Anion gap formula and normal value - Answer(Na + K) - (HCO3 + Cl)
Normal AGAP: 4-12
Asthma pt & Beta Blockers - Answeruse a cardioselective BB such as metoprolol or atenolol because
nonselective BB (carvedilol and labetolol) can cause a s/e of wheezing/bronchospasm
Glyburide (sulfonyurea) - Answerstimulate the release of insulin from beta cells/increase number of
insulin receptors
**contraindicated in elderly because they have low apetites (hypoglycemia risk) and not to be used
in pt with GFR <60
Osteopenia vs. Osteoporosis - AnswerOsteopenia: bone mineral density between -1 and -2.5
Osteoperosis: < -2.5 (first line treatment is a bisphosphonate like Alendronate (fosamax). undergo
DXA screening (bone density screening).
also described as a metabolic bone disorder characterized by inadequete mineralization of the bone
matrix. USPSTF recommends screening all women over age 65 but no repeat screenings
ABI ankle brachial index - Answernormal range: 0.9 and 1.4.
An ABI below <0.9 is PAD
phenytoin (dilantin) - Answernormal range: 10-20.
s/e: gingival hyperplasia
,Valproic Acid (Depakote) - Answernormal range: 50-100, >100 is toxic
s/e: hepatotoxicity
Glasgow Coma Scale (GCS) - AnswerEyes (4), Verbal (5), Motor (6)
Ranson's score (used for Pancreatitis) - AnswerGeorge - greater than 55 years of age (>70gallstone)
Washington - WBCs >16,000
Got - Glucose >200
Lazy - LDH >350
After* - AST >250
-----------------------------------------------then 48 hrs later:
He - Hct drop >10
Broke - BUN increase >5
C - Calcium <8
A - Arterial Pao2 <60
B - Base deficit >4
E - Estimated fluid sequestration >6,000 ml
patellofemoral pain - Answerpain around the rim of knee or back of knee usually caused by over
use/going up stairs/hiking repeatedly "runners knee". pain around underneath knee.
Tx: PT and strenghtening exercise best things... NSAID may help
ganglion cyst - Answerfluid-filled sac arising from joint capsules or tendons, typically in the hand.
transilliminates (differntiates from a solid mass). if any neuro symptoms like
paresthesia/numbness/coolness get an ultrasound or MRI for vetter visualization
Anterior Cruciate Ligament (ACL) injury - AnswerCaused by sudden stop with change in direction.
"popping sound". positive anterior drawer sign. positive lachman test (
iliotibial band syndrome - Answeran overuse injury caused by this band rubbing against bone, often
in the area of the knee. pain starts when climbing stairs or running down hills.
,tx: rest, foam roll, ice, NSAIDS,
ankylosing spondylitis - Answera form of rheumatoid arthritis that primarily causes inflammation of
the joints between the vertebrae in the spine - causing stiff back
it can affect almost any organ system.
ts: NSAIDS, second line intrasrticular steroid injection for unrelieved pain
Paget's disease - Answera bone disease of unknown cause characterized by the excessive breakdown
of bone tissue, followed by abnormal bone formation/remodeling
USPSTF falls recommendation - Answerat increased risk, recommend PT or exercise. no Vit D
recommendations. multifcatorial approachis selective when determining who needs it.
posterior cruciate ligament tear - Answermost occur during a fall on the flexed (bent) knee or a crush
injury. symptoms: joint effusion, internal pain and posterior drawer test*
- treatment: PRICE, physical therapy and rehabilitation, surgical repair
patellar tendonitis - Answerrunning injury, will not cause effusion. pain anteriorly.
Meniscus tear - Answerapleys compression test can help identify laxity. pt reports "catching or
locking"
most common cause of fever of unknown origin in adults - Answergiant cell arteritis
FRAX Tool (Fracture Risk Assessment Tool) - AnswerEstimates risk of osteoporotic fracture in the
next 10 years based off BMI, parental fcx history, and smoking h/o
best DVT prophylaxis in hip fcx pt - Answerlow molecular weight heparin
, trigger finger - AnswerA condition whereby the finger flexors contract but are unable to reextend
because of a nodule within the tendon sheath or due to the sheath being too constricted to allow for
free motion.
tx: splint and rest 3-6weeks usually resolves itself. stepwise NSAID, then steroid injection, and
surgery if conservative management fails.
before starting plaquenil for RA... - Answermust have an optho exam, cmp, cbc, and lfts
Gonorrhea - Answerbacterial STD, often asymptomatic but can causedysuria and yellow-green
discharge in men and women
tx: ceftriaxone 250 mg IM x 1 dose
sometimes add in azithromycin 1 g PO x 1 dose for chlamydia just in case
chlamydia - Answer"C" **for most common STD** in US
parastic STD, often asymptomatic, but can cause cloudy discharge, dysuria, postcoital bleeding
tx: azithromycin 1 g PO x 1 dose
or doxycylcine (vibramycin) 100 mg PO BID x 7 days
Syphillis - AnswerChronic STD caused by a spirochete bacteria (treponema pallidum)
primary- <1 yr; chacre is painless (indurated ulcer) at site of exposure
secondary- flu slike symptoms, rash on palms/plantar sufaces and mucous patches, maliase,
arthralgia, lymphadenopathy
tertiary- leukopenia, AA, meningitis, cardiac failure, hemiplegia
RPR test and FTA-ABS
tx:
primary/secondary - benzathine penicillin G 2.4 milllion units IM
Normal AGAP: 4-12
Asthma pt & Beta Blockers - Answeruse a cardioselective BB such as metoprolol or atenolol because
nonselective BB (carvedilol and labetolol) can cause a s/e of wheezing/bronchospasm
Glyburide (sulfonyurea) - Answerstimulate the release of insulin from beta cells/increase number of
insulin receptors
**contraindicated in elderly because they have low apetites (hypoglycemia risk) and not to be used
in pt with GFR <60
Osteopenia vs. Osteoporosis - AnswerOsteopenia: bone mineral density between -1 and -2.5
Osteoperosis: < -2.5 (first line treatment is a bisphosphonate like Alendronate (fosamax). undergo
DXA screening (bone density screening).
also described as a metabolic bone disorder characterized by inadequete mineralization of the bone
matrix. USPSTF recommends screening all women over age 65 but no repeat screenings
ABI ankle brachial index - Answernormal range: 0.9 and 1.4.
An ABI below <0.9 is PAD
phenytoin (dilantin) - Answernormal range: 10-20.
s/e: gingival hyperplasia
,Valproic Acid (Depakote) - Answernormal range: 50-100, >100 is toxic
s/e: hepatotoxicity
Glasgow Coma Scale (GCS) - AnswerEyes (4), Verbal (5), Motor (6)
Ranson's score (used for Pancreatitis) - AnswerGeorge - greater than 55 years of age (>70gallstone)
Washington - WBCs >16,000
Got - Glucose >200
Lazy - LDH >350
After* - AST >250
-----------------------------------------------then 48 hrs later:
He - Hct drop >10
Broke - BUN increase >5
C - Calcium <8
A - Arterial Pao2 <60
B - Base deficit >4
E - Estimated fluid sequestration >6,000 ml
patellofemoral pain - Answerpain around the rim of knee or back of knee usually caused by over
use/going up stairs/hiking repeatedly "runners knee". pain around underneath knee.
Tx: PT and strenghtening exercise best things... NSAID may help
ganglion cyst - Answerfluid-filled sac arising from joint capsules or tendons, typically in the hand.
transilliminates (differntiates from a solid mass). if any neuro symptoms like
paresthesia/numbness/coolness get an ultrasound or MRI for vetter visualization
Anterior Cruciate Ligament (ACL) injury - AnswerCaused by sudden stop with change in direction.
"popping sound". positive anterior drawer sign. positive lachman test (
iliotibial band syndrome - Answeran overuse injury caused by this band rubbing against bone, often
in the area of the knee. pain starts when climbing stairs or running down hills.
,tx: rest, foam roll, ice, NSAIDS,
ankylosing spondylitis - Answera form of rheumatoid arthritis that primarily causes inflammation of
the joints between the vertebrae in the spine - causing stiff back
it can affect almost any organ system.
ts: NSAIDS, second line intrasrticular steroid injection for unrelieved pain
Paget's disease - Answera bone disease of unknown cause characterized by the excessive breakdown
of bone tissue, followed by abnormal bone formation/remodeling
USPSTF falls recommendation - Answerat increased risk, recommend PT or exercise. no Vit D
recommendations. multifcatorial approachis selective when determining who needs it.
posterior cruciate ligament tear - Answermost occur during a fall on the flexed (bent) knee or a crush
injury. symptoms: joint effusion, internal pain and posterior drawer test*
- treatment: PRICE, physical therapy and rehabilitation, surgical repair
patellar tendonitis - Answerrunning injury, will not cause effusion. pain anteriorly.
Meniscus tear - Answerapleys compression test can help identify laxity. pt reports "catching or
locking"
most common cause of fever of unknown origin in adults - Answergiant cell arteritis
FRAX Tool (Fracture Risk Assessment Tool) - AnswerEstimates risk of osteoporotic fracture in the
next 10 years based off BMI, parental fcx history, and smoking h/o
best DVT prophylaxis in hip fcx pt - Answerlow molecular weight heparin
, trigger finger - AnswerA condition whereby the finger flexors contract but are unable to reextend
because of a nodule within the tendon sheath or due to the sheath being too constricted to allow for
free motion.
tx: splint and rest 3-6weeks usually resolves itself. stepwise NSAID, then steroid injection, and
surgery if conservative management fails.
before starting plaquenil for RA... - Answermust have an optho exam, cmp, cbc, and lfts
Gonorrhea - Answerbacterial STD, often asymptomatic but can causedysuria and yellow-green
discharge in men and women
tx: ceftriaxone 250 mg IM x 1 dose
sometimes add in azithromycin 1 g PO x 1 dose for chlamydia just in case
chlamydia - Answer"C" **for most common STD** in US
parastic STD, often asymptomatic, but can cause cloudy discharge, dysuria, postcoital bleeding
tx: azithromycin 1 g PO x 1 dose
or doxycylcine (vibramycin) 100 mg PO BID x 7 days
Syphillis - AnswerChronic STD caused by a spirochete bacteria (treponema pallidum)
primary- <1 yr; chacre is painless (indurated ulcer) at site of exposure
secondary- flu slike symptoms, rash on palms/plantar sufaces and mucous patches, maliase,
arthralgia, lymphadenopathy
tertiary- leukopenia, AA, meningitis, cardiac failure, hemiplegia
RPR test and FTA-ABS
tx:
primary/secondary - benzathine penicillin G 2.4 milllion units IM
