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Flashcards in AAFP Review Questions Deck (466)
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211

Pseudogout crystals

CPPD: rod shaped, rhomboid, weakly positive birefringence

212

Indications for ultrasound in pregnancy

Not mandatory in routine pregnancy.

Indicated for:
-evaluation of uncertain gestational age
-size/date discrepancies
-vaginal bleeding
-multiple gestations
-other high-risk situations

213

Advanced maternal age

Pregnant women who will be 35 or beyond at the estimated date of delivery

214

Women considering conception should take what?

Folic acid (400-800 μg if low risk, 4 mg if previous child w/ NTD, 1 mg if DM or epilepsy)

215

Naegele's rule

Subtract 3 months from the first day of the LMP and add 7 days to date the pregnancy

216

Screening for gestational diabetes

Between weeks 24-28

1-hour 50 g glucose challenge test

If positive, 3-hour 100 g GGT after overnight fast. Assess fasting, 1 hr, 2 hr, and 3 hr postload serum glucose samples.
-2 out of 4 positive values indicate GDM

Women diagnosed with GDM should be screened for T II DM at 12 weeks postpartum

217

Group B streptococcus screening

Between 35-37 weeks

Colonized women should be treated w/ IV abx at the time of labor or rupture of membranes

218

Late-term pregnancy

41 weeks, 0 days - 41 weeks, 6 days

219

Post-term pregnancy

Beyond 42 weeks or 294 days

220

Pre-term pregnancy

Birth before 37 weeks

If h/o pre-term, women should be given progesterone injections weekly from 16-37 weeks

221

Vaccinations during pregnancy

-prenatal visit: influenza
-27-36 weeks: tetanus toxoid, diphtheria, Tdap

Varicella, rubella, and live attenuated influenza NOT recommended

222

What to do if woman is Rh negative

Assess antibody screen or do indirect Coomb's

If Ab screen is negative, no isoimmunization --> give RhoGAM at 28 weeks and again at delivery if baby is determined to be Rh +

If Ab screen is positive, and the identity of the Ab is confirmed to be Rh (anti-D), check titer
-low titer: observe
-high titer: US +/- amniocentesis

223

BMI in children

Underweight: <5 percentile
Healthy weight: 5-85 percentile
Overweight: 85-95 percentile
Obese: >95 percentile

224

Pediatric failure to thrive

Weight below the 3rd or 5th percentile

OR

Decelerations of growth that have crossed two major growth percentiles in a short period of time

225

Mandatory newborn screens

PKU and congenital hypothyroidism

Hearing is almost always tested too

226

Lead testing

Between 12-24 months OR at 36 and 72 months

227

Screen for strabismus

Cover-uncover test

Positive: uncovered eye deviates to focus on the object

If positive, refer to ophtho immediately

228

Rear-facing car seat

Until 2 y.o. or until child has reached the maximum height or weight limit of the rear-facing seat

>40 lbs: booster seat

229

Top three causes of death in infants < 1

1. congenital abnormalities
2. short gestation
3. sudden infant death syndrome (SIDS) [babies should sleep on their BACK]

230

2 month vaccinations

RV #1
DTaP #1
Hib #1
PCV #1
IPV #1

231

4 month vaccinations

RV #2
DTaP #2
Hib #2
PCV #1
IPV #2

232

6 month vaccinations

DTaP #3
PCV #3
IPV #3

233

12 month vaccinations

MMR #1
Varicella #1
HepA #1

234

Treatment of allergic rhinitis

-antihistamines
-first gen: diphenhydramine, chlorpheniramine, hydroxizine [SE: sedation, dry mouth, dry eyes, blurred vision, urinary retention; careful in elderly]
-second gen: loratadine, desloratadine, fexofenadine, azelastine, cetirizine
-intranasal corticosteroids
-decongestants (alpha agonists)
-leukotriene inhibitors
-zafirlukast, montelukast, zileuton
-systemic corticosteroids (in severe cases)
-desensitization therapy

235

Non-nicotine smoking cessation therapy

Bupropion (Zyban) and Varenicline (Chantix)

Bupropion (Zyban)
-NDRI
-contraindications: eating disorders, seizures, MAO-I, careful in heart disease
-7-12 weeks, can be used up to 6 mo
-SE: insomnia, dry mouth
-pregnancy category C

Varenicline (Chantix)
-partial nicotinic receptor agonist
-SE: neuropsychiatric symptoms including behavior changes, agitation, depression, SI; nausea, insomnia, abnormal/vivid/strange dreams
-CI: h/o depression, heart disease
-pregnancy category C

236

Principles of medical ethics

-Autonomy
-Benificence
-Nonmaleficence
-Justice

237

MMA and homocysteine levels

High MMA: B12 deficiency
High homocysteine: folate deficiency

238

Anemia of chronic disease

-Normal ferritin
-TIBC decreased

239

Iron deficiency anemia iron studies

-Serum iron: low
-TIBC: high
-Transferrin saturation: low
-Serum ferritin: low

240

Common bugs causing traveler's diarrhea

Bacteria
-E. coli
-Salmonella
-Shigella
-Vibrio (non-cholerae)
-Campylobacter

Viruses
-Rotavirus
-Norovirus

Parasites
-Giardia lamblia
-E. histolytica
-Cryptosporidium parvum