Cases 26-30

Question 1

USPSTF guidelines for prostate screening

Answer 1

discussion to start PSA at 55 - 69

Question 2

If a patient ops for flex sigmoidoscopy instead fo colonoscopy, how frequent should they get one?

Answer 2

every 5 years

Question 3

If a patient ops for FOB or FIT instead fo colonoscopy, how frequent should they get one?

Answer 3

every year

Question 4

What should be ordered in a patient who is fatigued?

Answer 4

CBC

ESR

TSH

Question 5

What does HEEADSSS stand for?

Answer 5

Home
Education/Employment
Eating
Activities
Drugs
Sexuality
Suicide/Depression
Safety/Violence

Question 6

In a patient with testicular pain, if a cremasteric reflex is absent what could be the cause?

Answer 6

testicular torsion

Question 7

What is does the blue dot sign indicate?

Answer 7

torsion of a testicular appendage

Question 8

What is Prehn sign?

Answer 8

physical lifting of the testicle relieves the pain caused by epiddidymitis

(not relieved in testicular torsion)

Question 9

Regarding testicular torsion, what is the percent of teticular viability after 6 hours of scrotal pain?

Answer 9

90%

Question 10

Regarding testicular torsion, what is the percent of teticular viability after more than 12 hours of scrotal pain?

Answer 10

50%

Question 11

Regarding testicular torsion, what is the percent of teticular viability after more than 24 hours of scrotal pain?

Answer 11

10%

Question 12

Do Guidelines for Adolescent Preventative Services (GAPS) address diabetes prevention?

Answer 12

nah

Question 13

What is the most common malignancy affecting men between 15 and 35yo?

Answer 13

testicular cancer

Question 14

What is the most common type of testicular cancer?

Answer 14

Germ cell (seminoma)

Question 15

What is the difference between acute and chronic bronchitis?

Answer 15

Acute: productive cough lasting 1-3 weeks

Chronic: Productive cough lasting for at least 3 months for the past 2 years

Question 16

Name 4 classic COPD PE findings

Answer 16

Increased anterioposterior diameter of the chest

decreased diaphragmatic excursion

wheezing (often end expiratory)

Prolonged expiratory phase

Question 17

What happens to height of the larynx in COPD

Answer 17

Often decreases

Question 18

What cells are involved in COPD?

Answer 18

Macrophages, T killer cells, and neutrophils

Question 19

When do the major benefits of smoking cessation occur?

Answer 19

within the first year of quitting

Question 20

What are the GOLD grades for COPD?

Answer 20

Question 21

Based on CAT scores, how should group B, C, and D be treated?

Answer 21

Therapy for GOLD group B

In addition to a short acting beta agonist (SABA) for symptoms, patients in group B should be given a long acting beta agonist (LABA) or long acting anti-muscarinic antagonist (LAMA). Eventually, if symptoms worsen, they may be given both a LABA and LAMA.

Therapy for GOLD group C

In addition to a SABA, LABA, and LAMA, patients in group C should be given an inhaled corticosteroid (ICS).

Therapy for GOLD group D

In symptomatic COPD patients whose FEV1 is < 50% of predicted and severity of dyspnea and exacerbations is high, it is recommended that inhaled corticosteroids (ICS) be added to LABA bronchodilator treatment and/or LAMA. The addition of a glucocorticoid may increase the risk of pneumonia. Roflumilast, a Phosphodiesterase-4 inhibitor, can be substituted or added to the LAMA/LABA/ICS combinations. A SABA, ipratroprium, or can be used as needed. The cost of many of these inhalers can be a barrier to use. Oxygen therapy is indicated if room air oxygen saturations < 88%.

Question 22

What is the gold standard for diagnosing COPD?

Answer 22

PFT

In pulmonary function testing, either a FEV1/FVC ratio less than the 5th percentile, or less than 70%, confirms a diagnosis of COPD.

Question 23

Name 5 treatments that are used to treat alzheimer’s

Answer 23

Cholinesterase inhibitors
Vit E
Memantine
Respite
Atypical antipsychotics

Question 24

What tool has evidence support in diagnosing delirium?

Answer 24

Confusion Assessment Method (CAM)

Question 25

How many stages of labor?

Answer 25

First stage (latent 0 - 6cm; active 6 - 10 cm)

Second stage (10 cm to delivery)

Third stage (birth of baby to delivery of placenta)

Question 26

Name the 7 cardinal movements of labor

Answer 26

Engagement
Descent
Flexion
Internal rotation
Extension
External rotation

Expulsion