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Flashcards in AAFP Review Questions Deck (466)
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91

Neer test

Rotator cuff impingement

Arm extended and pronated, examiner passively lifts arm up past head

+ is pain

92

McMurray test

Meniscus

Patient supine, thumb and fingers in knee joint line, grasp heel, fully flex and extend knee while exerting valgus stress while externally rotating knee; repeat with varus stress while internally rotating knee

+ is catching

93

Cross arm test

AC joint

Arm at shoulder level, elbow 90 degrees, examiner brings across to touch other shoulder

+ is pain at AC joint

94

Apprehension test

Subluxation of the glenohumeral joint

Arm at shoulder level, elbow at 90 degrees, hand toward ceiling; anterior pressure on humerus

+ is apprehension of joint dislocating or pain

95

Straight leg raise test

Lumbar nerve root compression

Leg extended, hip at 90 degrees

+ is radiation pain or numbness down past knee

96

FABER test

SI joint

Hip in flexion, abduction, and external rotation ("figure 4")

+ is pain

97

Trendelenburg test

Hip abductor weakness

Patient stands on affected leg and lifts other leg

+ is pelvic drop to contralateral side

98

Colles fracture

Fracture of distal radius/ulna

Usually from fall onto an outstretched hand

99

Lachman test

ACL

Patient supine, knee flexed at 30 degrees, stabilize femur (hold it), pull tibia anteriorly

+ is lack of clear endpoint of displacement of tibia

100

Posterior drawer test

PCL

Patient supine, knee flexed at 90 degrees, fix foot (sit on it), push tibia posteriorly

+ is posterior displacement of tibia

101

Valgus stress test

LCL

Patient supine, leg slightly abducted at the hip, knee 30 degrees flexed, stabilize tibia, push knee inward

+ is laxity

102

Varus stress test

MCL

Patient supine, leg slightly abducted at the hip, knee 30 degrees flexed, stabilize tibia, push knee outward

+ is laxity

103

McMurray test

Meniscus

Patient supine, thumb and fingers in knee joint line, grasp heel, fully flex and extend knee while exerting valgus stress while externally rotating knee; repeat with varus stress while internally rotating knee

+ is catching

104

Gout treatment

Acute flare: NSAIDs + low dose colchicine

Maintenance: allopurinol (xanthine oxidase inhibitor), probenecid (increases uric acid excretion in the urine)

105

Target serum uric acid level in gout

<6

106

Most common joints involved in gout and pseudogout

Gout: first MTP
Pseudogout: knee

107

CASPAR criteria for psoriatic arthritis

3 or more out of 6 is positive

-psoriasis of the skin
present (2 pts)
past (1 pt)
FHx (1 pt)
-nail lesions (1 pt)
-dactylitis (1 pt)
-negative RF (1 pt)
-juxtaarticular bone formation on XR (1 pt)

108

Management of stable COPD

inhaled beta agonists (albuterol) and anticholinergic bronchodilators (tiotropium or ipratropium).

Oral steroids may be need for patients with more severe disease.

Supplemental oxygen has clearly been shown to prolong life in COPD patients – the only other intervention that does so is smoking cessation!

109

Colles fracture

Fracture of distal radius/ulna

Usually from fall onto an outstretched hand

110

Gonorrhea treatment

Ceftriaxone and azithromycin

Want to treat both chlamydia and gonorrhea to avoid development of PID which can lead to infertility

(G is much less common than C, and patients infected with G are likely to also be infected with C- the reverse is not true since C is so common/easy to acquire statistically)

111

If a patient tests + for chlamydia or gonorrhea, should the partner be treated?

Yes, or the patient will become reinfected

112

Combined OCP vs. progestin-only

Progestin only pills (a.k.a. “POPs” or “the mini pill”) are associated with more break-through bleeding and slightly higher failure rates than the combination pill that contains both estrogen and progesterone. Progestin only pills are more difficult to take, because they must be taken at the same time every day to maintain their efficacy. They are usually reserved for women who have a compelling reason avoid estrogen. Such patients might include women with migraine headaches, smokers over age 35, patients in the postpartum period, or women with clotting disease, cardiovascular disease, uncontrolled HTN, SLE, or hypertriglyceridemia

113

If a patient has myasthenia gravis, what conditions need to be considered?

Do a CT for thymic pathology. 75% will have thymic hyperplasia, and 15% will have an overt thymoma (removal of the thymus can be curative in some patients who fail medical therapy)

Also in younger females, consider autoimmune (SLE, RA, hyperthyroidism)

114

Mitral valve prolapse murmur

Midsystolic click followed by a late systolic murmur heard best at the apex of the heart

115

Atrial septal defect physical exam findings

Buzzword: fixed splitting of S2

Loud S1 with a fixed and widely split S2. Soft, midsystolic ejection murmur heard best at L 2nd ICS MCL.

ASDs are silent! The murmur heard is a systolic ejection flow murmur out of the pulmonic valve due to increased flow.

ASDs can remain asymptomatic for a long time, but eventually get pulmonary hypertension and shunt can reverse --> Eisenmenger syndrome

116

Medications beneficial in acute COPD exacerbations

corticosteroids, antibiotics (amoxicillin, trimethoprim/sulfamethoxazole, and doxycycline), and inhaled bronchodilators

117

Antibiotics used in COPD exacerbations

amoxicillin, trimethoprim/sulfamethoxazole, and doxycycline

118

Classic COPD x-ray

hyper-inflated lungs, flattened diaphragms, and a narrow cardiac silhouette

119

Management of stable COPD

inhaled beta agonists (albuterol) and anticholinergic bronchodilators (tiotropium or ipratropium).

Oral steroids may be need for patients with more severe disease.

Supplemental oxygen has clearly been shown to prolong life in COPD patients – the only other intervention that does so is smoking cessation!

120

X-ray appearance of coarctation of the aorta

Rib notching (d/t collateral circulation formation)