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Family Medicine > AAFP > Flashcards

AAFP Flashcards

1
Q

Management in a patient with symptoms of preeclampsia?

A

further evaluation, including a 24-hour urine for quantitative measurement of protein, blood pressure monitoring, and laboratory evaluation that includes hemoglobin, hematocrit, a platelet count, and serum levels of transaminase, creatinine, albumin, LDH, and uric acid.

A peripheral smear and coagulation profiles also may be obtained.

Antepartum fetal testing, such as a nonstress test to assess fetal well-being, would also be appropriate.

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2
Q

In a DM patient, where should they inject their insulin to prevent exercise induced hypoglycemia?

A

Abdomen

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3
Q

Treatment of DM in pregnancy?

A

Human insulin- doesn’t cross placenta.

Oral agents cross the placenta and make cause severe neonatal hypoglycemia

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4
Q

Acute asthma attack that is not responsive to B2 agonist should be treated with?

A

Oral corticosteroids

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5
Q

Management strategy to help prevent Premenstrual Syndrome?

A

Spirinolcatone during the luteal phase

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6
Q

Which class of medications are associated with increase risk of fall in elderly patients?

A

benzodiazepines, antidepressants, antipsychotics, antiepileptics, anticholinergics, sedative hypnotics, muscle relaxants, and cardiovascular medications.

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7
Q

Urge Incontinence?

A

occurs when patients sense the urge to void but are unable to inhibit leakage long enough to reach the toile

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8
Q

Stress incontinence?

A

coughing, lifting, sneezing

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9
Q

Overflow incontinence?

A

occurs when the bladder cannot empty normally and becomes overdistended

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10
Q

Functional incontinence?

A

cases where lower urinary tract function is intact but other factors such as immobility and severe cognitive impairment lead to incontinence

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11
Q

Treatment of Narcolepsy?

A

Stimulants, such as methylphenidate

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12
Q

Evaluation of Pulmonary Embolism?

A

check D-dimers to establish diagnosis

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13
Q

genetic QT syndrome is best diagnosed by?

A

Resting EKG that shows a QTc >460 msec in females and >440 msec in males.

This syndrome especially places young people at risk for sudden death. Management may include β-blockers, an implantable cardioverter-defibrillator, and no participation in competitive sports.

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14
Q

What dietary supplement has the best evidence of efficacy in the treatment of osteoarthritis of the knee?

A

Glucosamine sulfate

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15
Q

Antipsychotic with the least weight gain?

A

Aripiprazole

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16
Q

Symptoms and Lab findings of Multiple Myeloma. What would be the confirmatory test?

A

Diagnosis is confirmed by bone marrow examination showing >10% plasma cells in the marrow.

The serum level of monoclonal immunoglobulin is typically >3 g/dL

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17
Q

How to manage a small pneumothorax (<15% of lung volume) without apparent lung disease?

A

outpatient with analgesics and follow-up within 72 hours.

CT of the lung is needed in complicated cases, including patients with known lung disease or recurrent pneumothoraces.

A chest tube is required only when the pneumothorax involves >15% of lung volume.

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18
Q

Exercise recommendations for healthy adults?

A

engage in 30 minutes of accumulated moderate-intensity physical activity on 5 or more days per week.

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19
Q

Treatment of symptomatic terminally ill patient?

A

Morphine/Opiates

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20
Q

Indications for Pneumococcal vaccine?

A

All persons between the ages of 19 and 64 who smoke should receive this vaccine.

One-time revaccination after 5 years is recommended for persons with chronic renal failure, asplenia (functional or anatomic), or other immunocompromising conditions.age 65

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21
Q

Treatment for outpatient diverticulitis?

A

Amox/Clavulanic acid

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22
Q

What is fecal incontinence, specifically “overflow”?

A

commonly seen in institutionalized elderly due to medications causing constipation

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23
Q

Most important for preoperative assessment surgical risk in a patient with longstanding RA?

A

Cervical spine imaging to detect atlantoaxial subluxation would be most important for preventing a catastrophic spinal cord injury during intubation

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24
Q

Most frequent cause of constant unilateral obstruction in adults?

A

Septal devation

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25
Q

What muscle relaxant to avoid in substance abuse?

A

Carisoprodol is metabolized to meprobamate, which is a class III controlled substance

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26
Q

Muscle strength scale

A

Muscle strength is scored on a scale of 0 to 5.

The inability to contract a muscle is scored as 0. Contraction without movement constitutes grade 1 strength. Movement with the effect of gravity neutralized is grade 2 strength, while movement against gravity only is grade 3 strength. Movement against gravity plus some additional resistance indicates grade 4 strength. Normal, or grade 5, strength is demonstrated by movement against substantial resistance.

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27
Q

Which anti-hypertensive meds cause ankle edema?

A

The most common side effects of calcium channel blockers, such as amlodipine, are due to vasodilation.

One result of this may be peripheral edema, but it can also cause dizziness, nausea, hypotension, cough, and pulmonary edema.

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28
Q

Behcet’s Syndrome

A

recurring genital and oral ulcerations and relapsing uveitis.

It is more common in Japan, Korea, and the Eastern Mediterranean area, and affects primarily young adults.

The cause is unknown. Two-thirds of patients will develop ocular involvement that may progress to blindness.

Patients may develop arthritis, vasculitis, intestinal manifestations, or neurologic manifestations.

This disease is also associated with cutaneous hypersensitivity; 60%–70% of patients will develop a sterile pustule with an erythematous margin within 48 hours of an aseptic needle prick

29
Q

What test is best at detecting the rate of Down syndrome in the first trimester of pregnancy?

A

Chorionic villus sampling

can be offered at 10–13 weeks gestation, and has a 97.8% detection rate for Down syndrome—the best detection rate of studies offered in the first trimester

30
Q

Conventional therapy for acute pericarditis?

A

NSAIDS

31
Q

In patients with chronic renal disease with chronic normocytic anemia will have the best predictive outcome if you raise the hemoglobin level to:

A

10-12 g/dl

patients who had hemoglobin levels targeted to normal ranges did worse than patients who had hemoglobin levels of 10–12 g/dL

32
Q

Vocal cord dysfunction?

A

an idiopathic disorder commonly seen in patients in their twenties and thirties in which the vocal cords partially collapse or close on inspiration.

It mimics, and is commonly mistaken for, asthma.

Symptoms include episodic tightness of the throat, a choking sensation, shortness of breath, and coughing.

A careful history and examination reveal that the symptoms are worse with inspiration than with exhalation, and inspiratory stridor during the episode may be mistaken for the wheezing of asthma

Pulmonary function tests (PFTs) are normal, with the exception of flattening of the inspiratory loop, which is diagnostic of extra-thoracic airway compression

33
Q

What symptom makes the D/X of PE more likely, in a patient with sudden onset of dyspnea?

A

Chest Pain

34
Q

Nursemaid’s elbow?

A

one of the most common injuries in children under 5 years of age.

It occurs when the child’s hand is suddenly jerked up, forcing the elbow into extension and causing the radial head to slip out from the annular ligament.

35
Q

In a child with an acute asthma attack not responding to oral prednisolone and MDI albuterol should be given what?

A

IV magnesium sulfate.

intravenous magnesium sulfate has been shown to improve lung function and reduce the need for hospitalization

36
Q

SIDS vs. suffocation?

A

most common cause of death during the first 6 months of life in the United States, with a peak incidence at 2–4 months of age and a quick dropoff by the age of 6 months.

Suffocation should be considered when there is documentation of any of the following: infant age older than 6 months, previous similar sibling deaths, simultaneous twin deaths, or evidence of pulmonary hemorrhage

37
Q

Management in reducing oxalate stone formation?

A

Potassium citrate should be taken at mealtime to increase urinary pH and urinary citrate.

A low-sodium, restricted-protein diet with increased fluid intake reduces stone formation.

Oxalate restriction also reduces stone formation. Oxalate-containing foods include spinach, chocolate, tea, and nuts, but not yellow vegetables

38
Q

Initial imaging for a possible stress fracture?

A

Xray

These are usually negative initially, but are more likely to be positive over time. If the initial films are negative and the diagnosis is not urgently needed, a second plain radiograph can be performed in 2–3 weeks.

39
Q

Signs and Sx of Ethylene Glycol poisoining? Antidote?

A

patient who appears intoxicated but does not have an odor of alcohol, and has anion gap acidosis, hypocalcemia, urinary crystals, and nontoxic blood alcohol levels

The American Academy of Clinical Toxicology criteria for treatment of ethylene glycol poisoning with an antidote include a plasma ethylene glycol concentration >20 mg/dL, a history of ingesting toxic amounts of ethylene glycol in the past few hours with an osmolal gap >10 mOsm/kg H O2 (N 5–10), and strong clinical suspicion of ethylene glycol poisoning, plus at least two of the following: arterial pH <20 mmol/L, or urinary oxalate crystals.

Antidote: Fomepizole

40
Q

Safe to give in Diabetics with Chronic renal disease?

A

Glipizide

41
Q

Treatment in patients with essential tremor that are not responsive to Beta blockers?

A

Primadone

42
Q

Criteria for pre-eclampsia

A

blood pressure of 160/110 mm Hg or above on two occasions, 6 hours apart. Other criteria include proteinuria above 5 g/24 hr, thrombocytopenia with a platelet count <100,000/mm3, liver enzyme abnormalities, epigastric or right upper quadrant pain, and alteration of mental status

43
Q

which drug can elevate calcium by increasing PTH levels?

A

Lithium

44
Q

which DM medications delay gastric emptying?

A

Pramlinitide and Exenatide–> C/I in DM gastroparesis

45
Q

Dupuyten’s contracture is commonly seen in?

A

Diabetes Mellitus

46
Q

Probiotics

A

can lessen the severity and duration of infectious diarrhea

47
Q

recommended time to screen for gestational diabetes in asymptomatic women with no risk factors

A

24-28 weeks

48
Q

Self-Determination Act requires that

A

hospitals ask patients about advance directives

49
Q

Normal Ejection Fraction

A

55-75%

50
Q

common presenting symptom of obstructive sleep apnea

A

excessive daytime sleepiness

51
Q

recommended in the treatment of all four stages of COPD, from mild through very severe

A

Short-acting inhaled ß2 -agonists such as albuterol (Ventolin HFA), as needed for dyspnea

52
Q

In assessing the nutritional status of an infant it is useful to know that birth weight is expected to be regained within

A

14 days

53
Q

The advance directive specifications contained in an individual’s living will become effective

A

when the individual becomes unable to communicate health care wishes

54
Q

oppositional defiant disorder

A

pattern of negativistic, hostile, and defiant behavior lasting at least 6 months. The child will often lose his or her temper, argue with adults, actively defy or refuse to comply with adults’ requests or rules, deliberately annoy people, blame others for his or her mistakes or misbehavior, be easily annoyed by others, appear angry and resentful, or be spiteful or vindictive. At least four of these behaviors must be present to meet the criteria for diagnosis.

55
Q

In patients with type 2 diabetes mellitus, intensive glycemic control has not been shown to be beneficial for which one of the following diabetic complications

A

CV disease

56
Q

Women older than 65 years of age who have low serum TSH levels, indicating physiologic hyperthyroidism, are at increased risk for

A

hip fracture

57
Q

Tx for Non bulls Impetigo

A

Topical Mupirocin

58
Q

Antidepressant in children/adolescents

A

SSRI- fluoxetine

59
Q

Fibromyalgia is characterized by tender trigger points

A

along the medial border of each scapula

60
Q

Tx of Alopecia Areata

A

Intralesional triamcinolone (Kenalog) – corticosteroids

61
Q

risk factor for intermittent claudication

A

Diabetes mellitus and cigarette smoking are significant risk factors for intermittent claudication, as are hypertension and dyslipidemia.

62
Q

findings would indicate that the patient suffers from severe anorexia nervosa?

A

Hypotension, bradycardia, and hypothermia

63
Q

Risk of developing esophageal adenocarcinoma from barrel’s esophagus?

A

<1%

64
Q

treatment for an uncomplicated urinary tract infection,

A

Nifurantoin for 5 days

65
Q

First line tx for pyelonephritis

A

Ciprofloxacin

66
Q

Patient presents with pleuritic chest pain. what would you order?

A

EKG, chest film

67
Q

What test can differentiate between cardiac and pulmonary disease?

A

BNP

68
Q

Treatment for Raynaud’s

A

Nifedipine

69
Q

What’s a “double effect”?

A

used to justify medical treatment designed to relieve suffering when death is an unintended but foreseeable consequence. It is based on two basic presuppositions: first, that the doctor’s motivation is to alleviate suffering, and second, that the treatment is appropriate to the illness.

Family Medicine (4 decks)

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