Term
|
Definition
| Diabetes, HTN, sedentary lifestyle, obesity, tobacco use, abnormal lipid levels. Older age (men over 45, women over 55), male gender, and family history. |
|
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Term
| Ways to slow progression of CAD |
|
Definition
| ACEi, control BP (less than 130/80 for diabetics), prophalaxis with aspirin, use a statin |
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|
Term
| Symptoms of heart failure |
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Definition
| PND, orthopnea, pedal edema, dyspnea on exertion, fatigue |
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Term
| Signs of heart failure on PE |
|
Definition
| rales in lung bases, dullness to percussion, JVD, laterally displaced PMI, S3, hepato-jugular reflux |
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Term
| Etiologies of new onset CHF |
|
Definition
| acute MI, arrhythmias, CAD (ischemic cardiomyopathy), non-ischemic cardiomyopathy, uncontrolled HTN/diastolic dysfunction, valvular disease |
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Term
| Non adherence to HTN medications makes what type of heart failure most likely? |
|
Definition
| HTN/diastolic dysfunction |
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Term
| Lab studies to order to evaluate a patient with new onset CHF |
|
Definition
| CXR, EKG, echo, BNP levels (to differentiate between cardiac and non-cardiac conditions in patients with dyspnea) |
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Term
| Best option for management of a patient coming into your outpatient office with a new onset CHF and possible ischemia on EKG? |
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Definition
|
|
Term
| Findings on CXR of a CHF patient? |
|
Definition
| Cardiomegaly, central vascular congestion and hilar fullness, pleural effusions, cephalaization of pulm vasculature (pulm vessels seen in upper lung fields when you don’t normally see them there), kerley B lines (represent interstitial fluid in the lung tissue) |
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|
Term
| What does 2 D echo measure? |
|
Definition
| size of the chambers, the thickness of the walls, and the size of the cavity, evaluates movements of heart structures |
|
|
Term
| What does Doppler assess? |
|
Definition
| Blood flow (direction and velocity) |
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|
Term
| Medications used to manage systolic heart failure |
|
Definition
| ACE, ARBs, Digoxin, loop diuretics, metoprolol. DON’T use: CCBs, thiozoladindiones (rosiglitazone and pioglitazone) |
|
|
Term
| Difference between systolic and diastolic HF? |
|
Definition
| Systolic is EF less than 45% |
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Term
| Medications used to manage diastolic HF? |
|
Definition
| Diuretics, BB or CCB. Continue ACE, statins and aspirin as needed. |
|
|
Term
| Difference between primary and secondary dysmenorrhea? |
|
Definition
| Primary- painful menses without pelvic pathology. Secondary- WITH pelvic pathology |
|
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Term
| Risk factors for primary dysmenorrhea? |
|
Definition
| Depression/anxiety, smoking. Also can get this with anovulatory cycles in teens/twenties |
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|
Term
| Which of the following are normal PE findings in a non pregnany woman? 12wk size uterus, a nonmobile uterus, mildly tender ovaries, nabothian cysts on cervix, vaginal discharge |
|
Definition
| only 12 wk uterus and non mobile uterus are NOT normal. |
|
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Term
|
Definition
| Irregular, frequent bleeding. But does not have to be heavy. |
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|
Term
|
Definition
| Second half of a woman’s cycle |
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|
Term
| Differential for dysmenorrhea? |
|
Definition
| Adenomyosis, cervical stenosis, chronic PID, endometriosis, fibroids, ovarian cysts. NOT: IBD, IBS, psychiatric problems, uterine polyps |
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Term
|
Definition
| dysmenorrhea, increased urinary frequency, infertility, menorrhagia, large uterus |
|
|
Term
| Is PID pain related to the menstrual cycle? |
|
Definition
| NO. abd pain can happen at any time. |
|
|
Term
|
Definition
| presence of ectopic glandular tissue found in muscle |
|
|
Term
| How can you differentiate women with leiomyoma vs. endometriosis? |
|
Definition
| Leiomyomas don’t cause dyspareunia while endometriosis does. |
|
|
Term
| When does pain from ovarian cysts present? |
|
Definition
| Midcycle (or can be associated with menses) because related to ovulation |
|
|
Term
| Labs and radiologic studies for an older F presenting with dysmenorrhea? |
|
Definition
| CBC (for anemia), HCG ( for pregnancy), pelvic ultrasound, TSH |
|
|
Term
| At what age do you stop treating otitis media with antibiotics? |
|
Definition
|
|
Term
| Characteristic of influenza? |
|
Definition
| Fever, myalgia, sore throat |
|
|
Term
| How is syncope different from presyncope? |
|
Definition
| Syncope = temporary LOC, fainting/passing out vs. presyncope = feeling light headed or faint (not actually passing out) |
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|
Term
| Difference between disequilibrium and vertigo? |
|
Definition
| Disequilibrium = feeling of being off balance vs. vertigo = room spinning |
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|
Term
| Etiologies of presyncope? |
|
Definition
| Mi, anemia, Afib, thryotoxicosis, bradyarrythmias |
|
|
Term
| Diff diagnosis of vertigo? |
|
Definition
| Benign paroxysmal positional vertigo (BPPV), cerebellar stroke, meniere’s disease, TIA, vestibular migrane, vestibular neuritis. |
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|
Term
| How can you differentiate between central and peripheral causes of vertigo? |
|
Definition
| Peripheral produces a unidirectional nystagmus that does not change direction and is inhibited by fixation. |
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Term
| Constellation of vertigo, hearing loss and tinnitis makes you think of what peripheral lesion causing vertigo? |
|
Definition
|
|
Term
| Short burst of positional vertigo makes you think of what peripheral lesion? |
|
Definition
|
|
Term
| Vertigo unrelated to position with sign of a peripheral lesion, norm neurological exam and symptom onset shortly after upper URI makes you think of diagnosis? |
|
Definition
|
|
Term
| Tx for peripheral vertigo? |
|
Definition
| Diuretics, epley maneuvers, vestibular rehab exercises, vestibular suppressant medications (anti cholinergics or anti emetics) |
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