3P Exam Study Questions with Answers 2023 Graded A+

What would cause decrease in Digoxin levels - Antacids Taking Pyridium for UTI, what can Pyridium cause? - Hemolytic Anemia What can PCOS result in? - increased insulin levels, Androgens, hirsutism What is a hypertensive used in pregnancy - Methyldopa What is a characteristic of Placenta Previa? - painless red bleeding What is a characteristic of Rheumatoid arthritis ? - Red hot joints Medications that cause ototoxicity - Aminoglycosides, nasal decongestants, antihistamines Treatment period for enterobiasis - 2 weeks CBC Interpretation - MCV - mean corpuscular volume help diagnose different types of anemia (High=macrocytic like B12, Low=microcytic like Fe anemia) Rhogham given at how many weeks gestation? - 27 weeks Janesway lesions - Happen with endocarditis, non painful lesions seen on hands and feet, Osler same but painful Warfarin management - forgot a dose? - If under 12 hours take missed dose, if over skip and need INR redraw Taking an ACE or ARB what to know? - ACE (dry hacking) cough starts 1-2 weeks after med started, ACE (Lol) ARB (sartan) first line in HTN avoid initially in african americans, angioedema can occur Contraindication for hydrochlorithiazide - sulfa allergy, asthma, PCN hypersensitvity Murmurs Systolic - MR=Mitral regurge (SOB/Fatigue HF) Peyton Manning=phys murmur (asymptomatic) AS=Aortic Stenosis (Angina, syncope HF) MVP=Mitral valve prolapse (palps, CP, "click") Diastolic Murmurs (ABnormal) - AR= Aortic Regurge (angina, HF, dizzinness, CP) MS=Mitral stenosis (Dyspnea, Afib) Motivated - Systole-S1 closure of AV Mitral/tricuspid valve (lub) Mitral, Tricuspid, atrioventricular valves Apples - Diastole s2 closure of the aortic pulmonic valves (dub) aortic pulmonic semilunar Abnormal (extra) heart sounds - S3- CHF; possible normal for adolescent athletes, S4 LVH poorly controlled HTN, unstable angina Assessment of PAD - antiplatelets (Plavix, ASA), Pentoxifylline (decreases blood viscosity) to treat, ankle brachial index to check, angiography gold standard to diagnose Coronary artery Disease tx - Atorvastatin/rovustatin- use high dose meds for LDL>150, watch for LFTs and arthralgia. Change type and dose if problems. Stabilization of plaque with statins HF treatment - ACEI, ARB, or ARNI with BB and aldosterone receptor antagonist Scabies Treatment (Sarcopter Scabiei) - Topical Permethrin massaged from head to soles of feet and wach off with shower or bath after 8-14 hours. Treat again in 1 week Names of skin findings - Macule; freckle <1 cm, Papule Macule >1 cm chloasma, Papule <0.5cm elevated nevi (molluscum wart), Plaque (psoriasis, lichen planus), Nodule 0.5-2 cm lipoma, vesicle (herpes simplex contact derm, Keloid - hypertrophic scar that is invasive beyond point of original injury Skin continued - Bulla-second degree burn, friction burn Wheal- raised, mosquito bite, hive Scales;dandruff Crusts-scab from abrasian, impetigo Tinea - Fungal infections; Tinea capitis-round patchy scales on scalp (cradle cap) treatment Grisefulvin take with high fat meal 4-6 weeks 500 mg tinea corporis -red and scaly plaque on trunk (ring worm) Treatment is an azole for 2 weeks Melanoma How do you assess - ABCDE Asymmetry, border, color, diameter >6 mm, elevation Psoriasis - silvery white scales, nails are pitted; positive Auspitz sign- pinpoint bleeding occurs when lesions are scraped Shingles (Herpes Zoster) - Unilateral dermatomal rash- painful as it progresses to vesicles, Acyclovir within 48-72 hours or symptoms. May only transmit chickenpox virus to susceptible patients that have not gotten exposed or vaccinated yet. Post herpetic neuralgia pain is longer than 1 month after rash has resolved. Contact dermatitis - papules or vesicles 5mm or less, scaling, crusting, oozing. Tx corticosteroids/antihistamines Acne Vulgaris - Inflamm disorder where androgen-dependent sebaceous glands produce excess sebum. Areas most commonly affected are face, anterior and posterior chest, arms and shoulders. Treatment: Erythromycin/Benzyl peroxide=limit exposure to sunlight peroxide can decrease resistance to erythromycin Atopic dermatitis - Patchy plaque like rash with inflammation. common in people with other atopic illnesses (asthma, allergic rhinitis) Eye Findings in HTN and DM - AV nicking-arteries indent and displace veins, cotton wool spots-gradual vision loss, flame hemorrhages- blot and dot hemorrhages Tx of acute sinusitis in adults and pediatrics - Viral symptomatic tx only, is bacterial- amoxicillin first line symptoms>10 days purulent nasal discharge, fever, unilateral face or tooth pain Snellen test - Test for visual acuity; CN II What medications can cause ototoxicity - Aminoglycosides (tx otitis externa) , loop diuretics, quinine, ASA Rhinitis - Eosinophils due to WORMS, wheezes, weird diseases. Most effective tx for allergic rhinitis- Fluticasone Flonase Acute bacterial rhinosinusitis - For empiric tx of patients with acute bacterial rhinosinusitis who are allergic to penicillin, the best alternative first line therapy is Doxycycline Which immunoglobulin is responisble for the symptoms in the patient with allergic rhinitis? - IgE Assessment of a 4 year old visual acuity resulted in 20/30 in L eye and 20/40 in R eye. - Means vision is normal for his age, 20/20 vision at 6 years old Distinctive feature of cataracts - Absent red reflex Meclizine - Given for patients who present with Positional vertigo