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Family Shelf > Comquest Family Med > Flashcards

Comquest Family Med Flashcards

1
Q

EKG finding for Afib

A

narrow QRS, irregularly irregular P-P interval, and some conducted P-waves

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2
Q

EKG findings for A flutter

A

narrow QRS, regularly irregular P-P interval, and some conducted P-waves

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3
Q

EKG findings for 1st degree AV block

A

narrow QRS, regular P-P interval, and slowed conduction of P-waves

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4
Q

EKG findings for Mobitz II 2nd degree heart block

A

wide QRS, regular P-P interval, and some conducted P-waves (defect is below the level of the AV node)

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5
Q

EKG findings of 3rd degree heart block

A

wide QRS, regular P-P interval, and some conducted P-waves

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6
Q

Diagnosis of schizoaffective disorder

A

Pt has experienced a prolonged episode of a mood disorder, symptoms of schizophrenia, and at least two weeks of delusions or hallucinations that occur in the absence of a mood episode

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7
Q

What is the most important first step in management of epiglottitis?

A

protection of the airway with endotracheal intubation

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8
Q

Risk factors for brachial plexus injuries

A 
Forceps delivery 
Multiparity
Large for gestation age
Maternal diabetes
Breech presentation
Previous child with birth related brachial plexus injury
Shoulder dystocia
Prolonged second stage of labor
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9
Q

What is the most effective first step in the treatment of insomnia?

A

cognitive behavioral therapy

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10
Q

When can a pt return to school or work following diagnosis of Strep throat?

A

After completing a full 24 hours of antibiotic therapy if they are afebrile and otherwise feeling well.

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11
Q

What medication should be used for a pt in asystole?

A

Epinephrine is the only medication that should be used for asystole

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12
Q

What SSRIs are safe for use in pregnancy?

A

fluoxetine, sertraline, and citalopram

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13
Q

Describe Smith and Colles fractures

A

Smith: fracture of distal radius with ventral displacement (flexed wrist)
Colles: fracture of distal radius with dorsal displacement (FOOSH)

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14
Q

Enzyme affected in Gilbert’s

A

UDP-glucuronosyl transferase (30% of normal)

leads to increased indirect bilirubin

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15
Q

Enzyme affected in Crigler-Najjar

A

1: absence of bilirubin UGT
2: partial activity of bilirubin UGT (black liver)

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16
Q

What screening should diabetics receive annually?

A

urinary spot microalbumin/creatinine ratio to screen for neuropathy

if >30 should start ACE or ARB

Also, should get eye exam

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17
Q

Asplenic pt with unknown vaccination history should receive which vaccinations?

A 
Haemophilus influenzae type B
Monovalent meningitis B (MenB)
Pneumococcal conjugate (PCV13)
Quadrivalent meningococcal (MenACWY)
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18
Q

Predominant cell seen in pts with Reactive Airway Dysfunction Syndrome (RADS) or irritant-induced asthma

A

Neutrophils on bronchoalveolar lavage

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19
Q

Which clotting factor is affected in Von Willebrand disease and what bleeding test will it affect?

A 
Factor VIII (8)
PTT
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20
Q

Treatment options for migraines

A
  1. NSAIDs are first line but should avoid in pts who are or wanting to get pregnant, GI bleed, renal failure
  2. Triptans are next if NSAIDs fail
  3. Oral contraceptives but avoid in pts trying to get pregnant, hx of clotting disorder, smokers over 35
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21
Q

When should pregnant pts with HSV start to receive daily antiviral treatment?

A

36 weeks

***non-pregnant need daily if >10 episodes in a year

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22
Q

Dx criteria for Chronic Bronchitis

A

chronic obstructive cough for >3 months in 2 consecutive years with evidence of airway obstruction

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23
Q

Clinical features of Nevus simplex

A

benign skin lesion that appears as a flat pink or salmon-colors blanching skin patch between the eyebrows or on the nape of the neck

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24
Q

Clinical features of cutis marmorata

A

symmetric mottling of the skin that involves the trunk and extremities. Vascular response to the cold that resolves upon warming

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25
Q

What is the greatest risk factor for developing periductal mastitis?

A

smoking

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26
Q

When should pregnant women receive Tdap vaccine?

A

During every pregnancy between 27-36 weeks gestation

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27
Q

What imaging should be performed for a pt suspicious of having a TIA?

A

CT scan should be performed first. If negative, then perform MRI of the brain

28
Q

Treatment for external hemorrhoids

A

If thrombosed and presents within 72 hours of symptoms, then surgical elliptical excision should be performed

If not thrombosed or after 72 hours, then conservative treatment should be started

29
Q

Clinical features of allergic bronchopulmonary aspergillosis (ABPA)

A

repeated episodes of bronchial obstruction and bronchiectasis along with fevers, cough, malaise, and respiratory compromise. Will also produce thick, brown mucus plugs and eosinophilia

30
Q

Diagnosis of allergic bronchopulmonary aspergillosis (ABPA)

A
  • Hx of asthma or CF
  • Markedly elevated total serum IgE concentration
  • Positive skin prick test for Aspergillus
  • Precipitating IgG antibodies to Aspergillus
  • Central bronchiectasis on CT
31
Q

A1C goals

A

<7%

<8% in elderly pts with life expectancy <10 years, with multiple comorbidities

32
Q

What age should pts receive meningococcal vaccine?

A

11-18 years old. Recommended schedule is first dose at 11 or 12 with a booster at 16

33
Q

Treatment ladder for Cradle Cap

A
  1. Reassurance
  2. Vaseline or vegetable oil
  3. Tar-containing shampoos
  4. Topical ketoconazole or hydrocortisone
34
Q

Medications that drive potassium into cells

A

Insulin, pseudoephedrine, beta-agonists

35
Q

Diabetic glomerulonephropathy can be prevented by the addition of what medicine

A

ACE inhibitors

**inhibits constriction of the efferent renal tubule

36
Q

What vaccine should all pts who smoke receive regardless of age?

A

pneumococcal vaccination

37
Q

What gene mutation is seen in pts with Ehlers-Danlos?

A

COL5A1/COL5A2

38
Q

When should pt deliver if they have preeclampsia without severe features?

A

37 weeks

34 weeks if they have severe features

39
Q

When should healthy pt be screened for gestational diabetes?

A

28 weeks gestation

40
Q

What should be performed at 28 week prenatal visit?

A

CBC
Screening for gestational DM
Rho(D) if Rh negative
Tdap vaccine

41
Q

Clinical symptoms of polycythemia vera?

A 
pruritis
HAs
Dizziness
Erythromelalgia
Visual impairment 
JAK2 mutation
42
Q

When should pts be screened for abdominal aneurysm?

A

All males 65-75 who have ever smoked

43
Q

How does Crohn’s disease increase the risk of calcium oxalate stones?

A

Malabsorption of fatty acids and bile salts lead to an increase of oxalate absorption

44
Q

What is the best long-term treatment for patients with generalized anxiety disorder?

A

Cognitive behavioral therapy

Should be used rather than medication in women who are trying to get pregnant

45
Q

Describe Samter’s triad and what disease is it associated with?

A

aspirin intolerance, nasal polyps, and asthma

Aspirin-exacerbated respiratory disease

46
Q

How is aspirin-exacerbated respiratory disease diagnosed?

A

oral aspirin challenge test

dosage doubled q3hours until bronchospasm or respiratory episode is provoked

47
Q

Treatment ladder for Carpel Tunnel

A
  1. Neutral wrist splinting
  2. Corticosteroid injections or oral medication
  3. Surgical decompression
48
Q

MCC of abnormally elevated alpha-fetoprotein level on a quad screen?

A

inaccurate dating of pregnancy

49
Q

What is the most likely EKG finding in a patient with a PE?

A

sinus tachycardia

SI, QIII, TIII is also found but is extremely rare

50
Q

MCC of congenital sensorineural hearing loss and deafness

A

CMV

51
Q

Clinical presentation of ankylosing spondylitis

A

young patients presenting with insidious onset and gradual progression of pain at the sacroiliac joints

75% of patients are males

52
Q

tumor marker for testicular choricarcinoma

A

beta-hcG

53
Q

How to diagnose Riedel thyroiditis

A

confirmed by open surgical biopsy

distinguish it from other disorders by lack of cervical adenopathy

54
Q

Contraindications to vaccination

A

anaphylaxis
severe illness
live virus vaccines in immunocompromised or pregnant patients

55
Q

Medications with known ototoxicity

A

salicylates
loop diuretics
cisplatin
aminoglycosides

56
Q

Next step in management for infant that has apnea, grunting or heart rate <100

A

positive pressure ventilation

57
Q

Next step in management for infant that fails positive pressure ventilation or heart rate <60

A

intubation

58
Q

Treatment for patients with Temporal arteritis

A

Visual disturbances: IV prednisone

No visual disturbance: oral prednisone

59
Q

What part of the kidney do NSAIDs affect?

A

afferent artery

decreases prostaglandins which prevents vasodilation of afferent artery leading to reversible renal ischemia

60
Q

Mainstays of treatment for an acute asthma exacerbation

A

O2, inhaled beta-2-agonists, and oral corticosteroids

if mild and do not respond to one trial of inhaled beta-2-agonist treatment then give oral steroid

61
Q

How should medications be adjusted in pregnant pts with hypothyroid?

A

increase dosage by 30%

62
Q

Next step in management for newborn with hip dysplasia

A

Referral to orthopedics or PCP

63
Q

Treatment of Kawasaki disease

A
  1. IVIG
  2. High dose aspirin until fever free for 48 hours
  3. Low dose aspirin for 6 weeks after illness
64
Q

Echocardiogram schedule for Kawasaki disease

A

At time of diagnosis
2 weeks after diagnosis
6 weeks after diagnosis

65
Q

First step in evaluation for cause of iron deficiency anemia in men and postmenopausal women

A

colonoscopy and EGD looking for GI bleed

66
Q

Treatment options for aphthous ulcers

A
  1. reassurance as most heal within 2 weeks

2. topical corticosteroid

67
Q

Findings in CHARGE syndrome

A

CHD7 gene mutation

Coloboma (defects in iris)
Heart anomalies
choanal Atresia
Growth retardation
Genital anomalies 
Ear anomalies

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