Family Flashcards

1
Q

What are the two most common causes of decreased vision in elderly patients (especially >75)

A
  1. Cortical cataracts

2. Macular degeneration

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2
Q

What are side effects of Ginkgo biloba?

A

Increased bleeding risk, used for memory enhancement

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3
Q

What are side effects of Ginseng

A

Increased bleeding risk

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4
Q

What are side effects of Black cohosh

A

Hepatic injury, used for postmenopausal sx

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5
Q

What are side effects of Kava Kava

A

Sever liver damage

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6
Q

what is dx:
Pt experiences acute onset of flushing, throbbing headache, palpitations, abdominal cramps 30 mins after eating fish at a local restaurant (he has eaten this fish before)

A

Scombroid poisoning - ingestion of improperly stored seafood (histidine forms histamine)

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7
Q

What is the diagnostic test of choice for osteomyelitis?

A

MRI: sensitivity > 90%, high negative predictive value

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8
Q

How what is the gold standard for abx selection of osteomyelitis?

A

bone bx w culture - superficial wound cultures have little predictive value in identifying the underlying path organisms

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9
Q

In a brain dead organ donor, what are 3 factors that threaten organ viability? - What is done to manage this?

A
  1. Central DI - volume depletion
  2. Systemic hypotension (loss of sympathetic tone)
  3. Hypothermia

Maintain euvolemia w IV fluids and desmopressin, ionotropic/pressor support, Warm air blankets

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10
Q

What is the
1. first line
2. second line
therapy for postherpetic neuralgia

A
  1. Tricyclic antidepressants (amitriptyline) - should not be used in older pts or w cognitive impairment
  2. Gabapentin, pregab
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11
Q

What are recommendations by the American college of cardiology/America Heart Association for patients with diabetes?

A

Statin therapy for all patients

  1. 40-75 with Diabetes
  2. LDL >70 mg/dL
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12
Q

When should bone density screening begin in women without risk factors?

when should it be earlier?

A

65

earlier if post menopausal w risk factors:

  1. <127lbs
  2. chronic steroid use
  3. smoking,
  4. malabsorptive dz (ie pancreatic insuff in cys fibrosis)
  5. parent hx of hip fx, or personal hx of low impact fx
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13
Q

When should you screen earlier for colon cancer?

A

Screen at 40 or 10 before age of relative w Ca
Risk factors:
1. first degree relative <60 w Ca
2. >/= first degree relatives w Ca at any age

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14
Q

What is the management of a cat bite?

A

prophylactic augmentin

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15
Q

Which antihypertensive can cause a skin rash?

A

HCTZ - photosensitivity or dermatitis

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16
Q

How should healthcare workings possibly exposed to TB pt be managed?

A

Workers with a negative TB skin test - retest in 8-10 weeks

17
Q

Which patients is the HPV vaccine indicated for?

A

All pts 11-26

18
Q

What is dx?
53 yr old with worsening arthralgias, fatigue over the year. palpable liver 1cm below costal margin. fam hx of DM, started 6 months ago on metformin. Arthrocentesis of joint shows positively birefringent rhomboid-shaped crystals

A

Hereditary Hemochromatosis (bronze diabetes)

  • arthropathy + hepatomegaly + fam hx of diabetes
  • Calcium pyrophosphate in 50% of pts.

-20fold increase risk of hepatocellular carcinoma

19
Q

How do you manage the pt:

3 yr old with asymptomatic venous lead level 60 ug/dL (normal: <5)

A

Oral meso-2,3-dimercaptosuccinic acid (DMSA, succimer)

20
Q

How do you manage a pt with lead toxicity (70uq/dL) and or acute encephalopathy

A

hospitalization
Intramuscular dimercaprol
IV EDTA (calcium disodium edetate)

21
Q

Mgmt?
31 yr old chinese immigrant w abdominal fullness in epigastrum, occasional nausea, no heartburn, dysphagia, early satiety, weighloss

A

H. pylori testing (dyspepsia = chronic pain/fullness in epigastric area without significant heartburn)

“test and treat” strategy in pt <55
EGD in pts >55