EPC Exam 3
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Created by:
Patricia_brooks on May 2, 2012
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135 terms
Terms | Definitions |
|---|---|
 1st generation cephalosporin (similar to penicillin) | Cephalexin, Cefazolin |
| 2nd generation cephalosporin (similar to amoxicillin, only TETAN and FOX treat bacteroides) | Cefprozil, Cefditoren, Ioracarbef, cefotetan, cefoxitin, cefuroxime |
| 3rd generation cephalosporin (good gram positive and negative, TAZ covers pseudomonas) | Ceftazidime, cefotaxime, cefixime, ceftriaxone, cefpodoxime, cefdinir |
| 4th generation cephalosporin (like 3rd + pseudomonas) | cefepime |
| 5th generation cephalosporin (like 3 + MRSA) | ceftaroline |
| Alkylating Agents, non-specific/Go | Cyclophosphamide, Ifosfamide, Dacarbazine, Melphalan |
| Antitumor Antibiotics, non-specific/Go | Bleomycin, anthracyclines (doxorubicin) |
| Platinum, non-specific/Go | cisplatin |
| Antimetabolites, S | methotrexate, 6-mercaptopurine, 5-fluorouracil |
| Topoisomerase I inhibitors, S | irinotecan, topotecan |
| Topoisomerase II inhibitors, S and G2 | etoposide, teniposide |
| Microtubule inhibitors, M | Taxanes (paclitaxel and docetaxel) and Vinca alkaloids (vincristine and vinblastine) |
| Ester local anaesthetics | benzocaine, chloroprocaine, cocaine, procaine, tetracaine |
| Amide local anaesthetics | bupivacaine, lidocaine, mepivacaine, ropivacaine |
| epi | vasoconstriction at site of injection, keeps anaesthetic at site longer |
| anaesthetic produces its own vasoconstriction by blocking reuptake of DA | cocaine |
| class of antiarrhythmics produces primary effect via Na channel blockade | Class 1 |
| beta-blocker used to treat glaucoma because it doesn't have membrane stabilizing effect? | Timolol |
| SSRI SE | serotoninergic: diarrhea, weight gain, sexual dysfunction, GI disturbance |
| fluoxetine | active metabolite with longer half life, SSRI |
| sertraline | more diarrhea, SSRI |
| paroxetine | more sedating, more constipating, SSRI |
| citalopram and S-citalopram | lower Ki for SERT, doesn't inhibit P450 |
| fluvoxamine | potent CYP inhibitor |
| Typical D2 blocker | Haloperidol, Chlorpromazine |
| Typical D2 blocker | Prochlorperazine, Promethazine |
| Atypicals | Aripiprazole, Clozapine, Olanzapine, Quetiapine, Risperidone |
| Type 1 receptor agonists-mineralocorticoids (aldosterone agonists) | fludrocortisone (no glucocorticoid effects) |
| Type 2 receptor agonists-glucocortoid receptor agonists | Dexamethasone (no aldosterone affects), hydrocortisone (most like endogenous cortisol), methylprednisolone (solu-medrol is for IV injection and depo-medrol is for IM slow release), prednisone, prednisolone, triamcinolone |
| Estrogen | Ethinyl estradiol, mestranol |
| Progestins:androgenic/antiestrogenic | levonorGESTrel |
| Progestins:antiandrogen/antialdosterone | droSPIRenone |
| Progestins:injectable | medroxyprogesterone |
| morning after pill | LevonorGESTrel and uliPRISTal (selective progestin receptor modifier) |
| Antidote for Acetaminophen | N-acetylcysteine |
| Antidote for Atropine | physostigmine (crosses BBB) |
| Antidote for Beta-blocker | Glucagon |
| Antidote for Ca channel blocker | Ca |
| Antidote for Cyanide | Hydroxycobalamin, Na nitrite, Na thisulfate, amyl nitrate, fomepizole |
| Antidote for Fe | deferoxamine |
| Antidote for Metals | penicillamine, dimercaprol, edetate Ca disodium, succimer |
| Antidote for Methanol | fomepizole or ethanol |
| Antidote for organophosphate | atropine + pralidoxime |
| Chlamydia | most common male GU infection |
| Inflammation very common causing | epididymitis, orchitis, prostatitis |
| shaft of penis is formed by 3 columns | corpus spongiosum (containing urethra), 2 corpora cavernosa (smooth muscle contracts in ejaculation) |
| vascular supply of the penis | internal pudendal artery |
| venous drainage of penis | dorsal penile vein |
| 3 parts of prostate | prostatic (posterior), membranous (middle), cavernous (anterior) |
| covering the testes except posteriorly | tunica vaginalis |
| posterolateral surface of testes | epididymis |
| testes arterial supply | testicular artery |
| spermatic cord | vas deferens, testicular artery, vein from spermatic cord |
| venous drainage via | pampiniform plexus, right drains into IVC, left into left renal vein |
| Lymphatics into | preaortic and precaval nodes, not inguinal |
| vas deferens begin at | the tail of the epididymis and ascends within the scrotal sac as the spermatic cord, goes through inguinal canal |
| chancre | painless |
| chancroid | painful |
| hypospadias | urethra meatus not where it is supposed to be |
| Gonorrhea | check inguinal nodes |
| if you found a large scrotal mass | ask patient to lie down, if mass disappears it's a hernia, if it remains listen with a stethoscope, if bowel sounds are hear it is a hernia, shine a light from behind the scrotum and through th emass, if red glow is observed it probably isn't a hernia |
| incarcerated hernia | contents can't be returned to the abdominal cavity, need surgery |
| strangulated hernia | blood supply to entrapped contents is compromised, need surgery |
| suspect strangulation | tenderness, nausea, vomiting, consider surgery |
| Indirect hernia | children, above the inguinal ligament near midpoint, often into the scrotum, touches tip of finger |
| Direct hernia | men older than 40, above inguinal ligament, close to pubic tubercle, rarely into scrotum, pushes on side of finger |
| femoral hernia | women, below inguinal ligament, never into the scrotum, inguinal canal is empty |
| cryptorchidism | number 1 risk factor for testicular carcinoma |
| risk factors for testicular carcinoma | cryptorchidism, history of carcinoma in CL testicle, mumps orchitis, inguinal hernia, hydrocele in childhood |
| venereal wart | HPV |
| cluster of vesicles, shallow, painful nonindurated ulcers on red bases | genital herpes |
| Nongonococcal urethritis | 20-25 years old, sexually transmitted, urethral discharge, itching, dysuria, orchalgia |
| Reactive arthritis | Reiter's Syndrome. conjunctivitis, NGU, and arthritis triad, following chlamydia resp or GU infection |
| Molluscum Contagiosum | Pox virus, self limiting, 3-9 and 16-24, white colored papules, central depression, very contagious |
| Syphilitic chancre | painless, oval, round, dark red, ulcer, nontender enlarged inguinal lymph node, goes away |
| Hypospadias | congenital displacement of urethral meatus to inferior surface of penis |
| Peyronie's Disease | palpable nontender hard plaques found beneath skin, crooked painful erections |
| carcinoma of penis | indurated nodule or ulcer, nontender, not circumsized men, persistent penile sore |
| scrotal edema | pitting edema making scrotal skin taught |
| Scrotal hernia | indirect inguinal hernia thru external inguinal ring |
| Hydrocele | nontender, fluid filled mass within the tunica vaginalis, transilluminates |
| Acute Orchitis | testis acutely inflammed, painful, tender, swollen, hard to tell apart from epididymis, red, seen in mumps, unilateral |
| primary TC | common solid tumor, men 20-35, painless swelling, nodule of one testicle can't be separated from testicle, dull ache or heavy sensation in lower abdomen, neck mass, supraclavicular nodes, anorexia, nausea, back or abd pain, cough, chest pain, hemoptysis, SOB, weight loss, edema |
| acute epididymitis | inflamed epididymis is tender and swollen, red, co-existing urinary tract infection, prostatitis |
| epididymitis | most common cause of acute scrotal pain and swelling in men 18-50, fever, dysuria, edema, chronic >6 wks, quick onset could be torsion,infected urine passing to epididymis occurs during strenuous exercise with full bladder, orchitis, one side, dysuria, frequency, urgency, no N/V, if chronic no scrotal edema, epididymal tenderness, NORMAL CREMASTERIC REFLEX, Prehn sign (elevate hemiscrotum), pain improves when you remove the weight of the testes, Tx: reduce physical activity, scrotal support, cool packs, anti-inflammatory agents, antibiotics |
| Spermatocele and cyst of epididymis | painless, movable cystic mass just above the testis suggests spermatocele or epididymal cyst, transilluminate, can't tell apart |
| varicocele | varicose veins, paminiform plexus of the spermatic cord, bag of worms, gets better if you elevate testes, associated with infertile males, more common on left side |
| Torsion of spermatic cord | torsion or twisting of the testicle on its spermatic cord, acutely painful, tender, swollen organ retracted upward in scrotum, red, edematous, no UTI, most common in adolescents, SURGERY! Acute scrotal swelling in child is torsion till proven otherwise, N/V, high riding testis, no cremasteric reflex, erythema of scrotal wall and ecchymosis |
| Cremasteric reflex absent in | boys under 30 months old and in Testicular torsion |
| Pilonidal Cyst and Sinus | common, congenital, midline, asymptomatic |
| Phimosis | foreskin protracted |
| paraphimosis | ring, iatrogenic, occurring during catheterization or PE, retracted foreskin is tight and functions as a tourniquet causing glans to swell, blocking foreskin from returing to its normal position, EMERGENCY! vascular compromise, dorsal slit may need to be cut or squeeze glans penis |
| Balanitis | inflammation of the glans penis |
| prostate gland | lies aginst anterior rectal wall |
| prostate cancer | leading cancer diagnosed in men in US, 2nd leading cause of death |
| Prehn sign | relief of pain of epididymitis with scrotal elevation |
| Blue Dot Sign | Torsion of the appendix testis |
| Testicular torsion | acute onset, pain in testis, cremasteric reflex negative, high riding testis, bell-clapper deformity, profound testicular swelling, fever is unusual |
| Epididymitis | acute or chronic onset usually gradual onset, epidyimis pain, normal cremasteric reflex, epididymal induration and tenderness, positive urinalysis or culture, fever is common, |
| manual detorsion | 2/3 of cases are medial so rotate testicle laterally |
| Treatment of epididymitis | For men <35 years old: Ceftriaxone 250 mg IM plus Doxycycline 100 mg 2X daily for 10 days to cover C. Trachomatis and N. Gonorrhea. For men >35 years E.Coli is most common cause so treat with Ceftriaxone 250 mg IM plus a fluoroquinolone(ofloxacin 300 BID for 10 days or levofloxacin 500 daily fro 10 days) |
| Epididymitis | most common cause of scrotal pain |
| Bell clapper | tunica vaginalis goes all the way around the testicle, instead of only partially |
| speech | quality, quantity, organization |
| Mood | general feeling state. Ex: Joy, saddness |
| Affect | features a person portrays |
| expansion | range of emotion |
| modulation | how quickly your mood changes |
| consistency versus propriety | use consistent |
| content vs processes | content-what a patient says, process-how they communicate |
| Normal-->complete disruption | rambling-->overinclusivity-->circumstantiality (get to answer)-->tangentiality (don't get to answer, b/c irritated)-->loosening of associations (disrupted speech, can't connect subject with verb or object)-->word salad (random, nothing connects) |
| delusion | fixed, false idea, no logic or data to base it on, not believed by culture the patient belongs to |
| Illusion | mostly visual, sensory misinterpretation, interept the sensory event in context with setting |
| hallucination | mostly auditory, unique internal psychology, event separate from anything external |
| Perception and Coordination | print, write name, draw simple figures, draw clock face with time, interlocking hexagons |
| Orientation | person, place, time, day, date, month, year |
| attention | behavioral alerting response, digits forward, letters forward, touch dots on pad |
| concentration | digits backward, serial 7s from 100, serial 3s from 20, alternating numbers/letters, WORLD or STAR backward. Note paranoid people can't concentrate |
| Memory | immediate (digits, letters), intermediate (3 color coded objects beyond 3 minutes), remote (historical narrative or specific info (social security number) |
| 3 color-coded objects | red sports car, white lab coat (if this is the only thing they remember you know they need visual stimulation), big blue book |
| Intellectual ability | most reliable, valid, sensitive way to assess intellectual ability is by vocab and general fund of knowledge. Need to do this in their first language. |
| Abstracting ability | tested by interpretation of similarities and proverbs |
| Judgment | Intellectual: Hypothetical situations and operational:from history taken (trumps intellectual) |
| Insight vs self-awareness | self awareness- level of psychological self understanding |
| calculation | serial subtraction 7s from 100 or 3s from 20, simple arithmetic, figure change after a purchase |
| Delirium is always a 2nd diagonsis to | trauma, neoplasm, infection, intoxication, metabolic disorder, etc... |
| delusion | false, fixed beliefs |
| ideas of reference | everyday occurrences |
| Cognitive functions | include patient's level of alertness, attentiveness or concentration, orientation |
| altered mental status | functional (psychiatric) vs organic (medical: delirium or dementia) |
| Delirium | disturbance of consciousness with reduced ability to focus, sustain, or shift attention, develops over short period of time, fluctuates during the day |
| Delirium | acute onset, resolves with treatment of underlying condition, fluctuating levels of consciousness |
| Dementia | chronic, slow onset, progressive, memory impairment |
| Organic disease | unintelligible speech, aphasia, waxing, waning lucidity, visual hallucinations, abnormal level of alertness, disorientated to time, place, person, abnormal vitals/PE |
| Psychiatric Disease | gradual onset, intelligible speech, flat affect, auditory hallucinations, delusions, normal level of alertness, oriented to time, place and person, normal vitals, normal PE |
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