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AAFP Questions commonly missed

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Most consistent symptom of irritable bowl?
Abdominal pain
Barotrauma to the ear (suba, heavy wt lifting) causes what in the ear?
Perilympahtic fistula
Imaging of choice for possible septic hip joint
Ultrasound- highly sensitive for detecting effusion of hip joint
What is the female athlete triad?
Amenorrhea, osteoporosis + disordered eating
Treatment of Vfib after initial defibrilation fails?
Vasopressor: epinephrine or vasopressin
Use of Amiodarone
Treatment of Vfib unresponsive to shock delivery, CPR and vasopressor
Gold standard for dx of renal colic
CT
Radiographic features of benign nodules
Diameter <5mm, smooth border, solid appearance, concentric calcifications
Radiographic features of malignant nodule
size >10mm, irregular border, "ground glass" appreance, no calcifications
How do you modify hypothyroid treatment for pregnant women at 4-6 weeks gestation
Increase dose of levo
Meaning of likelyhood ratio values of 5-10
Greatly increase likelyhood of disease
Meaning of likelyhood ratio values of .01-0.2
Greatly decrease likelyhood of disease
Which lab values make Metformin contraindicated?
Cr of >1.4 in women, >1.5 in men
USPSTF recommendation on daily asprin
use for males 45-79 and females 55-79
Most common presenting symptom of Hodgkin lymphoma
Painless lymphadenopathy
A1C of 7.0% corresponds to what mean plasma glucose?
154
Acute onset severe pain, blurred vision, red conjunctiva and mild-dilated and sluggish pupil
Acute angle glaucoma
Flat-topped, sometimes violaceous papules on knuckles and interphalangeal joints
Grotton's papules: Dermatomyositis
Treatment for Supreventricular tachycardia
Adenosine
Which Vit D should you order for Vit D deficinecy lab?
25-hydroxy vitamin D
Travelers diarrhea prophylaxis
Rifaximin
When to treat flu and with what?
H1N1 is susceptible to Oseltamivir and Zanamivir (Zanamivir Contraindicated in resp problems), treat if requiring hospitalization
Treatment for suspected TB
INH, ethambutol, rifampin, pyrazinamide
Workup of incidental adrenal mass
Adrenal function test: overnight dexamethasone suppression, 24-hr fractionated metanephrine, catecholamines, aldosterone and renin
Treatment of diastolic dysfunction
ARBS and diuretics
Treatment of choice for decontamination due to medication ingestion
Single dose activated charcoal
When do you use gastic lavage in decontamination
Ingestion of poorly absorbed meds (iron, lithium) or enteric coated or extended release formulations
Blood glucose goal in pregnancy
fasting <100 and 1-hr postparandial <140
Major criteria for Polycythemia vera
Increased RBC mass, normal O2 sat, splenomegally, elevated B12, Platelets >400,000, WBC <12,000
First line therapy for nausea/vomiting in pregnancy
Vit B6, can also be used with doxylamine
Medical management of STEMI
give Clopidogrel and 181-325 Asprin
Treatment of resistant HTN in pt with Cr >1.5
Add loop diuretic (Lasix)
What kind of thyroid nodule does not require fine needle aspiration?
pt with depressed TSH and "hot" nodule
Donepezil increases the patients risk of what?
Bradycardia, syndopy, and pacemaker therapy
Daily recommedned amount of Vit D for infants to adolescents
400 IU daily
Occlusion of circumflex leads to changes in what leads?
I and AVL
Occlusion of the LAD leads to changes in what leads?
V1 to V6
Treatment for croup
Single dose of dexamthasone and aerosolized epi if stridor and retractions present
Treatment for PMS
luteal-phase spironolactone
Definition of preexlampsia
Elevated BP and proteinuria after 20 weeks
Antipsychotic with least wt gain?
Aripiprazole
Who should get the Pneumococcal polyvalent-23 vaccine?
1 dose for all adults at 65. 2 doses at 5 year intervals for persons 19-64 of age who have chronic renal disease, asplenia, or immunocompromising conditions (including smoking)
Outpatient treatment for diverticulitis
Amox/clav because covers anaerobes
Slipped capital femoral epiphysis symptoms/findings
Upper thigh/lower thigh/knee pain with activity. LIMITED internal rotation of the hip (especially when hip is flexed)
Initial management of hypercalcemic crisis?
Volume repletion and hydration followed by renal excretion by durosemide
Threefold or greater elevation of ALT in pancreatitis is predictive of what?
Gallstone pancreatitis
What screening test can you offer pregnant women in the first trimester for Downs?
Chorionic villous sampling
Best initial management for patient with A fib
Rate controll with Ca channel blocker or B blocker
When and how do you measure therapy with Enoxaparin?
Meausre in obese or pts with renal failure, measure anti-factor Xa levels
Characteristic vital signs in Anorexia
Bradycardia, hypotension, hypothermia
Are cluster headaches bilateral or unilateral?
Unilateral
What is the treatment for nail fungus?
Continuous therpay with oral terbinafine for 12 weeks
Meaning of S3 sound
Dilated left ventricle
Treatment for Raynauds
Calcium channel blockers, Nifedipine
Treatment for DVT during pregnancy
low molecular wt heparin, continue for 6 weeks after delivery
Only treatment for DM2 approved for children
Metformin and insulin
What is the ethic principle "double effect"
Used to justify medical treatment designed to relieve suffering when death is an unintended byt foreseeable consequence
When to start ABX in sinusitis
Start if symptoms persist for 7-10 days, Amoxicillin is first line agent
Two treatments for essential tremors of the hand
Propranolol and Tpiramate
Treatment for patellofemoral stress syndrome
Physical therapy
Treatment of first trimester lady exposed to Hep B
Hep B immune globulin and Hep B vaccine immediately after exposure
When do you screen for gestational diabetes in a women without risk factorss?
24-28 weeks
Treatment of latent TB
Isoniazid
Can the influenza vaccine be given during pregnancy?
YES, safe in all 3 trimesters
Treatment for Supreventricular tachycardia
Start with adenosine, if refractory or rapidly recurs use IV verapamil or B-blocker
Monotherapy of HTN in African-Americans?
Likely diuretic or calcium channel blocker(diltiazem)
Contraindications to beta-blockers in heart failure?
Hemodynamic instability, heart block, bradycardia, severe asthma
Criteria for severe preeclampsia
BP >160/100, proteinuria >5g/24hrs, thrombpcytopenia, LFT abnormal, epigastric pain, alterend mental status
Post-traumatic air-fluid level in sphenoid sinus
Associated with basilar skull fracture
most common cause of sinusitis
strep pneumo
Medications that negatively affect bone mineralization?
Phenytoin, glucocortiocoids, cyclosporine, phenobarb, heparin
FABER test (flexion abduction external rotation)
If pain is elicited posterior= sacroiliac involvement
Most common presenting symptom of open-angle glaucoma?
Tunnel vision
Most common congenital infection
CMV occurs in up to 2.2% of newborns, leading cause of congenital hearing loss
Most reliable predictor of survival in breast cancer?
Stage at time of dx
Most reliable US measurement of fetus in 1st trimester?
Crown-rump length
Most reliable US measurement of fetus in 2nd trimester?
Biparietal diameter