Family Medicine Clear-cut responses for academic success.
2 views 0 purchase
Course
MEDICINE
Institution
MEDICINE
Diverticulosis - Answer LLQ pain in the absence of unstable vitals/fever (indicating
inflammation = diverticulitis)
MC in sigmoid colon
Tx: high fiber diet
Bullous Pemphigoid - Answer Bullous pemphigoid is a chronic, autoimmune,
subepidermal, blistering skin disease that rarely involves mucous...
Family Medicine Clear-cut responses for
academic success.
Diverticulosis - Answer LLQ pain in the absence of unstable vitals/fever (indicating
inflammation = diverticulitis)
MC in sigmoid colon
Tx: high fiber diet
Bullous Pemphigoid - Answer Bullous pemphigoid is a chronic, autoimmune,
subepidermal, blistering skin disease that rarely involves mucous membranes.
Most patient > 60 years of age
Presents with widespread blistering, most prominent over the *flexor surfaces* and *perineal
region.*
Blisters may also be itchy and erosions may form
The bullae are initiated by the formation of IgG autoantibodies targeting the type XVII collagen
component of *hemidesmosomes.*
Proper treatments of bullous pemphigoid depend on the severity of the disease. For localized
disease, topical steroids plus a systemic anti-inflammatory medication may be sufficient.
Renal Artery Stenosis - Answer Drug resistant HTN, especially in a pt w. risk factors for
atherosclerosis (over pheochromo)
Bruit ausculatetd above and laterally to the umbilicus.
A *duplex ultrasonographic* scanning is the initial non-invasive, non-nephrotoxic test to
diagnose renal artery stenosis.
,2|Page
Statins
*HMG-CoA reductase inhibitors* such as atorvastatin should be added to the treatment regimen
of patients with renal artery stenosis to prevent further plaque build-up.
Niacin - Answer "H"iacin
Niacin is an effective medication choice for raising a patient's HDL.
Niaspan (Niacin) inhibits the hepatic production of VLDL and consequently its metabolite LDL.
It also raises HDL levels by reducing lipid transfer of cholesterol from HDL to VLDL and by
delaying HDL clearance.
Type I Diabetes Mellitus Glucose Monitoring - Answer Current recommendations suggest
that newly-diagnosed type 1 diabetics *check their blood glucose multiple times daily.*
The most common symptoms of type 1 diabetes mellitus are *polyuria, polydipsia, and
polyphagia,* along with lassitude, nausea, and blurred vision, all of which are due to the
hyperglycemia itself.
Peptic Ulcer Disease - Answer Peptic ulcer disease is a general term used to refer to a
breach in the mucosal lining of the stomach or duodenum. Most common etiological agents
include *Helicobacter pylori infection* and *non-steroidal anti-inflammatory drug use. *
There are two types of peptic ulcers:
Clinical symptoms that are common to both include epigastric pain or gnawing sensation that
occurs after meals. Other symptoms include angina, dyspepsia, hematemesis, fatigue and
dyspnea
1) gastric ulcers
2) duodenal ulcers
Pain that accompanies a duodenal ulcer usually occurs 2 to 3 hours after a meal when the
duodenum is empty. Approximately 50 to 80 percent of these individuals complain of pain at
,3|Page
night. Opposed to those with gastric ulcers, patients with duodenal ulcers typically report pain is
relieved by food or antacids.
Dx: Esophagogastroduodenoscopy is the preferred test in evaluation of PUD.
Urease breath test would follow to prove eradication of H.Pylori
Tx: Current treatment for Helicobacter pylori is triple therapy.
Ex) lansoprazole + clarithromycin + amoxicillin
Ex) Esomeprazole + " "
COPD PFTs/CXR/Acute Tx - Answer Pulmonary function tests in COPD reveal:
1) decreased FEV1/FVC ratio (<70% of predicted)
normal
2) decreased FVC (functional vital capacity)
3) a normal or increased TLC (total lung capacity),
4) decreased diffusion capacity (most notable in emphysema)
4) Increased residual volume (> 100%)
The chest radiograph of a patient with chronic obstructive pulmonary disease (COPD) will often
show hyperinflated lungs, decreased lung markings, flattened diaphragms, and widened
intercostal spaces.
The number one risk factor in COPD is smoking history.
*Smoking cessation is the most important lifestyle modification in COPD.*
Acute tx:
BiPAP, a form of noninvasive ventilation.
Supplemental oxygen therapy should be started in patients with evidence of cor pulmonale,
pulmonary hypertension, hematocrit greater than 55 percent or hypoxia while asleep or supine.
Also is O2sat < 89% at rest
, 4|Page
*Noninvasive positive pressure ventilation (NPPV) is the preferred method of respiratory
support for acute exacerbations of COPD with evidence of acute respiratory failure.* NPPV
refers to mechanical ventilation delivered without initiating an artificial airway. There are various
mechanisms of action including Continuous Positive Airway Pressure (CPAP) and Bilevel
Positive Airway Pressure (BPAP). BiPAP is commonly used to treat COPD exacerbations. It
reduces the respiratory load and diaphragmatic work of breathing and increases tidal volume
resulting in an improvement in oxygenation.
Lead Poisoning. - Answer Consider lead poisoning in patients presenting with abdominal
and neurological complaints in the presence of microcytic anemia and a source of exposure.
Peripheral smear shows irregularly enucleated erythroblastosis w/ blue inclusions.
Dementia + - Answer Hallucinations + parksinsonian features -->Lewy Body
Progressive memory loss, visuospatial disturbances, loss of ability to learn new things -->
Alzheimer's
Steady decline in function (may include specific motor function) secondary to a series of cerebral
infarctions --> vascular dementia
INITIAL Hypertension Treatment - Answer Blood pressure goal:
1) <150/90 mmHg if 60 or older
2) <140/90 mmHg for ages 18-59
*UNLESS DIABETIC!!!*
Than <140/90 mmHG REGARDLESS OF AGE
On questions, don't be fooled, if tx is reaching a pt to the range we want it (even if quite a bit
under; no change in tx)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller hamedbash. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.49. You're not tied to anything after your purchase.
