The least worrisome type of fluid seen as a result of pleural fluid analysis
Transudate pleural fluid
What test should be ordered to confirm a
... [Show More] suspected ascending aortic aneurysm?
CT Scan with contrast
Name risk factors for long-term care placement for the elderly population.
Male gender
80 y.o.+
Living Alone
bowel/bladder incontinence
Hx of falls
dysfunctional coping
Intellectual impairment
A patient with anterior epistaxis has been treated with direct pressure for 20 minutes. What are expected findings when the patient is instructed to gently blow their nose?
Successful treatment will be indicated by dark residual blood or clots being discharged from the nose.
If bleeding has not stopped you will see a bright red steady trickle of blood requiring more invasive measures.
What is the most common organism in treating otitis media, bacterial sinusitis, bacterial pharyngitis, AND community-acquired pneumonia?
Streptococcus pneumoniae
What is the greatest risk factor for vascular dementia?
Vascular diseases that result in target organ damage such as:
hypertension
dyslipidemia
diabetes
Hypertensive urgency vs emergency
- Hypertensive urgency: BP >200/120 w/o sx; Tx with PO furosemide, clonidine or captopril
- Hypertensive emergency: BP >200/120 WITH sx or evidence of end organ damage; Tx with IV nitroprusside, labetalol or nicardipine
*Both req immediate treatment
What annual lab testing should be done for patients taking atypical antipsychotics?
Lipid Panel
Name some atypical antipsychotics
OLAnzapine
CLOZapine
QUETIapine
RISPERidone
Aripiprazole
Ziprasidone
"It's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z"
If you are treating a car mechanic for a possible eye injury what test would you avoid?
MRI
possible metal in eye
What is the least invasive approach to rule out a pulmonary embolus?
D-dimer
When treating a patient with an unfractionated heparin infusion, what would you monitor for (to avoid a fatal complication) ?
Heparin-induced Thrombocytopenia (HIT). aka monitor for low platelets.
d/c heparin and intiate thrombin inhibitors!
What symptom differentiates vertigo from near-syncope and ataxia?
When the primary symptom identified is a sense of spinning this means vertigo and is usually an inner ear problem.
Ataxia is neurological
near-syncope may be cardiac, neuro or both.
When a patient is concerned about a family member not supporting wishes in end-of-life care, what legal document should be used?
advanced directive
What is contraindicative of rTPA therapy?
ST segment depression
Transtheoretical Model of Change
1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
psychotic disorder vs neurotic disorder
psychotic: distinct alteration in perception of reality
Neurotic: remain aware and interactive with reality
Cholinergics (Miotics)
Pilocarpine
Pilocarpine adverse effects
increased GI motility and bradycardia
Initial treatment for a panic attack in the ER
short-acting benzodiazepine for immediate symptom control
diazepam or
lorazepam
Aside from symptom control, medication use and PEFR testing, what should be included as part of the assessment for an asthmatic patient?
validated asthma questionnaire such as the ACT.
What is required for a diagnosis of Generalized Anxiety Disorder?
The patient will report both excessive anxiety and worry, and difficulty controlling that worry, for more days than not in the last six months
Levels of Prevention
Primary: prevent/promotion Secondary: screen-early detection
Tertiary: treat- to prevent further deterioration, rehab
For a patient being treated with an SSRI such as fluoxetine for PTSD that shows no improvement in symptoms after two months of treatment, what is the next line thearpy?
atypical antipsychotics
What murmur is heard in systole at the second ICS?
Aortic stenosis
Ms. ARD
Mr. ASS
What is the primary risk factor for pulmonary embolus?
1. DVT
DVT risks: polycythemia and stasis.
Differentiate between dementia types
Alzheimer's: long trajectory that progresses to confabulations
Lewy Body: rapid progression w/angry demeanor
Vascular: depressive affect, no confabulations, PMHx of vascular disease
Parkinson's: PMHx of parkinson's
What testing assesses for macular degeneration?
Amsler Grid- assessment of central vision changes seen in MD.
What is the Woods Lamp used for?
Illuminate FUNGI, BACTERIA ,PIGMENTATION and other skin problems
Can also be used to detect corneal abrasions.
A 55-year-old female presents with acute onset left sided facial pain and an inability to move the left side of her face. She cannot smile, raise her eyebrow or even close her left eye, The immediate approach to this patient should include:
Corticosteroids
She has Bell's Palsy [Show Less]