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1

Stage hypertension

Pre-hypertension = 1 20–139/80–89

Stage I = 140–159/90–99
Stage II = 160+/100+

2

Herbal supplements causing hypertension

Arnica
Bitter orange
ephedra = Ma–huang
ginkgo
Ginseng
guarana
licorice
senna
St. John's wort

3

Treatment of cocaine-induced hypertension

–Nitroglycerin
–Benzodiazepines
–Calcium channel blockers
–Labetalol (only allowable beta blocker)

do not use beta blockers as this will increase the vasoconstriction of the coronary arteries

4

initiation of pharmacologic therapy for hypertension

Persons <60 years of age with a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥60 years of age with a systolic blood pressure ≥150 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥18 years of age with chronic kidney disease who have a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg
Persons ≥18 years of age with diabetes mellitus who have a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg

5

treatment for acute exacerbation of multiple sclerosis

steroids

6

diagnosis of serotonin syndrome

increase serotoninergic activity in Central nervous system
–Neuromuscular abnormalities
–Mental changes
–Agitation
–Confusion
–Tachycardia
–elevated blood pressure
–Dry mouth
–Usually within 24 hours of starting SSRI

–May have slow horizontal nystagmus
–May have spontaneous clonus

7

treatment of serotonin syndrome

–diazepam to count patient
–Propanolol for hypertension
–Antidote, if needed is cyproheptadine
–Avoid HALOPERIDOL

8

positive predictive value

the percentage of patients with a positive test for a disease who actually
have the disease.

9

negative predictive value

the percentage of patients with a negative test for disease who actually do not have the disease

10

defined sensitivity of the test

the percentage of people who have a disease who Will get a positive result

11

define specificity

the percentage of people who do not have the disease and get a negative test result

12

define Gilbert's syndrome

=hereditary condition with unconjugated hyperbilirubinemia
–usually normal liver enzymesan asymptomatic
–Bilirubin increases with stress, fasting, and infection

13

most likely drug involved in breast tenderness and gynecomastia

spironolactone

14

most common cause of death in rheumatoid arthritis

–coronary artery disease


Also have an increase in
––Thromboembolic events
––Infections
––Lymphoma
––Lung cancer

15

drug of choice for polynephritis

Cipro

16

findings in idiopathic thrombocytopenic purpura

thrombocytopenia which is isolated and has no other cause

17

drug of choice for pertussis

azithromycin

18

contraindications for ParaGard and or Mirena

–Mirena is preferred for most conditions

–ParaGard is preferred in the presence of severe liver disease, thromboembolic events, or liver cancer

19

prevalence of migraines

–men = 10%
–Women = 20% have them

20

classification of migraine headaches with aura


International Headache Society Diagnostic Criteria for Migraine Headache With and Without Aura
Migraine without aura

Headache lasts 4 to 72 hours (untreated or unsuccessfully treated)

Headache has at least 2 of the following:

Aggravation by or causing avoidance of routine physical activity (e.g., walking, climbing stairs)

Moderate or severe pain

Pulsating quality

Unilateral location

During headache, at least 1 of the following:

Nausea and/or vomiting

Photophobia and phonophobia

Not attributed to another disorder

History of at least 5 attacks fulfilling above criteria

21

classification of migraine headaches without aura

Migraine with aura*

Aura consisting of at least 1 of the following, but no motor weakness:

Fully reversible dysphasic speech disturbance

Sensory symptoms that are fully reversible, including positive features (e.g., pins and needles) and/or negative features (e.g., numbness)

Visual symptoms that are fully reversible, including positive features (e.g., flickering lights, spots, lines) and/or negative features (e.g., loss of vision)

At least 2 of the following:

Homonymous visual symptoms and/or unilateral sensory symptoms

At least 1 aura symptom develops gradually over 5 minutes, or different aura symptoms occur in succession over 5 minutes

Each symptom lasts at least 5 minutes, but no longer than 60 minutes

Headache fulfilling criteria for migraine without aura begins during the aura or follows aura within 60 minutes

Not attributed to another disorder

History of at least 2 attacks fulfilling above criteria

22

episodic vertigo triggered by head motion

episodic proximal positional vertigo

23

Ménière's disease

vertigo
tinitis
unilateral hearing loss
last 20 minutes–12 hours
Ear fullness

24

contraindications to MMR vaccine

–allergy to neomycin
–Immunosuppression
–Pregnancy

25

Lewy body dementia characterized by

–memory deficits
–Reduced alertness
–parkinsonian features
–rigidity
–Resting tremor
–Bradykinesia
–Gait disorder

26

triad of normal pressure hydrocephalus

"wacky, wet, wobbly,"

–personality change
–Urinary incontinence
–Gait disorder

27

Hashimoto's disease

–most common cause of hypothyroidism
–May actually start with hyperthyroidism
–anti-thyroglobulin autoantibodies
–anti-thyroid peroxidase

28

Graves' disease in pregnancy

= hyperthyroidism
–Treatment with PTU (propylthiouracil)
–use beta blockers initially if thyroid storm

29

differences between chalazion and hordeolum

chalazion = blocked oil duct

Hordeolum =infected oil duct

30

Salter-Harris fracture classifications

Salter I =S = slipped epiphysis
Salter II =A= above epiphysis
Salter III =L =lower than physis
Salter IV =T = through physis
Salter V =ER =wrecked physis ( compression)