• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/170

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

170 Cards in this Set

  • Front
  • Back
progression of OA?
symptomatic pain, deformation, loss of function
herberden and bouchard nodes are painful?
false
x-ray often correlates with symptoms in OA?
FALSE
first line drug of choice for OA?
acetaminophen
NSAIDS alter the course of OA?
false
which topical agent depletes substance P and is used in OA?
capsaicin
glucosamine is shown to have a better effect than placedbo for OA?
TRUE
acupuncture is equivalent to what traditional modality in treating back and knee OA?
oral treatment of mild symptoms
intense inflammation of first metatarsalphalangeal joint?
podagra
possible etiologies of gout?
alcohol, meats, and obesity. However, no effective preventions exist
main lab finding in gout?
increased serum uric acid;however this is often found in general population (20% can have it without gout)
main pathophysiology of gout?
decreased uric acid excretion by kidney(maybe sign of renal insufficiency)
pseudogout has what in synovial fluid?
calcium pyrophosphate
WBC count in synovial fluid for gout, pseudogout?
10-10,000 (infection are >50,000 with 95% PMN)
classic tx. of acute gout and its side effect?
colchicine "take till pain gone or diarrhea starts"
chronic gout treatment?
allopurinol and probenecid (usually for women with acute attack or one/two attacks a year)
MOA of probenecid and limitations?
increase uric acid excretion. contraindicated if creatinine clearance below 50mL/min or stones
most worrisome side effect of allupurinol?
rash
DOC for gout prevention before surgery?
colchicine (never use as long term prophylactic)
RA must involve how many joints?
three or more symmetrically
gender preference for RA?
women 4:1, ratio is 1:1 after menopause
pathologic inflammatory tissue found in RA?
pannus
systemic involvement of RA (4)?
fatigue, anorexia, wt. loss, and low-grade fever`
lab finding in RA?
elevated ESR, c-reactive protein(more specific), and positive RF
alternative supplement used in pain reduction for RA?
fish oil
first choice DMARDs in RA?
plaquinil, watch for drug deposition in eye(rare at recommended dose)

sulfasalazine well tolerate, watch for rare leukopenia and GI effects
standard tx. for RA?
methotrexate (macrocytic anemia and live problems are common side effect) with plaqunil or sulfasalazine
compication with methotrexate found in previous pulmonary patients?
diffuse pulmonary alveolitis
systemic symptoms of RA can be treated with?
azathiproine GI and hemo side effects common
rheumatoid vasculitis can be treate with?
cyclophosphamide, marrow suppression, bladder complication and cancer is concern
examples of TNF-inhibitors (3)?
etanercept, adalimumab, and infliximab
innocent bystander effect seen in RA?
tendon and surrounding tissue involvement around inflammed joint
general timeline for cold?
12-14 days. congestion longer than 14 days maybe another etiology
four common symptoms in sinusitis?
"double-sickening", ineffectiveness of decongestant, pruluent discharge, maxillary toothache
tx. for sinusitis?
TMP-SMX
age at which risk of strep throat decreases?
20, peak between 3 and 10
incubation period of EBV?
5-7 weeks
IgM test for mono (monospot) is positive how many weeks after symptom onset?
3-4 weeks. use VGA-IgM for earilerw
one symptom of pneumonia helpful in diffrentiating from URI?
tachypnea
tx for aspiration pneumonia?
amoxi/clauvulanic acid or clinda
additional symptoms in children with asthma?
atopy
confirmation of asthma using spirometry?
12% improvement in FEV1/FVC ratio
possible side effect of long-term steroids in children with asthma?
decreased height
peak flow level readings at which patient should seek medical attention?
50-80% of peak flow require concern, less than 50% require immediate attention
definition of chronic bronchitis?
at least 3months for 2 consecutive years
percentage of smokers who develop COPD?
10-15%
what other modality along with smoke cessation decrease mortality in COPD?
home O2
DOC for chronic bronchitis?
anticholinergics such as ipratroprium
side effects of B-agonist like albuterol?
tachycardia, nervousness, tremor
red flags in LBP?
age over 50, hx. of trauma, saddle anesthesia, loss of bladder and/or bowel function, persistant fever, night pain, hx. of cancer or metabolic disorder, major muscle weakness
timeline to see if conservative treatment works for LBP?
4-6 weeks
DOC for acute LBP?
NSAIDs over muscle relaxer, combination is not shown to be anymore effective
study results on the efficacy of acupuncture in LBP?
good for chronic but not for acute LBP
wt. loss of more than what percentage found in failure to thrive in elderly?
5%
most sensitive marker for CHF exacerbation in elderly?
JVD
one ddx for shoulder/hip weakness in elderly?
polymyalgia rheumatica
tx. time for stage 1 and 2 ulcers?
4-8wks
donut cushions are useful in the prevention of pressure ulcers?
false
data supports frequent repositioning prevents pressure ulcers?
false
necrotic tissue must be debrided before accurate staging. Where should this NOT be done?
heel
three most common complications of skin ulcers?
cellulitis, osteo, and sepsis
stage 2 ulcers involve which layers?
skin, but no fascia
best agent to clean and irrigate stage 2 ulcers?
NSS
three phases of postural stability?
input, processing, output
most sensitive screening test for balance in intermediate activity elderly?
10sec. one leg balance better than romberg
"up and go" test?
rise from seat, walk 10m, turn around and come back to sit. greater than 20sec. requires PT
functional reach test?
stand along wall, extend fist closest to fall and lean forward without losing balance. less than 6in. indicate significant risk for falls
relapse percentage in major depression?
50% rate increases after each relapse
which disease has highest co-existence with depression?
MI
three risk factors related to depression that cause preventable disease?
smoking, lack of exercise, and poor diet/alcohol use
clinical dx of major depression?
anhedonia and depressed mood along with four other changes for 2wks or more
timeline to see improvement in depressive sx. with meds?
6-8weeks
time period of anxiety necessary to dx GAD?
6 months
most likely organic cause of anxiety?
alcohol and drugs
benzo alternative for GAD?
buspar (buspirone)
short-term tx. of anxiety?
benzo
screening method for gestational diabetes?
1hour glucose test between 10-28wks. >140 must be repeated with 3hr glucose after overnight fast. one reading must be abnormal
what is mc etiology of dyspepsia?
PUD
four major causes of PUD?
h.pylori, NSAID, idiopathic, hyperacidity
hx. of what system disease increase risk of PUD?
cardiac
which common cause of dyspepsia is exacerbated by position?
GERD
dx. of gerd?
treatment with PPI,
difference in pain characteristic between tension and migraine headache?
migrain is pulsating
common age range for onset of primary headaches?
20-40yrs.
diagnosis steps in subarachnoid hemorrhage?
CT without contrast. if neg., then LP
three common drugs used for migraine?
amitryptyline, propanolol, timolol
initial tx. of cluster HA?
oxygen, tryptan, and DHE
most recent survey on improvement of HTN showed what?
improvement levels have leveled off
renal artery stenosis is likely cause of HTN at what age groups?
initial onsent is under 20 or above 50
caffeine and tobacco product should be avoided at least how many minutes before measurement?
30min.
recommended labs for pt. initial presenting with HTN?
EKG, UA, fasting glucose, K, Creat, fasting lipid panel
further evaluation is warranted when what treatments fail?
triple drug therapy
which anti-hypertensive has good effect on osteoporosis?
thiazides
which anti-hypertensive contraindicated in pregnancy?
ACE and angioII inhibitors
what are two groups of CCB and their different mech.?
ionotropic (verapamil and diltiazam) and vasodialators(amlodipine, nifedipine,felodipine)
which anti-HTN drug can increase risk of stroke in african americans?
ACE-I
which anti-HTN drug good in diabetic, previous MI, CHF, CKD?
ACE-I
what creat level indicated stoppage of ACE-I?
30% above baseline
max creat level safe for ACE-I use?
3.0
anti-htn drug good in ischemic heart disease?
b-blockers
anti-htn drug good in ASYMPTOMATIC heart failure?
ACE-I and B-blocker
initial reduction goal in HTN emergency?
systolic 20-40 and diastolic 10-20
drug of choice (3)for HTN emergency?
ntiroglycerin, labetalol, esmolol IV
thimersol still found in trace amounts in which vaccine?
influenza
medical conditions that may cause low seroconversion in HBV vaccine?
low birth weight and immunosuprresion
which interval in HBV vaccine said to increase seroconversion rate?
between second and third interval
when should pre-terms receive HBV?
should recieve first dose after 30days if weight is less than 2kg and mother is HBsAg negative
side effect of HBV vaccine?
pain at site MC, along with fatigue and headache
minimum titer value for HBV?
greater than 10mIU/mL
uncommon adverse reaction from DTaP?
crying greater than 3hrs., high pitched cry, seizures, hypotonic state
two types of pneumococcal and their mech. of action?
23-valent polysacchride works on b-cells directly (lower seroconversion b/c it doesnt work on memory t-cell), not effective in infants.
7-valent conjugate works on t-cells, effective in infants
mc side effect of PCV?
fever of 38C(100.4F) or less
HepA immunization schedule?
first dose at 12mo-15mo, next one 6mo later
rota virus administration and schedule?
orally, 2,4,6mo. do not repeat if vomiting occurs
max age for menarche?
less than 16y/o
normal range of menstural cycle?
22-45days
definition of primary amennorhea?
absence of menarche in less than 14y/o without secondary sex charac. or 16y/o with secondary sex charac.
definiton of secondary amenorhea?
6mo in regular cycle women or 12 months in irregular cycle
mc causes of primary amenorrhea?
gonadal dysgenesis(Turner syndrome most common) and delayed puberty
primary amenorrhea and monthly abd. pain may indicate?
imperforate hymen
amenorrhea and inability to smell(anosmia)?
kallman syndrome(failure of GnRH releasing cells migrating from olfactory bulb)
which hormone can have FSH-like effects?
TSH(precocious puberty in severe hypothyroidism)
anatomical abnormality found in testicular feminization(androgen insensitivity)?
lack of upper vagina and uterus due to mullerian duct inhibition by testes
absence of uterus and renal anomalies?
Rokitansky-Kuster-Hauser syndrome
lab work up for amenorrhea in pt with normal breast and pelvic examination?
test TSH to rule out hypothyroidism and hyperprolactonemia
lab work up for amenorrhea in pt with abnormal breast and normal pelvic examination?
test FSH for central or peripheral causes
treatment for hyperprolactonemia?
bromocriptine or cabergoline
three ways to check ovulation?
basal temp(increase of 0.5F), LH(home-kit), cervical mucosa(sticky white, to stretch clear)
age when biopsy is required for any irregular bleeding?
over 35 to rule out endometrial cancer
most commonly diagnosed eating disorder?
eating disorder NOS accounts for 6-10% of young women
differences between BN and binge type AN?
AN need to be less than 85% of ideal weight(BMI<17.5), purge amount and frequency is less
plain x-ray indicates osteoporosis after how much bone loss percentage?
50%
age recommended for osteoporosis screening in women with no risk factors?
65 and older
T-score of more than what indicate osteopororis on DEXA?
>2.5
one type of med that relieve osteoporotic bone pain after fx.?
calcitonin
example of SERI that also treats osteoporosis?
raloxifene works as estrogen AGONIST on bone, ANTAGONIST on breast and endometrial tissue
definiton of chronic pain?
pain lasting 3-6months
mc cause of chronic pain in older adults?
degenerative joint and disc disease
max dose of tylenol before liver damage?
4g/day
advantage of tramadol over other opiods?
lack the addictive properties
potential high dose side effect of tramadol?q
greater than 400mg/day can result in seizures
type of anti-depressant that achieves greatest anesthesia?
SNRI
SNRI studied to improve diabetic neuropathy?
duloxetine
side effects of SNRI?
HTN at high doses
worrisome side effect of TCA?
cardiac abnormailities
honey colored crusted plaque that is itchy occasionally and not painful?
impetigo (mc is staph aureus)
cellulitis can follow which type of impetigo?
non-bullous
ointment tx for impetigo?
mupirocin(bactroban)
clinical difference between alopecia areata and tinea capitis?
hair breaks off few mm above skin with tinea capitis
tinea versicolor tend to be pruritic?
no
confirmation of tinea?
KOH prep with hyphae from scrapings
gold tx for tinea capitis?
griseofulvin. topicals DO NOT work on capitis
tx. of thrush?
nystatin
classic early sx of scabies?
intense pruritis
two ways to tx scabies?
permethin cream or oral ivermectin
which type of lice is preventable with good hygiene?
body lice; hair and pub hair are not
tx. for lice?
permethin cream
sand paper skin around neck and moving down body and circumoral pallor around mouth indicate what disease?
scarlet fever
6-12mo infant with sudden high fever with rash on body than to ext. after afebrile for 3days
roseola caused by HHV-6
fifth disease infectious stage?
prodrome stage of URI-type sx. Rash is NOT contagious
slap-face lesion that transiently go away and come back on body?
parvo-virus B19(fifth disease)
complications of fetal parvo-virusB19 infection?
hydrops and demise
three of these critieria must be met for atopic dermatitis diagnosis?
pruritic, typical morphology, face and extensor area involvement in child and adolescent, recurrent dermatitis, FHx.
5 A's in smoking cessation?
ask about smoking, advise to quit, assess motivation, assist in planning, and arrange to follow-up
5 R's in smoking cessation?
Relevance, Risks, Rewards, Roadblocks, Repetition
two tests used for thoracic outlet?
Adson(extend, rotate to side of sx. and check for decrease in radial pulse), and Roo (abduct, flex, and ext rotate 90 degrees, open and close hand for 3 min.)
PE test used for cerviclal radiculopathy?
spurling(EStRt to sx. side, and compress head to reproduce symptoms)
shoulder pain with overhead motion with abrupt onset and tenderness of humeral tuberosity?
calcific tendonitis
definition of tendinosis?
overuse injury resulting in fluid exudation around tendon sheath
physical exam test used for dequervian's?
finkelstein