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Foundations Exam 3 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Thiamine (B1)

A

beriberi (neuropathy, edema) and Wernicke-Korsakoff syndrome (neurologic)

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2
Q

Riboflavin (B2), niacin (B3), pyridoxine (B6)

A

cheilitis, angular stomatitis, glossitis (oral)

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3
Q

Niacin (B3)

A

pellagra (diarrhea, dermatitis, dementia)

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4
Q

Folate

A

macrocytic anemia

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5
Q

Cyanocobalamin (B12)

A

peripheral neuropathy

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6
Q

Vitamin D

A

rickets, osteomalacia (bone weakening)

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7
Q

Vitamin A

A

night blindness

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8
Q

Zinc

A

taste disturbance, impaired wound healing

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9
Q

Iodine

A

goiter and hypothyroidism

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10
Q

Calcium

A

fractures, tetany

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11
Q

Iron

A

fatigue, pallor, pale conjunctiva, pica, koilonychia

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12
Q

Vitamin C and K

A

bleeding gums, easy bruising, slow healing wounds, petechiae/purpura

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13
Q

Vitamin E

A

sensory and motor neuropathy

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14
Q

Fluoride

A

tooth decay, tooth discoloration

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15
Q

Sodium

A

edema

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16
Q

Potassium

A

weakness, vomiting

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17
Q

Niacin

A

flushing

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18
Q

Gastroparesis

A

Delayed gastric emptying

Eat small, frequent, low fat, low fiber meals

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19
Q

Roux en y gastric bypass

A

Restrictive AND malabsorptive bariatric surgery

Eat small frequent meals and avoid simple sugars

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20
Q

Celiac disease

A

Immune disorder triggered by the ingestion of gluten leading to mucosal inflammation and villous atrophy

Eat gluten free diet

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21
Q

Irritable bowel syndrome

A

Functional bowel disorder characterized by chronic abdominal pain and altered bowel habits

Eat a FODMAP diet

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22
Q

Inflammatory bowel disease

A

Inflammatory disorders of the GI tract that can lead to mucosal inflammation, ulceration, and malabsorption (e.g. Ulcerative colitis and Crohn’s)

Eat well balanced nutrient rich diet

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23
Q

Chronic pancreatitis / pancreatic insufficiency

A

Exocrine dysfunction (digestive enzyme deficiency) can lead to protein and fat malabsorption

Avoid fat

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24
Q

Renal disease

A

Poor excretion can lead to sodium and fluid retention, hyperkalemia, and hyperphosphatemia

Dietary interventions:

  • Individualized protein, Na, K, PO4, and Ca intake
  • Phosphorus binders
  • Consult dietitian trained in renal nutrition
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25
Q

Risks of iron deficiency

A 
o	Blood loss
o	Celiac
o	H pylori
o	Roux en y gastric bypass
o	PPI use (omeprazole)
26
Q

Risks of B12 deficiency

A 
o	Vegan
o	Roux en y gastric bypass
o	Pernicious anemia 
o	Terminal ileum
o	Crohn’s
o	Celiac 
o	Chronic pancreatitis
o	Metformin
27
Q

HTN

A

• Grade A
o Age 18+
o Screen every 3-5 years until age 40, then annually

• Annual screening if at increased risk:
o High normal BP
o Overweight/obese
o African American

28
Q

HTN in children and adolescents

A

American Academy of Pediatrics: 3 years or older at every health care visit

NHLB, Bright Futures, AHA: 3 years or older annually

29
Q

Hyperlipidemia

A

• Grade B: low dose statin
o Age 40-75, no hx of CVD, 1 or greater CVD risk factor, 10 year CVD risk greater than 10%

• Grade C: low dose statin
o CVD risk 7.5 – 10%

• Insufficient
o Less than 20 years
o Over 76 years with no hx of CVD

30
Q

Coronary heart disease

A

• Insufficient: hs-CRP, ankle brachial index, coronary artery calcification score
o No hx of coronary heart disease

• Grade D: EKG
o Low risk adults

• Insufficient: EKG
o Intermediate or high risk adults

31
Q

Carotid artery stenosis

A

• Grade D
o 10% of strokes caused by carotid artery stenosis
o 1% of carotid artery stenosis is asymptomatic
o Potential for overall benefit limited by low prevalence and harms

32
Q

Abdominal aorta aneurysm - MEN

A

• Grade B
o 65-75 who have smoked

• Grade C
o 65-75 who have never smoked
o Selectively offer screening, rather than routinely screen

33
Q

Abdominal aorta aneurysm – WOMEN

A

• Insufficient
o 65-75 who have smoked

• Grade D
o 65-75 who have never smoked

34
Q

Peripheral artery disease

A

Insufficient evidence: ankle brachial index

35
Q

Aspirin prophylaxis (to prevent CVD and colorectal cancer)

A 
•	Grade B
o	50-59 with 10% or greater 10 year CVD risk
o	Not at risk of bleeding
o	Have 10+ year life expectancy
o	Willing to take ASA daily

• Grade C
o 60-69 with 10% or greater 10 year CVD risk
o More likely to benefit if above criteria met

• Insufficient evidence
o Younger than 50 and older than 70

36
Q

Colorectal cancer

A

• Grade A
o 50-75

• Grade C
o 76-85
o Most appropriate if healthy enough to undergo tx if cancer is detected, and there are no comorbid conditions significantly limiting life expectancy
o Greater benefit if never been screened

37
Q

Prostate cancer (PSA)

A

• Grade D
o Over 70

• Grade C
o 50-69
o Individualized after discussing benefits and harms with clinician and incorporating patient values and preferences in the decision

38
Q

Skin cancer

A

• Insufficient

• Grade B
o Counseling those with fair skin types

• Grade C
o Older than 24

39
Q

Breast cancer – USPSTF

A

• Grade C
o 40-49
o Individualize

• Grade B
o 50-74
o Screen every 2 years

40
Q

Breast cancer – ACOG (American College of Obstetricians and Gynecologists)

A
  • Offer at age 40, start no later than age 50

* Screen every 1-2 years until age 75 then discuss discontinuation

41
Q

High risk breast cancer

A
  • Annual screening mammogram starting at age 25, or 5-10 years before age of dx of affected relative
  • Supplemental screening breast MRI
  • Scheduled 6 months apart
42
Q

BRCA

A
  • Use familial risk assessment tool in women with hx or family hx of breast CA
  • Otherwise, Grade D
43
Q

Cervical cancer (Pap)

A

• Grade A
o 21-65
o Every 3 years

• Grade D
o Older than 65 or younger than 21
o Those with hx of hysterectomy

44
Q

Lung cancer

A

• Grade B
o 55-80 with hx of smoking
o Annual screening with low dose CT with 30 pack year hx, and patient currently smokes or has quit within past 15 years
o Discontinue if not smoked in 15 years or develops health problem substantially limiting life expectancy or willingness to have lung sx

45
Q

The clap and gon

A

• Grade B
o Screen in sexually active women 24 or younger and older women at increased risk

• Insufficient for men

46
Q

Hepatitis B

A
  • Grade A: screen pregnant women at first prenatal visit

* Grade B: screen those at high risk

47
Q

Hepatitis C

A

• Grade B
o Those at high risk
o 1 time screening to adults born between 1945-1965

48
Q

HIV

A 
•	Grade A
o	15-65 
o	Screen younger and older if at increased risk 
o	All pregnant women 
o	Pre exposure prophylaxis
49
Q

Syphilis

A

• Grade A
o Asymptomatic, non-pregnant adults and adolescents at increased risk
o Early screening in pregnancy women

50
Q

Depression

A

• Grade B
o General adult population, including pregnancy and postpartum women
o Screen for major depressive disorder in adolescents age 12-18
o Pregnant and postpartum: refer to counseling if at increased risk

• Insufficient
o Children 11 or younger

51
Q

Tobacco use

A

• Grade A
o Ask all adults, including pregnant women, about tobacco use
o Advise to stop tobacco and provide interventions
o In non-pregnant adults, provide rx for for cessation

52
Q

Tobacco use for children and adolescents

A

• Grade B
o Provide interventions, education, counseling, prevent initiation of tobacco use among school aged children and adolescents

53
Q

Alcohol

A

• Grade B
o 18 or older, including pregnant women
o Screen for unhealthy alcohol use in primary care settings and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use

• Insufficient
o 12-17

54
Q

Drug use

A

• Insufficient
o Screening adolescents, adults, and pregnant women
o Children, adolescents not already dx with substance use disorder

55
Q

Intimate partner violence

A

• Grade B
o Women of reproductive age

• Insufficient
o Older or vulnerable adults

56
Q

Thyroid dysfunction

A

• Insufficient evidence

57
Q

Thyroid cancer

A

• Grade D

58
Q

Osteoporosis

A

• Grade B
o Women 65 and older
o Postmenopausal women younger than 65 who are at increased risk of osteoporosis

• Insufficient
o Men

59
Q

Obesity

A

• Grade B
o Adults with BMI 30 or greater
o 6 years old or younger screen for obesity
o Offer interventions

60
Q

Vision

A

• Grade B
o Vision screening at least once in children age 3-5 for amblyopia or risk factors

• Insufficient
o Glaucoma
o Impaired VA in 65 older

61
Q

Hearing

A

• Insufficient

o Screening for hearing loss in asymptomatic adults 50+

62
Q

Fall and fracture risk

A
  • Grade B: exercise interventions for 65 older
  • Grade C: multifactorial interventions for 65 older
  • Grade D: vitamin D supplementation

Foundations Exam 3 (1 decks)

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