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Do or Die Flashcards

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1
Q

what category are ACEI/ARBs in 2nd & 3rd trimesters?

A

C & D respectively

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2
Q

which abx prolong QT?

A

macrolides -mycin

quinolones -floxacin

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3
Q

what is a major SE of quinolones?

A

tendon rupture

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4
Q

HIV increases risk of what with abx use?

A

sulfa-related Steven’s Johnson syndrome

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5
Q

ASA suppresses platelet function for how long?

A

irreversibly x7 days

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6
Q

ASA should not be used in which patient population?

A

<16 years old (Reye syndrome)

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7
Q

which abx is used to treat MRSA infection?

A

Bactrim

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8
Q

S. aureus infection is treated with which abx?

A

doxycycline

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9
Q

how should you treat severe poison ivy?

A

14-21 days of oral steroids

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10
Q

which abx interfere with warfarin?

A

erythromycin
clarithromycin
sulfa

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11
Q

which vaccines are considered live vaccines?

A 
MMR
Flumist
rotavirus
varicella
zoster
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12
Q

parameters for mammograms?

A

50-74 years old, every 2 years

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13
Q

parameters for pap smear?

A

21-65 years old, every 3 years

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14
Q

parameters for colonoscopy?

A

50-75 years old, every 10 years

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15
Q

parameters for pneumovax?

A

one time at age 65

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16
Q

parameters for Tdap?

A

one time, then Td booster

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17
Q

normal Rinne test (VIII)?

A

AC > BC

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18
Q

otitis external treatment?

A

cortisporin drops

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19
Q

which vitamin is a teratogenic?

A

high-dose vitamin A

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20
Q

major SE of cholesteatoma?

A

erodes bones of the face damaging CN VII; need abx & debridement

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21
Q

pinguicula

A

yellow triangular thickening (outer cornea)

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22
Q

chalazion

A

“bead” in the upper eyelid

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23
Q

pterygium

A

yellow triangular thickening (inner cornea)

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24
Q

foods that have increased levels of vitamin K?

A

mayo
canola
soy bean

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25
what is a common SE of minocycline?
vertigo, dizziness
26
features of mitral regurg (blood regurg in the L atrium)?
holosystolic murmur, blowing quality | usually grade II-III
27
MR s/s?
``` decreased cardiac output DOE CP orthopnea syncope ```
28
valves of the heart
tricuspid- R atrium & R ventricle pulmonary- R ventricle & pulm artery mitral valve- L atrium & L ventricle aortic valve- L ventricle & aorta
29
blood flow through the heart
``` SVC R atrium R ventricle pulmonary artery pulmonary vein L atrium L ventricle aorta ```
30
areas of the heart
``` aortic pulmonic Erb's tricuspid mitral ```
31
common form of HTN target organ damage?
LVH
32
when do you hear an S3 heart sound?
systolic dysfunction | HF
33
when do you hear an S4 heart sound?
diastolic dysfunction poorly-controlled HTN recurrent MI
34
immediate intervention is anaphylaxis in primary care?
``` ABCs supine position EMS IM epi benadryl, ranitidine IV access, O2 monitoring ```
35
stages of change
``` precontemplation contemplation preparation action maintenance/relapse ```
36
recommendation for breast ca screening?
mammogram annually at age 45 to 54 (then biennially)
37
recommendation for colorectal screening?
colonoscopy every 10 years beginning at age 50
38
recommendation for lung ca screening?
*people at high-risk* 55-74 annual LDCT
39
finasteride (PROSCAR, PROPECIA) falls into which category?
X | 5-alpha reductase inhibitor
40
what does specificity mean?
DO NOT have a disease
41
what is the most common cause of otitis media?
pseudomonas
42
Rocky Mtn Fever presentation
103-105 fever | petechiae (start on hands/feet)
43
Rocky Mtn Fever treatment
doxycycline
44
Remeron is good for which population and why?
elderly | appetite stimulant
45
what score on the MMSE qualifies for dementia?
<24
46
what does CURB-65 stand for?
``` confusion BUN >7 RR >30 SBP <90, DBP <60 age >65 ```
47
what is Korsakoff-Wernicke?
B1 deficiency (chronic)
48
what is the least sedating antihistamine making it OK for elderly?
claritin
49
which oral antidiabetic is not good for the elderly?
glyburide
50
when should osteoporosis screening begin?
age 65
51
who should receive Flumist?
2-49 years ONLY
52
at what age can you receive the shingles/zoster vaccine?
age 60
53
acute closure glaucoma s/s
acute, severe eye pain HA n/v
54
when someone has senile arcus you should...
screen for cataracts
55
gastroparesis is a contrindication for what?
Exenatide (Byetta) | Glucagon-Like peptide 1 receptor
56
PCOS is a risk factor for what?
DMII
57
abnormal lab values in hyperthyroid?
decreased TSH, increased free T4
58
what medication should be avoided in BPH?
elavil
59
what is 1st line treatment for cellulitis?
dicloxacillin PCN allergy- macrolides (Clinda) ? of MRSA- Bactrim
60
what abx should be used for bites?
Augmentin
61
what is hidradenitis suppurativa?
A chronic skin condition featuring lumps in places such as the armpits or groin.
62
how do you treat hidradenitis suppurativa?
Augmentin (S. aureus)
63
how do you treat impetigo?
keflex | macrolides (Clinda)
64
what is impetigo?
highly contagious, causing red sores on the face
65
what are the s/s of meningitis?
``` sudden onset sore throat cough fever HA stiff neck photophobia changes in LOC ```
66
what is recommended for meningitis prophylaxis?
rifampin
67
how is meningitis treated?
IV rifampin and vancomycin
68
s/s of Lyme disease?
``` erythema migrans (bulls-eye) flu-like symptoms ```
69
treatment of Lyme disease?
doxycycline
70
what medication is used to treat varicella and shingles?
acyclovir
71
how do you identify tinea infections?
KOH slides
72
how are tinea infections treated?
-azoles
73
what is the identifying symptom in Measles?
Koplik spots- white, with red base
74
mneumonic MOTIVAED
mitral, tricuspid- AV valves
75
mneumonic APPLES
aortic, pulmonic- semilunar valves
76
a split S2 heart sound signifies what?
normal when heard on inspiration
77
MR. ASH
systolic murmurs MR- left, radiates to apex & axilla AS- right, radiates, noisy
78
MS. ART
diastolic murmurs MS- apex, "snap", low-pitch AR- right, high-pitch, "blowing"
79
CHADS2
``` CHF HTN age diabetes stroke/TIA ```
80
why are CCBs used in a-fib?
rate control
81
what does paroxysmal atrial tachycardia look like on an EKG?
peaked QRS, P waves
82
when does paroxysmal atrial tach occur?
carotid massage | straining
83
what is the 1st line antihypertensive in DM?
ACE/ARB
84
when should an ACE/ARB never be used?
pregnancy | renal artery stenosis
85
what is the first line med for HTN in men with BPH?
-zosin
86
when should thiazides not be used?
sulfa allergy
87
what do you see on an exam in a patient with diabetic retinopathy?
microaneurysms cotton wool spots neovascularization floating spots in visual field
88
what defines NYHA class II?
ordinary physical activity = DOE, fatigue
89
aside from HTN, when are CCBs used?
Raynauds
90
what is the first line treatment in COPD?
inhaled anticholinergics and/or LABA
91
what are the inhaled anticholinergics?
``` Ipratropium bromide (Atrovent®) Tiotrpium Bromide (Spiriva®) ```
92
what are the LABAs?
``` Foradil Serevent Brovana Perforomist (-terol) ```
93
what are the SABAs?
-buterol
94
s/s of acute CAP?
green-rust colored sputum
95
how do you treat acute CAP (no comorbidities)?
macrolide (Clarithro, Azithro)
96
how do you treat acute CAP (comorbidities)?
levaquin
97
how do you treat atypical PNA (gradual onset)?
macrolides
98
how do you treat acute bronchitis?
symptom management
99
what are the absolute contraindications for oral contraception?
``` My- migraine with aura C- CAD/CVA U- undiagnosed bleeding P- pregnant L- liver E- estrogen-dependent tumor T- thrombus S- smoker >35 ```
100
s/s of acute pancreatitis?
+Cullen +Gray-Turner epigastric pain that radiates to back
101
s/s of acute diverticulitis?
LLQ pain rebound pain +Rovsings
102
s/s of acute appendicitis?
RLQ pain +psoas +obturator +McBurney's
103
s/s of acute cholecystitis?
RUQ pain pain radiates to R shoulder +Murphy's
104
how do you treat an H. pylori infection?
clarithromycin amoxicillin PPI
105
how do you treat diverticulitis?
cipro with Flagyl
106
treatment for C. diff?
Flagyl
107
what does it mean when you are HBsAg +?
+ virus, infections
108
what does it mean when you are anti-HBS +
immune
109
what does lone GGT elevation mean?
alcoholism
110
what is a contraindication to using fluoroquinolones?
<18 years old
111
what do you use to treat UTIs?
Bactrim
112
what signifies a UTI (on lab test)?
>10,000 of ONE organism
113
how do you treat acute pyelonephritis?
recephin
114
what tests are used to test for meningitis?
Kernig (flexion hip & knee) | Brudzinski (flexion of neck)
115
cranial nerves
``` olfactory optic occulomotor trochlear trigeminal abducens facial acoustic glossopharyngeal vagus spinal hypoglossal ```
116
tensions HA is?
bilateral
117
s/s of cluster HA?
tearing | nasal congestion
118
treatment of cluster HA
high-dose oxygen
119
when are MCHC and MCH decreased?
iron-deficiency anemia | thalassemia
120
when is TIBC increased?
iron-deficiency anemia
121
when is ferritin decreased?
iron-deficiency anemia
122
when do you see a normocytic anemia?
chronic illness | autoimmune d/o
123
what do pernicious, folate and B12 anemias have in common?
megoblastic RBCs
124
blepharitis is most common in?
fair-skinned people
125
which diagnostic test finds ca ONLY and not polyps?
fecal immunochemical test
126
what does stridor sound like?
high-pitched | harsh on inspiration
127
what is not elevated in pancreatic ca?
amylase
128
what is tinea cruris?
jock itch
129
how do you treat duodenal ulcers?
antimicrobial therapy
130
what vital signs represent shock?
HR >100, BP <80, RR >24
131
Osler nodes and Janeway lesions are indicative of what?
bacterial endocarditis
132
what is vasogenic shock
anaphylaxis
133
how do you treat osteamalacia?
calcium & vitamin D
134
what is the first-line diagnostic testing in ED?
serum glucose TSH lipid panel
135
how do you identify nephrotic syndrome?
proteinuria hypoalbuminemia increased glomerular permeability edema
136
how do you treat pernicious anemia?
B12 for life
137
what is Fifth's disease?
erythematous, macular rash on the cheeks & ears | "slapped cheek"
138
what is autoimmune thyroiditis?
when the body sees the thyroid gland and hormones (TSH, T3, T4) as a threat
139
iron absorption decreases with?
antacids H2 fluoroquinolones
140
S1 heart sound indicates what?
mitral stenosis
141
nitroglycerin can have what SE?
headaches
142
what are the low-potency topical corticosteroids?
hydrocortisone 2.5% flucinolone 0.01% triamcinolone 0.025% desonide (Desowen)
143
what is a normal T4 in the elderly?
8.1
144
what do you see on eye exam wth hypertensive retinopathy?
AV nicking | copper & silver wire arterioles
145
how frequently should you test for DMII after age 45?
every 3 years
146
what is Korsakoff's syndrome?
chronic thiamine deficiency
147
s/s of pulmonary embolus?
``` SOB friction rub tachycardia tachypnea pleuritic chest pain chest discomfort ```
148
what does increased ICP look like on exam?
optic disc swollen with blurred edges
149
who is high risk for prostate ca?
African American- begin to screen at age 40
150
when should you begin screening for prostate ca?
50 yo
151
what are the risk factors for endocarditis?
h/o cardiomyopathy bicuspid aortic valve
152
BRATY diet
bananas, rice, applesauce, toast, yogurt
153
what is a hordeolum?
stye
154
when do you see respiratory alkalosis?
pulmonary embolus
155
when do you see respiratory acidosis?
obstructive lung disease sleep apnea Guillain Barre syndrome
156
what can cause gouty arthritis?
``` thiazides ASA niacin cyclosporine alcohol ```
157
how do you treat an HPV lesion?
trichloracetic acid
158
how do you treat AOM in PCN allergic?
clarithromycin
159
Katz Index
0-6, lower the score the higher the function
160
what causes a gastric ulcer
NSAIDs | steroids
161
which type of ulcers have a higher risk of malignancy?
gastric
162
how do you treat uncomplicated PNA?
macrolides | doxycycline
163
s/s of angle-closure glaucoma?
rapid onset eye pain blurred vision halos
164
what increases susceptibility of gastroenteritis?
increased age poor physical gastric surgery
165
open-angle glaucoma?
increased cup to disc ratio
166
how do you diagnose meningitis?
CSF culture | blood, throat cultures
167
what puts someone at an increased risk for UTI?
low lactobacilli colonization
168
s/s of TB?
fever dry cough malaise
169
what is pseudogout?
calcium pyrophosphate deposition
170
what is the first line treatment for AOM?
amoxicillin
171
causes of chronic blood loss?
erosive gastritis menorrhagia GI malignancy
172
causes of reduced RBC production?
nutritional deficit anemia of chronic disease bone marrow suppression reduced erythropoietin production (chronic renal failure)
173
what medications can cause reduced RBC production?
chronic PPI use | metformin
174
microcytic
MCV <80
175
normocytic
MCV 80-96
176
macrocytic
MCV >96
177
normochromic
MCHC 31-37
178
hypochromic
MCHC <31
179
Normal RDW
11.5-15%
180
normocytic, normochromic with normal RDW is etiology of?
acute blood loss | ACD
181
microcytic, hypochromic with elevated RDW is etiology of?
IDA
182
what test confirms IDA?
Ferritin
183
microcytic, hypochromic with normal RDW is etiology of?
alpha or beta thalassemia
184
who is at risk for alpha thalassemia?
asian, african
185
who is at risk for beta thalassemia?
african mediterranean middle eastern
186
macrocytic, normochromic with elevated RDW is etiology for?
pernicious anemia B12 deficiency folate deficiency
187
normal hgb?
12-14
188
normal hct?
36-43
189
iron supplements should be taken...
on an empty stomach
190
what is the most common type of anemia in childhood, pregnancy, elderly and in women during reproductive years?
IDA
191
acute rhinosinusitis (ARS) is caused by?
allergens, environmental irritants or infection | can last up to 4 weeks
192
acute bacterial rhinosinusitis (ABRS) is caused by?
secondary infection following viral URI
193
first-line treatment for ABRS?
augmentin | doxycycline in PCN allergy
194
in conductive hearing loss, the Weber test lateralizes to....
affected ear
195
how do you treat sensorineural hearing loss?
hearing aids or implants
196
in conductive hearing loss, the Rinne test....
BC >AC
197
s/s of allergic rhinitis (AR)?
nasal congestion rhinorrhea sneezing intraocular and/or nasal itching
198
what is the controller therapy for AR?
``` intranasal corticosteroids (Flonase, Nasacort) LTM (Singulair) as an add-on if not adequately controlled ```
199
what is the reliever therapy in AR?
2nd gen oral antihistamines (loratadine, cetirizine)
200
when should a patient be referred to opthamology?
eye triad: red, painful eyes with new-onset vision changes
201
what is macular degeneration?
central vision loss
202
open-angle glaucoma is identified as?
peripheral vision loss
203
what test is used for early detection of macular degeneration?
Amsler grid
204
what is presbyopia?
hardening of the lens resulting in close vision problems
205
what is anosmia?
diminished sense of smell
206
what is presbycusis?
difficulty with conversation in a noisy place
207
suppurative conjunctivitis treatment?
cipro-, levo-, moxi
208
otitis externa treatment?
mild: acetic acid with propylene glycol and hydrocortisone moderate: drops with cipro and hydrocortisone
209
malignant otitis externa treatment
PO cipro
210
exudative pharyngitis treatment?
pCN V
211
what does actinic keratosis look like?
red or brown, scaly, often tender
212
how do you treat actinic keratosis?
5-fluorouracil 5% imiquimod topical diclofenac
213
which type of skin carcinoma is most common?
basal cell
214
which type of skin carcinoma is more likely malignant?
squamous cell
215
how is scabies treated?
permethrim lotion
216
what are mid to higher potency corticosteroids used in contact dermatitis therapy?
triamcinolone 0.1% | clobestasol 0.05%
217
when >20% of BSA is affected with contact dermatitis, how should it be treated?
prednisone PO
218
s/s of brown recluse spider bite?
red, white and blue
219
treatment for MSSA?
dicloxacillin | cephalexin
220
what is the topical treatment for impetigo?
mupirocin
221
what is the treatment for nonpurulent cellulitis, erysipelas, and impetigo?
PCN VK Keflex dicloxacillin clinda
222
what are the characteristics of first degree burns?
superficial red, painful, dry no blisters
223
what are the characteristics of second degree burns?
superficial partial thickness or deep partial thickness red, blistered swollen, painful (maybe)
224
what are the characteristics of third degree burns?
full thickness | white or charred
225
rule of 9s
1%: genitalia, palmar aspect of hand 9%: head & neck, upper limbs, 18%: lower limbs 36%: trunk
226
treatment of 2nd degree burns?
bacitracin silvadene bactroban
227
s/s of hypothyroidism?
``` thick, dry skin hyporeflexia thoughts too slow weight gain constipation menorrhagia easily chilled ```
228
s/s of hyperthyroidism?
``` smooth, silky skin hyperreflexia mind racing weight loss frequent, low volume, loose stool oligomenorrhea heat intolerance ```
229
common causes for hypothyroidism?
hashimotos RAI treatment lithium, amiodarone, interferon
230
lab values with hypothyroidism?
increased TSH | decreased T3 & T4
231
when should TSH be checked after starting levothyroxine?
8 weeks of therapeutic therapy
232
how should levothyroxine be taken?
with water on an empty stomach same time every day do not take within two hours of iron, calcium, aluminum, magnesium
233
at what point should hypothyroid be treated?
TSH >5
234
what is the treatment for hyperthyroid?
beta-blocker (tremor & tachycardia) PTU RAI
235
what is the role of parathyroid hormone?
appropriate body calcium levels
236
clinical presentation for primary hyperparathyroidism?
moans, groans, stones and bones... with psychic overtones
237
a thunderclap HA is suggestive of what?
subarachnoid hemorrhage
238
what are the abortive medications used in migraine HA treatment?
triptans | ergots
239
what are the prophylactic medications used in migraine treatment?
beta blockers tricyclic antidepressants (-triptyline) depakote, topiramate, sodium valproate butterbur, feverfew, CoQ10, riboflavin
240
which medication is used in the treatment of cluster HAs?
lithium
241
which lab tests are used when there is suspected temporal arteritis?
CRP | ESR
242
treatment for temporal arteritis?
high-dose systemic steroids (6 months-2 years) until biopsy
243
what can be taken to help reduce the risk of developing cataracts?
antioxidants (E & C)
244
what would you expect to see on CSF eval of someone with bacterial meningitis?
WBC median count of 1200 cells/mm3 of CSF with 90 – 95% neutrophil reduced CSF glucose amount below the normal level of about 40% of the plasma level an elevated CSF protein level
245
what EKG findings are associated with digoxin toxicity?
AV heart block
246
what are the triad of responses known as Cushings response seen in neurologic deterioration?
widened pulse pressure bradycardia irregular respiratory pattern
247
most cost-effective method of diagnosing H. pylori infection is?
stool antigen testing
248
how do you establish the diagnosis of GERD?
s/s of heartburn & regurg | DO NOT perform endoscopy, barium, H. pylori
249
when is an endoscopy warranted?
``` dysphagia odynophagia (painful swallowing) unintended weight loss hematemesis melena chest pain choking ```
250
what is recommended treatment for the presumptive diagnosis of GERD?
PPI | once/day, before the first meal
251
other than pharmacologic, what are recommendations in GERD treatment?
head of bed elevation avoidance of meals 2-3 hours before bed weight loss avoiding food that can trigger reflux (chocolate, caffeine, alcohol, acidic foods)
252
in which disease processes to you expect to see leukocytosis?
appendicitis pyelonephritis bacterial pneumonia
253
s/s of duodenal ulcer?
``` intermittent upper abd pain epigastric burning, gnawing pain relief with foods, antacids tender at the epigastrium slightly hyperactive bowel sounds ```
254
s/s of erosive gastritis?
NSAID use intermittent nausea, burning pain limited to upper abd worse with eating hyperactive bowel sounds
255
s/s of diverticulitis?
intermittent LLQ pain fever, cramping, nausea 4-5 loose stools/day negative Blumberg's
256
what are acute disease markers of hep A infection?
HAV IgM | elevated hepatic enzymes
257
what are the acute disease markers for hep B?
``` HBV core IgM ab (earliest to become positive) HBsAg (always growing) HBeAg (extra contagious) elevated hepatic enzymes IgM anti-HBc + ```
258
what are the chronic disease markers for hep B?
HBsAb (Bye)
259
what markers indicate that you are still susceptible to hep B?
HBsAg negative anti-HBc negative HBsAb negative
260
what are the acute markers for hep C?
anti-HCV + HCV viral RNA elevated hepatic enzymes
261
what are the chronic markers for hep C?
anti-HCV present HCV viral RNA normal to slightly elevated hepatic enzymes
262
what indicates that hep C was present in the past?
HCV RNA absent | anti-HCV present
263
what are symptoms of acute hepatitis infections?
``` fever fatigue loss of appetite n/v abdominal pain gray-colored BM joint pain jaundice ```
264
what are the preferred antimicrobials in s. pneumoniae CAP?
doxycycline azithro-, clarithro-, erythro standard dose amox
265
what are the preferred antimicrobials in s. pneumoniae CAP with risk for DRSP?
HD amox | moxi-, levo-, gemi-
266
what are the preferred antimicrobials in h. influenzae CAP?
``` cephalosporins augmentin macrolides respiratory fluoroquinolones doxycycline ```
267
in which population is h. influenzae common?
tobacco-related lung disease
268
what are PE findings with consolidation in PNA?
dullness increased tactile fremitus bronchial or tubular breath sounds late inspiratory crackles
269
what are PE findings with pleural inflammation (pleurisy) in PNA?
sharp, localized pain, worse with deep breathing/movement/cough audible pleural friction rub (inspiration & expiration)
270
treatment of acute bronchitis d/t respiratory tract virus?
Atrovent albuterol short course of oral steroid
271
treatment of acute bronchitis d/t bacterial pathogens?
macrolide | doxycycline
272
clinical presentation of active TB?
``` cough unexplained weight loss/anorexia fever night sweats hemoptysis chest pain fatigue ```
273
what diagnostic tool is used to make the diagnosis of asthma and COPD?
spirometry
274
what diagnostic tool is used for monitoring asthma?
peak flow meter
275
what would you expect to find of PE during acute asthma or COPD flare?
``` hyperresonance decreased tactile fremitus wheeze (expiratory first, then inspiratory) low diaphragms increased AP diameter ```
276
what are the most common COPD symptoms?
chronic cough chronic sputum activity intolerance progressive over time
277
in GOLD 1, mild COPD, what is the expected FEV1?
>80%
278
in GOLD 2, moderate COPD, what is the expected FEV1?
50%-80%
279
in GOLD 3, severe COPD, what is the expected FEV1?
30-50%
280
in GOLD 4, very severe COPD, what is the expected FEV1?
<30%
281
treatment recommendations for GOLD 1-2?
low risk/less symptoms: SAMA or SABA PRN | low risk/more symptoms: LAMA or LABA on set schedule
282
treatment recommendations for GOLD 3-4?
high risk/less symptoms: ICS + LABA (or LAMA) on set schedule high risk/more symptoms: ICS + LABA (or LAMA) on set schedule
283
in addition to bronchodilator use, what would be used in COPD exacerbation?
prednisone 40 mg/d 5-10 days | consider adding ICS
284
in absence of risk factors, when should screening for DM occur?
age 45 (repeated at least at 3 year intervals)
285
which lab values are indicative of DM?
fasting plasma glucose >126 random >200 with symptoms (pols) 2 hr OGTT >200 A1c >6.5%
286
what is a normal A1c?
<5.6
287
what is a normal fasting plasma glucose?
<100
288
what is a normal peak postprandial (1-2 hr post meal) plasma glucose?
<140
289
thiazolidinediones (Actos, Avandia) should not be used in which patient population?
HF- edema risk | should not be used with insulin or nitrates
290
which medications are the sulfonylureas?
glipizide glyburide glimepiride
291
GLP-1 agonists (Byetta, Victoza) should not be used in which patients?
gastroparesis | severe renal impairment or ESRD
292
what are the short-acting, rapid-acting insulins?
Humalog | Novolog
293
what are the regular insulins?
Humulin R | Novolin R
294
what are the long-acting insulins?
Levelmir | Lantus
295
what are the intermediate-acting insulins?
Novolin N | Humulin N
296
what are the components of metabolic syndrome?
``` large waistline HLD low HDL HTN high glucose ```
297
what is the BP goal in patient with DM and/or CKD?
<140/<90
298
BP goal in patients >60 with no DM or CKD?
<150/<90
299
what labs should be monitored with diuretic use?
Na K Mg
300
when is aldosterone most often use?
HF
301
what are the effects of statin therapy?
decrease LDL 18-55% | increase HDL 5-15%
302
what is the most frequent cause of HF?
systolic LV dysfunction
303
PE findings in genital herpes (HHV-2)?
painful ulcerated lesions | lymphadenopathy
304
PE findings in chlamydia?
irritative voiding symptoms mucopurulent discharge large number of WBCs cervicitis common
305
treatment of chlamydia?
azithro
306
PE findings in gonorrhoeae?
purulent discharge irritative voiding symptoms large number of WBCs
307
treatment of gonorrhoeae?
ceftriaxone one-time dose + azithro one-time dose
308
PE findings in trichomoniasis?
``` dysuria itching vulvovagnial irritation frothy, cervical petechial hemorrhages alkaline pH large number of WBCs ```
309
treatment of trichomoniasis?
Flagyl one-time dose
310
PE findings in syphilis?
chancre, firm, round, painless genital and/or anal ulcers with clean base and indurated margins
311
PE findings in genital warts (HPV)?
verruca-form lesions
312
treatment of genital warts?
``` podofilox liquid nitrogen cryoprobe trichloroacetic acid topical imiquimod (external only) ```
313
PE findings in PID?
``` irritative voiding symptoms fever abdominal pain CMT vaginal discharge increased risk of ectopic pregnancy and/or infertility ```
314
treatment of PID?
ceftriaxone one-time dose + doxycycline x14 days with out without Flagyl
315
treatment of acute, uncomplicated UTI in nonpregnant woman?
Bactrim
316
acute bacterial prostatitis PE findings?
``` irritative voiding symptoms suprapubic, perineal pain fever tender, boggy prostate leukocytosis ```
317
treatment of acute bacterial prostatitis in <35 yo?
ceftriaxone one-time dose + doxycycline x10 days
318
PE findings in prostate ca?
nodular, firm, nontender prostate
319
treatment for urge incontinence?
``` detrol ditropan VESIcare enablex toviaz ```
320
paraphimosis
retracted foreskin that cannot be brought forward to cover the glans
321
varicocele
"bag of worms"
322
hydrocele
collection of serous fluid that causes painless scrotal swelling, easily recognized by transillumiation
323
phimosis
foreskin cannot be pulled back to expose the glans
324
cryptorchidism
testicle located in inguinal canal or abdomen
325
opportunistic conditions for which there is no effective therapy?
cryptosporidiosis microsporidiosis progressive multifocal leukoencephalopathy
326
testing for HIV
ELISA | then Western blot to confirm
327
SIGECAPS (depression)
``` sleep interest guilt energy concentration appetite psychomotor suicide ```
328
WATCHERS (GAD)
``` worry anxiety tension in muscles concentration difficulty hyperarousal energy loss restlessness sleep disturbance ```
329
SSRIs (most to least energizing)
``` fluoxentine sertraline citalopram escitalopram paroxetine ```
330
SNRIs
venlafaxine duloxetine desvenlafaxine
331
SDRI
Wellbutrin
332
which SSRi has the longest half life?
fluoxetine (84 hours)
333
FINISH (antidepressant discont. syndrome)
``` flu-like symptoms insomnia nausea imbalance sensory disturbances hyperarousal ```
334
medications used to slow AD?
vitamin E 1000 | or selegiline
335
mild to moderate stage treatment of AD?
donepezil rivastigmine galantamine
336
moderate to severe AD treatment?
Namenda
337
treatment of agitation in AD?
risperidone (if environmental manipulation fails)
338
medications with significant anticholinergic effect?
amitriptyline doxepin oxybutynin
339
mneumonic for anticholinergic effects
``` dry as a bone red as a beat mad as a hatter hot as a hare can't see can't pee can't spit can't shit ```

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