Leik Review with Complete Solutions

Infections of Vagina/Labia - ANSWER-bv, candidiasis, trichomoniasis Infections of cervix, endometrium - ANSWER-Chlamydia Trachomatis effects cervix, endometrium, fallopian tubes and pelvic cavity Sx/Sym of Acute Abdomen - ANSWER-positive obturator/Psoas Obturator Sign - ANSWER--pain elicited on internal rotation of right hip from 90 degrees hip/knee flexion. -acute abdomen/appendicitis Psoas Sign - ANSWER--acute abdomen/appendicitis -when pain occurs with passive extension of the thigh while the patient is lying on the side knees extended, or when pain occurs w/ active flexion of thigh at hip Medicare Part A - ANSWER-Inpatient Hospitalization and skilled care given in a certified SNF. Mycoplasma Pneumonia - ANSWER-most common in children and young adults spread thru droplets, sneezing, coughing. dx based on symptoms and xrays with lower lobe infiltrates PPD - ANSWER-Must have an induration of 10mm or to be + Must be indurated not just red Durable Power of Attorney - ANSWER-agent is designated by pt to make all medical decisions as well as private affairs in the event the pt becomes unable to make decisions. no one has the ability to override the agents decisions. Beta Blockers - ANSWER-avoided in emphysema -reduction in forced expiratory volume in 1 second (FEV1) increased airway hyperresponsiveness and inhibits bronchodilator resonse to beta agonists in non-selective BBs & high doses of cardioselective BBs Sx/Sym of Pregnancy Induced Hypertension - ANSWER--edema of the face & upper extremities -wt gain, blurred vision, elevated BP, proteinuria, HA B12 Deficiency-- B12 Anemia - ANSWER--can cause nerve cell damage if not treated -Sym B12 deficiency includes: tingling/numbness in fingers and toes, difficulty walking, mood changes/depression, memory loss, disorientation, dementia Alpha Feta Protein (AFP) - ANSWER-Produced in maternal and fetal liver, commonly seen in multiple gestations due to the growing fetuses, and enlargment of liver... Calcium Channel Blockers - ANSWER-CCBs act by blocking calcium channels in heart muscle and blood vessels, and keeping more calcium in bones Lachman Maneuver - ANSWER-Test performed to assess for knee instability, indicates a tear in the ACL TORCH - ANSWER-Toxoplasma Gondii, other infections, rubella, cytomegalovirus, herpes. Heberdens Nodes - ANSWER-DJD, distal interphalangeal joints. Drawer Sign - ANSWER--performed on the knee or ankle to assess for instability. affected knee will have more laxity when compared with unaffected. Evaluate Renal Function - ANSWER-Serum creatinine evaluates renal function. End product of creatine metabolism. not affected by fluid or dietary intake of meat. Chronic Use of NSAIDs - ANSWER-disrupts production of prostaglandins, decreases blood supply & breaks down protective layer of the mucosa leading to gastric disease Common Signs of depression - ANSWER-anhedonia (loss of interest), unintentional weight loss/gain, fatigue, change in appetite, insomnia and hypersomnia, feelings of guilt, worthlessness, suicide. Murphy's Sign - ANSWER-+ if pain occurs when performing RUQ Palpation while pt takes a deep inspiration. causing pt to stop deep breath. As liver is palpated it will descend and push up against the inflamed gall bladder and cause sharp pain (cholecystitis) Placenta Previa - ANSWER--abnormal implantation of the placenta. symptoms are painless, bright red bleeding Vaginal Atrophic Changes - ANSWER--menopause, hotflashes, irregular periods, cyclic mood swings. Vaginal changes such as dryness and thinning occur. Target organ damage in HTN - ANSWER-long term uncontrolled hypertension. organs affected include: brain (stroke), eyes (retinopathy, AV nicking, bleeding and blindness), heart (heart disease, left ventricular hypertrophy, MI and/or CHF), kidneys (renal failure, proteinuria) Bacterial Vaginosis - ANSWER--bacterial infection of vagina, copious off-white to gray d/c w/ foul odor w/out vaginal erythema or irritation. Wet prep will show + clue cells. Wet prep with "whiff test" will be positive for strong "fishy" odor when vaginal d/c mixed with KOH Lichen Sclerosus - ANSWER-disease of skin, white spots appear on skin and change over time. commonly seen in genital and rectal areas, shiny and smooth and spreads into patches. skin appears thin and crinkled. tears easily, bright red and purple bruises common. skin becomes scarred. Heart Sounds: S1 & S2 - ANSWER-s1 closure of mitral/tricuspid valve s2 closure of semi-lunar: aortic and pulmonic 12 Weeks Gestation - ANSWER--uterus measures the size of grapefruit, felt just above the suprapubic bone on bimanual exam. Medicare Part B - ANSWER-Covers outpatient physician visits, labs and xrays. Durable medical equipment. mammograms/colonoscopy after age 50, rehab. Anesthesia is Part A Risk Factors for Suicide - ANSWER-1. elderly white male (esp after lose of spouse) 2. past hx of suicide 3. family hx 4. plans for use of letal weapon such as gun/knife 5. females have higher attempt rate, males success 6. personal hx of bipolar disorder or depression Subconjunctival Hemorrhage - ANSWER--benign disorder occurs from an increase in intraocular pressure, caused by coughing, vommitting, bearing down with childbirth or BM, heavy lifting. What is Tonometry - ANSWER-used to measure intraocular pressure (IOP) the eye screen for glaucoma. Normal range for IOP 10-22 mmHg. Rocky Mountain Spotted Fever - ANSWER-bite from tick infected with Rickettsia rickettsii. mortality 1-7% if untreated. Atopic Dermatitis - ANSWER--lesions occur in a linear fashion -many different stages including papules/vessicles, w/ weeping, drainage and or crusting. Lesions commonly found on scalp, face, forearms, wrists, elbows and backs of knees. -commonly pruitic aka excema S1, S2 and S3 heart sounds - ANSWER-- heard with CHF, the inability of the heart to pump sufficient amount of blood to the organs to meet bodys requirement. common to hear all 3 on exam. Signs and Symptoms include fatigue, sob w/ activity, and edema of lower extremities. G6PD Deficiency Anemia - ANSWER-Glucose-6-phosphate dehydrogenase (G6PD) is hereditary. occurs when RBCs break down and hemolyze. due to missing or lack of enzyme needed to help RBCs work efficiently. Certain foods and medications trigger the reaction. Meds like antimalarial, aspirin, nitrofurantin, NSAIDS, quinidine, quinine, sulfa meds. Priapism - ANSWER-urologic emergency, painful erection not related to sex. if untreated can cause erectile dysfunction and penile necrosis. Assoc with Sickle Cell anemia, leukemia, spinal cord injury and some pharmas. RH Positive Red Blood Cells - ANSWER-mothers autoantibodies can attack the fetus's RH-positive red blood cells, and cause destruction of these. can cause severe anemia & complications in fetus. preventable with admin of RhD immunoglobulin, to an RH negative mother at 28 wks and after birth of newborn. Folic Acid Supplements - ANSWER-in pregnancy to prevent risk of neural tube defects. Pheochromocytoma - ANSWER-adrenal gland tumor w/increased production of adrenaline and non-adrenaline which can cause an increase in bp Renovascular Stenosis - ANSWER-narrowing of one or both arteries leading to the kidneys, it can cause severe hypertension and reversible kidney damage. Coarctation of the Aorta - ANSWER-congenital heart defect, narrowing of the aorta that causes the heart to work harder to get blood to flow through the narrow passageway to other organs, causes increase in BP Chlamydia trachomatis - ANSWER-Fitz-Hugh-Curtis is a complication of having pelvic inflammatory disease, caused by a vaginal infection such as gonnorhea or chlamydia. Causes inflammation and infection in the pelvic cavity. Left untreated can cause adhesions stretching from peritoneum to the liver. TB for a High Risk Population - ANSWER-5 mm induration considered positive for high risk population. Varicella in HIV - ANSWER-contraindicated inevitable abortion - ANSWER-vaginal bleeding with pain and cervical dilation and/or effacement. threatened abortion - ANSWER-is defined as vaginal bleeding w/ absent or minimal pain and closed long and thick cervix. incomplete abortion - ANSWER-moderate to diffuse bleeding. passage of tissue and painful uterine cramping or contractions. Acute pelvic inflammatory disease - ANSWER-sudden onset of inflammation and pain that affects the pelvic area, cervix, uterus, and overies. caused by infection. Rubella - ANSWER-contraindicated in pregnancy Medicare part B - ANSWER-covers: outpatient, physician visits, labs, xrays, durable medical equipment, mammograms, colonoscopy after age 50 annually and rehabilitation Ishihara Chart - ANSWER-test for color blindness Sx and Sym of Left Sided Heart Failure - ANSWER-Tachypnea, labored breathing, rales/crackles in the lower bases of the lungs, which can develop into pulmonary edema. Food migraine triggers - ANSWER-aspartame, tyramine, nitrites, msg and/or red wine. foods thought to cause a change in the blood vessels and increased blood flow to the brain. Prophylaxis for dental work - ANSWER-recommended for pts at high risk for bacterial endocarditis: prosthetic valve, previous history of endocarditis, congenital heart defects. Sx and Sym of Measles - ANSWER-fever over 101, coryza, cough, conjunctivitis, rash and Kopliks spots on buccal mucosa Treponema pallidum - ANSWER-gram-negative spirochete bacterium causes syphilis Elisa Test for HIV - ANSWER-Needs to be confirmed with Western Blot New Onset of AFib - ANSWER-thyroid disease, prior to decreasing or stopping meds should do baseline blood work Pre-eclampsia classic triad - ANSWER-Hypertension, Edema, proteinuria Cushing Syndrome - ANSWER-Elevated serum cortisol levels Presumptive Signs of Pregnancy - ANSWER-amenorrhea, breast tenderness, n/v, fatigue, increased urinary freq Probable Signs of Pregnancy - ANSWER-Signs detected by examiner: enlarged uterus Hegars Sign: softening of lower portion of the uterus Positive Signs of Pregnancy - ANSWER-Audible fetal heart tones, cardiac activity on ultrasound Chadwicks Sign - ANSWER-Bluish discoloration of the cervix and vagina due to increased vascularity and congestion in the pelvic area during pregnancy Detecting HPV Infection on the Penis - ANSWER-acetic acid applied to shaft to look for acetowhite changes. lesions turn white OCD Signs and Symptoms - ANSWER-ritualistic behaviors repeated, increased anxiety, attempting to ignore repetitive behaviors, freq intrusive and repetitive thoughts OCD Treatement - ANSWER-Paroxetine (Paxil) antidepressants, clomipramine (anafranil) fluvoxamine (Luvox), fluoxetine (prozac), paroxetine (paxil) sertraline (zoloft) MMR and Pregnancy - ANSWER-MMR should not be administered to pregnant women. Women should avoid becoming Pregnant 28 days following vaccination UTI - ANSWER-Defined as presence of 100,000 organisms per ML of urine in asymptomatic pts. or 100 per mL with Pyuria (more than 7 wbcs per mL). Uterine Growth during Pregnancy - ANSWER-At 12 weeks palpable just above the symphasis pubis 20 weeks= level of umbilicus after 20 weeks measurements in cm approx= to weeks of gestation Phalen Test - ANSWER-used to identify inflammation of the median nerve seen w/ carpal tunnel syndrome. Full flexion of the wrist for 60 seconds. Positive findings= reproduction of the symptoms such as numbness and tingling of the thumb, index finger and middle finger Physiologic Anemia in Pregnancy - ANSWER-due to increase in blood plasma volume during pregnancy when compared t the production of RBCs Albuterol inhaler (Proventil) - ANSWER-SABA rescue, acts quickly to dilate tubes in lungs. Meds with steroids and leukotrienes helped inflamed channels stay open and clear but take longer to get into system. Rovsings Sign - ANSWER-id's an acute abdomen, performed with patient in supine position, palpating deep into the LLQ of the abdomen and having referred patient in RLQ Cauda Equina Syndrome - ANSWER-surgical emergency, sx/sym include: change in bowel/bladder function, acute pressure on sacral nerve root causing inflammatory and ischemic changes to the nerve and leading to permanent nerve damage Faun Tail Nevus - ANSWER-Sign of spina bifida== abnormal tuft of hair in the LS area of spine