Fam med - Imma treat you!

Question 1

What are the treatment options for squamous cell carcinoma?

Answer 1

surgical excision, radiation therapy, or cryotherapy for smaller lesions

Question 2

What are the treatment options for actinic keratosis?

Answer 2

5 fluorouracil

Question 3

What is the best treatment option for tinea ungulum?

Answer 3

griseofulvin, terbinafine 250mg or itraconazole as 200mg pulse therapy

Question 4

When is Moh’s surgery indicated?

Answer 4

non melanoma greater than 2 cm

Question 5

What advice can you give to patients to help them manage their migraine headaches?

Answer 5

Headache diary, decrease use of caffeine, try to get more sleep

Question 6

What are the 5 major classes of medication that can be used to treat headaches?

Answer 6

riptans, ergot alkaloids, aspirin/butalbital/caffeine, acetaminophen/butalbital/caffeine, acetaminophen/dichloralphenazone

Question 7

What methods of migraine prophylaxis are there?

Answer 7

Beta-blockers, Neurostabilizers, Tricyclic antidepressants, Calcium channel blocker,

Question 8

How should you treat a patient with suspected GERD?

Answer 8

test and treat strategy - PPI
-refer for endoscopy if persistent after 8 weeks, use 24 hour probe when GERD not responding and pat. considering surgery

Question 9

What are the next steps in managing GERD in a patient who does not respond to therapy?

Answer 9

The H. pylori IgG serologic test - shows if ever been infected with H. Pylori. urease breath test remains less acurate on PPI therapy, FOBT,

Question 10

What is the recommended tx regimen for patients with H pylori?

Answer 10

Standard dose PPI + amoxicillin 1 gram + clarithromycin 500mg all twice daily for 10-14 days OR Standard dose PPI once or twice daily + metronidazole 250 mg, tetracycline 500 mg, + bismuth subsalicylate 525 mg each four times daily for 10-14 days

Question 11

Describe how you quit smoking

Answer 11

start taking buproprion 1 week before quit date. 1 pill a day for 3 days, then 2 pills a day for a few days, then quit and continue 2 pills a day

Question 12

How is bronchitis treated?

Answer 12

usually don’t need to treat - symptom management

Question 13

How do you tx PNA in infants?

Answer 13

admit always, tx with ampicillin and gent

Question 14

How do you tx PNA 3 weeks to 6 months?

Answer 14

admit if bacteria - give cefuoxime

Question 15

How do you tx PNA 3 months to 5 years (and above)

Answer 15

admit if breathing badly. give CTX or amox;

Question 16

What is the treatment of choice for pharyngitis?

Answer 16

penicillin VK

Question 17

What is the treatment for tinea pedis?

Answer 17

tolnaftate

Question 18

What are the tx approaches for testicular torsion?

Answer 18

Manual detorsion of the torsed testes,

orchipexy of both contra and ipsilateral testis

Question 19

How does COPD treatment differ with varying degrees of COPD?

Answer 19

if moderate, add inhaled anticholinergics
if severe (less than 50% predicted) add inhaled glucocorticoids

Question 20

What are the indications that a COPD patient may benefit from antibiotic therapy?

Answer 20

increased dyspnea (A), increased sputum (phlegm) production (C), and a change in color of sputum

Question 21

What are the major classes of antidepressant medications?

Answer 21

Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants (TCAs)
Monoamine oxidase (MAO) inhibitors
SNRI

Question 22

What is effexor?

Answer 22

Serotonin and norepi reuptake inhibitor

Question 23

What is Buproprion?

Answer 23

norepi and dopamine reuptake inhibitor

Question 24

What are common side effects of SSRIs and SNRIs?

Answer 24

headaches, sleep disturbances, hyponatremia, serotonin syndrome (lethargy, restlessness, hypertonicity, rhabdo)

Question 25

What are the uses of zoloft?

Answer 25

approved specifically for obsessive-compulsive, panic, and posttraumatic stress disorders.

Question 26

What are common side effects of prozac?

Answer 26

agitation, motor restlessness, decreased libido in women, and insomnia.

Question 27

What are the uses and side effects of Paxil?

Answer 27

Strong antianxiety; side effects: significant weight gain, impotence, sedation, and constipation.

Question 28

What is the usage for Lexapro

Answer 28

GAD

Question 29

What are the uses and side effects of Luvox?

Answer 29

Particularly useful in obsessive-compulsive disorder. | Greater frequency of emesis compared to other SSRIs

Question 30

What are the side effects of Celexa?

Answer 30

nausea, dry mouth, and somnolence

Question 31

What is the LDL goal if you have a CAD equivalent?

Answer 31

less than 100

Question 32

What medications have been shown to improve heart failure outcomes?

Answer 32

ARBs, ACEIs, beta blockers, spironolactone in patients with class III and IV HF

Question 33

What are the best treatment options for dysmenorrhea secondary to leiomyomas?

Answer 33

ibuprofen (decreases prostaglandins), mirena (for women trying to maintain fertility), combined hormones, depo, paragard IUD (no hormones)

Question 34

What are the tx options for women with dysmenorrhea without uterine path?

Answer 34

acupuncture, transcutaneous nerve stimulation, thiamine

Question 35

What are the tx options for PMS?

Answer 35

SSRIs, oral contraceptives, danazol, GnRH agonists (inhibit ovulation)

Question 36

When should you treat otitis media?

Answer 36

tx wtith antibiotics if children less than 6 months | if older, watchful waiting

Question 37

What treatments are useful in vertigo?

Answer 37

rehab, anticholinergic suppressants (meclizine), anti-emetics

Question 38

What are the treatment options for grave's?

Answer 38

Methimazole, radioactive iodine (takes a few months to work) surgery - propanolol for symptomatic management

Question 39

How is hypothyroidism treated?

Answer 39

1.5-1.8 mcg per kilogram of thyroxine, check TSH 1 month later

Question 40

What medication is the first choice analgesic for short and long term treatment of osteoarthritis?

Answer 40

acetominaphen

Question 41

What test can be used to assess for a cruciate ligament rupture?

Answer 41

anterior or posterior drawer test

Question 42

What test can be used to assess for a meniscus injury?

Answer 42

mcMurry test (rub femur against tibia)

Question 43

What test can be used to assess for IT band syndrome?

Answer 43

ober test (turn patient on side, let leg relax and see if knee relaxes to ground)

Question 44

What is the follow up for radioactive iodine treatment?

Answer 44

TSH drawn every two to three months until it has stabilized. The time frame can be extended after that to six months or longer.

Question 45

Describe the tier model for management of type 2 diabetes

Answer 45

HbA1C>6.5 - metformin + lifestyle changes HbA1C>8 - lifestyle changes, metformin, + sulfonyurea, Reassessment -add basal insulin as needed Next step: Add rapid acting insulin with meals

Question 46

How soon after a stroke should rehab start happening?

Answer 46

24-48 hours

Question 47

What is the best initial treatment for carpal tunnel?

Answer 47

nocturnal wrist splint

Question 48

What agents are used to tx hyperlipidemia?

Answer 48

statins - first line therapy nicotinic acid - increases HDL fish oil supplements

Question 49

What are common side effects of statins?

Answer 49

Hepatic dysfunction | myopathy `

Question 50

What medical options exist to reduce weight?

Answer 50

Orlistat, Phentermine, ariatric surgery (D) Indications: Patients with BMI >40 or BMI ≥35

Question 51

What are common side effects of stimulant drugs?

Answer 51

Appetite suppression, tics, weight loss, insomnia, lower socioeconomic status, Prader-Willi