Term
| Office screening for lipids, Pap, chlamydia, HIV, bone mineral, AAA, mammography |
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Definition
| Lipids - men >35, men and women > 20 if CV risk factors, all q5y PAP - q3 untl 70 Chlamydia - sexually active F <25 and older HIV - 13-64 Bone mineral density - F > 65, at risk 60-64 AAA - x 1 in men 65-76 who have ever smoked Mammo - at 40, with clinical exams at 20. BRCA with FH only. |
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Term
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Definition
| q2 years if <120/80, yearly if prehypertension. |
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Term
| Screen for diabetes if BP ... |
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Definition
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Term
| DO NOT routinely screen for |
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Definition
| hemochromoatosis, thyroid dz, glaucoma, CAD in asymptomatic pts, carotid disease, herpes, hepatitis |
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Term
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Definition
| likelihood of developing disease given the presence of an autosomal dominant gene |
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Term
| Chronic basal pain meds dosing |
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Definition
| Start with 30-50% of average 24 hour narcotic dosage, titrating upward q3-4 days. |
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Term
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Definition
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Term
| Acute, sub-acute and chronic cough |
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Definition
| Acute < 3 weeks, subacute 3-8 weeks, chronic >8 weeks |
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Term
| Differential of chronic cough |
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Definition
| Asthma, bronchitis, bronchiectasis (voluminous sputum production), Upper Airway Cough Syndrome (postnasal drip), GERD. |
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Term
| Bronchitis and bronchietasis tx |
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Definition
Bronchitis - inhaled steroid., possible abx
Bronchiectasis - abx |
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Term
| Definition of chronic fatigue |
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Definition
| 6 months of unexplained fatigue plus four or more of...memory impairment, sore throat, tender LN, muscle pain, joint pain, HA, unrefreshing sleep, postexertional malaise lasting 24 hours. |
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Term
| Treatment for chronic fatigue |
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Definition
| Graded exercise program, CBT, SSRI. |
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Term
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Definition
| CHOLE - Cigarette, HTN, Older (M > 45, F > 55), Low HDL, Elder h/o premature CAD |
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Term
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Definition
High risk - CAD or equivalent - < 100, treat > 130
Mod high risk - 2+ risk factors + 10yr risk 10-20% - goal < 130, treat > 130
Mod risk - 2+ risk factors + 10 yr risk <10% - goal < 130, treat > 160
Low risk - 0-1 risk factor - goal < 160 treat > 190 |
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Term
| When to treat hypertriglyceridemia |
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Definition
| When elevated (200-500) and non-HDL cholesterol (total - HDL) exceeds goal LDL + 30 OR level > 500 |
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Term
|
Definition
| PAD, AAA, carotid artery dz, TIA, DM |
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Term
| Treatment for hypertriglycerides |
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Definition
| Fibrates - fenofibrate is better than gemfibrozil with statins. Also niacin, omega 3 (maybe) |
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Term
| Obesity classes based on BMI |
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Definition
| Class I 30-35, Class II 35-40, Class III >40. Morbit obesity is Class III or Class II with complications of obesity (afib, CAD, DMII, etc.) |
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Term
| Intermediate risk factors for ED treatment |
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Definition
| Asymptomatic and 3 or more cardiac risk factors, moderate, stable angina, recent MI (2-6 weeks), NYHA II, h/o stroke or TIA. Must have stress or be referred to cardiologist. |
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Term
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Definition
| absence of cremasteric reflex is 99% sensitive. Surgery before US. No salvage beyond 48 hours. |
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Term
| Sinusitis acute, recurrent and chronic |
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Definition
| Acute < 4 weeks, recurrent > 3 x /year, chronic > 12 weeks |
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|
Term
| Pharyngitis due to corynebacterium has... |
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Definition
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Term
|
Definition
If 2-3 are present, test and treat with Pen V if positive. Four are present, treat.
Fever, no cough, exudate, tender anterior cervical nodes |
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Term
| Before starting antidepressant therapy... |
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Definition
| rule out bipolar do - could precipitate a manic event. |
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Term
|
Definition
| fibromyalgia, neuropathic pain - duloxetine |
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Term
|
Definition
| CBT AND drug tx (paroextine, sertraline, venlafaxine) |
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Term
|
Definition
| 1 month of re-experiencing the event, avoiding reminders, heightened arousal |
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Term
|
Definition
| anxiety do, somatoform do, eating do |
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Term
| Niacin deficiency manifestations |
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Definition
| 3 Ds - diarrhea, dementia, dermatitis |
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Term
| Eye exams in geri patients |
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Definition
| Periodic eye chart in office (Snellen), periodic ophtho exams after 65. |
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Term
| Medication to prevent falls |
|
Definition
| Remove psychotropics, Vit D 1000 IU daily (goal 25-hydroxy D > 30 ng/mL |
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Term
| Treatment for stress incontinence |
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Definition
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|
Term
| Treatment for urge incontinence |
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Definition
| Oxybutinin, bladder training |
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Term
| >4 METs (metabolic equivalents) |
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Definition
| ability to climb a flight of stairs, walk up a hill, walk level ground @ 4 MPH |
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Term
|
Definition
| anticoagulants as possible, diuretics, cholestyramine, oral hypoglycemics, estrogen (DVTs), MAOIs, herbals |
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Term
| After angioplasty, postpone surgery by... |
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Definition
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|
Term
| Pre-op start B-blockers in patients who... |
|
Definition
| have inducible ischemia for elective vascular surgery, who have a clear indication (start several days before), or with RCRI score >= 3. |
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Term
| When should DVT prophylaxis continue out of hospital |
|
Definition
| After hip or knee replacement / repair and abdominal surgery for CA |
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|
Term
| Knee and hip post-op DVT prophylaxis |
|
Definition
| LMWH, warfarin, fondiparinux. NOT SQH. |
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|
Term
| Pre-op treatment of hyperthyroidism |
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Definition
| PTU, Potassium iodide, BB, steroids. |
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|
Term
| Moderate stress dose steroids |
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Definition
| Hydrocortisone 50mg IV pre-op, then 25mg IV q8 x 2 days |
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|
Term
| High-risk surgery pre-op stress dose steroids |
|
Definition
| Hydrocortisone 100mg IV pre-op, then 50mg IV q8 x 3 days |
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|
Term
| ADHD symptoms must be present before... |
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Definition
|
|
Term
| Pulsitile tinitus' origin |
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Definition
|
|
Term
| Continuous tinnitus' origin |
|
Definition
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|
Term
| BV symptoms, diagnosis, tx |
|
Definition
| Puritis, smooth, white discharge, "whiff test" +, pH > 4.5, clue cells. Metronidazole 500 BID x 1 week. |
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Term
| Yeast infection symptoms, signs, tx |
|
Definition
| Cottage cheese d/c, pH < 4.5, wet mount with hyphae. Fluconazole 150mg x 1 or OTC. |
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Term
|
Definition
| Strawberry cervix, green bubbly d/c, pH >> 4.5. Oral metronidazole 2g x 1. |
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Term
| Identify breast mass or lump diagnostic radiology |
|
Definition
| <30 US, >30 mammo - observe if cystic, aspirate or biopsy or excision if not clearly cystic. |
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Term
| Breast skin changes, peau d'orange tx |
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Definition
| <30 abx for presumed mastitis. If not resolved or >30, then b/l mammo, if abnormal, biopsy or excision. |
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Term
| USPSTF screening for pregnant women |
|
Definition
| asymptomatic bacteriuria, syphilis, Hep B, iron defiiciency anemia |
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Term
|
Definition
| >7 days, facial pain and purlulent nasal d/c |
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|
Term
| When to give stress dose steroids |
|
Definition
| If pt took more than 20mg/d x 3 weeks in last year |
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|
Term
| Meniere's triad of symptoms |
|
Definition
| Tinitus, vertigo, hearing loss |
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|
Term
| Rough diagnosis of hip pain |
|
Definition
| Anterior - hip pain, lateral - bursal pain, posterior - sciatic pain |
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|
Term
| When is surgery indicated for incontinence |
|
Definition
| Moderate to severe stress incontinence. Also, estrogen creams or gels for stress. |
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Term
| Pre-op cardiac testing is indicated for... |
|
Definition
| patients with active cardiac conditions - unstable angina, decompensated HF, significant arrhythmia, or severe valvular HD |
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