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55 Cards in this Set
- Front
- Back
- 3rd side (hint)
what is the maximal duration of ARS?
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which sinus issue can last up to 4 weeks?
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what is ABRS?
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- relatively rare |
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prior to choosing an antimicrobial therapy, what are questions to ask? |
to which situation to the following questions apply: - what is/are the most common pathogen(s) causing this infection? - what is the spectrum of a given antimicrobial's activity? - what is the likelihood of a resistant pathogen? - what is the danger if there is treatment failure? |
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what is the most common causative bacterial organism for ABRS, AOM and CAP? |
S. pneumonia is the most common bacterial pathogen for which maladies?
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Gram + diplococci, ABRS causative organism in adults 38%, children 21-33% - describes which organism?
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what is the gram stain, morphology, and percentage of ABRS caused by S. pneumonia?
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what is the percentage of drug resistance (DRSP) for S. pneumonia?
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which organism has >= 25% DRSP? |
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in patient's with recurrent infection and tobacco use, what is the most common pathogen for ABRS, AOM and CAP? |
H. influenza is the most common pathogen for which maladies especially under which patient conditions? |
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which common pathogen is a G - bacillus? |
H. influenzae has what gram stain and morphology? |
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>= 30% PCN resistance via beta-lactamase is characteristic of which organism causing ABRS, AOM and CAP? |
H. influenzae has which % of resistance using which resistance mechanism? |
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what is the less common pathogen associated with ABRS and AOM and an uncommon cause of CAP?
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M. catarhallis is a less common pathogen causing which maladies?
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Gram negative coccus uncommonly associated with ABRS, AOM and rarely associated with CAP
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M.catarhallis has what gram stain and morphology? |
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which pathogen has >= 90% PCN resistance via beta-lactamase production?
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M. catarhallis has what % of abx resistance to which abx? |
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in the treatment of ABRS, under what three conditions do you consider initiating antimicrobial therapy? |
under the following conditions of ABRS, what is your next move? - persistent and not improving >= 10 days - severe >= 3-4 days - worsening or double sickening >= 3-4 days |
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what is a special consideration for the following populations when choosing abx? - < 2 yo or >65 yo - prior abx w/in the past 2 months - prior hospitalization w/in past 5 days - comorbidities - immunocompromised |
what are patient characteristics that put them at risk for antimicrobial resistance? |
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when is the appropriate time to use intranasal corticosteroids in ABRS? |
ABRS + allergic rhinitis allows the use of which medication for symptom relief? |
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what is first line therapy for ABRS?
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amoxicillin-clavulanate (875/125 BID or 500/125 TID) is which line therapy for which malady?
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what is second line therapy for ABRS?
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amoxicillin-clavulanate (2000/125) or doxycycline (100 BID or 200 daily) is which line of therapy for which malady? |
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what is/are the indicated therapy/ies for ABRS in a pt with a beta-lactam allergy?
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- doxycycline (100 BID or 200 daily) - levofloxacin (500 daily) - moxifloxacin (400 daily) |
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in ABRS, if there is a risk for antibiotic resistance or failed initial therapy what/which antibiotic(s) are recommended?
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- Levofloxacin 500 daily - Moxifloxacin 400 daily are indicated for ABRS treatment under which circumstances? |
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what are first line treatments for allergic rhinitis (AR)?
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intranasal corticosteroids (-sone, -sonide: Flonase, Nasacort, nasonex) are first line treatment for which malady? |
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leukotriene receptor antag (LTRA) or leukotriene modifiers (LTM) aka montelukast (Singulair) is best for AR when used alone or in combination with this other rx?
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antihistamines work well in combination with which med(s) for AR? |
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mast cell stabilizers (cromolyn) are more or less effective than intranasal corticosteroids for control therapy of AR?
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this class of AR controller medications is less effective than intranasal corticosteroids for sx relief BUT their ocular formulation are effective for ocular sx |
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what are the three major classes of reliever (rescue) therapy for AR?
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- decongestants - anticholinergics are all which types of meds for AR? |
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for relief of nasal congestion in AR, which class of medications are most effective? |
intranasal corticosteroids are most effective for relief of which AR symptom? - nasal antihistamines are less effective |
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examples of second generation oral antihistamines include?
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loratadine (Claritin), desloratidine (clarinex), cetirizine (Zyrtec), levocertrizine (Xyzal) and fexofenadine (Allegra) are all examples of which meds used in the treatment of AR? |
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when are short-term PO corticosteroids indicated for use in AR? |
which medication(s) used in AR indicated for severe or intractable nasal symptoms or significant polyposis? |
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what are adverse effects of anticholinergics?
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- dry as a bone - red as a beet - mad as a hatter - hot as a hare - can't see - can't pee - can't spit - can't (something that rhymes with spit [constipation]) |
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which CN controls the puff out your cheeks?
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CN VII controls which common neuro assessment technique? |
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which CN controls using eyes to follow fingers without moving head?
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CN III controls which common neuro assessment?
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which CN controls shoulder shrug?
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CN XI controls which common neuro assessment? |
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which CN controls stick out tongue?
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CN XII controls which neuro assessment? |
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what are the physical exam findings of a normal TM? |
these describe a TM in which state? - pale, gray, translucent appearance - cone of light and bony landmarks visible - mobile with pneumatic otoscopy |
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what are the physical exam findings of a TM with otitis media with effusion (aka serous otitis)? |
these describe a TM in which state? - air-fluid level visible (often with air bubbles) - opaque yellow or blue color - cone of line and bony landmarks diminished or absent - TM mobility with pneumatic otoscopy limited |
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what is the treatment for otitis media with effusion (aka serous otitis)? |
Tx of underlying cause (such as allergic rhinitis) and/or spontaneous resolution 1-3 weeks without special intervention |
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what are the pt statements in their history regarding otitis media with effusion (aka serous otitis)? |
with this middle ear pathology, the pt will c/o: - ear fullness or pressure - otalgia or ear itch - conductive hearing loss - no fever or otorrhea |
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what are the pt statement(s) in their history regarding acute otitis media? |
with this middle ear pathology, pt will c/o: - otalgia - ear fullness, pressure - conductive hearing loss - fever (common) |
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what TM findings are common with acute otitis media? |
what middle ear pathology has these PE TM findings? - TM redness -TM bulging - cone of light and bony landmarks absent - absent TM mobility with pneumatic otoscopy - otorrhea possible with TM rupture |
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what is the treatment for acute otitis media? |
this/these are the tx(s) for which middle ear pathology? - analgesia, ABX - however, high rate of spontaneous resolution without abx tx |
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on funduscopic exam, the finding of a deeply-cupped optic disc indicates ? |
what is the funduscopic exam finding of acute angle-closure glaucoma? |
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which of the following ophthalmologic conditions is considered an emergency: open angle glaucoma or angle closure glaucoma? |
angle closure (aka acute angle closure) glaucoma is considered an emergent or non-emergent eye condition? |
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which of the following ophthalmologic conditions is considered a chronic condition: open angle glaucoma or close angle (or angle closure) glaucoma? |
open angle glaucoma is considered a chronic condition or emergency? |
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when is surgical intervention indicated for acute angle closure glaucoma? |
surgical intervention is indicated once the IOP is normalized in which type of glaucoma? |
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AV nicking is a funduscopic examination finding in which pathological state? |
on funduscopic examination of a patient with longstanding uncontrolled HTN, what would you expect to find? |
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Papilledema on funduscopic examination indicates which pathological state? |
Increased ICP is indicated by which funduscopic finding? |
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untreated open angle glaucoma is at times called the "silent thief" - why? |
slow progressive peripheral vision loss esp in the elderly is usually caused by which pathological state? |
the silent thief |
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what two types of medication are used for the tx of open angle glaucoma? |
reduce production of intraocular fluid - topical beta-adrenergic antagonists - topical alpha-2 agonists - less selective sympathomimetic - topical carbonic anhydrase inhibitors increased fluid outflow - prostaglandin analogs - miotic agents (parasympathomimetics) |
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what is the treatment for acute angle closure glaucoma? |
treatment for which type of glaucoma includes: - prompt ophthalmologic referral - relief of acute intraocular pressure (eyedrops: beta-adrenergic antag, alpha-2 agonist, carbonic anhydrase inhibitors) - increase fluid outflow (prostaglandin analog, hyperosmotic agents) -SURGERY once IOP is normalized |
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components of the eye emergency triad? |
- acute vision change - eye redness - eye pain constitute which eye malady? |
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what are the three eye emergencies? |
trauma, anterior uveitis (aka iritis) and angle closure glaucoma all have what in common?
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what is the clinical presentation of anterior uveitis (aka iritis)? |
- keratic precipitates in cornea (white patches in a red cornea) - pupil usually constricted - irregularly shaped pupil - perilimbal injection (ciliary flush) are indicative of which ophthalmologic emergency? |
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what is the intervention for anterior uveitis (aka iritis)? |
- referral to ophthalmology - topical or systemic corticosteroids - cycloplegics - more intervention determined by etiology bc this is often r/t autoimmune dz or rxn (ankylosing spondylitis, IBD, reactive arthritis [Reiter's syndrome], psoriatic arthritis) are the interventions for which eye emergency? |
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what is the PE findings for angle-closure glaucoma? |
- slit-lamp evaluation may reveal corneal edema, synechiae, corneal edema -irregular pupil shape - segmental iris atrophy - cornea and scleral injection - ciliary flush (red sclerae emerging from iris) are PE findings for which ophthalmologic emergency? |
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amsler grid test is used to determine which pathological state? |
early detection of macular degeneration is detected by which screening test? |
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what are the interventions necessary for acute angle closure glaucoma? |
- referral to ophthalmology - block aqueous production, reduce vitreous volume, facilitate aqueous outflow with Diamox (actetazolamide), topical beta blocker, and pilocarpine |
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tonometry is what? |
what is the test for glaucoma (inc IOP)? |
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