Term
| nonmaleficence and beneficence |
|
Definition
nonmaleficence = do no harm
beneficence = further patients well being |
|
|
Term
| what is the cause of most acute diarrhea |
|
Definition
| infectious diarrhea is 90% of acute diarrhea causes |
|
|
Term
| what is the major sign of invasive bacterial infection |
|
Definition
|
|
Term
| what are the hemorrhagic/invasive species |
|
Definition
EIEC
yersinia
shigella
entameoba histolytica |
|
|
Term
| when someone comes in with acute diarrhea what is the first test to order |
|
Definition
| examine stool for leukocytes |
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Term
|
Definition
| diarrhea for less than 2 weeks |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| organism that causes diarrhea after trip to mexico |
|
Definition
|
|
Term
| what comes from undercooked chicken |
|
Definition
|
|
Term
| what comes from undercooked beef |
|
Definition
|
|
Term
| what comes from mayo? timing |
|
Definition
within 6 hours of eating = staph aureaus
8-12 c. perfringens
12-14 ecoli
any/other timing = salmonella |
|
|
Term
| raw seafood causes what gi bug? |
|
Definition
|
|
Term
| what type of diarrhea found in daycares |
|
Definition
|
|
Term
| nursing home and hospital diarrhea |
|
Definition
|
|
Term
| when do you need to do a work up of diarrhea |
|
Definition
profuse diarrhea
dehydration
fever over 100.4
bloody
severe abdo pain
diarrhea over 48 hrs
children, elderly, immunocomp pts |
|
|
Term
| tests for volume states on PE |
|
Definition
mucous membranes
skin turgor
capillary refill |
|
|
Term
| what is the major antibiotic that causes c diff |
|
Definition
clindamycin
but any abx can cause it |
|
|
Term
| first step in tx of acute diarrhea |
|
Definition
fluid replacement
checking and correcting electrolytes |
|
|
Term
|
Definition
pedialyte of gatorade if they can tolerate PO
IVF if they cannot |
|
|
Term
| most common kind of infectious diarrhea |
|
Definition
|
|
Term
| best way to prevent spread of infectious diarrhea |
|
Definition
|
|
Term
| treatment of travelers diarrhea |
|
Definition
|
|
Term
|
Definition
| pregnant and children cannot have quinolones like cipro |
|
|
Term
| what do you use for travelers diarrhea in children or pregnant women |
|
Definition
| azithromycin single 1000mg dose |
|
|
Term
| when can you use rifaximin |
|
Definition
| only in travelers diarhhea that is NOT bloody, NO fever and NON invasive |
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Term
|
Definition
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|
Term
| most appropriate therapy for sprained ankle |
|
Definition
Protection
Rest
Ice
Compression
Elevation
+NSAIDS |
|
|
Term
| what type of injury most commonly causes sprained ankle |
|
Definition
| inversion of an ankle that is plantar flexed |
|
|
Term
| what side of the ankle more commonly injured |
|
Definition
|
|
Term
| what protects the medial ankle from injury |
|
Definition
| a thick deltoid ligament complex |
|
|
Term
| what are the lateral ligaments of the ankle |
|
Definition
anterior talofibular ligament (ATFL)
calcaneofibular ligament (CFL)
posterior talofibular ligament (PTFL) |
|
|
Term
| which of the lateral ligaments is most likely injured |
|
Definition
|
|
Term
|
Definition
1: stretching ATFL
2: partial tear of atfl and stretch CFl
3: complete tear of ATFL and CFL and partial tear of PTFL |
|
|
Term
| what are the associated sx with each grade of ankle sprain? |
|
Definition
1: swelling, pain, no mechanical instability and little to no functional loss
2: more pain swelling and bruisin and some joint instability and start to loose ROM
3: significant joint instability and loss of function |
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|
Term
|
Definition
| rules to help us determine who to xray with a sprained ankle |
|
|
Term
| when do you xray with the ottawa ankle rules |
|
Definition
any of the following indicate xray:
bony tenderness over navicular bone
bony tenderness at base of 5th metetarsal
pt cannot bear weight |
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|
Term
|
Definition
|
|
Term
|
Definition
sprain is stretch/tear ligament injury
strain stretch/tear of mm or tendon |
|
|
Term
| what are the three things that can be injured in shoulder rotator cuff injury |
|
Definition
supraspinatus
infrapinatus/teres minor
subscapularis |
|
|
Term
| how would you test a patient to see if supraspinatus is injured in a rotator cuff injury? |
|
Definition
| tested with empty can test. arm abducted, elbow extended, thumbs down pt elevates arm against resistance |
|
|
Term
| how would you test a patient to see if infraspinatus/teres minor is injured in a rotator cuff injury? |
|
Definition
check external rotation.
elbos at side and flexed 90 deg, pt externally rotates aginst resistance |
|
|
Term
| how would you test a patient to see if subscapularis is injured in a rotator cuff injury? |
|
Definition
lift off test
pt places dorsum of hand on lumbar back and attempts to lift hand off of back |
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|
Term
|
Definition
|
|
Term
| what are the ottawa knee rules? |
|
Definition
xray knee if:
1. age over 55
2. isolated patella tenderness
3. tenderness at head of fibula
4. inability to flex the knee to 90 degrees
5. inability to bear weight for 4 steps immediately in the examination room (limping is ok) |
|
|
Term
| how do you test for syndesmosis injury |
|
Definition
squeeze test
squeeze tibia and fibula together at midcalf to elicit pain |
|
|
Term
| how do you test a lateral ankle sprain to see if it is ATFL |
|
Definition
| anterior drawer test. dr pulls forward on pts heel while stabilizing lower leg with other hand and excessive movement suggests atfl tear |
|
|
Term
| hos do you test a lateral ankle sprain to see if it is CFL |
|
Definition
inversion stress test
dr inverts ankle with one hand while stabilizing lower leg with other hand, excessive translation of a clunk of the talu = ligament tear |
|
|
Term
|
Definition
| lachman test = drawer test |
|
|
Term
|
Definition
valcus stress
medial force o knee and lateral force on ankel with excessive translation suggests a tear |
|
|
Term
|
Definition
varus stress test.
lateral force on knee and medial force on ankle with excessive translation suggests a tear |
|
|
Term
| what is the most likely cause of persistently stiff, painful or unstable joints after sprains? |
|
Definition
|
|
Term
| who do the ankle ottawa rules not apply too? |
|
Definition
children
ppl with AMS
ppl who wait over 10 days to get checked after injury |
|
|
Term
| what do you do if you suspect that a pts decline in ROM is due to pain and you want to examine the joint? |
|
Definition
| inject lidocaine into the joint |
|
|
Term
| what is an "adequate xray" in joint injury |
|
Definition
| two views at 90 deg to eachother |
|
|
Term
| what does the lower urinary tract consist of |
|
Definition
|
|
Term
|
Definition
| 3+ rbc per HPF on 2+ properly collected urinalyses |
|
|
Term
| first steps in managing urinalysis with rbc found incidentally |
|
Definition
urine culture
and
repeat urinalysis
and if they have lots of risk factors for something (cancer or an infection) you can work them up without waiting for repeat |
|
|
Term
| how do you image upper vs lower urinary tracy |
|
Definition
lower: cystoscopy
upper: intravenous pyelogram or CT |
|
|
Term
| what is the liklihood that bladder cancer presents as asymptomatic microscopic hematuria |
|
Definition
|
|
Term
| golmerular vs renal nonglomerular hematuria vs urologic hematuria |
|
Definition
3 classes of hematuria
glomerular = RBC casts, dysmorphic RBCs, protein in urine
renal nonglomerular = protein in urine but NO casts or dysmorphic rbcs
urologic hematuria : no casts, no protein, no dysmorphic rbcs |
|
|
Term
| what causes renal nonglomerular hematuria |
|
Definition
tubulointerstitial disease
renovascular issues
metabolic disorders |
|
|
Term
| what are the causes of urologic hematuria |
|
Definition
tumors
calculi
infection
trauma
prostate issues |
|
|
Term
| how do you store urine in a clinic |
|
Definition
refrigerate
cannot use if it has sat out for more than 2 hours |
|
|
Term
|
Definition
|
|
Term
| major cause of interstitial nephritis |
|
Definition
| analgesics or other drugs |
|
|
Term
| how long does ecercise induced hematuria last |
|
Definition
|
|
Term
| how do prophylax against contrast dye induced kidney injury |
|
Definition
| n-acetylcysteine can help lower risk |
|
|
Term
| what do you do if there are 2 + urinalysis with microscopic hematuria but your initial work up is negative? |
|
Definition
| repeat bp, UA and urine cytology at 6, 12, 24 and 36 months. if ok then no further f/u required |
|
|
Term
| when do you work up gross hematuria |
|
Definition
|
|
Term
|
Definition
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