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190 Cards in this Set
- Front
- Back
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Main differences between ulcerative colitis and crohns...
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Crohns- from mouth to anus, right lower quadrant pain, bleeding is uncommen
Ulcerative colitis- bleeding more common, limited to colon |
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What labs are done on the first prenatal visit/ first trimester?
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hematocrit, type and screen, antibody test, VDRL, hepatitis, rubella, (GC DNA probe, PPD, Pap, urine are also done according to some books)
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What happens to maternal blood pressure during pregnancy?
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Lowers during 1st and second trimester and returns to baseline in 3rd
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What is a sibilant wheeze?
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Ronchi
seen with bronchitis |
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When is a serum alphafetalprotein drawn?
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16-18 weeks
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When do you have increased vocal resonance?
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With a consolidation
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What medicaiton is known to cause galactorrhea?
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Elavil- amytriptyline
Dopamine-receptor antagonists (eg, phenothiazines, butyrophenones, thioxanthenes, risperidone, metoclopramide, sulpiride, pimozide) Dopamine-depleting agents (eg, methyldopa, reserpine) Others (eg, isoniazid, danazol, tricyclic antidepressants, monoamine antihypertensives, verapamil, estrogens, antiandrogens, cyproheptadine, opiates, H2-blockers [cimetidine], cocaine |
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What development is seen in a 15 months old?
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6-10 words, 2 words together, scribble, up steps but not down, hugs toy, simple tasks
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With what condition do males complain of having noticed their penis getting smaller?
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Hydrocele, also see pear shaped mass with shiny stretched skin and erythema
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What is the most common cause of fecal incontinence in elders?
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Fecal impaction
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What is the key to managing long term treatment of COPD?
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Oxygen and vaccines
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What precentage of outpatient office visits are related to dermatology?
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15%
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Do skin tags have thickening at the base?
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no- warts do
acrochordon- should be flesh colored, irritated by jewlery, clothing and shaving |
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How is phentermine used with obseity?
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Short term use only.
Merida-sibutramine - no longer on market |
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What is the 3rd leading cause of death in 15-24 year olds?
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Suicide
1-accident 2-homicide 3 suicide 4-cancer |
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What is Pneumocyctis jiroveci?
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Formerly PCP
seen in HIV pts pregressive pneumonia with fever, weight loss, cough, and rarely hemopytsis, caused by fungai, may have extrapulmonary symptoms and treated with Bactrim |
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What sport should a child with a conculsive disorder participate in?
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tennis
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What is a carbuncle?
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Boil larger than an abscess
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Unilateral pruluent rhinitis in a child is most commonly caused by what?
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FB
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When do you start fetal movement counts and how should they be done?
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after 28 weeks
10 movements in 1 hours preform on left side same time of day if no movement -->non-stress test immediately |
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What is a non-stress test?
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A.Reactive (Normal)
1.Two or more Fetal Heart Rate increases in 20 minutes 2.Accelerations increase by 15 beats for 15 seconds 3.Related to fetal movement B.Non-reactive 1.Monitoring for two 20 minute periods 2.Neither period yields adequate accelerations 3.Adjuncts to assist fetal activity fail a.Acoustic stimulation b.Manual stimulation c.Glucose drink if non-reactive then BBP |
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What is biophysical profile?
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A.Fetal Breathing 1.Thirty seconds sustained breathing in 30 minutes
B.Fetal Tone1.Episode extremity extension and flexion C.Body Movement1.Three episodes body movement over 30 minutes D.Amniotic Fluid Volume 1.More than 1 pocket amniotic fluid > 2 cm in depth E.Non-Stress Test 1.Reactive normal is 8-10 |
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Normal L/S ratio
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2:1
The lecithin-sphingomyelin ratio is a test of fetal amniotic fluid to assess for fetal lung immaturity surfactant |
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Does radiation treatment for cancer affect growth of a child?
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yes, growth hormone is the 1st hormone to be affected
possibly need growth hormones |
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how long after acute illness with hepatitis A will the titer disapear?
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3-6 months
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What are the meglitinides?
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Prandin-repaglinide
Works by stimulating pancreas to secrete more insulin Repaglinide should not be administered concomitantly with gemfibrozil, clarithromycin or azole antifungals such as itraconazole or ketoconazole[citation needed]. Administration of both repaglinide and one or more of these drugs results in an increase in plasma concentration of repaglinide and may lead to hypoglycemia. |
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When should flu vaccine be given
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annually in fall
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What is prinzmetal's angina?
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CHARACTERIZED BY ST ELEVATION
Prinzmetal angina, also known as variant angina or angina inversa, is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than directly by atherosclerosis (buildup of fatty plaque and hardening of the arteries). It occurs more in younger women. |
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What type of laxitive should be avioded in a pregnant woman who is constipated?
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Mineral oil
-bulk forming, colace and fluids encouargement are ok |
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What is sensitivity?
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the ability of a test to indentify those with the disease, few false negatives
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What is specificity?
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the ability of the test to indentify those without the disease, few false positives if has a high specificity
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What is a positive predictive value?
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proportion of the sujbects who are correctly diagnosed
- all of these people tested positive but this # tells you of those diagnosed the proportion that is actually positive |
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What is a negative predictive value?
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proportion of subjects that tested negative that actually are
number of negatives/ true negative and false negatives |
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What is the most common cause of cushings?
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Iatrogenic from glucocorticoids
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What is cushing syndrome?
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C - Central obesity, Cervical fat pads, Collagen fibre weakness, Comedones (acne)
U - Urinary free cortisol and glucose increase S - Striae, Suppressed immunity H - Hypercortisolism, Hypertension, Hyperglycemia, Hypercholesterolemia, Hirsutism Hypernatremia, Hypokalemia I - Iatrogenic (Increased administration of corticosteroids) N - Noniatrogenic (Neoplasms) G - Glucose intolerance, Growth retardation |
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What is cushing's triad
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result of increased ICP
1-increased BP 2- Decreased HR 3 Widening pulse pressure |
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When do you see Moon face & buffallo hump
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Cushing's
increased cortisol |
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What is Chevostek's sign
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The Chvostek sign (also Weiss sign) is one of the signs of tetany seen in hypocalcemia.
Tap facial nerve and it will contract is hypocalcemia |
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When are the tremors with Parkinson's most prevalent?
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At rest
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What is evaluation and management is reference to billing for service?
What is the key? |
Based on history, physical exam and medical decision making
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What order should a wet mount, GC DNA probe and PAP be preformed in?
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PAP, then smear (GC), then wet mount
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Warning sign of worsening conjuntivitis?
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pain
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sign of respiratory distress in children
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nasal flaring
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What is Proscar?
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Finasteride (Proscar) is used alone or in combination with another medication (doxazosin [Cardura]) to treat benign prostatic hypertrophy (BPH, enlargement of the prostate gland).
It also may decrease the chance that prostate surgery will be needed. |
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Optic disc is normally what color?
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Yellowish pick
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how does the immune system change in an older adult?
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increased in IgA and IgG
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moro reflex disappears when?
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5 months
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What can digoxin and tagamet cause that would not be good for males?
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Gynecomastia
marijuana can too |
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Who can not get prostate cancer
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orchiectomy
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What is a pylorplasty?
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Enlarges opening of stomach
to duodenum, to increased gastric emptying |
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What is steatohepatitis?
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Non-alcoholic fatty liver disease (NAFLD) is one cause of a fatty liver, occurring when fat is deposited (steatosis) in the liver not due to excessive alcohol use. It is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states (e.g. diabetes mellitus type 2) such as weight loss, metformin and thiazolidinediones.[1] Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD this being regarded as a major cause of cirrhosis of the liver of unknown cause.[2]
Aymptomatic elevation of liver enzymes |
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What is WHI
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women's health initiative
studies of older women |
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How many times a day is gloctrol xl taken
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once daily with food
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What is good for painful neuropathy in DM
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TCA
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What is the ortolani test
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physical examination for developmental dysplasia of the hip
It is performed by an examiner first flexing the hips and knees of a supine infant to 90 degrees, then with the examiner's index fingers placing anterior pressure on the greater trochanters, gently and smoothly abducting the infant's legs using the examiner's thumbs. A positive sign is a distinctive 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum Specifically, this tests for posterior dislocation of the hip. |
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What is barlow's
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The maneuver is easily performed by adducting the hip (bringing the thigh towards the midline) while applying light pressure on the knee, directing the force posteriorly.[2] If the hip is dislocatable - that is, if the hip can be popped out of socket with this maneuver - the test is considered positive. The Ortolani maneuver is then used, to confirm the positive finding (i.e., that the hip actually dislocated).
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What is tofranil impipramine
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TCA
also helps with bladder control in urge incontinence |
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Piaget's theory of development
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0-24sensorimotor- things do not exist when out of sight
2-7-preoperational- egocentric, no conservation 8-11-concrete operational- here and now, conservation, reversibility 12-18- formal operational- abstract thought |
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At what age can you copy a circle?
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3
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At what age can you copy a square and string beads
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5
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At what age can you cut a line with scissors
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4
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At what age can you hop on one foot
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4
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Negativism and ritualism are seen at what age
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2
like it done the same way each time and like to say no |
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At what age can you button a button
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4
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How many inches does a 6-11 year old grow per year?
how many pounds/year? |
3 inches
5-7 libs |
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Do autoantibodies increased or decrease with age
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increase
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What age can a child manipulate objects best by
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12 y/o
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When is handedness noted
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6 y/o
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Normal newborn headcircumference
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32-37 cm
2 cm > chest |
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When do you stop measuring the head circumference and why?
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2 years, most brain growth happens in 18-24 month range
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when is the pincer grasp seen
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9 months
large grasp and hand movements at 3-4 months |
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What are some language landmarks at...
12mo 24 mo 36 mo |
12- 2-3 words
24- 2 wrd phrases 36-3 wrd sentanct, full name, plurals |
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What is marasmus?
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form of severe protein-energy malnutrition characterized by energy deficiencyMarasmus occurrence increases prior to age 1, whereas kwashiorkor (just protein not calories) occurrence increases after 18 months
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At what age do adults lose height
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55
men 1 inch women 2 |
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What is ABCT of mental status exam
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appearance, behavior, cognition and thought
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When is the dentist concerned that the 1st tooth has not erupted
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12 mo
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When does a child have nocturnal emissions
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14 y/o or 6-12 mo after penile enlargement
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What comes first testicular growth or hair growth
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testicular
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What is the most common form of mental retardation
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Fragile X
dx after 2 |
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When should a child double their birth weight
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5 months
triple @ 12 mo quad @ 24 |
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when does a female have full breast growth
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26
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When is female onset of puberty a concern
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no meses by 16 or no breast growth by 13
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What heart sound is normal in thin young kids
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s3
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When is visual acuity testing initiated
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3 y/o
if @ 4 y/o and have 20/40 see optho |
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What is the best recommendation for an obese client in reference to weight loss
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exercise
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What is a quick way to remember to peak and of insulins
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short 2-4
intermediate- 12 long 16 |
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When do you see less AOM
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after eustachian tube are less horizontal and begin to angle, around 7??
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What is the most common agent use in UNACCIDENTAL death
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car exhaust
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What is still recommended for accidental poisoning in children
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ipecac
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How many vaccines does a child get before age 5
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25
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What is the best indicator of body fluids/hydration status in older adult
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body weight
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Most affected joint in DJD
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hip
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What is the most effective intervention to reduce the severity and incidence of any disease
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counsel and address personal needs of client
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Who should be screen for skin cancer
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anyone at risk
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What do you need to do in order to prepare for FOB
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no asa x 7d
no raw fruit or veggie or processed meat for 3 d no vit C for 3 days of collection |
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How long do you have to wait to take BP in arm of pt with mastectomy
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not advised
studies have shown that even after 30 years they are at risk for lymph issues protect arm from burns, heavy lifting, BP, blood draws and have good wound care |
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What lifestyle modifications are helpful in preventing colon CA
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ASA
increased fiber and physical activity |
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What is scleroderma
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autoimmune-fibrosis, vascular issues and autoatnibodies
avoid cold, quit smoking--> raynauds with this |
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What is the target heart rate for aerobic exercise
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220-age or 60% increase of normal pulse
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What are some examples of saturated fat
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anything that is sold at room temperature- cocoa, coconut oil palm oil
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What is a side effect of tetracycline
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teeth staining
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Most common injury leading to hospitalization
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fall
also #2 cause of deaths |
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What are some risk for DJD
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obese, repetitive motions
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Suggestions for arthritis
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heat, rest, splint, mechanics, and lose weight
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Gout puts you at risk for what
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kidney stones and damage
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Should those with MS be advised to avoid hot showers
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yes
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What are the restrictions for flying while pregnant
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not with high risk
airline want a note for MD at 35 weeks check for anemia, or Hg < 8.5 prior to flying-pt may need o2 no sickle cell, no with asthma and heart disease |
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What is the most dangerous industry
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farming/agriculture
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Advice for trigeminal neuralgia
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regular dental care
protective eyewear and artificial tears do not chew on affected side |
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Can you have MMR 3 months prior to pregnancy
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no
no live viruses recommended |
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Advice for spinal stenosis
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exercise in flexed forward position, extension worsens
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When do you want to give HPV
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before coitarche
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Something to use at home for cerumen
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mineral oil
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Why do a viral load as opposed to CD4
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more accurate
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What can you see with bulimia pt's
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UTI
caries injury to hands when given them food, it is good to give food that you can divide in portions |
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How is the Hep B vaccine given
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1st does
2nd one month later 3rd 6 months later if miss and > 6 months, do titer first |
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Signs of vit C deficiency
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bleeding gums, capillary rupture, and brown scaly skin
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Signs of vit A deficiency
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bones and teeth
see in 1-2 years anemia night vision issues plugged hair folicles |
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Advice for anorexia
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increased cal 200/week
supplements |
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Signs of Vit D deficiency
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Rickets
osteomalacia |
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What do food high in K and NA do
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lower Bp
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Home treatment for pediculosis
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mayonaise or white rain conditioner
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Effect pesticide in the environment have on people/kids
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endocrine disorders/dysfunction
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What nerve innervated to anterior 2/3 of tongue
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facial nerve
posterior is CN IX glossopharyngeal |
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What is remote memory vs recent
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recent is what you ate for breakfast
remote is days to years |
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Brudzinski's sign
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bend the head on the bed
testing for nuchal rigidty and meningeal irritation |
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ageusia
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loss of taste
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agnosia
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loss of ability to discriminate sensory stimuli
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When does OCD usually manifest by
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15 y/o
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What are the best meds for OCD
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TCA
clomipramine-Anfranil |
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Myesthenia Gravis
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Antibodies to acetylcholine receptors
fluctuating muscles weakness and fatigue ptosis unilaterally crisis- paralyzed muscles of respiration tx thymectomy- to remove antibodies from circulation |
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What are the medications for MS
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interferon B to dercrease exacerbation (in relapsing forms)
also use plamsaphoresis with andrenalcorticotropin hormone tyrsabi- delays impairment |
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What is huntington's chorea
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muscle coordination issues and cognitive decline
progressive inherited |
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What is a main difference between dementia and depression
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the person with dementia will try to hide the memory loss and the depressed with complain about it
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What to pt's with senile demetia most commonly die from
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pneumonia
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Who is at more risk for suicide- depression or dementia
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depression
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How to help with regular bowel movements in quadrapelgic
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suppository, digital stimulation and regular patterns
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What does low glucose in the CSF mean
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meningitis
normal value 40-80 |
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what is a rhizotomy
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severe trigeminal nerve to tx tic d.
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Characteristics of Meniere's disease
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episode of attackes and fullness, attacks are longer than BPV
BOV- short attacks, all positional |
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What is helpful in herpes zoster a year after episode to tx pain
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tca
steriods given only early |
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what is the first s/s of parkinson's disease
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tremor at rest
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What is a hard activity for cerebellar dysfunction
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key inlock
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MMSE scores
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total 30
older in 80 norm 25 2-25 alz 10-19 middle alz <10 late alz |
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antidote for benzo overdose
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Romazicon-flumezinel
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best approach when addressing alcoholism
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direct
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precontemplation
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what would it take for you to change
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contemplation
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what would it take for you to change now
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prepare
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discuss technique with pt
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action
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discuss challenges
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maintain
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reflect on change
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how many days does thc stay in urine
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30 d
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What is decoriticate posturing
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flexed
injury above midbrain |
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What is decerebrate
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extended away from body
pon, medulla, diencephalon WORSE |
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Will you have normal reflexes in a slipped disc
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no +1
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what is Kernigs
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for meningeal irritation
bend knee |
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what is the most common intracranial hemorrhage
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subdural
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What do you see with an epidural hemorrhage
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loc, lucid perios--> rapid deterioration
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what is hallpike used for
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vertigo
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stages of grief
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shock, denial, anger, bargaining, depression, acceptance
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What causes rebound headaches
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meds used for > 3 weeks
ergotamine |
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What is the FAQ questionairre
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functional activities
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What is the most common cause of cerebellar disease
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ETOH
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What is the most common cause of stroke
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Thrombus-slow progression
Lacunar- slow, less common (arterial flow) |
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What is the leading cause of death in stroke pt's
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pneumonia
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What is an absence seizure
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petite grand mal
seen in kids blank stare no postictal or aura |
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what does heel toe walk test
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proprioception and cerebellar
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At what level of the spine is the diapragm
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C3
injuries below with will have functioning respiration |
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When can a pt use a manual wheelchair? at what level of spinal injury
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C7-8
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What do you see cogwheel with
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Parkinsons
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What medication mimics dopamine
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bromocriptine-pergolide PARLODEL
used for hormone imbalances as well- elevated prolactin |
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What are some meds use in Parkinsons and why
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Bromocriptine-replace dopamine
anticholinergics- treats resting tremor levodopa- dopamine precursor tolacapone-COMT inhibitor- redcues oral degradation of dopamine MAO-B rasagline |
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What is the most common type of MS
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chonic relapsing- few remissions more disabling
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What is a laminectomy
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remove part of lamins that was presssing on spine
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what is a foraminotomy
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enlarge the opening between the disc and the joint
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S/S of EPS
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akasthesia, dystonia, parkinsoniam
tx- cogentin |
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what is the first s/s of increased ICP
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altered mental status
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How does the body respond after a stroke to perfuse the area infarcted?
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High BP
will resolve on own |
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what is enuresis
|
pee
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what is encopresis
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poop
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What is a med used to prevent recurrent stroke
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Ticlid ticlodipine
anitplatelet drug like plavix |
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what is sensory ataxia
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brusqueness of movement stamping feet
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What does parkinsons gait look like
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trunk forward
shuffle-festination |
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what is an antalgic gait
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seen with osteo of hip
limp limb shortening |
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what is a cerebellar gait
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wide swinging of the trunk
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most common cause of encepalitis
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viral
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what is a good sign when assessing a baby with spina bifida
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perineal sensation
assoc with good outcomes |
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is surgery for sciatica assoc with better outcomes
|
yes
earlier tx assoc with better outcome as opposed to waiting for sx |
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What does basilar artery perfuse
|
temporal, thalmus, cerebellum, midbrain
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Which type of meningitis has rapid onset
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bacterial
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