3P Exam Study Exam With Verified Solutions Questions Accurately Solved.

What would cause decrease in Digoxin levels - correct answer Antacids Taking Pyridium for UTI, what can Pyridium cause? - correct answer Hemolytic Anemia What can PCOS result in? - correct answer increased insulin levels, Androgens, hirsutism What is a hypertensive used in pregnancy - correct answer Methyldopa What is a characteristic of Placenta Previa? - correct answer painless red bleeding What is a characteristic of Rheumatoid arthritis ? - correct answer Red hot joints Medications that cause ototoxicity - correct answer Aminoglycosides, nasal decongestants, antihistamines Treatment period for enterobiasis - correct answer 2 weeks CBC Interpretation - correct answer 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? - correct answer 27 weeks Janesway lesions - correct answer Happen with endocarditis, non painful lesions seen on hands and feet, Osler same but painful Warfarin management - forgot a dose? - correct answer If under 12 hours take missed dose, if over skip and need INR redraw Taking an ACE or ARB what to know? - correct answer 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 - correct answer sulfa allergy, asthma, PCN hypersensitvity Murmurs Systolic - correct answer 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) - correct answer AR= Aortic Regurge (angina, HF, dizzinness, CP) MS=Mitral stenosis (Dyspnea, Afib) Motivated - correct answer Systole-S1 closure of AV Mitral/tricuspid valve (lub) Mitral, Tricuspid, atrioventricular valves Apples - correct answer Diastole s2 closure of the aortic pulmonic valves (dub) aortic pulmonic semilunar Abnormal (extra) heart sounds - correct answer S3- CHF; possible normal for adolescent athletes, S4 LVH poorly controlled HTN, unstable angina Assessment of PAD - correct answer antiplatelets (Plavix, ASA), Pentoxifylline (decreases blood viscosity) to treat, ankle brachial index to check, angiography gold standard to diagnose Coronary artery Disease tx - correct answer 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 - correct answer ACEI, ARB, or ARNI with BB and aldosterone receptor antagonist Scabies Treatment (Sarcopter Scabiei) - correct answer 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 - correct answer 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 - correct answer hypertrophic scar that is invasive beyond point of original injury Skin continued - correct answer Bulla-second degree burn, friction burn Wheal- raised, mosquito bite, hive Scales;dandruff Crusts-scab from abrasian, impetigo Tinea - correct answer 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 - correct answer ABCDE Asymmetry, border, color, diameter >6 mm, elevation Psoriasis - correct answer silvery white scales, nails are pitted; positive Auspitz sign- pinpoint bleeding occurs when lesions are scraped Shingles (Herpes Zoster) - correct answer 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 - correct answer papules or vesicles 5mm or less, scaling, crusting, oozing. Tx corticosteroids/antihistamines Acne Vulgaris - correct answer 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 - correct answer Patchy plaque like rash with inflammation. common in people with other atopic illnesses (asthma, allergic rhinitis) Eye Findings in HTN and DM - correct answer 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 - correct answer Viral symptomatic tx only, is bacterial- amoxicillin first line symptoms>10 days purulent nasal discharge, fever, unilateral face or tooth pain Snellen test - correct answer Test for visual acuity; CN II What medications can cause ototoxicity - correct answer Aminoglycosides (tx otitis externa) , loop diuretics, quinine, ASA Rhinitis - correct answer Eosinophils due to WORMS, wheezes, weird diseases. Most effective tx for allergic rhinitis- Fluticasone Flonase Acute bacterial rhinosinusitis - correct answer 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? - correct answer IgE Assessment of a 4 year old visual acuity resulted in 20/30 in L eye and 20/40 in R eye. - correct answer Means vision is normal for his age, 20/20 vision at 6 years old Distinctive feature of cataracts - correct answer Absent red reflex Meclizine - correct answer Given for patients who present with Positional vertigo Pterygium - correct answer growth on conjunctiva of fleshy tissue, sx redness, swelling, yellow spot or bump dry itchy like sand in eye Eye emergencies - correct answer papillaedema (increase ICP, swollen optic disc engorged tortuous retinal veins), Acute closed angle glaucoma is unilateral eye pain rapid onset and loss of vision Presentation with foreign body in eye - correct answer only remove with wet cotton swab if not able to send to opthamologist Meniere's Disease - correct answer A 45 year old patient complains of vertigo, tinitus, and pressure in the right ear Hyperopia - correct answer Light that is focused behind the retina causes the visual disturbance Mononuleosis - correct answer Most commonly caused by EBV can be passed sexually Which medication is most commonly associated with hypoglycemia - correct answer Glyburide How does myxedema present and what is its indicative of - correct answer found in patients with hypothyroid, hypothermia, thickening of the tongue, and disorientation Assessment findings PCOS - correct answer Hirsutism, hyperinsulinemia, elevated lipids, abnormal hair, acne Assessment finding and RX for hyperthyroidism - correct answer M/C cause is Graves' disease, finding include tachyC, Afib, weight loss, hyperactivity, warm, moist skin, flushed Hyperprolactinemia - correct answer Menstrual dysfunction, ED, pain in breast, loss of libido, lactation, vaginal dryness, infertility Hyperandrogenism - correct answer High levels of Androgens in females, sx include acne, seborrhea, hair loss on scalp, increased body or facial hair, infrequent or absent menstruation, Can be caused by PCOS DM - correct answer A1c over 6.5 or fasting glucose over 126, initiate Metformin at initial diagnosis Assessment of neuropathy - correct answer In distal lower extremities, long effect of hyperglycemia, paresthesias and burning Treatment and Presentation of Giardiasis - correct answer Foul smelling stools, abdominal pain, flatulence spread fecal-oral route. Tx is Metronidazole 250 mg TID Presentation and assessment of Cirrhosis - correct answer Coagulopathy, variceal bleed, hepatic encephalopathy, extrahepatic sx- neuro, psychiatric, arthralgia, autoimmune disorders, glucose intolerance. Pt early stage of cirrhosis likely to have thrombocytopenia Assessment of Hepatitis - correct answer Malaise, fever, jaundice, fatigue, weight loss, joint pain, dark urine, RUQ pain, liver enlargement, pancytopenia. Elevated ALT/AST, bili, alk phos GERD - correct answer Pyrosis (heartburn), burning beneath sternum, regurgitation, postnasal drip, throat clearing, chronic cough, chronic sore throat, hoarseness. Tx 8 week course of PPI H Pylori Algorithm - correct answer Amoxicillin BID, Clarithromycin BID, PPI BID x 14 days. If PCN allergy tx would change to Metronidazole BID, Clarithromycin BID, PPI BID x 14 days Which of the following symptoms associated with GERD is considered an alarm symptom? - correct answer Odynophagia (Pain with swallowing, maybe w/wo difficult swallowing) Crohn's Disease - correct answer Chronic bloody diarrhea- fatigue, abdominal pain, prolonged diarrhea, with/without bleeding, weight loss and fever. Skip lesions, cobblestone appearance and fistulas common. Slow progressive inflammation small intestine and or large intestine or TI. TX- Budesonide 5-aminosalicylates Common pathogens that cause Gastroenteritis - correct answer Common pathogen gastroeneritis <1 y.o., adults (norovirus, enteric adenovirus, astrovirus), campylobacter jejuni in children, Salmonella most common foodborne illness, Giardia Lambia most common parasitic Pyloric Stenosis Presentation - correct answer narrowing of the pyloric sphincter due to hypertrophy of pyloric muscle- forceful vomiting usually 2-3 weeks of age Hepatitis B - correct answer Bloodborne/body fluids highly infectious, patients who test positive for HBV and HCV should also be screened for HIV due to common transmission routes Pinworm infection - correct answer Enterobiasis vermicularis- Helminths can be transmitted by the bite of blood sucking insects. TX: 3 doses of medication sep by 3 weeks Pyrantel Pamoate- two weeks apart and retest in two weeks post tx Ulcerative Colitis - correct answer Only present in colon Pancreatitis - correct answer Pancreas Enzymes amylase and lipase are inactivated when the pH is below 5. which of the folowwing is NOT an enzyme produced in the panceas? Pepsin