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Family med > deck 18 > Flashcards

deck 18 Flashcards

1
Q

best evidence for physical activity in elderly

A

fall prevention

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2
Q

preferred anticoagulant for venous thrombosis during pregnancy

A

LMWH (unfractionated heparin requires more monitoring and may increase risk of HIT)

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3
Q

mediastinal widening in MCV crash patient

A

partial rupture of thoracic aorta

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4
Q

most common presenting symptom of hodgkin’s lymphoma

A

painless lymphadenopathy

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5
Q

pseudoaddiction

A

term used to describe patient behaviors that may occur when pain is undertreated.

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6
Q

management of pt on narcotics using alcohol/illicit drugs

A
  • expected that alcohol and illicit drugs not be used concurrently.
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7
Q

OTC cough and cold products cannot be used in infants/childrens younger than…

A

2

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8
Q

gout triggers

A

red meat, seafood, alcohol, nuts and beans (high in purines)

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9
Q

food that reduces frequency of gout attacks

A

dairy products

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10
Q

pharmacokinetic factors that change with age

A
  • volume of distribution (due to increase in ratio of fat to lean body weight)
  • liver metabolism, renal excretion
  • *transdermal asborption DOES NOT CAHNGE.
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11
Q

CBT for GAD?

A

Has been shown to be at least as effective as medication.

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12
Q

pertussis diagnosis

A

nasopharyngeal culture + PCR testing

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13
Q

preferred opioids for use in patients with ESRD

A

fentanyl (metabolized in liver) and methadone

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14
Q

how to correlate A1C with glucose level

A
  • 6.0 –> 120 mg/dl

- each percentage point corresponds to increase in 30 mg/dl rise in average glucose

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15
Q

ABG with PE

A

PO2 and PCO2 decreased, pH elevated

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16
Q

management of stable patient with SVT

A

first line –> vagal maneuvers

second line –> IV adenosone

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17
Q

lab to order for vitamin d deficiency

A

25-hydroxyvitamin D

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18
Q

ottawa ankle rules for radiographs

A

According to these guidelines, an ankle radiograph series is required only if there is pain in the malleolar zone and bone tenderness of either the distal 6 cm of the posterior edge or the tip of either the lateral malleolus or the medial malleolus. Inability to bear weight for four steps, both immediately after the injury and in the emergency department, is also an indication for ankle radiographs. Foot radiographs are required only if there is pain in the midfoot zone and bone tenderness at the base of the 5th metatarsal or the navicular, or if the patient is unable to bear weight both immediately after the injury and in the emergency department.

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19
Q

most common cause of incontinence in elderly patients

A

detrusor instability

- can become worse after TURP

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20
Q

best med for prophylaxis of traveler’s diarrhea

A

rifaximin

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21
Q

treatment of choice for decontamination of most medication ingestions

A
  • single dose of activated charcoal

- should be used within 1 hour of ingestion

22
Q

cutoff fasting plasma glucose for managing GDM

A

start meds if above 100

23
Q

DM meds for GDM

A

NPH + lispro BID

24
Q

asthma diagnosis

A

Need spirometry to diagnosis

25
Q

PMS syndrome caveat

A

symptoms are generally worse prior to menses, but can occur to some degree during menses and throughout the month

26
Q

PMS symptoms

A

anxiety, sleep disorder, fatigue, persistent depressed mood, decreased libido

27
Q

medicare part A covers

A

(hospital insurance) covers inpatient care in hospitals and skilled nursing facilities, hospice, and home health services.

28
Q

medicare part B covers

A

outpatient physician services, including office visits and home health services.

29
Q

medicare part D

A

prescription drug coverage.

30
Q

tetanus booster recommendation

A

Tdap (Due to waning immunity to pertussis. unless less than 5 years since last booster)

31
Q

management of isolated, enlarged cervical lymph node

A

1) Immediate biopsy is warranted if the patient does not have inflammatory symptoms and the lymph node is >3 cm, if the node is in the supraclavicular area, or if the patient has coexistent constitutional symptoms such as night sweats or weight loss. Immediate evaluation is also indicated if the patient has risk factors for malignancy. Treatment with antibiotics is warranted in patients who have inflammatory symptoms such as pain, erythema, fever, or a recent infection.
2) if no malignancy RF’s, monitor node for 4-6 weeks.

32
Q

STEMI definition

A

ST-segment elevation of greater than 0.1 mV in at least 2 contiguous precordial or adjacent limb leads.

33
Q

most important goal in STEMI management

A

1) begin fibrinolysis less than 30 minutes after contact with health system
- oral clopidogrel + chew large dose aspirin

34
Q

“enteric” meaning for drugs

A

coating that prevents dissolution or disintegration in the gastric environment

35
Q

drug you can’t use anymore for head lice

A

Lindane (efficacy has waned + neurotoxic)

36
Q

thyroid nodule management

A

1) Measure TSH
2) IF suppressed, get a radionuclide thyroid scan –> if hot, FNA not needed. If cold, FNA
3) If TSH normal, get an FNA

37
Q

HEENT associated with DM

A

parotid gland enlargement + candidiasis + periodontal bleeding

38
Q

tooth erosion can also be a feature of…

A

GERD

39
Q

management of infected ingrown toenail

A
  • partial avulsion of the medial nail plate and phenolization of the matrix at this visit
40
Q

if you can’t get IV access then…

A

IO access. no contraindications. all IV drugs can be given IO.

41
Q

biguanide mehcanism

A

decrease hepatic glucose production + increase insulin sensitivity

42
Q

DPP-4 mechanism

A

prevent GLP-1 breakdown

43
Q

elevated LH/FSH with absent menses suggests…

A

ovarian failure

44
Q

treatment of hirsutism in premenopausal women

A

spironolactone

45
Q

best drug with osteoporotic women w/ breast cancer FH

A

raloxifine

46
Q

raloxifine MOA

A

estrogen agonist in bone, antagonist in uterus and breast

47
Q

management of benign FNA cytology with firm, fixed breast mass

A

excisional biopsy (biopsy results don’t match clinical results)

48
Q

flashing lights + visual field defect

A

retinal detachment

49
Q

med that falsely depresses PSA levels

A

finasteride

50
Q

onset of somatization disorder

A

usually before 30

51
Q

test of choice if endoscopy is unsuccessful due to active bleeding

A

A technetium-99m blood pool scan to determine site of bleeding

Family med (48 decks)

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