Term
|
Definition
|
|
Term
| opacity of the normally clear crystalline lens |
|
Definition
|
|
Term
| complaints of glare and difficutly driving at night |
|
Definition
|
|
Term
| risk factors for cataracts (6) |
|
Definition
smoking
UV light exposure
metabolic d/o
long term steroid use
dermatologic factors
meds - chlorpromazine or amiodarone |
|
|
Term
| abnormal increase in IOP - 2 kinds |
|
Definition
glaucoma
open angle
closed angle (emergency) |
|
|
Term
| sudden unilateral pain, blurring and loss of peripheral vision followed by loss of central vision, incandescent light, halos, head ache |
|
Definition
|
|
Term
|
Definition
|
|
Term
| main risk factor for glaucoma |
|
Definition
long term steroid use
other meds - amphetamines and chlorpromazine |
|
|
Term
|
Definition
acute - emergency ophtho referral
topical - pilocarpine
systemic - carbonic anhydrase inhibitors
dichlorphenamide
acetazolamide
mannitol - slow IV drip |
|
|
Term
| drooping of the upper eye lid |
|
Definition
|
|
Term
| meds that can cause ptosis |
|
Definition
| high doses of opioid drugs - morphine, oxycodone, or hydrocodone. mild version also seen with pregabalin |
|
|
Term
| unilateral paralysis of the face, including forehead - CN 7 may be compressed and demyelinated in response to inflammation within the facial canal. |
|
Definition
|
|
Term
|
Definition
60% recover completely without tx.
controversial tx includes administration of corticosteroids within 5 days of onset |
|
|
Term
| nasal polyps in children may suggest |
|
Definition
|
|
Term
|
Definition
| nasal corticosteroids for 1-3, or a short course of oral corticosteroids |
|
|
Term
| triad of nasal polyps, asthma, and _______ |
|
Definition
|
|
Term
| acute vs subacute vs chronic sinusitis |
|
Definition
acute < 4 wks
subacute 4-12 wks
chronic > 12 wks |
|
|
Term
|
Definition
H influenzae
S. Pneumoniae
M. Catarrhalis |
|
|
Term
|
Definition
limited coronal CT
if malignancy is suspected - MRI with gadolinium should be ordered instead of CT |
|
|
Term
|
Definition
2/3 of pts improve in 2 wks w/o tx
abx reduce course by 50% - augmentin, amox, cephalexin, cefuroxime, cefaclor, cefixime, quinolones (cipro), macrolides (azithro, clarithro) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| subtle, sneaky night time cough in a child might indicate |
|
Definition
|
|
Term
| obstructive changes of spirometry |
|
Definition
|
|
Term
| increased PaCO2 and respiratory acidosis may indicate the need for |
|
Definition
|
|
Term
|
Definition
| inhaled short acting beta-2 agonist (albuterol) |
|
|
Term
|
Definition
|
|
Term
| types of inhaled corticosteroids |
|
Definition
| advair, flovent, beclomethasone, budesonide, fluticasone - most effective long term asthma therapy |
|
|
Term
|
Definition
| severe bronchospasm that does not response to aggressive therapies in 30-60 minutes |
|
|
Term
| rule of 2's for who needs controller therapy |
|
Definition
2 beta agonist canisters/year
2 doses of beta agonist/week
2 nocturnal awakenings/month
2 unscheduled visits/year
2 prednisone bursts/year |
|
|
Term
| inflammation of the large airways of the lower respiratory tract |
|
Definition
|
|
Term
| infection of the smaller airways - more common in the 1st year of life |
|
Definition
|
|
Term
| hx of recurrent LRI's, hemoptysis, and clubbing of the digits long term - often accompanied by foul smelling sputum |
|
Definition
|
|
Term
| chronic non productive cough keep in mind |
|
Definition
|
|
Term
| MC etiology for hemoptysis |
|
Definition
|
|
Term
|
Definition
| hypoxia, pulmonary HTN, right sided heart failure |
|
|
Term
pink puffers
blue bloaters |
|
Definition
pink puffers - emphysema
blue bloaters - chronic bronchitis |
|
|
Term
| hypersecretion of mucous and cough in 3+ months for 2+ years - experience chronic hypoxia and resultant cyanosis |
|
Definition
|
|
Term
| early onset emphysema think of |
|
Definition
| alpha 1 antitrypsin deficiency |
|
|
Term
|
Definition
| MAT (multifocal atrial tachycardia) |
|
|
Term
| type of hernia common in emphysema pts |
|
Definition
|
|
Term
| COPD can lead to what lab changes in advanced stages |
|
Definition
polycythemia vera
thrombocytosis |
|
|
Term
| ABG difference in emphysema and chronic bronchitis |
|
Definition
emphysema - nromal to decreased PaO2 and normal to mildly decreased PaCO2
chronic bronchitis - markedly decreased PaO2 and increased PaCO2 |
|
|
Term
| TLC is increased in emphysema or chronic bronchitis |
|
Definition
| emphysema (trouble expelling all inhaled air leads to hyperinflation) |
|
|
Term
|
Definition
bronchodilators - beta 2 agonists (albuterol, formoterol, salmeterol, terbutaline)
anticholingergics may be more effective in COPD - atrovent
anti-inflammatories - veclomethasone, budesonide, fluticasone, triamcinalone, oral steroids
CPAP - goal is to shift PaO2 to 60-65 |
|
|
Term
| MC infiltrative lung diseases |
|
Definition
rheum d/o - scleroderma, polymyositis, SLE, RA, ank. spondylitis)
drug induced changes
primary diseases (sarcoidosis, amyloidosis, neurofibromatosis, pulmonary neoplasm/lymphoma)
occupational (asbestosis, silicosis, siderosis)
idiopathic |
|
|
Term
| 4 types of bronchogenic carcinoma |
|
Definition
squamous cell - centally located
adenocarcinoma (MC) - peripheral
large cell - aggressive course
small (oat) cell - centrally located and cause narrowing. |
|
|
Term
| bronchogenic cancer with the earliest mets |
|
Definition
|
|
Term
| MC site of mets from bronchogenic adenocarcinoma |
|
Definition
|
|
Term
|
Definition
| isolated pulmonary HTN - right sided heart failure is a complication not an essential feature |
|
|
Term
| cardiac features of cor pulmonale |
|
Definition
| LSB/R epigastrum S3, loud S2, ejection click. frequenly holosystolic murmur - accentuated by inspiration |
|
|
Term
|
Definition
ECG changes associated with cor pulmonale
tall peaked P waves in the inferior leads and V1, QRS right axis deviation coupled with prominent R waves in V1-V3 |
|
|
Term
| definition of pulmonary HTN |
|
Definition
| mean pulmonary artery pressure > 25 at rest or > 30 during exercise |
|
|
Term
|
Definition
|
|
Term
|
Definition
vasodilator therapies
warfarin
anti-inflammatory therapies - nitric oxide, prostacyclin analogs
inhalation therapies - O2, ethyl nitrite
iloprost and bosentan |
|
|
Term
| Most useful clinical sign when considering a penumonia dx is |
|
Definition
|
|
Term
| MC pneumonia pathogen in young adults |
|
Definition
|
|
Term
| MC pneumonia etiology in infants |
|
Definition
|
|
Term
| MC pneumonia pathogen in adults |
|
Definition
|
|
Term
| average HR increase per 1 degree C rise in temp |
|
Definition
|
|
Term
| ominous signs in pneumonia |
|
Definition
| tachypnea and accessory muscle use |
|
|
Term
| splinting is suggestive of |
|
Definition
| bacterial pneumonia on the side of the lag with inspiration |
|
|
Term
| 4 studies to be done on every pneumonia pt |
|
Definition
CXR
sputum
CBC
blood culture |
|
|
Term
|
Definition
IV rocephin or zithromax
cephalosporins (rocephin)
flouroquinolones (cipro)
macrolide (zithromax, azithromycin)
augmentin
tetracyclines (doxycycline)
Bactrim
Amox for peds (up to 100mg/kg) |
|
|
Term
| MCC of infection related mortaility |
|
Definition
|
|
Term
| aspiration pneumonia common in alcoholics |
|
Definition
|
|
Term
|
Definition
clindamycin
oxygen prn
surgery if massive
bronchoscopy |
|
|
Term
|
Definition
|
|
Term
| 2 MC veins involved in UE DVT |
|
Definition
|
|
Term
|
Definition
CT scan or VQ scan
if you can't get a CT due to obesity - treat prophylactically with lovenox |
|
|
Term
|
Definition
|
|
Term
|
Definition
oxygen
heparin followed by lovenox or warfarin
consider thrombolytics (streptokinase, urokinase, alteplase) |
|
|
Term
| dyspnea at rest almost always implies |
|
Definition
| ventilation/perfusion mismatch |
|
|
Term
|
Definition
PE rule out criteria
low pre test probability based on hx
age less than 50
pulse rate less than 100
oxygen sat greater than 94%
no hormone use |
|
|
Term
| lassitude, weight loss, fever, cough, night sweats, hemoptysis |
|
Definition
|
|
Term
| apical or subapical cavitary infiltrates are classic of |
|
Definition
|
|
Term
| hwo do you perform a TB test? |
|
Definition
5 tuberculin units injected intradermally, reaction read in 48-72 hrs.
normal population > 15mm
high risk > 10mm
HIV/immune compromised > 5mm |
|
|
Term
|
Definition
isoniazid
rifampin
ethambutol
pyrazinamide
streptomycin |
|
|
Term
| prophylactic tx of latent TB or signicantly exposed persons |
|
Definition
|
|
Term
| non caseating epithelioid granulomas |
|
Definition
|
|
Term
| common systems involved in sarcoidosis |
|
Definition
lung
skin
eye
liver
lymph nodes |
|
|
Term
| red nodules on the legs associated with sarcoidosis |
|
Definition
|
|
Term
| plaques on the nose, cheeks, lips, ears |
|
Definition
|
|
Term
| MC CN palsies associated with sarcoidosis |
|
Definition
|
|
Term
|
Definition
stage 1 - hilar adenopathy
stage 2 - adenopathy + infiltrates
stage 3 - infiltrates
stage 4 - fibrosis |
|
|
Term
| infiltrates in asbestosis are commonly where |
|
Definition
|
|
Term
| most sensitive test for interstitial lung disease |
|
Definition
|
|
Term
|
Definition
active disease - methotexate
minimally active - hydroxychloroquine |
|
|
Term
|
Definition
type of sarcoidosis
hilar adenopathy
erythema nodosum
uveitis, fever, arthritis
pts with lupus, cardio or neuro manifestations don't usually see remission |
|
|
Term
| how much pleural fluid accumulation generally leads to DOE? |
|
Definition
|
|
Term
| new, localized chest pain, referred to the shoulder. decreased breath sounds, dullness to percussion, decreased tactile fremitus |
|
Definition
|
|
Term
| how much pleural fluid accumulation is necessary to show blunting of the costophrenic angles |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| instilling a chemical between the layers of the pleura to irritate and fuse them together - prevents future chance of pleural effusion |
|
|
Term
|
Definition
|
|
Term
| MC etiologic factors for ARDS |
|
Definition
|
|
Term
|
Definition
intubation and mechanical ventilation
fluid management - dry lung is happy
corticosteroids |
|
|
Term
| gold standard for confirmation of a pneumothorax |
|
Definition
|
|
Term
|
Definition
spontaneous - tall, thin, young males
secondary - COPD, pneumonia, PCP
tension - positive pressure in the pleural space |
|
|
Term
| CXR findings in pneumothorax |
|
Definition
| thin visceral pleural line lying parallel to the chest wall, separated by a radiolucent band devoid of lung markings (looks like a tracing) |
|
|
Term
|
Definition
small spontaneous might heal on it's own
large = needle decompression followed by chest tube |
|
|
Term
| healing rate of pneumothorax |
|
Definition
| body will rebasorb 1-2% pre day, accelerated 4x by giving 100% oxygen |
|
|
Term
| how can you enhance the size of a pneumothorax? |
|
Definition
| by expiration - volme of lungs are decreased in expiration so the pneumothorax should make itself "appear" more |
|
|
Term
| components of Tetrology of Fallot |
|
Definition
RV outflow obstruction
membranous VSD
overriding aorta across the VSD
RVH |
|
|
Term
| foam cells are associated with |
|
Definition
|
|
Term
|
Definition
BB
CCB (afterload reduction)
platelet inhibiting agents (ASA, plavix) |
|
|
Term
| clenching fist against chest wall |
|
Definition
|
|
Term
| back up of blood into the atria (dyastolic) |
|
Definition
|
|
Term
| back up of blood into the ventricles (systolic) |
|
Definition
|
|
Term
|
Definition
stable - predictable
unstable - increasing severity/frequency
Prinzmetal's (variant) - coronary vasospasm |
|
|
Term
| blood test for cardiac ischemia |
|
Definition
troponin T and I (preferably I)
CK-MB |
|
|
Term
|
Definition
|
|
Term
ST depression indicates
ST elevation indicates |
|
Definition
depression - ischemia
elevation - infarction |
|
|
Term
|
Definition
cornerstone - sublingual NTG (no more than 3 doses)
avoid NTG in right sided MI (posterior/inferior) |
|
|
Term
|
Definition
heparin
ASA
nitro IV
glycoprotein IIb/IIIa inhibitors
angiogram/possible revascularization |
|
|
Term
| tx of Prinzmetal's variant angina |
|
Definition
nitrates for acute tx
CCBs for more chronic tx |
|
|
Term
| irreversible cardiac injury occurs in how long |
|
Definition
20-40 minutes - some say 90 minutes
necrosis is complete after 3-6 hours |
|
|
Term
| artery involved in anterior MI |
|
Definition
|
|
Term
| artery involved in an inferior and/or posterior MI |
|
Definition
|
|
Term
| artery involved in a lateral MI |
|
Definition
|
|
Term
|
Definition
| at rest or first thing in the morning (high levels of cortisol) |
|
|
Term
| evolving changes of an ECG in MI |
|
Definition
| peaked T waves --> T wave inversion --> ST elevation --> Q waves |
|
|
Term
|
Definition
2, 3, avf = inferior
1, 2, avl, V5, V6 = lateral
V1-V4 = anterior
1, avl, V1-V4 = anterolateral |
|
|
Term
|
Definition
|
|
Term
| where does a non-Q wave or non stemi MI take place? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
MONA
oxygen
aspirin
nitro
morphine
BB
thrombolytics
angioplasty |
|
|
Term
|
Definition
ASA
BB
CCB if EF < 40
thrombolytic therapy isn't recommended |
|
|
Term
| hypertensive urgency vs emergency |
|
Definition
urgency - high BP without end organ damage or papilledema
emergency (malignant) - increased BP associated with papilledema or other end organ damage |
|
|
Term
| white coat syndrome can increase BP how much? |
|
Definition
|
|
Term
|
Definition
UA - look for proteinuria, RBC, WBC
renal function and electrolytes
liver function tests
cholesterol and triglycerides
EKG |
|
|
Term
|
Definition
ACEI/ARB
diuretics
antiadrenergic agents
vasodilators
CCB
Combo Agents - BB + ACE |
|
|
Term
| preferred tx for pregnant pt wth HTN |
|
Definition
|
|
Term
| what HTN meds are cotraindicated in pregnancy |
|
Definition
|
|
Term
| definition of hypotension |
|
Definition
|
|
Term
| clinical presentation of shock |
|
Definition
| sudden decreased BP, hypotension, cold/clammy skin, pallor, cyanosis, weak/thready pulse, rapid/shallow breathing, anxiety/confusion/lethargy |
|
|
Term
| definition of orthostatic BP |
|
Definition
drop in SBP of 10-20 mm Hg, increase in pulse more than 15 BPM
when changing from lying to standing |
|
|
Term
|
Definition
| inadequacy of intravascular volume caused by arterial and/or venous dilation, circulating blood volume is normal. |
|
|
Term
|
Definition
| failure of ventricle to pump at sufficient rate, LVEF < 40 |
|
|
Term
| causes of systolic heart failure |
|
Definition
| impaired contractility or increased afterload |
|
|
Term
|
Definition
| problem fillng due to abnormally increased filling pressures. LVEF > 40 |
|
|
Term
| causes of diastolic heart failure |
|
Definition
| cardiomyopathies, HTN, amyloidosis, sarcoidosis, radiation fibrosis, hemochromatosis |
|
|
Term
| MCC of biventricular failure |
|
Definition
|
|
Term
| JVD, ascites, hepatomegaly, LE dependent edema, weight gain |
|
Definition
| right sided heart failure |
|
|
Term
| SOB, DOE, persistent fatigue |
|
Definition
|
|
Term
| most important lab test to dx CHF |
|
Definition
| BNP - secreted by the brain whenever there is an accumulation of fluid in the lungs/pulmonary volume overload - bocks release of ADH to allow diuresis |
|
|
Term
| CXR signs of heart failure |
|
Definition
|
|
Term
|
Definition
LMNOP
lasix
morphine
nitrates
oxygen
patient position
also consider: vasodilators (ACEI/ARB), venous dilators, arterial dilators, combined nitrates/hydralazine, nesiratide
DON'T GIVE a CHF pt BB
digoxin
spirinolactone
dobutamine and milrinone(watch for increased HR and arrhythmias) |
|
|
Term
|
Definition
|
|
Term
| MCC of acute infective endocarditis |
|
Definition
|
|
Term
| MCC of subacute infective endocarditis |
|
Definition
|
|
Term
| S&S of infective endocarditis |
|
Definition
subungual "splinter" hemorrhages
Osler's nodes (painful)
Janeway lesions (palms and soles)
splenomegaly |
|
|
Term
| best test for endocarditis |
|
Definition
| echo - detects vegetations on leaflets |
|
|
Term
| how often should blood cultures be obtained in infective endocarditis |
|
Definition
| every 24-48 hrs for 7-10 days |
|
|
Term
| empiric tx of infective endocarditis |
|
Definition
|
|
Term
| tx of endocarditis - strep, enterococci, staphylococci |
|
Definition
strep - PCN G, ceftriaxone
enterococci - PCN G with gentamycin or streptomycin
staphylococci - nafcillin or oxicillin |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| totally erratic heart rhythm |
|
Definition
|
|
Term
| how do you analyze an ECG? |
|
Definition
RRAHI
rate
rhythm
axis
hypertrophy
infarction |
|
|
Term
| tx of WPW with wide QRS tach |
|
Definition
procainamide
DO NOT use verapamil or digoxin - doesn't slow the re-entrant pathway |
|
|
Term
SA rate
junctional rate
ventricular rate |
|
Definition
SA = 60-100
junctional = 40-60 (normal WRS with p waves)
ventricular = 20-40 (wide WRS without p waves) |
|
|
Term
|
Definition
|
|
Term
|
Definition
doppler U/S
D-Dimer
contrast venography
CT |
|
|
Term
|
Definition
| can be placed in pts with DVT who are not candidates for anticoagulation |
|
|
Term
| pain, erythema, inflammation, edema, and a palpable cord |
|
Definition
|
|
Term
|
Definition
| repeated migratory thrombophlebitis (thrombophlebitis migrans) as a non-metastatic manifestation of pancreatic carcinoma |
|
|
Term
| MC of dilated cardiomyopathy |
|
Definition
alcoholism
other causes = peri-partum, post-viral, HTN, toxins |
|
|
Term
| causes of restrictive cardiomyopathy |
|
Definition
|
|
Term
| cardiomyopathy that leads to sudden death in healthy young athletes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| least common cardiomyopathy |
|
Definition
|
|
Term
| treatment of hypertrophic cardiomyopathy |
|
Definition
| BB and CCB to decrease contractility |
|
|
Term
| gold standard for dx of cardiomyopathy |
|
Definition
|
|
Term
| ejection fraction difference in diastolic and systolic cardiomyopathy |
|
Definition
diastolic = preserved EF
systolic = decreased EF < 40 |
|
|
Term
| tx of dilated cardiomyopathy |
|
Definition
treat CHF - ACEI, BB, diuretics, digoxin
chronic anticoagulation
avoid alcohol
dual chamber pacing
transplant
treat arrythmias |
|
|
Term
| tx of restrictive cardiomyopathy |
|
Definition
prevent atrial arrhythmias
control heart rate
treat sxs of heart failure (use diuretics with caution as they may decrease stroke volume to the point of leadign to systemic hypotension) |
|
|
Term
| tx of hypertrophic cardiomyopathy |
|
Definition
aimed at increasing diastolic dysfunction and decreasing LV outflow obstruction
maintain NSR
BB or CCB
avoid digoxin, beta agonists, nitrates
septal myotomy
endocarditis/thromboembolism prophylaxis
avoid athletics |
|
|
Term
| ulcer pain relieved by eating food |
|
Definition
|
|
Term
| tx of peptic ulcer disease |
|
Definition
|
|
Term
|
Definition
PPI + clarithro + amox
PPI + clarithro + metronidazole |
|
|
Term
| ulcer pain exacerbated by eating food |
|
Definition
|
|
Term
| tx of active duodenal ulcers |
|
Definition
|
|
Term
| dx study for erosive esophagitis |
|
Definition
|
|
Term
| triad of dysphagia/webs, iron deficiency anemia, glossitis |
|
Definition
|
|
Term
|
Definition
| asx outpouchings in the duodenum |
|
|
Term
|
Definition
| inflammation of diverticulosis causing abdominal pain, constipation followed by bouts of diarrhea, bloating, fever, vomiting, and urge to have a bowel movement |
|
|
Term
| tx of diverticulosis vs diverticulitis |
|
Definition
losis = high fiber
litis = low residue |
|
|
Term
|
Definition
| heartburn 30-60 minutes after meals |
|
|
Term
|
Definition
| asthma, cough, laryngitis |
|
|
Term
|
Definition
| dysphagia, weight loss, bleeding |
|
|
Term
|
Definition
mild - antacids (H2RA), sucralfate
moderate - H2RA, PPI. dc tx after 8-12 wks if not cleared up or recurs refer to GI
severe - consider ZES. tx = surgery |
|
|
Term
|
Definition
Battett's esophagitis - incrased risk of adenocarcinoma.
EGD recommended every 2-3 years
stricture - EGD, dilation, long term PPI |
|
|
Term
umbilical discoloration
flank discoloration |
|
Definition
umbilical - Cullen's
flank - Grey Turner's
both signs of necrotizing pancreatitis |
|
|
Term
| MC etiology of acute pancreatitis |
|
Definition
|
|
Term
| amylase or lipase more specific for pancreatitis |
|
Definition
|
|
Term
| pancreatitis + increased alk phos and bilirubin |
|
Definition
|
|
Term
| tip off sign for pancreatitis |
|
Definition
|
|
Term
first study for pancreatitis
gold standard study |
|
Definition
first = ultrasound
gold standard = CT |
|
|
Term
| complication of pancreatitis |
|
Definition
| pseudocyst - collection of fluid within or adjacent to the pancreas. can happen 1-4 weeks after acute pancreatic attack, can rupture, develop fistula, and drain into the peritoneum |
|
|
Term
| key indicators of chronic pancreatitis (2) |
|
Definition
elevated fasting BGL
ERCP = "chain of lakes" |
|
|
Term
|
Definition
ICU admission
NPO, IV fluids
NG tube to suction
analgesics
"rest" the pancreas - 3-7 days
prophylactic abx
TPN to prevent nutritional deficiency |
|
|
Term
| tx of chronic pancreatitis |
|
Definition
control pain - morphine/dilaudid
replace pancreatic enzymes
maintain low fat diet
H2RA/PPI for acid suppression
octreotide (if unresponsive to pancreatic enzyme replacement)
oral hypoglycemics or insulin
cyanocobalamin (if not absorbing B12) |
|
|
Term
|
Definition
|
|
Term
| diarrheal stool with blood and/or mucous, localized to LLQ, decreased haustal markings, lead pipe deformity |
|
Definition
|
|
Term
|
Definition
sulfasalazine
mesalamine agents
glucocorticoids
azathioprine and 6-MP
cyclosporine
surgery |
|
|
Term
| chronic, recurrent diarrhea, RLQ pain, diarrhea, transmural thickening, skip lesions |
|
Definition
|
|
Term
|
Definition
sulfasalazine
mesalamine
glucocorticoids
azathioprine and 6-MP
metronizazole
must supplement fat soluble vitamins and B12
cyclosporine
methotrexate
infliximab
surgery |
|
|
Term
|
Definition
associated with clindamycin among other abx
c. difficile
tx = metronizazole |
|
|
Term
|
Definition
< 45, no alarm sxs, neg PE, neg labs = noninvasive H Pylori testing. return of sxs = EGD
> 45, alarm sxs, + PE, or + labs = EGD right away |
|
|
Term
|
Definition
weight loss
recurrent vomiting
evidence of bleeding
anemia |
|
|
Term
| screening test for hepatocellular carcinoma |
|
Definition
| alpha-fetoprotein testing |
|
|
Term
| MC type of gallbladder stone |
|
Definition
|
|
Term
|
Definition
| RUQ pain, fever, jaundice - cholangitis |
|
|
Term
|
Definition
RUQ pain
fever
jaundice
hypotension
altered mental status
= ascending cholangitis |
|
|
Term
| diagnostic and therapeutic test for choledocholithiasis |
|
Definition
|
|
Term
| postcholecystectomy syndrome |
|
Definition
| GI distress and persistent pain in the RUQ |
|
|
Term
|
Definition
| calculus in the common bile duct that have usually originated in the GB |
|
|
Term
| first test for acute cholecystitis. if negative, follow up test? |
|
Definition
initial = ultrasound
follow up = HIDA |
|
|
Term
| potential complications if stones are left in the gallbladder |
|
Definition
biliary sepsis
porcelain gallbladder - increased risk of cancer |
|
|
Term
| medical criteria for constipation |
|
Definition
| < 3BM/wk with excessive straining |
|
|
Term
|
Definition
| inadequate fiber/fluid intake, or exercise |
|
|
Term
|
Definition
metamucil, fibercon, benefiber
high fiber diet (>25g)
reinforce importance of fluids and exercise
consider osmotic laxatives (ducosate - safe in the elderly) |
|
|
Term
|
Definition
I&D = extreme relief
conservative = high fiber/fluids, stool softeners, proctofoam, anusol suppositories |
|
|
Term
| tx of Traveler's diarrhea |
|
Definition
single dose Cipro
BRAT diet
rehydration
anti-diarrheal agents - imodium or pepto bismol |
|
|
Term
| clues to malabsorption disorder |
|
Definition
weight loss
fecal fat > 10g/d
anemia
hypoalbuminemia |
|
|
Term
| causes of malabsorption (6) |
|
Definition
celiac sprue
Crohn's disease
Whipple's
small bowel resection
lymphatic obstruction
panreatic disease |
|
|
Term
| explosive, watery diarrhea, lots of gas |
|
Definition
|
|
Term
|
Definition
|
|
Term
| pinworm infection - positive scotch tape test |
|
Definition
|
|
Term
|
Definition
|
|
Term
| hookworm infection from eating raw or undercooked pork |
|
Definition
|
|
Term
|
Definition
| mebendazole or albendazole |
|
|
Term
| MC bacterial cause of diarrrhea |
|
Definition
|
|
Term
|
Definition
| campylobacter or giardiasis |
|
|
Term
|
Definition
|
|
Term
| sudden increase in BUN/creatinine |
|
Definition
|
|
Term
| causes of acute renal failure |
|
Definition
pre-renal
intrinsic
post renal |
|
|
Term
|
Definition
flouroquinalones
nitrofurnatoin (preferred in pregnancy) |
|
|
Term
|
Definition
|
|
Term
| fever, flank pain, irritative voiding sxs, positive urine culture |
|
Definition
|
|
Term
|
Definition
|
|
Term
| first line study for nephrolithiasis |
|
Definition
|
|
Term
|
Definition
calcium pyrophosphate (MC)
struvite (staghorn calculus)
uric acid (radiolucent) |
|
|
Term
| causes of high anion gap metabolic acidosis |
|
Definition
MUDPILES
methanol
uremia
DKA
propylene glycol
isoniazid
lactic acidosis
ethylene glycol
salicilates |
|
|
Term
| causes of normal anion gap acidosis |
|
Definition
| loss of bicarb from the GI tract or kidneys (diarrhea) --> hyperchloremia |
|
|
Term
| auses of respiratory acidosis |
|
Definition
| respiratory depression, lung conditions, COPD, ALS, MS, Guillain-Barre |
|
|
Term
| causes of respiratory alkalosis |
|
Definition
| brainstem excitation (anxiety), fever, pregnancy, sepsis, cardiac dz, mild CHF, mechanical overventilation |
|
|
Term
| pH and CO2 go in the same direction |
|
Definition
|
|
Term
| pH and CO2 go in opposite directions |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
increased tissue breakdown
hemolysis/thrombocytosis
renal failure (MC)
ACEI
hyporenemic
hypoaldosteronism
cell death and metabolic acidosis |
|
|
Term
|
Definition
diuretics (MC)
renal tubular acidosis or GI losses |
|
|
Term
|
Definition
malignancy
hyperparathyroid/thyroid
sarcoidosis
MM |
|
|
Term
|
Definition
chronic renal failure (MC)
hypoparathyroidism |
|
|
Term
| classic findings of hypocalcemia |
|
Definition
Trousseaus sign - carpal tunnel spasm after BP cuff applied for 3 minutes
Chovstek's - facial muscle spasm when you tap in front of ear |
|
|
Term
|
Definition
|
|
Term
|
Definition
alcoholism
diarrhea
hypoparathyroidism
hyperaldosteronism
diuretics
nutrition deficiency |
|
|
Term
| MC type of urinary incontinence in women |
|
Definition
|
|
Term
| MC type of urinary incontinence in elderly |
|
Definition
|
|
Term
| tx of urinary incontinence |
|
Definition
Kegals
pessary or added structural support
rx = anticholinergics, oxybutynin/tolterodine tartrate (detrol), b-agonists
surgical repair |
|
|
Term
|
Definition
|
|
Term
| how do you decide when to xray an ankle sprain |
|
Definition
|
|
Term
| MC arthropathy among adults |
|
Definition
|
|
Term
| negatively bi-refringent needle shaped yellow crystals |
|
Definition
|
|
Term
| positively bi-refringent rhomboid shaped blue crystals |
|
Definition
|
|
Term
| fluid analysis - yellow, 200-300 wbc's, 25 pmn's, negative culture |
|
Definition
|
|
Term
| fluid analysis - yellow to opalescent, 3000-50,000 wbcs, 25-50 pmns, negative culture |
|
Definition
|
|
Term
| fluid analysis - yellow to green, greater than 50,000 wbc's, 75 pmn's, positive culture |
|
Definition
|
|
Term
|
Definition
PT/OT
NSAIDS with DMARDS (methotrexate) |
|
|
Term
|
Definition
NSAID
intra-articular corticosteroids |
|
|
Term
| recent prolonged coughing or repetitive upper limb movement causing microtrauma. CP worse with inspriation. reproduced by putting pressure on the sternum |
|
Definition
|
|
Term
| when is ERT effective for osteoperosis |
|
Definition
| as prevention not once it has developed |
|
|
Term
| still having a uterus mandates what kind of hormone replacement therapy |
|
Definition
| combined - estrogen + progesterone |
|
|
Term
| risks of combined hormone replacement therapy |
|
Definition
| increased incidence of breast cancer, ischemic stroke, DVT, PE, CAD, and dementia |
|
|
Term
| tests for falls in the eldery |
|
Definition
|
|
Term
| complications of falls in the elderly |
|
Definition
| leading cause of nonfatal injury to the elderly and their complications are the leading cause of death in persons over age 65 |
|
|
Term
| MC risk factors for falls in the elderly |
|
Definition
postural hypotension
use of benzos or other sedatives
use of anti-HTN meds
polypharmacy
environmental hazards
gait/balance impairment
impairement of muscle strength/ROM |
|
|
Term
| fx of the wrist with dorsal displacement |
|
Definition
|
|
Term
| fx of the wrist with volar displacement |
|
Definition
|
|
Term
| fx of the proximal third of the ulna with dislocation of the radial head |
|
Definition
|
|
Term
| fx of the radius with dislocation of the ulna |
|
Definition
|
|
Term
| fx at a right angle to the axis of the bone |
|
Definition
|
|
Term
| tx with twisted apperance of the bone |
|
Definition
|
|
Term
| fx between the horizontal and vertical positions |
|
Definition
|
|
Term
|
Definition
|
|
Term
| several large bone fragments separated from the main body of a fractured bone |
|
Definition
|
|
Term
| fracture that penetrates through the skin |
|
Definition
|
|
Term
|
Definition
0 = skin intact (red)
1 = breaks skin/epidermis into dermis (abrasion)
2 = into tendon/no osteomyelitis/no abscess
3 = deep/osteomyelitis or abscess
4 = gangrene of part of the foot
5 = gangrene of the whole foot |
|
|
