Leik Book Exam Tips, questions and answers with verified content. 100% correct

Leik Book Exam Tips, questions and answers with verified content. 100% correct What are the main 2 bacteria in CAP? S. Pneumoniae and H. Pneumoniae What are the top two bacteria in atypical pneumonia? mycoplasma pneumoniae Chlamydia pneumoniae What is the color of sputum in bacterial pneumonia? rust colored or blood tinged COPD/smokers are more likely to have what organism in CAP? H. Flu Do you give antibiotics in bronchitis? NOOOOOOOO What is required for CAP diagnosis? presentation and chest x-ray DO NOT PICK PHLEGM FOR C&S What does cholestertoma present with? hearing loss, no TM, purulent exudate with odor and yellowing to whitish cauliflower mass in the middle ear What to use in patients with a penicillin allergy? macrolides or gram positive quinolones What does a Rinne test of BC>AC mean? conductive hearing loss What is the finding of the Weber test for conductive hearing loss? lateralization to the bad ear What does a normal finding on a Rinne test mean? AC>BC and sensorneuro hearing loss or normal What is the first line treatment for seasonal allergic rhinitis? topical steriod nsasl spray What do you give for new onset urticaria? benadryl or zyrtec How does mono usually present? generalized maculopapular rash enlarged tonsils with cryptic exudate sore throat enlarged cervical nodes What is treatment for otitis externa? cortisporin What is the most common pathogen in otitis externa? pseudomonas How long should someone hold out from contact sports after being diagnosed with mono? 4 weeks What kind of contraindications do timolol drops have? same as beta blockers What is a red, spot like rash that starts on the palms an feet/soles with headache and myalgia? Rocky mountain spotted fever Does melanoma have to be flat? Nope! can be raised What does 20/40 vision mean? It means that patient can see at 20 feet what a normal person can see at 40 What is the most common treatment for ceruminosis? carbamde peroxide What are the causes for herpes keratitis? herpes simplex or varicella zoster Where are the shingles located in herpes keratitis? what nerve Trigeminal nerve What do you use fluorescein strips for? abrasion or herpes keratitis What is a major skin symptom of erythema migrains? target lesion in lyme disease What is the treatment for lyme disease? doxy What is actinic keratosis a precursor to? squamous cell carcinoma if actinic keratosis is bad, what can you do? 5-fu, topical cream What is a big example of a A DMARD? methotrexate What is mild acne treated with only? Topicals What is a Christmas tree pattern or a herald patch seen in? pityriasis rosea What is prophylaxis for post herpatic neuralgia? TCA like amitriptyline What is the organism in erysipelas? Strep What is the preferred antibiotic in bites? augmentin If the patient is allergic to bactrim, what can be used for an MRSA infection? doy or minocycline or clindamycin What is treatment for a recluse spider bite? antibiotics on the wound cold packs NSAIDS Where are all murmurs with apex found? MITRAL Where is the mitral area described as? fifth ICCS on the left side of the sternum medial to the midclavicular line If the apex murmur occurs during S1, what is ? mitral regurgitation If the apex murmur is S2? Mitral Stenosis where does mitral regurgitation radiate? To the axilla Where does Aortic Stenosis radiate? to the neck ONLY SYSTOLIC MURMURS RADIATE ON THE TEST ... What heart sound is a sign of CHF? S3 What heart sound is indicative of LVH? S4 Where is a split S2 best heard? At the pulmonic area, left sternal border How do you treat a subungal hem? trephenation What OTC med can be used for PHN and trigeminal neuralgia? capsacin cream what is the maximum amount of days toradol can be used? 5 days what is the max dose of tylenol in na day? 3-4g/d does asa irreversibly suppress platetlets? yes, for 7 days what symptom would make you think asa toxicity? tinnitus when is a thrill first palpated in a murmur? grade 4 what should be ruled out with a pulsitile mass? AAA what do you order to rule this out? ultrasound and ct what is a goal INR for a-fib? 2-3 what are the causes of AF? alcohol CAD CHF history of an MI older age hypertension stimulants hyperthyroid cocaine what do you do it the INR is between 4.01 to 4.99? hold one dose. DO NOT GIVE VITAMIN K what is the first line treatment for HF? ace or arb what are meds for raynauds? calcium channel blockers what is the first line treatment for hypertension? lifestyle changes and diet what is the first line treatment for high cholesterol? lifestyle changes and meds if needed what is an example of a high intensity statin? atorvastatin 40-80mg or rosuvastatin 20-40 mg if an adult has a ldl of greater than 190, what med do they get? high intensity statin if tryglycerides are elevated above 500, they need? fenofibrate first before treating the LDL What do high triglycerides cause? pancreatitis what are signs of bacterial endocarditis? splinter hemorages jane way lesions oslers nodes what is metabolic syndrome criteria? obesity htn hyperlipidemia elevated trigs low hdl elevated fasting glucose insulin resistance what is nonalcoholic fatty liver disease signs? negative hep panel and slight elevation in ast and alt what is considered abdominal obesity in males? >40 inches what is considered abdominal obesity in females? >35 inches what is the mnemonic for PEF? hag (height, age, gender) What is an overweight BMI? greater than 25 what is first line treatment for mild COPD? saba or short acting anticholinergic if the patient is on a saba, what do you pick? add a short acting anticholinergic like atrovent if the short acting are not working, what do you add? laba what are two types of labas? salmeterol and formeterol what is the only drug class that is for rescue? saba 5 mm induation for mantoux hiv re3cent contact with tb previous tb immunocompromised induration 10mm on mantoux recent immigrant child under 4 iv drug user homeless health care worker high risk congregate setting like a jail induration of 15mm of more everyone else what is step 3 for asthma? fev1 of 60-80% what is fev1 greater than 80% mild persistant if the patient is step 3, what meds should they be on? low dose ics and LABA when someone is having an asthma attack, how do they sound? quiet after the saba? wheezing what is the first line treatment for severe asthmatic exacerbation or resp distress epi What is subclinical hypothyroidism? elevated TSH normal free T4 if tsh is greater than what, need work up? 5 what side effect is common in older people who are starting levothyroxine? cardiac what dose should you start with in older adults 12.5-25 mcg Do you treat subclinical hyperthyroidism no, recheck in 6 months when do you recheck tsh 6-8 weeks if the tsh is what, the dose is right? 0.5-5 what does radioactive iodine result in? hypothyroidism what does chronic amenorrhea and hypermetabolism result in? osteoporosis what does rapid acting insulincover? 1 meal at a time what does regular insulin cover? from meal to meaL what doess nph insulincover? from breakfast to dinner what does lantus cover once a day what is first line treatment for dm 2? metformin what do you do if the patient is taking 500 of metformin once daily and the a1c is high increase to 500 bid what do you do if the patient is taking 500 metformin bid and the a1c is still high? increase to 1000 bid what meds can you use with metformin? sulfonurea like glipizide or actos when do you start basal insulin in dm 2? if the patient cannot tolerate metformin and the level is greater than 9 or if two oral drugs and still higher than 9 what are findings in hypertensive retinopathy? copper wire, av nicking what is the length of an a1c? 3 months what diabetic med can make heart failure worse? actos What are the microvascular complications of diabetes? retinopathy, nephropathy and neuropathy What are the macrovascular complications of diabetes? cad, pad or stroke what is charcots foot and ankle more common in? diabetes What is lid lag a sign of? hyperthyroidism what are alopecia of the outer 3rd of the eyebrow indicitave of? hypothyroid What is Barrett's esophagus related to? esophageal cancer how to diagnose barretts? upper endo with biopsy what is cullens sign? It is the presence of superficial edema and bruising around the umbilicus - it is suggestive of acute pancreatitis or an intraabdominal bleed. What is Grey Turner's sign? Blue discoloration on the flanks. A sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity what is pancreatitis pain? severe mid epigastric pain that radiates to the midback what are psos and obturator positive for? appy how many days do h-pylori ulcers need treatedfor? 14 days what are worrisome signs for esophageal cancer? pain with swallowing, early satiety and weight loss what is the treatment for IBS increased fiber what is the treatment for acute diverticulitis increase fiber if the patient needs treated for gerd, what to start with? h2 then move to ppi what does a HBsAG-positive always mean? they have an acute infection are PCR tests for antibodies? nope, they are for the presence of viral rna what hep has the highest risk for liver cancer or cirrhosis? hep c what is the first step in testing for hep c hcv antibody if the hcv antibody is reactive, what do you do order and hcv rna what does a lone elevated ggt mean? alcohol when is alk phos elevated? during growth spurts what must you have to get hep d? hep b which test is more sensitive to liver damage, ast or alt alt Where is AST also found? heart muscle and skeletal system what are senstivie tests for pancreatitis? amylase and lipase what is the definition of a uti >100,000 if a healthy woman has an uncomplicated uti, how many days can you treat for? 3 days what is indicitive for pyelo on a urine wbc casts with protein is pyelo what is better for kideny fuction, bun or creatinie creatinine what is the best measure gfr which kidney sits lower right due to liver what do bands indicate? super infection what increases the risk of uti in women spermicide if you have a rash on the tip of noses or temple area, what do you need to look for shingles what cranial nerve is infected with shingles that would cause blindness? 5 what is temporal arteritis treated with high dose steriods what is the screening for temporal arteritis? sed rate what is the inflammation in CTS? median nerve what are the symptoms of cluster? tearing and nasal congestion, occurs several times a day