Shared Flashcard Set

Details

case 11
fam med cases
24
Medical
Graduate
01/25/2011

Additional Medical Flashcards

 


 

Cards

Term
Joint involvement in gout, RA and OA
Definition
Gout: great toe
RA: 3 joints, hands and feet (morning stiffness)
OA: Knees, hips and back (older adults0
(worse with effort)
Term
PHQ2 Depression screen
Definition
w/in past month

1. Have you often been bothered by feeling down, depressed or hopeless?
2. Have you often been bothered by little interest or pleasure in doing things?
Term
Carpal Tunnel's Findings
Definition
asymmetry of the wrists, skin discoloration, swelling or warmth,
and atrophy of the thenar eminence (the raised fleshy area on the palm of
the hand near the base of the thumb)
Tinel's sign: tapping median nerve-->symptoms
Phalens test: flexion of wrists--> reproduction of symptoms
Term
Rheum Arthritis Clinical features
Definition
3 or more joints, typically involves hands and feet, bilateral involvement of joints, subQ nodules that are firm and tender @ pressure points. Check serum RF
Term
SLE clinical features
Definition
migratory joint pain, fever, skin rashes, Raynaud's phenomenon, pleuritis, or chest pain

Malar "butterfly rash" over nose and cheeks w sun exposure

Discoid lesions (erythematous) with scaling
Term
Gout clinical features
Definition
monoarticular arthritis, often in great toe
Term
Psoriatic Arthritis clinical features
Definition
Psoriatic plaques: thickened silvery plaques, located on extensor surfaces. Psoriasis must be present to make the dx.
Term
Lyme Disease clinical features
Definition
Borriela burgdorferi, w acute monoarticular joint pain
Term
Septic Arthritis
Definition
single painful, swollen, warm joint, +fever. Risk factors:diabetes, RA, prosthetic joints, recent surgery, preceeding skin infection. Diff from gout by joint aspiration.
Term
Popliteal Cyst clinical features
Definition
Assoc w RA or OA. Posterior knee pain, difficulty flexing
Term
Ankylosing Spondylitis
Definition
spondyloarthritis of axial skeleton. Assoc w HLAB27. Chronic back pain, loss of motion of spine. Hips sometimes involved.
Term
Xray findings of Osteoarthritis
Definition
Joint space narrowing (best predictor of prognosis)
subchondral cysts
osteophytes
subchondral sclerosis
Term
Arthrocentesis findings for sprain/meniscal injury (simple effusion)
Definition
Clear straw colored transudative fluid
Term
Artherocentesis of ACL tear or fracture
Definition
Hemarthrosis; dark discolored fluid
Term
Artherocentesis of osteochondral fracture
Definition
Hemarthrosis + fat globules; dark, discolored fluid with fat globules
Term
Artherocentesis for septic arthritis
Definition
Turbid fluid, High leuk count (15k to >200k)
Term
Artherocentesis findings in SLE, gout, RA
Definition
Inflammation; slightly turbid fluid w moderate white cell count (3K-50k). Crystals in gout (- bifringent) and pseudogout (+ bifringent)
Term
Osteoarthritis Management
Definition
Acetominephen is first line. NSAIDs are second line.

Others: cox2 inhib, Tramadol (opioid), low impact exercise, phys therapy, acupuncture, intra-articular steroid injections (no more than 3 injections a year)
Term
Chronic Pain management
Definition
1) Tramadol
2) Short acting opioid soon converted to long acting opioids
3) TCA antidepressants
4) Anticonvulsants (esp for trigem neuralgia)
Term
Carpal Tunnel Syndrome management
Definition
Nocturnal splint for 1 month, then reassess. nerve conduction study is not necessary.
Term
Screening for lipid disorders
Definition
Women > 45 (w risk)
Men > 35 (w risk)
Term
Abd aortic aneurysm screen
Definition
USPSTF
men:one time ultrasound between 65-70 w hx of smoking
women: no screen
Term
Zoster vaccine is available when?
Definition
after age 60
Term
When is the pneumococcal vaccine offered?
Definition
Age 65
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