FM - Random Flashcards
(142 cards)
1
Q
painful arc test
A
AC or glenohumeral injury
2
Q
hawkins test
A
rotator cuff tendonitis or subacromial impingement
3
Q
neer impingement
A
rotator cuff tendonitis
4
Q
empty can
A
supraspinatus
5
Q
fixed ext rotation
A
infraspinatus and teres minor
hold until m. falls
6
Q
lift-off
A
subscapularis
7
Q
SSRI w/ rebound anxiety/irritability/paresthesias, N/V/D
A
Paxil (paroxetine)
8
Q
chloroquine-resistant malaria
A
mefloquine
9
Q
mefloquine-resistant malaria
A
doxycycline
10
Q
UTI tx in pregnancy
A
nitrofurantoin
11
Q
triple therapy
A
clarithromycin
amoxicillin
PPI
12
Q
quadruple therapy
A
metronidazole
tetracycline
PPI
bismuth salicylate
13
Q
Red Man Syndrome
A
vanco
14
Q
orange/red urine
A
rifampin
15
Q
oto/nephrotox
A
aminoglycosides (gentamicin)
16
Q
C/G screen
A
<25 y/o F
sexually active
17
Q
HEADSS
A
home education activities drugs sex safety/suicide
18
Q
high-intensity statin
A
<75yo w/ CVD
40-75yo w/ DM and CHD risk >7.5%
> 21yo w/ LDL >190 or TG >500
19
Q
Either High or Moderate
A
> 75yo w/ CVD
40-75yo w/o DM but w/ CHD risk >7.5%
20
Q
Moderate-intensity Statins
A
40-75yo w/ DM and CHD risk <7.5%
21
Q
Statins
A
Lowers LDL
AE: Monitor LFTs (monthly for 3 months, then 2-4x/year) Benign CPK elevation
C/I: Acute/Chronic Liver disease
22
Q
Niacin
A
Lowers TGs, Raises HDL
AE: Cutaneous Flushing Monitor LFTs (same as above)
C/I: Gout, Chronic Liver Disease, Diabetes w/ poor control
23
Q
Resins / Bile Acid Sequestrant (Cholestyramine)
A
Lowers LDL, Increases TGs
AE: Diarrhea, poorly tolerated
CI: high triglycerides
24
Q
Fibrates (gemfibrozil: Lopid)
A
Lowers TGs
(main)
Raises HDL
Lowers VLDL
AE: Gallstones, Myopathy, Monitor LFTs
C/I: Severe Renal/Hepatic Disease
25
>60yo
Treat if >150/>90 (either) to goal of <150/<90 (both)
26
<60yo
Treat if >140(SBP) or >90 (DBP) to <140(SBP) and <90 (DBP)
27
>60yo w/ CKD/T2DM
Treat if >140(SBP) or >90 (DBP) to <140(SBP) and <90 (DBP)
28
30-60yo
Treat if DBP >90 to goal of <90
Use HCTZ, CCB, or ACEi
*ACEi good in diabetics, bad in black patients
29
18-30yo.
Treat if DBP >90 to goal of <90
grade E
30
<60yo
Treat SBP >140 to goal of <140
grade E
31
>18 w/ CKD or diabetes
Treat >140/>90 to goal of <140/<90
32
>18yo w/ CKD (but not DM)
Treat with ACEi or ARB to improve renal function
33
Non-black population
HCTZ, CCB, or ACEi/ARB
34
Black population
HCTZ or CCB
35
If BP goal not obtained after 1 mo.
Increase dose of anti-HTN or add second drug
If not obtained after 2nd drug, add 3rd drug .
If BP goal not obtained after 3rd drug, refer to hypertension specialist
36
ACEi pros
Good vs. DM, CHF, CAD, CKD; good post MI
37
ACEi cons
Increased BUN/Cr (AKI), bilateral RAS, dry cough in 10%, angioedema, hyperkalemia, ineffective in AA, teratogenic
38
b-blockers pros
Good post-MI, good vs. CAD, angina, CHF, tachyarrhythmias, performance anxiety, headache prophylaxis, glaucoma, essential tremor
39
b-blockers cons
Worsens asthma and COPD; can cause or worsen depression, fatigue, decreased stamina, sexual dysfunction, heart block/bradycardia; poor effectiveness in AAs and danger of withdrawal
40
CCBs pros
Good vs. diastolic CHF, tachyarrhythmias, angina, headache prophylaxis, Raynaud’s disease
41
CCBs cons
Bad vs. systolic CHF; can worsen or cause leg edema, constipation, headache, GERD, heart block/bradycardia
42
Diuretics
Good vs. osteoporosis, kidney stones, Can cause hypokalemia; can worsen gout; increases glucose peripheral edema; also, cheap and synergistic intolerance and lipids with other meds
43
Thiazolidinediones
-azone
can inc MI risk inc bladder cancer
44
Metformin
dec hepatic gluconeogenesis
45
sulfonylureas
K(ATP) chan activator
increased insulin secretion from beta cells
46
glinides
K(ATP) chan activator
increased insulin secretion from beta cells
47
Alpha-glucosidase inhibitors
acarbose, miglitol, voglibose
AE: diarrhea, bloating
ci: cirrhosis or CKD (serum creatinine >2.0mg per dL)
48
Incretion enhancers
GLP-1 agonists and DPP-4 inhibitors
49
HS rxn to Abacavir
HLA-B5701
50
CD4 100-200
TMP/SMX or Dapsone if G6PD deficiency for PCP
51
CD4 50-100
TMP/SMX for toxoplasmosis
52
CD4 <50
azithromycin 1200mg PO/wk for MAC
53
melanoma suspicion
excisional biopsy (saucerization or elliptical excision) w/ <3mm margins
punch biopsy OK if lesions <4mm
54
erythema nodosum or panniculitis
excisional biopsy (saucerization or elliptical excision)
55
Rashes/blister involving just dermis (cutaneous lymphoma, pemphigoid, etc)
shave or punch biopsy
56
basal cell CA
excisional biopsy
57
impetigo
Topical Mupirocin
58
Actinic Keratosis
topical 5-FU, cryotherapy
59
fifth disease
parvo
| no longer contagious if rash seen, but send letter to previous contacts esp preg women
60
tine versicolor
selsium blue
61
tine corporis
azole creams
62
tine capitis
oral azoles or griseofulvin
63
colorectal cancer screening
btwn 50-75
FOBT x3
flexible (yearly)
sigmoidoscopy + ROBT (q5yr)
colonoscopy (q10yr)
64
colorectal cancer screening
hx of polyps
repeat colonoscopy at 3yr, if nml then repeat in 5yr
65
colorectal cancer screening
FHx of CRC/adenomatous polyps
first colonoscopy at 40 y/o or 10 yr before age of dx
repeat 3-5 yr if nml
66
colorectal cancer screening
FHx of FAP
genetic testing at 10 y/o
if + --> colonoscopy every 1-2 yr or prophylactic colectomy
67
colorectal cancer screening
FHx of HNPCC
genetic testing at 18 y/o, if + ...
21-40 y/o --> colonoscopy ev 2 yr
40+ --> colonoscopy ev yr
68
osteoporosis
screen women >65 y/o
no screen for men
69
AUDIT-C
1. How often was alcohol consumed in past year?
2. How many drinks were had on a typical day of drinking in the past year?
3. How often did you have 6 or more drinks on one occasion in the past year?
70
PREP (Truvada) eligibility
anal/vaginal:
HIV-infected sexual partner
Recent bacterial STI
High number of sex partners
Inconsistent or no condom use
History of engaging in commercial sex work
Being in a high prevalence area or network
IVDU:
HIV-positive injecting partner
History of sharing injection equipment
History of recent drug treatment (but currently injecting)
71
How to rule out acute or chronic HIV
Combined HIV Ag/Ab test (4th generation test) w/i 7d of initiating PrEP
72
contraindications to PREP
HIV-infection
high risk HIV exposure within last 72hr (use PEP instead, then consider PrEP)
eGFR <60
73
PREP (when taken daily) offers full protection after _d for rectal and _d for vaginal sex
7d for rectal 20d for vaginal
74
Gender identity
A person’s internal sense of being a man/male, woman/female, both, neither, or another gender
75
Genderqueer (adj)
Describes a person whose gender identity falls outside the traditional gender binary. Other terms for people whose gender identity falls outside the traditional gender binary include gender variant, gender expansive, etc. Some- times written as gender queer
76
Non-binary (adj)
Describes a person whose gender identity falls outside the traditional gender binary. Sometimes abbreviated to NB or “enby.” Some people identify as “non-binary,” while others identify with another non-binary gender identity, such as genderqueer, gender fluid, or agender
77
Transfeminine/Trans feminine (adj.)
Describes a person who was assigned male at birth, and who identifies with femininity to a greater extent than with masculinity
78
Transmasculine/Trans masculine (adj.)
Describes a person who was assigned female at birth, and who identifies with masculinity to a greater extent than with femininity
79
Transsexual (adj.)
Sometimes used in medical literature or by some transgender people to describe those who have transitioned through medical interventions. Avoid using this term to describe transgender people unless they identify them- selves as such, as it is largely outdated.
80
Two-Spirit (adj.)
A modern term connecting LGBT Native American and American Indian people with their cultures and tradition
81
Beer's criteria
potentially inappropriate meds for elderly
82
Chantix and NRT can or cannot be combined?
Can be combined, has better outcomes
83
Top causes of cough
asthma
GERD
postnasal drip
84
HITS
IPV screening
Hurt, Insult, Threaten, Scream
score >10 is +
85
STAT
IPV screening
Slapped, Threatened, and Throw
+ answer to any is a + screen
86
IPV screening tools
HITS
STAT
WAST
87
biguanides
MOA: dec hepatic glucose output
- metformin
- riomet
AE: N/D, bloating, B12 deficiency
don't use if GFR <30
"caution" if GFR <45
* NO weight gain/hypOglycemia
* safe in stable CHF
88
sulfonylureas
MOA: stimulates sustained insulin release
- glyburide
- glipizide
- glimepiride
AE: hypOglycemia and weight gain!!!!!!!!
89
SGLT2 inhibitors
MOA: dec glucose reabsorption in kidneys
-flozin
AE: hypotension, UTIs, inc urination, genital infections, ketoacidosis
*NO weight gain/hypOglycemia
90
DDP-4 inhibitors
MOA: incretin enhancers, prolongs action of gut hormones, inc insulin secretion, delays gastric emptying
-gliptin
AE: HA and flu-like sx
*NO weight gain/hypOglycemia
91
dx criteria for chronic fatigue syndrome
need ALL major PLUS: 8 minor, OR 6 minor and 2 physical
major:
- at least 6 mo
- does not resolve w/ bed rest
- reduces activity to <50%
- other conditions have been excluded
physical:
- Low-grade fever
- nonexudative pharyngitis
- lymphadenopathy
minor: Sore throat; mild fever or chills; lymph node pain; generalized muscle weakness; myalgia; prolonged fatigue after exercise; new-onset headaches; migratory noninflammatory arthralgia; sleep disturbance; neuropsychological symptoms (e.g., photophobia, scotomata, forgetfulness, irritability, confusion, inability to concentrate, depression, difficulty thinking); description of initial onset as acute or subacute
92
SNRI or SSRI are more effective
SNRI slightly, but higher rate AE (N/V)
93
for tx-naive pt, all ___ antidepressants are equally effective
second gen
94
Which anti-depressants should be avoided in older adults
paroxetine (Paxil) and fluoxetine (prozac)
95
Tx for a first episode of major depression should last at least
4 mo.
96
MDD
presence of greater than 5 of the following (must include 1 or 2)
1. depressed mood
2. anhedonia (dec interest/pleasure)
3. weight/appetite change
4. insomnia or hypersomnia
5. psychomotor agitation or retardation ~daily
6. fatigue or loss of energy
7. feelings of worthlessness or xs or inappropriate guilt
8. indecisiveness/dec concentration
9. recurrent death/suicide thoughts
97
acupuncture
benefits chronic low back pain
98
coenzyme Q10
safe ADJUNCTIVE therapy in pt w/ HF and may improve clinical outcomes
99
exercise
small-moderate effect in reducing anxiety sx
100
fish oil
effective tx for hyperTG
101
ginkgo biloba extract EGb 761
improves cognition in pt w/ dementia
102
CBT
effective for tx of insomnia
103
movement-oriented mind-body approaches (yoga, tai chi, qi gong)
may be beneficial for sleep (esp older adults, cancer survivors)
104
probiotic supplementation
significant reduces incidence of abx-assoc diarrhea
105
St. John's wort (hypericum perforatum)
benefits pt w/ mild-moderate depression
106
adjunctive CAM therapy
coenzyme q10 (rest are first-line)
107
easily-absorbed types of Omega-3
EPA
DHA
fish and algal oil supplements
108
omega-3 vegetarian food sources
flax
walnuts
chia
diet supplements made from blue green algae
109
daily fiber recommendation
30g
110
daily protein recommendation
50g
111
daily calcium recommendation
1000mg
1200mg (if postmenopausal woman)
112
single question alcohol screening
“How many times in the past year have you had five (men)/four (women) or more drinks in a day?”
113
DASH diet sodium limit
2400mg
114
social determinants of health
Education, employment opportunities, water, sanitation, housing, food access, level of social inclusion / exclusion, social support networks, stress, early childhood development, race/gender/sexual orientation/etc (as they impact the other SDHs)
115
effective cold tx for children
```
acetylcysteine
analgesics
honey
intranasal ipratropium (atrovent)
nasal saline irrigation
ointment (camphor, menthol, eucalyptus oils)
vitamin C
```
116
effective cold tx for adults
```
acetaminophen
antihistamine + decongestant
intranasal ipratropium (atrovent)
intranasal oxymetazoline
lactobacillus casei
NSAIDs
zinc acetate or gluconate
```
117
STEPS approach for diabetes tx
safety, tolerability, effectiveness, price, and simplicity.
118
DPP-4 inhibitors
-pancreatitis, hypOglycemia, slight high rate CHF
119
amalyin analogues
serious hypOglycemia
| should not be used in pt w/ gastroparesis
120
DM 2 screening (USPTF)
40-70 y/o overweight or obese adults
repeat testing every 3 years if results are normal
121
DM 2 screening (ADA)
45 y/o and older OR younger than 45 with major risk fx (exp. A1c >5.7)
122
DM2 dx
1. fasting glucose >126mg/dL
2. random glucose >200
3. 75g two-hour oral glucose tolerance test >200mg/dL
123
acamprosate ci
renal failure
124
naltrexone ci
liver failure
125
antiepileptic useful in alcohol dependency
topiramate
126
risk fx of patellofemoral pain syndrome
female sex
running, squatting, stairs
dec quads strength
dynamic valgus
127
most effective tx in improving long and short term pain of patellofemoral pain syndrome
exercise therapy
128
NSAIDs effect on patellofemoral pain syndrome
improvement may be limited to one week
129
consistent benefits in tx depression
yoga
130
inconsistent in tx depression
tai chi
| qi gong
131
adjunctive depression tx
exercise
| mindfulness-based intervention
132
most effective tool in ID delirium
confusion assessment method
req 1 and 2, and either 3 or 4
1. acute, fluctuating
2. inatttention
3. disorganized thinking
4. alt level of consciousness
133
delirium
```
disturbance in attention
level over short pd of time
disturbance in cognition
not explained otherwise
evidence that disturb is direct physio consequence
```
134
The ________ has the best combination of positive and negative likelihood ratios in the dx of ADHD
Conners Abbreviated Symptom Questionnaire
135
window period
15-17d
| from HIV detection to date it can be detected on labs
136
ankylosing spondylitis
Onset <40 years old, gradual onset
Pain duration >3 months
Morning stiffness
Improved by exercise
137
spinal stenosis
leg pain on walking
| relieved by sitting or standing
138
acute low BP pharm tx
NSAIDs, acetaminophen, m. relaxants
139
chronic low BP pharm tx
```
gabapentin
topiramate
cymbalta
NSAIDs
opioids
spinal manipulation (only up to 6 mo.)
```
140
non effective chronic LBP tx
```
skel. m. relaxants (cyclobenzaprine)
acetaminophen
antidepressants (EXCEPT cymbalta)
lidocaine patches
transcutaneous elec n. stim
epidural steroid injections
```
141
women dx with gDM should receive a 75g glucose tolerance test when postpartum?
between 4-12 wk postpartum
142
Pt w/ hypertensive disorders of preg should have a BP check when postpartum?
within 7d
