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joy's deck for FNP > Main points > Flashcards

Flashcards in Main points Deck (116):
1

temporal arteritis s/s

L temporal headache, scalp tenderness, indurated temporal artery. Pt with elevated WBC (>12,000), shift to the left, neurtrophilia (>70%) likely is bacterial infection

2

sensitivity

rule out, do Not have the disease

3

specificity

rule in, have the disease

4

cuada equina syndrome

a rare disorder that usually is a surgical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. You may need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs.

5

meningococcoal meningitis

caused by Neisseria meningitides.
affects the the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia).

6

Kiesselbach’s plexus

Over 90% of nose bleeds occur in the anteroinferior (front bottom) nasal septum and is formed by anastomoses (coming together) of 5 arteries

7

test for sickle cell anemia, g6pd anemia, alpha/beta thalassemia

hemoglobin electrophoresis

8

otitis media 1st and 2nd line rx

1st line: amoxicillin
2nd line: amoxicillin-claculanate (augmentin) bid x 10-14 dAYS if no improvement

9

alternative for PCN allergy

macrolides (azithro/z pack, eryrho, clarithro) or clindamycin (lincosamide)

10

s/e erythromycin

n/v. switch patient to azithro (z pack)

11

If COPD patient on ipratronium bromide (Atrovent) for sob, add what rx if s/s still there?

add albeterol inhaler (Ventolin)

12

Triad for mono

sore throat, prolonged fatigue, enlarged cervical nodes ( if present in older patient, reactivated mono)

13

lupus or SLE (systemic lupus) s/s

butterfly rash (malar rash). advise spf

14

polymyalgic rheumatica (PMR) s/s

An inflammatory disorder causing muscle pain and stiffness around the shoulders and hips. long term low dose steroids. PMR >risk for temporal arteritis

15

gold standard for temporal arteritis

biopsy of the temporal artery. refer pt to ophthalmologist for management

16

finkelstein test

thumb in fist, pain to radial wrist is positive for de quervains tenosynovitis

17

diabetic retinopathy

neovascularization, microaneurysyms, cotton wool spots, hard exudates

18

hypertensive retinopathy

av nicking, silver/copper wire arterioles

19

scoring for reflex

0 absent
1 hypoactive
2normal
3 hyperative
4 clonus

20

benign variants

s4 in elderly, torus palatinus, fishtail uvula

21

1st line for htn

arb/ace, esp with diabetic pts and mild renal disease

22

ipratropium (atrovent) is an anticholingeric

true

23

Penicillin drugs

amoxicillin (broad spectrum), penicillin VK

24

macrolide

erythromycin, azithromycin (zpack), clarithromycin (biaxin)

25

cephalopsorin 1st generation

Keflex

26

cephalosporin2nd generation

cefaclor, ceftin, cefzil

27

cephalosporin 3rd generation

rocephin, suprax, omnicef

28

quinolones

levofloaxacin (levaquin), moxiflozacin (avelox), gatifloxacin (tequin)

29

sulfa

bactrim/septra (trimethroprim/sulfamethazole), nitrofurantoic (macrobid)

30

tetracyclines

tetracycline, doxy, mino (minocin)

31

antitussives

dextromorphan (robitussin), benzonate (tessalon perles)

32

avoid nitrofurantoin and sulfa drugs (bactrim/septra/macrovid)during pregnancy,

true

33

tx for cutaneous anthrax

cipro 500mg bid for 2 months

34

prochaska theory

change theory ( decision theory)

35

age 11 most children can understand abstract thinking

ie NP asks child about proverbs

36

hemoglobin males

14-17.4 g/dl

37

hemoglobin females

12-16 g/dl

38

hematocrit males

42%-52%

39

mcv

80-100

40

rdw

>15%

41

platelet

>140,000 increased risk for bleeding

42

reticulocytes

.5-1.5% of red blood cells (increased in acute bleed). starting tx for vitamin def (iron, b12, folate)

43

neutrophils

>50%= increased risk for bacterial infection

44

band forms (immature abc)

>6%,increased risk for bacterial infection. aka "shift to the left)

45

eosinophils

>3% (increased in allergies)

46

TSH

>5.0 (hypo)

47

psa

>4 (BPH, prostate cancer)

48

ferritin

49

ESR (sed rate)

elevated in RA, lupus, temporal arteritis

50

potassium

3-5

51

primary prevention

anything "that will prevent the disease or social condition"
ex: youth violence, safety promotion, immunizations, spf, lifestyle, osha laws

52

secondary prevention

"screening" for disease;
cbc for anemia, tsh for thyroid, uspstf, suicide risk assessment, depression assessment, cancer tests (bse, gse)

53

tertiary prevention

limiting harm

ie:exercise for obese patient
supports groups (AAA), rehab (PT, OT, speech therapy)

54

microscopy for candidiases

large number of WBC, psuedohyphae, spores ( spaghetti and meatballs)

55

1st line for CAP

macrolides

56

s/e ca channel blocker

swollen ankles/headache

57

s/e of diuretics

hyperuricemia, hyperglycemia

58

s/e bb

depression and fatigue

59

highest prevalence of cancer

skin cancer (basal cell)

60

highest mortality of cancer (both sexes)

lung

61

disease causing most deaths overall

heart disease

62

most common gyn cancer

uterine

63

tarus palatinus

benign bony growth midline of hard palate

64

leukoplakia

slow growing white plaque on the tongue or inside the mouth. considered precancerous legion dt poorly fitted dentures, tobacco. refer for biopsy

65

oral hairy leukoplakia

"PAINLESS" white corrugate patch associated with HIV and AIDS of the EBV

66

initial workup for ovarian cancer

intravaginal US and CA 125

67

risk factors for ovarian cancer

early menarche, late menopause, nulliparity, endometriosis, pcps, family hx, vrca1 and via 2 higher risk for BOTH breast and ovarian

68

breast cancer screen

50-74, every 2 years

69

cervical cancer

21-65, every 3 years

70

colon

50-75. fecal occult every year, sigmoidoscopy every 5 years, colonscopy q 10yrs

71

skin cancer counseling

spf 10a-3p

72

smoking cessation

ask all adolescents and adults

73

fall prevention

age 65+. recommend mod-int aerobic activity 150 min or 2/5 hours/week

74

high risk ovarian cancer

ashkenazi jew, brca gene, family history of 2 or more first or 2nd degree relative

75

AAA

one time screen for men 65-75 who are cigarette smokers. test is US of the abdomen

76

barretts esophagus

precancerous lesion of the esophageal. managed by gastroenterologists. tx is lifetime of PPI.

77

high risk for esophagus cancer

>50yo, chronic GERD, smoker

78

s/s of gynecomastia

disc like breast tissue that is mobile, tender, and asymmetric

79

food interactions with tetracycline

dairy

80

high potassium content food (avoid in warfarin)

potatoes, apricots, brussel sprouts, banana, oranges, raisins, green veges

81

avoid what foods with warfarin

Vit K (kale, collard greens, broccoli)

82

migraine headaches and maoi avoid which foods

high tyramine ( cheese, lava beans, beer, wine, fermented foods)

83

maoi rx

marplan nardil, parnate

84

plant sterols that reduce LDL

benecol spread, wheat germ, sesame/corn oil, peanuts

85

magnesium

nuts, whole west, laxatives, antacids

86

iron

beef, liver, black eye peas

87

pityriasis rosea

maculopapular rash oval shaped with a herald patch ( xmas tree formation)

88

maculopapular rash in a lace like pattern

fifth disease, Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. "slapped cheek"

89

classic location of scabies

finger webs, waist, penis. "excoriated pruiritic rash". high risk group is health care worker, prison. Treat all family members, clean used clothes with hot water

90

scarlatina

sandpaper like texture, "strawberry tongue", skin desquamination ( peeling) of the palms and soles. Not itchy .

91

Impetigo

initially appear as papules that develop into bullae. "weeping" rash with honey exdate. Very itchy

92

cutaneus larva migranes

red wavy lines, red, itchy. common locations are body exposed to contaminated soil, sand (soles of feet). Cutaneous larva migrans is a parasitic skin infection caused by hookworm larvae that usually infest cats, dogs and other animals. Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that have been contaminated with animal faeces

93

tx for cutaneus larva migrans

ivermectin once a day for 2 days or albendazole for 3 days

94

1st line for AOM and acute sinusitis in children and adults

amoxicillin. If recent antibiotics 3 mos or tx failture, 2nd line is augmenten bid or cefdinir (Omnicef) bid.

if PCN allergy, alternative is azithromycin (z pack) or clarithromiycin (niacin)

95

Best place to listen for s3

pulmonic area. s3 is pathognomic for heart failure

96

PPD

must have induration, not just "red" . Gold standard is sputum culture, Tx is with 3 anti tubercular drugs, base lie LFT level and follow up are recommended for pts on INH.

97

senile arcus or

arcus senilis

98

AOM or

purulent otitis media

99

Group a beta strep or

strep pyogenes

100

enterobiasis or

pinworms

101

b12 or

cobalamin or cyanocobalamin

102

scarlet fever or

or scarlatina

103

condyloma acuminata or general warts

or genetical warts

104

tic douloureux or

or trigeminal neuralgia

105

tinea cruris or

jock itch

106

giant cell arteritis

temporal arteritis

107

light reflex or

hirschberg test (test for strabismus)

108

sentinel nodes or

virchows nodes. Virchow's node (or signal node) is a lymph node in the left supraclavicular fossa (the area above the left clavicle). The finding of an enlarged, hard node (also referred to as Troisier's sign) has long been regarded as strongly indicative of the presence of cancer in the abdomen, specifically gastric cancer, that has spread through the lymph vessels.

109

erythema migraines or

lyme disease.

110

lyme disease

erythema migraines. Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. The two most-used antibody tests are the enzyme-linked immunosorbent assay (ELISA) and the Western blot

111

1st line for depression, OCD, generalized anxiety disorder, panic and social disorder, premenstrual mood

SSRI. ie fluoxetine or Prozac (pms), citalopram (celexa), escitalopram ( lexapro), fluoxetine (prozac), sertraline (Zoloft), paroxetine (Paxil)

112

TCA used for

depression, ocd ( 2nd line), migraine headache prophylactic, neuropathic pain. amitriptyline (Elavil), nortriptiline (Pamelor). Do not give to suicidal patients as they can hoard and OD (cardiac and CNS toxicity)

113

carbamazepine ( Tegretol)

anticonvulsants used for chronic pain and trigeminal neuralgia

114

1st line drug for HTN uncomplicated

Thiazide diuretic. TZD mech of action on the bone is decreases calcium excretion by the kidneys and stimulates osteoclast. Helps with bone formation

115

1st line drug for HTN in diabetic or renal disease

ace/arb

116

HTN pts with migraines or DM with no chronic lung disease best rx

BB (contraind in chronic long; asthma, COPD etc)