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FM Flashcards

1
Q

Definition of Functional Dyspepsia

A

Presence of postprandial fullness, early satiety or epigastric pain or burning in the absence of causative structural disease

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2
Q

Initial strategy for functional dyspepsia

A

Test and treat for H. pylori

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3
Q

When should you proceed directly to endoscopy in dyspepsia cases?

A

With the presence of warning signs: unintended weightless, progressive dysphagia, persistent vomiting, suspected GI bleeding, family hx of cancer

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4
Q

How many patients does eradicating H. pylori help?

A

1 in 15

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5
Q

Testing for H. pylori

A

Most do serologic (readily available and low cost)

Urea breath is more accurate

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6
Q

Differential for dyspepsia

A

Functional dyspepsia, peptic ulcer disease, reflux esophagitis, cancer, GB, gastroparesis, Crohn, parasites, ischemic bowel disease, medication effect, pancreatitis

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7
Q

Treating functional dyspepsia

A

PPP show best outcomes
H2 blockers work
Gastric acid suppressants and pro kinetics may work
Some psychotropics work (mostly TCAs)

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8
Q

Annual incidence of VTE

A

1-2/1000

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9
Q

What percent of patients with CTE will have recurrence within 10 years?

A

1/3

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10
Q

When do you not treat a DVT?

A

Isolated, distal DVT that is asymptomatic and no risk factors for extension

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11
Q

Time frame for anticoagulation

A

Everyone for 3 months
6 months when DVT is unprovoked
Indefinite with second incidence

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12
Q

When is unfractionated heparin preferred?

A

Severe renal insufficiency, high bleeding risk, hemodynamic instability, morbid obesity

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13
Q

Which drugs do not require a heparin bridge?

A

Eliquis (Apixaban) and Xarelto (rivaroxaban)

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14
Q

Which noac has a reversal agent?

A

Dabigatran

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15
Q

When should thrombolytic therapy be initiated in a VTE patient?

A
  • Persistant hypotension or shock
  • Acute PE patients that are deteriorating
  • Massive proximal LE thrombosis or iliofemoral thrombosis with severe symptoms and limb ischemia
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16
Q

When should you anticoagulation a SVT

A

When close to the saphenous vein or extensive

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17
Q

Anticoagulation in cancer patients

A

LMWH

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18
Q

Treatment of VTE in pregnancy

A

LMWH

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19
Q

Treatment of VTE in pregnancy

A

LMWH

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20
Q

Leading cause of mortality in the US

A

CAD

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21
Q

Divisions of ACS

A

STEMI and NSTEMI

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22
Q

Definition of STEMI

A

Symptoms characteristic of cardiac ischemia with persistent ST elevation or new LBBB

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23
Q

Strongest predictor of ACS in low risk setting

A

Diaphoresis

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24
Q

ST segment elevation criteria

A

2mm for men/1.5 for women in V2 and V3
1mm in V1, V4-6, II, III, aVL and aVF
0.5mm in right and posterior leads

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25
Q

Common symptoms of heart failure

A

Dyspnea, fatigue, volume overload, edema, rales

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26
Q

Definition of heart failure

A

Clinical syndrome resulting from abnormalities that impair ability of the ventricle to fill with or eject blood

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27
Q

What is the underlying etiology in most heart failure patients?

A

CAD (60-70%)

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28
Q

What function is used to categorize heart failure?

A

LVEF

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29
Q

What classification system is used to gauge severity of heart failure?

A

The New York Heart Association

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30
Q

Absence of third heart sound and normal LVEF mean what in regards to heart failure?

A

They rule it out

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31
Q

What lab do you test in heart failure?

A

BNP

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32
Q

What criteria is used to diagnose heart failure?

A

Framingham

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33
Q

Score to determine stroke risk and anticoagulation needs in afib

A

CHADS2

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34
Q

Leading risk factors for CKD?

A

DM and HTN

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35
Q

Definition of CKD?

A

Presence of structural or functional abnormalities of the kidney with or without accompanying reduction in GFR

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36
Q

How is proteinuria detected

A

Urine screen fro albumin/creatinine ratio

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37
Q

What is the best measure of kidney function?

A

GFR (measure by creatinine clearance)

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38
Q

What GFR indicates loss of 1/2 kidney function?

A

<60 mL per minute per 1.73 m2

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39
Q

What is the normal urinary protein/creatinine ratio?

A

<200 mg per g

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40
Q

What is the normal urinary albumin/creat ratio?

A

<30 mg per g

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41
Q

What is the definition of microalbuminuria? Macroalbuminuria?

A

30-300 mg per g albumin/creat

>300

42
Q

When is albumin a sensitive marker of CKD?

A

When the CKD is caused by DM, HTN, or glomerular disease

43
Q

How do you stage CKD?

A

Based on GFR only

44
Q

CV screening recommendations from USPSTF

A

HTN with BP
M35 and W45 cholesterol screen
Adults >20 with other CV risk factors

45
Q

AAA screening guidelines

A

Men 65-75 if they have ever smoked

46
Q

PAD screening guidelines

A

Not recommended in asymptomatic patients

47
Q

Colorectal cancer screening guidelines

A

All adults >50 by either
FOBT on 3 consecutive BMs at home (annually)
flex sigmoid 3-5 years
Or colonoscopy every 10 years

48
Q

Screening guidelines for prostate cancer

A

Do not recommend routine use of PSA

49
Q

Screening guidelines for lung cancer

A

Level I

50
Q

Screening guidelines for obesity

A

Based on BMI; counseling on behavioral changes strongly recommended

51
Q

DMII screening guidelines

A

Not recommended in asymptomatic patients

52
Q

Adult vaccination recommendations

A

All adults 19-65 should receive Tdap

53
Q

Influenza vaccine recommendations

A

Everyone 6m and up annually

54
Q

Pneumoccocal vaccine recommendations

A

Single dose adults 65+

Younger adults w/: alcoholic, smoker, CVD, pulmonary, renal, hepatic disease, DM, immunodeficient, asplenic

55
Q

Treatment for stage I COPD

A

Short acting bronchodilators (B2 agonist and anticholinergics)

56
Q

When should you add inhaled steroids to a COPD patient?

A

At stage III and IV

do not improve pulmonary function but decrease acute exacerbations

57
Q

Definition of chronic kidney disease?

A

eGFR <60 for at least 3 months or evidence of kidney damage

<30 = severe

58
Q

What symptom is nearly universally present in peritonsillar abscess?

A

Trismus

59
Q

Sx of ankylosing spondylitis

A

Insidious low back pain. Improves with exercise, worse at night, worst in the morning

60
Q

At what ASCVD risk should you start statin therapy?

A

> or = to 7.5%

61
Q

What SSRI causes QT prolongation?

A

Citalopram (Celexa)

62
Q

What state can cause pseudohyponatremia?

A

Hypertriglyceridemia

63
Q

What is a contraindication to GLP-1 agonists?

A

Thyroid cancer

64
Q

Sx of proctalgia fugax

A

Episodic, sudden, sharp pains in the anorectal area that lasts seconds to minutes

65
Q

Which NOAC has a reversal agent?

A

Dabigatran (Pradaxa)

66
Q

When should you give RhoGAM?

A

When mom is Rh-, at 28 weeks and after any trauma etc

If baby is Rh+, give after birth

67
Q

Trisomy screening guidelines

A

Nuchal translucency at 10-13 and/or combined screen at 15-20 wks

68
Q

Screening for gestational DM

A

1 hr 50g glucose challenge at 26-28 wks, if positive (>140) do 3-h GTT (>200 considered diagnostic of GDM)
GTT (100g glucose load and then test at fasting, 1, 2, and 3 hrs); two abnml values = GDM

69
Q

When do you culture for GBS?

A

35-37 weeks

70
Q

At what gestation should labor be induced?

A

42 weeks

71
Q

Description of urticaria

A

large, irregularly shaped, pruritic, erythematous wheals

72
Q

4 Ts of anterior mediastinum

A

Thymoma, T-cell lymphoma, teratoma, Thyroid mass

73
Q

What is erythrasma and how is it diagnosed?

A

Intertrigionus rash caused by gram+ Corynebacterium
Seen in tow web spaces, groin and axilla
Fluoresces with UV

74
Q

Abx for traverlers diarrhea for someone going to Asia vs S. America/Africa

A

Azithromycin (Campy more common)

Cipro

75
Q

Description of rosacea and how to treat

A

Rash on central face that waxes and wanes, flushing, warmth, streaks
Metronidazole

76
Q

Best A1C range in a type 2 DM

A

7-7.9%

77
Q

First line treatment for allergic rhinitis

A

Inhaled corticosteroid

78
Q

Vaccine all members of a family with a new born should receive

A

Tdap

79
Q

Treatment for acute pyelonephritis

A

Oral fluoroquinolone; if resistant use one-time parental ceftriaxone or aminoglycoside

80
Q

Rx to prevent preeclampsia

A

ASA

81
Q

Factors that can falsely elevate A1c

A

Hypertriglyceridemia, hyperbilirubinemia, iron deficiency anemia, splenectomy, renal failure and aplastic anemia

82
Q

What should all children with Down’s be screened for

A

Cardiac, feeding, vision, hearing, thyroid and hematologic abnormalities

83
Q

First line treatment for kids with CAP?

A

Amoxicillin (strep pneumo is most common)

84
Q

Transient tachypnea of the newborn

A

Occurs ~2hrs of birth

Hyper-expansion with perihilar densities and fluid in the fissures on XR

85
Q

3 first line abx for uncomplicated UTI

A

Nitrofurantoin (5days)
Tri/Sulfa (3 days)
Fosfomycin (one time dose)

86
Q

Necrobiosis lipoidica diabeticorum

A

Seen in pts w/ DM

Sharply demarcated reddish-brown plaque with central yellow deposits in pretibial area

87
Q

Triad +1 symptoms of nephrotic syndrome

A

Edema, proteinuria, hypoalbuminuria

Hyperlipidemia

88
Q

Stages of labor

A

1st: latent (beginning up to 4cm) and active (3-4cm to 10cm)
2nd: 10cm to birth
3rd: delivery of placenta

89
Q

pH of vaginal fluid consistent with amniotic fluid

A

> 6.5

90
Q

Cause of early decelerations during labor

A

Compression of vagus nerve due to compression of head

91
Q

Cause of late decelerations during labor

A

Uteroplacental insufficiency

92
Q

Cause of variable decelerations during labor

A

Cord compression (most common type)

93
Q

Treatment for erythrasma

A

Erythromycin

94
Q

Friction rub would indicate what?

A

Pericarditis

95
Q

What opiate is best for people with kidney disease?

A

Methadone

96
Q

What is little league elbow

A

Proximal humeral epiphysitis

97
Q

Characteristics that indicate malignancy in a pulmonary nodule

A

> 10mm, upper lung, irregular or spiculated borders, no calcifications, ground glass, increasing size

98
Q

What movement makes pain with stenosis worse?

A

Extension

99
Q

Levels of ABI

A 
>1.4 = incompressible
1-1.4 = normal
.91-.99 = borderline
100
Q

Erythema toxicum neonatorum

A

-flesh-colored papules with an erythematous base
located on the face and trunk, containing eosinophils
-resolves in the first week or two of life

101
Q

Atopic triad

A

Asthma, atopic dermatitis (eczema), allergic rhinitis

102
Q

Normal GFR

A

90-120

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