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ADA screening for DM in Children
-symptomatic children (polyuria, polydipsia, polyphagia, blurred vision) regardless of risk
factors
-asymptomatic children after puberty or 10 years of age or older if overweight or obese
(>85th percentile). Plus 1 of the following:
*T2DM in 1st or 2nd degree relative
*high risk racial/ethnic group
*signs of insulin resistance (HTN, dyslipidemia, acanthosis nigricans, PCOS, SGA)
*maternal hx of DM or GDM during the child's gestation
Statistics
- leading causes of death: Heart disease, cancer, lung disease
- leading cause of cancer death: lung
- leading cause of death in adolescents: accidents
- most common cancer: skin.
- in males: prostate. in females: breast
suicide: males more successful, women more attempts. highest rate is older white
males.
Osgood-Schlatter:
knee pain in young adults, overuse. Repetitive stress pain, tenderness, swelling at the
tendon's insertion site. The tibial tuberosity. Rule out avulsion fracture if there is an
acute onset and order a lateral xray. RICE. Usually stops when the growth stops.
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If patient has right sided weakness, etc. the CVA occurred where
left side
initial evaluation of symptoms of acute prostatitis
Urinalysis and urine culture
A 65-year-old woman presents for a follow-up examination after a new patient visit. She
has not seen a healthcare provider for several years. She is a smoker and her
hypertension is now adequately controlled with medication. Her mother died at age 40
from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30,
and LDL = 200. In addition to starting Therapeutic Lifestyle Changes, the nurse
practitioner should start the patient on:
1. bile acid sequestrant.
2. a statin drug.
3. a cholesterol absorption inhibitor.
4. low-dose aspirin.
A statin drug
Ortolani's Click
a click is heard or felt as dislocation is reduced (developmental dysplasia of hip) (good
until one year)
Which of the following laboratory tests should a nurse practitioner order when the
suspected diagnosis is temporal arteritis?
Erythrocyte sedimentation rate (ESR)
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What are narrow therapeutic index drugs?
1. Warfarin sodium (Coumadin): monitor INR
2. Digoxin (lanoxin): monitor digoxin level, EKG, electrolytes(potassium, magnesium,
calcium)
3. Theophylline: monitor blood levels
4. Carbamazepime (Tegretol) and Phenytoin (Dilantin): Monitor blood levels
5. Levothyroxine: Monitor TSH
6. Lithium: Monitor blood levels, TSH (risk of hypothyroidism)
Otitis Externa tx
Fluoroquinolone & Polymyxin B cortisporin drops
An elderly male patient complains of a new-onset, left-sided temporal headache
accompanied by scalp tenderness and indurated temporal artery. The NP suspects
temporal arteritis. What screening test would you order to assist with diagnosis?
sedimentation rate (expect to be very elevated)
Basal Cell Carcinoma
Pearly domed nodule with overlaying telangiectatic vessels. Could be plaque, papule,
possible central ulceration and crusting. Dx: Biopsy Tx:
Normal, healthy woman of reproductive age
white, clear, flocculent(physiologic leukorrhea), no complaints, pH 3.8-4.2 (toward
acidic), no odor, microscopic shows lactobacilli (gram+bacteria)
Multiple infections from bacteria and fungus?
Screen for HIV
Screening Tests
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