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Family Medicine Fast Facts
Terms in this set (49)
1. MC bugs in sinusitis?
1. strep pneumo, H. inf, Moraxella
2. amoxicillin or TMP-SMX
1. pt you think has strep has negative rapid test- next step?
1. get throat culture. hold off on abx until results are back
1. agent in OE in diabetic pt?
2. MC pathogens in OM?
2. H. infl, moraxella, S. pneumo
1. MC cause of wheezing in child <2yo? MC agent?
1. bronchiolitis- inflam. of small airways-->mucus, edema. MC agent: RSV
2. supportive: hydration, humidified oxygen, bulb suction secretions
1. when is the earliest to screen pt for HTN?
2. when to start pap smears & frequency? what abt pt who had hysterectomy for cervical dysplasia?
3. when to do urine screen for chlamydia?
1. adolescent years (annually)
2. 21-65 yrs: annual for first 3 yrs, then space out q 3 years until 30yo, then space out to 5 years after that. cervical dysplasia pt should have annual paps.
3. sexually active women 16-25
1. guidelines for colonoscopy vs sigmoidoscopy?
2. pt with familial adenomatous polyposis?
3. for pt with UC?
4. pt with primary relative with colon CA?
1. colonoscopy q 10 years starting at 50. or can do flexible sigmoidoscopy q 5 yrs. Do DRE with fecal occult blood annually.
2. annual flexible sigmoidoscopy starting at 10yo
3. colonoscopy q2 yrs starting 8 yrs after Dx
4. 10 yrs before family member Dx and q5yrs!
1. screenings recs for breast CA?
2. guidelines for lipid screening?
3. "" screening for osteoporosis? preventative supplements?
4. "" screening smokers for lung CA?
1. q 2 yrs age 50-74
2. men starting age 35 and women 45. younger if RF
3. DEXA- women age 65 q 2 yrs. >400 U vit D, 1000 mg Ca, Raloxifene (SERM)
4. low dose CT age 55-80 or those with 30 pack yr Hx
1. when should adults get PPV vaccine?
2. herpes zoster?
3. when to screen for AAA? when is surgery indicated? MC risk factor?
4. aortic dissection- #1 RF? Tx for ascending vs descending?
1. age 65 or after.
2. Herpes zoster: 60
3. men 65-75 who smoke- screened 1x with US. surgery when >5.5cm or smaller but rapidly enlarging. RF: atherosclerosis.
4. HTN. ascending- emergent surgery. descending: beta blocker
1. when should men & women take ASA regularly?
2. earliest that child get first vision screen?
3. when should pt get first HbA1c screen?
1. men >45-79, women >55-79
3. 45 yo
1. which oral hypoglycemic has lowest rate of hypoglycemia?
2. which is the only safe one to give to adolescents?
3. DM pt needs to lose weight- which med? when CI?
4. what med to add after metformin failure? SE?
5. what DM med can be used in renal failure
3. metformin. CI when GFR <30
4. sulfonylureas (glypizide). SE: hypoglycemia > weight gain
5. thiazolidinediones, DPP-4 inh (sitagliptin)
1. which HTN meds for african americans?
2. which HTN meds for diabetcs?
3. which for isolated systolic HTN?
4. which for HTN + benign tremor?
1. HCTZ, CCBs
1. labs to order for HTN?
2. #1 lifestyle modification?
3. causes of 2ndary HTN- MC?
1. UA (occult blood, protein/crt), CBC, lipid profile, baseline ECG for end-organ damage
2. weight loss- 10kg decreases SBP 5-20
3. MC- renal a stenosis. CHAPS- cushing's, hyperaldosteronism (Conn's- 2nd MC), aortic coarctation, pheochromocytoma, stenosis of renal a
1. concerning SE of statin
2. which med to inc HDL & decr LDL
3. med to decr TG?
1. rhabdomyolysis- high crt kinase
2. niacin, also exercise
3. fish oil
1. which drugs can interfere with OCPs?
1. abx, phenobarbitol, carbamazepine, st. john's wort
1. MC type of melanoma?
2. MC melanoma in AA?
3. Most aggressive melanoma?
4. which skin CA is "pearly papule w telangiectasias"
5. which skin CA is "scaly, ulcerated"
1. superficial spreading
2. acral lentiginous
4. basal cell CA- rarely mets
5. squamous cell CA
1. pt has mild asthma and environmental allergies- which med is good for both of these?
2. pt has allergies & operates machinery in daytime- Tx?
3. Tx for allergic conjunctivitis?
4. first-line for allergic rhinitis?
2. Fexofenadine, loratidine- less sedating 2nd gen anti-Hist
3. anti-inflam drops or oral anti-Hist
4. CCS nasal sprays
1. pt has red eye- contrast appearance of uveitis vs conjunctivitis?
2. pt with HTN has sudden loss of vision in 1 eye- patho cause?
3. pt has "curtain coming down on vision"- cause? mgmt?
4. DM pt has floaters & streaks in vision- cause?
1. uveitis- red around eye in center. conjunctivitis- red in corners of eye
2. central retinal aa occlusion or retinal v occlusion
3. Amaurosis Fugax- MC atherosclerotic embolus from ICA. mgmt- get carotid doppler and echo
3. vitreous hemorrhage
1. pt in movies has sudden onset eye pain, double vision, N/V- worried about? Sx? Tx? complication?
2. pt has light flashes & loss of peripheral vision- Dx?
3. pt has itching, burning, crusting of eye. Eye is NOT red- Dx & Tx?
1. closed-angle glaucoma- RF prolonged pupillary dilation. Sx: red, hard eye Tx: eye drops (timolol, pilocarpine), IV mannitol/acetazolamide, laser peripheral iridotomy
2. retinal detachment
3. blepharitis- Tx with warm compresses & topical erythromycin
1. contrast a stye with a chalazion & Tx
1. stye is tender erythematous bump on edge of eyelid- warm compresses. chalazion is painless pump on eyelid- Tx with warm compresses & topical abx.
1. which HTN med is CI in pt with new-onset angina?
2. Pt has A-fib- Tx?
3. pt has exertional SOB- workup? severe DZ has which electrolyte abn? Tx of exacerbation?
4. systolic HF: chronic tx that decr mortality? Additional tx in III-IV failure?
2. anticoagulation if <48hrs. rate control w BB & CCB
3. BNP, echo. Late stage: low Na. Tx: LMNOP: loops, morphine, nitrates, O2, position (upright)
4. BB ,ACE-I/ARBs prevent remodeling = decr mortality. Type III/IV: spironolactone decr mortality.
1. systolic HF: heart sound, PMI, CXR, EF?
2. diastolic HF: heart sound, PMI, CXR, EF?
1. S3, displaced PMI, cardiomegaly, reduced EF
2. S4, normal PMI, normal heart size, normal EF (> 55%)
1. pt has chest pain with exercise- acute tx?
2. smoker has chest pain at night/AM and has ST elevation but - cardiac enzymes- Dx & Tx?
1. MONABC- morhine, O2, nitrates, ASA, BB, nondihydropyridine CCB
2. prinzmetal angina d/t vasospasm. Tx with CCB or nitrates
1. NSTEMI/untable angina Tx?
2. pt with MI- best predictor of survival?
3. sequence of ECG changes
4. timing of post-MI complications?
1. MONABC, where "C" or "see" stands for statin, clopidogrel, unfractionated heparin, or enoxaparin & in long term Tx, "A" is for ACE-I
3. peaked T waves, ST elevation, Q waves, T wave inversion
4. day 1: HF. days 2-4: arrhythmia, pericarditis. days 5-10: wall rupture, pericardial tamponade. weeks-mo: aneurysm
1. pericarditis: defn, Hx, PE, Dx?
2. cardiac tamponade- beck's triad? other Sx? echo? Tx?
1. defn: inflammation of pericardial sac. Hx: Pain worse with inspiration. PE: friction rub,. Dx: ST elevations in most leads
2. hypo-TN, distant heart sounds, JVD. also pulsus paradoxus (respir. variation in SBP). Echo: water bottle shaped heart. Tx: urgent pericardiocentesis
1. pt with all the med probs wants to prevent renal failure- most important factor?
2 pt on morphine should also be on?
1. glycemic control
2. stool softener
1. 60yo pt with microcytic anemia is Dx with gastric ulcer & H. pylori infxn. next step in mgmt?
2. first line test for H. pylori?
3. drawback of anti-H pylori Ab test?
4. gold standard test?
5. Tx regimen?
1. colonoscopy- any pt over 50 with anemia, regardless of other source of bleeding found
2. stool angtigen testing
3. cannot distinguish active infxn from treated infxn
4. endoscopy with biopsy
5. triple: PPI + 2 abx: pcn + macrolide (clarithromycin)
1. first line drug in CHF with pulm. edema?
2. which pts are eligible for cardiac resychronization therapy?
3. if having unprotected sex for 1 yr- risk of pregnancy?
2. class II-IV HF with EF <35%, dilated cardiomyopathy
1. contraceptive option in breastfeeding mom?
2. benefits of combination OCPs?
2. protect against ovarian, endometrial, colon CA, PID, fibrocystic breast DZ, decreased risk fibroids, ovarian cysts, improved bone mineral density
1. college pt has nuchal rigidity & rash- tx? roommates tx?
2. other MC agent in adults?
3. MC agents <1mo & Tx?
1. N. meningitis- Tx w IV vanc & ceftriaxone. dormmates: rifampin prophylaxis.
2. strep pneumo
3. GBS, E. coli, Listeria. Tx: Ampicillin + cefotaxime
1. pt was in the woods now has rash on wrists/ankles- dx? tx?
2. Pt comes in with bull's eye rash- Dx and Tx?
3. pediatric pt has fever 105 and no other Sx- Dx? complic?
4. rash diff. stages of healing & spares palms/soles- dx?
1. rocky mountain spotted fever. Tx with Doxy& continue 3 days after pt afebrile
2. Lyme DZ- Doxy
3. roseola- as fever breaks, rash begins on trunk and spreads to extremities. comlic: febrile seizure
1. first line Tx for pain in mild-mod IBS? if severe?
2. first line Tx for contipation dominant IBS?
3. first line Tx for diarrhea dominant IBS?
1. Dicyclomine, hyoscyamine- anti-spasmodic anti-cholergic. Severe: TCA
1. elderly pt has loss of speech discrimination- dx?
2. leading cause of blindness worldwide?
3. leading cause of blindness in US?
4. #1 and #2 RF for stroke?
1. Prebyscusis- sensorineural- MC form of hearing loss in elderly = + Weber test
2. age-related (senile) cataracts
3. diabetic retinopathy
4. #1: HTN, #2: a-fib (anticoagulate with warfarin)
1. Tx in alzheimers? which is DZ modifying? allele for hi risk?
2. which DM end-organ pathologies are co-dependent? (Tx-ing one treats the other?)
3. asthmatic on long term steroids has mucus plugging pulm infiltrate- Dx? other pt pop. that gets this?
1. donepazil- cholinesterase inh. Memantine is DZ modifying- NMDA antag. Apo E4
2. diabetic retinopathy & nephropathy
3. aspergillosis. also CF patients
1. contrast polymyalgia rheumatica w osteoporosis?
2. pt has sore throat and recently Tx-d in ED for urethritis. most likely Dx?
3. young pt on OCPs has HTN on 3 visits, next step?
1. PR: pain in proximal MUSCLES (MC shoulder) that is worse in AM but no joint pain or swelling- tx w CCS. OA has joint pain & swelling that is also worse in AM.
3. stop the OCPs
1. Tx for sleep-onset insomnia?
2. you suspect asthma but pt has normal LFTs- next step?
3. cardiac manifestations of anorexia?
4. initial therapy for smoking cessation?
2. methacholine challenge
3. mitral valve prolapse, bradycardia and cardiomyopathy
4 group therapy & nicotine patch
1. first line for diabetic neuropathy
2. Tx order for hyperglycemic hyperosmolar coma?
3. pt has HTN, hypo-K and hyper-Na- Dx?
2. NS-->then half NS when normotensive-->then add dextrose when glucose <250
3. Conn's syndrome
1. radon increases risk for what CA?
2. patient A has back pain worse with E/walkingn downhill- Dx?
3. patient B has back pain worse with F & + straight leg raise test- dx?
2. spinal stenosis (sciatica)- MC elderly
3. lumbar disc herniation
1. dude has shoulder pain and + speed/obrian's test- Dx? Tx?
2. runner has knee pain, + J sign & pain w stairs- dx?
3. tennis elbow involves tearing of what?
1. SLAP tear: superior labral tear: anter to poster. Tx is surgery
2. patellofemoral syn
3. extensor carpi radialis brevis
1. pt on oral hypoglycemic has nausea & flushing with EtOH- which med is she on?
2. name 3 preventative meds for migraines?
3. which used for abortive Tx?
1. 1st generation sulfonylurea- tolbutamide
2. topiramate (blocks Na channels), propranolol, amitriptilyne
1. pt has paresthesias in ulnar n- Dx?
2. compare & contrast duodenal vs gastric ulcer?
3. prostate CA most often spreads where?
1. cubital tunnel syn
2. duodenal- relieved by food, pain 2-3hrs after meal, worse @ night. Gastric- worsened w food, pain right after meal
1. pt has red eyes, urethritis, and painful joints- Dx? MC agents?
2. pt in clinic has the flu- which precautions should be in place?
3. which analgesic can hemophilia pt take?
1. Reactive arthritis (Reiter syn). Chlamydia, shigella, salmonella, campylobacter.
2. droplet precautions
3. tylenol = acetaminophen = no effect on platelets
1. young pt has b/l conductive hear loss, + FHx- Dx? other PE sign?
2. pt with HTN & HLD wants to get pregnant- stop which med?
3. target BP in diabetics?
1. otosclerosis- middle ear bones grow = loss of stapedial reflex
2. statins- teratogenic
1. name the dermatome for: nipple line?
3. compare HAV & HEV?
4. MC risk factor for endometrial CA?
3. both fecal-oral. HAV has vaccine & HEV does not. HEV more serious & has high infant mortality.
1. pt has lymphedema after mastectomy- tx?
2. which meds are assoc. with edema?
3. pitting is seen in which conditions?
1. intermittent pneumatic compression
2. CCB, NSAID, OCPs
3. DVT, CHF, venous edema
1. workup for DVT? tx?
2. how does parkinson's effect speech & writing?
3. how to confirm corneal abrasion? tx?
1. D-dimer, if + then doppler. Tx: LMWH-->warfarin
2. progressively inaudible speech; micrognathia (small handwriting)
3. slit lamp. tx: TMP/polymyxin B drops
1. pt hit on knee & now can't feel lateral leg- dx? nerve trapped where?
2. pt has RA- which meds can reactivate latent TB infxn?
3. which hepatitis uses reverse transcriptase?
4. which invades by coating itself with LDL/VLDL?
1. common peroneal (fibular) nerve- fibular head
2. Etanercept & infliximab
3. Hep B
4. Hep C
1. pt is a smoker/drinker has blisters on chest/hands- Dx?
2. pt has vesicles & crusting plaques in genitals, pruritis, discharge- dx?
3. pt has rash that shows acantholytic dyskeratosis- Dx?
1. porphyria cutanea tarda- def uroporphyrinogen decarboxylase in liver (metabolizes heme)
2. benign familial pemphigus
3. Grover's DZ
Name the Ab markers most specific for:
3. scleroderma- fibrosis/Raynaud's
4. Sjogren's DZ
1. Anti-citrullinated peptide
3. Anti-Scl-70, Anti-topoisomerase I
1. Tx for HTN crisis?
2. achilles tendon rupture- Dx test & tx?
1. IV labetolol, nicardipine, nitroprusside
2. Thompson test. Tx: cast in plantar-F for 6wks
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