SAM 2020 Flashcards

1
Q

risk factors of plantar fasciitis

A
Body mass index > 27 kg per m2
Excessive running
Intrinsic foot and calf muscle tightness
Leg length discrepancy
Occupations requiring prolonged standing or walking
Pes cavus (high arch)
Pes planus (excessive foot pronation)
Reduced ankle dorsiflexion
Sedentary lifestyle
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2
Q

management of plantar fasciitis

A

stretching of the plantar fascia
ice packing
massage
nonsteroidal anti-inflammatory drugs

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3
Q

ddx (skeletal conditions) of plantar fasciitis

A
skeletal causes: 
acute calcaneal fracture 
bone tumor 
Calcaneal apophysitis (Sever disease)
calcaneal stress fracture 
spondyloarthropathies 
soft tissue condition: 
Achilles tendinitis
Tarsal tunnel syndrome
Fat pad contusion
Plantar fibroma
Retrocalcaneal bursitis
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4
Q

antihypertensive safe for breastfeeding

A
  • labetalol
  • extended release nifedipine
  • methyldopa
  • captopril
  • enalapril
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5
Q

Modifiable risk factors of CRC

A
  • obesity
  • sedentary lifestyle
  • diet high in processed meat or calories
  • excessive EtOH intake
  • excessive smoking
  • control diabetes
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6
Q

hereditary conditions causing increased CRC

A

Familiar noncancerous polyposis

Lynch syndrome

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7
Q

topical treatment for rosacea

A

topical metronidazole
topical azelaic acid
topical ivermectin

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8
Q

definition of significant weight loss in elderly

A

reduction of 5% weight in 1 months or

reduction of 10% in 6 months

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9
Q

Etiology of elderly weight loss

A
  • side effect of meds or treatment (C/T, R/T, dialysis)
  • malignancy
  • CHF, COPD, CKD
  • pain
  • wandering, dementia, or psychiatric conditions
  • emotional or psychological problem (anxiety, depression, delusions)
  • impaired cognitive or physical functions
  • GI disease (malabsorption, GERD, constipation, N/V)
  • Endo: hypo- hyper- thyroidism, hyperparathyroidism, hypoandrenalism
  • oral health: poorly fit denture, diseased mucosa
  • swallowing disorder
  • loss appetite or early satiety
  • social factors: isolation, poverty, food prep access
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10
Q

instructions of loperamide for traveler’s diarrhea

A
  • Do not take it with dysentery (diarrhea with blood)

- seek medical attention if no improvement in 24-48 hrs

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11
Q

20) classic symptoms of Meniere disease

A

vertigo attack
unilateral hearing loss
tinnitus
aural fullness

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12
Q

treatment (pharm and non-pharm) for Meniere disease

A

dietary salt restriction
stress reduction
betahistine
diuretics

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13
Q

reproducible vertigo symptoms with certain head movement

A

Meniere disease attacks are not reproducible by specific head movements

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14
Q

driving instructions for patient diagnosed with Meniere disease

A

people with MD can drive provided they have enough warning before attacks (drop attacks)
should not drive if experiencing Drop Attacks (Tumarkin otolith crisis)

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15
Q

Causes of chronic non-bloody diarrhea +/- weight loss

A
  • IBS
  • IBD
  • malabsorption (celiac, lactose intolerance)
  • chronic infection (esp. immunocompromised pt): bacterial, mycobacterial, parasitic
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16
Q

Risk factors for torsade include the following

A

Congenital long QT syndrome
Female gender
Acquired long QT syndrome (causes of which include medications and electrolyte disorders such as hypokalemia and hypomagnesemia)
Bradycardia
Baseline electrocardiographic abnormalities
Renal or liver failure

17
Q

Risk factors for torsade include the following

A

Congenital long QT syndrome
Female gender
Acquired long QT syndrome (causes of which include medications and electrolyte disorders such as hypokalemia and hypomagnesemia)
Bradycardia
Baseline electrocardiographic abnormalities
Renal or liver failure

18
Q

Medications causing QT prolongation

A

anti-arrhythmic

  • amiodarone
  • Quinidine

anti-depressant

  • Fluoxetine (SSRI)
  • TCA (amitriptyline)
  • Doxepin
  • Venlafaxine

antibiotics

  • quinolone (Levofloxacin)
  • macrolide (Clarithromycin)

anti-psychotics
- Haloperidol

19
Q

Medications causing QT prolongation

A

anti-arrhythmic

  • amiodarone
  • Quinidine

anti-depressant

  • fluoxetine (SSRI)
  • TCA (amitriptyline)
  • doxepin
  • venlafaxine

antibiotics

  • Levofloxacin
  • macrolide (clarithromycin)

anti-psychotics
- haloperidol

triptan

20
Q

Medications causing QT prolongation

A

anti-arrhythmic

  • amiodarone
  • Quinidine

anti-depressant

  • fluoxetine (SSRI)
  • TCA (amitriptyline)
  • doxepin
  • venlafaxine

antibiotics

  • Levofloxacin
  • macrolide (clarithromycin)

anti-psychotics
- haloperidol

triptan

21
Q

Causes of secondary Raynaud phenomenon

A
  • mixed connective tissue disease (85%)
  • systemic sclerosis (scleroderma) - 90%
  • systemic lupus erythematosus
  • rheumatoid arthritis
  • Sjögren syndrome
  • polymyositis
22
Q

treatment of primary Raynaud phenomenon

A
Conservative:  - LSM 
avoidance of precipitating factors 
use of gloves
education
warming of the affected body part
cessation of vasoconstricting agents such as nicotine
PHARM: 
calcium channel blocker treatment; nifedipine is the usual choice
Topical nitroglycerin (1% or 2%) has been found to help if applied locally
23
Q

secondary Raynaud phenomenon

A
  • Conservative measures: less effective

- Pharmacologic options for secondary Raynaud phenomenon: including calcium channel blockers and prostacyclin analogues

24
Q

how to differentiate primary and secondary Raynaud phenomenon

A

nail fold capillary changes under Nailfold dermatoscopy

25
Q

antibiotics choice for simple MRSA skin infection (not perineal, not peri-rectal, no paronychia)

A
  • Septra (TMP/SMX)

- clindamycin

26
Q

Oral antibiotic options for treating skin and soft-tissue infections in patients with community-associated MRSA

A
  • clindamycin
  • trimethoprim/sulfamethoxazole (TMP/SMX; Bactrim, Septra)
  • tetracycline (doxycycline or minocycline [Minocin])
  • linezolid (Zyvox)
27
Q

risk factors of skin MRSA infection

A
recent antibiotics use 
contact sports 
group housing 
low SES 
IVDU
28
Q

Who should not be prescribed tetracyclines ? List TWO patient populations.

A
  • pregnant women

- children under 8 years

29
Q

When considering the treatment plan for this patient

A
  • monotherapy NOT recommended
  • limit antibiotic use to shortest possible duration
  • concomitant treatment with topical agents
30
Q

What are the cardinal symptoms of ADHD? List FOUR

A
  • inattention
  • impulsiveness
  • hyperactivity
  • forgetfulness
  • distractibility
  • poor academic performance
  • behavioural problems
31
Q

You want to obtain a more detailed history of this patient so you inquire about the mother’s
pregnancy with the patient. What are the prenatal risk factors for this condition? List TWO

A
  • smoking during pregnancy
  • prenatal alcohol exposure
  • low birth weight
32
Q

Which comorbidities are often associated with ADHD

A
  • oppositional defiant disorder
  • tic disorder
  • substance use disorder
  • anxiety
  • depression
  • Autism Spectrum Disorder (ASD)
  • learning disorders
  • intellectual disability
  • prematurity
33
Q

What are some other differential diagnoses to consider for this condition (ADHD)? List THREE.

A
  • oppositional defiant disorder (ODD)
  • tic disorder
  • substance use disorder
  • anxiety
  • depression
  • learning disorders
  • sleep disorders
34
Q

What is the GREATEST risk factor for ADHD? List ONE.

A

family history

35
Q

What are the TWO first-line interventions for ADHD?

A
  • amphetamine

- methylphenidate

36
Q

What should all patients be screened for prior to taking this medication? State ONE thing.

A
  • risk factors for sudden cardiac death
37
Q

What are the most common diagnoses and factors on history associated with spontaneous
pneumothorax? List THREE.

A
  • asthma
  • emphysematous bleb
  • tobacco use
  • congenital abnormality
38
Q

You read in his discharge note from the hospital that he suffered a small pneumothorax. He was
managed with conservative measures. In the case this had been a larger pneumothorax, what other
treatments might have been required? List TWO.

A
  • chest tube placement/drain/catheter placement
    (Accept any one)
  • surgical repair
39
Q

The parents would like to discuss the consequences of this event for their child’s health. What is the
MOST common complication following a pneumothorax? List ONE.

A
  • recurrence