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ANCC Review > need to knows > Flashcards

need to knows Flashcards

1
Q

COPD TX
groups A-D

A

A: SABA (or laba)
-albuterol (Proair)

B: LABA “-ol” (or lama)
-fomoterol
-salmeterol

C: LAMA “ium” (or lama/laba combo)
-tropium

D: LABA/LAMA Combo w/ICS “-one”, “-ide”
-fluticasone
-Budesonide

ICS info:
-dont not stop abruptly
-swish and spit after (we dont want thrush!)

SABA or LABA - LABA or LAMA -LAMA or LABA/LAMA COMBO - COMBO W/ICS

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2
Q

Sciatica

A

L3- straight leg
(be straight w/me)

L4- Squat/Rise test w/knee jerk
(squat to the floor)

L5- Heel walking w/toe numbness
(heel walk when you rise)

S1- walk on Toes w/decreased or no ankle jerk
(ballerina’s are fun)

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3
Q

Agnosia

A

impairment in the patient’s ability to understand information in relation to their senses.
(urinate on themselves)

-common in late stage Alzheimer’s disease

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4
Q

Apraxia

A

issues with voluntary motor skills.

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5
Q

Aphasia

A

when the patient has issues with impaired communication.

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6
Q

TX for Mild-Mod Dementia

A

Donepezil (Aricept)

Rivastigmine (Exelon)

Galantamine (Razadyn)

-AcCEPT that your EXELONt EX has demential and RAZ DYlaN

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7
Q

Most microcytic anemias are also

A

hypochromic in nature
(Hypochromic red blood cells are pale in color)

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8
Q

Adults presenting with cataracts

A

bilateral vision changes.
- difficulty seeing things at a distance (due to the myopic shift that occurs with cataracts)
- increased difficulty with night driving.
- foggy or cloudy vision
-presence of bilateral leukocoria on exam.

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9
Q

Central vision loss is related to

A

macular degeneration

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10
Q

NSAIDs are typically avoided in those with

A

heart failure due to their potential to exacerbate sodium retention. In addition, it has been found that NSAIDs may also decrease the effectiveness of antihypertensives.

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11
Q

carbamazepine (Tegretol) is an anticonvulsant and specific analgesic for trigeminal neuralgia. It has a black box warning for both

A

agranulocytosis as well as Steven-Johnson syndrome.

-Signs and symptoms of agranulocytosis include tachycardia, hypotension, sudden fever, and a severe reduction in the amount of white blood cells.

BLACK BOX warning of Agranulocytosis (low WBC)
-risk of liver toxicity

tEGRETol
“i rEGRET it all!” as she contorted her face
“the letter in this black box says i lost a GRANd to STEVEN”

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12
Q

A direct Coombs test can indicate a

A

hemolytic anemia in which the red blood cells are being destroyed prematurely

-lupus = risk for an autoimmune hemolytic anemia.

“if you lyce too many blood cells, you’ll be in the tOOMB”

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13
Q

Pterygium colli is the medical term for

A

“webbed neck” which is seen in Turner’s syndrome.

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14
Q

absolute contraindications of combined
contraceptives

A

“My CUPLETS”

My : migrane w/aura
C: CAD OR CVA
U: Undx genital bleeding
P: preggo / suspected preggo
L: Liver tumor/active dz
E: Estrogen dependent tumor
T: Thrombus or emboli
S: Smoker >35

Combined contraceptives can be useful
for patients with dysmenorrhea, hirsutism, and ovarian cysts.

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15
Q

Medications that
increase risk for nephrolithiasis ( kidney stones).

A

acyclovir, sulfadiazine, and indinavir can all cause nephrolithiasis, or a renal calculi.

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16
Q

Pleuritic chest pain is

reasons for it to occur are

A

a severe pain that occurs upon inspiration and expiration.

reasons for Pleuritic chest pain to occur is due to a
-pulmonary embolism
-Bornholm disease (also known as pleurodynia)
-An empyema (A collection of pus in the pleural space)

“P.E…..p- EmPyemA - A/B - BORN to know my ABC’s

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17
Q

Insulin aspart (Novolog) is a

A

rapid acting insulin that is commonly
used with a sliding scale. It is the appropriate insulin to increase when patients
experience glucose increases between meals.

“regular insulin” is also rapid

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18
Q

Insulin glargine and detemir are

A

once a
day insulin

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19
Q

DM diagnostic criteria

A

A1C: >6.5

Fasting Glucose: >126

2 hr GTT: >200

Random Glucose: >200 WITH SYMPTOMS

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20
Q

DM:

Polyuria

Polydipsia

Polyphagia

A

Increased Urine

Increased Thirst

Increased Hunger

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21
Q

The nucleic acid test (NAT)

The ELISA test

The rapid plasma reagin (RPR) & (VDRL)

The antinuclear antibody (ANA)

A

NAT: for chlamydia & Gonorrhea

ELISA: is an initial tool to help screen for HIV in exposed individuals

(RPR) test is a screening for syphilis.

(ANA) is used to screen for autoimmune disorders

  • if RPR or VDRL + for syphilis–> confirm with FTA-ABS (treponemal test)
22
Q

polycythemia vera TX

A

-Hydroxyurea can be utilized for these patients in order to slow down the production of more red blood cells.

-Aspirin can also be used to further help thin out the blood.

-Phlebotomy initiated when hematocrit is less than 45%

-The patient will require lifelong treatment as there is no cure present.

23
Q

A direct Coombs test can indicate

A

hemolytic anemia
(red blood cells are being destroyed prematurely)

-A patient diagnosed with systemic lupus erythematosus (SLE) is at an increased risk for an autoimmune hemolytic anemia.

24
Q

potential common signs and symptoms of polycythemia vera

A

-neurological symptoms such as a headache and paresthesias

-Distended retinal veins

-plethora (flushing of the skin)

-erythromelalgia (burning sensation)

25
Q

Actinic Keratosis

A

dry, scaly lessions (all colors)

-may lead to Squamous Cell Carcinoma (scaly laceration that bleeds easily–> sun exposed area)

ACTinic KERatosis
“ACT like you KER that my skin is flaking off!”

26
Q

Squamous Cell Carcinoma

A

Scaly ulceration that bleeds easily (sun-exposed area)

SQUAMous CARcinoma
“ew stop pulling them off in the CAR. your making me SQUIRM! getting skin and blood everywhere”

27
Q

Seborrheic Keratosis

A

Benign. tan/brown/black. Look as if they have been pasted on or dripped on by a candle.

-telangiectas can be present (visible vessels)
-common in elderly

SEBorrheic KERAtosis
“SEBordinate behavior KERA! dont paste-on your coworkers!”

28
Q

Lentingines

A

liver spots, are benign lesions that occur on the sun-exposed areas of the body. The backs of hands and face are common areas. flat, brown/tan age spots. “Moth eaten” edges.

-may lead to seborrheic keratosis

29
Q

keratosis pilaris

A

“chicken skin”
-harmless skin condition that causes dry, rough patches and tiny bumps, often on the upper arms, thighs, cheeks or buttocks.
-The bumps usually don’t hurt or itch

KERAtosis pILARIs
“im sorry KERA, but that chicken prank was hILARIous”

30
Q

Molluscum contagiosum

A

an infection caused by a poxvirus (molluscum contagiosum virus)

-flesh colored
-“dimpled” lesion
-very contagious
-resolve on their own
-child? groin area? –> maybe sexual abuse
-caused by the Poxvirus

-In peoplewith HIV, prevalence of molluscum contagiosum is up to 18%. Therefore, HIV testing is considered, especially if the lesions are large (greater than 10 mm), numerous, or widespread.

MULLUSC
“looks like mollusk’s on the bottom of a the gay cruise ship (HIV)…. what are you afraid of? Gayness is not contagious! lol, its not like the chicken POX”

31
Q

Lichen Simplex Chronicus

A

-simply chronic scratching
-skin becomes leathery/rubbery

tx: topical steroids

32
Q

Lichen Sclerosus

A

-discolored patchy/scaly skin
-post-menopausal women labia

“its like your LICkin her SCales on her whoo ha…”

tx: ONLY time you use topical steroids on genitals
ex: Clobetasol
“ive licked scaled all over the globe…”

33
Q

Lichen Planus

A

inflammatory skin condi. on flexor surfaces (mouth, skin, genitals)
-flat-topped bumps that itch
-lacy white mucous membranes

lIChen PLANus
“Ic! this wasn’t the PLAN- i shouldn’t be itching like this, in my white gloves, on my wedding day!”

34
Q

DO NOT treat Bronchitis with_______

A

antibiotics

-its usually viral

35
Q

Asthma

A
  1. ICS-LABA PRN
    (“-one”/”-ide”)/( “-ol”)
  2. ICS daily
  3. ICS + LABA daily

4-5. REFER

ICS/LABA PRN - ICS - ICS/LABA

36
Q

Intermittent Asthma
“Occasional”

Mild/Persistent Asthma

A

Intermittent:
-S/S 2 days or less a week
nighttime awakenings 2X monthly
FEV1 >80%

Mild/persistent:
-S/S > 2 days a week (not daily)
Nighttime awakenings 3-4X monthly.
FEV1 >80%

37
Q

Moderate Persistent Asthma

A

-Daily
-Nighttime awakenings > 1x/week (not nightly)
med use: daily

FEV1 60%-80%

38
Q

“-triptans”

A

-tx headaches

“dont TRIP! maybe the headache is just from the TAN”
Its not! its from that idiot
-dude bring your HR down.

Contraindicated w:
-uncontrolled HTN
-CAD (coronary artery dz)
&
-MAOI’s
could cause serotonin syndrome

(Marplan), (Emsam), (Nardil), (Parnate)
“My PLAN is.. um SAM is a NARD, and we should PARtner with NATE)

39
Q

Acne TX

A
  1. Benzo peroxide
  2. topical antibiotics/Retin-A
  3. oral antibiotics

then refer to derm

40
Q

Bells Palsy:

triggers?
CN?
Common issue?

A

triggers:
-preggo
-lyme Dz
-viral conditions

CN: VII

Common issue: corneal abrasion

41
Q

area of the brain:
-expressive aphasia impacts

-responsible for comprehending speech

A

-Broca

“BRO is expressive, but CAnt speak”

-Wernickes
(“WE’RE NICKEyS kids just singing?? I cant comprehend the words)
-alcoholic
-thiamine deficiency

42
Q

Tug Test

A

> 13.5 seconds = increased risk for falls

-patient sit back in a chair
-spot 10 ft away
- “Go,” begin timing.
-timing after patient sits back down.

Observe the patient’s postural stability, gait, stride length, and sway.

43
Q
  1. best antidepressant for elderly
  2. best antihistamine to use for elderly
A
  1. Zoloft
    “old people like to sit in the loft”
  2. Claritin
    -decreased sedation
44
Q

IBS vs. IBDisease

A

IBDisease:
1. crohns
-skip lesions
-fistulas
-strictures

“jOHN SKIPs church to go FIShing, but feels bad so brings his SCripTURES”

  1. ulcerative colitis
  2. colonis polyps
45
Q

most common skin cancer

A

Basal Cell Carcinoma

-waxy presentation
-w/telangiectas present (visible vessels)

46
Q

Underlining cause of:

1.Alzheimers

2.Parkinsons

3.Thiamine Deficiency

A
  1. beta amyloid protein deposites on frontal/ temporal lobe
  2. decreased Dopamine
  3. Alcoholics (likely have Wernicke-Korsakoff syndrome) “nicky is an alcoholic- its a shame, he’s got great thighs”
47
Q

TX for:

  1. Mild- Mod Dementia
  2. Severe Dementia
A
  1. -Aricept
    -Exelon
    -Razadyn

“AcCEPT that your EXELent EX has RAZ DYllin”

  1. C-Levodopa (Cinemet)
48
Q

Medicare A-D

A

A: inpatient, outpatient, skilled nurse facillities

B: Second opinions, equipment, emergent (ambulance rides)

C. Hearing, Vision, and Dental

D: Drug Coverage (non-annual vaccines)

49
Q

Fidelity

Justice

Veracity

Beneficence

Non-maleficence

Autonomy

Paternalism

A

Fidelity- maintain trust

Justice- treat all fair

Veracity- truth telling

Beneficence- do good

Non-maleficence- do no harm

Autonomy- make own decisions

Paternalism-next best choice if they refuse

50
Q

microvascular complications from DM

A

Neuropathy
-decreased sensation in hands/feet

Nephropathy
-kidney damage

Retinopathy
-change in vision

51
Q

GERD:
TX can last?

long term use can cause?

when to take them?

A

TX can last?
4-8 weeks w/PPI (“-prazole”)

long term use can cause? COB
-C-Diff
-Osteoporosis
-B12 deficiency

“I pp’d on the corn of the COB”

when to take them?
right before the first meal of the day

52
Q

Hidradenitis suppurativa (HS),

A

“acne inversus”

-chronic inflammatory skin condition
-deep-seated nodules
-abscesses
-draining tracts (w/odor)
-fibrotic scars

“worst type of acne in High School. the deep-seated one. try and pop it- it would stink!”

ANCC Review (19 decks)

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