Final 3- Test Devices, leg cramps, dental, sleep aids, hangover Flashcards
(136 cards)
1
Q
false positives and negatives on preg tests due to
A
- waiting too long to read or reading too soon
- doing test too soon
- insufficient contact time on strip
- fertility drugs taken (Profasi gives HCG-human chorionic gonadotropin which is what test tests for)
2
Q
pregnancy tests test for
A
HCG- human chorionic gonadotropin
3
Q
basal temperature method for ovulation
A
take temp orally in morning, do over 3 cycles, increase of .2’ for 3 days means done ovulating
4
Q
ovulation tests test for
A
LH
5
Q
when to start testing for ovulation
A
subtract 14 days from last day of cycle (likely day of ovulation), then start 3 days earlier than that
6
Q
ovulation watch
A
picks up Cl ions on skin, useless
7
Q
normal fasting blood glucose
A
3.8-6.1; optimal is 4-7
8
Q
post prandial blood glucose
A
4.4-7, optimal 5-11
9
Q
post prandial blood glucose
A
4.4-7, optimal 5-11
10
Q
fecal occult blood test
A
- detects presence of blood in stool
- test for colorectal cancer, evaluate cause of abdominal pain, evaluate cause of anemia, as part of routine physical exam if over 50
11
Q
clues to colorectal cancer
A
- over 50
- rectal bleeding
- change in bowel habits
- cramps/lower abdominal pain
- painful defecation
- polyps (via exam)
12
Q
taking blood pressure
A
- correct cuff size (snug, but can put 2 fingers in space)
- empty bladder
- rest 5 minutes before
- no smoking or caffeine in hr leading up to it
- don’t wear restrictive clothing
- bottom edge of cuff 2 cm (1 inch) above elbow
- arm at heart level/rest arm on table
- sit with back supported and feet flat, legs uncrossed
- don’t communicate during
13
Q
how many bp readings?
A
3 at least 5 minutes apart
14
Q
optimal bp
A
systolic less than 120 and diastolic less than 80
-normal is less than 130 and less than 85
15
Q
who needs and how often: bp test
A
all adults ever 2 years, more frequently if high reading or over 60
16
Q
who needs and how often: cholesterol measurements
A
all adults, every 5 years, more for those at high risk
17
Q
who needs and how often: pap test
A
all women within 3 years of being sexually active, no later than 21; annually until 30 if 3 consecutive have been normal, then once every 2-3 years (unless smoke or have multiple sexual partners)
18
Q
who needs and how often: breast cancer
A
all women over 50 annually
19
Q
who needs and how often: colorectal cancer screening
A
everyone over 50 annually
20
Q
who needs and how often: prostate cancer screening
A
black men, family history of it, starting at age 40. All other age 50 annually
21
Q
who needs and how often: diabetes screening
A
45 and older every 2 years
22
Q
who needs and how often: thyroid and bone density
A
over 50/65 respectively, on professional advice
23
Q
who needs and how often: thyroid and bone density
A
over 50/65 respectively, on professional advice
24
Q
who needs and how often: chlamydia
A
sexually active 24 and younger annually
25
possible causes of leg cramps
- growing pains, muscle cramps (charley horse) (kids)
- muscle cramps (adults)
- nocturnal leg cramps, drug induced (elderly)
26
possible causes of leg cramps
- growing pains, muscle cramps (charley horse) (kids)
- muscle cramps (adults)
- nocturnal leg cramps, drug induced (elderly)
27
muscle cramp (charley horse)
painful contraction of calf muscle, often while in bed/lying down
-linked to activity level (too much/little)
28
growing pains in kids
- age 4-8 typically
| - possible link to nutritional deficiency, but if deficient will have other issues as well
29
leg pain/cramps common in pregnancy in ___
3rd trimester, at night usually, 30% of women
30
varicose veins
worse on standing, evident visually
31
drugs that can induce leg cramps
diuretics, statins
32
myositis vs muscle cramping
- muscle cramping and weakness, increased liver enzymes, only 0.1-1% drug users
- cramping is usually mild and goes away with use, but happens 5-10% of users
33
myositis vs muscle cramping
- muscle cramping and weakness, increased liver enzymes, only 0.1-1% drug users
- cramping is usually mild and goes away with use, but happens 5-10% of users
34
peripheral neuropathy
more tingling than pain, diabetics, worse at night
35
peripheral vascular disease
cholesterol build up in legs, coolness in toes, numbness, harder to find pulse, 10% get intermittent claudication( get symptoms (pain/cramping) with exertion)
36
intermittent claudication
in peripheral vascular disease, get symptoms (pain/cramping) with exertion
37
DVT (deep vein thrombosis)
leg swelling, warm to touch, tender in clot area
| -brought on by exertion, relieved with rest
38
nocturnal leg cramps
contraction of calf muscle at night, NOT RLS
| -cause unknown, linked to posture, feet, drugs, thyroid, etc
39
non medical treatment for nocturnal leg cramps
-stretch out calf, relaxing bath, ice/cool packs
40
quinine
- last resort for leg cramps, historically for malaria
- tonic water doesn't have enough to be effective
- won't see high enough dose in OTC because of potential SEs
41
magnesium and leg cramps
unlikely to help
- 320-420 is safe
- 800-900 mg starts laxative dose (400 mg/ 5mL contains 160 mg elemental; laxative dose is 30-60 mL HS)
42
painkillers and leg cramps
will be gone by time take unless know one is coming on
| -use acet over NSAIDs as age
43
restless leg syndrome
sleep disorder for 5-10% people
- compelling urge to move legs and irritable sensation
- worsens during rest/evening
- inability to stay still while at rest
- walking/movement helps
44
sciatica
pain from low back to back of thigh/behind knee down bum
45
drugs that can induce leg cramps
diuretics, statins
| -antipsychotics, estrogens, CCBs, lithium, oral steroids
46
peripheral vascular disease
cholesterol build up in legs, coolness in toes, numbness, harder to find pulse, 10% get intermittent claudication( get symptoms (pain/cramping) with exertion)
-poor wound healing and painful to walk on
47
sciatica
pain from low back to back of thigh/behind knee down bum
48
fibromyalgia
widespread muscle pain throughout body for minimum of 3 months
- pain radiating or just sore and achy
- most tender points on upper body
49
chronic fatigue syndrome
more than 6 months, in women more, exhaustion/joint/muscle pain, headahces, memory/thinking dysfunction, depressed immune, sore throat and lymphnodes
50
parkinson's
tremor and shaking at rest, sluggish movement initiation, muscle rigidity
51
multiple sclerosis
women more than men, age 20-40 most common, tingling/numbness/weakness in arms/legs/trunk/face
-muscle stiffness and may lose strength or dexterity in leg or hand
52
huntingtons
occasional jerks or spasms eventually leading to abnormal movements of entire body
53
muscular dystrophy
young children, weakness of muscles closest to torso (pelvis--> shoulders)
-can't fully extend muscles
54
dystonia
- ex// writers cramp
| - involuntary, slow repetitive sustained muscle contractions that cause freezing in the middle of an action
55
dystonia
- ex// writers cramp
| - involuntary, slow repetitive sustained muscle contractions that cause freezing in the middle of an action
56
guillain barre syndrome
rapid (2-3 weeks) muscle weakness sometimes leading to paralysis (begins with tingling and loss of sensation)
57
tetra cyclines can't be used in which trimester
2nd and 3rd, or in children whose teeth are still developing (before age 8)
58
if bioflim is not removed, it turns in to
plaque, then the bacteria produce acids that harden it
59
plaque turns in to
tartar (calculus), which hardens more and is petrified plaque (can't be brusehd off, needs DDS)
60
if under 3 and at risk for cavities, use
F toothpaste, rice grain size
61
if under 3 and not at huge risk for cavities
no toothpaste, wipe teeth with wet cloth or finger toothbrush
62
if under 3 and not at huge risk for cavities
no toothpaste, wipe teeth with wet cloth or finger toothbrush
63
children 3-6 can brush with assistance from adult, toothpaste wise:
F, size of pea
64
what does fluoride do
helps remineralize teeth, has a topical and systemic effect, our drinking water has enough
65
fluorosis
exposure to too much fluoride during years of enamel develpment
66
sensitive teeth caused by
exposing dentin (softer part of tooth under enamel) that has tubes with nerve endings filled with fluid. hot/cold food/drinks causes fluid to move causing pain
67
common ways to expose dentin
- brushing too hard
- gingivitis
- receding gums
68
what to use for sensitive teeth
- strontium=most common, blocks tubule openings
- potassium reduces nerve conduction
- Ca and PO4 help repair areas
69
causes of toothache
- tooth decay
- abcess
- infected gums
- damaged filling
- repetitive motions (chew gum, grind teeth=bruxism)
70
red flags of toothache
-fever, pus, swelling, headache
71
treatment for toothache
- pain killers (acet or nsaids)
- heat* or cold packs on outside of cheek
- topical benzocaine (no relief if pain is from tooth, only if originates from gums)
- clove oil=likely no effect
72
teething: lower central incisors appear (bottom middle teeth)
6-10 months
73
teething; upper central incisors appear
8-12 months
74
teething: upper second molars appear
25-33 months
| -first are around year one
75
age ids have all 20 baby teeth usually
3
76
teething symptoms
- extra drooling
- irritable
- facial rash
- mild temperature
- diarrhea from extra saliva (if beyond mild, likely GI virus)
77
treating teething
- teething ring (toys, cold facecloths)
| - rub infant's gums with fingers
78
topical benzocaine not for children under ___ because
- 2, risk of methomoglobinemia* (blood less efficient at oxygen transport --> death) or disabling gag reflex
- comes in 7.5-10%
- apply thin layer QID
79
topical benzocaine not for children under ___ because
- 2, risk of methomoglobinemia* (blood less efficient at oxygen transport --> death) or disabling gag reflex
- comes in 7.5-10%
- apply thin layer QID
80
symptom length of cold sores
7-10 days (vesicles appear and crust over in 1-3 days)
81
prodromal cold sore period
6-24 hours before, tingling and pain
| -can start in mouth or lips (generally on lips) around nostrils
82
impetigo vs cold sore
impetigo is not on lips usually around and way less painful
83
if lesion lasts more than 2 weeks, might be concern-
could be squamous/basal cell (--> cancer)
84
non drug treatment cold sores
- reduce stress (prevention)
- protect from sun
- don't pop/squeeze
- ice cube
- lip balm (to keep soft)
85
abreva
- docosonal 10%, 5x/day
- must be used early on at first sign of tingling, antiviral, can reduce viral entry in to host cell, might resolve about 1 day faster
- not useful after see vesicle
86
polysporin hydrocolloid
seals area of cold sore and just makes look a little better
87
treatment of cold sores
- acyclovir is 5x/day that is too much!
- BID 2 doses valacyclovir (2500 mg) and famicyclovir 750 mg) are most common prophylactic ones
- can take 12 hours before as prophylaxis if know when or triggers for it
88
treatment of cold sores
- acyclovir is 5x/day that is too much!
- BID 2 doses valacyclovir (2500 mg) and famicyclovir 750 mg) are most common prophylactic ones
- can take 12 hours before as prophylaxis if know when or triggers for it
89
topical acyclovir for cold sores
- cream has 8x the drug levels, ointment is useless
| - Xerese: improve healing by 1.4 days and was 50% smaller
90
if waited too long to treat cold sore, now what
- keep moist
- not abreva because so expensive and won't get full benefits
- alcohols and sulfates may be drying
- propolis= honey base
91
treatment of cold sores
- acyclovir is 5x/day that is too much!
- BID 2 doses valacyclovir (2000 mg) and famcyclovir 750 mg) are most common acute treatment ones, must start before lesion appears
- can take acyclovir 12 hours before as prophylaxis if know when or triggers for it, 400 mg BID beginning 12 hours before exposure of trigger and for duration of exposure
92
if waited too long to treat cold sore, now what
- keep soft and dry
- not abreva because so expensive and won't get full benefits
- alcohols and sulfates may be drying
- propolis= honey base
93
aphthous ulcers
canker sores
- cream/white colored lesion with red/inflamed border
- painful, unknown etiology
94
hand foot and mouth disease
- coxsackie virus
- begins with fever, malaise, sore throat
- canker sores are far more painful, but will get other sores in mouth from this
- skin rash develops over 1-2 days
- usually only happens once to person
95
drug induced ulcers (mouth)
- NSAIDs (low suspicion)
- beta blockers
- cytotoxic agens (methotrexate)
96
stomatitis
caused by radiation or chemo
97
non pharm treatment for canker sores
- try to prevent local trauma
- reduce stress
- nutritional deficiences
- sinse with salt water several times a day, esp after meals (hydrogen peroxide not as effective, avoid alcohol based ones)
98
pharm treatment for canker sores
- benzocaine: apply directly to lesion, short term pain relief (under an hour), can be used in combo with analgesics, risk methomoglobemia
- mucosal adherant protectant (zilactin, orabase-contains benz 20% therefore only 4x/day)
- magic mouthwash (milk of magnesia and diphenhydramine)= protects as well, lets lesions)
- RX:
- oracort (triamcinolone) paste=topical steroid HS, small dab, don't rub in
- tantum oral rinse (benzydamine) for lesions quite widespread in mouth from chemo and radiation
99
thrush symptoms
- creamy white lesions along tongue or cheek, can be painful or burning, may bleed when scraped
- infants increased fussiness
100
thrush symptoms
- creamy white lesions along tongue or cheek, can be painful or burning, may bleed when scraped
- infants increased fussiness
101
risk factors for thrush
disease states (DM
102
risk factors for thrush
disease states (DM
103
non pharm treatment thrush
- improve inhaler use (spacer, MDI, gargle with water post use)
- clean dentures overnight (allows gums to heal)
- clean baby pacifiers and bottles
104
pharm treatment thrush
- gentian violet 1% (messy, effective, mucosal irritation, treat mom too, some queston safetey)
- nystatins and iconazoles=most effective
- nystatin
105
nystatin dose for thrush
- infants up to one year 200000 U suspension QID (sweep in mouth with q tip)
- children and adults 500000 U susp QID (retain in mouth as long as possible swallow, symptomatic relief in 24-48 hours, continue use for 48 hours after cure, typically 7 days)
- well tolerated, doesn't interact with other medicines, short contact limits efficacy
106
xerostomia
common in elderly, dry mouth
107
function of saliva
- remineralize teeth
- lubricates oral mucosa
- local antimicrobial activity
- part of taste sensation
108
causes of dry mouth
- radiation/chemo
- mouth breathing
- chronic disease
- medications (many)
109
non pharm treatment xerostomia
-sip water, gum/candies (sugar free), humidifier during sleep
110
pharm treatment xerostomia
-saliva substitutes (short duration due to swallowing)
111
halitosis
bad breath
| -from poor dental hygeine, aromatic foods, tobacco, caffeine, xerostomia, sinus infection, GERD
112
halitosis treatment
-good oral hygeine, clean tongue (white=bacterial build up likely), fluids, sugar free gum, raw veggies, mouth washes, chlorophyll, chlorhexidine (peridex, DDS only, most effective in preventing biofilm, DDS only)
113
gingivitis
gums red, swollen, bleed easily
| -if untreated results in periodontitis
114
gingivitis causes
- inadequate brushing/flossing--> plaque/tarter
- medical disorders/meds
- tobacco
115
temporo mandibular joint
-most common between 20 and 40, jaw gets stuck or locked in position, clicking/popping, can't open mouth wide, pain
116
temporo mandibular joint
-most common between 20 and 40, jaw gets stuck or locked in position, clicking/popping, can't open mouth wide, pain
117
chamomile, Valerian (sleepy time tea), warm milk
more TLC factor than help
118
nytol
uses diphenhydramine SE of sedation (gravol, dyminhydrinate, is a salt of it, but lower MW so less sedation)
- can get tolerance and rebound insomnia
- with long term use only; constipation and urinary retention
119
melatonin (dosing)
- best agent for sleep (better than diphenhydramine)
- make more naturally at night, but less as age
- 5-10 mg (try 5 first, but 10 still very safe)
- no sign of tolerance or negative effects on sleep so far
- pick one; quick release or XR, both in one product won't work
- worth a try for sure
120
breathe right strips and snoring
more for congestion, opens up nose
121
sleep apnea
- stop breathing
- connection with snoring
- CPAP= positive air pressure in to throat, pushes tissue back and away to help breathe normally)
122
amount needed for caffeine to increase analgesic effectiveness
70-*100 mg
123
caffeine and weight loss
- appetite suppression more likely
- has some effect on fatty tissue but it is minor at best
- can increase mental alertness
124
caffeine dosing limit
400-450 mg /day
125
onset of tolerance/dependancy to caffeine
100 mg/day
126
caffeine in pregnancy
avoid if possible, but less than 300 mg /day (3 cups) appears safe
127
cause of snoring
muscles in roof of mouth, tongue and throat relax as fall asleep; if relax enough, may vibrate and partially obstruct airways (more forceful airflow=increased vibration)
-being overweight contributes, or enlarged tonsils, or alcohol (sedation), or sleep apnea
128
hangovers caused by
- dehydration (inhibition of anti diuretic hormone)
- cytokines
- increased acetaldehyde
129
alcohol breakdown pathway
alcohol by ADH to acetaldehyde to ALDH to acetic acid
130
destined genetically for hangovers if less
ALDH
131
fatty meals do what to alcohol
slow dumping into system and allow liver more time to break it down
132
alcohols that give less hangover
white rum, vodka, gin
133
alcohols that cause worse hangover
wines, tequila, dark liquors
134
resveratrol (wine) and ethanol good for health?
falling to wayside, probably not
135
don't take acetaminophen with alcohol if
- chronic alcoholic
| - liver disease
136
ibuprofen/naproxen and GI irritation and dehydration
- alcohol long term may cause GI probs, but acutely NBD
- dehydration means kidneys are less profused and PGs are what control this; if block with NSAID can cause prob, but probably not significant
