What is the treatment of choice for community acquired, uncomplicated pneumonia?
amoxicillin
Vitamin B12 deficiency anemia is a type of
... [Show More] ____________ anemia.
pernicious; macrocytic
Prostate infection or inflammation can cause a sharp rise in PSA values. When should this value go back down to normal levels and be checked after an acute infection?
4 weeks
The most common cause of atypical pneumonia in adults
mycoplasma pneumoniae
An herbal supplement thought to help BPH
saw palmetto
A male patient presents to your clinic with a lump in his breast. How should we work this up?
clinical breast exam, mammogram, AND ultrasound
If a patient with strep comes back after 48 hours with no improvement on antibiotics, what should you then prescribe?
a penicillin or cephalosporin with beta lactamase coverage
How long must a tick be attached to the skin in order for Lyme disease to be transferred?
48 hours
When should kids be treated for hypertension?
if they also have diabetes, are symptomatic, have hypertension > 95th percentile, or when end organ damage is present
ACEIs can cause what electrolyte abnormality?
hyperkalemia
A positive "drop arm" test is a sign of what?
torn rotator cuff
The medical term for spoon shaped nails
koilonychia
Koilonychia is a sign of what?
iron deficiency anemia
How is influenza diagnosed?
a nasal swab
What finding would be most likely to differentiate gout from septic arthritis?
fever would be indicative of septic arthritis
Diphenhydramine has __________ properties and is contraindicated in which patient populations?
anticholinergic; elderly and those with glaucoma
The medical term for flat feet
pes planus
How does plantar fasciitis usually present?
as pain in the morning with resolution after several steps, but as it worsens the patient will start to complain of heel pain throughout the day and with walking
Scope of practice for NPs is not influenced by which entity?
a court of law
Used to establish a designated level of professional competence
licensure
Treatment of subclinical hypothyroidism is generally not indicated unless the TSH is ___________.
greater than 10
In the presence of an elevated serum TSH, what is the next step in management?
repeat TSH plus free T4
Patients with a history of UC or Crohn's should have a colonoscopy how often?
every 1-5 years due to the increased risk of colorectal cancer
What is the first line treatment for community acquired atypical pneumonia?
macrolides such azithromycin. If the pt cannot take a macrolide, then they can do levofloxacin or doxycycline
What is metatarsus adductus?
the medical term for in-toeing
What is true regarding older adults who are overweight?
mortality in older adults related to overweight states declines over time
How do we manage rubella immunity in pregnant women?
we screen all pregnant women with a rubella titer. If they had a protective rubella titer in a previous pregnancy, then they do not need to be checked again. If they are found to not be immune when pregnant, then she should be vaccinated AFTER delivery
How is permethrin applied to the skin for scabies?
a one time application to all skin below the neck and then left on for 8-12 hours is sufficient
After exposure to HIV, when will the patient seroconvert and become positive?
3 months
Is age less than 18 years a risk factor for an ectopic pregnancy?
no; but personal history of PID, an IUD, previous ectopic pregnancy, previous tubal surgery, pathology, or ligation all are risk factors
What is Tanner stage 5 of breast development in females?
projection of the nipple only
What are two common classes of drugs that interact with grapefruit juice?
statins and CCBs
Ankle inversion is a common complaint from a patient with what?
a lateral ankle sprain
How can we best diagnose coarctation of the aorta?
by comparing the upper and lower extremity blood pressures
What is the most important risk factor for developing breast cancer in women of average risk?
age
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What is the recommended treatment for blepharitis?
erythromycin 1cm ribbon 5x daily for 7 days
What is the recommended treatment for severe anorexia with delusions?
2nd atypical antipsychotics
What lab values need to be monitored in a patient on Tizanidine?
LFTs and BP at baseline and 1 month after the max dose is achieved (can cause hepatotoxicity and hypotension)
What class of drug is dabigatran (pradaxa)?
direct thrombin inhibitor
The most effective treatments for acne related to increased sebum production are what?
oral contraceptives and isotretinoin
Oral contraceptive regimen in which both the estrogen and progesterone concentrations vary throughout the cycle
quadriphasic
Oral contraceptive regimen in which the estrogen and progestin doses are fixed throughout the cycle
monophasic
Oral contraceptive regimen in which in the estrogen dose remains the same for the first 21 days of the cycle, while progestin is lower in the first half and higher in the second half
biphasic
Oral contraceptive regimen in which the estrogen remains consistent and the progestin dose varies
triphasic
Patients who are receiving beta blockers may find what treatment for allergies ineffective?
treatments containing epinephrine
For a patient on warfarin who needs to receive a tetracycline antibiotic, how will we adjust their warfarin?
tetracyclines depress prothrombin activity, same as warfarin, so we need to decrease the warfarin to avoid an increase in INR and significant bleeding
What is the herbal, valerian root often used for?
insomnia/sleep, ADHD, anxiety, depression
What is the herbal, saw palmetto, often used for?
BPH
What is the herbal, black kohosh, often used for?
symptoms of menopause - hot flashes
What is the herbal, St. John's wart, often used for?
depression
What are the intrauterine transplacental infections that can be passed from mother to infant?
think TORCH; toxoplasmosis, Other (syphilis, varicella zoster, parvovirus) Rubella, Cytomegalovirus and Herpes simplex, as well as tuberculosis. Note that chlamydia is NOT transplacental, but rather transvaginal during childbirth
The antibiotic of choice for a dog bite
augmentin; doxy if there is a penicillin allergy
Obese women should gain how much weight during pregnancy?
11-20 pounds
Overweight women should gain how much weight during pregnancy?
15-25 pounds
Normal weight people should gain how much weight during pregnancy?
25-35 pounds
Underweight people should gain how much weight during pregnancy?
28-40 pounds
Pregnant women should increase their daily caloric intake by how many calories per day?
300
Immunizations are considered to be what level of prevention?
primary
Children can start to ride a tricycle around age _____
3
A gray or white ring present around the peripheral iris
arcus senilis
What causes arcus senilis?
it is a normal, benign condition with aging, but can also occur in younger people as a result of high cholesterol and triglycerides
How is a diagnosis of neuroblastoma confirmed?
via serum catecholamine testing and a biopsy
Are saturated or unsaturated fatty acids better for you?
unsaturated
Which patient populations are thalassemias most common in?
mediterranean countries (greece and turkey), asia, africa
Is Meniere's disease most often unilateral or bilateral?
unilateral
What type of hearing loss occurs in Meniere's disease?
sensorineural
Dix Hallpike maneuver is the standard clinical test for _______
BPPV
How do we test cerebellar function?
rapid alternating movements, finger to nose test, balance (romberg), gait
The first sign of puberty in girls
thelarche (breast budding)
When the uterine lining grows in to the uterine muscle wall
adenomyosis; this is often asymptomatic and may result in heavier periods
What are the 4 components of Tetralogy of Fallot?
VSD, pulmonic stenosis, overriding aorta, right ventricular hypertrophy
What does the murmur of Tet of Fallot sound like?
harsh systolic murmur at the left upper sternal border
What is a tet spell?
when the child turns blue during crying or feeding
How do we treat thrush in infants?
application of nystatin to inside of the mouth, sterilize all pacifiers and bottle nipples; a topical antifungal may be applied to the nipples
HMO and PPOs are called what?
managed care plans
TCAs can cause what worsened problem in a patient with BPH?
urinary retention [Show Less]