Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Family Medicine > Case Files 7-12 (J) > Flashcards

Case Files 7-12 (J) Flashcards

1
Q

What is the single greatest cause of preventable death?

A

Tobacco use (no shit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the “5 A’s” of tobacco cessation?

A

Ask about use

Advise to quit

Assess willingness

Assist

Arrange followup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 non-nicotine pharmacological treatment adjuncts for smoking?

A

Buproprion (wellbutrin) and varenicline (chantix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A pregnant woman wants to quit smoking, what can we prescribe her?

A

Both Buproprion (wellbutrin) and varenicline (chantix) are category C and considered safe in pregnancy. nicotine replacements are category D.

  • Buproprion = antidepressant (helps with withdrawal symptoms and cravings)*
  • Varenicline = nicotonic receptor partial agonist (decreases cravings and pleasurable effects)*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or False: Most smokers fail quitting multiple times before finally quitting.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 65yo female presents with worsening dyspnea, fatigue, dizziness, and palpitations. She has conjuctival pallor on PE. Most likely diagnosis?

A

Anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 65yo female presents with worsening dyspnea, fatigue, dizziness, and palpitations. She has conjuctival pallor on PE. Next Step?

A

CBC with RBC indices, and a reticulocyte count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A 65yo female presents with worsening dyspnea, fatigue, dizziness, and palpitations. She is demented and confused. On PE she has Glossitis, decreased vibratory senses, ataxia, paresthsia, and pearly gray hair at her temples. What is the most likely cause of her anemia?

A

Vitamin B12 deficiency. If she did not have the neurological defects it is suggestive of a folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 65yo female presents with worsening dyspnea, fatigue, dizziness, and palpitations. On PE she has Glossitis, koilonychias (spoon nails), and dysphagia. What is the most likely cause of her anemia?

A

Profound iron deficiency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of microcytic anemia?

A

Iron deficiency (most common), chronic disease, thalassemia, sideroblastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of macrocytic anemia?

A

B12 deficiency (most common), folate deficiency (most common) (yes they are both most common. deal with it), hypothyroid, Chemo, Liver disease, myelodysplastic syndrome

B12 and Folate are both needed to generate precursors for DNA and RNA division. Without them, RBCs grow (in preparation for chromosomal duplication) and stall because they cannot pair precursors to multiply…“stuck being big” = megaloblatic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of normocytic anemia?

A

renal failure, multiple myeloma, acute blood loss, hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you differentiate anemia due to low iron from chronic disease?

A

Low Iron: Low serum Iron, Low Transferrin, Low ferritin, High TIBC

Chronic Disease: Low/Normal serum iron, Low/normal transferrin, high/normal ferritin, Low TIBC

  • Ferritin = storage form*
  • Transferrin = carrier form (blood)*
  • TIBC = blood test for iron (transferrin should normally be 1/3 saturated)*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the hemoglobin threshold for transfusion?

A

Less than 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common cause of B12 deficiency?

A

Pernicious anemia (lack of intrinsic factor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common cause of folate deficiency?

A

Alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a common cause of anemia in geriatric patients?

A

GI bleed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A 40 yo male comes in complaining of nausea, vomiting, and diarrhea. on PE he has dry mucus membranes (or is found to have orthostatic hypotension). what is the appropriate next step?

A

fluid resuscitation. either NS or LR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what % of acute diarrhea is infections.

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

“Doc! I just got back from Mexico and i cant stop shitting. what’s causing this?”

A

most likely enterotoxigenic E Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

“Doc! I just got back from camping and i cant stop shitting. what’s causing this?”

A

most likely Giardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

“Doc! I just got back from the on base family day cook-out and i cant stop shitting. what’s causing this?”

A

6 hours ago? Staph Aureus

8-12 hours ago? Clostridium perfringens

12-14 hours ago? E coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

“Doc! I cant stop shitting. I think I ate some undercooked chicken.” what’s causing this?

A

most likely Salmonella or Shigella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

“Doc! I cant stop shitting. I think I ate some undercooked hamburger.” what’s causing this?

A

enterohemorrhagic E. Coli

25
Q

“Doc! I cant stop shitting. I think I ate some raw seafood.” what’s causing this?

A

Vibrio, Salmonella, or hepatitis A

26
Q

Which patient groups with acute diarrhea require a workup? (hint most dont)

A

if they have a fever, bloody stools, or dehydration. Also kids, geriatrics, and immunocompromised patients.

27
Q

What antibiotic is classically (as in on tests) associated with C. Diff?

A

Clindamycin

28
Q

What is the best way to prevent the spread of diarrhea?

A

wash your nasty ass hands

29
Q

“Hey doc im going to mexico this weekend, and I dont want to get diarrhea. What can I do?”

A

Avoid raw fruits and veggies, dont get ice or use tap water, Use bottled water to brush your teeth.

30
Q

a patient has had acute diarrhea for >3 days and your sure that its bacterial. what antibiotics should you use?

A

Ciprofloxacin 500mg BID for 3 days (not to be used in pregnant women or children)

Azithromycin for pregnant women (single 1000mg dose) or children (10mg/kg daily x 3 days)

31
Q

“hey doc my kid has diarrhea. We got a note saying that its going around at the day care. Whats causing this?

A

most likley rotavirus

32
Q

Oh shit! Johnny has C.Diff! what do we treat him with?

A

Metronidazole (flagyl) or Vancomycin

33
Q

When should a woman get BRCA tested?

A

-2 1st degree relatives with breast cancer -3 1st or 2nd degree relatives with breast cancer -breast AND ovarian cancer in 1st or 2nd degree relatives -a 1st degree relative with bilateral breast cancer - a male family member with breast cancer

34
Q

At what age should we start screening for hypertension (men and women)?

A

18 (level A) for both

35
Q

At what age should we start screening for lipid disorders (men and women)?

A

20 if high risk 35 for men 45 for women

36
Q

When should women start getting routine mammograms?

A

FUCK THIS QUESTION! its every 1 or 2 years starting at age 40 or 50 depending on which guideline you look at.

37
Q

tell me about cervical cancer screening

A

pap smears starting at age 21. every 3 years until age 30, then you start concurrent HPV testing and can go every 5 years.

38
Q

how do you screen for osteoporosis? At what age do you start in women?

A

DEXA scan. 65

39
Q

how much calcium and vitamin D should women over 50 take a day?

A

1200mg of calcium and 400-800 IU of vitamin D

40
Q

what are the two most common side effects of bisphosphonates?

A

errosive esophagitis and gastritis

41
Q

what are the risk factors for domestic violence?

A

Think about the show cops: young couples, low income, pregnant, divorced, with mental illness, and you know there is some kind of substance involved.

42
Q

A 19yo sailor comes in for ankle pain saying he rolled it playing basketball. On PE his ankle is swollen but he can bear weight, and there is no focal tenderness or ligament laxity. What is his most likely diagnosis?

A

Ankle sprain

43
Q

A 19yo sailor comes in for ankle pain saying he rolled it playing basketball. On PE his ankle is swollen but he can bear weight, and there is no focal tenderness or ligament laxity. What is the next step?

A

PRICE Protection Rest Ice Compression Elevation

44
Q

What is the most commonly injured ankle ligament in an ankle sprain?

A

Anterior talofibular ligament (ATFL)

45
Q

What are the Ottawa ankle rules?

A

only get x-rays if the patient is unable to bear weight, or has point tenderness over: the distal 6cm of the medial or lateral malleolus, base of the 5th metatarsal, or navicular bone

46
Q

What is the difference between a sprain and a strain?

A

Sprain: ligament Strain: tendon/muscle (T is for tendon)

47
Q

Matching: Test and Structure Empty Can test

A

Supraspinatus

48
Q

Matching: Test and Structure external rotation

A

infraspinatus and teres minor

49
Q

Matching: Test and Structure behind the back lift off test and/or internal rotation

A

subscapularis

50
Q

Matching: Test and Structure hawkins

A

impingement

51
Q

Matching: Test and Structure Anterior Drawer-ankle

A

ATFL

52
Q

Matching: Test and Structure inversion of ankle

A

CFL

53
Q

Matching: Test and Structure Squeeze test (squeeze the tib/fib together)

A

syndesmosis

54
Q

Matching: Test and Structure Thompson squeeze test (squeeze the calf)

A

Achilles tendon

55
Q

Matching: Test and Structure Lachman and anterior drawer

A

ACL

56
Q

Matching: Test and Structure Valgus stress

A

MCL

57
Q

Matching: Test and Structure Varus stres

A

LCL

58
Q

What is the initial diagnostic imaging modality of choice for a patient with joint pain?

A

x ray

59
Q

A patient comes in stating that they are still stiff and sore 4 weeks after getting a sprained ankle. What is the next step?

A

Refer to physical therapy. the most common cause of pain/stiffness in a join following a sprain is inadequate rehabilitation.

Family Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions