Leik chp 1 exam info Flashcards
(43 cards)
A patient with an elevated WBC count accompanied by ______ and the presence of ________ most likely has a serious bacterial infection
neutrophilia (>70%) bands (“shift to the left”)
__________ is defined as the ability of a test to detect a person who has the disease.
Sensitivity
__________ is defined as the ability of a test to detect a person who is healthy (or to detect the person without the disease)
Specificity
A ______ study follows a group of people who share some common characteristics to observe the development of a disease over time (ex. the Framingham Nurses’ Health Study)
cohort
Trauma to ________ ________ will result in an anterior nosebleed
Kiesselbach’s plexus
The diagnostic or gold-standard test for sickle cell anemia, glucose-6-phosphate dehydrogenase (G6PD) anemia, and alpha or beta thalassemia is the ___________ ____________.
hemoglobin electrophoresis
Distinguishing between first- and second-line antibiotics:
A 7 year-old child with acute otitis media (AOM) who is treated with amoxicillin returns in 48 hours without improvement (complains of ear pain, bulging tympanic membrane). The next step is to discontinue the amoxicillin and start the child on a second-line antibiotic such as _____________ ___(frequency) x ____ days
amoxicillin-clavulanate BID x 10 days
Alternative antibiotics for PCN-allergic patients:
If pt has a gram-positive infection, the possible alternatives are __________, ____________, or _______ with gram-positive activity such as levofloxacin or moxifloxacin
macrolides, clindamycin, or quinolones
If a patient has an infection that responds well to macrolides (azithromycin, clarithromycin, erythromycin), but she thinks she is “allergic” to erythromycin (symptoms of nausea or GI upset), inform her that she had an adverse reaction, not a true allergic reaction (hives, angioedema) and switch her from erythromycin to _____________
azithromycin (usually a Z-Pack)
If a patient fails to respond to the initial medication, _____ _________ _______
Ex. A pt with COPD is Rx’d Atrovent for dyspnea. On follow-up, the patient complains that his symptoms are not relieved. The next step would be to Rx an albuterol inhaler or to prescribe a combination inhaler.
add another medication (follow the steps of the treatment guideline)
Disease states on the exam are usually presented in their full-blown “classic” textbook presentations. Ex. In the case of acute mono, the patient will most likely be a teen presenting with the classic triad of ________, ___________, and _______________. If the patient is older, but has the same signs and sx, it is still mono.
sore throat, prolonged fatigue, enlarged cervical nodes
Ethnic background may give a clue for some diseases. Ex: ______ thalassemia is more common among Southeast Asians (Filipinos). _________ thalassemia is more common among Mediterranean people.
Alpha - Southeast Asians
Beta - Mediterranean
On the exam, no asymptomatic or “borderline” cases of disease states are presented. For ex. - In real life, most patients with iron-deficiency anemia are asymptomatic and do not have either ______ or ______-______ nails. On the exam, they will probably have those clinical findings plus the other findings of anemia.
pica
spoon-shaped
Become familiar with lupus or systemic lupus erythematosus (SLE). Ex. A ___ rash is present in most patients with lupus. These patients should be advised to avoid or to minimize _________
malar (butterfly)
sunlight
Become familiar with polymyalgia rheumatica. Ex. First-line treatment for PMR includes ______-_____ ______.
Long-term steroids. Long term, low-dose steroids are commonly used to control symptoms (pain, severe stiffness in shoulders and hip girdle)
Polymyalgia rheumatica patients are also at higher risk for _______ _______.
Temporal arteritis
Some conditions need to be evaluated with a radiologic test. Ex. Damaged joints: order _______ first, but _____ is the gold standard.
x-ray
MRI
The abnormal eye findings in diabetes (diabetic retinopathy) and hypertension (hypertensive retinopathy) should be memorized. Learn to distinguish each one.
Ex. Diabetic retinopathy: ______, ______ ______ _____, __________
neovascularization, cotton wool spots, microaneurysms
The abnormal eye findings in diabetes (diabetic retinopathy) and hypertension (hypertensive retinopathy) should be memorized. Learn to distinguish each one.
Ex. hypertensive retinopathy: ________ _______, _______ or ______ _______ ________
AV nicking, silver or copper wire arterioles
Become knowledgeable about physical exam “normal” and “abnormal” findings. Ex. When checking DTRs in a patient with severe sciatica or diabetic peripheral neuropathy, the ankle jerk reflex (Achilles reflex) may be ______ or ________. Scoring: 0
1
2
3
4
absent
hypoactive
Scoring: 0 - Absent
1 - hypoactive
2 - normal
3 - hyperactive
4 - clonusThere are only a few questions on benign or physiologic variants.
Ex. A benign S4 heart sound may be auscultated in some ________ patients.
elderly
There are only a few questions on benign or physiologic variants.
Ex. _______ ________ and ________ _______ may be seen during the oral exam in a few patients.
Torus palatinus
fishtail uvula
Know the preferred and/or first-line drugs used to treat some diseases. Ex. _____ or ________ are the preferred drugs to treat hypertension in diabetics and patients with mild to moderate renal disease because of their renal-protective properties.
ACEI
ARBs
When meds are used in the answer options, they will be listed either by name (generic and brand name) or by drug class alone. Ex. Instead of using generic/brand name of ipratropium (Atrovent), it may be listed as a drug class (\_\_\_\_\_\_\_\_\_\_\_\_)
anticholinergic
