ABFM Boards Flashcards
Why no anticholinergics with breastfeeding?
Long term, anticholinergic effects inhibit oxytocin and GH release
What class does meclizine belong to?
Antihistamine
How does progesterone affect breastfeeding?
Interferes with prolactin binding to alveolar breast cells
How can reglan affect breastfeeding?
Reglan is a galactogogue. Will increase prolactin levels.
X-linked ichthyosis is associated with what?
low/undetectable estriol level
MOA of Alzheimer’s
reduced choline acetyl transferase leading to decreased ACh and cortical function
Class of agents for initial tx. mild Alzheimer’s
Give examples (4).
Cholinesterase inhibitors (reduce progression and improve symptoms of disease)
Donepezil [Aricept]
Rivastigmine [Exelon]
Galantamine [Reminyl]
Tacrine [Cognex]”
Why was Tacrine discontinued in 2012?
Hepatotoxicity, GI side effects
What is treatment for MGUS?
Watchful waiting
What is an indication for Rhogam in the FIRST trimester?
Rh negative mom with vaginal bleeding
When is Rhogam usually given?
28 weeks
erythema annularea centriguam. Description and key info?
can be fungi-related, can be cancer related
have a “trailing” scale
What causes erythema chronicum migrans?
Lyme Disease
What disease is erythema marginatum seen?
Rheumatic fever
How long should sutures below the knee be left in place?
10-14 days
At what age: rolling over back to front and crawling/creeping?
by 7 months
At what age: pincer grasp (2)?
immature: 6-8 months
mature: 10-11 months
At what age: pull to stand?
9 months
At what age: 10 word vocab, mama, dada, 1-step commands, separation anxiety at bedtime, object permanence, beginning of self-conscious awareness?
18 months
At what age: broad jump
36 months
Difference between ectopic pregnancy and spontaneous abortion?
ectopic is painful and first trimester, whereas spontaneous is painLESS
Addison’s Disease v. Cushing’s Disease
Addisons: adrenal insufficiency. Cortisol and aldosterone are decreased, but ACTH is increased.
Cushing’s: pituitary ACTH excess leading to excess cortisol. And suppression by dexamethasone.
At what age: laugh responsively?
4 months
If woman has a clot, what would be best tx. of menorrhagia?
Progesterone-only modality: Mirena, Depo. (No estrogen-containing products/OCPs)
What antibiotics are contraindicated in pregnancy (5 categories)?
Fluoroquinolones: harm to fetus
TMP (1st trimester): neural tube defects
Nitrofurantoin (3rd trimester): hemolytic anemia
Sulfa (3rd trimester): jaundice
Tetracyclines (all trimesters): tooth discoloration
What class of medications can commonly cause abnormal uterine bleeding/anovulation?
Antipsychotics (e.g. Haldol)
Sensitivity
TP/(TP+FN)
If a person has a disease, how often will the test be positive.
If highly sensitive, and the test result is negative, person does NOT have the disease.
Helps rule out disease “SNOUT”
Specificity
TN/(TN+FP)
If a person DOES NOT have the disease, how often will the test be negative?
If test is positive, they likely have the disease.
Rules in diagnosis “SPIN”
Positive Predictive Value
TP/(TP + FP)
What is the chance that an individual with a positive test has the disease?
Negative Predictive Value
TN/(TN + FN)
If the test result is negative, what are the chances that the person DOES NOT have the disease?
e.g. D-Dimer (negative D-Dimer reliably excludes PE)
Give an example of what p value and confidence interval mean in relation to each other?
for example: if p = 0.012, and the confidence interval is a range, THEN: there is a 1.2% probability of achieving the same study outcome if the null hypothesis is true
If Lachman test has sensitivity of 85% and specificity of 94%, what does that mean? What is it good to test for?
Specificity: if a person has a positive Lachman test, then chances are they have the condition.
Tests for ACL tears.
Common cause of meningitis in children 1+ mo.
S. Pneumonia, N. meningitidis
What are some of the mainstay drugs to treat bipolar disease?
Valproic acid [Depakote]
Llithium
What is the most common US finding of ovarian torsion?
Ovarian enlargement.
Abnormal flow is suggestive but not confirmatory.
What are risk factors for asthma-related death?
comorbidities illicit drug use low socioeconomic status psych problems previous intubation 2+ hospitalizations/3+ ER visits in past year
What PEF value indicates a severe asthma exacerbation?
<40%
An oral corticosteroid given within ____ of admission to the ER has been shown to decrease the risk of hospitalization?
1 hr
Over ____ % of patients with COPD have high bacterial concentrations in the lower airways
50
Granulomatosis with polyangitis: kidney biopsy pattern
crescentic glomerulonephritis, no immune deposits (pauci-immune)
Anti-glomerular basement membrane: kidney biopsy pattern
linear immune complex (Ab to Type IV collagen)
What is the preferred anticoagulant to use in renal failure?
Warfarin
What is the diagnosis and treatment for sclerodermal renal crisis?
DX:
CBC with smear
Serum Cr
Estimate GFR/test urine protein:creatinine ratio
Tx:
ACEi
What makes up Killian’s triangle of Zenker diverticulum?
inferior constrictor muscles
posterior hypopharynx
cricopharyngeus mm
True or false: HIV infection is not an indication for inpatient management of Pelvic Inflammatory Disease?
TRUE. HIV infection is NOT an indication for inpatient management of PID.
True or false: IgE-based food allergy tests coincide with trigger foods all the time.
FALSE: Even if test is + for a food and you eliminate it, it might not achieve disease remission. In contrast, food elimination diet in negative allergy test patients was found to be effective.
When does teething begin?
6-8 mo.
Why should you start thyroxine 50-100 pg/day in maternal hypothyroid patients?
Higher risk of pre-eclampsia, abruption, lower IQ
What is pseudohypertension?
Loss of elasticity/compliance of vessels prevents collapse via blood pressure cuff, so Korotkoff sounds are heard immediately and BP appears grossly elevated. Happens often in ICU settings. Often older pts.
True or False: Breastfeeding provides adequate levels of vitamin D.
False. Breastfeeding does NOT provide adequate levels of Vitamin D.
What is recommended suggestion of Vitamin D supplementation for breastfed infant? When should it start?
400 IU Vitamin D daily started within first 2 months
Posterior sternoclavicular joint dislocations are a life-threatening emergency. Why?
Dyspnea
Dysphagia
Hoarseness (recurrent laryngeal n. injury)
Upper extremity paresthesias
What is commotio cordis?
arrhythmia caused by blow to the chest
Sudden onset SOB in teenager who was playing sports?
vocal cord dysfunction
What are the 4 Centor criteria? And what is it used for?
Fever
Tender neck adenopathy
Exudative tonsillitis
NO cough
Centor criteria is used to determine the likelihood of a bacterial infection in a person who complains of a sore throat.
S&S of Kawasaki Dz.
Most concerning complication of it?
"5+ day fever conjunctivitis cervical lymphadenopathy red lips/strawberry tongue/edema erythema/edema of hands and feet polymorphous rash ESR elevated medium-sized vessel vasculitis
Coronary Artery Disease”
