Flashcards in AAFP Review Questions Deck (466)
Diabetes A1c goals
Most diabetics: <7%
<6.5% reasonable for patients w/ short duration of DM, long life expectancy, and no significant CV disease
7.5-8% reasonable for patients w/ short life expectancy, CV disease, 2+ CVD RFs, or duration of disease 10+ yrs
First line therapy for type 2 diabetes
Glucose monitoring in non-insulin DM?
Self-monitoring of blood glucose levels for patients taking non-insulin therapies does NOT significantly affect glycemic control
Drugs for postherpetic neuralgia
Topical: lidocaine patches, capsaicin cream
Oral: gabapentin, pregabalin, amitriptyline
Risks of PPIs
Fractures of the hip/wrist/spine, CAP, C. diff and other enteric infections, hypomagnesemia, cardiac events if administered w/ clopidogrel
First-line therapy for constipation in kids
Oral osmotic (e.g., PEG)
When can kids with lice return back to school?
Recurrent uveitis should raise suspicion for?
Most comon conditions assx w/ uveitis:
When should red eye be referred to ophtho?
Vision changes (could be glaucoma)
Empiric tx for classic pyelonephritis
Immune thrombocytopenic purpura presentation and treatment
Easy bruising, low platelets, giant platelets
Corticosteroids (IVIG and rituximab have also been used as first-line)
TMP/SMX if allergic or intolerant to macrolides
Which diabetes medication does not cause hypoglycemia?
Metformin (but there is risk for lactic acidosis)
Which vessels are present in the newborn umbilicus?
2 arteries and 1 vein
How to avoid kidney injury in rhabdomyolysis?
Rapid large infusions of isotonic saline
How to diagnose fibromyalgia?
Symptoms (NOT tender points)
How to enhance oral absorption of supplemental iron?
Vitamin C (or a meal high in meat protein)
Changes to pharmacokinetics that occur with aging
In older persons there
is a relative increase in body fat and a relative decrease in lean body mass, which causes increased
distribution of fat-soluble drugs such as diazepam. This also increases the elimination half-life of such
medications. The volume of distribution of water-soluble compounds such as digoxin is decreased in older
patients, which means a smaller dose is required to reach a given target plasma concentration. There is also
a predictable reduction in glomerular filtration rate and tubular secretion with aging, which causes
decreased clearance of medications in the geriatric population. The absorption of drugs changes little with
Which NSAID is not associated with an increased risk of MI and thus preferred in patients with cardiovascular risk factors?
NSAIDs cause an elevation of blood pressure due to their salt and water retention properties. This effect
can also lead to edema and worsen underlying heart failure. In addition, all NSAIDs can have a deleterious
effect on kidney function and can worsen underlying chronic kidney disease, in addition to precipitating
acute kidney injury. Celecoxib, ibuprofen, meloxicam, and diclofenac are associated with an increased risk
of cardiovascular adverse effects and myocardial infarction, compared with placebo. However, naproxen
has not been associated with an increased risk of myocardial infarction and is therefore preferred over
other NSAIDs in patients with underlying coronary artery disease risk factors
Acute laryngitis treatment
Acute laryngitis most often has a viral etiology and symptomatic treatment is therefore most appropriate.
A Cochrane review concluded that antibiotics appear to have no benefit in treating acute laryngitis.
How to check for hyperaldosteronism?
Peripheral aldosterone concentration
(PAC) and peripheral renin activity (PRA), preferably after being upright for 2 hours, are the preferred
screening tests for hyperaldosteronism. A PAC >15 ng/dL and a PAC/PRA ratio >20 suggest an adrenal
cause. Abdominal CT may miss adrenal hyperplasia or a microadenoma.
Tinea capitis treatment
ORAL antigungal (e.g. griseofulvin)
If a patient had shingles, should they get vaccine?
Mild: 1-3 topicals
Mod: 2-3 topicals +/- oral
Severe: orals w/ 2-3 topicals
What is a level D recommendation?
A “D” recommendation means the U.S. Preventive Services Task Force (USPSTF) recommends against
the service. There is moderate or high certainty that the service has no net benefit or that the harms
outweigh the benefits.
What is a level I recommendation?
An “I” recommendation means the USPSTF concludes that the evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.
What is a level C recommendation?
A “C” recommendation means the USPSTF recommends selectively offering or providing this service to
individual patients based on professional judgment and patient preferences.
What is a level B recommendation?
A “B” recommendation means the USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit
is moderate to substantial.
What is a level A recommendation?
An “A” recommendation means the USPSTF recommends the service and there is high certainty that the net benefit is substantial. The highest levels of evidence and most recent evidence
available are used by the USPSTF in making all of its recommendations.