
GI upset (diarrhea) start low and go slow
333
monitoring for metformin and when to change dosing
renal function
if less than <46 1/2 dose
if less than <30 DC
334
avoid metformin in who and why
alcoholics- lactic acidosis risk
getting contrast- kidney damage
335
chich medications are most likely to give you hypoglycemia
sulfonylureas
336
which diabetic meds are considered cardio protective
SgLT2 (flozyn)
GLP-1
337
Annual DM screenings
-podiatry
-optho
microalbumin
A1c
338
at what A1c to start insulins
>9%
339
does metformin cause hypoglycemia?
NO
340
which disease is too little cortisol
addisons
341
which is too much cortisol
cushings
342
s/s of addisons
-hyperpigmentation
-hyperkalemia (but everything else decreased)
343
s/s cushings
-all labs are increased except K+
-moon face
-purple striae
-truncal obesity
344
safety concerns with addisons
addisonian crisis which can happen anywhere so they must carry steroids anywhere
345
how to Dx lupus
ANA alone is not enough but if ANA is positive with sterotypical symptoms it can be diagnostic
346
what is the Lupus rash and describe
-Malar rash (butterfly) which DOES spare the nasolabial folds
347
s/s of sjogrens syndrome secondary to lupus and how to treat
-dry mouth - gum
-dry eyes -eye gtts
348
what organ is most beat up from lupus
kidneys- keep eye on renal function
lupus nephritis is a thing
349
normal MCV level
80-100
350
MCV <80 what type anemia and causes
microcytic
"LIT"
-lead
-iron
-thalassemia
351
MVC of >100 what anemia and causes
Macrocytic
-folate
-b12
352
Anemia type and why in alcoholics
macrocytic due to increase in b12 and folate deficiencies
353
Neurologic symptoms in b12 deficiency anemia
-tingling hands and feet
-unsteady gait
-beefy red tongue (glossitis)
354
What is MCV
side of red blood cells
355
iron deficiency anemia s/s
-nail spooning
-pica
-pale
-fatigue
356
how to dx sickle cell AND thalassemia
hemoglobin electrophoresis
357
Two common causes of a sickle cell crisis
1) illness
2. dehydration
358
how to manage sickle cell crisis
- refer to ed for IVF and IV pain meds
359
Positive HBsAg means
There IS an infection (acute or chronic)
Ag= always growing
360
positive IgM means
M= misery this minute
Positive in an active acute infection
361
Positive IgG means
G=Gone
Positive in an old infection which is over
except if the Ag is also +
362
+ Ag and + G
chronic infection
363
-Ag and + G
infection over but was there
364
What to do to an exposed but unvacinated hep b
viccinate at gieve immunoglobulin
365
Is the hep B vaccine safe in pregnancy?
YES
366
What can thalassemia lead to and how to treat it??
-Hemacromatosis (Iron overload)
-Polycythemia vera (clotting risk)
Treat by blood letting!
367
Causes for polycythemia vera
-thalassemia
-living at high altitudes
-COPD
368
TNM staging
T= tumor size
N= nodes
M= metastasis
369
Two types of cancers of the lymphatic system
Hodgkin's and non hodgkins lymphoma
370
Which is the most common type of lymphoma in adults
non-hodgkins
371
S/S of lymphoma
-enlarged nodes
-fevers
-night sweats
-wt. loss
-fatigue
Workup with CBC
372
two types of lukemia
CLL
CML
373
CML cardinal symptoms
-spleen enlargement
-liver enlargement
-anemia
374
when is leukemia commonly found
on routine blood count (VERY HIGH WHITE COUNT)
375
how is CLL and CML differ in symptoms
CLL has overall less symptoms and may not require treatment
CLL with better prognosis
376
Leukemia symptoms for both CLL and CML
-night sweats
-fever
-fatigue
-bruising
-wt loss
-lymphademopathy
377
Describe a positive psoas
positive if pain on raising leg against pressure/resistance
Signals appendix
378
Describe a positive markle
(also called heel drop)
Positive if pain on Right side when pt hops on one foot
signals appendix
379
Describe a positive blumberg
(classic rebound tenderness sign)
Positive if pain upon releasing palpation of RLQ
APPENDiX
380
Describe a positive mcburney's point
(location 2/3 the distance from navel to right anterior superior iliac spine)
Positive if tender on palpation
indicates appendix
381
Describe a positive murphys sign
Pain produced with deep palpation of RUQ while pt takes deep breath
order a US if positive as indicates cholecystitis
382
Describe a positive oburator sign
positive in internal rotation of right hip at 90 degrees causes RLQ pain
signals appendix
383
How to confirm an appy?
CT
(US can be used but CT is betta!)
384
Describe a positive rovsing sign
(think reverse)
positive if palpation of the left produces pain on the right
indicates appendix
385
when to order a HIDA scan
when we suspect cholesystitis but US is negative (will tell us how the gallbladder is functioning in more detail)
386
why cant we do a HIDA first?
cant do it if there ARE gallstones
387
Describe cullens sign
"cullen=center"
Bruising around the umbillicus
sign of necrotizing pancreatitis, ectopic preg., or any abdominal bleeding
388
describe gray turner's sign
"turn the pt to see the turners"
bruising at the flanks
sign of necrotizing pancreatitis, ectopic preg., or any abdominal bleeding
389
Pancreas specific labs
amylase, lipase
390
patients with hypocalcemia are at risk for what
seizures
391
when would we see chvostek and trousseau signs
with very low Ca+ levels
(typically happens after a thyroidectomy when the parathyroid was accidentally damaged or removed)
392
Describe Chvostek sign
taping on pts cheek and one side grimaces
"stek=cheek"
393
describe trousseaus sign
inflation of bp cuff draws arm up with involuntary contraction
394
why might a H2 be more appropriate?
-cheaper
-good for mild cases
-those with osteoporosis, B12 deficiency or C. Diff
395
Long term PPI use can lead to
-c. diff
-B12 deficiency
-osteoporosis
396
who is a PPI particularly good to start on
anyone who has failed a H2
397
When to refer GERD pts
if no improvement with tx= get egd and h. pylori testing
398
Long term uncontrolled GERD can lead to
barretts esophagus
399
Most common cause of peptic ulcer disease
h. pylori
400
What is triple therapy for H. Pylori
"CAP"
-Clarithromycin +
-Amoxicillin +
-PPI
Use metronidazole instead of amoxicillin if PCN allergy
401
Quad therapy for h. pylori
-Tetracycline +
-metronidazole +
-PPI +
-Bismuth
402
WHy is quad therapy becoming more popular in h. pylori tx
abx resistance
403
How does a AAA present
pulsating abdominal mass and back pain
404
What are ultrasounds good at detecting outpt
-kidney stones
-AAA
-cholecystitis
405
what age to start colonoscopies and how often
CDC- 50
American cancer society- 45
Then q10 if clear w/ annual fecal occult
406
Who needs a colonoscopy earlier than 45
-history of colorectal Ca
-1st degree relative with CA
-Inflammatory bowel disease history (crohns, ulcerative colitis)
407
S/s of colorectal Ca
- ribbon stools
408
Where do most polyps occur in colon
descending
409
Difference between IBS and IBD
IBS is NOT inflammatory like IBD therefore CRP and ESR will NOT be elevated in IBS
410
Types of IBD
-UC
-Crohns
411
Differentials in all 4 quadrants
RUQ- cholecystitis, hepatitis, liver disease
RLQ- appendicitis
LUQ- pancreatitis
LLQ- diverticulitis
412
what is gluten found in
-wheat
-rye
-barley
413
s/s of trichomoniasis and how to treat
"strawberry cervix" (pinpoint hemorrhages)
Metronidazole
414
s/s of BV and treatment
-glue cells and positive wiff test
Metronidazole
415
S/S of gonorrhea and how to treat
-friable cervix and increased WBC
Rocephen
416
s/s of chlamydia and how to treat
-friable cervix and increased WBC
1st- doxycycline or azithromycin
417
S/s of herpes simplex and treatment
-painful, burning, vesicles
Acyclovir initiated in the first 48-72 hours
418
How to Dx syphilis
RPR first with FTA-AVS to confirm
419
s/s of syphillis
rash on palms and soles
420
how to treat syphilis
Pen G IM (bicillin)
421
Normal vaginal PH
3.8-4.5
422
what to avoid with flagyl and why
alcohol due to disulfram like reaction
423
Which is a reportable STI
HIV
syphilis
gonorrhea
chlamydia
424
what is herpes keratosis
herpes of the cornea
425
How to treat gonorrhea AND chlamydia together
Doxy plus rocephen
426
When is there true kidney damage on lab
whenever there are RBC (glomulo) and WBC (pylonephritis) casts on urine
REFER with casts!
427
three main kidney labs
-GFR
-Creatinine
-BUN
428
UTI dipstick results in a UTI
positive leukocytes and nitrites
429
Avoid bactrim in patients who also take
warfarin (increased bleeding risk)
430
Aboid cipro with pts who have a history of
tendon pain with prior floroquinolone
431
how to treat UTI in pregnant patients
PCN (augmentin, amoxicillin if covered)
432
BPH on DRE
symmetrically enlarged, rubbery prostate
433
first line tx for BPH
"-zosin" drugs
-terazosin, famsulosin
(relax bladder and prostate muscles)
434
how does finesteride (proscar) work
5-alpha-reductase inhibitor
Actually shrinks the prostate
435
What herbal supplement is popular for prostate issues and what does it interact with
saw palmetto
antiplatelets/anticoags
436
what is the PSA cuttoff before referring
4
437
s/s of epididymitis
1) positive prehn's sign (pain relieved when lifting scrotum)
2) unilateral pain
3) scrotum is swollen
438
Tx of epididymitis if under 35 yo
doxy or ceftriaxone
(usually caused by an STI)
439
tx of epididymitis if over 35yo
levofloxacin
440
S/s of testicular torsion
unilateral pain
absent cremasteric reflex
REFER
441
1st line tx for ED
PDE-5 (slidinafil, tadalafil)
442
what is a contraindication for PDE-5's
NITRO
other undiagnosed heart concerns
443
Who are good candidates for progestin-only birth control
-breastfeeding
-HTN
-smokers
-Migrain pts with aura
444
Non-hormonal BC
copper IUD
445
what does the depo increase the risk of
osteoporosis (limit to 5yr use and take Vt. D)
446
Highest clot risk birth control
zulane patch
447
Who is not a good candidate for estrogen contrining OCP
-migrains with aura
-clot history
-liver disease
-older than 35
-smokers
448
what should always be ordered with a women under 50 who has an abd complaint?
HCG preg test
449
Minors do NOT need parental consent for:
-STI tx
-contraception
-pregnancy care
450
When to start pap smears
ACOG- 21
ACS- 25 yrs
451
risks of hormone replacement
-increased CVC, clot and CA risk
452
HRT increases what type of cancer
ovarian
453
What SSRI can be used for nightsweats and hot flashes associated with menopause
paroxatine (Paxil)
454
does topical estrogen carry the same risk as oral?
no
455
Herbal supplement often used for menopause and its contraindications
ginko (anticoags)
Black cohosh
456
PCOS is caused by
high androgen levels
457
PCOS increases the risk of
-fertility issues
-DM
-hyperlipidemia
-increased endometrial and ovarian CA
458
treatment for PCOS
-metformin
-OCP
459
Causes of glactorrhea
-stimulation
-medication SE
not associated with CA
460
What to check with galactorrhea
-Prolactin level (if high it could be a prolactoma)
-medication list (atypical antipsychotics olanzapine, ziprexa)
461
Subjective or presumptive pregnancy signs
-amenorrhea
-nausea
-breast tenderness
(there are other possible causes)
462
Probable pregnancy signs
"HCG"
-helgar sign (cervical softening)
-Chadwick sign (blue cervix)
-Goodell sign (cervical softening)
-positive preg test (could be something other than a viable fetus)
463
positive or objective pregnancy signs
-Palpation of fetus
-Ultrasound of fetus
-fetal heart tones
464
Most common cause of ectopic pregnancy
-misshapened fallopian tube
-PID/STI hx
-endometrosis
-Prior ectopic preg
465
Fundal height at 12 week
symphsis pubis
466
fundal height at 20 w
level of umbilicus
467
when to test for GBS in preg
36-37w
468
when to test for GDM in preg
24-28w
469
You cannot give which vaccines in pregnancy
live vaccines
-MMR
-Rota
-Intranasal flu
-Varacilla
470
who and when is rhogam given to
all Rh- moms at 28 weeks
if babe is Rh+ mom gets another at 72hrs postpartum
471
Do we need to treat asymptoatic UTIs in pregnancy
YES
472
how to treat UTI in pregnancy
"CAMP"
-cephalosporins (check trimester)
-amoxicillin
-macrobid (check trimester)
-PCN
473
When do we do AFP testing
15-20
474
What is AFP looking for
neural tube defects if high
if low= downs
475
what prevents neural tube defects
folic acid- start before conceving
476
what are downs people at risk for
-alzheimers
-hypothyroidism
-cervical spine instability (get cspine xray prior to sports)
477
What is placental abruption and s/s
a medical emergency in the 3rd trimester
-severe pain
-bleeding and ridged abdomen
478
What is placental previa and s/s
-placenta is covering the cervical opening
-Light, PAINLESS bleeding
479
how to treat mastitis
-dicloxacillin
if pcn allergy- keflex or clindamycin
480
if tx failure in mastitis
refer for mammo
481
Should mastitis pts stop breastfeeding
no
482
osteoporosis on dexa value
-2.5+
483
value of osteopenia on dexa
-1 to -2.5
484
What increases the risk of osteoporosis
-PPI
-Steroids
-Depo
-Smoking
485
How to prevent osteoporosis
take Ca and Vt. D
wt. bearing exercise
486
Drugs used to treat osteoporosis
Bisphosphonates:
-alendronate (fosamax)
-Ibandronate (boniva)
-Zoledronic acid (reclast)
487
when and where would you see bouchards nodes?
in BOTH RA and OA
Boney swelling of the proximal interphalangeal joint
488
When and where would you see heberdens nodes?
in OA
swelling od distal interphalangeal joint
489
When do you see swan neck deformity
RA
490
S/S of RA
SYSTEMIC SYMPTOMS
-any age
- fast onset
- bilateral
- stiffness for over one hour
-swan neck deformity
491
s/s of OA
- occurs as patient ages
-slow onset
-unilateral
-stiffness in AM for less than 1 hr
-No systemic symptoms
492
treament for RA
DMARs - methotrexate
493
Treatment for OA
Nsaids
tylenol
exercise
494
What deficiency can come from methotrexate
folic acid deficiency
495
OA on xray
joint space narrowing
496
what and where is ankylosing spondylitis
A autoimmune and chronic inflamatory arthritic disease
Starts low and works up
497
How to dx ankylosing spondylitis
Xray or MRI
498
what is a "bamboo spine"
a description of ankylosing spondylitis on xray
499
What is a scaphoid fracture also called
navicular fracture or snuffbox fracture
500
how to diagnose and when for a scaphoid/navicular/snuffbox fx
x-ray and can take 2 weeks to "show up"
501
how do we treat scaphoid/navicular/snuffbox fractures
-place pt in thumb spica splint even if xray is negative (prevent osteonecrosis)
502
two signs for carpal tunnel
-Phalen's (backward prayer hands)
-Timel's (taping inner wrist)
503
how to treat carpal tunnel
-splint
-steroids
504
Pt says there is a "pebble" in shoe between 3rd and 4th toes with N/T
morton's neuroma
505
Lateral epicondylitis aka
tennis elbow
506
medial epicondilitis aka
golfers elbow
507
tx of lateral and medial epicondylitis
- RICE
-NSAID
-PT/OT
508
Mcmurray test
lateral and medial meniscus
positive with clicks
supine, knee at 90 degrees and twist
509
apleys test
meniscus
prone, bend knee, twist heel
510
valgus (knockneed)
MCL
511
lachmans test
ACL rupture
pushing femur and lower leg in opposite direction
512
anterior drawer
ACL
pulling lower leg forward
513
varus (bowlegged)
LCL
514
continued knee popping
meniscus
515
how to evaluate for sciatica
straight leg raise
516
diminished knee jerk after squat and rise
L4
517
numbness in the big toee when heel walking
L5
518
absent ankle gerk when walking on toes
S1
519
Rotator cuff tear tests
-Arm drop test- abduct arm out, ask them to return it slow, will be + if arm suddenly "drops"
-Empty can test- (supraspanatous specifically)- arms out, thumbs down, against resistance
520
which med is used for prevention of gout flares
allopurinol
521
SE of allopurinol
-Bone marrow suppression
522
Medications used in a gout flare
-NSAID (indomethacin, naproxen)
-steroids
-colchicine (multiple joints/severe)
523
lifestyle modifications for gout
-low purine diet
-no alcohol
avoid diuretics (tzd can increase uric acid)
524
Diagnosis of gout
elevated uric acid level (not always elevated in an acute attack)
525
What is fibromyalgia
condition with widespread pain and sensitivity
526
How to dx fibromyalgia
Must have these for 3+ months
-pain
-fatigue
-walking up not feeling refreshed
-cognitive problems
527
Treatment for fibromyalgia
"treat your celf"
-duloxetine (cymbalta)
-amitriptyline (elavil)
-pregabalin (lyrica)
- cyclobenzaprine (flexeril)
528
what key lifestyle modification for fibromyalgia
exercise
529
what is hallus valgus aka
bunion
530
Which joint is affected with hallux valgus
first metatarsophalngeal joint
531
how to treat hallux valgus
-brace
-surgery
532
how to dx hallux valgus
x-ray
533
Where is the pain located with plantar fasciitis
heel
534
who is plantar fasciitis most common in
runners
535
when is the pain with plantar fasciitis worst
in the am then it goes away thorugout day
536
treatment for plantar fasciitis
-stretches
-ice
-supportive inserts
-NSAID
-surgery referral
537
Cauda Equina s/s
-sever low back pain
-saddle anesthesia
-new incont.
538
how to tx cauda equina
ER for sx
539
De quervains tenosynovitis s/s
pain in the lower thumb and wrist
540
how to test for de quervains
finklstein test (grip thumb and angle wrist down)
541
bursitis of elbow aka
olecranon bursitis
542
tx of bursitis
-rest
-ice
-NSAID
-joint aspiration and abx if needed
INJECT ONLY LARGE BURSAS
543
posterior fontenelle closure
2-3 mo
544
strabismus disappears
4-6mo
545
palmer grasp disappears
5-6mo
546
kid can stand
12mo
547
kid can sit up unassisted
6mo
548
separation anxiety
9mo
549
say momma and dadda
12mo
550
can walk
12-17mo
551
anterior fontenelle closes
12-18mo
552
hold spoon
15-18
553
genu varum (bowlegs) dissapear
2-3yrs
554
copy a circle
3yrs
555
draw a cross
4yrs
556
ride a bike
5-6yrs
557
birth wt doubles
6mo
558
birth weight tripples
12mo
559
walk up steps
2yrs
560
draw person with 3 parts
4 yrs
561
draw person with 6 parts and coppy a square
5yr
562
can count to 10
5 yr
563
draw some letters and numbers
5 yrs
564
birth reflexes
-rooting
-tonic neck
-grasp
-morow
-stepping
565
toilet training starts at
2yr and may take 1-2 to complete
566
What supplement do breastfed babes need
vt. d.
567
what does HIB protect against
epiglotitis (drooling, respiratory distress)
568
who gets dtap vs tdap
less than 7 gets Dtap
569
bili level for lights
15
570
Mnemonic for kid vaccines
"its time for many happy happy vaccines"
IPV
Tdap
MMR/MENG
hepb
HIB/HPV
varcilla
571
How to check for leukocoria
white reflex
572
what does leukocoria indicate
-retinoblastoma
-conginital cataracts
573
when does regression usually occur
with big life changes
574
what age is too early for puberty
girls- before 8
boys- before 9
575
throw out which of the 5 tanner stages
1-nothing
5-everything
576
what tanner stage does puberty start
stage 2 with breast budding and straight pubic hair
577
what stage does menses start
stage 4 (2-3 yrs after start of puberty)
578
what stage is most important for boys
stage 3- penis grows in length
579
when to investigate no menses
after 15
580
when will girls reach adult height
when they start periods
581
long term SE of anorexia
bone loss
heart disease
582
long term SE of bulimia
dental errosion
esophageal concerns
583
indicators eating disorders are improving
-menses returns
-gain wt
584
what are salter harris fractures, who are they common in and risks
-fractures along the growth plate
-common in pediatric long bone fx
-stunted growth is a risk of not treated
585
what is cryptorchidism
undecended teste
586
what does cryptorchidism increase risk of
testicular CA
587
what is a hydrocele
abnormal fluid around teste
588
589
cause of hydrocele
trauma or born with it
590
Treatment for hydrocele
most self resolve
591
slate gray nevi aka
mongolian spots
592
when do most slate gray nevi resolve
by age 5
593
treatment of acute otitis media
amoxicillin after 2-3 day watchful period
594
otitis externa caused by
pseudomonias
595
how to treat otitis externa
-ofloxicin gtts
-steroid gtts
-analgesic gtts
596
how to treat a cholesteatoma
refer to ENT for removal
597
what is a cholesteatoma
cauliflower-like growth in ear
598
s/s of coarctation of the aorta
-higher bp in arms, lower in legs
-poor lower pulses when compaired to uper
599
how to diagnose vesicoureteral reflux?
voiding cystourethrogram (graded 1-5)
600
what is vesicoureteral reflux
when urine flows back into the ureters and leads to dilation of the kidneys
601
when do we refer for vesicoureteral reflux
stage 3
602
s/s of fetal alcohol
-thin upper lip
-smooth philtrum
-low nasal bridge
603
cause of acne
-genetics
-increase in androgens
604
three step acne treatment approach
-benzoyl peroxide
-topical abx
-oral abx
605
s/s turners syndrome
-female
-short stature
-webbed neck
606
long term effects of turners
-delayed puberty (14yo+)
-fertility issues
607
how to confirm turner's syndrome
karyotype
608
osgood-schlatter disease is what
pain over the anterior tibial terbercle near tendon insertion
609
osgood-schlatter disease treatment
-NSAID
-ICE
will outgrow when bones stop growing
610
s/s of nasal foreign object
-nasal pain
-unilateral drainage
611
Hypertrophic scar will
regress over time
612
S/s of kawasaki disease
-fever 5+ days
-Strawberry tongue
-Peeling rash
613
Treatment for kawasaki disease
-high dose ASA
-IViG
614
Raye's stage 1
stage1: severe vomiting, diarrhea, lethargy, stupor, increased alt/ast
615
Rayes stage 2
personality changes
irritability, aggression, hyperactive
616
rayes stage 3-5
confusion, delerium
cerebral edema
coma
seizures
death
617
what causes pyloric stenosis
swelling or thickening of the pyloric sphincter preventing passage of food from stomach to small intestine
618
what causes intussusception
when part of instesting slides inside or "telescopes" into itself
619
s/s of pyloric stenosis
-projectile vomiting
-olive shaped mass on palpation
620
s/s of intussusception
-jelly like stools
-sausage shaped mass on palpation
621
dx for pyloric stenosis and intussusception
US then refer!
622
St. john's wart
used for depression
concern for serotonin syndrome when taken with SSRI/NRI
623
giko
memory and cognition
concern for increased bleeding when taken with anti-platelets or blood thinners
624
black cohosh
menopausal symptoms
625
CoQ10
cardiac health
626
echinacea
cold/flu symptoms and immune support
627
evening primrose
PMS and menopausal symptoms
628
Kava Kava
anxiety
629
Sam-E
depression
630
saw palmetto
BPH symptoms
631
Soy isoflavones
menopausal symptoms
mimic estrogen
632
valerian root
insomnia
633
634
635
Laba examples
salmeterol,
formoterol,
olodaterol
636
ICS examples
-budesonide
-fluticasone
-beclomethasone
-mometasone
