Flashcards in AAFP Review Questions Deck (466)
Loading flashcards...
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