Cases 11-15

Question 1

What are the most common causes of knee pain in adolescents

Answer 1

patellar subluxation

tibial apophysitis (Osgood-Schlatter)

Patellar tendonitis

Question 2

What are the most common causes of knee pain in an adult?

Answer 2

patellofemoral syndrome (diagnosis of exclusion for anterior knee pain)

overuse syndrome (pes anserine bursitis, suprapatellar bursitis, prepatellar bursitis, infrapatellar bursitis)

tramatic injuries (ligament and maniscal injuries)

inflammatory process (RA, OA, septic, reactive arthritis)

Question 3

What should be initial management for OA?

Answer 3

exercise

Question 4

What is a major side effect from NSAIDs

Answer 4

GI upset

Question 5

How do NSAIDs affect HTN medications?

Answer 5

They decrease the effectiveness

Question 6

How do NSAIDs affect sulfonylureas?

Answer 6

They increase the effect

Question 7

When does USPSTF recommend colorectal cancer screening?

Answer 7

50-75

Question 8

When should mammogram screening begin according to USPSTF?

Answer 8

50-74

Question 9

What does USPSTF say about AAA screening?

Answer 9

men with a history of smoking between 65-75 should have a one time screen

woman should NOT be screened

Question 10

What does USPSTF recommend regarding carotid artery screening?

Answer 10

don’t screen asymptomatic patients

Question 11

When should pneumovax be given?

Answer 11

65+ one dose

Question 12

When should zoster vaccine be given?

Answer 12

60+ one dose

Question 13

When should someone with OA be referred to ortho?

Answer 13

When ALL non-operative management has failed to relieve symptoms adequately

Question 14

What does the USPSTF recommend for women tryin to get pregnant

Answer 14

400-800mcg of folic acid

Question 15

What are some signs of pregnancy?

Answer 15

amenorrhea

fatigue

nausea

breast tenderness

Question 16

How do you calculate the estimated due date?

Answer 16

add 1 year - 3 month + 1 week

Question 17

What are recommended lab studies to investigate 1st trimester bleeding?

Answer 17

CBC

wet mount for trich and PCR for G/C

progesterone (<5 is bad)

b-hcg

Question 18

What is the most common cause of persistent cough and wheezing?

Answer 18

asthma

Question 19

Can ASA cause asthma

Answer 19

yeah

Question 20

how long does chronic sinusitis last for (at minimum)?

Answer 20

12 weeks

Question 21

Name the 3 points that help establish a diagnosis of asthma

Answer 21

1. Episodic symptoms of airflow obstruction or hyperresponsiveness are present.
2. This obstructive airflow is at least partially reversible.
3. Alternative diagnoses are excluded.

Question 22

How do you classify intermittent, mild, moderate, and severe asthma?

Answer 22

frequency of symptoms
frequency of nighttime awakenings
frequency of short-acting beta2 agonist use for symptom control interference with normal activity
FEV1 value
FEV1/FVC ratio

Question 23

What s the most concerning long-term effect of asthma

Answer 23

less reversibility of the airway obstruction

Question 24

what are some long-term effects of uncontrolled asthma

Answer 24

Airway remodelling
Inflammation
Mucous hypersecretion
Airway smooth muscle hypertrophy
Angiogenesis
Subepithelial fibrosis

Question 25

How do you manage asthma?

Answer 25

Question 26

regarding peak flows in PFTs, what defines green zone, yellow zone, and red zone?

Answer 26

Question 27

an improvement in FEV1 value by ___ or increase in the percent predicted FEV1 value by ___ after bronchodilatoe is given diagnostic for asthma

Answer 27

an improvement in FEV1 value by 12% or increase in the percent predicted FEV1 value by 10% after bronchodilatoe is given diagnostic for asthma

Question 28

what is the expected weight gain in a pregnant woman with a BMI between 18.5 and 24.9?

Answer 28

25-35 lbs

Question 29

what is the expected weight gain in a pregnant woman with a BMI between 25 and 29.9?

Answer 29

limit weight gain to 15-25lbs

Question 30

what is the expected weight gain in a pregnant woman with a BMI \>30?

Answer 30

limit weight gain to 11-20lbs

Question 31

When should GDM and Rhogam be screened/administered?

Answer 31

~28 weeks

Question 32

if placenta previa does not resolve, what do you do?

Answer 32

c-section

Question 33

define chronic HTN in pregnancy

Answer 33

elevated BP detected before 20 weeks gestation that persists 12 weeks postpartum

Question 34

define gestational HTN

Answer 34

The presence of persistent systolic blood pressure of ≥140 mmHg and/or a diastolic blood pressure of ≥90 mmHg, **without proteinuria**, in a previously normotensive pregnant woman at or after 20 weeks of gestation.

Question 35

define preeclampsia

Answer 35

The presence of persistent systolic blood pressure of ≥ 140 mmHg and/or a diastolic blood pressure of ≥ 90 mmHg, with proteinuria of 0.3 grams or greater in a 24-hour urine specimen.

Question 36

define eclampsia

Answer 36

Eclampsia describes the occurrence of one or more convulsions in the presence of preeclampsia without the presence of another underlying neurologic disorder in a pregnant woman with a history of elevated blood pressure and proteinuria.

Question 37

What are some signs of severe preeclampsia?

Answer 37

Visual disturbances severe headache right upper quadrant or epigastric pain nausea vomiting decreased urine output

Question 38

common pregnancy rashes

Answer 38

The primary treatment goal is generally relief of symptoms, which can be ameliorated by topical emollients and glucocorticoids. Generally, oral steroids are not needed. Antihistamines can also be helpful, but also cause sedation.

Question 39

Which contraception method should be avoided in postpartum who plan to exclusively breastfeed?

Answer 39

progestin only

Question 40

when is serum screening performed?

Answer 40

15-21 weeks

Question 41

Define moderate drinking

Answer 41

1 drink a day for women 2 drinks a day for men

Question 42

define binge drinking

Answer 42

consumption of five or more alcoholic beverages on one occasion on one or more days in a 30-day period.

Question 43

Define heavy drinking

Answer 43

consuming five or more alcoholic drinks on a single occasion, five or more days in a 30-day period