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Combank Family Med > Family Med > Flashcards

Family Med Flashcards

1
Q

what meds can cause underactive bladder

A

CCBs, anticholinergics

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2
Q

location of piriformis tender point

A

7-10 cm medial and cephalad from the ipsilateral greater trochanter

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3
Q

microaneurysms are most commonly seen in what pts

A

diabetic

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4
Q

patients who are at increased risk for colon cancer, what is their screening

A

colonoscopy every 5 years starting at age 40 or 10 years younger than the earliest diagnosis in their family, whichevere cums first

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5
Q

with adenovirus conjuncitivitis what else would you see

treatment

A

associated pharyngitis, fever, malaise, preauricular LAD

hot compress, can use topical abx to stop 2ndary bacterial infection

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6
Q

H pylori

best diagnostic test

best eradication

A

diagnostic: serology
eradication: urea breath

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7
Q

conjunctivitis: watery discharge, mild foreighn body sensation and photophobia

A

viral

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8
Q

what seen in HTN retinopathy

A

cottow wool patches and A-V nicking

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9
Q

treatment of allergic conjunctivitis

A

ketorolac solution and cold compress and antihist

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10
Q

uterus is small and contracted and products of conception all gone from uterus and cervical os closed

A

complete abortion

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11
Q

what is memantine used for

A

dementia

NMDA receptor antagonist, that is neuroprotective

good for mod to severe alzheimers
can use in combo with donepezil or galantamine

usually excessive NMDA stimulation from ischemia can lead to excitotoxicity

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12
Q

the preferred test for TB infection in persons previosuly vaccinated with BCG is what

A

quantiferon-TB Gold test

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13
Q

which flu vaccine is recommended for pts with egg allergy

A

inactivated intramuscular vaccine IIV3 or IIV4

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14
Q

if pt has a first degree relative diagnosed with CRC at age over 60 then when should they get screened

A

every 10 years starting at age 40

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15
Q

diabetic retinopathy categories

A

non proliferative: cotton wool spots, intra retinal hemorrhages, macular edema

proliferative: neovascularization from VEGF

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16
Q

intermittent claudication or chronic lower extremity pain in young adult

claud with movement and palpable pedal pulses

A

popliteal artery entrapment

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17
Q

lip smacking and head jerking are classic for what

A

tardive dyskinesia

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18
Q

which hiv drugs should never be used for post exposure prohpylaxis

A

abacavir and nevirapine

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19
Q

chlamydial conjunctivitis caused by what serotypes and treatment

A

D and K

oral tetracycline, doxy, or erythromycin

also treat sex partners

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20
Q

if pt needs to be evaluated with endocopy for concern of brisk bleed or perforation upon initial eval then what test for h pylori

A

rapid urea breath test

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21
Q

anterior chapman point for the sinuses is where

posterior?

A

between clavicle and first rib

posterior is C2 articular pillar

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22
Q

what kind of conjunctivitis: bilateral itching, tearing, redness, strigny discharge and photohobia with foreign body sensation

treatment

A

allergic

cold compress, oral antihistamines, or topical antihist or anti-inflamm dropletws

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23
Q

UTI: motile gram neg rod with fruity odor

A

pseudomonas

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24
Q

what do you see in alport syndrome renal biopsy

A

basement membrane splitting

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25
Q

lesion of what causes left homonymous hemianopsia

A

right optic tract

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26
Q

wegner or goodpasture is in older pts

A

wegner

goodpasture is younger

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27
Q

treating incontinence

A

behavior mod first and exercises

then oxbutynin or tolterodine

neuromodulation of sacral nerve in severe cases

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28
Q

instrumental activiteis of daily living

A

phone, shop, food prep, housekeep, laundry, transportation, taking meds, finances

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29
Q

HIV prophylaxis post needle stick

A

NRTIs: tenofovir, emtricitabine
NNRTIs: efavirenz, delaviridine

common is : enofovir-emtricitanbine with raltegravir (integrase inhibitor)

alt: tenofovir-emtricitabine with ritonavir

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30
Q

when would biopsy be appropriate for initial testing in a pt with signs of peptic ulcer disesase

A

signs of bleed, anemia, early satiety, unexplained weight loss, dysphagia, odynophagia, recurrent vomiting, history of GI cancer, previous malignancy

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31
Q

how long should metformin be D/C after IV contrast

A

48 hours

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32
Q

most documented causes for miscarriages

A

maternal age
history of previous miscarriage
maternal smoking

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33
Q

step wise approach to diagnose galactorrhea

A

1) b-hcg to rule out pregnancy
2) check prolactin level
- if over 20 ng/mL then MRI of brain
3) if normal then check thyroid for hypothyroid
4) detailed review meds

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34
Q

what makes restless leg syndrome better

A

movement

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35
Q

diagnosing onychomycosis

treatment

AE of treatment

A

microscopic eval of toenail scrapings using KOH prep

terbinafine for 12 weeks

GI upset, rash, HA, hepatotox, prolonged QT, SJS

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36
Q

incontinence what should be done

A

bladder diary, exacerbating factors

UA to R/O UTI and a PSA in male pts

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37
Q

a creatinine of less than or equal to what with no AKI can use IV contrast

A

1.5 mg/dL

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38
Q

TG levels

normal
borderline high
high
very high

A 
normal = <150
BH        = 150-199
high      = 200-499
severe  = >500
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39
Q

after treatment of h pylori what is best test for eradication of bacteria

A

urea breath test 4 weeks post treatment

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40
Q

options with spontanesous abortion

A

expectant management and observation

medical managment with misoprostol

D and C

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41
Q

does PID increase risk of miscarriage

A

no only incrase risk infertility

42
Q

confirmation of H pylori can best be achieved with what study in a pt without biopsy being neccessary

what pts?

A

pts under 55 and who do not have any red flag signs and sx

serologic study with test and treat method

detects IgG abs against h pylori antigens
very sensitive but not as specific bc titers may be elevated after eradication of infection

if positive then active infection in 50% of pts, so start triple therapy, then try serology after treatment and see if negative

43
Q

small yellow, round spots with soft or hard borders spread unevenly in the retina as a result of normal aging but can be from macular degeneration

A

drusen

44
Q

abrupt feeling of urination but cannot make toilet on time

A

urge incontinence

detrusor overactivity

45
Q

treatment for goodpasture

A

plasma exchange, corticosteroids

46
Q

functional incontinence

pt

causes

A

pt knows have to pee but physical or mental reasons cannot reach toilet

mental: confusion in dementia and delirium
physical: vision, dexterityh, mobility

other: anxiety/depression, hyperglycemia or HF fluid overload, UTI, preganancy, nocturia

47
Q

most important risk factor to help AAA from growing

A

stop smoking

48
Q

postvoid residual of over ___ mL indicates urinary retetion

do what next

A

200

if this is case then get renal US to rule out hydronephrosis
get PSA too

49
Q

white ovoid lesions with irregular borders on retina

A

cotton wool patches

HTN

50
Q

15 mm induration PPD test is positive on what people

A

all

51
Q

ADLs

A

transfer, continence, toileting, bathing, dressing, feeding

52
Q

sciatica vs piriformis syndrome pain location and cause

A

piriformis: pain in butt and hamstrings
- sitting too long or squatting

sciatica: causes pain in distal extremity as well
- injury

53
Q

abx in human bite

A

augmentun

54
Q

products of conception can be seen or palpated through the internal cervical os

A

inevitable abortion

55
Q

allergic conjuncitivitis differs from viral how

A

similar with bilateral watery discharge but pruritus and a foreign body sensation are unique to allergic causes

56
Q

mixed incontinence is a combo of what

A

stress and urge incontinence

57
Q

who does overflow incontinenece occur in

A

pts who have blockage of bladder outlet like BPH or weakening of detrusor muscles

neuropathy from diabetes or MS too

58
Q

in asx pt with a AAA under ____ can just monitor

3-4 cm monitor what

4-5.4 cm monitor what

A

5.5

3-4 cm monitor US Q 2yrs
4-5.4 cm monitor Q 6-12 months

59
Q

what weird drug is used in parkinsons that is also antidepressent and good for dementia

A

selegeline

60
Q

a family history of a father or brother before age ___ or in mother or sister before age ___ increase pt liklihood to get heart disease

A

men: 55
women: 65

61
Q

ST depression in anterior leads and positive cardiac biomarkers including troponin

A

NSTEMI

62
Q

good treatment for mild dementia

A

donepezil

63
Q

most common cause of bacterial conjunctivitis and what are sx and tx

A

staph, strep, haem, morax. pseduo

rapid onset hyperemia, tearing with spread to other eye in less than 2 days with mucopurulent discharge and crusting

cipro, erythro, sulfacetamide

64
Q

treatment of increased TGs if over 500 or under

A

over 500 then fibrates

under 500 statins

65
Q

what antibodies can be positive in goodpasture

A

anti glomerular BM abs for sure

30% will have p-ANCA and c-ANCA too

66
Q

AE selegeline

A

weight gain, anxiety, insomnia

67
Q

moderate persistent asthma treatment

A

SABA and ICS + LABA

68
Q

vaginal bleeding but no products of conceptions in the vagina and cervical os closed

A

threatened abortion

69
Q

example: leaving a scalpel blade inside of the pt during a surgical procedure. what law thing

A

res ipsa loquitor or “the things speak for itself.”

70
Q

what age for women is a risk factor for CAD

A

55

71
Q

pt with CVA and residual R UE and R LE paresis presents with urinary incontinence. what type

A

functional incontinence

72
Q

chapman point of ____ may be present with anypathology involving the retina or inner chamber of the ye

A

anterolateral humeral head

73
Q

rapid onset of purulent copioius exudate in eye

what is cause and treatment bc bad thing can happen

A

bcaterial conjunctivitis from n gonorrhoeae

blindness possible

1 dose of 1 g IM ceftriaxone and topical therapy

74
Q

a ___ can present as a left homonymous hemianopsia and headache in the absence of any focal motor deficits

A

acute cerebral vascular accident

75
Q

normal BMI

overweight

obese
class I
class II 
class III
A

normal: 18.5-24.9
overweight: 25.0-29.9

class I: 30-34.9
class II: 35-39.9
class III: 40 and above
76
Q

5 mm induration on PPD test indicates positive screen in what pts

A 
HIV
contact with TB person
fibrotic change on chest radiograph
organ transplant
immunosuppressed
77
Q

vaginal bleed and cramping pelvic pain and cervical os open and products of conception seen or palpated withhing cervical canal

A

incomplete abortion

78
Q

involuntary contractions of major muscle groups characterized by torticollis, retrocollis, and oculogyric crisis

rapid in onset

A

dystonias

79
Q

what meds can cause ED

A 
SSRIs
b-blockers and CCBs
alpha blockers (finasteride)
TCAs
digoxin
antihistamines
80
Q

pseudomonnas UTI most commonly seen in what pts

A

foriegn body or obstruction of GU system

81
Q

initial management of NSTEMI

which drugs show reduction in mortality

A

morphine, oxygen, nitroglycerin, aspirin, beta blocker, statin, clopidogrel, heparin

only aspirin and beta blockers reduce mortality

82
Q

combo ICS and LABA

A

budesonide-formoterol

mometasone-formoterol

fluticasone-salmeterol

83
Q

motor restlessness and inability to sit still, early and late in antipsychotic drug treatment

A

akathisia

84
Q

alternative to colonoscopy

A

FOBT every year starting at age 50

sigmoidoscopy every 5 years starting at age 50

85
Q

10 mm induration is apositive screen in what persons for PPD

A

recent (<5 yrs) immigrants from high prev countries
IV drug user
employee or resident at prison, military barrack, nursing home, hospitals, lab personall
under 4 or child

86
Q

what antibodies in wegener granulomatosis

A

c anca only, not p-anca

87
Q

treatment of CAP by age

A

under 60
-doxy, macrolide, moxifloxacin, levofloxacin, tigecycline

over 60
-augmentun, macrolides, fluoroquin, 2/3rd gen cephalosporins

88
Q

which diuretics block urate excretion

A

thiazides and loop diuretics

89
Q

what is the first line treatment for graves

A

methimazole

90
Q

most common electrolyte abnormality in cushings

A

hypokalemia

91
Q

what are some of the electrolyte abnormalities and lab values that hydrochlorothiazide cuases

A

hypokalemia, hyponatremia, hyperuricemia

92
Q

side effects of simvastatin

A

myopathy, rhabdomyolysis, hepatotoxicity

93
Q

primary ovarian failure

how to diagnose
sx
tx

A

FSH elevation in menopausal range on 2 occasions separated by at least 1 month

oligomenorrhea/amenorrhea and signs of estrogen deficiency
-vaginal dryness, itching, atrophy, hot flahses, decreased bone mineral density, etc

estrogen and progesterone replacement therapy

94
Q

prolactinoma and estrogen

A

prolactinoma can cause of secondary ovarian failure

oligomen/amenorrhea, infertility, signs of estrogen deficiency

95
Q

hip adductors

what nerve and roots

A

adductor brevis, longus, magnus
pectineus, gracilis, obturator externus

obturator nerve L2-L4

96
Q

what is gluteus medius innervated by

A

superior gluteal nerve L4-S1

97
Q

glutues maximus nerve and action

A

inferior gluteal nerve L4-S1

hip extensory

98
Q

FEV1/FVC ratio in COPD

A

less than 0.7

99
Q

what is treatment in pt with primary hyperparathyroidism with calcium under 12mg/.dL

over 12mg/dL

A

under: parathyroidectomy
over: preop treatment with saline, loops, IV bisphosphonates or calcimimetics (cinacalcet)

100
Q

75 gram glucose tolerance test and BG measured after 2 hours drink is given what level indicates DM

A

200 or above

101
Q

random blood glucose and typical sx of diabetes what level of BG would indicated DM

what if no sx

A

200 or above

no sx then wouldn’t indicate it

102
Q

somatic symptom disorder

A

pain at 4 diff sites
2 GI sx
1 sexual
1 neuro sx

tx: freq office visits
analgesics
SSRIs
psychotherapy

Combank Family Med (1 decks)

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