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111 Cards in this Set
- Front
- Back
- 3rd side (hint)
Tanner 1 |
pre-puberty
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Tanner 2
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Male: testes enlarge; scrotal skin changes in texture, pigment; scant pubic hair
Female: breast budes; downy pigmented pubic hair |
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Tanner stage 3
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Both: Growth spurt
Male: penis lengthens "pencil penis", scrotum becomes larger; pubic hair increases, darkens, becomes coarse. Female: breast mound becomes larger; pubic hair increases, darkens, becomes coarse spreads to mons. |
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Tanner stage 4
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Male: increase length and width of penis, darkening of scrotal skin; adult-like pubic hair, not yet spread to medial thighs.
Female: Menarche; areola elevated as second mound above level of breast; adult-like pubic hair not yet spread to medial thigh. |
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Tanner stage 5
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Adult genitalia with pubic hair spread to medial thigh.
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Tanner stage 3
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Both: Growth spurt
Male: penis lengthens "pencil penis", scrotum becomes larger; pubic hair increases, darkens, becomes coarse. Female: breast mound becomes larger; pubic hair increases, darkens, becomes coarse spreads to mons. |
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Tanner stage 4
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Male: increase length and width of penis, darkening of scrotal skin; adult-like pubic hair, not yet spread to medial thighs.
Female: Menarche; areola elevated as second mound above level of breast; adult-like pubic hair not yet spread to medial thigh. |
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Tanner stage 5
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Adult genitalia with pubic hair spread to medial thigh.
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Tanner stage 3
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Both: Growth spurt
Male: penis lengthens "pencil penis", scrotum becomes larger; pubic hair increases, darkens, becomes coarse. Female: breast mound becomes larger; pubic hair increases, darkens, becomes coarse spreads to mons. |
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Tanner stage 4
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Male: increase length and width of penis, darkening of scrotal skin; adult-like pubic hair, not yet spread to medial thighs.
Female: Menarche; areola elevated as second mound above level of breast; adult-like pubic hair not yet spread to medial thigh. |
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Tanner stage 5
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Adult genitalia with pubic hair spread to medial thigh.
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List characteristics of candida vulvovaginitis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of bacterial vaginosis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of atrophic vaginitis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of HSV-2. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of nongonococcal urethritis/ cervicitis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of gonococcal urethritis / vaginitis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of trichomoniasis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of syphilis. What is the antibiotic of choice?
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s
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Rx:
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List characteristics of genital warts. What is the antibiotic of choice?
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s
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Rx:
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What are characteristics of normal/healthy vaginal discharge or vaginal environment?
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s
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Rx:
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What are characteristics of PID? What are the treatments of choice?
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s
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Rx:
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What are pathogens and treatment for acute, uncomplicated UTI?
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s
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Rx:
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What is treatment of acute uncomplicated pyelonephritis (outpatient therapy)?
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s
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Rx:
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Compare pathogens and treatment for epididymitis / epididymoorchitis in men <35y.o. and men >35y.o.
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<35y.o. -
>35y.o. - |
Rx: |
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Complaints & clinical findings in acute bacterial prostatitis. What is treatment of choice?
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<35y.o. -
>35y.o. - |
Rx:
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Treatable causes of urinary incontinence:
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"diappers"
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Rx:
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When would you initiate HIV antiretrovial therapy? (i.e. CD4 count, clinical situations)
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s
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s
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Highest rate of HIV transmission is through ___________?
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Receptive anal intercourse.
(then insertive anal intercourse, needle stick, receptive vaginal intercourse) |
s
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Incidence of BPH in men.
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50% in men 51-60 y.o.
80% in men 80+ y.o. |
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Drug classes for treatment of BPH. MOA of these drugs.
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Alpha-1 receptor blockers
5-Alpha reductase inhibitors |
s
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At what age do you start screening for Prostate cancer? What is the screening?
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50. Start at 45 for men at high risk. PSA and DRE annually.
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At what age do you start screening for cervical cancer?
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21
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Which HPV types are associated with high cervical and colorectal malignancy?
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16, 18, 31, 33, 35, 39 have high malignancy rates
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Which cause genital warts?
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6 and 11 cause warts.
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Who would you screen for HIV?
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Offer to all patients ages 13-64 regardless of risk factors and all pregnant women.
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What is phimosis?
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s
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What is paraphimosis?
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s
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Exam findings of hydrocele . . .
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s
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Exam findings of varicocele. . .
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s
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Define chyptorchidism. . .
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s
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Condition characterized by scrotal pain, loss of cremasteric reflex.
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testicular torsion
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Define menopause.
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12 months s/p last menses.
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Average age of menopause.
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51 y.o.
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Pros/Cons of HRT for menopause.
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Pros: best treatment for vasomotor sx (i.e. hot flashes), conserves bone density.
Cons: Risks of CVD. Contraindicated in h/o breast, ovarian cancer, stroke, CVD or high risk factors for CVD. |
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Treatment options for menopausal vasomotor symptoms, emotional lability. . .
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HRT; SNRI venlafaxine (Effexor); SSRIs sertraline (Zoloft) and paroxetine (Paxil); Gabapentin (Neurontin); high dose vitamin E, phytoestrogens may help.
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Most common etiology of dementia
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Alzheimers Disease (50-80%)
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Labs for work up of patient with new onset mental status change. . .
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CMP
glucose calcium LFTs Vitamin B12, folate TSH RPR CBC with diff UA, Urine C&S ECG maybe: Tox screen, HIV, CT/MRI, PET scan, CXR, ESR |
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List Alzheimer-Type Dementia pharm treatment.
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Vitamin E
Cholinesterase inhibitors (donepezil/Aricept) N-methyl-D-aspartate receptor antagonist (memantine/Namenda) Treat depression with SSRIs, MAOIs, Treat other sx such as pain or infection. Antipsychotics for agitation, psychosis. |
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DSM IV criteria for GAD
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At least 3 Sx on most days x 6 months:
Excessive anxiety, worry. Difficulty controlling worry. Irritabily. Difficulty concentrating Sleep disturbance Physical symptoms - restlessness or feeling on edge, fatigue, muscle tension. |
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SSRI with longest 1/2 life:
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Fluoxetine (Prozac)
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SSRI with shortest 1/2 life:
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Paroxetine (Paxil)
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Why might you avoid prescribing Paxil in the elderly patient?
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Side effect of sedation
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Which SSRIs are CYP 450 isoenzyme inhibitors?
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Fluoxetine (Prozac) and paroxetine (Paxil). Sertraline (Zoloft), but less so.
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DXA scan normal result
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within 1 SD of "young normal" adult
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DXA scan = osteopenia
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BMD between 1.0 and 2.5 SD of "young normal" adult
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DXA scan = osteoporosis
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2.5 SD or more below "young normal" adult
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Risk factors for osteoporosis:
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s
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Who would you treat for osteoporosis?
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s
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What are treatment options for osteoporosis?
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s
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What is recommended daily dose of Calcium and Vitamin D for adults >50 y.o.?
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Clinical features of Rheumatoid arthritis?
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s
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Clinical features of Osteoarthritis?
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s
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What labs would you order if you suspect a patient has RA?
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s
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Indications for imaging in back pain are:
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s
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First line therapy for prepatellar bursitis is _________.
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Joint aspiration.
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Chief complaint in diagnosis of lateral epicondylitis?
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Decreased grip strength.
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Chief complaint in diagnosis of medial epicondylitis?
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Decreased grip strength.
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Activity that causes medial epicondylitis?
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Golf
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Activities that causes lateral epicondylitis?
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Tennis, hammering, repetitive lifting.
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Treatments for acute gout attack are:
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Naproxen sodium
colchicine or PO corticosteroid local steroid injection for those with contraindications to NSAIDs |
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Where to tophi form in gout?
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Areas of cooler body temp: auricles, extensor surface of hands, elbows.
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Most problematic joints affected by OA are ____ and ____.
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Hips and knees.
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Peak age of onset of RA?
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20-40 y.o.
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Most common site for a cervical disc lesion is:
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C5-C6
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Most common causes of neck pain are soft tissue abnormalities caused by injury or wear and tear; rarely infection and tumors.
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The most common diagnosis for complaint of acute low back pain is:
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lumbosacral strain
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- Erector spinae muscle often implicated.
- Rarely a precipitating incident; usually the culmination of many events, often in individuals who have poor conditioning or poor posture/scoliosis -PE will show straightening of lumbosacral curve, normal neuro exam |
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When is imaging indicated for a patient who complains of back pain?
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If suspicious for or to rule out:
cancer/malignancy (i.e. systemic symptoms) paget's disease spondylolithesis scoliosis trauma old age (or other risk factors for compression fracture) osteoporosis |
CT or MRI if radiculopathy
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Management of lumbosacral strain includes:
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ice/heat therapy
gentle stretching and activity NSAIDs muscle relaxants (beware of abuse potential) aerobic and toning exercise instruction for proper body mechanics |
early mobilization leads to better outcomes.
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What is reactive arthritis? What are its causes?
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Acute nonpurulent arthritis complicating an infection elsewhere in the body. AKA Reiter's Syndrome.
"can't pee, can't see, can't climb a tree" (asymmetrical oligoarthritis, sausage-shaped finger, cervicitis or acute diarrhea within 1 month of onset of arthritis; conjunctivitis/iritis, genital ulceration or urethritis. |
S/P acute bacterial diarrhea (Shigella, salmonella, campylobacter); STDs (chlamydia trachomatis, ureaplasma urealyticum)
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T or F:
CCBs may cause increase in GERD symptoms. |
True
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What may be a clinical presentation in multiple myeloma?
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Older age (average 66 yo)
pain in long bones, especially spine anemia (normocytic, normochromic) hypercalcemia renal insufficiency MM is a neoplastic proliferation in the bone marrow which results in skeletal destruction. |
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What does AV nicking indicate?
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Long standing hypertension.
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What is pyrosis?
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heartburn
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Is a pink-red TM in a screaming child a normal or abnormal finding?
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May be normal - hyperemia and flushing of the face that occurs with crying.
A distorted or erythematous TM is suggestive of OM. |
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Where do direct inguinal hernias occur?
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Hesselbach's triangle
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Where do indirect inguinal hernias occur?
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Internal inguinal ring
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What is a common complaint of a man with an inguinal hernia?
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scrotal heaviness at the end of the day
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What is the MMSE commonly used to assess?
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Evaluation for dementia.
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What enzymes are elevated with alcoholism?
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AST, ALT, GGT
AST will be higher than ALT GGT may be elevated if AST, ALT are normal - indicates liver damage. |
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What medications can be used to treat anorexia and bulemia?
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SSRIs. Usually in high doses.
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What is the rapid HIV test? (i.e. screening test first performed)
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ELISA test
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What is the confirmatory test for HIV positive result in rapid HIV test?
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Western Blot.
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A patieint was exposed to HIV through sexual intercourse. He should be followed with screening tests to identify seroconversion for how long?
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1 year
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Why would lotions (versus creams or ointments) be discouraged in treating atopic dermatitis?
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High water content and low oil content of lotions lead to water evaporation on the skin and further skin drying.
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What is the drug 5-fluoraouracil (topically) used to treat?
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basal cell carcinoma
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Which BPH medication provides immediate relief of symptoms?
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alpha blockers
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What effect do 5-alpha reductase inhibitors have on PSA results?
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this drug will reduce PSA levels by 50% or greater within the first 3 months and will sustain this reduction as long as the medication is taken due to MOA of interference with prostatic intracellular androgen response mechanism.
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Definition of TIA.
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A sudden onset of focal neurological symptoms that lasts less than 24 hours. Not benign. . . Even brief ischemia (infarction begins once an area has been ischemic for 1 hour), can produce irreversible brain damage.
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Dietary triggers of gout. . .
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High purine foods. Meat, fish, alcohol.
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What is the incubation period for a primary scabies infection?
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3-4 weeks
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Pharm treatment for shingles within 72 hours of onset?
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antiviral (acyclovir)
pain meds |
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What age do you start screening women for osteoporosis?
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65 y.o.
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What is the minimum time between Hep B vaccines? (also applies to DTaP, IPV and MMR)
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1 month
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What is the minimum time between varicella vaccines?
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3 months
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What is normal pressure hydrocephalus?
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Symptoms include gait difficulty, cognitive disturbance and urinary incontinence.
CT will show enlarged ventricles. |
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What are the three most common causes of bacterial diarrhea in the US?
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salmonella
campylobacter shigella |
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Primary headache red flags:
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S
N O O P |
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normal vaginal pH
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3.8-4.2
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When evaluating serum creatinine in the elder, the NP considers that:
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This value is influenced by glomerular filtration rate.
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What would liver enzymes show in a patient with alcoholism?
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Elevation of AST and ALT, ratio 2:1. Within 3 x ULN.
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Most common 2 causes of acute pancreatitis?
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gallstones and alcoholism
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