Family Med Flashcards by Emily Rowe

What are the signs/symptoms of retinal artery occlusion?

Acute-onset, painless, unilateral vision loss
Afferent pupillary defect (dilation of the affected pupil when a swinging flashlight moves toward it)
Retinal pallor on fundoscopic exam
Cherry-red spot in the macula

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What is the most common mechanism of injury in an ankle sprain?

Inversion of a plantar flexed foot

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What are the stages of hypertension?

Normal: < 120 / < 80
Elevated: 120-129 / < 80
Stage 1: 130-139 systolic OR 80-89 diastolic
Stage 2: >/= 140 systolic OR >/= 90 diastolic
Crisis: >/= 180 systolic OR >/= 120 diastolic

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What should be suspected in patients presenting with hemolysis following an oxidative stressor, such as recent administration of a drug?

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

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What are the physical exam findings in a patient with bacterial endocarditis?

Fever
Roth spots
Osler nodes
Murmur

Janeway lesions
Anemia
Nail bed hemorrhages
Emboli

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What leukemia is caused by a reciprocal translocation on the long arms of chromosomes 9 and 22 (AKA the Philadelphia chromosome)?

Chronic myelogenous leukemia (CML)

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What are the signs/symptoms of sarcoidosis?

Cough, dyspnea, fever, fatigue, skin lesions, arthralgias
Bilateral hilar adenopathy on CXR
Hypercalcemia, hypercalciuria, elevated serum ACE on labs

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What signs/symptoms are pathognomonic for sarcoidosis?

Lupus pernio
Chronic, violaceous, raised plaques and nodules commonly found on the cheeks, nose, and around the eyes

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What medications are used as abortive therapy for migraines?

Triptans, DHE, antiemetics, NSAIDs

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What medications are used as prophylactic treatment for migraines?

TCAs, beta-blockers, anticonvulsants (valproic acid, topiramate), CCBs

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When should you avoid triptans and DHE?

In patients with uncontrolled HTN or cardiovascular disease

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What medication class is used to treat symptoms and prostate size in patients with BPH?

5-alpha-reductase inhibitors (ex finasteride)

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What is an occupational lung disease associated with nuclear power, nuclear reactor, dental, metal machine shops, and aerospace industries?

Berylliosis

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What is the American Diabetes Association diagnostic criteria?

Symptoms & random BG >/= 200
Fasting BG >/= 126 on 2 occasions
BG > 126 2 hrs after 75g GTT
A1C >/= 6.5

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What is the treatment for Lyme in a pregnant patient?

Amoxicillin

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External hemorrhoids that fail conservative treatment require what treatment?

Hemorrhoidectomy

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What is Samter’s triad?

Nasal polyps, asthma, and aspirin-sensitivity (related to allergies)

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What are the most common bacterial causes of acute otitis media?

Haemophilus influenzae and Streptococcus pneumoniae

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What is the treatment of choice in otherwise healthy patients with community acquired pneumonia?

Amoxicillin or doxycycline

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What is cholesteatoma?

Keratinized collection of desquamated epithelial tissue in the middle ear or mastoid

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What are the signs/symptoms of cholesteatoma?

Painless, malodorous otorrhea and conductive hearing loss

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What type of murmur can be heard as a soft, high-pitched, crescendo-decrescendo murmur during midsystole along the left sternal border?

Still murmur

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What maneuver should be performed if you suspect an innocent murmur of childhood?

Standing

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What is metabolic syndrome?

The combination of central obesity, insulin resistance, hypertension, high triglycerides (>150), and low HDL (<40-50)

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In patients with mono, which lymph nodes are typically enlarged?

Posterior cervical

What is the preferred diagnostic test for nephrolithiasis?

Noncontrast CT of abdomen and pelvis

What is 1st line pharmacologic treatment for chronic glaucoma?

Prostaglandin analog (e.g., latanoprost)

What is an essential tremor relieved and exacerbated by?

Relieved: small amounts of alcohol Exacerbated: anxiety

Immune thrombocytopenia (ITP) is an immune-mediated disorder characterized by what?

Isolated thrombocytopenia (< 100,000) with normal hemoglobin, hematocrit, and white blood cell counts

What should patients with SLE avoid?

Pregnancy for 6 months following active disease

What lab tests high specificity for SLE?

Anti-double-stranded DNA and anti-Smith antibodies

For patients considered to have high cardiovascular risk, when is follow-up lipid screening performed?

Men: 25 to 30 years Women: 30 to 35 years

What is the treatment for kids who present with GI symptoms and likely a shigella infection?

Azithromycin

What medication improves symptoms of claudication and can increase walking distance by suppressing platelet aggregation and dilating arterioles?

Cilostazol

What is the recommended first-line therapy for acute bacterial rhinosinusitis?

Augmentin 875 mg/125 mg BID or 500 mg/125 mg TID for 5 to 7 days Doxycycline if penicillin allergic

What are the most common pathogens causing community-acquired pneumonia?

Streptococcus pneumoniae and Mycoplasma pneumoniae

What makes up the Samter triad?

Asthma, aspirin sensitivity, and nasal polyps

Allergic contact dermatitis is what type of hypersensitivity reaction?

Type IV (mediated by T lymphocytes)

What are common causes of allergic contact dermatitis?

Poison ivy, poison oak, topical antimicrobials (e.g., bacitracin, neomycin), anesthetics, nickel, and adhesive tape

What drug used to treat TB is known to cause neuropathy?

Isoniazid

When prescribing isoniazid, what other medication can be given to help avoid neuropathy?

Vit B6

What is Pancoast syndrome?

A tumor that may develop dermatomal symptoms stemming from C8, T1, and T2 due to involvement of the brachial plexus which can result in muscle atrophy, weakness, and pain. Horner syndrome can be present.

What is Horner syndrome and what other syndrome is it associated with?

Ipsilateral ptosis and miosis Associated with Pancoast syndrome

What are the treatment options for warts?

Topical salicylic acid (1st line) Cryotherapy (1st line) Topical cantharidin Laser Topical immunotherapy (reserved for refractory cases)

What are the physical exam findings in a patient with hypertrophic cardiomyopathy?

Pulsus bisferiens (biphasic pulse due to aortic regurgitation) Triple apical impulse (prominent atrial filling with early and late systolic impulses) Prominent a wave due to reduced right ventricular compliance Loud S4 gallop

What things would cause the murmur associated with hypertrophic cardiomyopathy to decrease or increase?

Decrease: actors that increase the preload (squatting, hand-grip) Increase: factors that decrease the preload (standing, Valsalva maneuver)

What is a Monteggia fracture?

Fracture of the proximal ulnar shaft with a radial head dislocation

What are the classic findings of rheumatoid arthritis?

Symmetric swelling Pain and stiffness of multiple joints Morning stiffness Symptoms that are worse in the morning, worse after inactivity, and alleviated by mild activity

What are first-line agents for patients with abdominal discomfort or pain due to irritable bowel syndrome?

Antispasmodic agents, such as dicyclomine or hyoscyamine

What are the characteristics of nonproliferative diabetic retinopathy?

Tortuous, dilated retinal vessels in the macula and may cause retinal hemorrhages without neovascularization

What are histopathologic findings indicative of Alzheimer disease?

Amyloid plaques and the accumulation of hyperphosphorylated tau protein in neurofibrillary tangles within the brain

How do patients with polycythemia vera present?

Vasomotor symptoms, such as erythromelalgia and aquagenic pruritus Headache, dizziness, and early satiety Facial plethora (ruddy cyanosis) and splenomegaly Elevated hemoglobin and hematocrit

What type of hearing loss is seen with Ménière disease?

Low-frequency sensorineural hearing loss

What type IV hypersensitivity reaction is associated with herpes simplex virus?

Erythema multiforme

What are clinical manifestations of chronic Addison disease?

Weakness Fatigue Loss of appetite GI symptoms Weight loss Dizziness Hypotension Hyperpigmentation of the skin

What abnormal gene is associated with familial adenomatous polyposis (FAP)?

APC mutation

What is the first-line drug choice for generalized epileptic seizures?

Valproate

What gram stain results would you expect to find in a patient with bacterial meningitis?

Gram-negative diplococci

What are the T scores associated with osteoporosis and osteopenia?

Osteoporosis: ≤ −2.5 Osteopenia: < −1.0 and > −2.5

When should a pregnant patient with hyperthyroidism be transitioned from PTU to methimazole?

If dx prior to pregnancy and on methimazole: switch to PTU once pregnancy confirmed If dx in 1st trimester: start on PTU and switch to methimazole in 2nd trimester If dx after 1st trimester: start with methimazole

What medication is effective in preventing recurrent hepatic encephalopathy?

Rifaximin

What is first-line pharmacological therapy for osteoporosis?

Bisphosphonates (e.g., alendronate, pamidronate, zoledronic acid)

What are the signs/symptoms of acute myeloid leukemia?

Fatigue Weakness Easy bleeding Pallor Bruising Shortness of breath Normocytic, normochromic anemia Decreased platelet count Myeloblasts with Auer rods

What bacteria is associated with the development of magnesium ammonium phosphate crystals in the urine, leading to nephrolithiasis?

Proteus mirabilis

What medication is FDA approved to treat Bipolar I?

Quetiapine

What are the signs/symptoms of Bells palsy?

Waking up with unilateral facial nerve paralysis, hyperacusis, and taste disturbance that does NOT spare the forehead

What antibiotic should be prescribed a patient with a corneal abrasion who wears contacts?

Topical gentamicin

What is the effect of low serum estradiol and progesterone (common in birth control) levels on gonadotropin-releasing hormone, follicle-stimulating hormone, and luteinizing hormone at the beginning of the menstrual cycle?

All increase

What are drusen spots?

Atrophic changes and yellow retinal deposits associated with dry macular degeneration

Children who present with early-onset hypertension or a new murmur should be considered for what disorder?

Coarctation of the aorta

Patients with anemia secondary to vitamin B12 deficiency often present with what symptoms?

Fatigue Shortness of breath Glossitis Paresthesia Numbness Gait abnormalities

What does the U.S. Preventive Services Task Force suggest for breast cancer screening women with a normal risk?

Bilateral screening mammography at age 50 years and repeating the screening every 2 years until the patient is 74 years old

What is Gilbert syndrome and what occurs in patients who have it?

Most common inherited disorder of bilirubin glucuronidation There is a deficiency in the enzyme uridine 5’-diphospho-glucuronosyltransferase

Acute bacterial suppurative parotitis is typically caused by what bacteria?

Staphylococcus aureus

What is the treatment for outpatient septic bursitis?

Bactrim if MRSA suspected Cephalexin or dicloxacillin if MSSA or Streptococcus 10 days

When might you see warfarin-induced skin necrosis?

In patients with protein C deficiency

Patients with a first-degree relative diagnosed with colorectal cancer should begin screening when?

10 years younger than the age at which that relative was diagnosed

HLA-B27 is associated with what disease?

Ankylosing spondylitis

If someone's sputum culture comes back positive for TB, what results do you expect to see?

Rod-shaped, aerobic, acid-fast bacterium

Family Med Flashcards

(79 cards)