Theory

Question 1

What are the main characteristics of family practice?

Answer 1

1) Definitive care
2) One-person responsibility
3) Problem oriented
4) Continuous
5) Lasts of a lifetime
6) Independent from age, gender, social status
7) Complex, somatic, psychic, social
8) Integrative
9) Situative office home
10) Preventive approach

Question 2

What is the core competencies of family practice?

Answer 2

1) Primary care management
2) Person-centered care
3) Specific problem solving skills 4) Comprehensive approach
5) Community orientation
6) Holistic modeling

Question 3

What are the components of the primary care team?

Answer 3

1) GPs and specialists working in primary care
2) Nurses – practice, district, psychiatric
3) Midwifes
4) Social workers
5) Health visitor
6) Practice managers
7) Receptionists

Question 4

What is the European definition of family practice?

Answer 4

1) First medical contact
2) Coordination with other professions
3) Person-centered approach
4) Relationship over time
5) Longitudinal continuity of care
6) Community-based decision making
7) Management of acute and chronic problems
8) Management of undifferentiated illnesses at an early stage 9) Preventive therapy and promotion of health

Question 5

What is the definition of BMI?

Answer 5

weight (kg) / height (m)2

Question 6

What are the categories for BMI?

Answer 6

**

Question 7

Cost of overweight on the health system

Answer 7

2-8% or 5-10% of all health expanses

Question 8

Stepped care approach to obesity

Answer 8

1) Lifestyle intervention
2) Hypocaloric diets
3) Pharmacotherapy
4) Intragastric devices
5) Gastric pacemakers
6) Adustable gastric banding
7) Roux-N-Y Gastric bypass
8) Biliopancreatic diversion

Question 9

True for waist circumference and risk of heart disease

Answer 9

The higher the waist circumference the highter the risk for CV disease. Men > 102
Women >88

Question 10

True for primary hypertension and therapy

Answer 10

Idiopathic. Risk factors: smoking, obesity, family history.
Treatment: α2 receptor agonists (clonidine), β-blockers, diuretics (hydrochlorothiazide), ACE-I, renin inhibitors, angiotensin blockers, Ca2+- blockers, direct vasodilators.

Question 11

Hypertensive patient with increased creatinine, what do we expect?

Answer 11

Renal arterial stenosis

Question 12

What is correct for Diabetes Mellitus and family practice

Answer 12

1) Screening
2) Diagnosis
3) Treatment
4) Control
5) Teaching, education

Question 13

How do you diagnose DM?

Answer 13

**

Question 14

Which is true for OGTT?

Answer 14

1.75 g/Kg = 75 gr glucose

Check before exam, 30’ min, 1 hour, 90’ min, 2 hours. Simple, cheep, useful

Question 15

What are the Signs of DM?

Answer 15

1) Polydipsia
2) Polyuria
3) Exhustion
4) Rapid weight loss
5) Increasing short-sightedness 6) Ketosis
7) Nausea, vomiting 8) Abdominal pain 9) Glucosuria

Question 16

Primary treatment objectives for DM:

Answer 16

1) Relief symptoms
2) Improve quality of life
3) Prevent acute and chronic complications 4) Reduce mortality
5) Treat accompanying disorders

Question 17

Therapy of Diabetes Mellitus?

Answer 17

Oral antidiabetics or insulin

Question 18

Emergencies in family medicine

Answer 18

1) Cardiac
2) Asthma exacerbation
3) Psychiatric
4) Impaired consciousness
5) Hypoglycemia
6) Anaphylaxis
7) Seizure
8) Shocks
9) Poisoning/OD

Question 19

Basic life support, the protocol

Answer 19

Shake and ask are you ok? 
Call for help
Free airways and check breathing
call ambulance
start CPR 30x2.

Question 20

True for ECG of a person with ACS

Answer 20

1) Transient ST elevation
2) Dynamic T wave changes
3) ST depression
4) Normal or unchanged ECG doesn’t exclude ACS

Question 21

Treatment of unstable angina

Answer 21

Aspirin – 500 mg PO Clopidogrel – 300 mg PO Metoprolol – 25 mg PO

Question 22

What are the first line drugs used for acute heart failure

Answer 22

10) Nitroglycerin spay – 1 spray every 5-10 minutes. Max 3 times 11) Furosamide IV – 40-80 mg
12) Morphine – 5-10 mg
13) Nitroglycerine – 5 mg into 500 ml infusion
14) Dopamine – 50 mg into infusion

Question 23

Hypovolemic shock

Answer 23

Mechanism: fluid loss  hypoperfusion  MOF
Signs: tachycardia, delay capillary refill, tachypnea, low pulse pressure, cold skin, anxiety, low systolic BP, oliguria, mental status changes.
Treatment: ABCD, OMV

Question 24

Which is true for the life expectancy of smokers?

Answer 24

Reduce survival in average of 10 years

Question 25

What is the correct for the causative relationship between death and
smoking?

Answer 25

Death from lung cancer, ischemic heart disease and COPD. Reduces survival in average of 10 years.
Quitting at any age will increase life expectancy.

Question 26

True for second-hand smoking and health risk

Answer 26

20-30% increase for lung cancer.
25-30% increase risk for heart disease. Cause and worsen asthma, COPD, emphysema. Increase risk for nonfatal acute MI.
Higher risk for children hospitalization.

Question 27

What is true for pregnancy and smoking.

Answer 27

Increased risk for miscarriage, stillbirth, SIDS.
4 fold risk for low birth weight.
Impaired infant lung function.
Association with cognitive and developmental syndromes.

Question 28

True for smoking withdrawal and side effects

Answer 28

**

Question 29

Criteria for insomnia

Answer 29

At least 6 months. All must have day time consequences

1) Difficulty initiating sleep
2) Difficulty maintaining sleep
3) Early morning awakening
4) Non restorative sleep

Question 30

DSM-IV definition of parasomnias

Answer 30

1) Nightmares 2) Night terrors 3) Sleepwalking

Question 31

OSAS

Answer 31

> 15 apnea / hour OR 5 apnea/hour + symptoms Complications: HT, DM, MI, CVA, depression

Question 32

OSAS therapy

Answer 32

1) Weight control
2) Avoidance of alcohol
3) Smoking secession
4) CPAP
5) Oral appliances
6) Surgery

Question 33

Which is true for major depression?

Answer 33

At least 2 weeks with 5 symptoms:
At least one main feature:
 1) Persistent sad mood
2) Loss of interest or pleasure
Rest from minor features:
1) Change in appetite or weight
2) Change in sleep
3) Psychomotor agitation or retardation
4) Fatigue
5) Worthlessness or guilty feelings
6) Concentration difficulties or indecisiveness
7) Recurrent thought of death or suicide

Question 34

Life time prevalence of major depression

Answer 34

4.6-15.7%

Question 35

Risk factors for suicide

Answer 35

1) Elderly
2) Male
3) Caucasian
4) Living alone
5) Prior suicide attempt
6) Family history
7) Medically ill
8) Psychosis
9) Alcohol or other substance abuse

Question 36

Lower back pain from musculoskeletal origin

Answer 36

1) Felt from erector spinea or gluteal muscles
2) Will affect the ability to sit stand and walk
3) Agonizing pain, worse in certain movements
4) Tenderness over the back
5) Muscle spasms

Question 37

Lower back pain and bed rest therapy

Answer 37

When painful – bed rest.

When pain gradually decrease – start physical activity.

Question 38

Prevention of lower back pain

Answer 38

1) Screening and early recognition of static disorders and anatomic abnormalities
2) Encouragement of physical activity of the whole population – develop and strengthen trunk musculature, flexibility and body endurance

Question 39

Therapy of chronic lower back pain

Answer 39

1) Medications – pills, injections, infusions
2) Physiotherapy
3) Massage
4) Balneotherapy
5) Supervised gymnastic
6) Psychological guides