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PGY-4 Board Prep > Adult Primary Care > Flashcards

Adult Primary Care Flashcards

(83 cards)

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1
Q

Screening for diabetes - ADA

A

everyone over 45
Adults w/ BMI >25 or 23 if Asian + RF
q3 years

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2
Q

Metformin MOA

A

decrease hepatic glucose output

enhance insulin sensitivity

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3
Q

SGLT-2 inhibitors MOA

A

blocking renal glucose absorption

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4
Q

SGLT-2 inhibitors name of drugs

A

“ifozin”

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5
Q

SGLT-2 inhibitors adverse effects

A

gential/urinary infections
need to be decreased in CKD
increased risk of DKA

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6
Q

GLP-1 receptor agonists MOA

A

mimic effects of increntins + delay gastric emptying (wt loss)

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7
Q

GLP-1 receptor agonists names

A

-“atide”; injectable!

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8
Q

GLP-1 receptor agonists AE

A

GI side effects

pancreatitis

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9
Q

DPP4 Inhibitors MOA

A

increase incretins

increased risk of pancreatitis

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10
Q

Example of DPP4 Inhibitor

A

sitagliptin (Januvia)

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11
Q

Colon Cancer Screening

A

Age 50-75

annual FOBT or q10y colonoscopy

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12
Q

Early Screening for Colon Cancer

A

High risk pts include those with a relative <60 or at least 2 relatives at any age
Start at 40 or 10 years before
Screen q5y

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13
Q

Breast Cancer Screening Ages

A

40/50-75

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14
Q

Cervical Cancer Screening Ages

A

21-65

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15
Q

Lung Cancer Screening

A

ages 55-80
at least 30 pack years
current or quit in the last 15 years

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16
Q

Abdominal Aorta Aneurysm Screening

A

Men 65-75 who have smoked!

selective screening for family history in non-smokers in this age range

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17
Q

Osteoporosis screening

A

DEXA at 65 or 10 year risk of 8.4%

possibly age 70 in men

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18
Q

Lipid Screening

A

age 40-75, q5y

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19
Q

STD Screening

A

all women <24, gonorrhea + chlymadia

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20
Q

Weight Loss Surgery if BMI…

A

> 40 or >35 + comorbidities

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21
Q

L3 Sensation

A

anterior thigh/knee

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22
Q

L4 Sensation

A

anterior shin

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23
Q

Patellar Reflexes

A

L4 nerve root

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24
Q

L5 Sensation

A

dorsum of foot

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25
Weak great toe dorsiflexion
L5 nerve root
26
Ankle Reflexes
S1 Nerve root
27
Weak Toe Walk
S1 Nerve root
28
spondylosis spondylolisthesis spondylolysis
spondylosis - disc space narrowing spondylolisthesis - anterior displacement of vertebrae spondylolysis - non union fracture of pars
29
lordosis
inward curvature of lumbar spine
30
kyphosis
outward curvature of thoracic spine
31
straight leg raise test positive
sciatic symptoms at angle less than 60 | radicular pain below the knee
32
straight leg raise test specify and sensitive
sensitive but not specific
33
increasing specificity of SLR test
great toe dorsiflexion and contralateral test
34
Cervical Radiculopathy
compression of nerve root | radiation arm pain and numbness
35
Spurling Test
test for cervical radiculopathy extend and lateral flex neck, apply downward pressure positive = reproduce pain
36
Cervical Myelopathy
compression of cervical spinal cord | difficulty with dexterity, fine object manipulation, upper motor signs
37
Lateral Epicondylitis
tennis elbow repetitive use of extensor tendons pain w/ increased wrist extension
38
Medial Epicondylitis
golfers elbow repetitive flexion worse with resisted wrist flexion
39
Olecranon Bursitis
posterior elbow swelling and tenderness | usually due to trauma, gout, infection
40
Ulnar Nerve Entrapment
parathesias and numbness of 4th and 5th digit
41
Phanel Test
flexion of hands at wrist
42
Tinel Test
percussion of median nuerve
43
Scaphoid fracture
falling onto extended hand | pain and tenderness in anatomic snuff box
44
DeQuervian Tendonopathy
pain at thumb base
45
HPV Vaccine ages for three dose series
Three doses 13-26 for all male and female | shared decision making 27-45
46
Osteoporosis Screening in less than 65, risk
10 year fracture risk >9.3
47
Alcohol Use Disorder : Naltrexone
first line in those w/ CKD | CI in cirrhosis
48
Indications for Bariatric Surgery
BMI >40 or >35 + weight related comorbidities
49
Indications for Weight Loss Medications
BMI >30 or >27 + weight related comorbidities
50
AUSAI in BPH
Medications for scores >8
51
Treatment for Epididymitis
<35 ceftriaxone + doxy | >35 ceftriaxone + FQ
52
HRT for Menopause
if uterus, estrogen + progesterone (avoid unopposed estrogen-related endometrial proliferation)
53
AUB Management, pre versus post menopausal
pre: U/S post: endometrial biopsy
54
Bacterial Vaginosis - Dx
Fishy odor Thin white or gray + whiff test clue cells
55
Trichomoniasis - Dx
discolored d/c strawberry cervix wet mount w/ trichomonads
56
Eye dx - FB sensation
keratitis
57
What needs immediate ophtho eval?
keratitis scleritis uveitis/iritis
58
Keratitis Symptoms
FB sensation Blurred vision Dendritic Branching Ciliary Flush
59
Episcleritis
Minimal pain | Superficial redness of vessels!
60
Scleritis
pain w/ eye movements, globe tenderness tearing, photophobia, decreased or loss of vision diffuse red/violet coloration
61
Uveitis/Iritis
floaters | hypopyon, ciliary flush
62
Ciliary Flush in...
uveitis or keratitis
63
Hypopyon
fluid in dependent portion of anterior chamber | uveitis/iritis
64
Age Related Macular Degeneration Symptoms
dry - slowly vision loss versus wet - acute vision loss | painless blurring, warping of central vision, scotoma
65
ARMD Dry exam findings
drusen (yellow-white lesions)
66
ARMD Treatment
- smoking cessation - anti-oxidants - VEGF inhibitor eye injections
67
Optic Neuritis
afferent pupillary defect pain w/ eye movement vision loss, esp loss of color vision
68
Retinal Detachment
unilateral increase in floaters --> sudden, peripheral vison loss ("black curtain" urgent ophtho consult
69
Retinal Artery Occlusion
acute, painless, vision loss cherry red spot surrounded by retinal pallor urgent ophtho consult
70
Retinal Vein Occlusion
acute painless vision loss retinal hemorrhage and cotton-wool spots urgent ophtho consult
71
Primary Open-Angle Glaucoma
bilateral painless gradual peripheral vision loss
72
Angle-Closure Glaucoma
acute severe eye pain, increased ICP symptoms (N/V/HA) blurred vision in halos around lights dilated fixed pupil
73
Weber Test
conductive hearing loss = louder in affected ear | sensioneural hearing loss = louder in unaffected ear
74
Rinne Test
Normal: AC > BC Conductive: decreased in affected ear, BC >AC Sensineural: loud/louder in affected ear, AC>BC
75
Causes of Conductive Hearing Loss
cerumen impaction, TM perf otosclerosis cholesteatoma
76
Ototoxic drugs (sensineural hearing loss)
aminoglycosides NSAIDs loop diuretics
77
Paroxetine AE
weight gain, sexual dysfunction
78
Antidepressant with lowest rate of discontinuation syndrome
fluoxetine
79
Stress Incontinence Rx
pelvic floor training+/- biofeedback No medications consider pessaries
80
Urgency Incontinence Rx
bladder training, timed voiding | Rx - Antimuscarinics > Mirabegron
81
Overflow Incontinence Rx
double voiding, triggered voiding, catheriziation | If BPH, can use alpha blocker/5alpha reductase
82
Functional Incontinence Rx
caregiver-prompted timed voiding
83
Timed Up and Go Test abnormal if
longer than 12 seconds

PGY-4 Board Prep (18 decks)

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