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Year 3 > COMBANK FM COMAT > Flashcards

COMBANK FM COMAT Flashcards

1
Q

Kid XR showing coin facing you on AP film

A

coin in esophagus

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2
Q

Kid XR showing coin facing you on lateral film

A

coin in trachea

  • would also show signs of airway compromise
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3
Q

s/sx of tuberculosis

A

hemoptysis, night sweats, fever, weight loss

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4
Q

alarm sx of GERD

A

dysphagia, weight loss, bleeding, iron deficiency anemia

  • mean it’s complicated GERD
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5
Q

GERD Tx: uncomplicated vs complicated

A 
uncomplicated = PPI
complicated = need imaging (upper endoscopy)
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6
Q

HTN meds in black ppl

A

HCTZ first line (JNC 8 - Outdated)

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7
Q

Empiric outpatient treatment of young patients with CAP (community acquired pneumonia)

A

Doxycycline or macrolides are good first-line choices

– cover typical and atypical CAP

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8
Q

treatment of CAP (community acquired pneumonia) In patients over 60 years of age or those with significant comorbidities

A

usually is typical CAP
tx is second or third generation cephalosporins, amoxicillin/clavulanic acid, macrolides, and fluoroquinolones with pneumococcal coverage

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9
Q

who gets flu anti-viral drug tx

A

pts who fall in the high risk groups or time frame of less than 48 hours

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10
Q

flu vaccine for pts with egg allergy (severe)

A

inactivated influenza vaccination (IIV3)

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11
Q

pharm tx to lower TG levels

A 
<500mg/dL = statin
>500mg/dL = fibrate followed by statin later
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12
Q

Severe hypertriglyceridemia is associated with an increased incidence of

A

acute pancreatitis.

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13
Q

s/sx peripheral arterial occlusion

A

Claudication symptoms, pale cool extremity, and decreased distal pulses

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14
Q

s/sx Thrombophlebitis

A

tenderness to palpation, erythema, and often warmth and swelling in the area of inflammation

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15
Q

s/sx Chronic venous insufficiency

A

lower leg aching pain and cramping
bilateral lower extremity swelling, varicose veins, and hemosiderin staining (brawny brown deposits) of the anterior shins

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16
Q

live attenuated vaccines

A

MMR
Varicella
Influenza (nasal spray)
Rotavirus

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17
Q

individuals who are able to make personal health care decisions for those who are incompetent

A

spouse, followed by a parent, followed by the next of kin, followed by a default surrogate.

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18
Q

new guidelines recommend initiating of HMG-CoA reductase inhibitors (statins) in patients with an LDL-C _____

A

> 190 mg/dL

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19
Q

New strains of multi-drug resistant organisms should be reported to

A

cdc

and County health department too

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20
Q

fhx that is risk factor for heart disease

A

Family history in
father or brother with a heart attack BEFORE age 55,
or in
mother or sister BEFORE age 65

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21
Q

AOM (Acute OM) vs OME (OM with effusion)

A

OME is middle ear effusion w/o acute symptoms

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22
Q

Inflammation with bulging of the TM on otoscopy is highly predictive of

A

AOM (Acute OM)

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23
Q

Migraine headaches s/sx

A

throbbing, usually unilateral headaches that last between 2 and 24 hours

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24
Q

gender diff in migraine vs cluster

A

Migraine is more common among women, while cluster headaches are seen overwhelmingly in men.

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25
Q

Cluster headaches s/sx

A

intense pain near the eye with many headaches in a short period of time followed by headache-free periods.

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26
Q

common migraine vs classic migraine

A

Common migraine by definition does not include an aura.

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27
Q

relation between L5 and sacrum

A

L5 and the sacrum always rotate in opposite directions.
— Sidebending of L5 engages the ipsilateral sacral oblique axis.

Forward sacral torsions are associated with type I (neutral) mechanics at L5 whereas backward sacral torsions are associated with type II (non-neutral) mechanics at L5

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28
Q

EBV (Mono) dx confirmed by:

A

latex agglutination assay that detects heterophile antibodies

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29
Q

best diagnostic test for H. pylori

A

serology

30
Q

best test for eradication of H. pylori

A

urea breath test

31
Q

Overflow incontinence

A

unpredictable dribbling of urine or weak urine stream due to underactive bladder and/or outlet obstruction

32
Q

Mixed incontinence

A

combination of both stress and urge incontinence

33
Q

First line antibiotic therapy for human bites

A

amoxicillin/clavulanic acid

34
Q

What type of drug is Memantine ?

A

N-methyl-D-aspartate (NMDA) receptor antagonist that is thought to be neuroprotective

35
Q

initial treatment for mild to moderate dementia symptoms

A

cholinesterase inhibitor (galantamine or donepezil)

36
Q

treatment for moderate to severe dementia symptoms

A

Keep on cholinesterase inhibitor (galantamine or donepezil).

Add NMDA receptor antagonist (memantine) in moderate to severe Alz

37
Q

Supplement that can prevent Alzheimer’s disease

A

omega-3 FAs

38
Q

treatment of depression and mood disorders in dementia patients

A

SSRI (Ex/ citalopram)

39
Q

FEV1 and FVC changes in restrictive lung dz

A

FEV1 and FVC are both decreased, but proportionately so. Therefore, FEV1 is decreased but FEV1/FVC is normal.
Reversible with bronchodilator test.

40
Q

FEV1 and FVC changes in obstructive lung dz

A

FEV1 decreases to less than 80% predicted, FEV1/FVC ratio is less than 0.7, and there is incomplete reversal with inhaled bronchodilators.

41
Q

COPD Tx that improves mortality & QoL

A

Supplemental oxygen is the only modality that can improve pulmonary artery pressure, dyspnea, survival, and quality of life

42
Q

restless leg syndrome characteristic sx

A

bilateral pain or discomfort in legs present at rest but relieved with movement.

43
Q

lumbar disc herniation characteristic sx

A

back pain with radiation to bilateral lower extremity. Pain is usually worsened with sitting and backward flexion.

44
Q

difference between sciatica and piriformis syndrome

A

piriformis syndrome usually causes pain in the buttocks and hamstrings whereas sciatica typically causes pain in the distal extremity as well
– different hx too

45
Q

Dx steps in thyroid nodule

A
  1. measurement of serum TSH to evaluate for hyperthyroidism or hypothyroidism
  2. If TSH is normal, the next step in evaluation is ultrasound to evaluate for size and anatomic spread
46
Q

types of tumors that contain psammoma bodies

A

PSAMMoma (Papillary thyroid carcinoma, Serous cystadenocarcinoma of the ovary, Adenocarcinoma of the endometrium, Meningioma, Mesothelioma)

47
Q

adenovirus eye sx

A
  • most common cause of epidemic keratoconjunctivitis
  • palpebral conjunctiva is erythematous and copious watery discharge with some scant exudates
  • usually an associated pharyngitis, fever, malaise, and preauricular lymphadenopathy
48
Q

tx of allergic conjunctivitis

A
  • symptomatic with cold compresses, topical vasoconstrictors, antihistamines, and mast cell stabilizers
  • – topical nonsteroidal anti-inflammatory agents such as ketorolac are better alternatives to topical glucocorticoids
49
Q

imaging study of choice in evaluating a second febrile urinary tract infection

A

Voiding cystourethrogram

50
Q

Lloyd’s sign

A

positive costovertebral tenderness significant for pyelonephritis

51
Q

Osteitis fibrosa cystica dx

A
  • rare manifestation in severe cases of hyperparathyroidism
  • characterized by the appearance of brown tumors on x-ray (lesions are cysts filled with blood, fibrous tissue, and osteoclasts)
52
Q

Epley maneuver

A
  • method of otolith repositioning
  • patient is moved through a series of positions that attempt to move the otolith out of the semicircular canal.
  • first line of treatment for benign paroxysmal positional vertigo (BPPV).
53
Q

Dix-Hallpike maneuver

A
  • used to diagnose BPPV

- cannot be used for treatment of BPPV

54
Q

how to dx primary ovarian failure.

A

FSH (follicle stimulating hormone) elevation in the menopausal range on 2 occasions separated by at least 1 month

55
Q

typical organism for UTIs with indwelling catheter

A

pseudomonas aeruginosa

56
Q

Claudication in the young, healthy patient may be due to

A

adventitial cystic disease or popliteal entrapment.

57
Q

tx of painful diabetic neuropathy

A

TCAs (amitriptyline, desipramine) or anticonvulsants (pregabalin, gabapentin)

58
Q

goal INR in a patient with atrial fibrillation who is taking warfarin for anticoagulation for prevention of thrombotic events

A

2.0 to 3.0

59
Q

eye finding specific to diabetic retinopathy

A

neovascularization

60
Q

eye findings found in both diabetes and HTN retinopathy

A

cotton wool spots (more HTN)
retinal hemorrhage
microaneurysm (more DM)

61
Q

eye finding (more) specific to HTN retinopathy

A

AV nicking

62
Q

MOA of post-HIV exposure prophylaxis

A

typically involve NRTIs and/or integrase inhibitors

63
Q

Activities of daily living (ADLs)

A

transferring, toileting, continence, feeding, dressing and bathing
– note, NOT meal prep

64
Q

dosing of Ca and Vit D in osteoporosis

A

women: combined calcium intake (dietary and supplemental) of 1200 mg of calcium and 800 international units of vitamin D
men: 1000 mg of calcium and 600 international units of vitamin D

65
Q

most appropriate initial screening test at 11 weeks’ gestation

A

urine culture to rule out asymptomatic bacteriuria

— recc: screened for between 12-16 weeks gestation or at the first prenatal visit if it is later than 16 weeks

66
Q

contraindication to PDE-5 inhibitors

A

(ex/ sildenafil)
contraindicated in patients taking nitrates, as the combination of medication will precipitate dangerously low drop in blood pressure

67
Q

somatic symptom disorder dx

A
  • must present with multiple physical complains beginning before age of 30 years old.
  • physical complaints must consist of at least four different sites of pain
  • ROS must be positive for at least 2 gastrointestinal sx, 1 sexual sx, and 1 neurological sx
68
Q

Acute lymphoblastic leukemia s/sx

A
  • fever, malaise and fatigue in young children

- red flags: weight loss, pallor, petechiae, bone pain, generalized lymphadenopathy and hepatosplenomegaly

69
Q

1st line tx for Graves

A

methimazole

over PTU b/c of PTU’s potential hepatotoxicity

70
Q

AAA management: lesions <5.5cm

A

monitoring if asymptomatic

  • – Small aneurysms (3.0 – 4.0 cm) should be monitored by ultrasound every two years.
  • – Aneurysms 4.0 – 5.4 cm should be monitored by ultrasound or CT every six to twelve months

+ smoking cessation!

Year 3 (15 decks)

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