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DIT Step 2 > Family Medicine > Flashcards

Family Medicine Flashcards

(58 cards)

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1
Q

2 day old M infant with hip instability found on Barlow maneuver, next step?

A

Hip US

If positive, then ortho consult

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2
Q

Screening with US for hip dysplasia in…

A

all girls born breech

optional: girls with positive family history, boys breech

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3
Q

contraindications for administering MMR/rubella vaccine

A 
pregnant (vaccine can cross placenta)
CD4+ count < 200
chemo
transplant recipients
congenital immundodeficiency
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4
Q

newborn with non-erythematous, non-pustule acne

A

acne neonatorum

don’t pop them

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5
Q

newborn with erythematous, pusutule acne

A

erythema toxicum neonatorum

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6
Q

thromboprophylaxis for 62 F x total hip replacement

A

10-35 days of LMW heparin (enoxaparin), fondapariunoux, or warfarin

NOT SQ heparin

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7
Q

when start to introduce solids into diet of infant

A

4-6 mo

otherwise extrusion reflex = push food out of mouth

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8
Q

hematologic abnLs MC in pt receiving testosterone replacement

A

erythrocytosis

check HCT before tx, Q3-6 mo x 1 year, then yearly

risk VTE with increased HCT

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9
Q

borderline personality disorder

A

female
splitting
cutting

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10
Q

treatment plan for plantar fasciitis

A
  1. stretching
  2. avoid flat shoes and walking barefoot
  3. heel shoe inserts
  4. NSAIDs
  5. steroid inj
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11
Q

severe preeclampsia –> started on magnesium –> less responsive, decreased central reflexes –> administer ___?

A

MgSO4 toxicity –> 1st give calcium gluconate

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12
Q

62 M never had VZV as a child or vaccine, should he receive the VZV vaccine?

A

yes, he would benefit

FDA approved x age 50+ regardless of previous VZV or not

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13
Q

do not give VZV vaccine to

A

pregnant and immunocompromised

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14
Q

findings of PMR (polymyalgia rheumatica)

A 
> 50 yo
bilateral proximal
girdle joints
morning stiffness
lasts > 30 m
elevated ESR
sx relieved with low-dose PO steroids
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15
Q

9 yo boy with fatigue, tonsillar hypertrophy, mod OSA –> next best step tx?

A

kid: adenotonsillectomy
CPAP if surgery contraindicated

adult: CPAP

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16
Q

18 F no period for past 2 months, next step

A

BhCG

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17
Q

52 F postmenopausal on long-term (>3 mo) prednisone for severe RA –> how care for bone health?

A

start bisphosphonate
bone building exercises
milk/yogurt PO calcium (1200 mg daily)
stop smoking

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18
Q

bone health for > 50 M on prednisone

A

start bisphosphonate
1200 mg calcium daily
800 IU vit D daily
stop smoking

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19
Q

78 M with DM, HTN presents with HFrEF, which of meds (lisinopril, pioglitazone ,glipizide, saxagliptin) are contributing to his CHF?

A

piogliatzone can casue fluid retention

  • complicates CHF
  • contraindicated in pt w/ NYHC III or IV
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20
Q

6 mo M with low grade fever, vom, and diarrhea –> tx?

A

regular age appropriate diet = continued breastfeeding

if more dehydrated, PO rehydration THEN start bf

*simple sugars (juice, soda) make diarrhea worse due to increased osmotic load in gut

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21
Q

28 F hx HPV warts, wants HPV vaccine

A

no, only up to age 26

start M+F 11-2 yo

***if she were <26 yo and had warts and non-manog relationship these things do NOT exclude her from the vaccine, ONLY AGE

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22
Q

62 M cramping left calf, improves with rest, dec pedal pulses, shiny and hairless shins –> next step

A

ABIs

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23
Q

positive ABI ratio

A

ankle/arm

< 0.90 = PAD

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24
Q

pruritic LEs, no obvious rash –> dx and tx

Study These Flashcards
A

xerosis
MC cause of pruritis in the absence of pustular lesions

hydration with topical emollients

25
62 M hx of lung cancer has sCa2 15.1 mg/dL with nL serum albumin, polyuria, weakness --> next bes step
1. NS hydration (promote Ca2+ diuresis in urine) 2. calcitonin (quick, dec Ca2+ in hours) 3. bisphosphonate (dec bone Ca2+ reabs) PTHrP from squamous
26
8 mo F with antecubital and popliteal fossae rash, bother has it and uses pimecrolimus, what tell parents?
do not use pimecrolimus until 2 yo 1. topical emollients 2. low low corticosteroid topical
27
25 M producit ve cough x 7 d, no fever, no SOB, nL lung exam, acute bronchitis --> tx
supportive
28
42 F dx with RA, infliximab...what test before starting?
``` TB skin (PPD) hepatitis B surface antigen ```
29
65 M memory loss, wax/wane alertness, AH and VH, falls, resting tremor, mod rigidity, nL labs and nL CT --> Dx
Lewy Body Dementia dementia, fluctuation cognition, hallucinations, Parkinsonism
30
22 F sexually active, gradually worsening dysuria and UTI, no fever, no growth bacteria on UC, no improvement with nitrofurantoin --> likely
G/C
31
tx DTs
benzos
32
2 mo M, exclusively BF so needs...
vitamin D | 400 IU/daily in 1st week of life
33
26 M withdrawn, stops bathing, hear voices, no dep or mania, x 2 mo --> dx
schizophreniform | 1-6mo
34
mother with chronic hep B wants to breastfeed her baby, what do you tell her?
okay!
35
22 F lethargy, irr menses, abd pain, xerosis, parotid gland swelling, erosion on dental enamel, B/P --> tx
CBT counseling | SSRI - fluoxetine
36
23 M asthma, SABA 3x/wk --> tx
SABA prn start low dose ICS >2/wk = mild persistent asthma
37
USPSTF recs on AAA screening
male 65-75 smoking history one time abd US
38
42 F gnawing mid-epigastric pain x 3 weeks, improves with eating
duodenal ulcer | h. pylori
39
42 F sora areas on proximal nail folds over several fingers, dishwarsher --> tx
chronic paronychia - avoid irritants - topical med/high corticosterodis
40
21 F 26w GA frequent migraine HA, but AVOID ___ med
imitrex (triptans) = vasoCNX uterine and placental vessles | ergotamine = uterine contx and abortifacent
41
migraine meds contraindicated in pregnancy
triptans | ergotamines
42
22 M with meningococcal meningitis, ppx for roommate?
rifampin PO cipro PO or IM ceftriaxone
43
66 F TSH 11.0, free T4 nL --> dx
subclinical hypothyroidism - likely to progress to frank hypothy - assoc with CVD and inc LDL - tx if TSH > 10
44
37 obese M diagnose type 2 --> tx
lifestyle changes start metformin (warn about gi upset)
45
ottawa ankle rules
- malleolar zone pain - unable to bear weight - tenderness at base of 5th metatarsal or navicular
46
68 F PPI x GERD, SE?
dec Ca2+ absorption --> inc risk hip fx and osteoporosis inc risk CAP inc risk c. diff colitis dec b12 absorption
47
49 F abnl periods, dark blood at os, BhCG neg, HGB nL --> next step
endometrial biopsy ***in real life, endometrial US/transvaginal US
48
12 M bilatereal heel pain x 3-4 m, soccer, worse in practice, b/l posterior heel pain during dorsiflexion of ankles --> dx
calcanealapophysitis (Sever disease) | - inflammation due to rapid expansion of growth plate and oversue in sports
49
tx calcanealapophysitis
rest RICE NSAIds
50
22 F G1PO 38wGA, routine, fundus 40 cm, efw 4200g --> next best step
await spontaneous labor C/S, no trial labor if: - 4500 g + GDM/DM - 5000 g + no diabetes
51
86 M progressive symmetric HL --> MC HL
conductive high-frequency HL | hard time F>M voices
52
42 F cough x 3w, fatigue, sore throat, nasal congestion, low grade fever, no SOB, dramatic fits, post-tussive emesis, no smoking, no immunizations, excessive lacrimation, conj injection, nL CXR --> dx
pertussis - lasts weeks - post-tussive emesis - lacrimation - conjucntival inj - nL CXR + exam
53
2 F walking with mild in-toeing, next best step?
reassurance
54
48 F 2 cm darkly pigmented macule on forearm, IRR shape, variation color, enlarging --> next best step
excisional biopsy with 1-2 mm rim of nL appearing skin
55
25 F acute pelvic pain x 5d, sexually active, tenderness and fullness of R side --> imaging
transvaginal US = best initial study of F pelvic pain also BhCG lab
56
38 M father CRC, when begin CRC screening?
40 yo OR 10 y younger than earliest age onset (whichever is first)
57
41 M HTN, HLD severe pain R toe
gout
58
tx acute gout attack
- NSAIDs (naproxen 500 mg BID OR indomethacin 50 mg TID) - colchicine if first 12-24 h - STOP HCTZ

DIT Step 2 (8 decks)

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