Misc Flashcards
Hearing loss - Conductive
- causes
- Weber + Rinne tests
External ear
- ear wax
- otitis externa
- exostoses
Tympanic membrane perf
Middle ear
- otitis media
- otosclerosis
- neoplasm
- congenital malforation
Sx:
- OK loud noises
- decreased perception of Sound
Weber –> sound to affected side
Rinne –> abnormal; bone > air
Hearing loss - Sensorineural
- causes
- Weber + Rinne tests
Presbycusis
- symmetrica, gradual degen sensory cells and nerve fibers at base of cochlea
Noise induced damage
- hair cells in organ of corti damaged
Infection
Drugs
- aminoglycosides
- furosemide, ethracyrinc acid
- cisplatin
- vancomycin
- wuinidine
- ASA –> tinnitus + reversible hearing impairment
TORCH infections
MEniere’s dz
- fluctuating, unilateral
CNS
- acoustic neuroma
- meningitis
- meningioma
Sx:
hard to hear loud noises
- trouble w/ high freq
- + tinnitus
Weber –> sound to unaffected side
Rinne –> normal; bone < air
Tx OSA
mild - moderate = wt loss, no alcohol, prop up during sleep
Severe = > 20 apneic episodes = CPAP, uvulopalatopharyngoplasty, trache
Tx narcolepsy
Methylphenidate
Planned naps
Tx insomnia
Tx underlying cause
Psych eval if suspected
When use bariatric surgery for obesity?
If BMI > 40
CAGE for EtOH
Cut down
Annoyed
Guilty
Eye opener
Tx EtOH addiction
AA is best
Disulfiram
Naltrexone***
Acamprosate
Diazepam for w/d
Thiamine, folate, MV
Tx smoking cessation
Buproprion
Varenicline
How often reposition pt to prevent ulcers at bony prominces?
2 h
Tx uncomplicated acute otitis media
1st line = amoxicillin
When tx dental infection?
With what?
If it becomes cellulitis
- do not tx gingivitis, periodontitis, periapical abscesses
Tx w/ oral penicillin G
- if pcn allergy, clindamycin
leading cause of congenital hearing loss
CMV
Which opioid is contraindicated in elderly?
meperidine should not be used in the elderly because its metabolite can accumulate and cause seizures
Domestic violence demographic associations
Domestic violence cuts across all racial, socioeconomic, religious, and ethnic lines.
The only consistent risk factor for being a victim of domestic violence is female gender
Child is jehova’s witness, parents refuse tx, the pt is rapidly deteriorating and needs blood transfusion. What do you do?
Western courts have deemed that parents cannot refuse emergency, life-saving treatment to children based on these principles:
(1) the child’s interests and those of the state outweigh parental rights to refuse medical treatment;
(2) parental rights do not give parents life and death authority over their children; and
(3) parents do not have an absolute right to refuse medical treatment for their children, if that refusal is regarded as unreasonable.
When can physician bill for time spent with patient?
When counseling or coordination of care accounts for more than 50% of the face-to-face time of the encounter
Opiates in terminally ill pts used to relieve….?
pain
fatigue
dyspnea
When should babies start dada or mama
6-9mo
Leading cause of death on child > 1 yo
Accidents and injuries
How long should child sit in rear facing car seat
Until both 1 yo and weighs at least 20lb
The diagnosis of multiple myeloma is based on
evidence of myeloma-related end-organ impairment in the presence of M protein,
monoclonal plasma cells, or both.
This evidence may include hypercalcemia, renal failure, anemia, or skeletal lesions.
Patients should be screened for tuberculosis and hepatitis B and C before starting these drugs
TNF inhibitors
infliximab, adalimumab, certolizumab pegol, and golimumab.
If baby had mild hypochromatic anemia with elevated RDW, what would you do next?
Oral iron - see if there is a response to therapy
Most are Fe-deficient