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77 Cards in this Set
- Front
- Back
Allopurinol and colchicine each is used when?
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allopurinol - maintenance to keep uric acid low
colchicine - acute gout attack |
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Dysdiadochokinesia refers to:
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Neuro triad of symptoms with gait, memory, and speech - common in MS.
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How do antioxidants help MS?
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- MS is believed to be destruction of myelin sheaths via oxidation by oxygen-free radicals. Antioxidants (i.e. cranberries) may benefit.
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Someone with post-polio symptoms, wearing leg brace, why do you have them keep their affected from the exposure to cold or chilling?
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- Cold temperatures can cause loss of muscle strength in the affected group muscle (“cold limb”)
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How do you tell a migraine from a tension HA?
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- Sleep pattern disturbances (too little or too little). Alcohol, lighting, noxious stimuli, stress can all trigger both HAs.
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ALP is found mostly where?
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Liver (mainly), then bones
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ALP high, GGT high
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liver problem
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ALP high, GGT normal
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bone disease (Paget's disease)
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AST high, GGT high
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liver problem (alcohol abuse)
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What chemical in the CNS change during a migraine?
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- Serotonin levels decrease
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What are the differences of symptoms that show in a TIA of ANTERIOR cerebral circulation vs. POSTERIOR?
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- Anterior: behavior and cognition disorders
- Posterior: b/l vision disturbance with diplopia, dysarthria, motor/sensory b/l |
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In a pt who has sustained a closed head injury, lethargic, follow commands slowly, what abnormal VS will alert you?
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- Increase in BP, decrease HR increasing cerebral edema and ICP
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Child with purpuric rash with centrifugal distribution (with well-demarcated borders) and fever.
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- Meningococcemia; due to impairment of protein C anticoagulation pathway
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Tx for myasthenia gravis:
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- Pyridostigmine (Mestinon) (Ach-ase inhibitor)
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Horner’s syndrome:
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- Horney PAMELa = Ptosis, Anhidrosis, Miosis, Enophthalmos, Loss of ciliospinal reflex)
- Due to lesion or compression of one side of the cervical or thoracic sympathetic chain which generates symptoms on the ipsilateral (same side as lesion) side of the body. - Congenital, tumor, iatrogenic (meds) |
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Where is AST and ALT found?
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AST = S for skeletal, myocardium, brain, kidneys (major organs)
ALT = L for liver |
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What is the circulatory 1/2 life of AST and ALT? What is important about this?
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AST = 12-24 hrs
ALT = 37-57 (longer) ALT can detect hepatic damage even after damage has ceased. However, remember AST > ALT indicates alcohol, statin, and tylenol use. And ALT > AST indicates infectious hepatitis. |
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urine has conjugated or unconjugated bilirubin?
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conjugated
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what medication for gout oversecretors? undersecretors?
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- oversecretors: allopurinol
- undersecretors (90%): probenecid |
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Homonymous hemianopia:
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- Loss of vision in both eyes in either the R or L half of the visual field; due to CVA
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Where is the best place to evaluate skin turgor in adult?
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- Just below the clavicle or abdomen
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What skin disorder is sometimes associated with arthritis but may not be directed associated?
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- Psoriasis (psoriatic arthritis)
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Difference between nummular eczema and dyshidrotic eczema?
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- Nummular: coin-liked plaques, discoid, chronic pruritic, papules and vesicles on erythematous base
- Dyshidrotic: no evidence of sweating, bullous form called pompholyx, d/t emotional stress |
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Maculopapular skin lesion on back, warty, scaly, greasy, light tan.
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- Seborrheic keratosis (raised, tan-brown)
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What is medical mgmt of a brown recluse spider bite?
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- Ice pack for inflammation, elevate area; also associated with black eschar of sloughing tissue
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Severe reaction to black widow spider bite:
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- Abd rigidity, nausea, HA, bronchospasm, HTN, seizures, AMS
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What is a major side effect of sulfa drugs?
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- Erythema multiforme – high fever, weakness, blisters, bulla, ulcerations of mucous membranes
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When can kid with Fifth’s Disease (Erythema infectiosum) go back to school?
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- Communicable before rash erupts, so may go back to school when rash appears
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Where does roseola and rubella start?
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- Roseola starts on trunk after fever; spreads to extremities; supportive care
- Rubella starts on face and goes down trunk, while facial rashes disappear; clears in 3-5 days |
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How do BBs exacerbate psoriasis?
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- Decreases cAMP-dependent protein kinase (inhibitor of cell proliferation)
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Do not give what med in true postherpetic neuralgia?
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- Antiviral (acyclovir or valcyclovir); bc won’t work anymore (must give during early symptoms of tingling pain)
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Tx of rosacea:
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- Low-dose tetracycline or topical metronidazole
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Lidocaine with Epi 1-2% as local anesthesia maximum dose allowed is:
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- 7mg/kg
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Motor function of L4
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foot dorsiflexion
knee jerk reflex |
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Motor function of L5
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great toe dorsiflexion
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Motor function of S1
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foot eversion
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1. What drugs can cause hyperglycemia?
2. What drugs can precipitate gout attack? 3. What drugs can cause acute pancreatitis? |
- corticosteroids, niacin, thiazide diuretics
- niacin, thiazide diuretics, ASA, cyclosporine - corticosteroids, thiazides (causes increase of Ca2+), alcohol |
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Lab that tests for autoimmune thyroid disease.
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TPOAb (thyroid peroxidase antibody)
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Sulfonylurea mechanism of action.
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insulin secretagogues (they stimulate pancrease to release more insulin); long-acting.
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Meglitinides mech of action.
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same like sulfonylureas, but SHORT-acting (works in 20 minutes).
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Metformin mech of action.
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Inhibits hepatic gluconeogenesis; ↑ peripheral sensitivity
to insulin. |
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Why is weight loss seen in Metformin?
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- decreases intestinal absorption of glucose.
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Thiazolidinediones mech of action.
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↑ insulin sensitivity
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Caution what when giving sulfonylureas?
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- make sure pt has functioning beta cells.
- make sure pt does not have sulfa allergy. |
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Caution what when giving Metformin?
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- impaired renal function
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Caution what when giving Thiazolidinediones?
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- must monitor for hepatic toxicity (ALTs)
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Januvia must be used in combo with?
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- Metformin or a TZD.
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Acute weight loss --> think 6 reasons:
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cancer
leukemia/lymphoma TB AIDS depression DM type 1 |
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Dawn phenomenon
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insulin wears DOWN by DAWN
solution: move PM dose of insulin closer to bedtime. |
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Somogyi effect
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Pt is hypoglycemic in middle of night and REBOUNDS to hyperglycemia in morning.
solution: eliminate or reduce PM insulin. |
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How do corticosteroids cause hyperglycemia?
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Steroids prevent the uptake of glucose in cells.
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How do steroids cause HTN?
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steroids cause vasoconstriction.
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pt taking ethambutol for TB. Monitor what?
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- visual acuity, green-red preception (optic neuritis)
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prophylactic migraine treatment
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BB (propranolol?)
CCB (Verapamil) TCAs (amitriptyline) |
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Most common pathogen in Acute Bronchitis?
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RSV
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A BOGGY and tender prostate gland is consistent with __? Treatment for man >35yo? <35yo?
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acute bacterial prostatitis.
Tx with bactrim or cipro x 14 days if >35yo Tx with ceftriaxone 250mg IM + doxy if <35yo |
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What are 3 causes of secondary hypertriglycemia?
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- excessive alcohol use
- uncontrolled DM - untreated or undertreated hyperthryoidism |
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dilatory
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delaying; tending to delay, slow to act : he had been dilatory in appointing a solicitor.
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What can you Rx to PREVENT duodenal ulcers?
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antibiotics
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does serum albumin increase or decrease in elderly?
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- decrease
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The general principle of how drug absorption is altered in the eldery is:
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rate of absorption
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How does age affect ACE-I?
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less effective in elderly because they have reduced renal elimination.
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T or F: majority of ectopics resolve unpredictably without intervention.
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True
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What do you use to treat chlamydia in a pregnant woman?
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Erythromycin is recommended.
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The best advice to give someone who is taking a medication with a narrow therapeutic index is to tell them to take the medication HOW?
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- take it at the same time every day.
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When you prescribe a drug >90% protein-bound, it means that ___.
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Only protein-bound portion of the drug is therapeutically active.
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T/F: The charge of the State Board of Nursing is to ensure public safety.
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True
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T/F: Once I am certified, I can practice as a nurse practitioner.
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False, you practice even without certification.
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T/F: State level authorization dictates the ability of the NP to obtain a Federal DEA number.
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True.
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What is the ethical principle of beneficence?
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- to help people in need.
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someone taking TZD, monitor what?
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ALT
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crescendo-decrescendo murmur
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aortic stenosis
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clue cells on smear
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bacterial vaginosis
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First-line treatment of:
1) syphillis 2) gonorrhea 3) chlamydia |
1) penicillin G
2) Suprax or ceftriaxone 3) azithromycin or doxy |
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boggy prostate gland
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acute prostatitis
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prevent recurrence of duodenal ulcers, Rx:
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abx
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when is a child allowed to sit in a forward-facing car seat?
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- 1 year AND at least 20 lbs
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