Study guide Flashcards
(23 cards)
Why do SSRIs take 6 weeks to work
downregulation of serotonin receptor
treatment plan w/ SSRI
- treat for 8-12 months
- no change in 6 weeks = increase dose
- at max dose after 10 weeks, switch to another
side effects of SSRIs
sexual dysfunction, GI upset, weight gain, suicide, insomnia/sedation
discontinued SSRIs
rebound anxiety, paresthesias, n/v/d, worse with paxil (short half life
back pain red flags
- progressive
- incontinence
- neuro defect
- fever/constitutional symptoms
special causes of back pain
- cancer (weight loss, progressive)
- compression fracture (steroids, osteoporosis, trauma, elderly)
- spinal stenosis (pseudoclaudication)
- ankylosing spondylitis (young, morning stiffness, better w/ exercise)
- cauda equina (urinary retention, bilateral weakness, saddle anesthesia)
headache treatment
rest, hydration, triptans
when to prophylax for headaches
5 or 2 with aura
rotator cuff tendonitis
- Neer impingement test
2. external rotation difficulties
Ottawa ankle rules
xray with:
- ankle pain and tenderness over posterior or tip of posterior or lateral malleolus
- foot pain with tenderness of navicular or fifth metatarsal
- ankle/midfoot pain and cant take 4 steps after and in ER
when to use cipro for diarrhea
bloody or over 24 hours
nitrates in UTI
high PPV
complicated UTI
male, fevers, n/v, pyelo, previous UTI, nosocomial, less than 13 or older than 65, longer than a week, pregnant or immunocompromised
when to treat bronchitis with abx
- more than 2 weeks
- roller coaster course
- one sided sinusitis
anaerobe treatment
oral = penicillin, clinda 2nd line
GI = flagyl, clinda 2nd line
vaginal - flagyl, clinda 2nd line
signs of strep
headache, anterior cervical LAD, tender LAD, petechiae, abdominal pain
URI symptoms management
increase fluids, extra pillows, codeine, advil/tylenol, nasal saline, honey, zinc, inhalers
URI immune system help
rest, no alcohol, nutrition, empathy, echinacea, umcka, stress, decongestants
alternative URI treatments
zinc, umcka, echinacea, vitamin C
high risk of HIV
risk behaviors, high prevalence, anal sex, homeless, IV drugs
when you can confidentiality with teens
- mature minor
- pregnancy
- STDs
- addiction treatment
- mental health
- emergencies
mature teens
- married
- parenting child
- military
- apart from parents/managing own finances
not okay to keep confidentiality
- abuse
- suicide/homicide
- medical condition threatening of life or limb
