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Flashcards in Family medicine Deck (110):
1

age range gardisil is approved for

9-26

2

gardisil recommended for age range

11-18

3

normal range for BMI

18.5-25

4

zoster vax recommended at what age?

60

5

birth years for 1 time hep C screening

1945-1965

6

BMI range for morbid obesity

40+

7

diameter suspicious for melanoma

>6 mm

8

5 of 9 criteria for depression

SIG E CAPS
Sleep
Interest (loss of)
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicidal ideation

9

SSRI most likely to cause SSRI discontinuation syndrome

paroxetine

10

SSRI for GAD

Escitalopram

11

SSRI w/strong anti-anxiety effects

Paroxetine

12

SSRI with long half life

fluoxetine (prozac)

13

good SSRI for panic, OCD and PTSD

Sertraline

14

SSRI good for OCD, but Greater frequency of emesis

fluvoxamine

15

herb to tx depression

st. john's wort

16

time cutoff for bereavement vs MDD

2 months

17

positive ankle squeeze test

Syndesmotic sprain

18

3 lateral ankle ligaments

all end with fibular

Atf Cf Ptf

anterior talofibular, calcaneofibular, and posterior talofibular ligaments

19

ottawa ankle rule

There is pain in the malleolar zone AND either bony tenderness along the distal 6 cm of the posterior edge of either malleolus OR inability to bear weight 4 steps both immediately after the injury and in the emergency department (C).

20

ottawa foot rule

There is pain in the midfoot region AND one of the following: (a) bony tenderness at either the navicular bone or base of the 5th metatarsal OR (b) inability to bear weight four steps immediately after the injury and in the emergency department.

21

A1C diagnostic of DM

>6.5

22

posprandial glucose target 1-2 hours after meal

should be < 180 mg/dl

23

fasting glucose target

80 -120 mg/dl

24

if sugars are >200, what else needed to dx DM?

sx

25

Dx of PAD

ankle-brachial index <.9

26

pretest probability formula for DVT

Wells criteria

27

Wells criteria for DVT: width of leg circumference that is positive

greater than 3 cm

28

grade of ulcer with abscess or bone involvement

grade 3

29

length of time to use heparin in DVT to transition to warfarin

5 days

30

htn if >60 years old

150/90

31

BP cuff L and W requirements (2)

bladder of the cuff should be at least 80% of the arm circumference , and the width of the cuff must be at least 40% of the arm circumference

32

anti-hypertensive NOT to use in blacks

ACE inhibitors

33

reasons for ASA in men vs women

men to prevent MI
women to prevent ischemic stroke

34

myotome of dorsum of foot, lateral foot

L5, S1

35

cutoff for cervical cancer screening if negative paps

age 65

36

zoster offered at what age?

60

37

pneumovax at what age?

65

38

NSAIDS effect on warfarin

increase effectiveness

39

age at which NSAIDs increase GI bleeding risk

65

40

group to be screened for chlamydia

sexually active 24+ younger

41

naegele's rule for EDD (3)

add 1 year
subtract 3 mos.
add 1 week

42

definition mab

abortion w/o dilation of cervix

43

rubella titer (non-immune and immune)

non-immune = 1:3
immune = 1:10

44

sensitivity of Down's screening in triple screen and quad screen, respectively

70, 80

45

liver percussion 5-7-9 rule

upper borders

5th intercostal space in the midclavicular line
7th intercostal space in the midaxillary line
9th intercostal space in the scapular line

46

Obturator sign

Passively internally rotate hip

47

2 ways to elicit psoas sign

Have patient flex hip agains your resistance
Or
Passively extend hip

48

problem drinking vs risky/hazardous drinking

problem is problems in daily life
risky hazardous is >4 drinks/sitting

49

2 signs of portal htn

SPLENOMEGALY and VENOUS PATTERNS(veins away from umbilicus)

50

abdominal veins going up

IVC obstruction

51

patch

macule greater than 1 cm

52

bulla

fluid-filled, greater than 1 cm

53

1st line adult tx for tinea capitis

griseofulvin

54

2 meds besides HRT, SSRIs for hot flashes

clonidine
gabapentin

55

GERD/PUD sx w/o warning signs.
1st step?

4-8 week PPI trial

56

Center criteria of strep 5

NFALT

Fever
Tonsillar exudate
Lymphadenopathy
Age less than 15
No cough

57

infant return to birthweight at (time)

2 weeks

58

colic rule of 3

3 hours day
3X/week
over 3 weeks

paroxysmal

59

postpartum blues resolve by

10 days

60

age of infant where fever MUST be evaluated

under 2 months

61

external shoulder rotation with elbows down tests (2)

infraspinatous
teres minor

62

internal shoulder rotation with elbows down tests (1)

subscap

63

shoulder impingement testing (2)

neer/hawkins
1. pronate wrist and raise arm in front passively while holding AC joint.
2. flex elbow to 90 degress, push hand down slightly

64

sign to distinguish epididymitis from torsion

prehn sign
lifting testicle relieves epididymitis, not torsion pain

65

blue dot sign on scrotum

testicular appendix torsion

66

Dx of COPD (2)

Fev1/fvc less than 70% or below 5th percentile.

67

2 high intensity statins

Atorvastatin 40-80 mg

Rosuvastatin 20-40 mg

68

age must treat otitis media

less than 6 months

69

3 types of dizziness

vertigo
presyncope
disequilibrium

70

vertigo with hearing changes, tinnitus
most likely dx

meniere's

71

HEEADSSS interview

Home
Education/Employment
Eating disorder screening
Activities / Affiliations /Aspirations
Drugs (including alcohol, tobacco, steroids)
Sexuality
Suicidal behavior (along with depression and mental health concerns)
Safety (abuse, fights, weapons, seatbelts, etc.)

72

Asymmetrical Tonic Neck Response of infant

Turning the newborn's head to one side causes gradual extension of arm toward direction of infant's gaze with contralateral arm flexion--like a fencer.

73

TORCH infections

Toxoplasmosis, Other transplacental infections, including HIV, hepatitis B, human parvovirus, and syphilis, Rubella, Cytomegalovirus and Herpes virus type 2.

74

sheets of lymphocytes with interspersed macrophages

Burkitt Lymphoma

75

newborn with sensorineural deafness, eye abnormalities (retinopathy, cataracts), and patent ductus arteriosus.

congenital rubella

76

newborn with microcephaly, jaundice, hepatosplenomegaly, low birth weight, and petechiae at birth.

CMV

77

Marfanoid body habitus, a hypercoaguable state, and possible developmental delay. The condition can be diagnosed by testing for increased methionine in a patient’s urine or blood

homocystinuria

78

Children present by six months of age with hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula

defect in sphingomyelinase occurs in Niemann-Pick disease

79

inherited in an autosomal recessive pattern. Individuals present with hypoglycemia, hepatomegaly, and metabolic acidosis

defect in glucose-6-phosphatase occurs in Von Gierke’s disease

80

Age for mmr, hepA

1 yr

81

Age cutoff Dtap vs Tdap

DTap until 7 yrs

82

random sugar cutoff for DM2 (with sx present

200

83

2 hour GTT cutoff for DM2

200

84

error with a BP cuff too large

too low BP

(cuff should span 2/3 of arm circumference

85

Calorie deficit to drop 1 pound?

Reasonable goal = .5 to 1 pound/week

3500

86

quantitative pilocarpine iontophoresis testing
dz?

CF

87

exhaled NO test
dz?

primary ciliary dyskinesia

88

bruton tyrosine kinase gene sequencing
dz?

X-linked agammaglobulinemia

89

most effective postcoital birth control

copper IUD

90

2 shots for all pts with chronic liver dz

hep A
hep B

91

4 screenings if PID

HIV, syphilis, cervical cancer, hep B

92

normal JVD pulse

less than 3 cm

93

pulmonary nodules are not cancer if stable for?

over 2 years

94

risk of not treating hyperthyroidism

bone loss

95

3 labs to order in a female with amenorrhea, -BHCG

PRL, TSH, FSH

96

osteomyelitis pathogen after stepping on nail

pseudomonas

97

acute tx (2) of central retinal artery occlusion

ocular massage
high flow O2

98

odynophagia

pain with swallowing

99

endopthalmitis

infection of aqueous or vitrious humor

100

hypopyon

WBCs in anterior chamber eye

101

Direct vs indirect Coombs

Direct if autoimmune hemolytic anemia (ig on rbc)
Indirect if checking serum for unbound ig. Trx or maternal

102

while testing for gestational DM, abnormal 1 hour test cutoff

140

103

gestational DM 3 hr GTT cutoffs at 1,3 hours

180, 140

104

timeline concerning for rebound headaches (time analgesics used)

3 months

105

timeline for tPA

3 hours

106

age for dexa in women

65

107

Td vs TDap in adulthood

Tdap once as an adult
them td q10 yrs

108

pneumonia shot regimen for 65+

PCV13
PPSV23 6-12 mos. later

109

pneumonia shot regimen for very high risk adults

PCV13
PPSV23 6-12 mos. later

110

pneumonia shot regimen for under 65 w/risk (DM, COPD, etc)

PPSV23 alone