Term
| What is the common cause and tx of otitis media |
|
Definition
1) S.pneumo, H.flu
2) no rx and f/u PRN if 6+mo sx; amox (80mg/kg/d TID) |
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Term
| What is the common cause and tx of acute sinusitis |
|
Definition
1) s. pneumon, H. flu
2) amox at 2x dose (80mg/kg/d TID); levofloxacin if resistant |
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Term
| What is the common cause and tx of pharyngitis |
|
Definition
1) G-A-strep
2) PCN 500mg PO BID for 10d; erythromycin x10d if PCN allergy; amox in children |
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Term
| What is the common cause and tx of pneumonia |
|
Definition
1) s. pneumo, atypicals, H.flu
2) macrolide, doxycycline; levofloxacin if refractory, elderly, or co-morbidities |
|
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Term
| What is the common cause and tx of traveller's diarrhea |
|
Definition
1) e. coli, salmonella, shigella, campylobacter, parasite (Giardia, entamoeba)
2) Bacterial: cipro 500mg PO BID x3d if sx 24+hrs, fever, bloody diarrhea; single dose azithromycin for children
2) parasite: metronidazole |
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Term
| What is the common cause and tx of pseudomembranous colitis |
|
Definition
1) c. dif
2) Flagyl or PO vanco |
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Term
| What is the common cause and tx of UTI (uncomplicated) |
|
Definition
1) e. coli, G-, s. saprophyticus
2) macrobid 100mg PO BID x5d, bactrim DS PO BID x3d; second line: cipro 250mg PO BID x3d |
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Term
| What is the common cause and tx of STD |
|
Definition
- tx if pt has sx and tests + for one, treat for both:
1) chlamydia and gonorrhea
2) azithro 1000mg PO once (chlamydia); suprax 400mg PO once |
|
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Term
| What is the common cause and tx of vaginitis |
|
Definition
1) candida: OTC antifungals, fluconazole 150mg PO x3
2) bacterial vaginosis: flagyl (PO/PV)
3) trichomonas: flagyl (treat partner) |
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Term
| What is the common cause and tx of acne |
|
Definition
1) P. acnes
2) doxy (beware of photosensitivity rxn) |
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|
Term
| What is the common cause and tx of cellulitis/impetigo/abscess |
|
Definition
1) strep, staph
2) diclox/keflex QID; 2nd line- clinda; drain abscess; bactroban for impetigo, bactrim/doxy for MRSA |
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Term
| What are the major s/e of the following oral abx: PCN |
|
Definition
- GI upset
- allergic rxn (rash, anaphylaxis
- yeast infection
- dec seizure threshold
- c. diff colitis |
|
|
Term
| What are the major s/e of the following oral abx: cephalosporins |
|
Definition
- GI supset
- allergic rxn (5% cross-allergenicity w PCN)
- yeast infection
- C. diff colitis |
|
|
Term
| What are the major s/e of the following oral abx: macrolides: |
|
Definition
- GI upset
- allergic rxn (rare)
- yeast infection
- C. diff colitis
- inc QT interval when combine w azoles (anti-fungals)
- drug interactions by accel p450 |
|
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Term
| What are the major s/e of the following oral abx: bactrim |
|
Definition
- allergic rxn (rash, steven's johnson syndrome)
- GI upset
- yeast infection
- c. diff colitis
- e. multiforme
- anemia w G6PD deficiency |
|
|
Term
| What are the major s/e of the following oral abx: tetracyclines |
|
Definition
- GI upset
- hotosensitivity rash
- allergic rxn
- C. diff colitis
- yeast infection
- bone/teeth discoloration in children and fetus |
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Term
| What are the major s/e of the following oral abx: metronidazole (flagyl) |
|
Definition
- disulfiram-like rxn
- GI upset
- metallic taste
- allergic rxn |
|
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Term
| What are the major s/e of the following oral abx: clindamycin |
|
Definition
- GI upset
- allergic rash
- yeast infection
- C. diff colitis |
|
|
Term
| What are the major s/e of the following oral abx: fluoroquinolones |
|
Definition
- GI upset
- allergic rxn (1%)
- H/a
- yeast infection
- c. diff colitis
- dmg developing cartilage: avoid in pregnancy,kids |
|
|
Term
| What is the coverage of the following oral abx: PCN |
|
Definition
+++ group A strep, oral anaerobes, T. pallidum (syphilis)
++ strep pneumoniae
--- s. aureus, gonorrhea |
|
|
Term
| What is the coverage of the following oral abx: amoxicillin |
|
Definition
+++ GAS, listeria**, oral anaerobes
++ strep pneumo, enterococcus**
+ H flu*, moraxella*, e. coli*
--- s. aureus, gonorrhea |
|
|
Term
| What is the coverage of the following oral abx: dicloxacillin |
|
Definition
+++ s. aureus,
++ strep
+ oral anaerobes
---G-,MRSA |
|
|
Term
| What is the coverage of the following oral abx: augmentin |
|
Definition
+++ GAS, oral anaerobes, Hflu, E.coli, P. multoxida, s. aureus
++ strep pneumo, enterococcus
--- resistant pneumococcus |
|
|
Term
| What is the coverage of the following oral abx: 1st gen ceph (e.g. cephalexin) |
|
Definition
+++ GAS, s. pneumo
++s. aureus
+ h.flu, moraxella, e.coli |
|
|
Term
| What is the coverage of the following oral abx: 2nd gen ceph (cefuroxime) |
|
Definition
+++ H. flu, e. coli, moraxella
++S. pneumo, G-, GC |
|
|
Term
| What is the coverage of the following oral abx: erythromycin |
|
Definition
+++ "atypicals" (mycoplasma, chlamydia, legionella), GAS, Pertussis
++ S. pneumo, C trachomatis, P acnes
+ s. aureus, H.flu, moraxella |
|
|
Term
| What is the coverage of the following oral abx: azithromycin |
|
Definition
+++ atypicals, GAS, C. trachomatis, pertussis
++ strep penumo, H.flu, Moraxella, s. aureus |
|
|
Term
| What is the coverage of the following oral abx: TMP-SMX |
|
Definition
+++ e. coli, PCP
++ S. pneumo, H. flu, MOraxella, MRSA
--- GAS, anaerobes |
|
|
Term
| What is the coverage of the following oral abx: doxycycline |
|
Definition
+++ c. trachomatis, lyme, P.acnes, MRSA, RMSF, atypicals
++ s. pneumo, H flu, moraxella |
|
|
Term
| What is the coverage of the following oral abx: metronidazole (flagyl) |
|
Definition
+++ abd/vag anaerobes, C.dif, B. vaginosis, Trich, Giardia, ameobiasis
--- G-, G+ |
|
|
Term
| What is the coverage of the following oral abx: clindamycin |
|
Definition
+++ oral/vaginal anaerobes, S. aureus, GAS
++ B. vaginosis, S. pneumo, Trich
--- G-, MRSA |
|
|
Term
| What is the coverage of the following oral abx: ciprofloxacin |
|
Definition
+++ G-, pseudomonas
++gonorrhea, enterococcus
+strep
---anaerobes, atypicals |
|
|
Term
| What is the coverage of the following oral abx: levofloxicin |
|
Definition
+++ G-, pseudomonas, atypicals, s. pneumo
++ enterococcus
---anaerobes, staph |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding children |
|
Definition
1) newborn screen/hearing test
2) fluoride (6mo+)
3) vision screen 0-5yrso
4) obesity screen (6+yrso)
5) depression (12-18yrso) |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding cardiovascular screening |
|
Definition
1) BP screen for 18+yrso
2) lipi screening in men 35+yrso; screen men and women 20+ if CAD RF
3) DM screen in adults w HTN
4) smoking cessation
5) obesity screen/counseling
6) AAA screening in men 65-75yrso
7) ASA for men 45-79yrso, women 55-79, if outweighs GI risk |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding osteoporosis screening |
|
Definition
| - all women 60+yrso w risk factors or 65+yrso w/o RF |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding cancer screening in clinical practice |
|
Definition
1) colorectal CA screen 50-75yrso q10yrs OR annual FOBT OR flex sig q5yrs w FOBT q3yrs
2) Fhx of colon ca: screen at 40 or 10yrs prior to dx of family member dx
3) mammograp q2yrs in women 50-74yrso
4) women w FHx of breast/ovarian Ca for BRCA testing and genetic counseling
5) pap smear at 21yrso or within 3yrs of sexual activity is 21-yrso |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding pregnancy |
|
Definition
1) test: syphilis, anemia, HepB, chlamydia (0-25yrso), HIV, gonorrhea
2) test: asisx bacteriuria in pregnant women at 12-16wks
3) smoking cessation breastfeeding counseling |
|
|
Term
| What are Class A/B recommendations for clinical practice regarding STDs |
|
Definition
- chlamydia, gonorrhea in women 0-25yrso or high risk
- HIV screening in high risk
- syphilis screening if high risk
- STD preention counseling for sexually active people |
|
|
Term
What level evidence for the following:
newborn screen/hearing test
scoliosis in adolescents
lead screen average risk
flouride at 6+mo
newborn hyp dysplasia/hyperbilirubinemia screening |
|
Definition
|
|
Term
| What are D level evidence recommendations for cardiovascular disease |
|
Definition
1) routine screening for CAD w EKG, stress test, cardaci CT in pt at low risk
2) aspirin for primary VCA prevention in women 0-55yrso or for primary MI prevention in men 0-45yrso
3) carotid artery disease screening if asissx
4) PVD screening if asisx
5) AAA screening in women of any age |
|
|
Term
What level evidence for the following:
asisx bacteriuria screening in nonpregnant people
beta carotene supplements to prevent ca/CAD
screen for tobacco/alcohol/depression use in adults
aspirin/NSAIDS to reduce colon CA risk
screening asisx adults for COPD using spirometry |
|
Definition
|
|
Term
| What are D level evidence recommendations for cancer screening |
|
Definition
- colorectal ca screen 85+yrso
- prostate ca screen 75+yrso
- pancreatic ca screen
- testicular exam (even in high risk adolescents or adults)
- hormone replacement in postmenopausal women to prevent chronic illness
- ovarian ca screen w CA-125,u/A, pelvic exam
- bladder ca screen
- teaching breast self-exam
- BRCA test if no FHx
- pap smear after total hysterectomy for benign disease
- pap screening in 65+yrso w 3 nl screen in past 3yrs and no abnl in 10yrs |
|
|
Term
| What are D level evidence recommendations for pregnancy |
|
Definition
- bacterial vaginosis screening in average risk pregnancy
- HSV screening |
|
|
Term
| What are D level evidence recommendations for STD |
|
Definition
- HSV screening
- Hep B and C screening
- syuphilis screening in general population
- gonorrhea screening in low risk adults |
|
|
Term
| What are the components of the confusion assessment method/CAM for delirium? What is a positive result? |
|
Definition
1) acute onset and fluctuating course
2) inattention
3) disorganized thinking
4) altered level of consciousness
- delirium if (1) AND (2) WITH EITHER (3) or (4) |
|
|
Term
| Describe the miniCOG screen for dementia |
|
Definition
1) Registration: 3 objects, repeat until learned
2) Clock-drawing at "10 past eleven" - 2pts
3) Recall: previous 3 objects
SCORING: 0-2 = (+) for dementia proceed to more formal testing; 3-5 = (-) screen for dementia |
|
|
Term
| What are examples of ADLs vs IADLs |
|
Definition
1) ADLs: bathing, dressing, toileting, feeding, transferring, continence, ambulation
2) IADLs: telephone, traveling, shopping, meal preparation, housework, taking medicine, money management |
|
|
Term
| What are reversible conditions assoc w urinary incontinence captured by the mnemonic DIAPERS |
|
Definition
1) Delirium
2) Infection
3) Atrophic vaginitis
4) pharmaceuticals (diuretics, alpha-adrenergic agonists/antagonists, anticholinergic agents)
- Endocrine (DM)
- Restricted mobility
- Stool impaction |
|
|
Term
| What are barriers to sexual activity int he elderly |
|
Definition
- diabetes
- arthritis
- fatigue
- fear of MI
- vaginal dryness
- impotence
- depression |
|
|
Term
| What are medications associatd with increased fall risk in the elderly |
|
Definition
- anti-arrhythmics/digoxin
- antihistamines
- antihypertensives
- antipsychotics
- benzodiazepines
- diuretics
- muscle relaxants
- narcotics
- laxatives
- MAOIs
- TCAs
- vasodilators |
|
|
Term
| Describe "Get-up-and-go" test |
|
Definition
1) pt asked to rise from sitting position
2) hands crossed across chest, walk 10ft
3) turn around, return to chair and sit down
*30+sec, higher risk of falls, need for therapy or aid* |
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