Family medicine Flashcards
(110 cards)
1
Q
age range gardisil is approved for
A
9-26
2
Q
gardisil recommended for age range
A
11-18
3
Q
normal range for BMI
A
18.5-25
4
Q
zoster vax recommended at what age?
A
60
5
Q
birth years for 1 time hep C screening
A
1945-1965
6
Q
BMI range for morbid obesity
A
40+
7
Q
diameter suspicious for melanoma
A
> 6 mm
8
Q
5 of 9 criteria for depression
A
SIG E CAPS Sleep Interest (loss of) Guilt Energy Concentration Appetite Psychomotor Suicidal ideation
9
Q
SSRI most likely to cause SSRI discontinuation syndrome
A
paroxetine
10
Q
SSRI for GAD
A
Escitalopram
11
Q
SSRI w/strong anti-anxiety effects
A
Paroxetine
12
Q
SSRI with long half life
A
fluoxetine (prozac)
13
Q
good SSRI for panic, OCD and PTSD
A
Sertraline
14
Q
SSRI good for OCD, but Greater frequency of emesis
A
fluvoxamine
15
Q
herb to tx depression
A
st. john’s wort
16
Q
time cutoff for bereavement vs MDD
A
2 months
17
Q
positive ankle squeeze test
A
Syndesmotic sprain
18
Q
3 lateral ankle ligaments
A
all end with fibular
Atf Cf Ptf
anterior talofibular, calcaneofibular, and posterior talofibular ligaments
19
Q
ottawa ankle rule
A
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
Q
ottawa foot rule
A
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
Q
A1C diagnostic of DM
A
> 6.5
22
Q
posprandial glucose target 1-2 hours after meal
A
should be < 180 mg/dl
23
Q
fasting glucose target
A
80 -120 mg/dl
24
Q
if sugars are >200, what else needed to dx DM?
A
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
