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Biomed for NCCAOM 2019

Compartment Syndrome Serious condition involving inc. pressure, can lead to muscle and nerve damage and blood flow problems. Acute or chronic, resulting from trauma or overuse. Emergency situation, bc insufficient blood supply could lead to loss of limb. Fasciotomy is tx.
6P S/S of Compartment Syndrome Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia (inability to regulate core body temp)
Ehlers-Danlos Syndrome A group of genetic connective tissue disorders characterized by unstable, hypermobile joints, loose, "stretchy" skin, and fragile tissues.
Raynauds Syndrome Hands appear white (no blood flow) to blue (zero oxygen) to red (return of blood flow) Causd by Crest Syndrome, emotional stress
Carpal Tunnel Syndrome Def. Entrapment of the median nerve, decrease in size or space of the carpal tunnel, leading to paresthesia, pain or occasional paralysis.
Carpal Tunnel Syndrome causes Can be precipitated by overuse of wrist flexors, diabetes mel, or a thyroid dysfunction. Commonly occurs in pregnant and middle aged women.
Carpal Tunnel Syndrome S/S Aching over thenar eminence of hand and proximal forearm and may extend into shoulder. WORSE AT NIGHT or when wrists flex or extend.
What long standing Syndrome can lead to thenar atrophy Carpal Tunnel Syndrome
Tests for Carpal Tunnel Syndrome Phalen's maneuver (plus reverse Phalen's) and Tinel's Sign
Medial Epicondylitis Chronic elbow pain, aka Golfer's Elbow, Reactive tendon pathology of flexor forearm muscle. Pain is worsened with wrist flexion and felt along SI channel on forearm as well. Caused by repetitive stress
Lateral Epicondylitis Chronic elbow pain, aka Tennis Elbow Reactive tendon pathology of extensor forearm muscle Lateral upper forearm pain/tenderness, worsened with extending the wrist or grasping things Caused by repetitive stress
Osteoporosis Common metabolic bone dz characterized by low bone mass (T-score = -2.5 or lower) and architectural disruption.
Osteoporosis S/S Hip fractures, vertebral compression fractures, loss of height, progressive thoracic kyphosis, and/or distal Radius fractures (colles fractures) following minimal trauma.
Osteoporosis Risk factors: smoking, age, corticosteroid use, xs caffeine or alcohol intake, amenorrhea, eating disorders.
Osteoporosis DX: DEXA (dual xray absorptiometry) measuring T score. T score: -1 or higher=normal -1 to -2.5=osteopenia -2.5 or lower= osteoporosis
Osteoporosis TX: prevention, treatment with calcium and vit D supplements.
Rotator Cuff Supraspinatus: Infraspinatus: Teres minor: Subscapularis
Teres minor adducts and externally rotates
Infraspinatus externally rotates
Supraspinatus abducts (initially before the deltoid) most common RC injury
Subscapularis adducts and internally rotates
Tests for rotator cuff tear Drop arm test, Hawkins kennedy, and the Apprehension test
Bicipital tenosynovitis DX: Yergason's test and speed test
Bunion Deformity of the joint connecting the big toe to the foot Also called Hallux abducto valgus
Valgus usually refers to knees coming inward while feet go outward, but in this case refers to toes going outward from the joint that protrudes inward
Varus usually means knees go outward Tx: splint or surgery
Plantar fasciitis Pain in heel and bottom of foot usually worse with first steps of the day, or after rest. Most common cause of heel pain. The fascia can be torn or inflamed.
Mortons Neuroma Benign neuroma of the intermetatarsal plantar nerve most common between the 3rd and 4th intermetatarsal space but also found between the 2nd and 3rd, resulting in entrapment of affected nerve.
Mortons Neuroma S/S -Pain and/or numbness relieves sometimes by moving Some consider not a true tumor, but a neurofibroma.
Mortons Neuroma Tx orthotics, corticosteroid injection, possibly a pad placed under the metatarsal
Secondary Cancer Called by the name of the first location, ie if pancreatic cancer metastasizes and spreads to the liver, the cancer in the liver is called pancreatic cancer.
Benign tumors do not spread or metastasize.
Metastasis definitive criteria for malignancy
Metaplasia A change of cells to a form that does not normally occur in the tissue in which it is found.
Hyperplasia proliferation of cells that increases over all size of tissue
Neoplasm abnormal cell proliferation creating new tissue
Dysplasia the increased growth of immature cells with a simultaneous reduction in the growth of mature cells, their numbers and their site of growth
Biopsy the most definitive diagnostic method for cancer
Benign tumors Grow slow
Benign tumors Well defined capsule
Benign tumors Non invasive
Benign tumors Well differentiated
Benign tumors Low mitotic index
Benign tumors Do not metastasize
Benign tumors Good prognosis
Malignant tumors Grows rapidly
Malignant tumors Non encapsulated
Malignant tumors Invasive
Malignant tumors Poorly differentiated
Malignant tumors High mitotic index
Malignant tumors Poor prognosis
Lipoma Benign adipose tissue tumor
Osteoma Benign tumor of bone
Leiomyoma Benign tumor of the smooth muscle (ie uterus, stomach)
Rhabdomyoma benign tumor of striated muscle
Pheochromocytoma benign tumor of adrenal medulla
Teratoma benign tumor made up of several different types of tissue, such as hair, muscle, or bone. They typically form in the ovaries, testicles, or tailbone and less commonly in other areas
Highest Incidence tumors/cancer in men 1. Prostate 2. Lung 3. Colon
Highest Incidence tumors/cancer in women 1. Breast 2. Lung 3. Colon
Highest Mortality tumors/cancer in men 1. Lung 2. Prostate 3. Colon
Highest Mortality tumors/cancer in women 1. Lung 2. Breast 3. Colon
#1 risk for bladder cancer Smoking
Lymphoma malignant tumor of lymphoid tissue
Carcinoma malignant cancer of epithelial cells
Sarcoma malignant cancer of connective tissue
Colon cancer Screening starts at 50 years old every ten years unless pt has a family Hx
Breast cancer risk factors nulligravida (zero pregnancy), early menarche, sister with breast cancer, family hx, more time menstruating.
Types of skin cancer Basal cell carcinoma, Squamous cell carcinoma, melanoma
Basal cell carcinoma - most common type of skin cancer - Found in sun exposed areas - Telangiectasia (blood vessels seen) rolled borders, central ulcer, - tx= surgical resection
Squamous cell carcinoma 2nd most common skin cancer Assoc. w/ excess exposure to sunlight & immunosuppression and arsenic Found mostly on face & upper lower lip
Squamous cell carcinoma precursor= Actinic Keratosis (a precancerous patch of thick, scaly, or crusty skin) Locally invasive, it may spread to lymph nodes and will rarely metastasize
Melanoma Most common cause of death related to skin cancer Significant risk of metastasis Depth of tumor correlates to prognosis and risk of metastasis precursor=dysplastic nerves
Melanoma signs "ABCDE" Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution over time
Fitzpatrick scale Predicts cancer risk based on color of skin
Epithelial tissue lining, transport secretion, absorption Gi tract, hollow organs, skin surface
Connective tissue support, strength, elasticity bone, tendon, fat
Muscular tissue movement cardiac, smooth, skeletal
Nervous tissue information synthesis, communication, control brain, spinal cord, nerves
Range of Motion The linear or angular distance that a moving object may normally travel while properly attached to a fixed point. Each specific joint has a normal range of motion expressed in degrees
Active ROM px performs movement unassisted
Passive ROM therapist moves with no help from PX
Goniometer and inclinometer used to measure ROM
Type of muscle shape, #nuclei, striation, voluntary/involuntary
Skeletal muscle tissue elongated shape, multiple nuclei, striation, voluntary
Cardiac muscle tissue branching shape, single nuclei, striation, involuntary
Smooth muscle tissue spindle shaped, single nuclei, not striated, involuntary
Acanthosis Nigricans darkening of skin at body folds esp around neck and axilla. Sign of diabetes
Lichen Planus (6p): Pruritus, Papule, Plaque, Purple, Polygal, Planar
Nerve targeted and specific, chemical and electrical
Endocrine slow, chronic control, continues after stimulation stops
Hypothalamus Master gland controlling both nervous system and endocrine via interaction with pituitary
Thyroid produces T3, T4, and Calcitonin
Calcitonin targets bone. It decreases blood Ca, increases Ca deposition and ossification
Graves Disease also known as toxic diffuse goiter, is an autoimmune form of hyperthyroidism. The immune system creates antibodies known as thyroid-stimulating immunoglobulins. Creating an increase in thyroid production of T3 and T4
Hyperthyroidism increased levels of T3 and T4, most commonly due to Graves Disease
Hyperthyroidism S/S: weight loss, heat intolerance, anxiety, palpitations, increased bowel frequency, insomnia, and menstrual abnormalities.
Hyperthyroidism DX: serum TSH levels (1st test)
Hyperthyroidism Complications: thyroid storm (acute life threatening form of thyrotoxicosis, way too much T3 & T4) heart rate, blood pressure, and body temperature danerously elevated
Hypothyroidism decrease in T3 T4
Hashimoto’s thyroiditis autoimmune hypothyroidism. The most common cause of hypothyroidism. Elevated TSH because of low T3 T4
Hashimoto’s thyroiditis S/S: weakness, fatigue, cold intolerance, constipation, weight gain, depression, hair loss, menstrual irregularities, hoarseness. Dry, cold, puffy skin accompanied by edema, bradycardia and delayed relaxation of DTR’s(deep tendon reflex)
Hashimoto’s thyroiditis Dx: serum TSH followed by free T4 levels
Hashimoto’s thyroiditis Tx: for uncomplicated(hashimoto,) levothyroxine
Hashimoto’s thyroiditis Complications: myxedema coma, decreased mental status, hypothermia
Parathyroid PTH targets bone and kidney. Increases blood Ca, decreases urinary excretion. Osteoporosis can result from too much PTH.
Adrenal Cortex GFR = Zona Glomerulosa, Zona Fasciculata, Zona Reticularis
Zona Glomerulosa Produces aldosterone
Zona Fasciculata Produces glucocorticoids
Zona Reticularis Produces sex hormones, ex: estrogen
Hirsutism a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, coarse hair on body areas where men typically grow hair — face, chest and back.
Ligament Treitz ligament that connects the esophagus to the duodenum. The ligament denotes the border between upper and lower GI
Cachexia loss of unintended weight, significant decrease in appetite, muscle atrophy, fatigue, weakness. Mostly as a complication of other diseases such as AIDS or Cancer.
Cryptosporidiosis caused by the protozoa cryptosporidium, causing respiratory and gastric illness, primarily involving watery diarrhea. Most commonly isolated in patients with HIV.
BMI: Obesity = >30
Cholelithiasis gallstones, biliary colic, that block the cystic duct.
Cholelithiasis S/S: abdominal pain RUQ(may radiate to shoulder or subscapular area), dyspepsia, flatulence, nausea, vomiting
Cholelithiasis Risk factors: 4F Female Fat Forty Fertile (pregnant)
Cholelithiasis DX: RUQ ultrasound
Cholelithiasis TX: if symptomatic= cholecystectomy, If asymptomatic= no tx required
Cholecystitis acute or chronic inflammation of the GB usually from cholelithiasis.
Cholecystitis S/S: RUQ pain, Fever , nausea, vomiting, Murphy’s sign.
Cholecystitis DX: leukocytosis, Ultrasound(to look for stone, or bile sludge
Cholecystitis TX: if severe, cholecystectomy using laparoscopy
Alcoholic hepatitis AST:ALT ratio greater than 2:1
Exocrine digestive enzymes
Endocrine hormone=insulin and Glucagon
Insulin decreases blood glucose, increases glycogen, fat, and protein synthesis
Glucagon increases blood glucose, decreases glycogen and fat metabolism
Glycogen stored sugar energy
Pancreatitis May be acute or chronic. Epigastric pain may radiate to back
Acute pancreatitis autodigestion of pancreas by pancreatic enzymes.
Acute pancreatitis Causes "Get Smashed" Get: Gallstones and ethanol make up 50% of cases Ethanol alc Trauma Smashed: Steroid, mumps, autoimmune dz, scorpion sting, hypercalcemia, hypertriglyceridemia (more than 1000), ERCP, drug (sulf drug)
Acute pancreatitis DX Lab will reveal increased lipase, and possibly amylase
Chronic pancreatitis Chronic inflammation, atrophy and calcification of the pancreas. There is no increase in lipase and amylase like there was in acute pancreatitis
Chronic pancreatitis Major cause: Adult: alcohol; kids: cystic fibrosis
Chronic pancreatitis S/S Triad = Diabetes mellitus + Steatorrhea (fat in stool) + pancreatic calcification on CT Scan Other: pancreatic insufficiency, fat soluble vitamin deficiency Increases risk for pancreatic adenocarcinoma
Pancreatic Adenocarcinoma Pancreatic cancer 75% of cases found in the head of the pancreas
Pancreatic Adenocarcinoma S/S abdominal pain radiating to back, obstructive jaundice, weight loss, migrating thrombophlebitis (trousseau sign), red, swollen, tender on palpation) painless jaundice and enlarged Gb
Pancreatic Adenocarcinoma TX:
Diabetes Mellitus Type 1 autoimmune pancreatic B Cell destruction leading to insulin deficiency and abnormal fuel metabolism. Failure to produce enough insulin, previously referred to as juvenile diabetes.
Diabetes Mellitus Type 1 acute complication Sudden onset DKA/diabetic ketoacidosis (Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness)
Diabetes Mellitus Type 2 A dysfunction in glucose metabolism characterized by insulin resistance that may lead to B Cell burnout and insulin dependence. Previously referred to as adult onset diabetes.
Diabetes Mellitus Type 2 acute complication hyperglycemic hyperosmolar state (high blood sugar causing dehydration, high osmolarity, coma, death)
Diabetes Mellitus Type 2 S/S include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness.
Diabetes Mellitus Type 2 medication metformin
Diabetes Mellitus Type 2 complications (macrovascular) atherosclerosis, coronary artery dz. (microvascular) retinopathy, nephropathy, neuropathy. Excess glucose stored in liver and muscles as glycogen.
Diabetes Mellitus Type 2 DX A1c 6.5 or higher
Gastric ulcer worse with food
Duodenal ulcer better with food
Diverticulosis Outpouchings of mucosa and submucosa that herniate through the colonic muscle layers in areas of high intraluminal pressure. Most commonly found in the sigmoid
Diverticulosis S/S painless and sudden bleeding, generally presenting at hematochezia. Symptoms associated with anemia (fatigue, lightheadedness, dyspnea on exertion)
Diverticulosis risk factors low fiber, high fat diet. Advanced age (over 80 yrs old makes up 65% of cases.) and CT disorders (eg Ehlers Danlos syndrome)
Diverticulosis DX only diagnosable by colonoscopy, abdominal x ray, contrast CT.
Hematochezia passing of fresh blood through the anus, with or without stools
Melena dark, tarry, blood in stool indicating upper GI bleeding
Diverticulosis vs Diverticulitis No pain Lower - left quadrant pain Bleeding fever, N/V leukocytosis, perforation
Diverticulitis inflammation and potential perforation of the diverticulum, 2nd to fecalith impaction.
Diverticulitis S/S Presents with LLQ pain, fever, N/V, constipation or diarrhea Serious condition can lead to peritonitis and shock
Diverticulitis DX CBC may show leukocytosis. Abdominal x ray, colonoscopy, barium enema. Must avoid sigmoidoscopy/colonoscopy with early diverticulosis to avoid perforation.
Small bowel obstruction: (SBO) S/S moderate-severe abdominal pain, copious emesis, cramping pain
Small bowel obstruction: Distal moderate-severe abdominal pain, copious emesis, cramping pain. plus fever, signs of dehydration, and hypotension.
Small bowel obstruction DX abdominal distention ( distal SBO) abdominal tenderness, visible peristaltic waves, fever, hypovolemia. Look for surgical scars/hernia. Rectal exam. Makes high pitched “tinkling” bowel sounds, later no sounds
Small bowel obstruction Etiology in order of prevalence: adhesion post surgery(60%), Hernia, neoplasm, other(volvulus, intussusception, gallstones ileus, foreign body, crohns, cystic fibrosis, stricture, hematoma.
Partial SBO flatulence continues but no stools
Complete SBO no flatulence no stools
Eating disorders anorexia and bulimia both can have purging and binge eating, but anorexia will have both amenorrhea and a low BMI (about 13)
UTI Mostly in women. 80% of cases=E Coli
UTI Risk factors catheters and other urologic instruments, anatomic abnormalities (BPH, vesicoureteral reflux). Previous UTI’s or pyelonephritis, diabetes M, recent antibiotic use, immunosuppression and pregnancy.
UTI S/S dysuria, urgency, frequency, suprapubic pain, possible hematuria.
UTI in Children bedwetting, poor feeding, recurrent fevers and foul smelling urine.
UTI DX vaginitis, STD’s , urethritis, acute urethral syndrome, prostatitis
Infection causes of UTI’s “SEEKS PP” Serratia, Ecoli, Enterobacter, Klebsiella pneumoniae, Staphylococcus saprophytous, Pseudomonas, Proteus Mirabilis
Nephrolithiasis renal calculi/kidney stone
Nephrolithiasis S/S Unilateral flank tenderness, flank pain may radiate to groin, nausea, vomiting, +/- hematochezia. NO FEVER
Nephrolithiasis complication hydronephrosis, pyelonephritis.
Nephrolithiasis DX (NON CONTRAST) CT Scan or KUB X Ray
Nephrolithiasis TX treat and prevent by encouraging fluid intake
Cystoscopy looks at bladder
Temporal Arteritis due to subacute granulomatous inflammation of large vessels including aorta, external carotid artery(esp temporal branch) and vertebral arteries.
Temporal Arteritis Most feared manifestation is blindness 2nd to occlusion if the central retinal artery (a branch of the internal carotid)
Temporal Arteritis Risk Factors over 50 and female
Temporal Arteritis S/S headache scalp pain and temporal tenderness, jaw claudication, fever, permanent monocular blindness, weight loss, myalgia, arthralgia (esp of shoulder and hip)
Temporal Arteritis DX ESR over 50 (erythrocyte sedimentation rate, has to do with inflammation), ophthalmologic eval, temporal artery biopsy
Temporal Arteritis TX high dose prednisone begun immediately to prevent blindness.
Hemophilia Deficiency of clotting factor, X linked
Hemophilia Types A: factor 8 deficiency (90%) B: factor 9 deficiency (9%) C: factor 11 deficiency (1%)
Von Willebrand DZ (vWD) most common inherited bleeding disorder Autosomal dominant
Von Willebrand DZ (vWD) S/S heavy menstrual bleeding, bleeding after minor injuries, bleeding gums.
Von Willebrand DZ (vWD) Tx a bleeding episode is treated with DDAVP (desmopressin)
Thrombophlebitis migrans blood clot occurring repeatedly in different locations, migrating indicated by the Trousseau sign of malignancy.can indicate pancreatic cancer
Hypertension >140 systolic and or >90 diastolic measured 3xs at separate occasions. Classified as 1st or 2nd degree.
1st degree (essential hypertension) (Idiopathic) has no identifiable cause. 95% of hypertensive cases.
1st degree (essential hypertension) Risk Factors Family Hx of hypertension or heart disease, high sodium diet, smoking, obesity, race (Black more than white), advanced age. Asymptomatic until complications.
1st degree (essential hypertension) Must rule out brain(stroke, dementia), Eye (cotton wool exudates, hemorrhage), heart (left ventricle hypertrophy) and Kidney (proteinuria, chronic kidney Dz. Renal Bruits may signify renal artery stenosis as the cause.
1st degree (essential hypertension) Tx “ABCD”. ACE inhibitors or ARBs, Beta-blockers, CCBs, Diuretics. Thiazide diuretics, calcium channel blockers, and angiotensin converting enzyme inhibitors.
2nd Degree hypertension cause is known and can be any of “CHAPS” C ushing syndrome, H yperaldosteronism, A ortic cooptation, P heochromocytoma, S tenosis of renal arteries
Aortic Dissection commonly associated with hypertension Asymmetric pulses and Bp measurements are indicative of aortic dissection
Aortic Dissection S/S sudden tearing/ripping pain in: the anterior chest (ascending dissection) Interscapular back pain (descending dissection)
Abdominal Aortic Aneurysm More than 50% dilation of aortic walls Usually asymptomatic, discovered incidentally. Pulsatile abdominal mass, or Abdominal bruits
Abdominal Aortic Aneurysm Dx all men 65-75 with HX of smoking should be screened once by ultrasound for AAA
Abdominal Aortic Aneurysm Tx <5cm = monitor, >5.5cm (abdominal), 6cm (thoracic) = surgical repair Symptomatic or ruptured aneurysm = emergency medical surgery
Apex of heart location 5th ICS
B Cell precursors to plasma cells, source of antibodies, helps w/immunity, comes from bone marrow, matures in bone marrow
T Cell comes from bone marrow, matures in thymus
Incidence Newly Dx #. Number of dz that allows us to determine probability of being diagnosed with a disease during a time.
Prevalence The total # of existing cases. A measure of Dz that allows us to determine a person’s likelihood of having a Dz.
Morbidity another term for illness. A person may have several comorbidities.
Mortality another term for death. # of deaths due to a Dz divided by the total population.
Hepatitis C mostly transmitted via blood.
Lyme Disease caused by a spirochete, tick born disease
Lyme Disease 1st S/S red rash bullseye (erythema chronicum migrans), flu like symptoms, +/- facial nerve palsy
Lyme Disease Later S/S monoarthritis( large joints, migratory polyarthritis), cardiac (AV node block), neurologic (encephalopathy, facial nerve palsy, polyneuropathy)
Lyme Disease Tx Doxycycline, ceftriaxone
Other tick borne dz rocky mountain spotted fever, babesiosis
Rocky mountain fever fever rash on palms/soles that spread to the trunk.
VAricella-Zoster virus (VSV) causes 2 dz; varicella and herpes zoster. Transmission occurs via respiratory droplet or direct contact.
Chicken Pox (varicella) Prodrome: malaise, fever, headache, myalgia. Occurs 24 hrs before onset of rash Pruritic lesions appear in crops over 2-3 days
Chicken Pox (varicella) Evolve from red macules - grouped central vesicles - crusting over Patient has any and all of the stages at any time, over entire body Not on palms or soles of feet
Shingles (Zoster) Virus lays dormant in the dorsal root ganglia. Lesions crop up on nerves dermatomal distribution
Shingles (Zoster) Outbreaks = intense local pain, then arise with grouped blisters on an erythematous base If immunocompromised can lead to severe local Dz Older patients with severe zoster can develop postherpetic neuralgia
Herpes Simplex Virus painful recurrent vesicular eruption of the mucocutaneous surface due to infection with HSV
Herpes Simplex Virus 1 oral, labial
Herpes Simplex Virus 2 genital lesions
Recurrent HSV 1 (oral)common cold sore presenting with an erythematous base with a cluster of crusted vesicles. Triggered by sun or fever
Recurrent HSV 1 Prodromal S/S tingling, burning pain, lymphadenopathy, fever, discomfort, malaise.
Recurrent HSV 2 (genital) unilateral cluster of blisters on an erythematous base with less pain and systemic involvement then HSV 1 infection
HSV 1 & 2 Tx oral or IV acyclovir
HIV retrovirus that destroys CD4 and T lymphocytes
HIV 1st test ELISA which can have a false positive due to high sensitivity and moderate specificity
HIV 2nd test western blot. Low sensitivity, high specificity
AIDS HIV infection + CD4 count of less than 200 + Aids defining illness
AIDS defining condition Cytomegalovirus retinitis (with loss of vision) Pneumocystis jiroveci pneumonia Chronic intestinal cryptosporidiosis HIV related encephalopathy Mycobacterium TB (pulmonary or extrapulmonary) Invasive cervical cancer
Tuberculosis fever, tachycardia chronic cough, bloody sputum, weakness, weight loss, swollen lymph nodes.
Mononucleosis swollen neck, enlarged spleen(so avoid contact sports) Caused by EBV(epstein Barr virus)
Neuropathy Dz of peripheral or autonomic or cranial nerves
Neuritis inflammation of a nerve
Radiculopathy Dz of spinal nerve root and nerves
Trigeminal Neuralgia cranial nerve 5, stabbing pain
Thumb Dermatome C6
Nipple Dermatome T4
Umbilicus Dermatome T10
Knee Dermatome L4
Dorsum of foot Dermatome L5
Achilles tendon Dermatome S1
Perineum Dermatome S2-4
Bell's Palsy a lower motor neuron lesion of cranial nerve 7 that causes ipsilateral facial paralysis on both the forehead, cheek and anterior 2/3 rds of the tongue. Complete destruction of the facial nucleus itself or its branchial efferent fibers.
Bell's Palsy May involve inability to close eye on involved side.
Bell's Palsy Cause May occur: idiopathically, as a complication of AIDS, lymes, sarcoidosis, tumors or Diabetes. 3x’s more likely to occur in pregnant women, 4x’s more likely in diabetics than those without.
Parkinson’s a long-term idiopathic hypokinetic degenerative disorder of the central nervous system that mainly affects the motor system.
Parkinson’s Begins after age 50-60 Attributable to dopamine depletion in the substantia nigra Characterized pathologically by lewy bodies (intraneural eosinophilic inclusions)
Parkinson’s S/S "PARTS" “4 PaRTS” or “PARKINSONS” Postural instability Rigidity (cogwheeling) Tremors (pill rolling/resting tremor) Slowed movement (bradykinesia)
Parkinson's S/S "PARKINSONS" “PARKINSON'S”= P ill rolling, A kinesia/bradykinesia, R idgidity, K yphoisis, I nstability, N eck/head tremor, S? , O culogyric crisis (fixation of eyes in upward direction) N ose tapping, S mall writing (micrographia)
Parkinson's Tx Levodopa and carbidopa, both are dopamine precursors. “Levo”=amino acid that crosses the BBB. “Dopa”=precursor to dopamine. Carbidopa, blocks metabolism of levodopa in the periphery.
Essential Tremor action tremor. Most common movement disorder. Tremors often temporarily are relieved with alcohol consumption.
Essential Tremor Tx Medication = beta blockers
Multiple Sclerosis Patients should avoid hot weather because it exacerbates their s/s
Meningitis S/S high fever, neck stiffness, headache, altered mental state
Meningitis Dx tests include kernig and brudzinski
Dyspareunia painful sex
Endometritis inflammation of the endometrium. Associated with retained products following delivery, miscarriage, or abortion of foreign bodies (ex: IUD) Promotes infection by bacterial flora from vagina or intestinal tract.
Endometritis S/S fevers and chills
Endometriosis functional endometrial tissue outside the uterus
Endometriosis CYCLICAL pelvic pain, rectal pain, dysmenorrhea, dyspareunia, Chronic LB and pelvis pain Pain during or after sex
Endometriosis Dx Confirmed by laparoscopy.
Endometriosis S/S Lesions have a blue-black “raspberry” or dark brown “burned powder” appearance Ovaries may have Endometriomas : characteristic “chocolate cysts”
Adenomyosis endometrial tissue in the Myometrium of the uterus NON CYCLICAL pain, menorrhagia and enlarged uterus (boggy and big)
Ectopic Pregnancy Fertilized egg implants outside the uterus. Site of implantation is usually tubal.
Ectopic Pregnancy S/S PAVE - Pain(abdominal), Ammenorrhea, Vaginal bleeding, Ectopic Pregnancy
Ectopic Pregnancy Dx Approach all women with abdominal pain of reproductive age as if they might have ectopic pregnancy until proven otherwise. Pregnancy test with a transvaginal ultrasound revealing an empty uterus. Confirm with a serial hCG without appropriate HcG doubling.
Ectopic Pregnancy Tx Medication Methotrexate is good for small unruptured pregnancy. Otherwise surgical options include: salpingectomy or salpingostomy with evacuation via laparoscopy/laparotomy if patient is hemodynamically unstable.
Ectopic Pregnancy Complications tubal rupture hemoperitoneum which constitutes an obstetric emergency.
Uterine Leiomyoma Fibroids Most common benign neoplasm in female genital tract Majority are asymptomatic
Uterine Leiomyoma Fibroids S/S Mostly no symptoms Longer, heavier periods Pelvic pressure, bloating, constipation and rectal pressure, urinary frequency or retention Secondary dysmenorrhea, dyspareunia Firm nontender, irregular, englarged "lumpy bumpy" or cobblestone uterus.
Pre-eclampsia hypertension and proteinuria plus edema
Preeclampsia Tx delivery of fetus
Eclampsia hypertension and proteinuria plus seizures.
Eclampsia Tx delivery of fetus
Benign Prostatic Hyperplasia Enlargement of the prostate that is a normal part of the aging process. Seen in more than 80% of men by age 80. Presents commonly above 50 years old.
Benign Prostatic Hyperplasia S/S Obstructive symptoms: hesitancy, weak stream, intermittent stream, incomplete emptying, urinary retention, bladder fullness. Irritative symptoms: Nocturia, daytime frequency, urgency incontinence, opening hematuria.
Benign Prostatic Hyperplasia Dx DRE (Digital rectal exam) the prostate is uniformly enlarged with rubbery texture. If prostate is hard and or has irregular lesions, cancer should be suspected. Hx and Exam. Check UA for infection or hematuria, both of which should prompt further eval.
Benign Prostatic Hyperplasia Tx terazosin (alpha-1 beta blocker), Finasteride(5alpha-reductase inhibitor), TURP (transurethral resection of the prostate. )
Prostate Cancer most common incidence, and 2nd leading cause of cancer death in men.
Prostate Cancer S/S usually asymptomatic, but may present with obstructive urinary symptoms, lymphedema due to obstructive metastasis, constitutional s/s, back pain due to bone metastasis.
Prostate Cancer Risk Factors advanced age and family hx
Prostate Cancer Dx DRE may reveal a palpable nodule or area of induration. Early, usually not detectable on visual exam. Marked increase in PSA (above 4 mg/ml) The definitive Dx comes from Ultrasound guided transrectal biopsy.
Prostate Cancer Prevention DRE for all males above 50 years old
Fitzpatrick scale scale predicting skin cancer probability based on skin color
Goniometer used to measure ROM
Inclinometer used to measure ROM
McBurney’s point appendicitis
Murphy’s sign Positive result = cholecystitis. Palpation of gb area makes the patient hold their breath while wincing in pain
Trousseau Sign migratory blood clotting indicative of either pancreatic, gastric or lung cancer
Asymmetric pulses and Bp measurements are indicative of aortic dissection
Courvoisier’s law if painless enlarged GB and painless mild jaundice then, not cholelithiasis, but potentially malignancy of the gallbladder or pancreas.
Tinel sign pain when striking the median nerve confirms carpal tunnel
Phalen’s sign if pain when holding hands in reverse prayer position, held for 30-60 sec, then a positive sign of carpal tunnel. Reverse phalen’s is same test but with prayer hands.
Kernig's sign positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee(beyond 130 degrees) is painful (leading to resistance). Indicates either meningitis, or subarachnoid hemorrhage.
Brudzinski doctor bending the neck forward, makes the patient brings up knee. Sign for meningitis
Ankle jerk reflex (Achilles reflex) Achilles tendon is tapped while foot is dorsiflexed. Tests function of the gastrocnemius muscle and the nerve that supplies it. A positive result would be the jerking of the foot towards its plantar surface. Confirms nerve emerging from S1, is working.
McMurray test test for meniscus tear
Drop arm test tests for supraspinatus rotator cuff tea
Hawkins kennedy rotator cuff
Apprehension test rotator cuff
Yergason's test bicipital tenosynovitis
Speed test bicipital tenosynovitis
Urea breath test used to DX H.pylori infection
Sweat test measures the amount of salt in the skin. Useful in dx cystic fibrosis.
(used 1st)ELISA and (2nd)Western Blot test HIV test
TSH blood test best test for screening/assessing thyroid function
OTC pregnancy test measures hCG(human chorionic gonadotropin) that comes from placenta. It maintains the corpus luteum for the 1st trimester, eventually placenta takes over. Low, or slowly increasing hCG can suggest a miscarriage.
Creatinine creatine is a byproduct of muscle metabolism removed from blood via GFR in Kidneys
DEXA/DXA Scan evaluates bone density.
UT Scan Pulses of high-frequency ultrasound, generally above one megahertz, are created by a piezoelectric transducer and directed into the body.
CT Scan combines series of X-ray images from different angles around body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. calcification of pancreas, most amount of radiation
Xray a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of your body
Biopsy an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.
Cystoscopy looks at bladder
Bronchoscopy views the airway
Endoscopy looks for upper GI bleeding going as far as the duodenum
Colonoscopy looks at lower GI
KUB X RAY Kidney ureter and bladder imaging
Cholecystectomy surgical removal of the gallbladder.
pancreaticoduodenectomy (Whipple Procedure) surgery to remove pancreatic tumors
Cholelithiasis RUQ
Appendicitis RLQ
Diverticulitis LLQ
Ovarian torsion, ectopic pregnancy RLQ and/or LLQ
Cholelithiasis RUQ to shoulder/subscapular area
Nephrolithiasis flank to groin
Abdominal aortic aneurysm abdominal to back
Appendicitis periumbilical to McBurney’s point
Pancreatic adenocarcinoma abdominal pain radiating to back
Cytochrome P450 major enzyme responsible for drug metabolism
Cytochrome P450 Inducer decreases drug effect by increasing metabolism (st john's wort)
Cytochrome P450 Inhibitor increases drug effect by decreasing metabolism of drug (grapefruit)
Statins: ex imvastatin, atorvastatin, pravastatin
Statins Adverse side effects myalgia (so don't take with grapefruit juice, a cytochrome inhibitor). This happens because statins block the coenzyme Q10
Lasix(furosemide ) a diuretic can deplete potassium. Can also cause tinnitus
Finasteride (Proscar) benign prostatic hyperplasia and male pattern baldness. Includes 5a reductase inhibitor, prevents testosterone from converting to DHT which enlarges the prostate. Medication can produce false negative test for prostatic cancer because of this
First generation antihistamines Diphenhydramine (benadryl) have a side effect of drowsiness
Second generation antihistamines Cetirizine (zyrtec) claritin. Side effect: minimal toxicity
Aspirin (Salicylate) overdose S/S tinnitus, nausea, high temp., and hyperventilation
Corticosteroids long term results in s/s of cushing's syndrome, hirsutism and abdominal striae
Antifungal drugs end in -azole
Fat soluble vitamins A,D,E,K
Water soluble vitamins B,C
Antioxidants A,C,E
Vitamin E Toxicity causes easy bruising….also nausea, gastric distress, abdominal cramps, diarrhea, headache, fatigue. Inhibits platelet aggregation. Muscle weakness. Creatinine urea
Carotenemia S/S yellow skin on palms and feet, but not sclera (jaundice has sclera that are yellow) all from too much carotene.
Pellagra Vitamin B3 deficiency (niacin)
Pellagra S/S 4D's - Diarrhea, Dermatitis, Dementia, Death
Neurofibroma type of nerve tumor that forms soft bumps on or under the skin
Cheyne stokes Abnormal pattern of breathing characterized by progressively deeper, sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea. Pattern repeats
Drugs that cause constricted pupils Heroin, Morphine, Opiates (Oxycodone, Fentanyl), Methadone, Codeine, Hydrocodone
Drugs that cause red eyes Marijuana, Cocaine or Crack, Benzodiazepines (Xanax), Depressants (alcohol or sedatives)
Drugs that cause dilated pupils Amphetamines, Methamphetamines, Cocaine or Crack, Hullucinogens (LSD or mushrooms), Marijuana, Speed
Which Hepatitis has a vaccine A
Hep. E mode of transmission food/fecal
Hep. A mode of transmission food/fecal
Hep. B mode of transmission Blood
Informed consent includes Risk of treatment, treatment procedures, alternative to treatment
First sign of Mono. severe sore throat
Do what first when a person faints check for responsiveness
One required to make Diabetes M. diagnosis 1. Fasting plasma glucose >126, 2 occasions 2. Radom plasm glucose >200 plus symptoms 3. 2 hour postprandial glucose >200, 2 separate occasions 4. HbA1c 6.5% or higher
Secondary hypertension causes Cushing's syndrome, Conn's syndrome, pheochromocytoma
CN lesion of Bell's Palsy CN VII Facial, lower motor neuron lesion
Most common cause of acute lower GI bleeding in patients over 40 years old. DiverticulOSIS
Cytoscope Flexible and rigid, look at bladder
BMI:Overweight >25
BUN reveal kidney function. The liver makes urea as a waste product of protein, which makes blood urea nitrogen (BUN).
Cranial nerve for balance VIII
Pernicious Anemia Cobalamin, Vitamin b12 def.
Wernicke-KorsaKoff disease thiamine, vitamin B1 def. Neurological condition: confusion, problems with voluntary movements, eye abnormalities. Thiamine helps in the processing of glucose
Medication for KD stones and chronic gout Allopurinol
Cause of SOB in children hernia
MOA of Warfarin (Coumadin) Inhibits synthesis of Vit. K
Hormone that increases Calcium levels in blood PTH
Adrenal medulla hormones epinephrine, norepinephrine (adrenaline)
Diameter 3cm Stone can be treated with ESWL, percutaneous nephrolithotomy, retrograd ureterscopy
3 Levels of Meninges protective tissue called the dura mater, arachnoid mater, and pia mater that surround the neuraxis. The meninges of the brain and spinal cord are continuous, being linked through the magnum foramen.
RAAS renin-angiotensin-aldosterone system, plays an important role in regulating blood volume and systemic vascular resistance, which together influence cardiac output and arterial pressure. Renin - kidneys, Agt. - blood & tissues, Ald. - adrenal cortex
ACE Angiotensin-converting enzyme
Which organ/organs releases ACE Lungs & kidneys
What do ACE inhibiters intercept ACE (Angiotensin-converting enzyme)
Hormone high in menopause FSH
Hormone high in galactorrhea Prolactin
Negative feedback loop with birth control pills (Estrogen and Progesterone or just Progesterone) 1st - suppression of gonadotropins, 2nd (FSH,LH) through - feedback inhibition, 3rd inhibition prevents rise in FSH (necessary to trigger ovulation)
Which hormone increases during ovulation Progesterone
Constricts pupils Parasympathetic nervous system
CN VII (facial nerve) Innervates anterior 2/3 of tongue
CN IX (glossopharyngeal) innervates posterior 1/3 of tongue
Cerebellum controls muscle tone, balance, coordination and is involved in speech
Arachnoid villi absorb excess CSF
2 most common cause of kidney failure type 2 diabetes and hypertension
Types of COPD Asthma, emphysema, chronic bronchitis
Blue bloater type COPD Daily productive cough for three months or more in at least 2 consecutive years Overweight and cyanotic Elevated hemoglobin Peripheral edema Rhonchi (crackles) and wheezing Purulent sputum CO2 retention (Insensitive to it)
Pink puffer type COPD Permanent enlargement and destruction of airspaces distal to terminal bronchiole Older and thin Severe dyspnea Quiet chest Barrel chest X-ray: hyperinflation w/flattened diaphragms Pursed-lip breathing Cachectic appearance Minimal cough CO2 ok
Chlamydia (most common STD) can cause Pelvic inflammatory disease (PID)
Cluster headaches Circation periodicity; unilateral and orbital head pain; can be recurring or remission; sweating, swelling, tearing, runny nose .
Meningitis headaches Neck stiffness or meningismus; fever; severe "splitting"; Nausea/vomiting; sensitivity to light
Differentiate between histamine headache and cluster headache Histamine headaches are cluster headaches caused by either a release of histamine or ingestion of histamines
Refer to ER Meningitis
Differentiate between Wernicke's Encephalitis (usually occurs in alcoholics) and meningitis Inflammation of the meninges, the membranes that surround the brain and spinal cord, is called meningitis; inflammation of the brain itself is called encephalitis.
When do Wernicke's Encephalitis and meningitis occur together? Myelitis refers to inflammation of the spinal cord. When both the brain and the spinal cord are involved, the condition is called encephalomyelitis
Temporal arteritis headache in the temple, behind the eye, severe. Jaw pain and potentially shoulder and hip pain
Fainting from hyponatremic hypotension Mild cases are asymptomatic. The common symptoms include: Loss of energy Nausea and vomiting Confusion Muscle spasms Low blood pressure Dark scanty urine Irritability, disorientation and neurological manifestations Convulsions
Strep can cause acute glomerulonephritis
______sided heart failure can be associated with distended jugular veins Right
Hiatal hernia causes and S/s primarily attributed to gastroesophageal reflux disease (GERD) Symptoms: Heartburn Bitter or sour taste in the mouth or throat Stomach pain Severe chest or abdominal pain w/ nausea and/or vomiting, and no bowel movements or pass gas (needs ER)
Hiatal Hernia Weakened muscle tissues make the stomach bulge and push through the diaphragm
Hiatal Hernia risk factors Ageing, weakened diaphragm, large hiatus opening, increased abdominal pressure bc of pregnancy, obesity, severe cough, or straining during bowel movements, frequent vomiting or coughing, ascites or abnormal collection of fluid in the abdomen
Left-Hemisphere controls Movement of the right side of the body Verbal language Numerical skills Written language Reasoning Scientific functions
Left-Hemisphere stroke effects Paralysis(hemiplegia) on R side of body Aphasia - speech & language problems Memory problems - shortened attention span, difficulty learning new info. Problems w/concept & generalization Development of slow & cautious behavioral style
Right-Hemisphere controls Movement of left side of body Perceptual tasks - judging distance, size, speed or position or seeing how parts are connected to wholes
Right-Hemisphere stroke effects Left hemiplegia Spatial and perceptual problems - misjudge distances Can't tell right-side-up from upside down Judgment and impulse problems Left-side "neglect", "forgetting" or "ignoring" things on left side Bad short-term memory
S/S of ulcerative colitis Bloody, sticky diarrhea, abdominal pain
S/S of scabies on the hands Itchy web on skin of fingers, tunnels and burrows on hands
Measles little white cluisters in cheek (koplik spots) and red patches on face and body
Inflammatory breast cancer Dimples around nipple with redness and an orange peel look, no enlarged lymph nodes in axillae and no pain
Young 3 year old with sudden wheezing and no other symptoms Can have aspiration of foreign body
Patient with big belly, who gains weight and has hirsutism indicates Cushing's syndrome
Meniere's Dz triad: tinnitus, monaural (one ear) fullness, fluctuating hearing loss and episodic vertigo that lasts 2 hours
Benign paroxysmal positional vertigo lasts a few seconds, not hours
Vestibular neuritis Affects the labyrinth and a has different pattern than 2 hours of vertigo without hearing impairment.
Raynaud's Dz spasm of arteries cause episodes of reduced blood flow. white-blue-red
Reye's Syndrome Swelling of brain and liver. Can be induced in children given aspiring, during the chicken pox or flu.
Reye's Syndrome S/S Hx of flu/chicken pox, child. Heavy vomiting Fatty liver Delirium coma Can be life threatening
Best diagnostic exam for heartburn Endoscopy
Occult blood test examines the stool
DEXA tests for Bone density
Best imaging for soft tissue MRI
Best cost effective test for DVT D'Dimer
DVT Deep vein thrombosis, blood clot forms in a vein deep in the body. Usually lower leg or thigh.
Best imaging test for cranial fracture or subdural bleed CT or flat plate x-ray
Barium enema screens for Colon cancer
CPK (Creatine phosphokinase) and troponin levels indicate MI/Heart attack
ESR can help Dx Temporal arteritis and inflammation
ESR (erythrocyte sedimentation rate) Blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample. Faster-than-normal rate may indicate inflammation in the body.
Other names of ESR Sed rate (sedimentation rate) and Westergren sedimentation rate
ACE inhibitors Vasodilates to lower blood pressure in tx of CHF and hypertension, -april
CA channel blockers Dilate arteries and lower the pumping power of the heart, -ipine
Beta blockers Block effects of the hormone epinephrine, also known as adrenaline. Heart beats slower and with less force, thereby reducing blood pressure, -olol
Coq10 prescribed for Patients taking statins
Statins prescribed for High cholesterol
Muscle most likely injured when a person falls and injures rotator cuff, Supraspinatus
Numbness of thumb and index finger with decreased bicep tendon reflex involves spinal segment C6
Sitting for a long time can affect Piriformis muscle
Pain between 3rd and 4th toe can be Morton's neuroma
Flexing leg 90 degrees of a patient prone with pressure on the ankle and rotation of the knee tests for Meniscus tear
Trendelenburg test assesses for Weak medial gluteus
Selenium is a mineral that also works as an Antioxidant obtained through diet Metabolism and thyroid function Reduce oxidative stress, keeps free radical numbers in check Reduce risk of certain cancers Protect against heart disease Prevent mental decline Boosts immune system Help Asthma
Excess intake of Vit A or B3(nicacin) Can damage the liver
Vitamin C helps Absorb iron
Vitamin K def. can lead to Easy bruising, bleeding and bone mineral loss
Best diet for kidney disease Low nitrate, low potassium, low phosphorus DASH Diet - rich in fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. It is low in salt and sodium, added sugars and sweets, fat and red meats.
Diet high in fat and low in carbs causes Ketosis/ketoacidosis
What do you do with a pneumothorax patient (cough, SOB after needling) and you have called the ambulance Watch closely and wait for ambulance
If treating a child and notice bruises Call child protective services immediately and directly. Do not just tell your supervisor.
Patient authorization needed to release psychiatric notes unless patient is Incapacitated
HIPAA (Health Insurance Portability and Accountability Act) Created national standards to protect a patient's identifiable information in healht records. Allows patient greater access to their own records.
FERPA (Federal Eucation Rights and Privacy Act) Similar to HIPAA, but applies to the school setting and defines access to and protects the educational record of a student, including a school health record.
Minors have a right not to disclose medical notes to parents after a certain age 18. unless state laws allow a younger age and at the discretion of medical provider.
If father wants 16 year old kids medical records they can be released to him except… Adults cannot access child's medical records related to STDs, abortion or birth control
Medical records of patients are owned by Practitioner, not the hospital or patient
Which employees in your clinic need blood borne pathogen education Anyone at risk of coming into contact with blood.
Shoulder limited ROM in passive and active tests, limiting activities of bathing/brushing hair, but not much pain in ROM tests. Frozen Shoulder/Adhesive capsulitis
Frozen shoulder/Adhesive capsulitis Dull or aching pain in outer shoulder area. Pain sometimes in upper arm Stiffness or restricted motion 3 Stages: Freezing (acute pain), Frozen (less pain), Thawing (increased ROM)
Rotator cuff tear Pain at rest and at night, esp. if lying on affected shoulder Pain when lifting and lowering arm or specific movements Weakness when lifting or rotating arm Crepitus or crackling sensation when moving shoulder in certain positions
Dynamometer Tests strength when diagnosing rotator cuff injuries
Bicipital tenosynovitis Inflammation of the tendon and sheath lining of the biceps muscle Pain or tenderness front of the shoulder, worsens with overhead lifting or activity Pain or achiness that moves down the upper arm bone Snapping sound or sensation in shoulder
Falling off ladder leading to lower limb nerve stuff-paralysis and loss of BL/bowel fnx. Vertebral fracture T11/T12
Guillian-Barre Syndrome Rare disorder Immune system attacks nerve cells Weakness, numbness and tingling in extremities usually first symptoms Sensations can quickly spread, paralyzing whole body Exact cause unknown Usually appears after Resp. or Digst. tract infection
What is most important on an intake form from a public health perspective: occupation/travel history or age/gender Age/gender
Winged scapula, what muscle/s affected Long thoracic nerve - Serratus Anterior Dorsal scapular nerve - Rhomboid Spinal accessory nerve - Traps
2 types erectile dysfunction Organic and phychogenic
What might be indicated with long term low grade fever Malignancy
GYN symptoms of pain, etc. when several courses of antibiotics did not work Possibly PID (Pelvic inflammatory disease)
PCOS (Polycystic ovary syndrome) Infrequent, irregular, or prolonged periods Excess male hormone (androgen) Hormonal disorder common among women of reproductive age
PID (Pelvic inflammatory disease) Occurs when sexually transmitted bacteria spread from the vagina to the womb, fallopian tubes or ovaries. Often caused by Chlamydia
PID S/S Pelvic pain Fever and chills Vaginal discharge Pain in lower abdomen Pain during sex Abnormal uterine bleeding Difficulty urinating
PID Tx Antibiotics Possibly surgery if not treated immediately
More useful/accurate test for blood sugar long term Hb A1c
Acupuncture practitioner practicing w/ HIV HBV - You can practice once appearing in front of a board who ensures you know best practices for managing condition in clinic setting
Tardive Dyskinesia + another symptom are side effects of what kind of drug Antipsychotics
Tardive Dyskinesia Serious side effect that may occur with certain medications used to treat mental illness. TD may appear as repetitive, jerking movements that occur in the face, neck, and tongue
What type of anemia is sickle cell Hemolytic
Addison's disease Primarily due to deficiency of cortisol and aldosterone. Weak muscles Decreased heart rate Darkening of the skin (hyperpigmentation)
Cushing's syndrome High levels of cortisol Rise in hormone levels could be due to increased production of cortisol or overuse of corticosteroids S/S: Hump between shoulders (Buffalo hump) Round face (Moon face) Purple stretch marks on the skin Weight gain
Thryroid storm Occurs as a result of untreated or undertreated hyperthyroidism. Characterized by increased heart rate, restlessness, persistent sweating, and loss of consciousness, nausea and abdominal pain. And other hyperthyroid S/S such as exophthalmos
Exophthalmos (exophthalmus, exophthalmia, proptosis, or exorbitism) A bulging of the eye anteriorly out of the orbit Can be either bilateral or unilateral
Cutting Maneuver Sidestep then quick change in direction. 70% of ACL injuries
Niacin toxicity S/S Severe skin flushing combined w/dizziness Rapid heartbeat Itching Nausea and vomiting Abdominal pain Diarrhea Gout
Deficiency with nerve damage. B12 Needed for myelin sheath
Megaloblastic anemia Known as these anemias: B12 Folate deficiency Macrocytic
B12 and Cobalamin deficiency Pernicious Anemia
Pulsatile mass lateral to umbilicus AAA (Anterior Aortic Aneurysm)
What imaging/enema/test for diverticulosis colonoscopy abdominal CT/Barium Enema (which is a contrast type of Xray)
Test for venous thrombosis Doppler CT
Risk factors for blood clots Cancer HIV Vit K excess Smoking birth control pills sedentary trauma surgery
Fainting cause for a teenage girl standing for 2 hours during a choir rehearsal Vasovagal syncope Fainting caused by nerve impulses that slow heart rate Also possibly low blood sugar
Elem school teacher, rash pustules Chicken pox
HIPAA - email The Privacy Rule allows covered health care providers to communicate electronically, such as through email, with their patients, provided they apply reasonable safeguards when doing so.
Created by: Qajun