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BOARD FM > AAFP Questions > Flashcards

AAFP Questions Flashcards

1
Q

Site for emergency tracheostomy

A

Directly above the cricoid cartilage, through the cricothyroid membrane.

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2
Q

Retinal Vein occlusion

A
  • Sudden Painless loss of vision. no redness. HTN and DM are RF. Will see dilated and torturous veins on fundo
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3
Q

What can cause false positives for opioids

A

Ibuprofen, Diphenhydramine, Dextrometharphan, fluroquinolones

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4
Q

Secondary amenorrhea

A

No period for 3 months or irregular period for 6 months. Warrants FSH and LH work up

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5
Q

Colonoscopy screening in IBD

A

10 years after diagnosis and repeat 2-5 years

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6
Q

In which patients tramadol should be avoided in?

A

Seizures

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7
Q

Treatment of Rosacea

A

Doxycycline

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8
Q

Chronic midsubstance Achilles tendinitis

A

It is >6 weeks
Eccentric exercise involving gastronemius and soleus muscle

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9
Q

Which EKG abnormality cannot be evaluated with treadmill stress test?

A

LBBB can lead to false positives.

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10
Q

Which 2 rashes are similar (1 is STD)

A

Rocky mountain fever and Syphilis

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11
Q

Conditions that reduce INR and need HIGHER coumadin dose

A

Hypothyroidism, diabetes, hyperlipidemia, visceral carcinoma

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12
Q

Conditions that increase INR and need LOWER coumadin dose

A
  • Skinny (malnutrition, hyperthyroidism, hypermetabolic state, scurvy, anorexia)
  • Kidney, liver function bad. Heart failure
  • Fever, Infxn
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13
Q

Palavizumab indications

A
  • Born before 29w GA and <1y of age at the beginning of RSV season, or less than 32w GA who develop chronic lung disease of prematurity. After >1y, only if infants have chronic lung disease of prematurity requiring intervention
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14
Q

Maternal benefits of breast feeding

A

Cardiometabolic (Diabetes, HTN)
Ovarian and breast ca
PP depression

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15
Q

Athlete Triad

A

Disordered menses, low bone density and less energy compared to calories burnt.

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16
Q

PVCs

A

PVC burden of >10% can cause dilated CMpathy. Evaluate with echo. Should be treated with anti-arrhythmetics.

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17
Q

Hep A Prophylaxis

A

1-40y: Vaccine only
<1: Immunoglobulin
>40/ immunocomp: Vaccine and immunoglobulin

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18
Q

Pityriasis Versicolor

A

Tx: Selenium sulfide (others are miconazole, terbinafine)

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18
Q

MODY (Mature onset diabetes in young age)

A

Patients who are young, not fat and have preserved pancreatic B cell function. Dont respond to metformin but do to sulfonylureas

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18
Q

Whooping Cough in adults

A

Non-specific URI with intense coughing following. Nasopharyngeal swab and PCR. Azithro not to treat but reduce transmission.

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18
Q

What factors used in BP in kids

A

height (cuff size), sex and age

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18
Q

What is associated with prolonged recovery in concussions?

A

headaches lasting longer than 60 hours, fogginess or 4 or more symptoms post injury

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18
Q

Drugs for osteoporosis

A

Prolia (in renal dysfunction GFR >35) or bisphosphonates (cant do more than 5 years due to inc risk of atypical fractures)

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18
Q

Sesamoid Fracture

A

usually great toe. Blow, trauma, inc physical exercise.

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18
Q

Incidental Adenoma work-up

A

Rule out MACS (small secretion of cortisol) with dexa suppression test

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18
Q

Primary hyperaldosteronism

A
  • Hypertension, hypernatremia, hypokalemia
  • Dx: CT Abd, elevated Ald/renin
  • Treat: U/l adenoma (Sx or aldosterone antag- spironolactone, epleronone) and b/l (aldosterone antagonist or potassium sparing (triamterene, amiloride)
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18
Q

Delirium tremens

A

Occurs 3-10 days post last drink. Even fever can occur.

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18
Q

Cocaine abuse

A

Can cause non-cardiogenic pulmonary edema.

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18
Q

Treatment of resistant heart failure

A

Vasodilators (Hydralazine, nitrates)

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18
Q

Tinea Capitis treatment

A

Oral griseofulvin or terbinafine

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18
Q

Metal FB in eye

A

Can cause rustic ring as it is toxic. Even if able to remove, refer to ophthal within 24-48h

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18
Q

Orthostatic hypotension

A

Drop in SBP 20 and DBP 10 within 3 minutes of standing up. HR changes by at least 30

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19
Q

Timed Up and go

A

10 seconds

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20
Q

Most common pregnancy complications in white woman

A

Obstetric and placental

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21
Q

What to do if a patient on DAPT needs surgery?

A

Should continue ASA but DC clopidogrel 5 days before

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22
Q

Carbapezapine side effect

A

Agranulocytosis

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23
Q

AAP recommendation regarding screening for hyperlidemia

A

Start in 9-11 years

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24
Q

Herald Patch, Christmas tree pattern

A

Oval, erythematous scaly lesions. Seen in Pityriasis roasea

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25
Q

Rockall scoring system for mortality in GIB patients

A
  • Age >60, SBP <100, HR >100, signs of shock and co-morbidities
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26
Q

Rotavirus vaccine age specifications

A

Cant start post 15 weeks and dont continue past 8 months

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27
Q

Mallet Fracture

A

Blow to tip of finger causing distal phalanx fracture. Needs to be in extension splint for 8 weeks if <30% joint space involvement, otherwise need surgery

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28
Q

Hypoactive sexual desire disorder

A

No issues but just lack of sexual interest. In menstruating women, topical testosterone works.

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29
Q

Internal and external hemorrhoid management

A
  • Internal: Banding or infra-red coag
  • External: Elliptical incision if thrombosed and conservative if not.
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30
Q

Myelodysplastic syndrome

A

Causes megaloblastic anemia, thrombocytopenia and leukopenia. Before formation to leukemia

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31
Q

Stages of Asthma

A
  • Intermittent (rule of 2): <2 days/wk, <2 nights/month, <2 days SABA/week. Normal FEV1 and ratio normal
  • Mild persistent (rule of 2): >2d/w, up to 4n/mo, >2x SABA/week. FEV >80
  • Mod persistent: Daily day symptoms and SABA use, x1n/week. FEV1 <80. Ratio reduced by 5
  • Severe persistent: Daily, nightly, SABA mutliple times a day. FEV1 <60 and ratio reduced >5
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32
Q

SSRI you CANNOT use in pregnant

A

Paroxitine

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33
Q

Zoster Oticus

A
  • Painful vesicles around palate and ears. Called Ramsay hunt syndrome if facial nerve involved.
  • Careful to differentiate from herpes which only causes lesions in mouth
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34
Q

Occupational resp issues
-Asbestosis
- Silica
- Berrylium

A
  • Asbestos: Ships, rail workers, boilermakers
  • Silica: Sandblasters
  • Berrylium: Mining and manufacturing
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35
Q

What happens to HR with age?

A

Resting and exercising HR decreases with age

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36
Q

Which medications are contraindicated in patients with cirrhosis?

A

NSAIDs.. As it can precipitate hepatorenal syndrome.

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37
Q

Erythrasma

A
  • Erythematous and itchy patch
  • Caused by cornybacterium
  • Coral red on woods lamp
  • Treat with topical erythromycin
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38
Q

GBS PPx in pregnancy in penicillin allergic patient

A

Cefazolin and Vanc/Clinda if higher concern for anaphylaxis.

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39
Q

Hoarseness

A

If persists >3 months, should be evaluated with laryngoscopy

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40
Q

Kidney stones

A
  • Calcium oxalate, uric acid, cysteine form in acidic urine
  • Struvite and calcium phos form in alkaline urine
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41
Q

Acne

A
  • Non-inflammatory acne (comedones)- Treat with topical retinoids.
  • Inflammatory (papules, pustules)- Mild/Mod (topical Abx but with BP) and severe (oral Abx).
  • Resistant- Oral Tret
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42
Q

Most SPECIFIC sign of SCFE

A

internal rotation of the hip, especially when hip is flexed 90 degrees

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43
Q

Hypersensitivity pneumonitis

A

SOB, cough, chills appears within 4-6 weeks of exposure like mold. Usually resolves on own and get rid of offending agent.

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44
Q

Most common metabolic abnormality in CKD

A

Hyperparathyroidism. Ca and Phos levels are monitored every 3-6 months. alk phos every 6-12 months.

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45
Q

How to treat cough of normal cold?

A

Inhaled ipratropium is the ONLY recommended medicine.

46
Q

Jaundice in newborns

A
  • Breast milk Jaundice: Peaks around 2 weeks. Good weight gain.
  • Breastfeeding Jaundice: When less breast milk is given. Low weight.
  • Physiologic: appears <4 days.
  • ABO hemolytic Jaundice: Mother has O pos blood and baby has A, B, A/B
47
Q

Fluoride in children

A
  • Supplement >6 months
  • Deficiency appears with opaque, flecks in a lacy pattern or mottling.
48
Q

Switching from dabigatran to warfarin

A

Start warfarin 3 days before stopping dabigatran.

49
Q

Incision to drain a felon

A

High lateral

50
Q

DRESS syndrome (Drug related eosinophilia and systemic symptoms)

A
  • 1/3 cases are by ant-epileptics and highest mortality is with Allopurinol
  • Presents with erythroderma, fever, LNpathy, eosinophilia and elevated liver enzymes
  • Tx: Stop drug and start steroids.
51
Q

Marfan syndrome

A
  • Echo if family history even if asymptomatic. If symptomatic then 2 or more of features. Need echo every 6 months. Treat with BB
52
Q

Most common stress fracture

A

Tibial

52
Q

False positives of drug abuse

A

poppy seed, selegine, NSAID, dextromethorphan, venlafaxine, rifampin, vicks

53
Q

Hyperthyroidism in pregnancy

A

PTU in first trimester and then methimazole

54
Q

Fat pad Atrophy

A

Common cause of heel pain geriatric patients. Get worse as the day goes by

55
Q

Worst withdrawal in which SSRI?

A

Venlafaxine. Abrupt withdrawal with confusion, agitation, seizures.

56
Q

Incontinence MOA

A
  • Stress incontinence (Sphincter problem)
  • Urge (Detruser instability)
  • Overflow (detruser hypotonia)
57
Q

Melanoma diagnosis and treatment

A
  • Diagnose with elliptical excision
  • Treat with MOHS
58
Q

Best treatment for SVT if no underlying heart conditions

A

Adenosine push

59
Q

Chlamydia

A

Should be screened and treated as it can lead to infertility in the future.
Treat partners in the last 60 days .
Avoid sex for 7 days after treatment.
Does need test of cure.

60
Q

Morning sickness in pregnancy

A

If more than 9 weeks then need to look for a different cause.

61
Q

Most common cause of seizures in old people

A

Stroke

62
Q

Age related macular degeneration risk factors

A

Hypertension and smoking

63
Q

Abnormal pap test- Most dangerous lesion

A

Atypical glandular cells not other specified. precancerous.

64
Q

Granuloma Annulare

A

Looks like ring worm. May not respond to anti-fungal, can use topical steroids but usually self limiting.

65
Q

When is surgery indicated in Dupytrens Contracture?

A

If MCP is more than 30 degrees or PIP joint of any degree

66
Q

How often do we need to repeat cologuard?

A

Every 3 years

67
Q

Most common causes of cough in adults and children

A
  • Adults: Upper airway cough syndrome, Asthma, Eosinophilic bronchitis and GERD
  • Kids: UACS, bacterial bronchitis and asthma
68
Q

Appropriate treatment of acute rhinosinusitis (No Abx)

A

Intranasal steroids.

69
Q

ADHD treatment

A

Meds only after 6 years. 5-6 years should be treated with behavioral therapy

70
Q

Excess of which vitamin is associated with hypercalcemia

A

Vitamin A

71
Q

Test of diagnosis for Cushing’s Syndrome

A

Urinary cortisol, dex suppresion test

72
Q

Penis lesions

A
  1. Pearly penile lesions: Small skin colored dome lesions around sulcus glans
  2. Lichen Nitidus: Hypopigmented lesions
  3. Lichen Sclerosis: Hypopigmented lesions that itch and bleed. May predispose to Ca.
  4. Ca: Beefy red lesions
  5. Angiokeratomas: Reddish-bluish papules around penis and scrotum
73
Q

Treatment of chronic tension type headache

A

Amitryptiline. Reduces duration and frequency

74
Q

When should you get MRI of breasts

A

Women at very high risk for breast cancer such as those with genetic mutations, a history of breast irradiation, or a very high-risk family history.

75
Q

Leser Trelat sign

A

Sudden onset of SK can indicate malignancy especially stomach adenocarcinoma

76
Q

Which is the most common reason for hirsutism?

A

PCOS

77
Q

Preoperative management of Warfarin

A
  • High risk patients (TIA/Stroke/DVT/Heart valve within last 3 months or stenting within last 6 months) would need bridging therapy
  • Low risk can have warfarin stopped 5 days prior and restart 1-2 days later
78
Q

What is the common etiology of acute bronchitis

A

99% of cases are viral adn 1% is others

79
Q

WPW syndrome treatment

A

Catheter ablation

80
Q

Treatment of pulmonary hypertension secondary to COPD

A

Supplemental oxygen. Treatments of pulmonary arterial hypertension should not be used and can cause V/Q mismatch

81
Q

Which antihypertensive can help with OSA

A

OSA can lead to resistant HTN. Spironolactone can reduce pharyngeal edema.

82
Q

Fetal Alcohol syndrome

A

Curvature of the fifth finger of hands or flexion deformity of fingers

83
Q

Which is an absolute contraindication of fibrinolytic therapy?

A

Ischemic stroke within last 3 months with patients with STEMI unless present within 4.5 hours.

84
Q

Lymphadenopathy in patients

A

Older patients with chronic Lpathy shoulder undergo biopsy evaluation.

85
Q

Post bariatric surgery monitoring

A
  • DEXA every 2 years
  • CBC, BMP, Vitamin D and B12
  • Wait 12-18 months to get pregnant
  • No fluids before and after meals
86
Q

Functional ovarian cyst

A

Usually go away and repeat in 8-12 weeks.
>10 cm or symptomatic then can consider removal
CA-125 only for post menopausal

87
Q

Who should be treated for asymptomatic bacteruria

A

Pregnant, before prostate or urological procedure

88
Q

When should we start checking BP in kids?

A

3 years

89
Q

Precocious puberty in boys age

A

<9

90
Q

Lupus treatment

A

Mild: Hydroxychloroquine (dec arthritic pain)
Moderate, lupus nephritis: Azathioprine, cyclosporine
Severe and refractory: Rituximab, Mycophenalate

91
Q

Low and high BNP

A

Low: Obese
High: elevated creatinine or low albumin

92
Q

Anticoagulation decision with elderly

A

Use CHADsVASc. If concern for bleeding especially if >65 then use HAS-BLED.

93
Q

Factors that predict if cardioversion will be successful in an A.fib patient

A

LA size (the larger, the worse outcome), underlying heart disease (RHD) and time patient has been in A.fib.

94
Q

How to evaluate for scoliosis

A

Bent over test- 90 degrees parallel to the floor and use a scoliometer
Can get xrays and use the cobb angle (usually more than 20 degress)

95
Q

AAP screening
-Dyslipidemia
- Depression
- IDA

A

Dyslipidemia 9-11
Depression 11-21
IDA 1

96
Q

Plaque Psoriasis treatment

A

Topical steroids. If still have symptoms can ADD calcipotriene or tazarotene

97
Q

Nutrition in severe pancreatitis

A

Enteral is preferred. Helps maintain gut barrier.

98
Q

Chronic paroxysmal hemicrania

A

Like cluster headaches. But occur in women multiple times a day. Responsive to indomethacin

99
Q

Treating Insomnia

A

Melatonin, doxepin then Lunesta (Eszopiclone) which has longer half life or zaleplon

100
Q

Carotid artery stenosis

A

Asymptomatic would need Statin and yearly USG.
>70% would need intervention

101
Q

Solar Lentigines

A

Liver spots. Need biopsy if bleeds, itches, painful or rapidly grow. Can be treated with cryotherapy, topical retinoids.

102
Q

Topamax side effect

A

Can cause metabolic acidosis and lead to hypercalciuria and leads to stone formation

103
Q

Factors that predict severity of pancreatitis

A

Cr, BUN, hematocrit

104
Q

Stress cardiomyopathy management

A

Treat with BB, ACE I and diuretic. Dont need a statin.

105
Q

Alcohol use disorder in early remission

A

Should have not had a drink for at least 3 months but less than 12

106
Q

Cobb angle more than what needs surgical referral/bracing

A

> 25 will need bracing and monitoring
40 would need surgery

107
Q

Treatment of anti-depressant induced sexual dysfunction

A

Wellbutrin

108
Q

Blepharitis

A

Inflammation of eyelids and can present with some crusting. Treatment with warm compress and mild shampoo. Moderate with topical Abx and severe with oral Abx.

109
Q

Is EKG needed for pre-op?

A

Only for high risk surgeries or if patients have cardiac history no matter the age

110
Q

Biggest risk factors for esophageal cancer

A

Obesity or GERD

111
Q

Aricept side effect

A

Can cause bradycardia and part of beer’s criteria

112
Q

First line anti-hypertensive in pregnancy

A

Oral labatolol. Not Nifedipine as it can cause hypotension.

113
Q

Anti-depressant which can be used in hospice and has shortest time to act

A

Ritalin (psychostimulant). Takes couple days to act.

114
Q

ICU related delirum treatment

A

Atypical Antipsychotics (Zyprexa, seroquel)

115
Q

Lithium side effects

A

Li- Leucocytes increase (leucocytosis)
Th- Thyroid
IU- Inc urination (DI)
M- Maformation (Ebstein)

116
Q

Pustular Rosacea treatment

A

Doxycyline

117
Q

ACS Abx

A

Always cover for Atypicals with Azitho

118
Q

Factors associated with recurrence of BCC

A
  • Mask areas, hand/feet/genetalia
  • > 2cm and more than 0.6 cm in HR areas
119
Q

When is extracoporal shock therapy useful?

A

Rotator cuff calcific tendinitis

120
Q

Common side effect of Aromatase inhibitors

A

Like Letrozole.
Causes myalgias

121
Q

What type of anemia is common with Mylodysplastic syndrome?

A

Macrocytic Anemia

122
Q

Which head bleed needs immediate neurosurgical ref?

A

Cerebellar.
INR >1.5 needs reversal

123
Q

Bipolar depression treatment

A

Lithium or depakote

124
Q

CDC recs regarding travelling to TB endemic areas

A

Obtain a skin test prior to leaving and then get another 8-10 weeks after

125
Q

Adrenarche

A

Usually if that is before sexual characteristics have developed then is idiopathic

126
Q

What is severity of Anorexia based on?

A

BMI

127
Q

Waldenstrom Microalbuminuria

A

+Bens Jones proteins

128
Q

Which childhood condition is most effective with intense BT

A

Autism and should be started before 3.

129
Q

Statins

A

Moderate: Simvastatin 20-40, Lipitor 10-20
High: Lipitor 40-80, Crestor 20-40

130
Q

Infantile hemangioma

A

gone by 5 mo. steroid injection

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