NSG 6420 FINAL (A+ graded latest update)

NSG 6420 FINAL (A+ graded latest update) Most accurate test in diagnosing pancreatitis? Correct answer: LIPASE When to d/c an ACE I based on creatinine Correct answer: 2.0 Predisposing factors of hyperthyroidism Correct answer: Fam hx of hyperthy or other autoimmune, RA, vitiligo, pernicious anemia, trisomy 21, pregnancy/mothers with grave's, puberty, myasthenia gravis, addison, amiodarone, Iodine contrast dye, stress, sex steroids, DM I, SLE, smoking, neck radiation hypothyroidism prevalence Correct answer: More prevalent in women than men at a ratio of 5- 10:1 More common in older: >60 yrs increases to 6-10% of women and 2-3% of men with 13.7% with subclinical presentation DM diagnosis Correct answer: A1C: >/6.5% FPG >/126 2 hour PP glucose >/200 during OGTT Random: >/200 with sx DM 2 symptoms Correct answer: fatigue, recurrent infections, recurrent vaginal yeast infections, prolonged wound healing, visual changes, may have classic sx of type 1 (polys) When is Niacin used? Correct answer: In combo with other meds to tx triglycerides Common sign associated with parkinsons? Correct answer: pill rolling tremor First line tx for OA? Correct answer: Acetaminophen MOA of metformin? Correct answer: Pulls glucose into muscle cells to be utilized -enhances insulin sensitivity at tissues -Reduces glucose production by liver When is MRI indicated in low back pain? Correct answer: neuro defects Test for tenosynovitis? Correct answer: Finkelstein Tests for Carpal tunnel? Correct answer: Phalen's and Tinnel's Rotator cuff injury test Correct answer: Inability to maintain abduction Initial treatment for diagnosis of bursitis? Correct answer: Rest/avoidance of activity and NSAIDs OA risk factors? Correct answer: Older age, sex (women), obesity, joint injuries, genetics, bone deformities OGTT diagnoses what? Correct answer: gestational diabetes Lab indicative of hypothyroidism? Correct answer: TSH primary screening test: Increased TSH, dec free T4: primary Central: Dec TSH, serum T4 dec, notice impaired TSH response to TRH Tx levels above 10 or if symptomatic Normal TSH levels? Correct answer: 0.40-4.2 Hypothyroidism labs? Correct answer: Increased TSH Decreased T3 T4 S/sx of grave's Correct answer: Diffuse enlargement of both thyroid lobes, with uniform uptake of isotope and elevated radioactive iodine uptake -weight loss/inc appetite Fatigue/weakness, tremors, heat intolerance, nervousness/anxiety, heart palps, consipation/diarrhea, swelling, inc sweating, diplopia, fine hair, moist smooth skin, hyperactivity, nightmares RAI in hyperthyroid tx Correct answer: single dose to 2 doses of 75-200 mCi/g capsule orally to render hypothyroid **Tx of choice for Grave's dx -Euthyroid in 2-6 months **NOT IN children or pregnancy Lantus- type of insulin and peak Correct answer: Long-acting -Peak: no pronounced peak -onset 1-2 hours duration 24+ hours CKD risk factors Correct answer: DM, HTN, Heart dx, smoking, obesity, high cholesterol, AA/NA/Asian-am, fam hx, >65yrs Gold standard for diagnosis of CKD? Correct answer: MVP heart sound Correct answer: crisp mid systolic click Rovsing sign Correct answer: RLQ pain with palpation of the LLQ- suggests peritoneal irritation in the RLQ precipitated by palpation at a remote location Obturator sign Correct answer: RLQ pain with internal and external rotation of flexed right hip- suggests inflamed appendix is located deep in the right hemipelvis Psoas sign Correct answer: RLQ pain with extension of right hip or with flexion of right hip against resistance- inflamed appendix located along course of right psoas muscle -(lifting extended right leg against resistance) Murphy sign Correct answer: Increased tenderness with inspiration in RUQ- gallbladder Tenderness at McBurney's point Correct answer: appendicitis Negative HbsAg Positive HbsAb Negative HbcAB Correct answer: indicative of immunization Synthroid dosage Correct answer: Kg x 1.6 Hypothyroid prevalence in countries Correct answer: prevalence in US is low compared to rest of world 0.3% d/t iodine consumption S/sx hypothyroidism Correct answer: depression, forgetfulness, los of hair, weight gain, dry skin, infertility, brady, goiter, brittle nails, cold skin, constipation, fullness in throat (hashimoto), jaundice, and distention, muscle aches Hypothyroidism physical findings Correct answer: decreased mentation, swelling hands and feet (non pitting), periorbital puffiness, coarsening of voice, brady, inc DBP, reduced SBP, delayed relaxation of DTR (achilles) Most common etiology of cervicitis? Correct answer: Infection: STDs -Chlamydia. trachomatis (number 1)and N.Gonorrhoeae Choice of antibiotics for cervicitis? Correct answer: Azithromycin and doxy DOC for tx of trich Correct answer: metronidazole or tinidazole Tx of choice for epididymitis Correct answer: ceftriaxone plus doxycycline Skin lesion fluoresces under a wood's lamp- what microscopic finding is consistent with this? Correct answer: Spores