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Internal medicine > Family med > Flashcards

Family med Flashcards

1
Q

Neonate should visit

A

within 1-2 Weeks of birth

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2
Q

Infant should visit at

A

at 2, 4,6, 9, and 12 months

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3
Q

Toddler should visit at

A

15, and 18 months; 2 and 3 years old

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4
Q

Preschoolers should visit

A

annual visits beginning at 3 years old

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5
Q

Primary school age visit

A

annual visits 5 through 10 years old

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6
Q

Middle school age visit

A

annual visits 10 through 13 years old

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7
Q

Middle and late adolescent period should visit

A

annual visits 13 through 19 years old

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8
Q

Social smile

A

8 wks

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9
Q

Fixes head and follows by turning head

A

3 months

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10
Q

Head control

A

4 months

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11
Q

Sits unsupported

A

9 months

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12
Q

Palmar grasp and transfer toys

A

9 months

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12
Q

Polysyllabic babble (Mama, Dada)

A

7 months

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13
Q

Fear of strangers

A

10 months

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14
Q

Mature pincer

A

12 months

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15
Q

Walks at

A

18 months

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16
Q

Feeds self

A

18 months

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17
Q

6-10 words

A

18 months

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18
Q

— Posterior Fontanelle
— Anterior Fontanelle

A

: Usually, cannot be palpated after two months of age

Generally, closes between 10-24 months of age, the fontanelles of premature infants tend to close later.

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19
Q

The minimal acceptable weight gain in the neonatal period and infancy is

A

30 g/day through 3 months of age
20 g/day 3-6 months
10 g/day 6-12 months.

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20
Q

Newborn screening program

A

Thyroid function test (TFT) for Congenital Hypothyroidism Phenyl-ketonuria (PKU)
Hearing screening

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21
Q

Screening of vision is done at ___ years of age by Visual Acuity Testing and Cover/uncover Test for Amblyopia.

A

3

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22
Q

It is normal for infants to have occasional ________until 3 months of age

A

strabismus

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23
Q

universal screening of all newborn infants for hearing loss at birth_________

A

“before 1 month of age”

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24
Q

AAP recommends universal screening of Hb for anemia at

A

12 months.

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25
Q

AAFP, AAP and NICE recommend initiating an evaluation for ADHD for any child ____ year presenting by academic or behavioral problem

A

4-18

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26
Q

USPSTF recommends screening children aged _______ years and older for obesity

A

6

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27
Q

The Egyptian Pediatric Clinical Practice Guidelines Committee recommends starting daily iron supplementation from age 6 months through ______ years (19 if girl)

A

12

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28
Q

Infants who are exclusively breastfed or receive less than 1 liter of formula daily should be supplemented with 400 IU of vitamin D daily, starting in the first few days of life and continuing until they are

A

12 months

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29
Q

Infants should never have a bottle in bed, and babies should be weaned to a cup by ______

A

12 months

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30
Q

SSHADESS stands for

A

Strength or interests
School
Home
Activities
Drugs/Substance use
Emotions/Depression
Sexuality
Safety

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31
Q

HEADSSS risk assesment

A

Home
Education/Employment/Eating
Activities
Drugs
Suicidality/Depression
Sexuality/Sexual behavior
Safety
Spirituality

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32
Q

USPSTF recommends screening for major depressive disorder (MDD) in adolescents aged

A

12 to 18 years

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33
Q

PHQ-2 (Patient Health Questionnaire-2) is a useful screening tool that when positive should be followed by the PHQ-9 for more definitive diagnosis.

A

For depression screening

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34
Q

Exercise recommendations adults

A

A. Low to moderate level aerobic activity
* Frequency: Daily
* Duration: 30 minutes or more of cumulative activity, may split into three ten-minute activities daily
* Example: walking, using stairs instead of elevator

B. Moderate to vigorous aerobic activity
* Frequency: 3-5 times per week
* Duration: >20-30 minutes moderate intensity
* Example: football, biking, swimming, and running

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35
Q

Guidelines recommend calculating global CHD risk every____ years for all adults over age _____years or those with 2 or more risk factors, in order to consider risk modification.

A

5

40

36
Q

The USPSTF (US preventive service task force) recommends low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) in adults aged ______ years who have a _____ or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.

A

40 to 59

10%

37
Q

Blood pressure readings should be obtained at _____ office visit and at least____ every 2 years.

A

every

once

38
Q

The USPSTF recommends screening all men regardless of risk starting at age ____, and women at high risk at age ______; men and women should be screened earlier if high risk.

A

35

45

39
Q

Cervical cancer screening

A

Routine cytology (Pap smear), Every 3 years in a sexually active woman aged 21 until 65.

40
Q

Breast cancer screening

A

Mammography every 2 years, starting at 40 until 74

41
Q

Colorectal cancer screening

A

Fecal occult blood testing (annually)
Sigmoidoscopy (every 5 years)
Colonoscopy (every 10 years)

Starting at 45 till 75

42
Q

Lung cancer screening

A

Low dose CT annually, starting at 50 and ending at 80

43
Q

Screening in adolescents

A

✔ Screening for primary hypertension
✔ Screening for iron deficiency anemia
✔ Screening for hepatitis B virus infection
✔ Screening for obesity :
✔ Screening for depression by PHQ2 and confirm by PHQ9

44
Q

Immunization in adolescents

A

By age 11 to 12 years, they should have received

A booster dose of tetanus if > 5 years elapsed since last dose

Meningococcal vaccine

HPV

Annual influenza

Pneumococcal if high risk for infection

45
Q

✔ Screening for Fall ➡ Timed get up and go test

A
  • < 20 seconds = Independent
  • > 30 seconds = High risk
46
Q

Finger test is used to screen for

A

hearing impairment in geriatrics

47
Q

Advise travelers to use at least DEET

A

20%

48
Q

The most common cause of travelers diarrhea is

A

enterotoxigenic E coli (ETEC)

49
Q

For diarrhea, ________ has antisecretory and antimicrobial properties, to | stool frequency and shorten the duration of illness (15 mL or 2 tablets every 30 minutes for up to 8 doses)

A

bismuth subsalicylate

50
Q

Offer _________ vaccine fortravel to certain parts of sub-Saharan Africa and tropical South America.

A

yellow fever

51
Q

Offer the _________ vaccine for travel to Saudi Arabia during the Hajj (required by the Saudi Arabian government)

A

meningococcal

52
Q

Suspect ______ in any child with fever >38°C with no obvious cause. If any ‘Red’ flags, admit/refer for emergency assessment.

A

UTI

53
Q

Around 2-5% of pregnant women have _________, defined as pure growth of >105 organisms/mL

A

asymptomatic bacteriuria

54
Q

Criteria for pre diabetes

A

FPG 100 mg/dL to 125 mg/dL (IFG) OR

2-h PG during OGTT 140 mg/dL to 199 mg/dL (IGT) OR

Hemoglobin A1C 5.7-6.4%

55
Q

Criteria for the diagnosis of diabetes Type 2

A

FPG >126 mg/dL. Fasting is defined as no caloric intake for at least 8 h.
OR

2-h PG >200 mg/dL during OGTT.
OR

Hemoglobin A1C >6.5%.
OR

In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose >200 mg/dL.

56
Q

Treatment Goal of Diabetes

A

> Set A1 C/blood glucose target (HbA 1 c<7%)

57
Q

Diabetes physical activities recommendation

A

> 150+ min/week of moderate-to-vigorous activity over at least 3 days/week with no more than 2 consecutive days without exercise.

> All adults, with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior.

> Prolonged sitting should be interrupted every 30 min for blood glucose benefits, particularly in adults with type 2 diabetes.

58
Q

Diabetic foot care for patient

A
  1. Do not smoke
  2. Inspect feet daily
  3. Wash feet daily and dry carefully
  4. Avoid temperature extremes
  5. Do not walk barefoot
  6. Do not use adhesive tapes
  7. Do not soak feet
  8. For dry skin, use cream
  9. Wear properly fitting stockings
  10. Do not cut coms and calluses
  11. Shoes should be comfortable
  12. Cut nails straight across
  13. Notify your physician of blisters or sores on foot
59
Q

Most common cause of fatigue

A
  • Upper respiratory tract infection
  • Iron deficiency anemia
  • Acute bronchitis or bronchiolitis
  • Adverse effect of a medication taken at the proper dose
  • Depression or other mental disorder.
60
Q

Medications associated with fatigue

A
  • Antihistamines
  • Corticosteroids
  • Antidepressants
  • Beta-blockers
  • Muscle relaxants
61
Q
  • Patients describe a brief spinning sensation brought on when turning in bed or tilting the head back to look up.
  • The dizziness is quite brief, usually seconds.
  • Patients may experience nausea but rarely vomit.
  • Ear pain, hearing loss, and tinnitus are absent
A

Benign paroxysmal positional vertigo

62
Q
  • Characterized by the rapid onset of severe, persistent vertigo, nausea, vomiting, and gait instability, spontaneous vestibular nystagmus, a positive head impulse, and gait instability without a loss of the ability to ambulate
A

Vestibular neuritis

63
Q
  • Acute vertigo with hearing loss, ipsilateral facial paralysis, ear pain, and vesicles in the auditory canal and auricle are typical features
A

Herpes zoster oticus

64
Q
  • Spontaneous episodic vertigo lasts for minutes to hours, usually associated with unilateral tinnitus, hearing loss, and ear fullness.
  • The vertigo associated with Meniere disease is often severe and associated with nausea and vomiting and disabling imbalance
A

Meniere disease

65
Q

Medications that can cause vertigo

A
  • Alcohol
  • Antihistamine
  • Antiarrhythmics,
  • Antihypertensives,
  • Antidementia
  • Benzodiazepine
    Antiepileptics
65
Q
  • Traumatic peripheral vestibular injury following direct concussive head trauma,
  • Symptoms of vertigo, nausea, and vomiting, and imbalance are maximal at onset and improve over days to months, depending on the severity of the injury.
A

Labyrinthine concussion

66
Q

________examination can help distinguish central from peripheral causes of vertigo.

A

HINTS (head-impulse, nystagmus, test of skew)

67
Q

__________can diagnose benign paroxysmal positional vertigo.

A

Dix-Hallpike maneuver

68
Q

patient looks straight ahead; alternate eye cover testing checks for ability to maintain vertical alignment of the eyes. Deviation of the covered eye after uncovering suggests a central cause.

A

Test of Skew

69
Q

Three general classes of drugs can be used to suppress the vestibular system:,

A

Antihistamines - Meclizine, dimenhydrinate, diphenhydramine

Benzodiazepines - diazepam, lorazepam, clonazepam, alprazolam

Antiemetics - ondansetron, prochlorperazine, promethazine, metoclopramide, domperidone

70
Q

6- If the office blood pressure is between 140/90 mmHg and 180/120 mmHg, offer _________________ to confirm the diagnosis of hypertension.

A

ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM)

71
Q

In people with type 2 DM, or aged > 80 years old or with symptoms of postural hypotension (falls or postural dizziness): measure blood pressure with the

A

person either supine or seated then measure blood pressure again with the person standing for at least 1 minute before measurement. If the systolic blood pressure falls by 20 mmHg or more when the person is standing, consider diagnosis of postural hypotension.

72
Q

white-coat effect also known as

A

masked hypertension

73
Q

Always ask about asthma before prescribing ____________ and advise patients to stop using them if asthma worsens.

A

NSAIDs

74
Q

5 “A”s approach

A

Ask,
Advise
Assess
Assist
Arrange

75
Q

Ask every tobacco user if he or she is willing to try to quit at this time (e.g., within the next _______).

A

30 days

76
Q

The approved non-nicotine medications are_______

A

bupropion and varenicline.

77
Q

Red flags for abdominal pain

A
  • Sudden onset of severe pain
  • Pain that interrupts sleep
  • Bilious vomiting
  • Hematemesis, hematochezia
  • Hypotension, tachycardia
  • Patient lying very still
  • Guarding and/or rigidity (focal or diffused)
  • Rebound tenderness (focal or diffused)
  • Absent bowel sounds
  • Gross abdominal distention
  • Pain out of proportion to abdominal findings
  • Age > 50 years
  • Previous abdominal surgery
  • History of CAD and/or atrial fibrillation
78
Q

Most airlines allow women to fly up to______weeks of pregnancy

A

37

79
Q

Acute diverticulitis : sy,ptoms

A
  • Pain in the left lower quadrant
  • Fever & leukocytosis
  • Possible abdominal mass
  • Guarding & rebound guarding
  • Constipation, Diarrhoea
80
Q

Diet recommendations for diabetes

A

✔ 80 % of your daily CHO of low glycemic index
✔ 20 % of Moderate glycemic index

81
Q

Acute Conjunctivitis; bacterial vs viral

A

✔ Bacterial :
- $ Yellow Sticky discharge

✔ Viral :
- $ Association with URTI
- Watery discharge

82
Q

Low UTI (cystitis) vs Upper UTI (pyelonephritis) symptoms

A

✔ Lower UTI (Cystitis) ➡ local symptoms :
- Dysuria
- Urgency
- Low abdominal pain

✔ Upper UTI (Pyelonephritis) ➡ Systemic symptoms :
- Loin pain
- Fever
- Rigors or hematuria

83
Q

▶ Follow up should be initially for HTN

A

✔ Every 1-4 weeks till BP is controlled then ✔ Every 3-6 months if controlled
✔ Monthly if controlled

84
Q

▶ Relievers : taken only when needed for athsma

A
  • Inhaled LABA + Corticosteroid
  • Inhaled SABA + Corticosteroid
85
Q

▶ Controllers : taken daily to prevent symptoms for asthma

A
  • Inhaled Corticosteroids
  • Inhaled LABA
  • Anticholinergics
  • Leukotriene modifiers
86
Q

______are both are not licensed for use during pregnancy nor breastfeeding

A

Varenicline or bupropion

Internal medicine (3 decks)

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