Term
| in an elderly pt who is suspecious for alzhiemers what labs do you order. image? |
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Definition
b12
rpr (for neurosyphillis)
tsh
hiv
ct mri |
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Term
| major features of dementia |
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Definition
memory loss
decline of executive functioning |
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Term
| most common cause of dementia |
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Definition
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Term
| pathological dx of alzheimers |
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Definition
| plaques and neurofib tangles |
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Term
| diagnostic criteria of alzhiemers |
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Definition
1. gradual onset and progression of cognitive dysfuntion in one or more area of mental function (aphasia, apraxia or agnosis)
2. not caused by anything else |
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Term
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Definition
| dementia in the elderly 2/2 depression |
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Term
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Definition
nausea, vomit, diarrha, dizziness, ha
arrythmia, bradycardia, urinary retention |
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Term
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Definition
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Term
| manage hallucinations and agitation in alzhiemers pts |
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Definition
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Term
| dementia, gait distrubance and incontinence |
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Definition
| normal pressure hydrocephalus |
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Term
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Definition
| lewy: more ups and downs, hallucinations earlier |
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Term
| do you do imaging in migraines? |
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Definition
| only if they have "red flag" symptoms |
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Term
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Definition
triptan
if otc nsaids dont work |
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Term
| migraine unilat or bilat? |
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Definition
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Term
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Definition
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Term
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Definition
rapidly increasing headache frequency
focal deficits
ha awakens pt from sleep |
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Term
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Definition
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Term
| work up of sudden onset HA |
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Definition
image
then lumbar puncture if image - |
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Term
| HA increasing in severity or frequency |
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Definition
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Term
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Definition
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Term
| work up of temporal arteritis |
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Definition
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Term
| focal neuro deficits + HA |
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Definition
| mass, vascular malformation, stroke |
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Term
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Definition
mass ledion
pseudotumor
meningitis |
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Term
| who gets migraine prophylaxis |
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Definition
| ppl who require acute tx more than 2 x week |
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Term
| goal tx in migraine prophylaxis |
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Definition
| reduction in severity and freq of HA by 50% |
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Term
| other drugs to use vs migraine |
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Definition
propanolol
timolol
divalproex sodium |
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Term
| most common form of primary HA |
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Definition
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Term
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Definition
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Term
| photophobia and phonophobia in tensino HA |
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Definition
| may have one, but not both |
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Term
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Definition
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Term
| cluster HA bilat or unilat |
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Definition
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Term
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Definition
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Term
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Definition
o2 at 6L min
dihydroergotamine
triptans |
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Term
| prophylaxis of cluster HA |
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Definition
verapamil
Li
divalproex sodium
prednisone |
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Term
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Definition
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Term
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Definition
| HA from caffeine, NSAIDS or other pain killers |
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Term
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Definition
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Term
| types of vague medical issues associated with domestic violence |
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Definition
chronic pain
frequent abdo or pelvic pain
depression, fatigue |
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Term
| exam/tests to order when suspicious of child abuse |
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Definition
retinal exam (retinal hemorrhage)
xray |
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Term
| what is the drs legal obligation in abuse |
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Definition
domestic violence against an adult does not need to be reported
violence against children ALWAYS needs to be reported |
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Term
| stocking glove burns of extremities |
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Definition
| immersion in scalding water |
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Term
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Definition
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Term
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Definition
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Term
| bucket handle fracture or corner fracture |
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Definition
| metaphysis of long bone has the corner chipped off. sign of child abuse |
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Term
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Definition
result of grabbing and squeezing the chest violently
very suspicious for abuse |
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Term
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Definition
aka toddlers fracture
common injury often confused with abuse, more often from learning to walk |
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Term
| multiple bruises on shins of child |
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Definition
| more common from falls and learning to walk in toddler aged children |
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Term
| drugs that more commonly cause fever |
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Definition
beta lactams
sulfa
heparin
amphotericin B |
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Term
| how do you get malignant hyperthermia |
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Definition
| autosomal dominant disroder |
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Term
| features of malignant hyperthermia |
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Definition
fever > 104
tachycardia
metabolic acidosis
calcium accumulation in skeletal mm --> rigidity |
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Term
| when does malignancy hyperthermia happen |
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Definition
| up to 24 hours after exposure to anestheis like halothane, succinly choline |
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Term
| tx of melignancy hyperthermia |
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Definition
antipyretics
oxygen
cooling blankets
dantrolene IV |
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Term
| 5 Ws of postoperative fever |
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Definition
| Water, Wind, Wound, Walk, Wonder Drugs |
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Term
| fever within 24 hours of surgery |
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Definition
sepsis from:
preexisting infection
intraperitoneal leak
toxic shock
malignant hyperthermia |
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Term
| time frame to get uti after surgery |
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Definition
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Term
| when is dvt a risk after surgery |
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Definition
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Term
| fever 1 month after surgery |
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Definition
delayed trasnfusion issues
transplant rejection
infective endocarditis |
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Term
| what factors indicate an infectious cause of fever |
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Definition
1. preoperative trauma
2. ASA score > 2 (aneasthesia)
3. onset on second post op day
4. WBC > 10,000
5. BUN > 15
6. chills/rigors |
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Term
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Definition
temp over 38 or under 36
HR over 90
RR over 20, or PaO2 <32
WBC > 12000 or under 4000 |
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Term
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Definition
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Term
| most common pathogen in post operative sepsis |
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Definition
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Term
| when is atelectasis a risk factor |
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Definition
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Term
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Definition
discoid inflitrate
elevated hemidiaphragm |
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Term
| major risk of atelectasis |
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Definition
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Term
| what type of abx do you use in aspiration pneumonia |
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Definition
anything with gram negative coverage
Clindamycin or
amox/clav or
metro + amox or penicillin |
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Term
| how many days of iv puts pt at risk for iv site infction |
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Definition
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Term
| largest cause of postoperative morbidity |
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Definition
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Term
| most important risk factory for pneumonia |
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Definition
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Term
| most common non infectious cause of post op fever is |
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Definition
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Term
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Definition
viral infection
nonspecific inflammation of small airways |
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Term
| most common cause of bronchiolitis |
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Definition
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Term
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Definition
starts with rhinorrhea in child
then they wheeze
then low grade fever
then rhinorrhea gets worse
then on PE they have wheeze, fine crackels, and increased work of breathing |
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Term
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Definition
| functional GI disorder characterized by chronic abdominal pain and altered bowel habits |
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Term
| area of abdomen that has most pain in IBS |
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Definition
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Term
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Definition
| cramping sensation of intermittent frequency and variable intesity |
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Term
| initial screening in someone with IBS signs and no other systemic issues |
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Definition
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Term
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Definition
antispasmodic: dicyclomine or
TCA if more severe
SSRI |
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Term
| tx diarrhea predominate ibs |
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Definition
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Term
| first line therapy in constipation predominant IBS |
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Definition
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Term
| most common valvular heart defect in US |
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Definition
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Term
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Definition
| subjective sensation of unduly strong, slow, rapid or irregular heart beats that may be related to an arrythmia |
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Term
| most common causes of palpitation |
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Definition
40% from primary rythm disturbance
31% anxiety/panic
6% drugs |
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Term
| what does long QT put you at risk for |
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Definition
ventricular arrhythmia
sudden cardiac death |
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Term
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Definition
| autosomal dominant but more commonly seen in women |
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Term
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Definition
| palpitations, syncope and fam hx of syncope or sudden death |
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Term
| what qualifies as a prolonged QT |
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Definition
| QTc over 470 msec in men or 480 in women |
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Term
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Definition
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Term
| palpitations in ppl over 50 |
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Definition
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Term
| syncope with resting tremor or brisk reflexes |
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Definition
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Term
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Definition
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Term
| best drugs for supraventricular rythms |
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Definition
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Term
| tx ventricular responses to atrial arrythmias (like flutter or fib) |
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Definition
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Term
| what is carotid sinus massage used for. how does it work |
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Definition
SVT
stimulates vagus nerve action to turn off AV node |
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Term
| other things to use besides carotid massage that work the same way |
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Definition
valsalva maneuver
cold applications to face
IV adenosine |
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Term
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Definition
warfarin (per chads2) +
BB or CCB |
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Term
| new onset PVCs usually indicate |
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Definition
| initial presentation of coronary artery disease |
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Term
| first imaging in suspected stroke |
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Definition
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Term
| most important risk factor for stroke |
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Definition
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Term
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Definition
| embolisms from heart, large vessels or small vessles |
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Term
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Definition
contralat hemiparesis, sensory loss, neglact and impaired gaze
aphasia if dominant hemisphere |
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Term
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Definition
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Term
| when do you give antihypertensives in the setting of a stroke |
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Definition
only if systolic is >220 or diastolic >120
goal 185/110 |
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Term
| drugs most commonly used to dec bp in setting of stroke |
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Definition
labetalol
nicardipine
sodium nitroprusside |
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Term
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Definition
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Term
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Definition
| symptomatic with 50-70% stenosis |
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Term
| what long term therapy would you give to pt with noncardioembolic stroke |
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Definition
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Term
| does hepatitis cause unconjugated or conjugated hyperbilirubinemia |
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Definition
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Term
| stigmata of alcohol abuse |
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Definition
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Term
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Definition
congenital reduction of conjugation of bilirubin
in 5% of population, nbd
during times of illness, drug use or stress the bilirubin level will increase. |
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Term
| is gilberts conjugated or unconjugated |
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Definition
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Term
| route of transmission of hep A |
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Definition
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Term
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Definition
| jaundice, fever, malaise, abdo pain, self limiting |
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Term
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Definition
4-6 weeks
but can last up to 6 mo |
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Term
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Definition
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Term
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Definition
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Term
| who should get hepA vaccine |
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Definition
ppl traveling to endemic area
MSM
children who live in areas with lots of hepA
ppl with chronic liver disease |
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Term
| prophylaxis of HepA in contacts of ppl with acute hepA |
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Definition
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Term
| incubation period of hepB |
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Definition
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Term
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Definition
acute or chronic infection
pt is infectious to others |
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Term
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Definition
| pt was either vaccinated or they resolved an infection |
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Term
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Definition
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Term
| what does anti HBcAg mean |
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Definition
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
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Term
| most common cause of chronic liver disease |
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Definition
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Term
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Definition
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