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Fam med aquifer > Cases 1-5 > Flashcards

Cases 1-5 Flashcards

1
Q

Does USPSTF recommend teaching patients breast exams? Do they recommend clinical breast exams?

A

They do not recommend teaching breast exams

USPSTF does not have a recommendation for clinical breast exams

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2
Q

When should cervical cancer screening begin?

A

age 21

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3
Q

How often should women between 21-29 get screened for cervical cancer?

A

every 3 years

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4
Q

How often should women between 30-65 get screened for cervical cancer?

A

every 3 years with cytology alone

OR

every 5 years with cytology and HPV testing

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5
Q

Should women over 65 get screened for cervical cancer?

A

women may choose to stop screening at 65 if their last three screens were normal

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6
Q

What happens to false negatives with an increase in sensitivity?

A

a decrease is false negatives

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7
Q

What happens to false positives with an increase in specificity?

A

decrease in false positives

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8
Q

What does the USPSTF say about skin cancer screening?

A

insufficient evidence to recommend for or against screening

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9
Q

What does the USPSTF say about lung cancer screening?

A

low dose CT scan for those between the ages of 55-80 who have smoked 30+ years

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10
Q

What does the USPSTF say about breast cancer screening?

A

every 2 years starting at age 50-74

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11
Q

What does the american cancer association say about breast cancer screening?

A

start at 40 every year

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12
Q

If a breast lump is felt, what is the diagnostic process?

A

Ultrasound to determine if cystic or solid:

  • If cystic, fine needle aspiration then send for cytology
  • If solid, mammogram
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13
Q

What are risk factors for breast cancer?

A

family history (first degree)

unopposed estrogen

BRCA mutation

Advanced age

smoking

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14
Q

At what age should women be screened for osteoporosis?

A

Women >65 should get a DEXA scan

Women <65 with a risk factor of a 65yo or greater should get a DEXA scan

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15
Q

With regards to preventative visits, what does the RISE mnemonic stand for?

A

Risk factors

Immunizations

Screening tests

Education

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16
Q

What is the leading cause of death in a 55yo male in the US? Second leading cause? Third?

A
  1. malignancy
  2. Heart disease
  3. Unintentional accident
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17
Q

What are four major risk factors for ASCVD?

A
  1. HTN
  2. HLD
  3. DM
  4. Tobacco
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18
Q

Define normal BP

A

<120 and <80

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19
Q

Define pre-hypertension

A

120-129 and <80

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20
Q

define stage 1 HTN

A

130-139 OR 80-89

21
Q

define stage 2 HTN

A

140+ OR 90+

22
Q

Define the following for BMI: underweight, normal, overweight, obese

A

underweight = <18.5

normal = 18.5 - 24.9

Overweight = 25 - 29.9

obese = 30+

23
Q

What are the ABCDEs of skin lesions

A

Assymetry
Border irregularity
Color non-uniform
Diameter > 6mm
Evolution or change over time

24
Q

Name 12 common causes for insomnia in the ederly

A
  1. poor sleep environment
  2. drugs
  3. sleep apnea
  4. restless leg syndrome
  5. periodic leg movement (involuntary leg jerking) and REM sleep behavior disorder
  6. Disturbances in sleep-wake cycle (jet lag or shift work)
  7. depression and anxiety
  8. CHF
  9. pain or pruritis
  10. GERD
  11. hyperthyroidism
  12. Circadian rhythm change
25
What are risk factors for completed suicide?
male older age previous attempts military service
26
What are the diagnostic criteria for major depression?
5+ SIG E CAPS symptoms for at least 2 weeks Sleep disturbances Interest loss Guilt Energy decreased Concentration decreased Appetite increase or decrease Psychomotor retardation Suicidal ideation
27
How do you initially screen for depression? What do you do if positive?
PHQ-2 then PHQ-9 if positive
28
What are common side effects of SSRI/SNRIs?
HA Sleep disturbances GI upset Sexual dysfunction
29
What is first-line therapy for insomnia in the elderly?
Cognitive Behavioral Therapy for Insomnia (CBT-I)
30
What are approved drugs for insomnia in the elderly?
Zolpidem, esZopiclone Doxepin (TCA) suvorexant (Orexin receptor antagonist)
31
What labs should you order in someone who is depressed or fatigued?
CBC (anemia) CMP TSH
32
What are the 6 Ps pf compartment syndrome?
Pain (out of proportion) Pallor Pulselessness Paresthesia Perishing cold Paralysis
33
what ligament does the anterior drawer test in the ankle?
anterior talofibular ligament
34
what ligament does the inversion stress test evaluate in the ankle?
calcaneofibular ligament
35
Describe a grade I ankle sprain (tear, pain, swelling, bruising, fucntional loss, instability, stretching of joint)
Tear = no tear or minimal Pain = mild pain Swelling = mild swelling Bruising = no bruising Functional loss = no functional loss Instability = no instability Stretching of joint = no excessive stretching
36
Describe a grade II ankle sprain (tear, pain, swelling, bruising, fucntional loss, instability, stretching of joint)
Tear = incomplete tear Pain = moderate pain Swelling = moderate swelling Bruising = moderate bruising Functional loss = moderate functional loss Instability = moderate instability Stretching of joint = some stretching
37
Describe a grade III ankle sprain (tear, pain, swelling, bruising, fucntional loss, instability, stretching of joint)
Tear = complete tear Pain = moderate to severe pain Swelling = severe swelling 4cm above the fibula Bruising = bruising present Functional loss = complete functional loss Instability = severe instability Stretching of joint = significant stretching
38
What is the inversion stress test? What ligament does it test?
physician manually inverts the patients ankle tests the calcaneofibular ligament
39
What is the cross-leg test? What ligament does it test?
Have the patient cross their leg looks for syndesmotic sprains (ligaments between tibia and fibula)
40
What is the most effective compression device for ankle injury?
semi rigid ankle support
41
When are radiographs of the **ankle** indicated?
1. pan in the malleolar zone AND bony tenderness along the distal 6cm of the posterior edge of malleolus OR 2. inability to bear weight immediately after injury and in the emergency room
42
When are radiographs of the **foot** indicated?
1. Pain in the midfoot zone AND pain at navicular bone or base of 5th metatarsal OR 2. inability to bear weight immediately after injury and in the emergency room
43
What are 7 common signs of hyperthyroidism?
Heat intolerance Tachycardia Fatigue Weight loss Tremor Increased sweating Exertional dyspnea
44
define clonus
dorsiflex the patient's foot results in a series of abnormal plantar flexions
45
What type of antibodies are produced in Grave's disease
thyrotropin antibodies
46
What is the most common manifestation of graves ophthalmopathy?
eyelid retraction and exophthalmos (causes corneal irritation cuz you can't close your eyes very well)
47
What is the most commonly used medication to treat Graves? How long does it take to see improvements in symptoms? How long does it take to truly suppress thyroid production?
methimazole 1 month to see symptom improvement 3 months for thyrod suppression
48
If a patient with Graves doesn't want to be treated with medication, what can you offer? How long after initial treatment should patients be seen for TSH blood work? Once treatment is confirmed, how often should you check blood TSH levels?
radioactive iodine 2-3 months after initial treatment 1-2 times yearly
49
What is a typical starting dose of levothyroxine? If the patient is not repsonding, should you jack the dose up? When determining the correct dose, how often should the patient be seen?
1.5mcg/kg NO! slowly titrate it up. 6 weeks

Fam med aquifer (8 decks)

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