Referral/Collaborations

Question 1

Diabetes screening: levels for fasting glucose, random glucose, glucose tolerance test, A1C

Answer 1

fasting glucose: 126
Random and GTT: 200
A1C: 6.5

Question 2

Cholesterol Screening: total cholesterol, VLDL triglycerides, LDL, HDL

Answer 2

Total cholesterol: 200
VLDL: 150
LDL: 100
HDL: low < 40

Question 3

JNC8 BP treatment threshold; AHA Stage 1 & Stage 2 Hypertension

Answer 3

JNC8 treatment threshold 140/90; older 150/90
Stage 1 Hypertension: 130/80
Stage 2 Hypertension: 140/90

Question 4

HTN treatment Non-African American

Answer 4

Thiazide diuretic
ACEI
ARB
CCB

Question 5

HTN treatment African American

Answer 5

Thiazide diuretic

CCB

Question 6

HTN Treatment DIabetic

Answer 6

ACEI

ARB

Question 7

HTN treatment in adults with chronic kidney disease

Answer 7

ACEI

Question 8

Mitral Stenosis

Answer 8

Loud S1 murmur, low pitched, mid-diastolic, apical crescendo rumble

MS. ARD

Question 9

Mitral Regurgitation

Answer 9

S3 with systolic murmur at 5th intercostal space MCL (apex); may radiate to base or left axilla; musical, blowing, or high pitched

MR. ASS

Question 10

Aortic Stenosis

Answer 10

Systolic, “blowing’, rough harsh murmur at 2nd right ICS usually radiating to the neck

MR ASS

Question 11

Aortic Regurgitation

Answer 11

Diastolic, blowing at 2nd left intercostal space

MS ARD

Question 12

S1

Answer 12

Mitral & Tricuspid valves close

Aortic & Pulmonic valves open

Question 13

S2

Answer 13

Aortic & Pulmonic valves close

Mitral & Tricuspid valves open

Question 14

Systole & Diastole

Answer 14

Systole: Period between S1 and S2
Diastole: Period between S2 and S1

Question 15

S3 & S4

Answer 15

S3: Kentucky; increase fluid states (CHF, pregnancy)
S4: Tennessee; stiff ventricular wall (MI, chronic hypertension, left ventricular hypertrophy

Question 16

Hyperthyroidism

Answer 16

More common in women
Onset 20-40
TSH low
T3, T4, thyroid resin uptake, free thyroxin increased
Refer to specialist
Propranolol
Thiourea drugs
Radioactive Iodine
Thyroid surgery

Question 17

Hypothyroidism

Answer 17

Pituitary deficiency of TSH
Hypothalamic deficiency of TRH
TSH elevated
T4 low or normal
Hyponatremia
Hypoglycemia
Levothyroxine 50-100 mcg

Question 18

HIV screening and confirmation

Answer 18

ELISA screening
Western Blot confirmation
HIV 1/2 antigen/antibody immunoassay and differentiation immunoassay
CD4 count: Normal >800
VIral load

Question 19

Chlamydia treatment

Answer 19

Azithromycin 1 gm x 1 or

Doxyxycline 100 mg BID x 7 days

Question 20

Gonorrhea treatment

Answer 20

Ceftriaxone 250 mg IM x 1

Azithromycin 1 gm PO x 1 to cover chlamydia

Question 21

Syphilis treatment

Answer 21

Early syphilis (less than 1 year(: Penicillin 2.4 million units x 1
Indeterminant/long duration: 2.4 million units IM weekly x 3 weeks