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Flashcards in Random Topics from Fitzgerald Deck (62)
1

Mammography at age

40 annually

2

Hypocalcemia correction with low albumin

add 0.8 md/dL calcium for every 1 gram albumin below 4

3

Medications that cause hyperkalemia

ACE-I
Heparin
NSAIDs

4

Opioid antagonists

Butorphanol
Naloxone
Naltrexone
Pentazocine

5

Complications of Acute Rhinosinusits

Orbital cellulitis
Osteomyelitis
Sinus Thrombosis

6

Treatment duration for ARS

No risk for resistance and 1st line therapy works= 5-7 days

Resistance7-10 days

7

Causes of chronic glaucoma

ethnicity, age, near-sightedness, DM

8

S/S of acute closed narrow angle glaucoma

ipsilateral HA
blurry vision
severe periorbital pain
Halos around objects
pain with eye movement

9

Normal variant in eye exam for contact wearers

absence of corneal reflex

10

Assessment of Asthma

Classify severity
Asthma control

11

Two medications that help with allergies in asthma

Leukotriene receptor antagonists (LTRA) -lukast
Omalizumab

12

When to consider and when to consult asthma specialist

Consider at stage 3
Consult at stage 4

both if required

13

Intubation criteria for asthma exacerbation

after 1 hour of treatment PEF/FEV1 42
absence of wheezing
drowsiness
confusion
bradycardia

14

Assessment of COPD

Exacerbation risk
Symptom assessment
Spirometric assessment

15

Steroid dose and duration for COPD exacerbation

40 mg/day for 5 days

16

Mild-Moderate COPD exacerbation requiring abx

Amoxicillin
Doxycycline
Bactrim

17

Severe COPD exacerbation requiring abx

Augmentin
Cephalosporin
Azithromycin
Clarithromycin
Fluoroquinolone

18

Booster phenomenon in TB

elders; infected long ago have initial negative mantoux but a positive mantoux when retested up to 1 year later due to first test boosting immune response

19

Two-step testing in TB

strategy to distinguish a boost reaction

Person with negative mantoux is retested 1-3 weeks later

Positive with second test= boosted reaction, not recent infection

20

PPD for TB

tests for exposure
can produce false positives

21

IGRA for TB

used for people who received BCG vaccine
useful in people who do not follow-up with skin tests
Pt should have either TST (mantoux) or IGRA not both

22

Most common cause of fatal CAP

Strep. pneumoniae

23

Pneumonia associated with close proximity to crowded areas

M. pneumoniae
C. pneumoniae

24

CURB-65

Confusion
Urea (BUN >19)
RR >30
BP 65

25

Admission for ICU with pneumonia

Shock or Respiratory failure
Or three minor criteria:
RR greater than 30, PaO2/FiO2 less than 250, Multilobar infiltrates, Confusion, BUN above 20, WBC under 4000, Platelets under 1000
Temp under 36.3, Hypotension requiring fluid resusc

26

Diagnostic criteria and management of ARDS

bilateral infiltrates
PA wedge pressure less than 19
PaO2/FiO2 under 200

TV 6ml/kg
Rate 10
PEEP 5-10
Sedation and paralyzing for compliance

27

LAMA mechanism of action (tiotropium)

anti-inflammatory
mucolytic activity

28

Highest risk for PE

stasis

29

Biggest lifestyle modification to reduce HTN

weight loss (5-20 mmHg per 10 kg weight loss)

30

HTN medication class not to be used with heart failure

CCB

31

Aldosterone risk with prolonged use

gynecomastia

32

abrupt withdrawal of clonidine can lead to

rebound HTN

33

Goal BP reduction in HTN urgency and emergency

Urgency: hours
Emergency: reduce MAP no more than 25% within 2 hours then toward 160/100 within 2-6 hours

34

High risk unstable angina

worsening mitral regurg
hemodynamic instability
sustained VT
PCI within 6 months
high TIMI/GRACE score
Reduce LV EF

35

Treatment in Chronic HF

Ace-I
Beta-blockers
Control comorbidities
Diuresis

36

Treatment of Acute HF

1. Vasodilator
MSO4
Diuresis 1-2x daily amount
Inotropes

37

Acute HF S/S

dyspnea at rest
coarse rales
S3
no peripheral S/S
Kerley lines

38

Chronic HF S/S

dyspnea with exertion
redistribution of flow on X-ray
JVD
abdominal discomfort
peripheral edema

39

Staging of HF (A-D)

A: high risk without structural disease or symptoms
B: Structural disease without symptoms
C: Structural and symptoms
D: Refractory HF

40

Treatment of pericarditis

pain meds
NSAIDs (not in renal failure)
Steroids

41

Phases of cardiac rehab

1: inpatient at hospital
2: medically supervised
3: daily life

42

target HR for patients with ischemic changes

10 bpm below level of ischemia
must be above resting HR

43

Most important risk factor in CAD

family history

44

HgbA1C percents with correlating glucose

5%- 97
6%- 126
7%- 154
8%- 183
9%- 212
10%- 240
11%-269
12%- 298

45

First line treatment in untreated hyperthyroidism

non-selective BB
Nadolol
Propranolol

Treatment
PTU
RAI

46

Signs of addisons disease

fatigue
hypotension
hyperpigmentation
arthralgias
uncontrolled inflammation

47

T score for osteoporosis

+1 to -1 Normal
-1 to -2.5 prevention to osteoporosis 1500 mg Ca 800units Vit D

48

Urinary incontinence testing

provocative stress testing
PVR
voiding records

49

Short term memory loss in elderly

normal age related change

50

medication for depression and appetite stimulation

remeron

51

Majority of elderly falls happen

in patient's home

52

Intra-renal failure can lead to ischemia when

MAP 30 minutes

53

Lupus like drug reaction (joint pain) in what meds

Procainimide
hydralazine
INH
quinidine
minocycline
diltiazem

54

Pain relief with BM

IBD

55

Tension/cramping pain indicates

obstruction
gastroenteritis
food-related

56

Inflammatory pain in abd

generalized to localized; worse with movement

appendicitis
cholecystitis
pancreatitis

57

Ischemic abd pain

deep acute pain, smokers at risk

ischemic bowel
Mesenteric artery infarct

58

Surgical abdomen diagnoses

dissecting aneurysm
ectopic pregnancy
appendicitis
perforated organ

59

Non-surgical abdomen diagnoses

cholelithiasis
PID
Gastroenteritis

60

Warning signs of surgical abdomen

intractable vomiting
Pain before vomiting
acute steady pain for hours
pain causing syncope
pain that disturbs sleep
pain >6 hours
well localized pain
unrelieved by analgesics
old abdominal scars

61

Wedge pressure in Cardiogenic shock

increased

62

Wedge pressure in Obstructive shock

decreased