Family Med Flashcards
tachycardia, no p waves, narrow QRS
SVT
SVT management
vagal
doesn’t work –> adenosine
doesn’t work –> verapamil
prevention: amiodorone
tan colored stools
pancreatitis
diff btwn meningococcal vaccines
both are quadrivalent
conjugate is newer, for age 2-55
polysaccharide is for all ages
diff btwn pneumococcal vaccines
13 = conjugate for immunocompromised pts 23 = polysaccharide = non-immunocomp chronic dz + healthy 65+
shots for asplenia
pneumococcal: PCV13 (unless already have, then 23)
menigococcal: conj if 2 - 55, polysac for older
Hib
first line for absence seizures (and how to choose)
ethosuximide (not w/ pancytopenia) valproic acid (not if they may get pregnant)
breast: dilated ducts filled with secretions and fibrotic debris
duct ectasia
when to give newborns vit D
few days after birth
all breastfed babies
formula babies drinking
when to give vit K to newborns
@ birth (IM)
newborns w/ bleeding in fist weeks of life
when to give vit B12 to newborns
veg moms who breastfeed
when to give Fe to babies
babies exclusively breastfed past 4 - 6 months
pre-diabetes HbA1c
5.7% - 6.4%
MC complication of nephrotic syndrome
venous thrombosis
smoking cessation in alcoholics
nicotine patches (not buproprion which lowers seizure threshold)
bone pain, anemia, hypercalcemia
multiple myeloma
infant: progressive food intolerance, bilious, non-bloody, non-projectile vomiting
malrotation
tx for exercise induced bronchoconstriction
beta-2 ag 10-15 min before exercise
tx for actinic keratosis
cryosurgery
abx for animal bite
amoxicillin-clavulanate (for gram neg + anaerobes)
cause of urinary obstruction in male infants
posterior urethral valves
how to dx post urethral valces
voiding cystourethrogram
risk w/ TG > 1000
pancreatitis
morton’s neuroma sx
pain btwn toes
Mulder’s sign
mulder’s sign
palpable, painful click (seen w/ morton’s neuroma)
positive McMurry sign
medial meniscus tear
when does Fe def anemia need blood transfusions?
Hb
definition of chronic bronchitis
3+ months of chronic cough/dyspnea in 2 years
when do you screen w/ CT for smokers
55 - 80 yo
30 pack year
smoke or quit w/in 15 yrs
colorectal cancer screening options
colonoscopy (10) sigmoidoscopy (5) fecal occult (1)
Tx: tetanus risk event, unknown vacc status
tetanus toxoid + tetanus Ig
MCC benign breast neo in women
fibroadenoma
intoeing w/ forward facing patella (no foot deformities) =
internal tibial torsion
C shaped lateral foot border w/ prominent 5th met styloid process
metatarsus adductus (pigeon toe)
intoeing MCCs
internal tibial torsion
tx for moderate to severe asthma exacerbation
oral corticosteroids
tx for mild asthma exacerbation that doesn’t respond well to inhaled beta-2-ag
oral corticosteroids
1st line: GAS pharyngitis
penicillin V (10 days)
(or amoxicillin alone if need)
if can’t oral –> penicillin G (1 IM)
biggest stroke risk
HTN
tx for preg hypothyroid
up levo immediately and repeat TSH in 5 weeks (check every TM)
4 Ds of epiglottitis
drooling
distress (resp)
dysphagia
dysphonia
thumb sign
epiglottitis
tx for alcoholic ketoacidosis
thiamine
glucose/fluid
kid w/ bilat irregular myoclonic jerks of UEs
juvenile myoclonic epilepsy
Tx: juvenile myoclonic epilepsy
valproic acid
austin-flint murmur
aortic regurge
widened PP, visible head pulsations
aortic regurge
type 2 DM 1st line Tx
metformin
sulfonylureas (if can’t use metformin)
meglitinides (w/ renal disease or increased risk of hypoglycemia)
MC cardiac abnormality w/ Friedrich ataxia
hypertrophic obstructive CM
temporal arteritis tx
corticosteroids
IV methylprednisolone if they have visual disturbances, oral prednisone if not
esophagus problems w/ DM
autonomic neuropathy
whats elevated in pagets?
alk phos
thyroid nodule workup
- TSH levels
- euthyroid –> U/S FNA bx
- malignant –> surgery
dx diff btwn hemo/pneumothorax
hemo has dullness to percussion (not tracheal dev)
pneumo has hyperresonance (tracheal dev away)
test for PAOD
ankle brachial index (ABI)
meds for asystole
epinephrine
vasopressin
asthma w/ brown mucus plugs
suspect allergic bronchopulmonary aspergillosis (ABPA)
older pt w/ rapidly growing thyroid mass
anaplastic thyroid carcinoma
parasite w/ B12 def
diphyllobothrium latum
when is Hb A1C inaccurate?
chronic kidney disease
high if on dialysis, low if uremic
mastitis workup
U/S to direct fine needle aspiration
mild vs severe preeclampsia
mild = 140/90 - 300 mg
flesh colored/erythematous plaques in circle
granuloma annulare
asthma sx that don’t respond to tx w/ flattened inspiratory loop
vocal cord dysfunction
when do you give kids fluoride?
6 mo
FLT: vaginal candidiasis
topical azole (like clotrimazole)
MC neonatal rash (+eosinophilia)
erythema toxicum neonatorum (healthy infant)
osteomyelitis etiology
kids: hematogenous
adults: soft tissue spread
MCC isolated, persistent proteinuria in children
orthostatic proteinuria
dx test for orthostatic proteinuria
first morning urine protein-to-creatinine ratio
CA risk in PCOS
endometrial cancer
thyrotoxicosis and pelvic mass
struma ovarii
caustic inhalation exposure –>
reactive airways dysfunction syndrome (RADS)
cell responsible in RADS
neutrophils
dx test for absence seizures in kids
hyperventilation
HIV vaccinations
flu, tetanus, pertussis
pneumococcal, hep B
T scores for osteopenia/porosis
penia: -1.5 –> -2.5
porosis:
for fasting lipid levels:
no food for 12 hrs
no alcohol for 24 hrs
bilat breast lumps and pain
fibrocystic breast dz
knee pain; tibial tuberocity tenderness
Osgood-Schlatter dz
tibial tuberocity avulsion (if acute)
MCC jaundice w/in 24 hrs of brith
ABO/Rh incompatibility
use direct Coomb’s test
test for OA of thumb
thumbs up –> rotate and push down
time diff: seborrheic dermatitis and atopic dermatitis
seborrheic: 1st month
atopic: 3 mo +
vaccines w/ egg
flu(***), MMR, yellow fever
vessel perforated w/ duodenal ulcers
gastroduodenal artery
vessel perforated w/ gastric ulcers
L gastric artery
diff btwn gastric/duodenal ulcers
gastric: worse w/ eating
dup: better w/ eating
tx for primary dysmenorrhea
- nsaids
2. OCPs
hematuria post athletics
IgA nephropathy
workup for early closure of fontanelles (
monitor head circumference
x ray
then CT
levels in anemia of chronic dz
normo - micro cytic (long)
serum Fe = low
TIBC = normal - low
ferretin = high
dx test for DM retinopathy
fluorescein angiography
Loeys-Dietz syndrome
marfan + atrophic scars, translucent skin
gradual scrotal pain that improves w/ elevation, cremasteric reflex in tact
epididymitis
MCC direct hyperbilirubinemia in newborns
biliary atresia
eclampsia prophylaxis
IV magnesium sulfate
tx for febrile seizures
acetaminophen
phases of thyroiditis
thyrotoxicosis
euthyroid
hypothyroid
recovery
testicular mass disappears while supine
varicocele
tx of aphthous ulcers
triamcinolone (topical CS)
nsaids
crescent shaped lucency @ femoral head
avascular necrosis
tests for dementia (for reversible causes)
TSH/T3/4 (hypothyroid) BMP (Cr/BUN) LFTs (cirrhosis) RPR (neurosyph) B12 depression CT (NPH, bleed) MRI (stroke)
recurrent itchy vesicular eruptions on fingers/palms/soles
dyshidrotic eczema
low-pitched vibratory systolic ejection murmur (loudest @ LL sternal border or supine)
still’s murmur
MC benign childhood murmur
young male w/ progressive low back pain and sacroiliitis
ankylosing spondylitis
flat pink/salmon blanching skin path btwn eyebrows or nape of neck
nevus simplex (stork bite, angel kiss)
port wine stain name
nevus flammeus
signet ring sign on chest CT
bronchiectasis
corneal abrasion txs
no contacts: polymyxin B/trimethoprim
contacts: quinolone/aminoglycoside
reactive non stress test definition
2 accelerations within 20 min (20 bpm increase for 30 s)
w/ or w/o fetal mvmt
rapidly growing, shiny red, nontender nodule that bleeds easily
pyogenic granuloma
FLT premature ejaculation
SSRIs
FLT insomnia
CBT
other tests w/ insomnia
TSH
UDS
CBC
sleep study
bite cells
G6PD def
acute sinusitis > 10 days w/o worsening
viral (rhino)
biggest RF for periductal mastitis
smoking
smoking caused renal cancer
transitional cell
limping obese kid w/ hip/groin pain, limited internal rotation
slipped capital femoral epiphysis
bronchoalveolar lavage shows lipid-laden macrophages (foamy)
lipoid pneumonia (kind of aspiration pneumonia) MC from misuse of petroleum jelly/mineral oil
how to reverse warfarin
vit K and FFP
test for cholelithiasis
RUQ U/S
fever, uterine tenderness, fetal tachy, premature rupture of membranes
chorioamnionitis
delayed femoral pulses
coarctation of the aorta
post abortion - fever, boggy uterus, foul smelling d/c
septic abortion
bilat proximal muscle aches, morning stiffness w/o joint pain, elevated ESR/CRP/IL6, normal CK
polymyalgia rheumatica (a/e temporal arteritis)
prolactinoma tx
bromocriptine
check for iron def anemia
serum ferritin (wtf)
drugs that up fetal HR
beta agonists (terbutaline)
hypopigmented patches (Ask-leaf), mental retardation, epilepsy
tuberous sclerosis
tumors a/w tuberous sclerosis
glioma, hamartoma, angiofibroma
triple therapy for h. pylori
PPI, amoxicillin, clarithromycin
or
bismuth subsalicylate, metronidazole, tetracycline
management of bloody diarrhea in kids
stool culture before abx
tx for ALS
riluzole (glutamate inhibitor)
which bx for skin
raised, non pigmented, non-melanoma = shave
pigmented and > 4 mm = excisional
non-pigmented, flat or pigmented
joint pain relief in CHF pts
not NSAIDs (–> Na/H2O retention)
acetaminophen
tramadol
opioids
clots in hematuria
extraglomerular bleeding –> do a renal/bladder U/S
baby w/ cyanosis during feeding and NG tube can’t go past nasal passage
choanal atresia (CHARGE syndrome)
first step management of vulvar/vaginal lesion
punch bx
check for squamous cell carcinoma
resp distress, worse w/ beta agonist
V/Q mismatch
