Leik chp 2 Question Dissection & Analysis Flashcards
(153 cards)
1
Q
pearly, wax-like, shiny appearance with telangiectasia is “classic” for what dermatological pathology?
A
basal cell carcinoma
2
Q
_______ melanoma has pigment such as brown or black color with irregular borders
A
nodular
3
Q
________ __________ is a precancer of squamous cell carcinoma and is usually located on the scalp (males), face, and the back of the hands (dorsum); They appear as a crusty/scaly growth that slowly enlarges over time
A
actinic keratosis
4
Q
The gold standard test for skin cancer is the ______ _______.
A
skin biopsy
5
Q
Sudden-onset red rashes on left lower arm and hand. During the skin exam, the NP notes that there are a few blisters. When the NP touches one of the blisters, it ruptures and drains clear serous fluid. Which of the following 3 conditions should the NP consider in the differential diagnosis? A. Contact dermatitis B. Erysipelas C. Psoriasis D. Impetigo E. Thermal burn
A
A. Contact dermatitis
D. Impetigo
E. Thermal burn
6
Q
Fragile, easily-ruptured blisters is a classic finding for _________ _________, an acute bacterial skin infection caused by Staphylococcus or Streptococcus
A
bullous impetigo
7
Q
__________ _________ can present with just red skin or red skin with blisters. The rash can be located anywhere on the body and it may have a pattern (like a belt) or no pattern.
A
Contact dermatitis
8
Q
________ is a type of cellulitis caused by strep. It resembles a bright-red, warm, raised rash (plaque-like) with discrete borders usually located on the face or the shins. Blistering is not present.
A
Erysipelas
9
Q
Rust-colored sputum is associated with _______ ______ infection.
A
Streptococcus pneumoniae
10
Q
Patients with _________ __________ may have chest congestion but not fever, chills, or productive cough with purulent sputum.
A
acute bronchitis
11
Q
Legionella pneumonia (Legionnaire’s disease) is uncommon in primary care. Look for history of exposure to “nebulized” water sources such as air conditioners, fountains, etc. Patients present with signs/symptoms of pneumonia that are accompanied by _____ ________.
A
GI symptoms.
12
Q
______ _________ and _______ ________ are 8 to 13 times more likely to develop liver cancer than other groups due to higher rates of chronic Hep B infection
A
Asian Americans & Pacific Islanders
13
Q
In alpha or beta thalassemia trait or minor, the following results are found:
normal to high serum ________ and serum ______ levels
Normal _________
A
ferritin, iron
TIBC
14
Q
the gold-standard test to diagnose any anemia involving abnormal hemoglobin (thalassemia, sickle cell, etc.) is the _________ _________
A
hemoglobin electrophoresis
15
Q
The _____ is a measure of the variability in size of RBCs (or anisocytosis). An elevated _______ is one of the earliest indicators of iron-deficiency anemia.
A
RDW, RDW
16
Q
The most common anemia in the world is _______ _______ anemia.
A
iron-deficiency
17
Q
In clinical practice, rule out _____ _____ anemia first before ordering a hemoglobin electrophoresis.
A
iron deficiency
18
Q
bacterial vaginosis: presence of ______ _____
A
clue cells
19
Q
What type of cell is a mature squamous epithelial cell with numerous bacteria noted on the cell surface and borders?
A
clue cell
20
Q
bacterial vaginosis: pH is ______.
A
alkaline
21
Q
trichomonas is a ______ or ______ ______ organism
A
protozoan; unicellular flagellated
22
Q
normal pH of vagina is acidic. normal acidity pH is ____ to ____
A
3.5 - 4.5
23
Q
_____ is the only vaginal condition with an alkaline pH for the exam.
A
BV
24
Q
_____ is not considered a STD. The sex partner does not need to be treated.
A
BV
25
_______ does not cause inflammation. The microscopy slide will have very few WBCs and a large number of clue cells.
BV
26
The vaginal discharge in _________ infection is a white color with a thick and curdlike consistency. Frequently causes itching and redness in the vulvovagina due to inflammation.
candida
27
The microscopy in candidiasis will show a large number of ______, ________, and ______
WBCs, pseudohyphae, and spores
28
_________ is normal flora of the GI tract and in some women's vaginas.
candida
29
__________ infection vaginal discharge is copious, bubbly, and green in color. It causes a lot of inflammation, resulting in itching and redness of the vulvovagina. It is considered to be a STI. The sex partner does / does not need to be treated.
Trichomonas
| does
30
______ (____ ____) is the gold standard of diagnosis for BV, candida vaginitis, and trichomoniasis for the exam.
microscopy (wet smear)
31
The first-line drug for treating for treating strep throat (streptococcal pharyngitis) is still ___________.
Penicillin VK
32
The first-line drug for treating for treating strep throat (streptococcal pharyngitis) is still ___________ for ___ days.
Penicillin VK; 10
33
Adverse side effects of the thiazide diuretics: ________ and __________
hyperuricemia and hyperglycemia
34
According to the IDSA and the ATS guidelines, outpatient treatment of CAP in healthy patients (no comorbidities) involves the __________
macrolides: Azithromycin, clarithromycin, or erythromycin
35
calcium channel blockers' side effects include _______- _______ and _______
swollen ankles and headache
36
beta blockers' side effects include _______ and ________
fatigue and depression
37
The most common cause of cancer DEATH overall (mortality) is _______ cancer
lung
38
The most common cancer overall (prevalence) is ______ cancer
skin
39
The most common type of skin cancer is _______ cancer
basal cell carcinoma
40
The most common cancer in females is _______ and the most common cancer in males is ________
breast
| prostate
41
Mortality statistics:
| Disease causing the most deaths overall is
heart disease
42
Mortality statistics:
| Cancer with the highest mortality: _______ cancer
lung
43
Mortality statistics:
| Cancer with the highest mortality in males (_____) and females (_______)
lung; lung
44
Mortality statistics:
Most common cause of death in adolescents:
_____ ________ _________
motor vehicle crashes
45
The most common cancer overall (males and females) (prevalence) is ______ cancer
skin
46
The most common type of skin cancer is _______ cancer
basal cell cancer
47
Prevalence
| The most common cancer in females is _______ and the most common cancer in males is ________
breast
| prostate
48
prevalence:
| Skin cancer with the highest mortality: ______
melanoma
49
Prevalence:
| What is the most common type of GYN cancer?
uterine/endometrial
50
Second most common GYN cancer?
ovarian
51
_______ cancer is not considered a GYN cancer
breast
52
___________ tongue is a benign physiological variant
geographic
53
A _________ tongue has multiple fissures and irregular smoother areas on its surface that make it look like a topographic map. The patient may complain of soreness on the tongue after eating or drinking acidic foods. Remember, this is a BENIGN physiological variant.
geographic
54
Leukoplakia is / is not a benign variant.
is not
55
___________ is a slow-growing white plaque that has a firm to hard surface that is slightly raised on the tongue or inside the mouth. It is considered a ________ lesion
Leukoplakia
| precancerous
56
The causes of leukoplakia include poorly _______ _______, ________ ______, and other types of ______
fitting dentures
chewing tobacco
tobacco
57
Leukoplakia: Refer the patient for a _______ b/c it can sometimes become malignant.
biopsy
58
Oral ________ _______ of the tongue is a ______ white patch that appears corrugated. It is usually located on the ________ aspects of the tongue or other areas inside the mouth and is associated with _____ and _____
hairy leukoplakia
painless
lateral
HIV and AIDS
59
Oral hairy leukoplakia is caused by ______-____ virus infection of the tongue. It is / is not considered a premalignant lesion.
Epstein-Barr
| is not
60
Always rule out ovarian cancer in a postmenopausal woman who has a _________ _______
palpable ovary
61
When ruling out ovarian cancer in a postmenopausal woman with a palpable ovary, the first step is to order a _______ and _________ ultrasound with ______, and refer to _________.
pelvic and intravaginal
| oncologist
62
The strongest risk factors for ovarian cancer (or breast cancer) is _______ ________ such as BRCA1 or BRCA2 mutations and _______ ________ _______
genetic predisposition
| positive family history
63
Patients with Barretts esophagus are treated with high-dose PPIs ______ ______
for life
64
The first-line treatment of mild, uncomplicated GERD is ______ _______
lifestyle changes
65
lifestyle changes in treatment of mild, uncomplicated GERD are avoid eating ___ to ____ hours before bedtime, _______ changes, ______ loss if _______
3 to 4
dietary
weight; overweight
66
Girls (and boys) Tanner stage I:
prepubertal pattern
67
Girls Tanner stage II:
breast bud and areola start to develop
68
Girls Tanner stage III:
breast continues to grow with nipples/areola (one mound/no separation)
69
Girls Tanner stage IV:
Nipples and areola become elevated from the breast (a secondary mound)
70
Girls (and boys) Tanner stage V:
Adult pattern
71
Boys Tanner stage II:
Testes and scrotum start to enlarge (skin starts to darken/more rugae
72
Boys Tanner stage III:
Penis grows longer (length) and testes/scrotum continues to become larger
73
Boys Tanner Stage IV:
Penis becomes wider and continues growing in length (testes are larger with darker scrotal skin and more rugae)
74
Remember, NEVER ________ a patient and/or family member. This will help rule out an incorrect answer
reassure
75
_________ ________ physical exam findings will show disk-like breast tissue that is mobile under each nipple/areola, the breast may be tender, and the breast can be assymetrical (one larger than the other)
Physiological gynecomastia
76
Overweight to obese males are at highest risk for ________
gynecomastia
77
Foods with high _______ content (aged cheeses, red wine, chocolate) can cause dangerous food-drug interactions with MAO inhibitors (Marplan, Nardil, Parnate)
tyramine
78
Foods and supplements containing stimulants, such as ________ and ________, are best avoided by patients with HTN, arrhythmias, high risk for MI, hyperthyroidism, albuterol use, and amphetamine use
caffeine and ephedra
79
Gluten/celiac disease: avoid _______, _______, and ______
wheat, rye, barley
80
Magnesium decreases BP, dilates blood vessels, and is found in nuts such as _____, _____, _____, some beans, ________ _______, also found in laxatives, antacids, milk of magnesia
almonds, peanuts, cashews
| whole wheat
81
Potassium helps decrease BP and is found in most fruits, esp ______, _______, _______, ______ and in some vegetables (brussel sprouts, potatoes)
apricot, banana, orange, prune
82
folate decreases _______ levels and fetal neural tube defects, and is found in _________ ______ fortified with folate, ______ _____ vegetables, and liver
homocysteine
breakfast cereals
green leafy
83
Iron is found in beef, ______, _______ beans, and ______-_____ ______
liver, black
| black-eyed peas
84
Vitamin K (should control intake if on anticoagulants) is found in _____ ______ vegetables, broccoli, and
green leafy
| cabbage
85
high sodium content (increases water retention, can increase BP) is found in _____ ______, pickles, ________ foods, canned foods, hot dogs, chips
cold cuts
| preserved
86
Celiac disease: lifetime avoidance of _____, _____, and ______
wheat, barley, rye
87
Gluten free: ______,
| _______, ______. Most people with celiac disease can eat ______.
rice, corn, potatoes (are gluten free)
| oats
88
Hypertension: Maintain an adequate intake of _________, _______, and _______.
calcium, magnesium, and potassium
89
Migraine headaches and MAOIs (Marplan, Nardil, and Parnate): avoid high _______ foods:
______ ______
_____ ______, fava beans, draft beer, anything fermented
tyramine
aged cheeses
red wine
90
Vitamin K decreases the effectives of ________
warfarin
91
ED treatment meds for anaphylaxis:
```
epi IM
100% O2 by face mask
antihistamine such as Benadryl
H2 antagonist such as ranitidine
bronchodilator such as Albuterol
systemic glucocorticosteroids such as prednisone
```
92
Patients with an atopic history (asthma, eczema, allergic rhinitis) with _______ ______ are at a higher risk for ______ and ________ allergies
nasal polyps
| ASA and NSAID
93
Anaphylaxis is classified as a ____ ____, _____- _____ reaction
type I; IgE-dependent
94
Biphasic anaphylaxis occurs in up to 23% of cases (symptoms may recur within ___ to ___ hours after initial episode). This is why these patients are discharged with a Rx for ________ _____ ______ and a long-acting _________ from the ED.
8 to 10
Medrol Dose Pack
antihistamine
95
The most common triggers for anaphylaxis in children are _______. In adults, they are ______ _____ and ________.
foods
insect stings
medications
96
Those between the ages of _____ and ____ are "young gerontologicals".
65 and 84
97
Those age _____ and older are "frail elderly"
85
98
______ are the first-line treatment for unipolar/major depression. They carry an FDA warning that they increase suicidality in children and young adults up to age 23.
SSRIs
99
________ (antidepressants) have many anticholinergic effects such as dry mouth, sedation, arrhythmias, confusion, and urinary retention
TCAs
100
________ (antidepressant class) have many anticholinergic effects such as dry mouth, sedation, arrhythmias, confusion, and urinary retention
TCAs
101
_________ (antidepressant class) have major food and drug interactions and are not first-line drugs
MAOIs
102
The differential diagnosis for an early morning cough includes _________ _______,
________ _________
__________
_______
postnasal drip
allergic rhinitis
sinusitis
GERD
103
```
Which of the following is most likely to be found in patients with a long-standing case of iron-deficiency anemia?
A Pica
B Fatigue
C Pallor
D Irritability
```
```
A Pica
(also spoon-shaped nails is associated with iron-deficiency anemia)
```
104
____________: a skin rash that has both color, are circumscribed, and are small spots on the skin. They are not raised or depressed
Macular
105
__________: a skin rash with small raised lesions varying from red to bright pink
papular
106
___________: A skin rash that has both color and texture, small raised skin lesions
maculopapular
107
A maculopapular rash in a lace-like pattern is ______ ________.
Fifth disease
108
Maculopapular rashes with papules, vesicles, and crusts are ______ ______ and _______ _______
varicella zoster
| herpes simplex
109
Maculopapular rashes that are oval shaped with a herald patch are __________ _________
pityriasis rosea
110
vesicular rashes on an erythematous base are _______ ______ and _______ _______
herpes simplex
| genital herpes
111
Assume that a patient has _______ if excoriated pruritic rashes are located in the finger webs and the penis until proven otherwise.
scabies
112
High risk people for ______ are health care providers, those with large populations like school workers, nursing homes, group homes, prisons
scabies
113
True/false:
| With scabies, All family members and close contacts must be treated at the same time as the patient.
true
114
The rash of _________ has a sandpaper-like texture and is accompanied by a sore throat, strawberry tongue, and skin desquamation (peeling) of the palms and soles. It is / is not pruritic.
scarlatina
| is not
115
The rash of ________ initially appears as papules that develop into bullae. These rupture easily, becoming superficial, bright-red, weeping rashes with honey-colored exudate that becomes crusted as it dries. The rashes are very itchy and are located on areas that are easily traumatized (face, arms, legs).
impetigo
116
Cutaneous ______ _______ (creeping eruption) rashes are shaped like red raised wavy lines (snake-like) that are alone or a few may be grouped. They are very itchy and may become excoriated from scratching (appears maculopapular)
larva migrans
117
The preferred treatment for larva migrans is systemic treatment with either ______ daily for __ to ___ days or _________ for 3 days
ivermectin 1 to 2
| albendazole
118
____________ is the preferred first-line antibiotic for both AOM and _______ _______ in children (for pts with no risk factors for resistant organisms like as in recent abx use)
amoxicillin
| acute sinusitis
119
____________ is the preferred first-line antibiotic for both AOM and _______ _______ in children (for pts with no risk factors for resistant organisms like as in recent abx use - past THREE months)
amoxicillin
| acute sinusitis
120
If pt with AOM or sinusitis is a treatment failure or was on an abx in the past 3 months, give second-line abx like _____ or _______ BID
Augmentin BID
| Omnicef BID
121
For pts who are PCN-allergic and have AOM or acute sinusitis, an alternative is _________ and ________
azithromycin (Z-pack)
| clarithromycin BID
122
```
Which of the following is the best location to auscultate a S3 heart sound?
Aortic
Pulmonic
Tricuspid
Mitral
```
mitral
123
Skin __________, not the red color, is the best indicator of a positive Mantoux reaction
induration
124
What is the gold standard test for pulmonary TB?
sputum culture
125
Is TB a reportable disease?
| Noncompliant patients can be ___________
yes
| quarantined
126
For pts on isoniazid, a baseline ______ level and follow-up testing are recommended.
LFT
127
degenerative joint disease is AKA ____
osteoarthritis
128
atopic dermatitis is AKA _______
eczema
129
lupus is AKA ____ ____ _____
systemic lupus erythematosus
130
enterobiasis is AKA _____
pinworms
131
vitamin B1 is AKA _____
thiamine
132
scarlet fever is AKA ______
scarlatina
133
otitis externa is AKA _______ _____-
swimmer's ear
134
condyloma acuminata is AKA _______ ______
genital warts
135
trigeminal neuralgia is AKA ______ ______
tic douloureux
136
temporal arteritis is AKA ___- _______ ______
giant cell arteritis
137
Iliopsoas muscle sign is AKA ____ sign
psoas
138
Light reflex is AKA ________ _____
Hirschberg (corneal reflex) test
139
sentinel nodes are AKA ____ _______
Virchow's nodes
140
erythema migrans is AKA ____ ____
Lyme disease
141
sinusitis is AKA ________
rhinosinusitis
142
major depression is AKA ________ ________
unipolar depression
143
All _______ patients should be screened for suicidal/homicidal ideation. Incorrect answers are statements that are judgmental, reassuring, vague, disrespectful, or do not address the issue of suicide in a direct manner.
depressed
144
When interviewing a ________, do it privately and with parents present
teen
145
SSRIs are the 1st line treatment for
D______
O_____
P_______
A_______
P______
S_______
depression
OCD
panic disorder
anxiety
PTSD
social anxiety disorder
146
TCAs are also used for prophylactic treatment of _______, _______ _______, and __________ pain
migraines
chronic pain
neuropathic
147
Do NOT give suicidal patients a Rx for ______ b/c of the high risk of hoarding the drug and overdosing, which can be fatal
TCAs
148
Anticonvulsants (Tegretol) are used for _____ _____ and ______ ______
chronic pain
| trigeminal neuralgia
149
Abuse:
If a history is being taken, pick the ___-____ question first. Interview both the possible abuser and patient together, then interview the patient separately.
open-ended
150
```
CAGE:
C ______
A ______
G ______
E ______
```
cut down
annoyed
guilty
early
151
The most common bacterial pathogen in otitis externa is __________ (bright green pus)
Pseudomonas
152
Differential diagnoses to consider for chronic cough are:
C_________ ________
A___ ______
T__
G_____
A________
L____ _______
Chronic bronchitis
Ace Inhibitors
TB
GERD
Asthma
Lung Cancer
153
Tay-Sachs (a rare and fatal genetic disorder) is most common among ______ ______
Ashkenazi Jews
