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PGY-4 Board Prep > Adult Primary Care > Flashcards

Adult Primary Care Flashcards

1
Q

Screening for diabetes - ADA

A

everyone over 45
Adults w/ BMI >25 or 23 if Asian + RF
q3 years

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2
Q

Metformin MOA

A

decrease hepatic glucose output

enhance insulin sensitivity

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3
Q

SGLT-2 inhibitors MOA

A

blocking renal glucose absorption

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4
Q

SGLT-2 inhibitors name of drugs

A

“ifozin”

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5
Q

SGLT-2 inhibitors adverse effects

A

gential/urinary infections
need to be decreased in CKD
increased risk of DKA

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6
Q

GLP-1 receptor agonists MOA

A

mimic effects of increntins + delay gastric emptying (wt loss)

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7
Q

GLP-1 receptor agonists names

A

-“atide”; injectable!

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8
Q

GLP-1 receptor agonists AE

A

GI side effects

pancreatitis

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9
Q

DPP4 Inhibitors MOA

A

increase incretins

increased risk of pancreatitis

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10
Q

Example of DPP4 Inhibitor

A

sitagliptin (Januvia)

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11
Q

Colon Cancer Screening

A

Age 50-75

annual FOBT or q10y colonoscopy

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12
Q

Early Screening for Colon Cancer

A

High risk pts include those with a relative <60 or at least 2 relatives at any age
Start at 40 or 10 years before
Screen q5y

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13
Q

Breast Cancer Screening Ages

A

40/50-75

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14
Q

Cervical Cancer Screening Ages

A

21-65

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15
Q

Lung Cancer Screening

A

ages 55-80
at least 30 pack years
current or quit in the last 15 years

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16
Q

Abdominal Aorta Aneurysm Screening

A

Men 65-75 who have smoked!

selective screening for family history in non-smokers in this age range

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17
Q

Osteoporosis screening

A

DEXA at 65 or 10 year risk of 8.4%

possibly age 70 in men

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18
Q

Lipid Screening

A

age 40-75, q5y

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19
Q

STD Screening

A

all women <24, gonorrhea + chlymadia

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20
Q

Weight Loss Surgery if BMI…

A

> 40 or >35 + comorbidities

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21
Q

L3 Sensation

A

anterior thigh/knee

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22
Q

L4 Sensation

A

anterior shin

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23
Q

Patellar Reflexes

A

L4 nerve root

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24
Q

L5 Sensation

A

dorsum of foot

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25
Q

Weak great toe dorsiflexion

A

L5 nerve root

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26
Q

Ankle Reflexes

A

S1 Nerve root

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27
Q

Weak Toe Walk

A

S1 Nerve root

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28
Q

spondylosis
spondylolisthesis
spondylolysis

A

spondylosis - disc space narrowing
spondylolisthesis - anterior displacement of vertebrae
spondylolysis - non union fracture of pars

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29
Q

lordosis

A

inward curvature of lumbar spine

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30
Q

kyphosis

A

outward curvature of thoracic spine

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31
Q

straight leg raise test positive

A

sciatic symptoms at angle less than 60

radicular pain below the knee

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32
Q

straight leg raise test specify and sensitive

A

sensitive but not specific

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33
Q

increasing specificity of SLR test

A

great toe dorsiflexion and contralateral test

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34
Q

Cervical Radiculopathy

A

compression of nerve root

radiation arm pain and numbness

35
Q

Spurling Test

A

test for cervical radiculopathy
extend and lateral flex neck, apply downward pressure
positive = reproduce pain

36
Q

Cervical Myelopathy

A

compression of cervical spinal cord

difficulty with dexterity, fine object manipulation, upper motor signs

37
Q

Lateral Epicondylitis

A

tennis elbow
repetitive use of extensor tendons
pain w/ increased wrist extension

38
Q

Medial Epicondylitis

A

golfers elbow
repetitive flexion
worse with resisted wrist flexion

39
Q

Olecranon Bursitis

A

posterior elbow swelling and tenderness

usually due to trauma, gout, infection

40
Q

Ulnar Nerve Entrapment

A

parathesias and numbness of 4th and 5th digit

41
Q

Phanel Test

A

flexion of hands at wrist

42
Q

Tinel Test

A

percussion of median nuerve

43
Q

Scaphoid fracture

A

falling onto extended hand

pain and tenderness in anatomic snuff box

44
Q

DeQuervian Tendonopathy

A

pain at thumb base

45
Q

HPV Vaccine ages for three dose series

A

Three doses 13-26 for all male and female

shared decision making 27-45

46
Q

Osteoporosis Screening in less than 65, risk

A

10 year fracture risk >9.3

47
Q

Alcohol Use Disorder : Naltrexone

A

first line in those w/ CKD

CI in cirrhosis

48
Q

Indications for Bariatric Surgery

A

BMI >40 or >35 + weight related comorbidities

49
Q

Indications for Weight Loss Medications

A

BMI >30 or >27 + weight related comorbidities

50
Q

AUSAI in BPH

A

Medications for scores >8

51
Q

Treatment for Epididymitis

A

<35 ceftriaxone + doxy

>35 ceftriaxone + FQ

52
Q

HRT for Menopause

A

if uterus, estrogen + progesterone (avoid unopposed estrogen-related endometrial proliferation)

53
Q

AUB Management, pre versus post menopausal

A

pre: U/S
post: endometrial biopsy

54
Q

Bacterial Vaginosis - Dx

A

Fishy odor
Thin white or gray
+ whiff test
clue cells

55
Q

Trichomoniasis - Dx

A

discolored d/c
strawberry cervix
wet mount w/ trichomonads

56
Q

Eye dx - FB sensation

57
Q

What needs immediate ophtho eval?

A

keratitis
scleritis
uveitis/iritis

58
Q

Keratitis Symptoms

A

FB sensation
Blurred vision
Dendritic Branching
Ciliary Flush

59
Q

Episcleritis

A

Minimal pain

Superficial redness of vessels!

60
Q

Scleritis

A

pain w/ eye movements, globe tenderness
tearing, photophobia, decreased or loss of vision
diffuse red/violet coloration

61
Q

Uveitis/Iritis

A

floaters

hypopyon, ciliary flush

62
Q

Ciliary Flush in…

A

uveitis or keratitis

63
Q

Hypopyon

A

fluid in dependent portion of anterior chamber

uveitis/iritis

64
Q

Age Related Macular Degeneration Symptoms

A

dry - slowly vision loss versus wet - acute vision loss

painless blurring, warping of central vision, scotoma

65
Q

ARMD Dry exam findings

A

drusen (yellow-white lesions)

66
Q

ARMD Treatment

A
  • smoking cessation
  • anti-oxidants
  • VEGF inhibitor eye injections
67
Q

Optic Neuritis

A

afferent pupillary defect
pain w/ eye movement
vision loss, esp loss of color vision

68
Q

Retinal Detachment

A

unilateral increase in floaters –> sudden, peripheral vison loss (“black curtain”
urgent ophtho consult

69
Q

Retinal Artery Occlusion

A

acute, painless, vision loss
cherry red spot surrounded by retinal pallor
urgent ophtho consult

70
Q

Retinal Vein Occlusion

A

acute painless vision loss
retinal hemorrhage and cotton-wool spots
urgent ophtho consult

71
Q

Primary Open-Angle Glaucoma

A

bilateral painless gradual peripheral vision loss

72
Q

Angle-Closure Glaucoma

A

acute severe eye pain, increased ICP symptoms (N/V/HA)
blurred vision in halos around lights
dilated fixed pupil

73
Q

Weber Test

A

conductive hearing loss = louder in affected ear

sensioneural hearing loss = louder in unaffected ear

74
Q

Rinne Test

A

Normal: AC > BC
Conductive: decreased in affected ear, BC >AC
Sensineural: loud/louder in affected ear, AC>BC

75
Q

Causes of Conductive Hearing Loss

A

cerumen impaction, TM perf
otosclerosis
cholesteatoma

76
Q

Ototoxic drugs (sensineural hearing loss)

A

aminoglycosides
NSAIDs
loop diuretics

77
Q

Paroxetine AE

A

weight gain, sexual dysfunction

78
Q

Antidepressant with lowest rate of discontinuation syndrome

A

fluoxetine

79
Q

Stress Incontinence Rx

A

pelvic floor training+/- biofeedback
No medications
consider pessaries

80
Q

Urgency Incontinence Rx

A

bladder training, timed voiding

Rx - Antimuscarinics > Mirabegron

81
Q

Overflow Incontinence Rx

A

double voiding, triggered voiding, catheriziation

If BPH, can use alpha blocker/5alpha reductase

82
Q

Functional Incontinence Rx

A

caregiver-prompted timed voiding

83
Q

Timed Up and Go Test abnormal if

A

longer than 12 seconds

PGY-4 Board Prep (18 decks)

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