clin skills final
LDL levels and when to initiate statin therapy
CVD (Hx MI, angina, stroke, PVD)
LDL >190
LDL 70-189 + DM + 40-75y/o
70-189 + 10y risk >7.5%
· Considerations for ordering open MRI
EKG leads
pulmonary vasculature in the apices
Cephalization-
EKG by hyperkalemia
5.5-6.5:Tall Peaked T waves
6.5-8: QRS wide, PR lengthened
8-10: P waves flat then disappear
>10: QRS merge w T wave, form sine wave
· What can hyaline casts in urine tell you
Normal. Composed of protein. No dz
· Gram - in urine results
Nitrates. Does not r/o bacteriuria
· pathologic Q-wave
1st downward deflection- depolarization of interventricular septum
Pathologic- >1mm width, >25% height of QRS
-previous MI d/t absence of electrical activity in damaged tissue
is associated with an elevated alkaline phosphatase level
Biliary obstruction, Bone Dz, perforated bowel or infarct, hyperparathyroidism, 3rd
trimester in pregnancy
· Post bursa aspiration signs of concern
, Pain, bleeding, infection, intra-articular inj, re-accumulation of fluid/ swelling
Inflammatory arthritis
SI joint + spine, postage stamp
Osteoartritis manifestations
unilateral joint space narrowing
· What cardiac node acts as an insulator, regulating conduction of the electrical
current from the atria to the ventricles
AV node
characteristics of a normal sinus rhythm
P precedes every QRS, narrow QRS, T wave after QRS, normal intervals, rate
60-100
azotemia
Nitrogen retention, high BUN
gallstone on ultrasound image
Indications for abdominal CT
mass, tumor, abscess, visceral infarct, trauma, staging malignancy, suspected stone,
urinary tract bleeding
Who should be tested for celiac disease if they have a gluten intolerance
Small bowel/ intestine damage
Neoclassic sympt: bloating, diarrhea, cramping
Evidence of malabsorption, Hx 1st' relative, DM1, elevated AST/ALT w/o explanation
a pericardial effusion on real-live ECHO
Small: <10mm
Mod: 10-20mm
Large: >20mm
· pharmacologic stress more appropriate than an exercise stress test
Pharmacologic= inable to perform maximal exercise effort
LBBB
· Pathology of Kerley B lines
Short horizontal line @ lung base
Interstitial edema in lung or thick interlobular septa
· Indications for double contrast barium study vs single with regard to an upper GI
series
LDL levels and when to initiate statin therapy
CVD (Hx MI, angina, stroke, PVD)
LDL >190
LDL 70-189 + DM + 40-75y/o
70-189 + 10y risk >7.5%
· Considerations for ordering open MRI
EKG leads
pulmonary vasculature in the apices
Cephalization-
EKG by hyperkalemia
5.5-6.5:Tall Peaked T waves
6.5-8: QRS wide, PR lengthened
8-10: P waves flat then disappear
>10: QRS merge w T wave, form sine wave
· What can hyaline casts in urine tell you
Normal. Composed of protein. No dz
· Gram - in urine results
Nitrates. Does not r/o bacteriuria
· pathologic Q-wave
1st downward deflection- depolarization of interventricular septum
Pathologic- >1mm width, >25% height of QRS
-previous MI d/t absence of electrical activity in damaged tissue
is associated with an elevated alkaline phosphatase level
Biliary obstruction, Bone Dz, perforated bowel or infarct, hyperparathyroidism, 3rd
trimester in pregnancy
· Post bursa aspiration signs of concern
, Pain, bleeding, infection, intra-articular inj, re-accumulation of fluid/ swelling
Inflammatory arthritis
SI joint + spine, postage stamp
Osteoartritis manifestations
unilateral joint space narrowing
· What cardiac node acts as an insulator, regulating conduction of the electrical
current from the atria to the ventricles
AV node
characteristics of a normal sinus rhythm
P precedes every QRS, narrow QRS, T wave after QRS, normal intervals, rate
60-100
azotemia
Nitrogen retention, high BUN
gallstone on ultrasound image
Indications for abdominal CT
mass, tumor, abscess, visceral infarct, trauma, staging malignancy, suspected stone,
urinary tract bleeding
Who should be tested for celiac disease if they have a gluten intolerance
Small bowel/ intestine damage
Neoclassic sympt: bloating, diarrhea, cramping
Evidence of malabsorption, Hx 1st' relative, DM1, elevated AST/ALT w/o explanation
a pericardial effusion on real-live ECHO
Small: <10mm
Mod: 10-20mm
Large: >20mm
· pharmacologic stress more appropriate than an exercise stress test
Pharmacologic= inable to perform maximal exercise effort
LBBB
· Pathology of Kerley B lines
Short horizontal line @ lung base
Interstitial edema in lung or thick interlobular septa
· Indications for double contrast barium study vs single with regard to an upper GI
series
