GIM Flashcards
(32 cards)
What additional step can help if an older adult is reluctant to stop driving?
Refer for an occupational therapy driving assessment.
What is the most likely diagnosis for lateral hip pain worsened by lying on the affected side?
Greater trochanteric pain syndrome (GTPS).
Besides GTPS, what is another common cause of lateral hip pain? A: Meralgia paresthetica.
NSAIDs are first-line therapy for greater trochanteric pain syndrome.
What MELD score suggests it is safe to proceed with surgery?
MELD score less than 8–10.
What should be done if a patient has a MELD score greater than 15?
A: Refer for liver transplant evaluation.
What is the recommended preoperative hemoglobin A1c target according to the Endocrine Society guidelines?
Less than 8%
What are the key features of an acute full-thickness rotator cuff tear?
Acute pain, weakness, and preserved passive range of motion. Repetitive overhead work.
Which medication is effective and safer for treating insomnia in older adults?
Doxepin.
In a patient with a coronary stent scheduled for elective surgery, what should be done with the P2Y12 inhibitor?
C/w ASA, hold Plavix
Which medication can quickly improve depression symptoms in palliative care patients?
Methylphenidate, relatively quick onset of action. As quickly as 24 to 48 hours after initiation.
How does medial tibial stress syndrome (shin splints) typically present, and is imaging needed?
Diffuse, often bilateral shin pain worsened by exertion with posteromedial tibia tenderness ≥5 cm; no imaging needed if diagnosis is clear.
What is the utility of likelihood ratios (LRs) in clinical practice?
LRs estimate posttest probability and remain useful even in low-prevalence conditions.
What provides the best protection against pressure injuries in hospitalized patients with limited mobility?
An advanced static mattress or mattress overlay made of specialized sheepskin, foam, or gel.
How does iliotibial band syndrome typically present?
Diffuse lateral knee and distal thigh pain with tenderness 2–3 cm above the lateral femoral condyle.
How should dyspnea be treated with nonpharmacologic measures?
Use handheld fans, posture adjustments, and breathing techniques like pursed-lip and diaphragmatic breathing.
What are the five phases of the Six Sigma quality improvement model?
Define, Measure, Analyze, Improve, Control (DMAIC).
How should prepatellar bursitis be evaluated?
Perform fluid aspiration and analysis to identify causes like gout or infection.
What is length-time bias in disease screening?
It occurs when screening preferentially detects slow-growing diseases, overestimating survival benefits.
What is overdiagnosis, and how is it related to length-time bias?
Overdiagnosis is detecting and treating disease that would not have caused harm; it is an extreme form of length-time bias.
What type of dressing is superior to gauze for treating pressure injuries?
Hydrocolloid or foam dressings.
What is a prospective cohort study, and what is it useful for?
It divides participants by exposure status and follows them over time to assess outcomes; useful for studying rare exposures and providing high-level evidence for diagnosis or prognosis.
When is a skilled nursing facility appropriate after hospitalization?
When a patient needs ongoing therapy but cannot tolerate 3 hours of therapy daily required for acute rehabilitation.
When is home health care appropriate after hospitalization?
When the patient needs skilled therapy and has either enough independence or 24-hour supervision at home.
When is an assisted living facility appropriate after hospitalization?
For patients who need long-term daily assistance with activities of daily living after completing rehabilitation.
What is required for a patient to be discharged to an acute rehabilitation facility?
Ability to participate in 3 hours of therapy at least 5 days per week.
When is placement in a nursing home appropriate after hospitalization?
For patients with chronic care needs who require 24-hour nursing care and are not expected to recover.
