All of the following are clinical eye findings found in some patients with chronic uncontrolled hypertension. Which is not associated with this
... [Show More] disorder?
AV nicking
B
Copper wire arterioles
C
Flame-shaped hemorrhages
D
Microaneurysms
Microaneurysms
The span of the normal adult liver is ____ in MCL
15 to 18 cm in the midclavicular line
Treponema pallidum
gram-negative spirochete bacterium that causes syphilis.
Tanner stages boys
In Tanner stage I:scrotom changes
Tanner II: The penis length remains unchanged. scrotom gets darker, pubic hair
Tanner III: Penis begins to lengthen.
Tanner IV: Penis increases in length and circumference.
Tanner V: Scrotum and penis are mature size.
Which of the following is the treatment for nongonococcal urethritis?
azithromycin 1 g PO in a single dose or doxycycline 100 mg PO BID for 7 days.
"triple therapy" for treating a Helicobacter pylori infection?
Amoxicillin BID, and
m
Omeprazole (Prilosec) daily
x
i
Clarithromycin (Biaxin) BID,
i
ll
in
Which drug is effective therapy for treating pain in patients who are having an acute exacerbation of gout?
Indomethacin (Indocin)
signs of mono in teen
pallentine petechia, posterior cervical nodes, sore throat
causative agent AND TX of tine capitus
malessezia furfur (tx. griseofolvin and SeSulfide (Versel) lotion)
Txs for acute prostatitis
Fluoroquines, flufonureas, tetracyclines, macrocodes NOT NITROFURANTOIN...can't penetrate tissue
most effective tx of acute anxiety
alprazolam (xanex)
Descriptions for:
1) Trichamonas
2) BV
3) Candida
1) rich: yellow-green discharge and smelly
2) gray, thin, fish smell
3) white curd-like thin discharge, no smell
treatment of transient insomnia in elderly
low dose doxepin (Sinequan)
with the diagnosis of siphilis which test will always be positive
FTA-ABs or MHA-TP both are treponemal tests.
-RPR is non-treponemal sensitive.
Ericsson stage in elderly
integrity vs. despair
Tx of Candidal vaginitis
mi.C.onazole (monistat), .C.lotrimazole (gone-lotrimin) x 7 days, CREAM
OR
Diflucan 100mg x 1 dose + terconazole (Tetrazole-3) CREAM
Sx of Trichamonas in female
grayish-green bubbly vaginal discharge (men have dysuria and frequency, or ASX)
Objective findings: "Strawberry cervix", swollen reddened vulvula
mico: unicellular organisms with flagella and large amounts of WBC
Tx of Trichamonas and BV
me.T.ronidazole (Flagyl) 2g PO x 1 dose --> treat partner (ORAL)
can also use azithromycin
female sx of BV
"fish-like" odor, profuse milk-like discharge
CLUE CELLS no WBC, +wiff test
Tx of Gonorrhoeae (gonoCoCCal)
.C.eftriaxone 250mg IM
can use azithromycin in beta-lactam allergy
a) OA nodes (DJD)
b) RA Nodes
a) Bouchards, heberdenes
b) swan neck and boutonniere
Impetigo treatment in peds
cephalexin
Outbreak and daily dosing for HSV
outbreak dosage: 800mg x 2 days
Daily dose: 400mg BID
Which organisms can cause epiglottis?
Hib, Pneumococci MCAT DOES NOT
what differentiates cataracts from glaucoma?
single eye diplopia
-both have halos and dilated pupils
Sx of Kawasaki disease
Persistent fever, rash of lips and oral cavity, red eyes
HSV order: ------
Chlamydiea order:-------
HIV order: -------
HSV: viral culture
chlamydia: ELISA
HIV: western blot
Systolic vs. diastolic HF:
systolic: heart contract (reduced ejection fraction)
diastolic: when heart can't relax (EF maintained)
Tx of PID
"Chlamidia MD"
Ceftriaxone IM-->covers Ghonnorhea
Doxycycline-->covers chlamydia
Metronidazole-->covers vaginal flora
Which of the following is the most common cause of nongonococcal urethritis?
Chlamydia trachomatis
While performing a Pap smear on a postmenopausal patient, several areas of flat white, irregularly shaped lesions are found on the patient's labia. The skin lesions look thin and atrophic. The patient reports that the lesions are itchy and have been present for several years. Which condition is best described?
Lichen sclerosus
Lichen sclerosus is more common in older women. It is a long-term chronic condition that affects the vulva and/or anal area in women. The lesions appear as small white spots early in the disease and grow into bigger patches. Itching is very common; however, other symptoms include discomfort, bleeding from skin tears, and blisters. A skin biopsy allows for differentiation from other dermatological conditions.
Pulsus paradoxus is best described as:
In patients with pulsus paradoxus, systolic pressure drops on inspiration due to the increased pressure (positive pressure). Some pulmonary risks of having increased pressure include asthma (esp. asthmaticus) and emphysema.
Strawberry hemangiomas
True strawberry hemangiomas will eventually resolve by the time the child goes to kindergarten. Most will reduce or disappear in the first 2 years. Laser treatment is rarely needed.
If left untreated, Zollinger-Ellison syndrome can cause what?
Severe ulceration of the stomach or duodenum
Zollinger-Ellison syndrome occurs when tumors (gastrinomas) in the intestine, pancreas, or lymph nodes near the pancreas produce excessive amounts of gastrin, which, in turn, increases the amount of acid produced by the stomach. High amounts of acid in the stomach produce ulcers of the stomach or duodenum. Untreated Zollinger-Ellison syndrome can lead to severe ulceration of the stomach or duodenum.
alternative antibiotics for penicillin-allergic patients. If the patient has a gram-positive infection, the possible alternatives are:
macrolides, clindamycin, or quinolones with gram-positive activity such as levofloxacin or moxifloxacin
acute mononucleosis in teen:
sore throat, prolonged fatigue, and enlarged posterior cervical nodes.
Diabetic retinopathy
neovascularization, cotton wool spots, and microaneurysms
HTN retinopathy
atrioventricular [AV] nicking, silver and/or copper wire arterioles
When checking deep tendon reflexes (DTRs) in a patient with -------------or------------, the ankle jerk reflex (Achilles reflex) may be absent or hypoactive.
severe sciatica or diabetic peripheral neuropathy
The preferred treatment for cutaneous anthrax is:
ciprofloxacin 500 mg orally BID for 60 days or for 8 weeks.
Seborrheic Keratoses
Soft wart-like skin lesions that appear "pasted on." Mostly seen on the back and trunk. Benign.
pulmonary changes in elderly
-FEV1 and FVC decrease with age,
-but residual volume increases.
GC/CC neonate RX opthamoligical infection
0.5% erythromycin or tetracycline ointment (1-cm ribbon per eye).
congenital glaucoma S/S and Tx
Vascular Lesions
Port Wine Stain (Nevus Flammeus)
Neonates with pink to red, flat, stain-like skin lesions located on the upper and lower eyelids or on the V1 and V2 branches of the trigeminal nerve (CN V) should be referred to a pediatric ophthalmologist to rule out congenital glaucoma. Blanches to pressure. Irregular in size and shape. Large lesions located on half the facial area may be a sign of trigeminal nerve involvement and Sturge-Weber syndrome (rare neurological disorder). The lesions do not regress and grow with the child. These lesions can be treated with pulse-dye laser (PDL) therapy.
Imiquimod
Imiquimod is an immune-modulator treatment for genital warts and patient can use at home.
Fitz-Hugh-Curtis Syndrome
Chlamydial and/or gonococcal infection of the liver capsule (not the liver itself). There is extensive scarring between the liver capsule and abdominal contents (e.g., colon). Scars look like "violin strings" (seen on laparoscopy). A complication of PID (10%) due to chlamydia and/or gonococcal infection.
Classic Case
Sexually active female with symptoms of PID complains of right upper quadrant (RUQ) abdominal pain and tenderness on palpation. The liver function tests are normal. Treated as a complicated gonorrheal/chlamydial infection (ceftriaxone [Rocephin] 250 mg IM plus doxycycline PO BID x 14 days).
Reiter's syndrome
More common in males. An immune-mediated reaction secondary to infection with certain bacteria (e.g., chlamydia) that spontaneously resolves. Treatment is supportive (e.g., NSAIDs).
Classic Case
A male with current history of chlamydia genital infection (i.e., urethritis) complains of red and swollen joints that come and go (migratory arthritis in large joints such as knee) and ulcers on the skin of the glans penis.
Mnemonic: "I can't see (conjunctivitis), pee (urethritis), or climb up a tree (migratory arthritis in large joint such as the knee)."
-----a--------- for both uncomplicated and complicated gonorrheal infection.
a) Use ceftriaxone (Rocephin) 250 mg IM x one dose
---a---- = (genital warts)
---b----- = (secondary syphilis).
a) condyloma acuminata
b) condyloma lata
All of the following are infections that affect mostly the labia and vagina except:
Bacterial vaginosis
B
Candidiasis
C
Trichomoniasis
D
Chlamydia trachomatis
Chlamydia trachomatis commonly affects the .C.ervix, endometrial lining, fallopian tubes, and pelvic cavity.
THINK "C' FOR CERVIX
A 21-year-old woman complains of left-sided pelvic pain accompanied by dyspareunia. During the gynecological exam, the nurse practitioner notices green cervical discharge. The patient mentions a new onset of a painful and swollen left knee and denies a history of trauma. This best describes:
Disseminated gonorrheal infection
Symptoms of pelvic inflammatory disease (PID) with painful, swollen joints of extremities indicate disseminated gonorrheal infection. Untreated disseminated gonorrhea can lead to septic arthritis. Symptoms may be mild, ranging from slight joint pain and no fever to severe joint pain with high fever. PID symptoms do not occur with septic arthritis, Reiter's syndrome, or chondromalacia of the patella.
A 13-year-old boy is brought in by his mother for a physical exam. During the genital exam, the nurse practitioner notices that the patient is at Tanner stage II. Which of the following is the best description of this Tanner stage?
The testicles become larger and the skin of the scrotum starts to become darker with straight, fine, countable hairs on the genitals and the axilla [Show Less]