Fam med - testing 1, 2, 3

Question 1

What test can be used to assess the strength of the anterior talofibular ligament?

Answer 1

anterior drawer test

Question 2

What are the criteria fro testing for strep throat?

Answer 2

one point for each Fever more than 38.0 Celsius
Absence of cough
Tonsillar exudates
Anterior cervical lymphadenopathy
Age less than 15 years old
if 2-3, test, treat if positive
if greater, treat emprically

Question 3

How do we decide if an ankle sprain patient needs x rays?

Answer 3

Ottawa rules
Pain in the malleolar zone AND either:
bony tenderness along the distal 6 cm of the posterior edge of either malleolus
OR inability to bear weight 4 steps immediately after the injury and in the emergency department.
foot - if tenderness at 5th metatarsal or naviucli or inability to bear weight

Question 4

What is the gold standard diagnostic test for COPD?

Answer 4

pulmonary function testing

Question 5

What are the criteria for diagnosis of depression?

Answer 5

5 of the following 9 criteria:
Sleep: Insomnia or hypersomnia nearly every day.

Interest (loss of): Anhedonia (loss of interest or enjoyment) in usual activities.

Guilt: Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

Energy (decreased): Fatigue or loss of energy nearly every day.

Concentration (decreased, or crying): Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

Appetite (increased or decreased): or significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month).

Psychomotor retardation: Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

Suicidal ideation: Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Question 6

How can you assess the severity of suicidal ideation?

Answer 6

Sex (male);
Age (< 19 or > 45);
Depression, diagnosis of;
Previous attempt(s)
Ethanol or other substance abuse
Rational thinking impaired (psychosis, delusions, hallucinations)
Social supports lacking
Organized plan for suicide
No significant other 
Sickness (physical illness).
Score of 4-6 - outpatient
Score of 7 - 10, hospitalization warranted

Question 7

What is the definition of PMS? Whow about PMDS?

Answer 7

breast soreness, weight gain, bloating etc. that sig. affect a patients life
Premenstrual dysphoric disorder is more severe

Question 8

What is def. of menorrhagia?

Answer 8

blood loss of 80mm

Question 9

What does a head thrust test indicate?

Answer 9

if normal, indicates that lesion is central

if nystagmus when suddenly thrust head, indicates peripheral lesion

Question 10

What test can be used to treat BPPV?

Answer 10

epley maneuver

Question 11

What test can be used to assess for syndesmotic sprains?

Answer 11

crossed leg test, positive ankle squeeze test - looks for high ankle sprains

Question 12

What tests can be used to assess the cause of hyperthyroidism?

Answer 12

Thyroid peroxidase antibodies, Radioactive iodine uptake (RAIU) test and scan

Question 13

What are the diagnostic tools available for carpal tunnel syndrome?

Answer 13

tinel’s, phalens - low sensitivity, high specificity

nerve conduction velocity study is diagnostic

Question 14

What test can be used to evaluate the strength of the supraspinatus?

Answer 14

empty can test

Question 15

What test can be used to evaluate the strength of the subscapularis?

Answer 15

lift off test

Question 16

What test can be used to assess for patellofemoral knee syndrome?

Answer 16

trapping an effusion

Question 17

What test can be used to assess for collateral leg pain?

Answer 17

varus (apply stress to medial knee) and valgus (apply stress to lateral knee) stress test

Question 18

What are the criteria for diabetes diagnosis?

Answer 18

1. A random glucose of 200 mg/dL or above, plus symptoms of hyperglycemia like polyuria or unexplained weight loss, or hyperglycemic crisis.
2. A fasting plasma glucose of greater than or equal to 126 mg/dL.
3. A hemoglobin A1C greater than or equal to 6.5%.

Question 19

What ABI is associated with PAD?

Answer 19

less than 0.9

Question 20

What are the components of wells criteria?

Answer 20

active cancer, paralysis, recently bedridden or surgery, localized tenderness, entire leg swollen, calf swelling more than 3cm, pitting edema, collateral veins
-> if over 3 points, high prob.

Question 21

What does the passive leg raise test indicate?

Answer 21

To differentiate between tight hamstrings and a sciatic nerve problem, raise the leg to the point of pain, lower slightly, then dorsiflex the foot. If there is no pain with dorsiflexion, the patient’s hamstrings are tight.

Question 22

How is metabolic syndrome defined?

Answer 22

3 of the following:
hypertriglyceridemia
low HDL
elevated fasting blood glucose
excessive waist circumference
hypertension

Question 23

What test can be used in babies to detect peripheral msk disorders?

Answer 23

This reflex is elicited by an abrupt change in the infant’s head position and consists of two parts:

Symmetric abduction
Extension of the arms followed by adduction of the arms, sometimes with a cry.
The reflex is present at birth and disappears by age 4 months.

Question 24

What might absent red reflex indicate?

Answer 24

Cataracts
Glaucoma
Retinoblastoma and
Chorioretinitis.

Question 25

What test can be performed to look for neuroblastoma?

Answer 25

VMA/HVA measures metabolites of catecholamines,

Question 26

On bone marrow aspiration, what would indicate neuroblastoma?

Answer 26

hyperchromatic nuceli, scant cytoplasm

Question 27

What can throw off a BP reading?

Answer 27

Positioning (C) may influence BP readings, white coat syndrome