2015-2016 Mock Samp Flashcards by Deleted Deleted

What is the most important lab test for AUB?

Pregnancy test

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What tests should not routinely be ordered with AUB?

LH/FSH
Estradiol
Progesterone

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What are indications for endometrial biopsy with AUB?

Age > 40
Obesity
Diabetes
Nulliparity
PCOS
Failure of medical treatment
Intermenstrual bleeding

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What are 4 contraindications for endometrial sampling in AUB

Pregnancy
PID
Clotting disorders
Cervical pathology

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What are four treatments for menorrhagia?

Iron
NSAIDs
Antifibrinolytics
OCPs

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What three things to treat angioedema secondary to ACEi? What do you add if severe?

Discontinue ACE
Corticosteroids
Antihistamines

Epinephrine if severe

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What are 5 conditions that may mimic GAD?

Hyperthyroidism
Pheo
Arrythmia
Epilepsy
Substance use
Substance withdrawal

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If patient has SNOOP with headache, what test should you order?

MRI head

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What is the prophylactic treatment for tension headaches?

TCA’s (Amitrtipyline, nortriptyline)

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Who is at risk for analgesia overuse headache?

NSAID/Tylenol > 15d/mo

Opiates > 10 d/mo

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What are three red flags in the crying infant?

Distended abdomen
Fever
Lethargy

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What are 5 possible causes of distended abdomen and crying infant?

Hirschsprung
Malrotation with volvulus
Necrotizing enterocolitis
Abdominal mass
Hepatosplenomegaly

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What are 5 possible causes of fever and crying infant?

AOM
Appendicitis
Meningitis
Osteomyelitis
Pneumonia
Sepsis
Viral resp infection

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What would you suspect in an infant with intermittent explosive diarrhea?

Hirschsprung’s

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What are two things that could cause scrotal swelling in an infant? What test would you order?

Testicular torsion
Incarcerated hernia

U/S

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What would you expect in a child with recurrent vomiting?

What test do you order?

Pyloric stenosis

U/S

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What are the diagnostic criteria for pediatric colic?

> 3 hours/day
3 days/week
3 weeks

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What are two treatments for pediatric colic?

Low allergen diet for mom

Probiotic

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What treatment class do you use for CAP?

Macrolide

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How long do you treat CAP?

5-7 days

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What one physical exam finding can you order to determine disposition for CAP?

Sp02

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What inpatient tests would you order to determine the cause of a CAP?

Gram stain and sputum culture
Blood culture
Legionella urinary antigens
PCR for respiratory viruses
PCR for chlamydia pneumonia

List 5 complications of constipation.

Rectal prolapse
Decubitus ulcer
UTI
Urinary retention
Hydronephrosis
Electrolyte disturbance
Fecal incontinence
Abdominal pain
Anorexia/weight loss

What can you offer for local disimpaction of fecal material?

Mineral oil enema
Warm water enema
Glycerin suppository

What osmotic laxative is best tolerated in elderly?

PEG

What percentage of asymptomatic gallstones will become symptomatic?

10-20%

List 3 medication classes for biliary colic.

NSAIDs Opiates Antispasmodics

List 4 complications of gallstones

Acute cholecystitis Choledocholithiasis Gallstone pancreatitis Acute cholangitis

What three imaging studies should be considered with biliary colic and indeterminate U/S?

CT HIDA scan MRCP

List 6 physical exam signs of liver disease.

``` Jaundice Muscle wasting Asterixis Gynecomastia Caput medusa Dupuytren's Testicular atrophy ```

What are 6 complications of liver cirrhosis?

``` HCC Varices Portal hypertension Liver failure Hepatic encephalopathy Spontaneous Bacterial Peritonitis ```

What are 5 risk factors for acquiring viral hepatitis?

``` IVDU High risk sex Tattoos Piercings Transfusions ```

What is the definition of GHTN?

Average sBP or dBP above 140 or 90

What are 8 labtests to do in patients with GHTN?

``` U/A Hgb (increased due to decrease in vascular volume/decreased in HELLP) WBC Platetlets Creatinine Uric acid AST ALT LDH Bilirubin ```

When must you deliver a preeclamptic patient by?

37 weeks. | Equivacal for 34-36+6

What are three BP medications contra-indicated in pregnancy?

ACEi ARB Thiazide diuretics

What are three BP medications safe in pregnancy?

Nifedipine Labetalol Hydralazine (IV)

What are 5 steps in management for pre-eclampsia?

``` Continuous EFM Continuous maternal monitoring Antihypertensives MgSO4 Avoid fluid overload ```

What medication and dose do you use for eclampsia?

MgS04 4g IV

What three medications for short-term treatment of chronic back pain?

NSAIDs Opioids Topiramate

What medications are not effective for chronic low back pain?

Acetaminophen Muscle relaxants Antidepressants

What are three conditions that would make you get imaging for back pain?

Fracture Cauda equina Infection

What causes spine pain worse with extension relieved with flexion?

Spinal stenosis

What two lab tests do you order for pediatric UTI?

U/A | Urine culture

What are 5 clinical signs that together would be suggestive of UTI?

``` Age under 12 months white race Fever Fever longer than 2 days Absence of other source of infection ```

How long do you treat pediatric UTI for?

7-10 days

What imaging do you order for pediatric UTI under 2 years?

Ultrasound of bladder and kidneys

What imaging do you order for two UTIs under age two?

Voiding cystourethrogram

What is the best diagnostic tool for stroke?

Nonconcrast CT

What medication do you treat an ischemic stroke with?

IV tPA

What are the two inclusion criteria for tPA?

Confirmation of ischemic stroke | Last seen normal 4.5 hours before administration

What are 4 contraindication on history for tPA?

Intracranial hemorrhage in previous 6 months Stroke or head/spinal trauma in 3 months Major surgery in 14 days Arterial puncture in 7 days

What are 5 lab findings that are contraindications to tPA

``` Hypoglycemia <2.7 hyperglycemia >22.2 Elevated aPTT Elevated INR>1.7 Platelet count below 100 ```

What are 5 things to help recurrent stroke?

``` HTN treatment Dyslipidemia treatment Diabetes treatment Lifestyle Patient education ```