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Flashcards in AAFP Review Questions Deck (466)
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31

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

32

First line therapy for type 2 diabetes

METFORMIN

33

Glucose monitoring in non-insulin DM?

Self-monitoring of blood glucose levels for patients taking non-insulin therapies does NOT significantly affect glycemic control

34

Drugs for postherpetic neuralgia

Topical: lidocaine patches, capsaicin cream

Oral: gabapentin, pregabalin, amitriptyline

35

Risks of PPIs

Fractures of the hip/wrist/spine, CAP, C. diff and other enteric infections, hypomagnesemia, cardiac events if administered w/ clopidogrel

36

First-line therapy for constipation in kids

Oral osmotic (e.g., PEG)

37

When can kids with lice return back to school?

Immediately

38

Recurrent uveitis should raise suspicion for?


Most comon conditions assx w/ uveitis:
-séronégative spondyloarthropathies
-sarcoidosis
-syphilis
-RA
-reactive arthritis

39

When should red eye be referred to ophtho?

Vision changes (could be glaucoma)

40

Empiric tx for classic pyelonephritis

Ciprofloxacin (cipro)

41

Immune thrombocytopenic purpura presentation and treatment

Easy bruising, low platelets, giant platelets

Corticosteroids (IVIG and rituximab have also been used as first-line)

42

Pertussis treatment

Azithromycin (Zithromax)

TMP/SMX if allergic or intolerant to macrolides

43

Which diabetes medication does not cause hypoglycemia?

Metformin (but there is risk for lactic acidosis)

44

Which vessels are present in the newborn umbilicus?

2 arteries and 1 vein

45

How to avoid kidney injury in rhabdomyolysis?

Rapid large infusions of isotonic saline

46

How to diagnose fibromyalgia?

Symptoms (NOT tender points)

47

How to enhance oral absorption of supplemental iron?

Vitamin C (or a meal high in meat protein)

48

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
advancing age.

49

Which NSAID is not associated with an increased risk of MI and thus preferred in patients with cardiovascular risk factors?

Naproxen

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

50

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.

51

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.

52

Tinea capitis treatment

ORAL antigungal (e.g. griseofulvin)

53

If a patient had shingles, should they get vaccine?

YES

54

Acne management

Mild: 1-3 topicals
Mod: 2-3 topicals +/- oral
Severe: orals w/ 2-3 topicals

55

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.

56

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.

57

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.

58

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.

59

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.

60

According to the DSM-5, what is the severity of anorexia nervosa based on?

According to the DSM-5, the level of severity of anorexia nervosa is based on the patient’s body mass
index (BMI). Mild is a BMI >17.0 kg/m2, moderate is a BMI of 16.0–16.99 kg/m2, severe is a BMI of
15.0–15.9 kg/m2, and extreme is a BMI <15.0 kg/m2.