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77 Cards in this Set
- Front
- Back
Allopurinol and colchicine each is used when? |
allopurinol - maintenance to keep uric acid low |
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Dysdiadochokinesia refers to: |
Neuro triad of symptoms with gait, memory, and speech - common in MS. |
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How do antioxidants help MS? |
- 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? |
- 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? |
- 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? |
Liver (mainly), then bones |
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ALP high, GGT high |
liver problem |
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ALP high, GGT normal |
bone disease (Paget's disease) |
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AST high, GGT high |
liver problem (alcohol abuse) |
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What chemical in the CNS change during a migraine? |
- Serotonin levels decrease |
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What are the differences of symptoms that show in a TIA of ANTERIOR cerebral circulation vs. POSTERIOR? |
- Anterior: behavior and cognition disorders |
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In a pt who has sustained a closed head injury, lethargic, follow commands slowly, what abnormal VS will alert you? |
- 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. |
- Meningococcemia; due to impairment of protein C anticoagulation pathway |
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Tx for myasthenia gravis: |
- Pyridostigmine (Mestinon) (Ach-ase inhibitor) |
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Horner’s syndrome: |
- Horney PAMELa = Ptosis, Anhidrosis, Miosis, Enophthalmos, Loss of ciliospinal reflex) |
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Where is AST and ALT found? |
AST = S for skeletal, myocardium, brain, kidneys (major organs) |
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What is the circulatory 1/2 life of AST and ALT? What is important about this? |
AST = 12-24 hrs |
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urine has conjugated or unconjugated bilirubin? |
conjugated |
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what medication for gout oversecretors? undersecretors? |
- oversecretors: allopurinol |
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Homonymous hemianopia: |
- 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? |
- Just below the clavicle or abdomen |
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What skin disorder is sometimes associated with arthritis but may not be directed associated? |
- Psoriasis (psoriatic arthritis) |
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Difference between nummular eczema and dyshidrotic eczema? |
- Nummular: coin-liked plaques, discoid, chronic pruritic, papules and vesicles on erythematous base |
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Maculopapular skin lesion on back, warty, scaly, greasy, light tan. |
- Seborrheic keratosis (raised, tan-brown) |
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What is medical mgmt of a brown recluse spider bite? |
- 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: |
- Abd rigidity, nausea, HA, bronchospasm, HTN, seizures, AMS |
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What is a major side effect of sulfa drugs? |
- 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? |
- Communicable before rash erupts, so may go back to school when rash appears |
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Where does roseola and rubella start? |
- Roseola starts on trunk after fever; spreads to extremities; supportive care |
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How do BBs exacerbate psoriasis? |
- Decreases cAMP-dependent protein kinase (inhibitor of cell proliferation) |
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Do not give what med in true postherpetic neuralgia? |
- Antiviral (acyclovir or valcyclovir); bc won’t work anymore (must give during early symptoms of tingling pain) |
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Tx of rosacea: |
- Low-dose tetracycline or topical metronidazole |
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Lidocaine with Epi 1-2% as local anesthesia maximum dose allowed is: |
- 7mg/kg |
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Motor function of L4 |
foot dorsiflexion |
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Motor function of L5 |
great toe dorsiflexion |
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Motor function of S1 |
foot eversion |
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1. What drugs can cause hyperglycemia? |
- corticosteroids, niacin, thiazide diuretics |
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Lab that tests for autoimmune thyroid disease. |
TPOAb (thyroid peroxidase antibody) |
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Sulfonylurea mechanism of action. |
insulin secretagogues (they stimulate pancrease to release more insulin); long-acting. |
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Meglitinides mech of action. |
same like sulfonylureas, but SHORT-acting (works in 20 minutes). |
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Metformin mech of action. |
Inhibits hepatic gluconeogenesis; ↑ peripheral sensitivity |
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Why is weight loss seen in Metformin? |
- decreases intestinal absorption of glucose. |
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Thiazolidinediones mech of action. |
↑ insulin sensitivity |
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Caution what when giving sulfonylureas? |
- make sure pt has functioning beta cells. |
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Caution what when giving Metformin? |
- impaired renal function |
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Caution what when giving Thiazolidinediones? |
- must monitor for hepatic toxicity (ALTs) |
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Januvia must be used in combo with? |
- Metformin or a TZD. |
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Acute weight loss --> think 6 reasons: |
cancer |
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Dawn phenomenon |
insulin wears DOWN by DAWN |
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Somogyi effect |
Pt is hypoglycemic in middle of night and REBOUNDS to hyperglycemia in morning. |
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How do corticosteroids cause hyperglycemia? |
Steroids prevent the uptake of glucose in cells. |
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How do steroids cause HTN? |
steroids cause vasoconstriction. |
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pt taking ethambutol for TB. Monitor what? |
- visual acuity, green-red preception (optic neuritis) |
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prophylactic migraine treatment |
BB (propranolol?) |
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Most common pathogen in Acute Bronchitis? |
RSV |
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A BOGGY and tender prostate gland is consistent with __? Treatment for man >35yo? <35yo? |
acute bacterial prostatitis. |
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What are 3 causes of secondary hypertriglycemia? |
- excessive alcohol use |
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dilatory |
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? |
antibiotics |
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does serum albumin increase or decrease in elderly? |
- decrease |
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The general principle of how drug absorption is altered in the eldery is: |
rate of absorption |
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How does age affect ACE-I? |
less effective in elderly because they have reduced renal elimination. |
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T or F: majority of ectopics resolve unpredictably without intervention. |
True |
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What do you use to treat chlamydia in a pregnant woman? |
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? |
- take it at the same time every day. |
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When you prescribe a drug >90% protein-bound, it means that ___. |
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. |
True |
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T/F: Once I am certified, I can practice as a nurse practitioner. |
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. |
True. |
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What is the ethical principle of beneficence? |
- to help people in need. |
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someone taking TZD, monitor what? |
ALT |
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crescendo-decrescendo murmur |
aortic stenosis |
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clue cells on smear |
bacterial vaginosis |
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First-line treatment of: |
1) penicillin G |
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boggy prostate gland |
acute prostatitis |
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prevent recurrence of duodenal ulcers, Rx: |
abx |
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when is a child allowed to sit in a forward-facing car seat? |
- 1 year AND at least 20 lbs |