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kelly's fam med AQ cases > 9 > Flashcards

9 Flashcards

1
Q

sequence of meds for increasing severity of asthma

A

1) SABA
2) SABA + ICS
3) SABA + ICS + LABA
4) SABA + ICS + LABA + po CVS

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2
Q

What is the treatment for asthma exacerbation?

A

Nebulizer + Steroids

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3
Q

What is the role of HIDA scan in gall bladder disease?

A

Allows you to visualize perfusion and see whether there are blockages

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4
Q

What are 3 colon genetic syndromes?

A

FAP, Lynch Syndrome, Peutz Jeghers

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5
Q

What are the 3 main cancers associated with Lynch Syndrome (mutation in DNA mismatch?

A

CEO - Colorectal, Endometrial, Ovarian

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6
Q

What 3 labs are helpful when diagnosing hemolytic anemia?

A

LDH, haptoglobin, bili

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7
Q

Who should be screened for DM?

A

> 45 y/o, BMI > 25, HTN

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8
Q

What fasting BG and A1C are pre-diabetes?

A

BG 100-125 and A1c 5.7-6.4

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9
Q

A patient is diagnosed with DM based on A1C of 9.5 What is appropriate treatment?

A

If A1C > 9 then start tx with INSULIN

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10
Q

What are SE of Metformin?

A

Lactic acidosis, Diarrhea

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11
Q

SE of Sulfonylurea?

A

Hypoglycemia, espeically susceptible if kidney disease since renally cleared

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12
Q

What is the equation for anion gap?

A

AG = ( Na + K ) - ( Cl + HCO3 )

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13
Q

A kid has bone aches, nose bleeds and bruises. What should you be thinking of?

A

AML

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14
Q

What are some structural causes of abnormal uterine bleeding?

A

PALM = Polyps, Adenomyosis, Leiomyomata, Malignancy/Hyperplasia

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15
Q

What is the Rotterdam criteria for PCOS diagnosis?

A

Polycystic ovaries by US
Hyperandrogenism (hirsutism, acne)
Dysmenorrhea

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16
Q

What does SIGECAPS stand for in depression screening?

A 
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor retardation
Suicidality
17
Q

You are contemplating diagnosis of dementia for a patient. What sort of workup should you do to rule out other causes?

A 
Depression screen (can look like and can be a co-morbid condition)
complete blood counts
basic chemistries
calcium
thyroid
vitamin B12 deficiency testing
folate deficiency
syphilis testing 
neuroimaging - brain MRI good place to start
18
Q

3 most common causes of dementia?

A

Alzheimers, vascular dementia, dementia with lewy bodies

19
Q

What is the name of frontotemporal dementia presenting with changes in personality, demeanor, and behavior?

A

Picks disease

20
Q

Differentiate delirium from dementia?

A

Delirium symptoms fluctuate over short periods of time, whereas dementia is a gradual decline

21
Q

What bedside instrument can help diagnose delirium?

A

Confusion Assessment Method (CAM)

22
Q

Which two tests can help assess cognitive function?

A

MMSE, MoCA

23
Q

Are the following IADLs or ADLs?
shopping

preparing meal
using the telephone
managing transportation needs
managing medications
managing finances
A

IADLs - skills required for independent living

24
Q

What is arcus senilis?

A

Grayish ring around eye. Common finding in elderly, and also seen in younger patients with hypercholesterolemia

25
Q

What makes up the mini-cog?

A

composite of the three-item recall and clock drawing

26
Q

Describe the Mini-Cog.

A

Ask the patient to remember 3 words. Have patient draw a clock with the clock face representing 10 past 11. Then ask the patient to recall the 3 words.

27
Q

Patient presents with acute worsening from baseline dementia. What is on your differential?

A 
Depression
Electrolyte abnormalities
UTI
Urinary retention
URI
Pain
Withdrawal
Acute Cerebral Vascular Event
Adverse drug effects
28
Q

What are some examples of electrolye abnormalities that can lead to delirium?

A

hypo or hypernatremia, hypercalcemia, hypokalemia, and metabolic acidosis

29
Q

What post void residual is normal?

A

< 100 ml

30
Q

A demented nursing home patient is having urinary incontinence. What is your ddx?

A

UTI or urinary retention secondary to medications or BPH with secondary overflow incontence

31
Q

What is a good empirical antibiotic treatment of UTI?

A

Ceftriaxone and cephalexin

32
Q

You place a patient with delirium on haloperidol to decrease hallucinations and agitation. What are some side effects to watch out for?

A

Sedation, constipation, tardive dyskinesia (involuntary spasms of the neck, tongue and lips - high doses for long periods), QT prolongation

33
Q

What medications have a role in treatment of Alzheimers and symptoms?

A

cholinesterase inhibitors (donepezil, rivastigmine, tacrine and galantamine)
Vitamin E
Memantine
Atypical Antipsychotics for ebhavioral disturbances - olanzapine (Zyprexa) and risperidone (Risperdal)

kelly's fam med AQ cases (10 decks)

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