Family Med Flashcards
What vaccine should be given to all MSM? What other groups should get this vaccine?
Hepatitis A
IVDA, travelers to countries where this is endemic, chronic liver disease
At what age can children start receiving the flu vaccine?
6 months
Give them two doses of the inactivated vaccine at least 4 weeks apart
What ages should receive the HPV vaccine?
Under 26
Age for zoster vaccine?
60 years old
Should you screen for lung cancer? If so, how?
No! Early detection shows no improvement in mortality
Ages for colon cancer screening
Age 50
or, if there is a hx of colon ca in the family, screen at age 40 or 10 years younger than the age that family member was diagnosed
(whichever age comes first)
Mammogram screening age
Age 50-74, every 2 years
Cervical cancer screening
Start at age 21, regardless of sexual hx
Age 21-29, pap smear every 3 years
Age 30-65, pap smear every 3 years or pap smear + HPV test every 5 years
Should you screen for prostate cancer? If so, how?
No, not sufficient evidence for or against
Patient newly on OCPs develops high blood pressure, what is the next step in management?
Stop OCP and recommend barrier method
IUDs inc risk of
STI
Emergency contraceptives
No medical contraindications Use within 72 hours of intercourse No inc risk of VTE, stroke or MI Do not disrupt current pregnancy or cause birth defects 75-85% effectiveness
AAA screening
Via Ultrasound
o In men aged 65-75 who have ever smoked
Td vs Tdap in adults
Tdap is recommended due to waning immunity against pertussis and due to inc in # of cases of pertussis
Murphy sign
= cholecystitis
sudden cessation of inspiratory effort during deep palpation of the right upper quadrant is called “Murphy sign”
Main causes of peptic ulcer disease
H pylori
NSAIDs
What are the alarm symptoms in GERD that would warrant evaluation with endoscopy?
Bleeding, abdominal mass, weight loss, dysphagia, or vomiting, especially if these symptoms are present in an elderly patient.
Causes of acute pancreatitis
- Gallstones
- Alcohol
- Idiopathic
Others: hyperlipidemia, infections, meds, trauma
Ranson’s criteria for pancreatitis (assess the severity and prognosis of pancreatitis)
On admission: Age>55 WBC>16,000 Glucose > 200 LDH >350 AST>250
During initial 48 hours: Hematocrit dec >10 BUN inc > 5 Calcium < 8 PaO2<60 Base deficit > 4 Fluid sequestration > 6
Treatment of lice
Permethrin 1%
Treatment of lyme disease
Early localized disease can be treated with oral anti- biotics (amoxicillin or doxycycline) for 14 to 21 days.
Early disseminated disease is treated with IV therapy for 2 to 3 weeks. Ceftriaxone or cefo- taxime and chloramphenicol are options.
Clusters of bites indicate what insect bite?
Fleas
What is the treatment for a person with a cat bite?
After a cat bite to the hand, hospitalization is indicated unless it is very superficial and does not appear to be infected. If the bite involves the tendon, joint capsule, or bone, hospitalization is also indicated.
*Bite wounds should NEVER be closed
When can you hear fetal heart tones?
12 weeks
When is Anatomy US perfromed for OB pts
18 weeks (2nd trimester)
When is Rhogam given?
28 weeks
if mom is Rh-
When is diabetes screen done in pregnant women?
2nd trimester: 24-28 weeks
If OB pt hasnt had MMR, when do you give them the vaccine?
Soon after delivery (postpartum)
Use of Aspirin
Men 45-79 (to prevent MI)
Women 55-79 (to prevent stroke)
Unnecessary 80 year and older
What asthma drug should not be used as monotherapy?
LABA (long acting beta agonists)
Which is more sensitive for ACL injury: Lachman or anterior drawer test?
Lachman
Centor criteria for strep throat
Absence of cough
Fever
Tender anterior lymphadenopathy
Tonsillar exudate
0-1 = analgesics and supportive care
3: test and treat if positive
4= tx with antibiotics
What can be used to treat dyspnea in cancer patients?
Opioids
What pneumococcal vaccine should be given to people with chronic disease under age 65
PPSV23
Pneumococcal vaccine 65+
PCV13, followed by PPSV23 after 6-12 months
Diagnosis of DM
One of the following:
- 2 fasting glucose measurements >126
- Random plasma glucose of >200
- Two hour postprandial glucose level of >200 in a symptomatic person
- Hemoglobin A1c >6.5%
PreHTN
systolic: 120-139
diastolic: 80-89
Stage 1 HTN
systolic: 140-159
diastolic: 90-99
Stage 2 HTN
systolic: 160+
diastolic: 100+
Blood Pressure Goals
> 60 yo:
<60 yo:
Diabetic:
CKD:
> 60 yo: < 150/90
<60 yo: <140/90
Diabetic, with no CKD: <140/90
CKD: <140/90
COPD drugs
Mild: SABA/SAMA
Moderate: add LABA/LAMA
Severe: add Inhaled corticosteroids
Very severe: Long term O2 therapy
IBD
Rectal sparing vs rectal involvement
Crohn = rectal sparing
Ulcerative colitis = rectal involvement
IBD
Inflammation of mucosa/submucosa vs transmural inflammation
Crohn = transmural inflammation UC = Inflammation of mucosa/submucosa
IBS integrative medicine therapy
Peppermint oil
Migraine prevention
Propranolol
Magnesium glycinate
Nausea in pregnancy
Doxylamine and vitamin B6
Tx for specific phobias
B blocker
ex. speech phobia = propranolol
Osteoporosis screening
Women: age 65+
Men: age 70+
Treatment of COPD exacerbation
Antibiotics and systemic corticosteroids
What conditions is pseudogout associated with?
Hemochromatosis
Hypothyroidism
Hyperparathyroidism
