Fam med - Imma treat you! Flashcards
What are the treatment options for squamous cell carcinoma?
surgical excision, radiation therapy, or cryotherapy for smaller lesions
What are the treatment options for actinic keratosis?
5 fluorouracil
What is the best treatment option for tinea ungulum?
griseofulvin, terbinafine 250mg or itraconazole as 200mg pulse therapy
When is Moh’s surgery indicated?
non melanoma greater than 2 cm
What advice can you give to patients to help them manage their migraine headaches?
Headache diary, decrease use of caffeine, try to get more sleep
What are the 5 major classes of medication that can be used to treat headaches?
riptans, ergot alkaloids, aspirin/butalbital/caffeine, acetaminophen/butalbital/caffeine, acetaminophen/dichloralphenazone
What methods of migraine prophylaxis are there?
Beta-blockers, Neurostabilizers, Tricyclic antidepressants, Calcium channel blocker,
How should you treat a patient with suspected GERD?
test and treat strategy - PPI
-refer for endoscopy if persistent after 8 weeks, use 24 hour probe when GERD not responding and pat. considering surgery
What are the next steps in managing GERD in a patient who does not respond to therapy?
The H. pylori IgG serologic test - shows if ever been infected with H. Pylori. urease breath test remains less acurate on PPI therapy, FOBT,
What is the recommended tx regimen for patients with H pylori?
Standard dose PPI + amoxicillin 1 gram + clarithromycin 500mg all twice daily for 10-14 days OR Standard dose PPI once or twice daily + metronidazole 250 mg, tetracycline 500 mg, + bismuth subsalicylate 525 mg each four times daily for 10-14 days
Describe how you quit smoking
start taking buproprion 1 week before quit date. 1 pill a day for 3 days, then 2 pills a day for a few days, then quit and continue 2 pills a day
How is bronchitis treated?
usually don’t need to treat - symptom management
How do you tx PNA in infants?
admit always, tx with ampicillin and gent
How do you tx PNA 3 weeks to 6 months?
admit if bacteria - give cefuoxime
How do you tx PNA 3 months to 5 years (and above)
admit if breathing badly. give CTX or amox;
What is the treatment of choice for pharyngitis?
penicillin VK
What is the treatment for tinea pedis?
tolnaftate
What are the tx approaches for testicular torsion?
Manual detorsion of the torsed testes,
orchipexy of both contra and ipsilateral testis
How does COPD treatment differ with varying degrees of COPD?
if moderate, add inhaled anticholinergics if severe (less than 50% predicted) add inhaled glucocorticoids
What are the indications that a COPD patient may benefit from antibiotic therapy?
increased dyspnea (A), increased sputum (phlegm) production (C), and a change in color of sputum
What are the major classes of antidepressant medications?
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants (TCAs)
Monoamine oxidase (MAO) inhibitors
SNRI
What is effexor?
Serotonin and norepi reuptake inhibitor
What is Buproprion?
norepi and dopamine reuptake inhibitor
What are common side effects of SSRIs and SNRIs?
headaches, sleep disturbances, hyponatremia, serotonin syndrome (lethargy, restlessness, hypertonicity, rhabdo)
What are the uses of zoloft?
approved specifically for obsessive-compulsive, panic, and posttraumatic stress disorders.
What are common side effects of prozac?
agitation, motor restlessness, decreased libido in women, and insomnia.
What are the uses and side effects of Paxil?
Strong antianxiety; side effects: significant weight gain, impotence, sedation, and constipation.
What is the usage for Lexapro
GAD
What are the uses and side effects of Luvox?
Particularly useful in obsessive-compulsive disorder.
Greater frequency of emesis compared to other SSRIs
What are the side effects of Celexa?
nausea, dry mouth, and somnolence
What is the LDL goal if you have a CAD equivalent?
less than 100
What medications have been shown to improve heart failure outcomes?
ARBs, ACEIs, beta blockers, spironolactone in patients with class III and IV HF
What are the best treatment options for dysmenorrhea secondary to leiomyomas?
ibuprofen (decreases prostaglandins), mirena (for women trying to maintain fertility), combined hormones, depo, paragard IUD (no hormones)
What are the tx options for women with dysmenorrhea without uterine path?
acupuncture, transcutaneous nerve stimulation, thiamine
What are the tx options for PMS?
SSRIs, oral contraceptives, danazol, GnRH agonists (inhibit ovulation)
When should you treat otitis media?
tx wtith antibiotics if children less than 6 months
if older, watchful waiting
What treatments are useful in vertigo?
rehab, anticholinergic suppressants (meclizine), anti-emetics
What are the treatment options for grave’s?
Methimazole, radioactive iodine (takes a few months to work) surgery - propanolol for symptomatic management
How is hypothyroidism treated?
1.5-1.8 mcg per kilogram of thyroxine, check TSH 1 month later
What medication is the first choice analgesic for short and long term treatment of osteoarthritis?
acetominaphen
What test can be used to assess for a cruciate ligament rupture?
anterior or posterior drawer test
What test can be used to assess for a meniscus injury?
mcMurry test (rub femur against tibia)
What test can be used to assess for IT band syndrome?
ober test (turn patient on side, let leg relax and see if knee relaxes to ground)
What is the follow up for radioactive iodine treatment?
TSH drawn every two to three months until it has stabilized. The time frame can be extended after that to six months or longer.
Describe the tier model for management of type 2 diabetes
HbA1C>6.5 - metformin + lifestyle changes
HbA1C>8 - lifestyle changes, metformin, + sulfonyurea,
Reassessment -add basal insulin as needed
Next step: Add rapid acting insulin with meals
How soon after a stroke should rehab start happening?
24-48 hours
What is the best initial treatment for carpal tunnel?
nocturnal wrist splint
What agents are used to tx hyperlipidemia?
statins - first line therapy
nicotinic acid - increases HDL
fish oil supplements
What are common side effects of statins?
Hepatic dysfunction
myopathy `
What medical options exist to reduce weight?
Orlistat, Phentermine, ariatric surgery (D)
Indications: Patients with BMI >40 or BMI ≥35
What are common side effects of stimulant drugs?
Appetite suppression, tics, weight loss, insomnia, lower socioeconomic status, Prader-Willi
