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,Sensitivity defined as the ability of a test to detect a person who has the disease.
Specificity defined as the ability of a test to detect a person who is healthy or to detect the person
without the disease.
Trauma to Kiesselbachs plexus will result in an anterior nosebleed
The diagnostic or gold standard test for sickle cell anemia, hemoglobin electrophoresis
G6PD anemia, and alpha or beta thalassemia
questions asking for "action" the initial action might be to interview and gather subjective data or the history
erythromycin "allergy" vs adverse reaction adverse reactio-symptoms of nausea or GI upset
allergy -hives, angioedema
acute mononucleosis the patient will most likely be a teen presenting with the classic triad of sore throat,
prolonged fatigue, and enlarged cervical nodes.
Alpha thalassemia more common among Southeast Asians such as filipinos
Lupus present with malar rash(butterfly rash)Pts need to avoid or to minimize sunlight
exposure(photosensitivity)
treatment for polymyalgic rheumatica(PMR) first line treatment for PMR includes long-term steroids. Long term steroids are
commonly used to control symptoms(pain, stiffness on shoulders, and hip girdle). PMR
pts have higher risk for temporal arteritis.
Gold standard exam for temporal arteritis biopsy of the temporal artery. refer pt to opthalmologist for mgt
Finkelstein's test Positive in De Quervains tenosynovitis
Anterior Drawer maneuver and Lachman maneuver Positive if anterior cruciate ligament (ACL) of knee damaged. The knee may also be
unstable
McMurray's sign Positive in meniscus injuries of the knee
,Damaged Joints order X-ray first, but MRI is the Gold Standard
Diabetic retinopathy neovascularization, hard exudates, cotton wool spots, and micoaneurysms
Hypertensive retinopathy AV nicking, silver and or copper wire arterioles
Checking deep tendon reflexes absent(0),
hypoactive (1)
normal(2)
hyperactive(3)
clonus(4)
define clonus Clonus is typically seen in patients with stroke, multiple sclerosis, spinal cord damage and
hepatic encephalopathy. Clonus has also appeared after ingesting potent serotonergic
drugs, where ingestion strongly predicts imminent serotonin toxicity (serotonin
syndrome). Clonus is a series of involuntary, rhythmic, muscular contractions and
relaxations. Clonus is a sign of certain neurological conditions, particularly associated
with upper motor neuron lesions involving descending motor pathways, and in many
cases is, accompanied by spasticity (another form of hyperexcitability).Unlike small,
spontaneous twitches known as fasciculations (usually caused by lower motor neuron
pathology), clonus causes large motions that are usually initiated by a reflex.
A rare but serious adverse effect of ACE inhibitors is angioedema
A common side effect of ACE inhibitors is a dry cough(10%)
First line drug to treat hypertension in diabetics and patients ACE inhibitors or ARBS
with mild renal disease because of their renal protective
properties
Penicillin amoxicillin(broad-spectrum PCN) Penicillin VK
Macrolide erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)
Cephalosporins: 1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd generation(Rocephin,
Suprax, Omnicef)
Quinolones with gram positive coverage levofloxacin(Levaquin), moxifloxacin(Avelox), gatifloxacin(Tequin)
, Quinolones ciprofloxacin(Cipro), ofloxacin(Floxin)
Sulfa trimethoprim/sulfamethazole(Bactrim, Septra), nitrofurantoin(Macrobid),
Tetracyclines tetracycline, doxycycline, minocycline(Minocin)
NSAID ibuprofen, naproxen(aleve, Anaprox)
Cox-2 inhibitors celecoxib (celebrex)
Antitussives dextromorphan(Robitussin), benzonate(Tessalon Perles)
Drugs allowed for pregnant or lactating women Category B
Pregnancy in pain order Tylenol instead of Ibuprofen
Avoid nitrofurantoin and sulfa drugs during 3rd trimester increase the risk of hyperbilirubinemia
best way method of spreading viruses or bacteria is making them airborne or nebulized
treatment of cutaneous anthrax Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic to ciprofloxacin , use
doxycycline 100mg BID
Good communication rules Ask open ended questions, do not reassure patients, avoid angering the patient, and
respect the patients culture.