Primary Care Flashcards
(209 cards)
1
Q
epigenetic event
A
genomic imprinting
2
Q
edema that occurs during inflammatory response is due to:
A
increased capillary permeability
3
Q
macrophages function by:
A
presenting antigenic fragments on their cell surfaces
4
Q
decrease in lymphatic drainage causes ______ changes in normal aging
A
skin
5
Q
a resistance to insulin by insulin-sensitive tissues
A
Type II DM
6
Q
Iron Deficiency Anemia Lab Values
A
EVERYTHING IS LOW (MCV, MCHC, RBC, Hgb, Iron)
except TIBC is high
7
Q
endorphins act to relieve pain by:
A
attaching to opiate receptor sites
8
Q
During type 1 hypersensitivity reactions, histamine released from degranulated mast cells causes:
A
gastric acid stimulation
9
Q
In Systolic Heart Failure, the renin-angiotensin-aldosterone system results in ________ preload and _________ afterload
A
increased preload
increased afterload
10
Q
_____ tumors retain parental cell functions
_____ tumors lose parental cell functions
A
benign retain
malignant lose
11
Q
GFR is most accurately reflected by this lab value
A
creatinine clearance
12
Q
Sickle cell disease is a inherited autosomal _________ disorder
A
recessive
13
Q
most common type of skin cancer
A
basal
14
Q
excessive cortisol production results in:
A
immune suppression
15
Q
During an IgE-mediated hypersensitivity reactions, what causes bronchospasm?
A
smooth muscle contraction caused by histamine bound to H1 receptors
16
Q
a collection of infected hair follicles occurring most often on the back of the neck, the upper back, and the lateral thighs that forms a mass and evolves into an erythematous, painful, and edematous mass and drains through many openings
A
carbuncles
17
Q
hormone that increases as adipocytes increase in size and will no longer decrease the appetite
A
Leptin
18
Q
During a stress response, the helper T (Th)1 response is suppressed by which hormone?
A
cortisol
19
Q
Hepatitis C can be confirmed with a positive:
A
IgG anti-HCV
20
Q
Polyuria occurs with diabetes mellitus because of:
A
elevation of serum glucose
21
Q
How does the aging process of the T-cell activity affect older adults
A
increased tendency to develop various infections
22
Q
benefit of the inflammatory response is to:
A
prevent infection of injured tissue.
23
Q
brain structure that regulates eating behavior and energy metabolism
A
hypothalamus
24
Q
Nicotine increases artherosclerosis by the release of:
A
epinephrine
25
Atopic dermatitis is due to:
genetic predisposition.
26
function of B lymphocytes
antibody synthesis
27
Aortic regurgitation causes:
diastolic murmur
28
long-term effect of cortisol dysregulation
osteoporosis and increased abdominal fat.
29
presence or absence of one or more extra chromosome
aneuploidy
30
change in a complete set of chromosomes
euploidy
31
medications are administered at dosing intervals close to:
their half-life
32
monotherapy for HTN in black population
calcium channel blockers (CCB)
33
treatment of choice for hives
Claritin
34
topical metronidazole for acne rosacea treatment lasts for:
a long period of time, maybe forever
35
Sulfa antibiotics (except Bactrim) have good gram-_________ coverage
negative
36
enzyme induction results in __________ pharmacological action of a drug
decreased
37
blocks dopamine recepters in the chemo trigger zone (CTZ), blocks cholinergic + histamine receptor sites
phenergan
38
occlusive dressings potentiate absorption of:
corticosteroids
39
prescribing of classes 1, 2, and 3 of ___________ should be done in consultation
corticosteroids
40
competitively binds to histamine receptors in parietal cells to stop acid secretion
H2 receptor antagonists (Pepcid, Zantac)
41
supplement that lessens the risk of paresthesias for diabetic patient on metformin
Vit B12
42
ACE Inhibitors are not combined with ARBS due to risk of:
worsening kidney function
43
antivirals work by reducing:
viral shedding
44
metformin-induced lactic acidosis results in:
respiratory and abdominal distress
45
do not give ACEI or ARBs to:
black population
46
Red Flag symptoms for Low Back Pain:
```
hx of trauma
parental drug use
unexplained weight loss
hx of cancer
long term use of steroids
fever
incontinence
intense localized pain
```
47
Midwife should __________ for thrombosed hemorrhoids
refer for draining
48
skin condition that may progress to squamous cell carcinoma
actinic keratosis
49
```
Risk Factors for ________:
fair skin
tendency to freckle/burn
blond/red hair
blue/green eyes
hx of severe sunburns
immunosuppression
family hx
```
skin cancer
50
small, dry, rough textured papules or plaques caused by excess exposure to UV rays
actinic keratosis
51
waxy or translucent appearance with raised edge and central erosion
basal cell carcinoma
52
larger than common moles with rough texture, irregular outline and differing colors that are common among women with melanoma
dysplastic nevi
53
scaly, thickened, poorly defined, occasionally hard or horn-lie on an erythematous base
squamous cell carcinoma
54
```
Symptoms of __________:
hyperresonance w/ percussion
wheezing
prolonged expiratory phase
diminished breath sounds
tachypnea
dyspnea
```
Asthma
55
KNOW ASTHMA CLASSIFICATION
!!!!
56
TB test >5 mm is considered positive in:
HIV positive patients
immunocompromised
abnormal chest radiograph consistent w/ TB lesions
recent contact w/ TB-infected person
57
```
Symptoms of _________:
night sweats
fever
malaise
weakness
anorexia
weight loss
productive cough
hemoptysis
chest pain
dyspnea
```
TB
58
```
Side Effects of ________:
tightness of chest/throat
flushing
numbness
tingling
dizziness
```
Sumatriptan (abortive treatment for migraines)
59
Reasons to refer to neuro for HA:
```
new type of HA in person > 50 years
sudden onset of worst HA ever
HA increasing in frequency/severity
HA initiated by exertion
focal neuro symptoms persisting after HA onset
HA after head trauma
```
60
most common herniated discs occur at:
L5-S1
61
symptoms of herniation at L5-S1:
pain in buttocks, lateral leg, malleolus
| numbness in lateral foot and posterior calf
62
HIV PrEP is contraindicated in:
patients w/ severe renal dysfunction
63
renal function tests should be repeated q_____ while on PrEP
6 months
64
response to HIV antiretrovirals is monitored by:
HIV RNA levels
65
major AIDS-defining diagnosis
PCP
66
Risk Factors for_________:
African American
Hispanic
first-degree relative w/ disease
SLE (Lupus)
67
```
Diagnosis of _________:
4 of 11 criteria present
dermatological symptoms
arthritis
serositis
renal/neuro/hematologic conditions
positive ANA test
immunologic positive test
```
SLE (Lupus)
68
WHO definition of anemia in women is Hgb < ____ mg/dL
12
69
initial management for suspected IBS
trial elimination of lactose, fructose, or sorbitol (one at a time)
70
```
Nonpharm treatment of __________:
activity as tolerated
hydration
adequate caloric intake in small meals
discontinuation of all but essential meds
alcohol avoidance
```
Hep B
71
85-95% of gallstones are comprised of:
cholesterol
72
most common causative agent of traveler's diarrhea
e.coli
73
for patient w/o bloody stool or fever, traveler's diarrhea should be treated with:
fluid intake and avoid anti-diarrheal agents
74
drug considered for use in conjunction with moderate-intensity statin for individuals w/ dyslipidemia who need but cannot tolerate high-intensity statins
Ezetimibe
75
drug that works by inhibiting cholesterol abdorption
Ezetimibe
76
low serum TSH and elevated free T4
primary hyperthyroidism
77
radioactive iodine treatment for Graves' disease usually results in long-term __________
hypothyroidism
78
Factors that exacerbate acne:
hormonal cycling
topical corticosteroids
contact w/ irritant oils
cosmetics
79
effective comedolytic agent for mild, non-inflammatory acne that is applied topically to affected areas
tretinoin cream
80
slow-growing, waxy, semi-translucent nodules w/ rolled borders that may have central ulcerations and telangiectasias
basal cell carcinoma
81
photosensitivity resulting in malar rash causing exacerbation of disease is symptom of
SLE (Lupus)
82
eye irritation with acute onset with itchy sensation/discomfort and mucopurulent discharge beginning in one eye and spreading to the other eye
bacterial conjuctivitis
83
```
Precipitating factors for __________:
infection
physical/emotional stress
blood loss
pregnancy
surgery
high altitudes
```
sickle cell crisis
84
yellowish/thickened fingernails/toenails
tingea unguium
85
good sensitivity and specificity for diagnosis of a patient who has an intermediate to high probability of DVT
duplex ultrasound
86
treatment goals for hyperlipidemia are based on:
risk factors
87
treatment goal for individual who has hyperlipidemia and clinically manifested CHD or CHD risk equivalent (like diabetes)
LDL < 100 mg/dL
88
Symptoms of _________:
pain that starts in epigastrium moving to RUQ
N+V
stop in inspiratory effort during deep palpation (Murphy's sign)
acute cholecystitis
89
```
Secondary causes of _________:
obesity
endocrine/metabolic disorders
obstructive liver disease
renal disorders
meds (like corticosteroids, thiazide diuretics, beta blockers)
```
dyslipidemia
90
mid or late systolic click is caused by:
mitral valve prolapse
91
late systolic murmur may be present in case of:
mitral valve regurgitation
92
pathologic murmurs increase with:
Valsalva maneuver
93
Virchow's Triad
endothelial damage, stasis, hypercoagulability
94
most common cause of community-acquired pneumonia
Streptococcus pneumoniae
95
Diagnosis of _______:
score-based algorithm that includes:
joint involvement (stiffness/swelling)
serology (RF, anti-citrullinated protein antibody)
acute-phase reactants (C-reactive protein, erythrocyte sedimentation rate "ESR)
duration of symptoms
RA
96
preferred therapy for long-term management for RA
DMARDs
97
med that may be added to DMARDs if monotherapy is ineffective for RA
immunomodulating biologic agent
98
Presence of at least 3 of these 5 risk factors:
abdominal obesity/waist circumference > 35 in
triglycerides > 150
HDL-C < 50
BP > 130/85
fasting glucose > 110
Metabolic Syndrome
99
Symptoms of ___________:
tonsillar enlargement w/ exudate
palatal petechiae at junction of hard/soft palates (25%)
lymphadenopathy (posterior cervical chain)
fever that increases w/ severity of disease
hepatomegaly (25%)
splenomegaly (50%)
lymphocytic leukocytosis w/ atypical lymphocytes on CBC
infectious mononucleosis
100
indicated medication for prevention and treatment of osteoporosis
Alendronate
101
indicated medication for treatment (not prevention) of osteoporosis
Calcitonin
102
_________ is recommended for postmenopausal women presenting with following criteria:
hip or vertebral fracture
T-score <2.5 at femoral neck or spine
T-score 1.0-2.5 at femoral neck or spine plus 10 year probability of hip fracture >3%
10-year probability of major osteoporotic-related fracture >20%
Pharmocological treatment
103
Consider __________ for these women:
age >70 w/ BMD T-score <1.0
age 65-69 w/ BMD T-score <1.5
postmenopausal w/ low trauma fracture as adult
historical height loss >4 cm
prospective height loss >2 cm
recent/ongoing long-term glucocorticoid treatment
vertebral imaging for VFA
104
```
Instructions for __________:
take on empty stomach
with 8 oz glass of water
in the morning
at least 30 min prior to beverage/food/other meds
avoid lying down for 30 min after taking
```
Alendronate
105
Diagnositic criteria for ____________:
restriction of intake relative to requirements
significantly low body weight
intense fear of gaining weight
persistent behavior that interferes w/ weight gain
disturbed body image
anorexia nervosa
106
high GGT may indicate:
heavy or chronic alcohol use
107
most common type of anxiety disorder
specific phobia
108
typical age for development of bulimia:
late adolescence to early adulthood
109
common characteristic of bulimia nervosa is __________ behavior
impulsive
110
```
SE of __________:
nausea
anxiety
insomnia/hypersomnia
headache
anorexia
sexual dysfunction
```
SSRI
111
majority of rapes are committed by _________ of the victim
acquaintances
112
severe asthma exacerbations with peak flow <60% may require treatment with:
systemic corticosteroids (PO for 5-10 days)
113
Zyban (buproprion hydrochloride) for smoking cessation must be started _______ prior to smoking cessation
1 week
114
```
Dietary sources of ___________:
dried beans
leafy green vegetables
citrus fruits
juices
fortified cereals
```
folic acid
115
model used to address sexual concerns and make appropriate referrals including permission giving, limited information, and specific suggestions
PLISSIT model
116
general term used to describe individual's pattern of emotional, romantic, and sexual attraction to other people
sexual orientation
117
delivery of healthcare services focused on early detection of disease states as well as interventions that limit severity and morbidity (risk factor identification, screening, counseling/education)
secondary prevention
118
frequency of recommended screening for chlamydia/gonorrhea for sexually active women < 25 years old or > 25 years old w/ risk factor of new sex partner, multiple sex partners, sex partner w/ other partners, exchanging sex of money/drugs)
annually
119
screen all women > ___ years old for osteoporosis
65
120
screen women < 65 years old for osteoporosis with risk factors of:
```
low BMI
hx of low-trauma fracture
smoking
alcohol intake > 3 drinks/day
family hx of hip fracture/osteoporosis
```
121
first-line abortive therapy for mild-moderate migraine
NSAIDs, acetaminophen, combination analgesics (ASA + acetaminophen + caffeine)
122
first-line abortive therapy for moderate-severe migraine
triptans (Imitrex, Zomig, Maxalt)
123
Contraindications for ___________:
do not use within 24 hrs of another ergotamine drug
coronary artery disease
HTN
use in pregnancy only if benefit outweighs risk
associated w/ preeclampsia, LBW, PPH if used in late pregnancy
triptans
124
second-line abortive therapy for moderate-severe migraine
ergotamines
125
```
Contraindications for __________:
do not use with triptan
coronary artery disease
HTN
pregnancy
```
ergotamines
126
presentation of otitis media
tympanic membrane erythematous and bulging
127
tested in a physical exam by observing symmetrical movement through the six cardinal fields of gaze without lid lag or nystagmus
extraocular muscle (EOM) function
128
lung sound that is heard over most of the lung fields
vesicular
129
increased transmission of vibrations through consolidated tissue- bronchus to chest wall- when patient is speaking (as is found in lobar pneumonia)
tactile fremitus
130
normal liver span measured at the right MCL
6-12 cm
131
only cranial nerve that is tested for sensory and motor function
CN V - trigeminal
132
Rubella immunity is shown by titer of _____ or greater
1:10
133
High Rubella titers (> 1:64) indicate:
current infection
134
Labs affected by pregnancy:
cholesterol
triglycerides
T4 levels
135
Even though Hgb/Hct may be lower in pregnancy, MCV should not change because:
RBC size will not change unless the woman has IDA, thalassemia, Vit B12 deficiency, folic acid deficiency
136
BMD T-score of -1 to -2.5
osteopenia
137
BMD T-score of > -1
normal bone density
138
BMD T-score of < -2.5
osteoporosis
139
fasting glucose of > _____ is diagnostic for diabetes
126
140
Romberg test of balance assesses ________ function
cerebellar
141
BMD test for premenopausal women to evaluate for secondary causes of osteoporosis
Z-score
142
extra heart sound that is normal to hear in 3rd trimester of pregnancy
S3
143
S2 heart sound is best heard at ______ of the heart
base
144
HIV test that detects HIV-1 antigen as early as as 2-6 wks after infection (levels of HIV-1 decrease once HIV antibodies develop)
HIV-1 p24 antigen test
145
HIV antibodies are detectable in 95% of individuals with ____ months of infection
6
146
abnormal finding in ophthalmoscope exam
tapering of veins
147
normal specific gravity of urine
1.005 -- 1.030
148
normal protein in urine
0-8 mg/dL
149
normal WBC of urine
0-4 per HPF
150
normal urine pH
4.6-8.0
151
addition of KOH to wet mount is used to detect
Candida pseudohyphae
152
HSV1 and HSV2 test may be done ___-___ months after infection to detect antibodies
1-2 months
153
somatic gene mutations may occur during:
after conception during any time of life
154
gene mutation of DNA copying mistake during cell division or exposure to ionizing radiation, chemicals, or viruses during gestation or later in life
somatic gene mutation
155
inherited gene mutation that occurs during conception that is present in sperm or egg cells of parent
germ cell mutation
156
CDC-recommended test for Trich
NAAT- more sensitive than wet mount
157
pre menopausal woman w/ anorexia nervosa may have low _____ and ______
FSH and estradiol
158
law that required an available data on potential drug-associated effects on female and male fertility to be published
2015 FDA Pregnancy Labeling Rule
159
plasma protein binding most significantly effects:
distribution
160
may decrease the hepatic metabolism of metronidazole and increase serum levels of:
metronidazole (Flagyl)
161
drug that initiates a physiologic response when bound to a drug receptor
agonist
162
this may be faster in pregnancy due to increase in GFR
drug elimination
163
a prodrug that is metabolized to a more active form by enzymes in the liver
tamoxifen
164
low serum bioavailability of atorvastatin is attributed to its:
extensive hepatic first-pass metabolism
165
single rescue dose of betamethasone should be given only to women less than _____ wks and have not had a previous course within the past 7-14 days
34+0
166
SE of increased insulin requirements in diabetics is caused by:
corticosteroids
167
Toxicity of Mg+ can occur at levels > ___ mEq/L
7
168
symptom of Mg+ toxicity
shortness of breath
169
antidote for Mg+ toxicity
calcium gluconate
170
do not give Mg+ for greater than 7 days because it may increase risk of:
fetal bone deminerlization
171
after giving Rubella vaccine to PP woman, you should:
draw titer in 3 months
172
when RhoGAM is given within 3 weeks of birth, PP administration may be withheld if:
Kleihauer-Betke test rules out fetal-maternal hemorrhage > 15 mL RBCs
173
inflammatory, well-circumscribed, erythematous macular and papular lesion with loosely adherent silvery white scale.
psoriasis
174
```
Risk Factors for ___________:
increasing age
obesity
rapid weight loss
pregnancy
hormones or other drugs [i.e. Rocephin]
ethnicity
family history
female gender
other metabolic diseases.
```
gallstones
175
Antibiotics are only recommended for _____________ if symptoms persist more than 10 days or if symptoms of complication
sinus headache
176
facial erythema, telangiectasia, papules, pustules, and prominent facial pores
acne rosacea
177
Danger signs for __________:
Onset of headaches after age 50**
Headache described as worst H/A ever
Onset of new or different H/A
Onset of a headache that progressively worsens**
H/A with stiff neck, fever, malaise, N/V
Presence of aphasia, weakness, and / or poor coordination**
Asymmetry of pupillary response
Decreased DTR's**
Papilledema
Painful temporal arteries
Personality change
Need only one to cause concern and refer to ER
Headaches
178
There is no carrier or chronic state of Hepatitis ___
A
179
These populations should be supplemented with Vit B6 while taking INH Isonaizide for TB
pregnant women
HIV+
diabetics
180
best dermatological vehicle for treating acne
gels
181
first-line antibiotic for Group A beta strep pharyngitis
PCN
182
Acne _________ occurs in an older population and does respond to oral antibiotics.
rosacea
183
Acne _________ occurs with comedomes
vulgaris
184
LBP w/ muscle spasms, prescribe:
muscle relaxer (Flexeril)
185
best treatment for viral conjuctivitis:
cool compress
186
```
Sx of ____________:
irritability
impaired functioning
social conflict
inability to concentrate
rapid speech
```
bipolar disorder
187
________ testing is no longer recommended for H.Pylori
serum
188
thioamide is used to treat:
hyperthyroidism
189
recheck TSH and T4 index q___-___ months in hyperthyroidism
3-4 months
190
first line management for Bell's palsy
prednisone given w/ antiviral if facial paralysis is severe
191
Pre-Diabetes management
exercise at least 150 min weekly including resistance exercise
192
```
Recommended labs for _______:
CBC w/ diff
LFTs
Ca+ levels
H.Pylori testing (breath or stool)
endoscopy (especially if over age 50)
```
PUD
193
temporary (few hours) of numbness in face/arm may be due to:
TIA
194
incapacitating pain + neuro deficits require:
referral
195
in mononucleosis, referral is indicated for:
unilateral palate swelling which means peritonsillar abscess
196
drug that is contraindicated with antifungals (-azoles)
statins
197
the most debilitating complication of chronic shoulder immobility and pain
adhesive capsulitis
198
raised, crusted lesion surrounding a central ulcer is most likely:
squamous cell carcinoma
199
most specific finding for costochondritis:
point tenderness over 3rd and 5th ribs
200
exercise recommendations for 25 yo woman
muscle strengthening 2 days/wk
| moderate-intensity aerobics 150 min/wk
201
2nd dose of Hep B vaccine is given ___ weeks after 1st dose
4 weeks
202
herpes zoster vaccine is offered to patients over age:
50
203
treatment w/ ICS increases risk for fetal:
gastroschisis
204
catarrhal stage of pertussis includes:
low grade fever
205
pregnancy-related change that affects the distributions of drugs
increased plasma volume
206
pregnancy-related change that affects the absorption of drugs
nausea/vomiting
207
pregnancy-related change that affects the metabolism of drugs
changes in estrogen/progesterone levels
208
avoid this drug in 3rd trimester due to risk of neonatal hyperbilirubinemia
sulfamethoxazole
209
avoid this medication in pregnant women due to risk of fetal ototoxicity
gentamycin
