Medical Terminology and Conditions: A Comprehensive Guide for Students, Exams of Nursing

Download Medical Terminology and Conditions: A Comprehensive Guide for Students and more Exams Nursing in PDF only on Docsity!

3Ps Exam | Actual Questions and Answers Latest Updated

2024/2025 (Graded A+)

herpes keratitis cause: herpes simplex virus or shingles symptoms: abrupt eye pain, blurred vision, tearing, vesicles on temporal side dx: fluorescein dye with fern like lesion tx: ophthalmologist or ER corneal abrasion symptoms: abrupt pain, abrasion that is round/irregular, foreign body sensation dx: fluorescein dye to r/u herpes keratitis tx: erythromycin ointment QID 3-5 days, DONT PATCH THE EYE alternatives meds: sulfacetamide, cipro, ofloxacin acute angle-closure glaucoma s/s: acute onset of eye pain, double vision, headache, nausea/vomiting, cloudy cornea, pupil dilated and does not react to light normal ICP: 8-21, AAG= > tx: ER stat papilledema s/s: optic disc swelling w/ blurred edges d/t increase ICP secondary to bleed, tumor, pseudo tumor tx: ER primary open angle glaucoma s/s: CN 2, gradual vision changes, peripheral vision first then central tx: IOP- elevated: ophthalmologist, medications: BB- timolol, and xalantan prostaglandin Cataracts s/s: night vision, glare w/ driving at night or alot of sun screen: red reflex absent from affected eye, normal reddish/orange glow Macular Degeneration s/s: painless loss of vision where straight lines appear curved, peripheral vision is preserved tx: amsler grid and refer to ophthalmologist retinal detachement s/s: flashes of light, looking through curtain, painless tx: ER dacryocystitis

def: infx of lacrimal sac from blockage s/s: thick discharge, pain, redness, swelling, warmth tx: lacrimal sac massage: downward toward mouth 2-3 times per day, systemic abx 7-10 days allergic rhinitis def: inflammatory changes, seasonal or daily s/s: congestion w/ clear mucus, itchy nose, sneezing, cough that is worse when lying down, blue/pale boggy turbinates tx: nasal steroid f/b antihistamine, decongestant, avoiding triggers epistaxis: nosebleed def: anterior nose bleed tx: blow their nose, tip forward, decongestant nasal Meneire's Disease s/s: triad = dizziness, tinnitus, hearing loss mnemonic: VAST = vertigo, aural fullness, sensorineural loss, tinnitus tx: supportive, antihistamine, antiemetics Acoustic Neuroma s/s: years 30-60, gradual hearing loss one side, sensorineural loss w/ tinnitus and facial numbness dx: MRI: bengin tumor tx: surgery cholesteatoma s/s: cauliflower inside the ear, foul smell, hearing loss, erode bone = CN 7 tx: surgery Battle Sign: Basilar Skull Fracture s/s: parietal bone fracture, raccoon eyes, bruising behind the mastoid, drainage from nose/ear tx: ER Benign Paroxysmal Positional Vertigo BPPV s/s: vertigo from sudden movements, lose balance, falls dx: GOLD STANDARD: Dix-Hallpike tx: Epley Maneuver by PT vestibular neuritis/labryinthitis cause: viral infx or inflammation s/s: severe vertigo w/ n/v for 1-2 days then lessen, tinnitus, sensorineural loss tx: zofran, methylprednisolone taper Acute Otitis Media: AOM

cause: strep pneumo s/s: unilateral ear pain, popping/muffled hearing, fever, TM rupture- blood/pus on pillow, TM red and bulging, TM immobile Tx: amoxicillin, recent ABX use = augmentin, cephalosporin Penicillin allergy: Type 1: levofloxacin, doxcycline. Type 2: 3 generation of cef hearing test: conductive hearing loss, Weber-lateral to bad ear, Rinne BC > AC Otitis Media w/ effusion s/s: painless, follow AOM d/t rhinitis, clear fluid in ear w/ pressure resulting in hearing loss. TM not red or bulging tx: treat like allergies, supportive therapy, oral decongestant, steroid nasal spray Hearing test: Weber: lateral to affected ear, Rinne BC>AC Otitis Externa cause: pseudomonas aeruginosa s/s: red/swollen ear canal that is tender, external ear pain, green, itching, hearing loss tx: topical steroid and antibiotic: Cortisporin or Cipro ear drops, NSAID, keeping out of water hearing test: Weber: lateral to affected ear, Rinne: BC>AC presbycusis s/s: sensorineural hearing loss w/o lateralization, inner ear, aging adult and high frequency acute bacterial rhinosinusitis cause: strep pnuemo, H. influenzae, viral s/s URI for longer than 10 days, unilateral facial pain/fullness, purulent nasal drip. Transilluminate: duller on affected side tx: augmentin, nasal irrigation, nasal steroids, NSAID Penicillin allergy: levofloxaxin or doxy infectious mononucleosis cause: Epstein bar virus s/s: sore throat w/ white exudate, posterior lymphadenopathy, fatigue for several weeks, rash, hepatomegaly, splenomegaly Triad: fever, sore throat, lymphadenopathy dx: monospot tx: symptomatic, rest, AB US strep and mono= give macrolide oral leukoplakia def: white patches on tongue tx: refer to ENT for biopsy Sialolithiasis s/s: pain lump on submandibular gland, pain w/ eating, calculi or salivary stones

aphthous stomatitis s/s: painful shallow ulcers 7-10 days on tongue/cheek tx: magic mouthwash: steroid, lidocaine, benadryl strep throat causes: Group A strep, viral: rhinovirus, RSV s/s: fever, sore throat, pain w/ swallowing, NO VIRAL SYMPTOMS, sandpaper rash dx: rapid antigen test, throat culture, NAAT criteria: score 3-4 confirm with strep test: fever, lymphadenopathy, exudate, no cough, age 3- 14 tx: 1-3 days after starting, penicillin BID 7-10 days, penicillin allergy= macrolide complication: scarlet fever arthitis, glomerularnephritis, cellulitis, sinusitis tonsillopharyngeal abscess s/s: deviated uvula w/ red mass, higher fever, sore throat, dysphagia tx: ER stat, airway compromise hypertensive retinopathy s/s: av nicking, retinal hemorrhages, copper/silver arterioles diabetic retinopathy s/s: cotton wool spots, microaneurysm, neovascularization koplik spots s/s: red papule w/ white center, rash, conjunctivitis, fever, cough cause: measles- rubeola hearing loss sensorineural: lateralization to good ear Rinne AC > BC conductive: lateralization to bad ear, BC>AC MR. ASS MVP mitral regurgitation aortic stenosis systole mitral valve prolapse mitral regurgitation location: 5th ICS MCL, apex, apical area MITRAL PROLAPSE HEARD HERE AS WELL prolapse: s/s: asymptomatic, palpitation, dizziness, fatigued, SOB aortic stenosis

RADIATES TO NECK

location: 2nd ICS right upper sternum MS ARD-E mitral stenosis aortic regurg diasole erb's point mitral stenosis mid/late diastole location: apex using bell s/s: shortness of breath aortic regurg 3/4 ICS erbs point sound: loud, high pitched grading murmur 1: barely audible 2: audible 3: clearly audible 4: thrill 5: hear w/ edge of scope off chest 6: dont need stethoscope to hear S associated with heart failure sound kentucky abnormal > 35 normal: children, athletes, pregnancy S LV hypertrophy sounds like tennesse mitral valve prolapse late systolic s/s: palpitations, CP, SOB tx: BB atrial fibrillation

s/s: intermittent persistent, SOB, CP, fatigue, dizziness, weakness, syncope, rapid heart beat dx: ECG tx: cardiology CHADS-VAS score: 0 low risk, 2 needs anticoag, CHF Hypertension Age > 75 Diabetes Stroke Vascular disease Age 65- 74 Sex: female higher risk anticoagulation factor Xa: direct inhibitors examples: - xaban dont use with valve problems wafarin: coumadin

• use for valvular and nonvalvular a. fib based on INR lots of drug interactions, avoid vitamin K anticoagulation therapy goal INR 2-3 for atrial fibrillation/dvt prosthetic valve: 2.5-3. duration: surgery/VTE = 3 months indefinite: recurrent VTE, irreversible risk factors paroxysmal SVT cause: caffeine, dig, illegal drugs s/s: tachy, peaked QRS, HR 15- 200 tx: cardiologist, 911, caridioversion pulsus paradoxus def: decrease in systolic BP > 10mmHg during inspiration cause: cardiac tamponade, effusion, MI, pericarditis s/s: exaggerated disease orthostatic hypotension def: decrease systolic by 20, diastolic by 10 s/s: asymptomatic, dizziness, lightheadedness, tachy infective endocarditis: bacterial

s/s: fever, chills, malaise, osler node: painful petechiae, splinter hemorrhage dx: blood culture, TEE tx: cardiology, IV abx prophylaxis: hx of endocarditis, heart valves, heart disease = penicillin AAA s/s: asymptomatic until rupture rupture: abdominal, bakc pain with pulsatile mass, s/s of shock dx: u/s tx: ER Coarctation of Aorta def: BP higher arms than legs s/s: pulses in legs not palpable, radial bounding, heart murmur dx: echo, CT, MRI hypertension def: > 130/ risk: stroke, MI, CKD, vascular secondary HTN: kidney, endocrine, pregnancy stages of BP elevated 120-129/ < stage 1: < 140/< 90 stage 2 > 140/> stage 1 BP elderly over 60: goal 150/ goal for most patient < 130/ ACC/AHA HTN lifestyle treatment: heart healthy, DASH, increase potassium, reduce alcohol, exercise thiazide diuretics: end in - ide dont give with sulfa allergy protective for osteoporosis SE: hyperglycemia, hyperuricemia, hypokalemia, hyponatremia lowers BP 2-8 points ACEI end in - pril first choice for diabetes to protect kidneys

SE: dry cough, hyperkalemia, angioedema, dont use ACE and ARB teratogenic Betablocker end in - lol good add on: not first choice avoid abrupt discontinuation to prevent HTN contraindicated: Asthma, COPD, CB, emphysema, brady calcium channel blocker end in - dipine first choice for isolated systolic SE: headache, ankle edema, bradycardia contraindicated: bradycardia, CHF, heart block Heart failure BP management ACE/ARB first line BB plust diuretic DM: BP management ACEI/ARB first line AA: CCB/Thiazide CKD BP management ACEI/ARB first line then CCB/thiazide Stroke hx BP management ACEI/ARB first line then CCB/thiazide for second line PAD/PVD s/s: intermittent claudication, atrophy/shiny legs, gangrene to toes, pain at night, poor perfusion dx: ABI: 0.9 or less, ateriography tx: avoid compression therapy, exercise by walking chronic venous insufficiency s/s: impaired venous return, achy leg w/ elevation, edema, hyperpigmentation, cold ulcers, pulses palpable dx: US tx: support stockings/elevation raynaud's phenomenon s/s: cold, numb, painful fingers/toes triggered by cold, higher risk of autommune tx: CCB, avoid cold weather, stop smoking, wear gloves

Acute Decompensated HF s/s: SOB, edema, hepatic congestion, abd tenderness, anorexia, tachy, nocturia, rales dx: BNP, CXR tx: cause of HF/refer to ER NY Heart Association class 1: no limitations class 2: ordinary result in fatigue/dyspnea class 3: marked limitation w/ normal activity class 4: symptoms at rest or w/ activity ACS s/s: CP that radiate to shoulder, neck, jaw, angina longer than 20 min, diaphoresis, SOB, palpitation dx: ECG tx: 911, CPR as needed, ASA, BB HLD total cholesterol: < 200 triglyceride < 150 LDL < 100 HDL > 40 men/>50 women Rhabdomyolysis def: breakdown of muscle tissue s/s: muscle fatigue, weakness, dark urine dx: CK, Cr, urinalysis tx: hold statin, hydrate, LFT, CK, Cr, K Statin Therapy end in - statin check LFT prior high: start low and slow for age < 75, cardiac/brain issue, LDL > 190 moderate: age 40-75, no ASCVD or DM, ASCVD >7. moderate 2: age 40-75, or age > 75 and not candidate for high, DM, LDL 70- 189 metabolic syndrome def 3 of 5 conditions s/s: obesity: 40in male/35 in female HTN, BG > 100, triglycerides >150, Decreased HDL pulmonary emboli cause: DVT s/s: sudden CP, SOB, cough that is blood tinged tachy, pallor

anaphylaxis: def: IgE tx: epi 1:1000 or SQ prior to 911 Spirometry diagnose COPD FEV1< 80% FEV1/FVC ratio <0. GOLD Guidelines for COPD Group A: SABA/SAMA, ANTICHOLINERGIC FIRST LINE Group B: LAMA/LABA, SABA Group C: LAMA, LABA, ICS, SABA Group D: refer Chronic bronchitis def: COPD inflammation of bronchi w/ excess mucus, purulent sputum longer than 3 months for 2 years tx: SABA and inhaled anticholinergic risk: bacterial infection emphysema s/s: hyperresonance, decreased tactile fremitus, egophony decreased, pursed lip breathing, weight loss dx: CXR CURB 65

1. Confusion
2. BUN>
3. RR>
4. BP<90/
5. 65yo One or less indicates patient can be treated outpatient, >1 =hospitalization community acquired pneumonia bacteria: strep pneumo, H. influenzae, mycoplasma s/s: fever, chills, productive cough, chest pain, mucus: yellow, green/rusty exam: crackles, wheezing, egophony, dullness dx: CXR GOLD STANDARD WBC > 11, elevated neutrophil, shift to left tx: healthy: amoxicillin +macrolide or doxycyline comorbidities: fluoroquinolones atypical PNA

bacteria: mycoplasma, chlamydia, legionella s/s: fever, chills, cough, rales, mild labs: CXR, CBC, PCR tx: macrolides, doxycycline asthma def: chronic airway inflammation d/t hyperresponsive airways and bronchoconstriction s/s: increased use of albuterol, chest tightness, cough tx: guidelines, resuce inhaler Asthma Classification Step 1 - Intermittent

• Symptoms two times or less per week; asymptomatic and normal PEF between exacerbations; requires SABA two days a week; exacerbations brief (few hours or days); varying intensity; no interference with normal activity
• Nighttime - two times or less per month
• Lung function - FEV1 >80% predicted; normal FEV1 between exacerbations Step 2: mild persistent
• Symptoms more than two times per week but less than one time per day; requires SABA more than 2 days/week but not more than one per day; exacerbations may affect activity (minor)
• Nighttime - 3 - 4 times per month
• Lungs - FEV >80% predicted Step 3: moderate persistent
• Daily symptoms, daily use of inhaled SABA, some limitations, exacerbations affect activity, two times or more per week; may last days
• Nighttime - more than one time per week but not nightly
• Lung - FEV >60% but <80% predicted Step 4: severe persistent
• Continual symptoms, requires SABA several times/day; extremely limited physical activity, frequent exacerbations z
• Nighttime - often seven times per week
• Lung - FEV <60% predicted Asthma treatment guidelines intermittent: ICS w/ SABA mild persistent: ICS moderate persistent: ICS, LABA or medium ICS or low dose ICS+LTRA 4 = refer urgent care for asthma

MDI/nebulizer 3x oral steroids for exacerbation monitor response asthma based on PEF/FEV well controlled >80% not well controlled 60-80% very poorly controlled < 60% tuberculosis s/s: fatigue, night sweat, fever, weight loss, cough dx: GOLD STANDARD C/S NAAT, AFT, CXR- black holes active TB: C/S, AFT, NAAT tx: latent rifamycin, 3-5 drugs TB skin testing highest risk: > 5mm in immunocompromised highest risk > 10mm: immigrant, drug users, exposed at home low risk: > 15mm no risk factors thyroid gland function secrete T3/T4, TSH in anterior pituitary hypothalmus regulate TSH parathyroid produces PTH and regulate calcium dx: elevated calcium d/t releasing too much tx: bisphosphonate Primary hyperparathyroidism high level of calcium asymptomatic hypothyroidism cause: hashimoto thyroiditis screening: TSH > 5 s/s: lethargy, constipation, weight gain, fatigue, irregular menstrual, delayed DTR, goiter, dry skin dx: High TSH low T4/normal or low T tx: synthroid: low and slow check TSH 6-8 weeks hyperthyroidism

cause: graves disease s/s: lid lag, exophthalmos, anxiety, tachy, heat intolerance, goiter, thyroid storm lab: TSH low and high T complication: arrythmia, angina, CHF, osteoporosis Tx: PTU, radioiodine ablation PTU for pregnancy cushing syndrome s/s: central obesity, moon face, hairy, hypertension, DM dx: elevated cortisol, increased BG/Na, decreased K Addison Disease s/s: craving salty food, hyperpigmentation dx: decreased cortisol, high k diabetes type 1 s/s: polyuria, polyphagia, polydipsia, weight loss cause: destruction of beta cells diagnosing DM prediabetes: fasting BG 100-125, random > 200 with symptom, A1c 5.7-6.4% goal: A1c < 7% if diabetic and every 3 months with changing therapy hypoglycemia cause: pancreas release glucagon stimulating conversion to glucose tx: 15g simple carb: orange juice, soft drink, candy and recheck in 15 glucagon: significant < 54 dawn phenomenon an increase in blood glucose in the early morning, most likely due to increased glucose production in the liver after an overnight fast tx: dont eat carbs at bedtime, take insulin at bedtime and increase insulin Somogyi effect early-morning hyperglycemia that occurs as a result of nighttime hypoglycemic episodes, caused by compensatory mechanism of growth hormone dx: set alarm between 2-3 for 1-2 weeks < 60 positive tx: lower insulin dose, change insulin, snack with evening insulin type 1 DM management insulin only type 2 DM

metformin: max dose 2g then add others type 2 DM w/ ASCVD/CAD SGLT-2: flozin: uses kidneys to excrete GLP1: stimulates insulin and inhibit glucagon DM w/ CKD: SGLT- 2 metformin first line for type 2 avoid w/ liver/kidney SE: gas, bloating, diarrhea sulfonylurea end in - ide risk of hypoglycemia thiazolidinediones: cause fluid retention dont give w/ CHF alpha glucosidase inhibitors blocks intestinal absorption of carbs hypoglycemia SE: gas, diarrhea, bloating Meglinitides

• glinide give with meals and cause hypoglycemia DPP- 4
• gliptin decrease appetite SE: nausea, stomach pain, diarrhea, hypoglycemia insulin short acting: duration 3-6 hours NPH: breakfast to dinner: 12-18 hours Basal insulin: lantus covers 24 hours microvascular damage retinopathy, nephropathy, neurpathy macrovascular

CAD

PAD

acute appendicitis s/s: periumbilical to right lower quadrant McBurneys point, anorexia psoas sign RLQ abd pain w/ right leg hyperextenion obturator sign RLQ abd pain w/ internal rotation of RIGHT hip Rovsing sign palpation of LLQ w/ pain in RLQ Markle test pelvic/abd pain when heel drops to floor Acute cholecystitis RUQ/epigastric colicky pain after eating fatty meal, nausea, vomiting exam: murphy sign: cessation of inspiration by hooking finger on right costal margin acute pancreatitis s/s: gray turner: bruising on flank, cullen sign: bruising around umbilicus, fever, anorexia, N/V dx: amylase, lipase tx: ER diverticulitis s/s: LLQ, fever, anorexia risk: low fiber, western diet lab: > 11 on WBC, neutrophilia tx: ED duodenal ulcer s/s: pain after meals 2-5 hours, pain when stomach empty or hunger, hx of OTC antacid, H2, PPI dx: endoscopy, H. pylori tx: H. pylori: urea breath test gastric ulcer s/s: pain with food, vomiting, early satiety, nausea tx: endoscopy adn biopsy H. pylori treatment

first line: Bismuth, Flagyl, Tetracycline, and PPI second: clarithymycin, amoxicillin, PPI zollinger-ellsion Syndrome tumor in pancreas w/ multiple ulcer d/t HCl tx: PPI GERD s/s: chronic cough, acid sour breath, sore throat, thinning enamel, mid sternal pain tx: mild: dietary changes and H2, not effective = PPI for 6-8 weeks causes: CCB, BB, HTN foods to avoid w/ GERD peppermint, chocolate, coffee, alcohol barrett's esophagus refer risk of cancer tx: PPI and H2 at bedtime irritable bowel syndrome def: abd cramping from stress, not inflammatory bowel s/s: pain and changes with stool, constipation, diarrhea, may have mucus but not blood or pus alarm sign: weight loss, abd mass, hx of cancer, pencil stool, bleeding Giardiasis cause: protozoa = diarrhea from fecal/oral hx of camping/outdoor activity s/s: foul smelling fatty stools and explosive diarrhea labs: c/s and parasite tx: tinidazole or flagyl celiac disease allergy to gluten s/s: hx of abd pain/bloating, fatigue, joint pain, weight loss tx: avoid wheat, barley ulcerative colitis s/s: colon/rectum only, rectal bleeding, 10-20 stools per day, rash crohn's disease s/s: ileum, ileocolitis, cobblestoning, may involve mouth, small intestine, colon, RLQ abd pain hemorrhoid

s/s: bright red blood from anal, stain toilet paper/water tx: OTC hemorrhoid remedy, prolonged sitting on toilet, increase fiber elevated AST elevated w/ MI found in liver, cardiac, skeletal, kidney, lung elevated ALT specific to liver alkaline phosphatase bone growing in children/teen, healing fractures liver, gallbladder, kidney, placenta gamma-gluatmyl transaminase/transpeptidase GGT elevation in alcoholic alk phost high and GGT: liver issue no GGT: bone issue acute hepatitis s/s: fever, fatigue, loss of appetite, malaise, nausea/vomiting, clay stool, jaundice lab: AST, AST, bilirubin tx: syntompatic except hep C hepatitis A IgG = G for gone IgM: Immediately infected Hepatitis B HBsAg: anti-HB immiinity IgM anti-HBc: core HBsAG: + infected anti-Hbs: + is immunity - no immunity anti-HBc: +infected from virus - immmunity Hepatitis C anti-HCV: positive need HCV-RNA creatinine def: end product of metabolism and figure out GFR value: >1.3 abnormal increase: older, race, CKD, high protein, AKI, nephrotoxic drug GFR

>

BUN:

urea from protein metabolism AKI def: decrease kidney function w/ GFR<60 and elevated Cr prerenal cause: hypotension, volume depletion, HF, drugs intrarenal: nephritis, kidney disease post renal: BPH, stone, cancer, clots s/s: edema, lugns w/ crackle, elevated BP, N/V, confusion asymptomatic bacteriuria def 105 colony w/ absence of UTI screen/treat pregnant women urinary tract infections bacteria: e.coli, klebsiella, staph risk factors: hx, pregnancy, intercourse, DM s/s: dysuria, urgency, abd pain lab: luekocyte esterase, nitrite tx: macrobid, bactrim UTI in males complicated UTI sexually active: NAAT tx: 7 days: bactrim, cipro, macrobid pyelonephritis bacteria: gram negative s/s: fever, flank pain, N/V, dysuria, frequency, nocturia tx: mild-outpatient fluoroquinolones diagnosis of kidney stone u/s RBC in urine glomerulonephritis subarachnoid hemorrhage s/s: worst headache, thunderclap, vomiting, seizure, confusion, stiff neck subdural hematoma

hx of falling, anticoaluants, skateboarding concussion dx w/ CT = NO CONTRAST post concussion syndrome after TBI s/s: headache, neck pain, dizziness, N/V, memory problem, faitgue Aphasia broca: expressive, difficulty forming words but understands in frontal lobe wernicke area: receptive aphasia, able to speak but can't understand migraine s/s: throbbing pain, N/V, photophobia, prodrome, flashing lights triggers: wine, fermented foods, MSG, stress tx: triptans, analgesic/caffeine, NSAID prophylaxis: migraine more than 3 per month, TCA, BB, CCB, anticonvulsants cluster headache s/s: one sided behind one eye/temple, nasal congestion, Horner syndrome, higher risk of suicide and occur day for weeks to months tx: oxygen, sumatriptan prophylaxis CCB tension headache cause: medication overuse s/s: tightness/bandlike that is mild-moderate tx: NSAID, acetaminophen, ASA prophylaxis: TCA, effexor Trigeminal Neuralgia CN s/s: electric pain in cheek/perinasal area tx: carbamazepine pseudotumor cerebri s/s: obese female w/ headache, high ICP, diplobia, visual symptoms, tinnitus tx: carbonic anhydrase inhibitors temporal arteritis: giant cell arteritis s/s: temple indurated like cord, blindeness, amaurosis fugax, blindness labs: increased CRP and ESR tx: high steroids: 60-100mg 2-4 weeks, refer ER polymyalgia rheumatica

s/s: bilateral joint stiffness, achiness in shoulder, neck, hip, torso, systemic symptoms exam: decreased ROM: shoulder, neck, hips tx: prednisone side effect of steroid: infection, weight gain, depression, osteoporosis bell's palsy: CN s/s: facial paralysis d/t inflammation and swelling, motor function impaired r/o lyme disease, shingle, TIA, MS tx: artificial tears, prednisone, antiviral seizure absence: sudden brief lapse of inattention tonic-clonic: tonic first then clonic fever decrease threshold Multiple Sclerosis s/s: opitc neuritis, lhermitte sign: shock from neck down through spine, fatigue, pins/needles dx: MRI tx: neurologist TIA/CVA def: embolic or hemorrhagic s/s: abrupt headache, N/V, nucal rugidity, stuttering/slurred speech, facial weakness TIA: neurologic dysfx without infarct FAST Face drooping Arm weakness Speech difficulty Time to call 911 cranial nerves 3,4,6 = EOM 5 trigeminal: herpes keratitis, corneal abrasion 1: olfactory 11: spinal accessory 8: ear exam 7: facial fibromyalgia tender point in 11/18 body point pain above and below wast 3 months

carpal tunnel median nerve tinel: tapping phalen: putting finger togehter iron deficiency anemia s/s: fatigue, weakness, pica, pallor, cheilitis, glossitis cause: blood loss, CHF, IBD, surgery labs: GOLD STANDARD FERRITIN, MCV low, Ferritin and Iron low tx: ferrous sulfate check retic thalassemia genetic defect lab: microcytic hypochromic but ferritin normal tx: genetic testing Normocytic anemia s/s: HTN, CKD, COPD, fatigue, pallor dx: MCV tx: cause macrocytic anemia due to folate or vitamin B12(cobalamin) deficiency (megaloblastic anemia), THF-M --> VitB12-M --> Methionine, (transfer of methyl groups) s/s; muscle weakness, neuro, tingling, glossitis, optic neuritis labs: macrocytic normochromic tx: vitamin b12 folate deficiency anemia cause: inadequate intake s/s: alcoholism, pallor, fatigue, diarrhea lab: macrocytic normochromic tx: folic acid, pregnant women 400mcg prior to pregnancy sickle cell anemia CBC screening lab: GOLD STANDARD HBG ELECTROPHORESIS dx: CVS or amniocentesis Thrombocytopenia

def: less than 150k cause: ITTP s/s: epistaxis, petechiae, hematuria, bruising navicular fracture s/s: falling on outstretched hand and pain below thumb area dx: xray wont show in 2 weeks, MRI, bone scan tx: thumb spica cast and ortho colles fracture distal radius w/ tilting upward tx: ER low back pain cause: inflammation, sciatica, sprain, spasm, herniated disc resolve 4-6 weeks sciatica: radiculopathy and cause of herniated sic lumbar stenosis: long periods of standing, walking dx: MRI sciatica s/s: L4-L5: sharp burning pain radiate to thigh and top of foot dx: straight leg raise w/ pain in buttocks/thigh/calf cauda equina s/s; loss of bladder, bowel fx, numbness of pelvic floor and saddle tx: ER ankylosing spondylitis def: progressive arthritis, chronic s/s: low back pain w/ stiffness at cervical then thoracic then lumbosacral, generalized symptoms exam: loss of flexion dx: MRI, XR, CRP, ESR tx: NSAID orthopedic injury RICE: rest, ice, compression, elevation medication: tylenol, ibuprofen, naproxen isometric exercise: resistance aerobic exercise mcmurray test

assess medial meniscus listen for click = positive dx: MRI drawer test Knee Flexed 90* and move tibia forward Tests anterior-to-posterior laxity anterior: check ACL posterio: PCL lachman test application of anterior and posterior force to the proximal posterior tibia to determine the stability of the ACL and PCL more sensitive for ACL valgus stress MCL: positive laxity or torn MCL. gum sticking brings knees together varus stress test application of a lateral force to the medial aspect of a joint in an attempt to create a gap in the lateral joint line, thereby testing the stability of the lateral aspect of the joint rotator cuff tendinitis s/s: gradual/acute pain w/ overhead, lifting/reaching pain, arm weakness tx: NSAID, PT, RICE lateral epicondylitis TENNIS worse w/ twisting/grasping tx: RICE, NSAID medial epicondylitis GOLFER: inner elbow tenderness to palpation of inner aspect Distal Bicep Tendon Rupture s/s: sudden pain w/ popping nose at bicep f/b bruising on bicep, bicep will not roll, difficulty twisting dx: MRI tx: surgery dequervain tenosynovitis/tendonitis

s/s: overuse/heavy lifting, inflammation with thumb/wrist tx: finkelstein: positive if pain/tenderness tx: splint 3-6 weeks, NSAID, ice morton neuroma def: scarring of digital nerve d/t high heels, tight shoes s/s: pebble mass and pain between 2/3 metatarsal, burning/numbness dx:Mulder's sign: grasp 1/5 metatarsal w/ pressure tx: NSAID, avoid trigger plantar fasciitis def: inflammation of plantar fascia from overuse s/s: pain on heel from bed in morning tx: stretching, ice, NSAID, sneakers osteoarthritis def: weight bearing joint/hand s/s: early morning stiffness that last less than 30 minutes, aggravated by cold, changes in weather, over use, heberden node high and bouchard below tx: tylenol, exercise rheumatoid arthritis def: autoimmune with systemic and bilateral inflammatory arthritis w/ multiple joints s/s: early stiffness longer than 1 hour, pain, warm, tender joint not relieved w/ rest swan-neck deformity, boutonniere, rheumatoid module tx: rheumatologist, NSAID, steroids, DMARDS, TNF risk factors for osteoporosis older women, thin frame, steroids, androgen deficiency, anorexia, gastric bypass, hyperthryoidism, ankylosing spondylitis, low ca, low vitamin d prevention of fracture with low D, high TSH, low HCT 600 - 800 vitamin D 1000 - 1200 ca Gout s/s: painful podagral and joint r/t alcohol, seafood/steak meal warm to touch, swollen dx: elevated uric acid, tophi tx: acute: allopurinol, NSAID, steroid, colchicine medial tibial stress syndrome

s/s: overuse and common in runners, inflammation of muscle tendon, bone dx: DO bone scan/MRI tx: RICE alcoholism CAGE: cut down annoyed guilty eyeopener evaluate for withdrawal tremor, anxiety, tachy, increased BP, insomnia, DT labs: elevated GGT, MCV > 100 tx: ER DT: benzo, clonidine anorexia s/s: lanugo, osteoporosis, BMI < 18.5, edema, heart problem, evaluate complication cause of cardiac attention-deficit/hyperactivity disorder (ADHD) s/s: hyperactivity, impulsivity, inattention affect function, behavior therapy, symptoms lasting longer than 6 months tx: behavioral, stimulants depression s/s lasting 2 weeks: fatigued, irritable, poor self-image, cognition, insomnia, hypersomnia, anorexia, increased appetite, weight loss, weight gain minor depression s/s: 2-4 symptoms of depression dx: r/o cause of hypothyroidism, autoimmune disorder labs: CBC, BMP, TSH, UA tx: SSRI: up to 6 weeks elderly and Depression SSRI: best safety citalopram, escitalopram, sertaline= lowest drug-drug interaction acute serotonin syndrome