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Family med > deck 20 > Flashcards

deck 20 Flashcards

1
Q

FH of sudden death + recurrent syncope suggests…

A

long-QT syndrome

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2
Q

Long-QT syndrome diagnosis

A

resting EKG

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3
Q

other thing to think about with young people and sudden death

A

long-QT syndrome

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4
Q

long-QT syndrome management

A

beta-blockers, implantable ICD, no participation in competitive sports

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5
Q

supplement that can reduce symptoms + possibly slow disease progression in patients with knee OA

A

glucosamine sulfate

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6
Q

atypical antipsychotic associated with least amount of weight gain

A

aripiprazole

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7
Q

MM confirmatory diagnosis

A
  • bone marrow exam showing greater than 10% of plasma cells
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8
Q

management of small spontaneous pneumothorax

A

outpatient management with analgesics + followup within 72 hours.

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9
Q

pain reduced when abdominal muscles are tightened suggests..

A

Garnett’s sign –> abdominal wall pathology such as a hematoma in abdominal wall musculature

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10
Q

current exercise recommendations to delay onset of heart disease and HTN

A
  • 30 minutes of accumulated moderate-intensity exercise 5 or more days per week
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11
Q

diastolic dysfunction pathophys

A

chronic systolic HTN –> LVH –> limited output

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12
Q

NNT

A

1/absolute risk reduction

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13
Q

other high risk group that should receive pneumovax

A

1) all smokers between ages of 19 and 64

2) one-time revaccination after 5 years for patients with chronic renal failure, asplenia.

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14
Q

diverticulitis abx

A

1) metronidazole

2) amoxicillin/clavulante

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15
Q

common cause of fecal incontinence in institutionalized elderly

A

Overflow incontinence (due to constipating meds)

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16
Q

cause of fecal incontinece in IBD

A

reduced storage capacity

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17
Q

cause of fecal incontinence in women

A
  • puborectalis and internal sphincter weakness from vaginal delivery
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18
Q

slipped capital femoral epiphysis pathognomic exam finding

A

limited internal rotation of flexed hip

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19
Q

campylobacter gastroenteritis

A
  • common in elderly and very young
  • very common
  • more common during summer
  • more common in males
  • mostly diarrhea with less N/V
20
Q

guidelines for BP control in stroke patients

A

Monitoring with no additional treatment for patients with a systolic blood pressure <220 mm Hg or a diastolic blood pressure <120 mm Hg. The elevated blood pressure is thought to be a protective mechanism that increases cerebral perfusion, and lowering the blood pressure may increase morbidity.

21
Q

most common cause of constant unilateral nasal obstruction

A

septal deviation

22
Q

initial management of hypercalcemic crisis

A

Volume repletion and hydration. The combination of inadequate fluid intake and the inability of hypercalcemic patients to conserve free water can lead to calcium levels over 14–15 mg/dL. Because patients often have a fluid deficiency of 4–5 liters, delivering 1000 mL of normal saline during the first hour, followed by 250–300 mL/hour, may decrease the hypercalcemia to less than critical levels (<13 mg/dL).

23
Q

muscle relaxant to avoid

A

carisoprodol (metabolized to meprobamate, which is a class III controlled substance0

24
Q

lab finding with very high PPV for acute gallstone pancreatittis

A

threefold or greater elevation in alkaline transaminase

25
Q

lab finding with high PPV for pancreatic necrosis

A

CRP

26
Q

USPSTF recommendation on vitamin supplements

A

no rec for vitamin supplements for any condition

27
Q

behcet’s syndrome

A

original description of Behçet’s syndrome included recurring genital and oral ulcerations and relapsing uveitis. It is more common in Japan, Korea, and the Eastern Mediterranean area, and affects primarily young adults. The cause is unknown. Two-thirds of patients will develop ocular involvement that may progress to blindness. Patients may develop arthritis, vasculitis, intestinal manifestations, or neurologic manifestations. This disease is also associated with cutaneous hypersensitivity; 60%–70% of patients will develop a sterile pustule with an erythematous margin within 48 hours of an aseptic needle prick.

28
Q

metatarsal stress fractures

A
  • common in runners
  • can be reproduced by having patient jump on affected leg
  • localized tenderness and swelling
29
Q

management of severe hyponatremia (with confusion and seizures)

A

Warrants urgent management with hypertonic saline.

  • Raise serum sodium level by 1-2 mmol/L per hour
  • some people recommend concomitant use of furosemide
30
Q

best initial management for patients in afib

A

rate control w/ CCB or beta-blocker + warfarin for anticoagulation

31
Q

best choice for anticoagulation in patients 65 and older with one or more RFs for stroke

A

warfarin

32
Q

enoxaparin/LMWH monitoring

A

only required in severely obese patients, should be monitored with anti-factor Xa levels

33
Q

management of asymptomatic patient with positive PPD

A

CXR

34
Q

management of high risk patient with initial negative PPD

A

two-step PPD

35
Q

management of asymptomatic patient with positive PPD + abnormal chest film

A

sputum culture for TB

36
Q

therapy for acute pericarditis

A

NSAIDS (aspirin and ibuprofen)

37
Q

erythrasma/corynebacterium infection ddx

A

coral-red fluorescence under a Wood’s light

38
Q

management of elevated transaminases in patient at risk for NAFLD

A
  • need to rule out hep B and C still (test for viral hepatitis)
39
Q

most common presenting symptom of OSA

A

excessive daytime sleepiness

40
Q

other OSA symptoms

A

snoring, unrefreshing or restless sleep, witnessed apneas and nocturnal choking, morning headache, nocturia or enuresis, gastroesophageal reflux, and reduced libido

41
Q

mild cognitive impairment defined as

A

motor function normal and normal functional activities/adls but objective evidence of memory impairment

42
Q

when does advance directive take effect

A

when individual becomes unable to communicate health care wishes

43
Q

usual management of patient with systolic HF

A

ACE inhibitor + beta blocker

44
Q

concern with angioedema and ACEI

A

ARB will prob do it too if ACEI is

45
Q

when metolazone is used for HF

A

volume overload unresponsive to increased doses of furosemide

46
Q

management of systolic HF for patient who can’t tolerate ACEI

A

isorbide + hydralazine

47
Q

concern in women over 65 with hyperthyroidism

A

increased risk for hip and vertebral fractures

Family med (48 decks)

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