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Flashcards in General Internal Medicine Deck (40):
1

Tdap (Age/freq, appropriate, contraindications?)

Everybody, q10 or q5 with wound, no contraindications

2

Pneumovax (Age/freq, appropriate, contraindications?)

Once before 65, once after, given to anybody with comorbid illness, so pretty much everybody

Can't give with live vaccines (Prevnar, zoster). So give prevnar first, then pneumovax 8 weeks later.

3

Prevnar (Age/freq, appropriate, contraindications?)

Once after 65, everybody, can't give with pneumovax.

Give prevnar first, then wait 8 weeks, then give pneumovax.

4

Zostavax (Age/freq, appropriate, contraindications?)

Give once at 60, everybody, don't give with pneumovax

5

Hep A/B (Schedule, appropriate, contraindications?)

Day 1 =A/b
Month 1 = B
Month 6 = A/B

Everybody, no contraindications

6

Meningococcal vaccine (Age/freq, appropriate, contraindications?)

Age 11, college, military, hajj, no contraindication

7

HPV (Age/freq, appropriate, contraindications?)

11-26, everybody, no contraindications

8

Flu vaccine (Age/freq, appropriate, contraindications?)

Everybody, every year, contrainidcation is egg allergy

9

Colon cancer (Age, method)

Once 50, earlier if strong family hx.

Colonoscopy q10
Flex sig q5 with FOBT q3
FOBT q1

10

Breast Cancer (Age, method)

50-74, mammogram every 2 years

11

Lung Cancer (Age, method)

55-74 with 30 pack year history, low dose CT

12

Cervical Cancer (Age, method)

21-65 pap q3
30-65 pap+HPV q5

13

Ovarian Cancer (Age, method)

BRCA 1/2+ Only, Transvaginal US + CA-125.

14

Dyslipidemia (Age, method)

High risk, M @25 F@35
Low Risk M@35, F@45

15

Hep C (Age, method)

If born between 1945 and 1965, ivdu, blood before 1992, cocaine, tattoo, prison

16

HTN (Age, method)

Everybody everytime, diagnose with 2 readings 2 weeks apart

17

Osteoporosis (Age, method)

Females @ 65, 60 if high risk, one time DEXA

18

AAA (Age, method)

Male 65 and history of smoking, abdominal US

19

HIV (Age, method)

Everybody once or every year

20

DM2 (Age, method)

Patients w/persistent BP>135/80
Patients >45 q3y
If obese, HLD, or first degree relatives

21

STI (GC CL)

Sexually active females

22

How to diagnose hypertension?

2BP checks separated by 2 weeks.

23

What to follow up with when HTN diagnosed?

Urinalysis for occult blood/BUN:Cr ratio, BMP, Lipids, EKG

24

Best ways to reduce HTN?

Exercise, Dash diet, sodium restriction

25

JNC 8 BP targets

Target is 150/90 for pts>60
Target is 140/90 for patients

26

Meds to treat HTN?

Don't use b blockers
Don't use ace/arb in blacks (use HCTZ), unless CKD

27

How much does a single drug lower BP?

About 15/10

28

Causes of secondary hypertension

Hyperthyroid
Hyperaldo
Hypercalcemia
Aortic coarctation
Renovascular Stenosis
Pheochromocytoma
Cushing
OSA

29

Drugs that cause HTN

Glucocorticoids
OCP
NSAIDs
Antidepressants
Decongestants
Stimulants

30

How to treat hypertensive encephalopathy?

Labetalol

31

How to calculate LDL

LDL = total cholesterol - HDL - triglycerides/5

32

Secondary causes of hyperlipidemia?

Hypothyroidism, nephrotic syndrome, liver disease, alcoholism, diabetes

33

Diagnosis of HDL

Based on 2 fasting measurements at least 1 week apart

34

Metabolic syndrome

3/5 of following: Abdominal obesity, tg>150, HDL 130/85, fasting BG >110.

35

Treatment for hyperlipidemia if low-medium risk

Lifestyle modification and high fiber diet. Should drop cholesterol by 15%

36

Use statins for

ASCVD (mi, tia, cva, pad, angina)
LDL>190
Diabetes,age 40-75 and LDL from 70-190
>7.5 ASCVD risk

37

Use high dose statins for

ASCVD 7.5, LDL>70
LDL>190

38

Triglyceride levels that cause pancreatitis

>500, start fibrates

39

How to work up back pain

See if there are alarm symptoms (focal neuro deficit, weakness, sensory loss, urinary symptoms, fever, IVDU). If so, give high dose dexamethasone, then get xray and MRI

If not, treat conservatively with 4-6 of nsaids.

40

Numbers to diagnose diabetes

1 random glucose >200
2 fasting bg >125
1 AIC>6.4