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FNP Leik System Review > 1,000 terms Sensitivity (SNOUT) Negative results rules out the disease. Specificity (SPIN) Positive results rules in the disease. Primary Prevention Prevent the disease in its entirety. Examples include healthy diet, exercise,€13,11
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FNP Leik System Review > 1,000 terms Sensitivity (SNOUT) Negative results rules out the disease. Specificity (SPIN) Positive results rules in the disease. Primary Prevention Prevent the disease in its entirety. Examples include healthy diet, exercise,
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FNP Leik
FNP Leik System Review > 1,000 terms
Sensitivity
(SNOUT) Negative results rules out the disease.
Specificity
(SPIN) Positive results rules in the disease.
Primary Prevention
Prevent the disease in its entirety. Examples include healthy diet, exercise, safety (helmets/seatbelts), immuniza...
000 terms sensitivity snout negative results rules out the disease specificity spin positive results rules in the disease primary prevention prevent the disease in
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FNP Leik System Review > 1,000 terms
Sensitivity
(SNOUT) Negative results rules out the disease.
Specificity
(SPIN) Positive results rules in the disease.
Primary Prevention
Prevent the disease in its entirety. Examples include healthy diet, exercise, safety
(helmets/seatbelts), immunizations, and job safety
Secondary Prevention
Early detection of a disease. Examples include screening tests
Tertiary Prevention
Rehabilitation of a disease. Examples include support groups, education for pts with
pre-existing disease, drug side effect safety, medical equipment safety, any type of
rehab like PT or OT
Breast Cancer Screening Guidelines (USPSTF)
Onset = 50yo. Biannual. Stop at age 74yo. No SBE.
Breast Cancer Screening Guidelines (ACA)
Onset = 40yo. Annual. No stop age.
Cervical cancer screening guidelines
Onset=21yo (immunocompromised individuals start at onset of sexual activity). Every 3
years Pap w/ no HPV test until 30yo. Pap and HPV test after 30 yo and can begin
screening every 5 years. Stop at age 65yo. Complete hysterectomy means no Pap
unless pt has history of cervical cancer or high grade lesion.
Colorectal cancer
Onset 50yo. 1) colonoscopy q 10 years if wnl, 2) sigmoidoscopy q 5 years if wnl, 3)
annual FOBT with 3 stool samples. Stop age 75 yo.
Prostate cancer
USPSTF does not recommend screening with PSA but it based on individual pt.
Lipid screening
Onset 18-35/45yo screen if at increased risk of heart disease. Males >35yo and
Females >45yo
Flu vaccine
LAIV - Live virus can only be given to healthy non-pregnant 2 -49 yo w/o recent hx of
asthma (Peds). Cautioned or C/I in pts with egg, gentamicin or gelatin allergy and kids
receiving aspirin therapy (Reye's syndrome). TIV (trivalent inactivated vaccine) is
approved for >6months.
Tetanus vaccine
Q 10 years. Booster for dirty wounds if last TDAP/Td is > 5 years old. >7yo receive
Td/TDAP. Avoid in egg allergy and Gullian Barre. 5 doses of DTAP aka Pediarix
(2,4,6,15 months and 5 yo) First TDAP is at age 11-12yo. Td is the booster every 10
years or if someone has never had TDAP (came out in 2005) then they should have a
one time dose of TDAP and then continue with Td boosters.
Pneumococcal vaccine
,PCV 23 given one time at age 65 yo in healthy adults and for persons who are 2 years
and older and at high risk for pneumococcal disease (e.g., those with sickle cell
disease, HIV infection, or other immunocompromising conditions). PPSV23 is also
recommended for use in adults 19 through 64 years of age who smoke cigarettes or
who have asthma. One time booster given 5 years after first dose (So non-healthy pts
will receive 2 doses of PSV23 over their lifetime). PCV 13 is for <5 yo. When both
PCV13 and PPSV23 are indicated, PCV13 should be administered first; PCV13 and
PPSV23 should not be administered during the same visit. When indicated, PCV13 and
PPSV23 should be administered to adults whose pneumococcal vaccination history is
incomplete or unknown.
Varicella Vaccine
60 yo. May be given to pts who have previously had shingles. May be given earlier at
age 50yo. Live virus so c/I include pregnancy and immunocompromised.
Herpes Keratitis
Inflammation of the cornea. C/O abrupt severe eye pain, photophobia and blurred
vision. Diagnose with fluorescein dye and black lamp. Look for fernlike lines (corneal
abrasions appear more linear). Infection permanently damages corneal epithelium
which may result in blindness.
Acute angle closure
Glaucoma (Increased ICP r/t blocked drainage duct). Elderly pt c/o abrupt onset of
severe eye pain, HA, N/V, halos around eyes, and decreased vision. Exam reveals mid-
dilated pupil that is oval shaped, cloudy cornea, and fundoscopic exam shows cupping
of the optic nerve. Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and
topical steroids. Sx may be required
Cholesteatoma
Cauliflower like growth in the middle ear. Pt c/o foul smelling discharge and hearing
loss. On exam, no TM or ossicles visible. PMhx of chronic OM. The mass is not
cancerous but it can erode in to the bones of the face and damage CN7. Tx = ENT
referral for sx, abx. Mass is usually made of epithelium and cholesterol. AKA pearl
tumor.
Battle's sign
Bruise behind the ear over the mastoid process. Hx of trauma, and indicates a fracture
of the basilar skull. Golden serous discharge from ear or nose. Refer to ED for abx and
imaging (CSF will be + for glucose. Mucous will be - for glucose).
Cavernous sinus thrombosis
Blood clot in w/I cavernous sinus. This cavity houses internal carotid artery and CN III,
IV, V and VI). PmHx of sinus or facial infection. Pt c/o severe HA, high fever, decreased
LOC, unilateral periorbital edema, photophobia, proptosis and inability to move eye
appropriately.
Peritonsillar abcess
Pt c/o severe sore throat, difficult and painful swallowing (odonophagia) and LOCKJAW
(trimus), and a hot potato voice. Unilateral swelling peritonsillar area and soft palate with
displaced uvula. Tx = I&D in ED or needle aspiration
Diptheria
Bull neck, dysphagia, and gray/yellow psuedomembrane that is not to displace (stuff is
like concrete) and may obstruct airway
,Geographic tongue
Benign finding
Torus Palatinus
Painless bony protuberance on hard palate that is benign
Fishtail uvula
Split uvula is usually benign (rarely a sign of cleft palate)
Nystagmus
Vertical nystagmus is always abnormal. Horizontal nystagmus that occurs on prolonged
lateral gaze and resolves when eye moves toward midline is benign
Papilledema
Optic disc swollen w blurred edges r/t increased ICP (most commonly from bleeding,
brain tumor, abscess or pseudo tumor cerebri).
HTN Retinopathy includes
result from damage and adaptive changes in the arterial and arteriolar circulation in
response to the high blood pressure such as Copper/silver arterioles, AV nicking,
blot/flame hemorrhages, hard exudates and papilledema
Copper/silver arterioles
Eye condition seen with poorly controlled HTN. Indicates sclerosis and hyalinization of
the arterioles. Silver is worse than copper.
Diabetic Retinopathy
Microaneurysms caused by new fragile arteries in the retina. Examples see cotton wool
spots, flame hemorrhages and dot-blot hemorrhages.
Cataracts
Opacity of cornea
Koplik's spots
Small sized red papules w/ blue white centers inside the cheeks by the lower molars.
They are the prodromic viral enathem of measles (Rubeola)
Hairy Leukoplakia
Pathognomic for Epstein barr virus in immunocompromised pts (seen w HIV). Tongue
disorder.
Sjogren's syndrome
Chronic autoimmune disorder characterized by decreased function of lacrimal and
salivary glands. Pt c/o dry eyes/mouth for > 3 months and/or gritty eyes. OTC eye drops
and refer to ophthalmology and rheumatologist
Blepharitis
Chronic condition. Base of eyelids are inflamed. Itch
y/irritation with some crusting. Tx is johnson's baby shampoo and may need
erythromycin optho ointment
Epitaxis
Posterior nasal bleeds can result in severe hemorrhage. Tx for anterior bleeds is tilt
head forward and apply pressure over nasal bridge. Afrin nasal spray can be helpful.
Strep throat -
Beta hemolytic streptococcus group A. Classic triad is no cough, sore throat, and
enlarged cervical anterior lymph nodes. Possible fever, petechiae on hard palate. Tx =
C&S or rapid strep test. PCN x 10 days. PCN alternative are Zpak or Levaquin (for pts
>18yo). Sequalae includes scarlet fever, rheumatic fever and peritonsillar abscess.
, AOM
Common organisms are streptococcus pneumoniae (gram +), haemophilus influenza
(gram - ), Moraxella catarrhalis (gram - ). Weber has lateralization to affected ear.
Decreased mobility (flat trace line on typanogram). Tx = amoxicillin (80-90 mg/kg/d for
peds x 10 days and 500-875mg/day BID for adults). 2nd line agents are Augmentin,
Ceflin and Cefzil. PCN alternatives include Macrolides, Bactrim or Levaquin (if old
enough).
Watchful waiting for 48-72 hrs in healthy children
Prevention: Hib, PCV13 & annual flu vaccinations; also avoidance of 2nd hand smoke
Bullous myringitis
AOM with blisters (bulla) on TM.
Hordeolum (aka stye)
Acute bacterial infection of a hair follicle on the eyelid. Pt c/o itching w PAINFUL
pustule. Tx abx and warm compress (Remember Horders live in a pig stye)
Chalazion
Chronic inflammation of the meibomian gland (aka sweat gland of the eyelid). Gradual
onset of superficial nodule which is NON-TENDER. Treat w warm compress. Refer for
surgical removal is it does not resolve.
Pinguecula
Yellow triangular thickening of the bulbar conjunctiva caused by UV light damage
(Penguins no volar far from the bulbar)
Pterygium
Same as pinguecula but it extends on the nasal and temporal cornea. Tx for both
include weak steroids, sunglasses and sx (pterodactyl extend their wings)
Subconjunctival hemorrhage
Blood is trapped underneath the conjunctiva and sclera second to broken arterioles
from coughing, sneezing, heavy lifting and vomiting. Self limiting. Resolves in 1 to 3
weeks
Primary open angle glaucoma
Most common type. R/t blockage of the aqueous humor inside of the eye. Gradual
onset. CN2 undergoes ischemic changes and permanent damage occurs. Pt c/o
peripheral vision loss and then central vision loss.
Anterior uveitis
(iritis) Pt c/o red sore eyes w/o purulent discharge. Higher prevelance in autoimmune
disorders (RA, lupus, ankylosing spondylitis), sarcoidosis, and syphilis. Ciliary flushing.
Age-related macular degeneration (AMD)
Caused from gradual damage to the pigment of the macula Typical pt = elderly smoker.
Pt c/o gradual or sudden onset of central vision loss. Straight lines may appear
distorted. Peripheral vision in intact.
Otitis externa
"Swimmer's Ear". Common organisms = pseudomonas aeruginosa, staphylococcus
aureus. Otolagia with tragus manipulation. Tx = corticosporin otic suspension QID X7
days. Prophylaxis is alcohol and vinegar
Infectious mononuoleosis
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