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Combank Family Med > Family Med > Flashcards

Family Med Flashcards

(102 cards)

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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
lesion of what causes left homonymous hemianopsia
right optic tract
26
wegner or goodpasture is in older pts
wegner goodpasture is younger
27
treating incontinence
behavior mod first and exercises then oxbutynin or tolterodine neuromodulation of sacral nerve in severe cases
28
instrumental activiteis of daily living
phone, shop, food prep, housekeep, laundry, transportation, taking meds, finances
29
HIV prophylaxis post needle stick
NRTIs: tenofovir, emtricitabine NNRTIs: efavirenz, delaviridine common is : enofovir-emtricitanbine with raltegravir (integrase inhibitor) alt: tenofovir-emtricitabine with ritonavir
30
when would biopsy be appropriate for initial testing in a pt with signs of peptic ulcer disesase
signs of bleed, anemia, early satiety, unexplained weight loss, dysphagia, odynophagia, recurrent vomiting, history of GI cancer, previous malignancy
31
how long should metformin be D/C after IV contrast
48 hours
32
most documented causes for miscarriages
maternal age history of previous miscarriage maternal smoking
33
step wise approach to diagnose galactorrhea
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
34
what makes restless leg syndrome better
movement
35
diagnosing onychomycosis treatment AE of treatment
microscopic eval of toenail scrapings using KOH prep terbinafine for 12 weeks GI upset, rash, HA, hepatotox, prolonged QT, SJS
36
incontinence what should be done
bladder diary, exacerbating factors UA to R/O UTI and a PSA in male pts
37
a creatinine of less than or equal to what with no AKI can use IV contrast
1.5 mg/dL
38
TG levels normal borderline high high very high
``` normal = <150 BH = 150-199 high = 200-499 severe = >500 ```
39
after treatment of h pylori what is best test for eradication of bacteria
urea breath test 4 weeks post treatment
40
options with spontanesous abortion
expectant management and observation medical managment with misoprostol D and C
41
does PID increase risk of miscarriage
no only incrase risk infertility
42
confirmation of H pylori can best be achieved with what study in a pt without biopsy being neccessary what pts?
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
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
drusen
44
abrupt feeling of urination but cannot make toilet on time
urge incontinence detrusor overactivity
45
treatment for goodpasture
plasma exchange, corticosteroids
46
functional incontinence pt causes
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
most important risk factor to help AAA from growing
stop smoking
48
postvoid residual of over ___ mL indicates urinary retetion do what next
200 if this is case then get renal US to rule out hydronephrosis get PSA too
49
white ovoid lesions with irregular borders on retina
cotton wool patches HTN
50
15 mm induration PPD test is positive on what people
all
51
ADLs
transfer, continence, toileting, bathing, dressing, feeding
52
sciatica vs piriformis syndrome pain location and cause
piriformis: pain in butt and hamstrings - sitting too long or squatting sciatica: causes pain in distal extremity as well - injury
53
abx in human bite
augmentun
54
products of conception can be seen or palpated through the internal cervical os
inevitable abortion
55
allergic conjuncitivitis differs from viral how
similar with bilateral watery discharge but pruritus and a foreign body sensation are unique to allergic causes
56
mixed incontinence is a combo of what
stress and urge incontinence
57
who does overflow incontinenece occur in
pts who have blockage of bladder outlet like BPH or weakening of detrusor muscles neuropathy from diabetes or MS too
58
in asx pt with a AAA under ____ can just monitor 3-4 cm monitor what 4-5.4 cm monitor what
5.5 3-4 cm monitor US Q 2yrs 4-5.4 cm monitor Q 6-12 months
59
what weird drug is used in parkinsons that is also antidepressent and good for dementia
selegeline
60
a family history of a father or brother before age ___ or in mother or sister before age ___ increase pt liklihood to get heart disease
men: 55 women: 65
61
ST depression in anterior leads and positive cardiac biomarkers including troponin
NSTEMI
62
good treatment for mild dementia
donepezil
63
most common cause of bacterial conjunctivitis and what are sx and tx
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
treatment of increased TGs if over 500 or under
over 500 then fibrates under 500 statins
65
what antibodies can be positive in goodpasture
anti glomerular BM abs for sure 30% will have p-ANCA and c-ANCA too
66
AE selegeline
weight gain, anxiety, insomnia
67
moderate persistent asthma treatment
SABA and ICS + LABA
68
vaginal bleeding but no products of conceptions in the vagina and cervical os closed
threatened abortion
69
example: leaving a scalpel blade inside of the pt during a surgical procedure. what law thing
res ipsa loquitor or "the things speak for itself."
70
what age for women is a risk factor for CAD
55
71
pt with CVA and residual R UE and R LE paresis presents with urinary incontinence. what type
functional incontinence
72
chapman point of ____ may be present with anypathology involving the retina or inner chamber of the ye
anterolateral humeral head
73
rapid onset of purulent copioius exudate in eye what is cause and treatment bc bad thing can happen
bcaterial conjunctivitis from n gonorrhoeae blindness possible 1 dose of 1 g IM ceftriaxone and topical therapy
74
a ___ can present as a left homonymous hemianopsia and headache in the absence of any focal motor deficits
acute cerebral vascular accident
75
normal BMI overweight ``` obese class I class II class III ```
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
5 mm induration on PPD test indicates positive screen in what pts
``` HIV contact with TB person fibrotic change on chest radiograph organ transplant immunosuppressed ```
77
vaginal bleed and cramping pelvic pain and cervical os open and products of conception seen or palpated withhing cervical canal
incomplete abortion
78
involuntary contractions of major muscle groups characterized by torticollis, retrocollis, and oculogyric crisis rapid in onset
dystonias
79
what meds can cause ED
``` SSRIs b-blockers and CCBs alpha blockers (finasteride) TCAs digoxin antihistamines ```
80
pseudomonnas UTI most commonly seen in what pts
foriegn body or obstruction of GU system
81
initial management of NSTEMI which drugs show reduction in mortality
morphine, oxygen, nitroglycerin, aspirin, beta blocker, statin, clopidogrel, heparin only aspirin and beta blockers reduce mortality
82
combo ICS and LABA
budesonide-formoterol mometasone-formoterol fluticasone-salmeterol
83
motor restlessness and inability to sit still, early and late in antipsychotic drug treatment
akathisia
84
alternative to colonoscopy
FOBT every year starting at age 50 | sigmoidoscopy every 5 years starting at age 50
85
10 mm induration is apositive screen in what persons for PPD
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
what antibodies in wegener granulomatosis
c anca only, not p-anca
87
treatment of CAP by age
under 60 -doxy, macrolide, moxifloxacin, levofloxacin, tigecycline over 60 -augmentun, macrolides, fluoroquin, 2/3rd gen cephalosporins
88
which diuretics block urate excretion
thiazides and loop diuretics
89
what is the first line treatment for graves
methimazole
90
most common electrolyte abnormality in cushings
hypokalemia
91
what are some of the electrolyte abnormalities and lab values that hydrochlorothiazide cuases
hypokalemia, hyponatremia, hyperuricemia
92
side effects of simvastatin
myopathy, rhabdomyolysis, hepatotoxicity
93
primary ovarian failure how to diagnose sx tx
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
prolactinoma and estrogen
prolactinoma can cause of secondary ovarian failure oligomen/amenorrhea, infertility, signs of estrogen deficiency
95
hip adductors what nerve and roots
adductor brevis, longus, magnus pectineus, gracilis, obturator externus obturator nerve L2-L4
96
what is gluteus medius innervated by
superior gluteal nerve L4-S1
97
glutues maximus nerve and action
inferior gluteal nerve L4-S1 hip extensory
98
FEV1/FVC ratio in COPD
less than 0.7
99
what is treatment in pt with primary hyperparathyroidism with calcium under 12mg/.dL over 12mg/dL
under: parathyroidectomy over: preop treatment with saline, loops, IV bisphosphonates or calcimimetics (cinacalcet)
100
75 gram glucose tolerance test and BG measured after 2 hours drink is given what level indicates DM
200 or above
101
random blood glucose and typical sx of diabetes what level of BG would indicated DM what if no sx
200 or above no sx then wouldn't indicate it
102
somatic symptom disorder
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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