3P Exam Study Guide

3P Exam Study Guide 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 LDL150, 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