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Family Med Notes Flashcards

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1
Q

Which has stronger familial predisposition - type I or type II DM?

A

Type II DM

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2
Q

Stages of CKD

A 
Stage I: GFR 90-100
Stage II: GFR 60-89
Stage III: GFR 30-59
Stage IV: GFR 15-29
Stave V: GFR <15 or dialysis
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3
Q

Diagnostic test to determine central vs peripheral cause of vertigo

A

Dix-Hallpike maneuver

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4
Q

Most common type of melanoma

A

Superficial spreading melanoma

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5
Q

Motor or sensory loss in all 4 limbs, crossed signs, disconjugate gaze, nystagmus, dysarthria, and/or dysphagia — where is the stroke

A

Vertebrobasilar

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6
Q

AAA screening guidelines

A

One-time screening for AAA by ultrasound in MEN aged 65-75 who have ever smoked

No routine screening for women

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7
Q

Outpatient abx for diverticulitis

A

Amox/clav
TMP-SMX
Cipro

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8
Q

Hypertrophic cardiomyopathy gets _____ with valsalva

A

Worse

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9
Q

Only legally required immunization for travel (and only for some countries)

A

Yellow fever

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10
Q

Abx for cat bite

A

Amoxicillin/clav acid (5 days prevention, 10 days to tx)

Clindamycin + fluoroquinolone if allergic to PCN

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11
Q

What kind of drug is ezetemibe?

A

Decreases cholesterol by interfering with absorption in the gut

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12
Q

Mucopurulent cervicitis is caused by gonococcal infections 50% of the time, and chlamydial infections 70% of the time. What is the tx?

A

Ceftriaxone IM for gonorrhea

Doxycycline oral for chlamydia

[alternative is cipro for gonorrhea or azithromycin for chlamydia]

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13
Q

Excessive menstrual flow, or prolonged duration >7 days at regular intervals

A

Menorrhagia

[common cause is leiomyomas]

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14
Q

What should you monitor in pts on statins?

A

Liver enzymes

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15
Q

Causes of late decels

A

Uteroplacental insufficiency/maternal hypotension

Epidural anesthesia

Oxytocin, HTN, DM

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16
Q

GI lipase inhibitor that results in 9% weight loss

A

Orlistat

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17
Q

Gold standard for dx and tx of choledocholithiasis

A

ERCP

[usually performed in setting of acute cholecystitis with increased liver enzymes

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18
Q

H.influenzae vaccine should not be administered before age _______ as immune tolerance to the antigen may be induced

A

6 weeks

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19
Q

SVT can be treated with carotid massage, valsalva, cold application to face, or pharmacologically with ______

A

Adenosine

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20
Q

DEXA scans start at age _____, or _____ if high risk

A

65; 60

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21
Q

Growth curve shows decrease in weight first, followed by decrease in height — what 2 possibilities?

A

Failure to thrive

Constitutional growth delay

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22
Q

How do you treat elevated potassium in the setting of CKD?

A

Treat with sodium polystyrene sulfonate, insulin + glucose, and retention enemas

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23
Q

Insulin secretagogues that stimulate beta cells in the pancreas to secrete insulin; tendency to cause weight gain and lose effectiveness over time; cause hypoglycemia

A

Sulfonylureas

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24
Q

Most effective pharmacotherapy at preventing relapse of alcohol abuse

A

Acamprosate

[better results than disulfuram, naltrexone, and SSRIs]

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25
Q

Prophylaxis for recurrent UTI

A

Start with single dose post-coital abx

If that doesn’t work, daily single dose abx for 3-6 months

If symptoms recur, may need to continue for 1-2 years

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26
Q

T/F: CCBs may worsen systolic dysfunction in CHF

A

True — some may worsen it such as nifedipine, diltiazem, and nicardipine

[amlodipine and verapamil are fine]

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27
Q

DM patients are at risk for invasive external otitis (malignant) with ________ (bug)

A

Pseudomonas

Tx with surgical debridement and IV abx

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28
Q

Inflammation of eyelid with loss of eyelashes and scaling

A

Blepharitis

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29
Q

Pt presents with diarrhea and pneumonia, you suspect legionella, what is next diagnostic step?

A

Urine antigen test or direct fluorescent antibody test

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30
Q

Most common type of melanoma in african americans and asians, found under the nails, on soles of feet and palms of hands

A

Acral lentiginous

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31
Q

Best dx test when spinal stenosis is suspected

A

CT scan

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32
Q

Short acting insulin option

A

Regular insulin

[30-50 min onset, 60-120 min peak, 5-8 hr duration]

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33
Q

DASH diet is high in what 2 electrolytes?

A

K+ and Ca+

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34
Q

Ranson’s criteria assess severity and prognosis of pancreatitis, what are they?

A 
Age >55
WBC >16,000
glucose >200
LDH >350
AST >250
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35
Q

Rocky mountain spotted fever presents with red macules on peripheral extremities that become purpuric and confluent. Treat with _______ that continues 2-3 days after pt is afebrile

A

Chloramphenicol

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36
Q

Stages of labor

A
  1. Onset of labor until cervix is completely dilated
  2. Complete dilation to delivery of fetus
  3. Delivery of fetus to delivery of placenta
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37
Q

Tx for scabies

A

Oral ivermectin

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38
Q

Blood pressure med that may cause nightmares

A

Propranolol

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39
Q

In women not breastfeeding, menstruation begins by the -___ postpartum month

A

3rd

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40
Q

5-15% of pts with colonic diverticulosis develop severe diverticular bleeding. It is unusual to find the source of bleeding during colonoscopy. ___________ should be the next diagnostic step

A

Tagged RBC scan

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41
Q

Up to what size can a skin lesion be before it is concerning for malignancy?

A

<6 mm

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42
Q

Most common type of skin cancer; pearly papules w/ central ulceration or telangiectasias; rarely metastasize

A

Basal cell

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43
Q

Growth curve shows simultaneous changes in height and weight

A

Familial short stature

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44
Q

Acute onset of severe vertigo lasting several days with symptoms improving over several weeks

A. Acoustic neuroma
B. Vestibular neuronitis
C. BPPV
D. Meniere disease
E. None of the above
A

B. Vestibular neuronitis

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45
Q

Twisting knee injury with sense of instability, feeling a “pop” and immediate effusion while still being able to bear weight

A

ACL

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46
Q

Enlargement of thyroid gland following viral illness and is often mildly tender

A

Subacute granulomatous thyroiditis

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47
Q

Skin cancer with irregularly shaped plaques/nodules w/ raised borders, bleed easily, scaly and ulcerated; higher rate of metastasis

A

SCC

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48
Q

What class of diuretic should be avoided in hypercalcemia

A

Thiazides

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49
Q

Major and minor criteria for CHF according to framingham heart study

A

Major (need 2) — PND, JVD, rales, cardiomegaly, pulmonary edema, S3, CVP >15, circulation time of 25 sec, hepatojugular reflex, wt loss of 4.5 kg over 5 days of tx

Minor — ankle edema, nocturnal cough, DOE, hepatomegaly, pleural effusion, decreased VC, tachycardia

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50
Q

Pt presents to ED with bilateral LE edema + s/s of CHF — what imaging do you order first?

A

CXR to rule-in CHF, followed by an echo

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51
Q

Tx for patellofemoral pain syndrome

A

Strengthen quadriceps and hip rotators

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52
Q

Postvoid residual that is diagnostic of overflow incontinence

A

> 200 ml

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53
Q

In pts with decreased sex drive and no other complaints or exam findings, assessment of hormone status is indicated. Testosterone levels should be checked in the morning when they peak, and free testosterone is a more accurate measure of androgen status. If free testosterone is low, workup continues to get FSH, LH, and PRL. Based on the following, what is the dx?

FSH and LH are high, and PRL is normal

A

Testicular failure

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54
Q

Most commonly reported symptom of hyperthyroidism

A

Tachycardia

[followed by fatigue, then weight loss, tremor, anorexia, and increased sweating]

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55
Q

Diabetic diagnostic criteria with HbA1c

A
  1. 5 and above = diabetes

5. 7-6.4 = pre-diabetic

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56
Q

When to vaccinate pregnant woman against varicella

A

Non-immune pregnant women or immunocompromised should not receive vaccine until after delivery

[household contacts of immunocompetent pregnant women do NOT need to delay vaccine]

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57
Q

Asthma symptoms <2x a week and nighttime sxs <2x a month

A

Mild intermittent

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58
Q

Which OCPs do not increase risk of venous thromboembolism?

A

Progestin only pills

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59
Q

What type of eye infection is characterized by deep boring eye pain, decreased vision, surrounding headache, and associated with autoimmune disease like RA or Wegeners?

A

Scleritis

[note that episcleritis is mild irritation compared to this]

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60
Q

Unilateral tinnitus and hearing loss; symptoms constant and slowly progressive. Vertigo, facial weakness, and ataxia can occur

A. Acoustic neuroma
B. Vestibular neuronitis
C. BPPV
D. Meniere disease
E. None of the above
A

A. Acoustic neuroma

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61
Q

Active phase of labor starts at ___cm of cervical dilation

A

3-4

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62
Q

Tx for cluster headache

A

Nifedipine

Mainstay of abortive tx is O2 and triptans

[other options are prednisone, indomethacin, lithium, verapamil, serotonin antagonists]

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63
Q

Most sensitive vs. most specific lab test for alcohol abuse

A

Most sensitive = GGT

Most specific = Elevated MCV

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64
Q

Side effects of metformin

A

Renal insufficiency (c/i if Cr >1.5)

Hepatic insufficiency or CHF

C/i in nursing moms

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65
Q

Define chronic renal failure

A

GFR <60 for 3+months

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66
Q

How do you differentiate Graves disease from thyroiditis?

A

T-99m radionuclide scan

Shows diffuse hyperactivity with graves

Shows patchy uptake with overall reduced activity in thyroiditis

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67
Q

EtOH guidelines in women, men, and pts>65

A

Women — no >7/week, no >3/one occasion

Men — no >14/week and no >4/one occasion

Pts >65 — no >1 drink/day

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68
Q

Hep A has early fecal shedding and is less infectious once patient is _______

A

Jaundiced

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69
Q

What do you do if pt complaining of classic UTI symptoms comes in and has a negative UA?

A

Get a culture

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70
Q

T/F: in pts clinically diagnosed with acute sinusitis, there is a significant difference between abx and placebo use

A

False — no significant difference

There IS a significant difference in pts with sinusitis dx by CT scan or bacteriology

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71
Q

Most common cause of hearing loss in elderly — associated with selective high frequency loss and difficulty with speech discrimination

A

Presbycusis

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72
Q

Tularemia presents with pain and ulceration at bite site; treat with ______ IM

A

Streptomycin

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73
Q

Normal fetal heart rate is 110-160, what causes bradycardia vs tachycardia?

A

Bradycardia = maternal hypothermia

Tachycardia = maternal fever

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74
Q

Tremor seen at rest and inhibited by movement

A

Parkinsonian tremor

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75
Q

Most common cause of death while traveling

A

Heart disease (2nd most common is accidents)

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76
Q

Diabetes diagnostic criteria regarding random glucose, fasting glucose and 2 hr plasma glucose

A

2 random glucose >200 with classic DM symptoms (polyuria, polydipsia, etc)

2 fasting glucose >125

2 hr plasma glucose >200 after 75 g glucose load

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77
Q

Naegles rule

A

Subtract 3 mo and add 7 days to first day of LMP

78
Q

Fever, swollen thyroid, clinical manifestations of a bacterial illness

A

Suppurative thyroiditis

79
Q

Which are more likely benign — hot or cold thyroid nodules?

A

Hot are more likely benign

80
Q

Menstrual bleeding at irregular intervals

A

Metrorrhagia

81
Q

Leading cause of severe vision loss in elderly; caused by atrophy of cells in central region of retinal pigment epithelium, resulting in loss of central vision

A

Macular degeneration

82
Q

Growth curve shows height velocity slowing first, and may plateau before weight changes are seen. Dx?

A

Hypothyroidism

83
Q

Women between the ages of ____-____ should get mammograms every _____

A

50-74; 2 years

84
Q

Daily asthma sxs and nighttime sxs at least weekly

A

Moderate persistent

85
Q

IBD characterized by continuous inflammation of the large bowel

A

UC

86
Q

What to do if patient is currently pregnant and non-immune to rubella

A

Vaccinate EARLY in postpartum period

87
Q

Macrocytic anemia with normal methylmalonic acid and increased homocysteine

A

Folate def

88
Q

What lab abnormality is more suggestive of gallstone pancreatitis vs. pancreatitis due to alcohol or hypertriglyceridemia?

A

Elevated ALT

89
Q

AAFP vs USPSTF prostate cancer screening recs

A

AAFP — insufficient evidence

USPSTF — recommends against

90
Q

Most aggressive type of melanoma that is often invasive at the time of dx

A

Nodular

91
Q

Palpable preauricular lymph node indicates what type of conjunctivitis?

A

Viral

92
Q

T/F: HPV vaccine can be given in pregnancy

A

False

93
Q

Subclinical hypothyroidism will progress at a rate of 2-5% per year. What are risk factors for progression?

A

Presence of autoantibodies

Old age

Female gender

TSH >10

94
Q

Roux en Y is reserved for those with BMI >_____ or >______ with obesity related complications

A

40;35

95
Q

Short acting insulin secretagogues that increase insulin secretion; taken no more than 2 hrs before meals because of rapid onset

Most valuable if fasting sugars are adequate but postprandial sugars are high

A

Meglitinides

96
Q

Venous congestion, N/V, bloating, constipation, abdominal pain, decreased appetite, fluid retention, weight gain, edema, JVD, hepatojugular reflex, hepatic ascites, and splenomegaly

Right or left sided heart failure?

A

Right sided

97
Q

HTN in pregnancy tx options

A

Methyldopa

CCBs

98
Q

Tinnitus and low frequency hearing loss associated with attacks of vertigo lasting several hours that may be associated with N/V. Treat with diuretics and salt restriction

A. Acoustic neuroma
B. Vestibular neuronitis
C. BPPV
D. Meniere disease
E. None of the above
A

D. Meniere disease

99
Q

Primary amenorrhea w/ normal secondary sex characteristics and normal initial labs. Next diagnostic step?

A

Progestin challenge test

If no withdrawal bleed — either inadequate estrogen production or outflow tract obstruction

100
Q

Drug of choice for urge incontinence

A

Anticholinergics (oxybutynin and tolterodine)

101
Q

______ is an osteoporosis tx that directly inhibits osteoclastic bone resorption and is considered an alternative in pts whom estrogen therapy is not recommended; also produces analgesic effect

A

Calcitonin

102
Q

Hyperlipidemia tx that decreases TGs, increases HDL, and decreases LDL, but may increase insulin resistance

A

Niacin

103
Q

T/F: bronchodilators improve the decline in function seen in COPD

A

False, symptomatic only

104
Q

Asthma symptoms >2x a week but <1x a day, nighttime sxs >2x/month

A

Mild persistent

105
Q

MOA of PTU vs. methimazole in tx of hyperthyroid

A

PTU — prevents peripheral conversion of thyroid hormone

Methimazole — inhibits organification

106
Q

Sterile inflammation of meibomian gland of the eye; painful nodule

A

Chalazion

107
Q

Thyroid _______ cells make calcitonin to lower Ca levels through renal excretion and by opposing osteoclast activation — decreasing Ca and P

A

Parafollicular

108
Q

Lipid screening guidelines for women

A

Screen if >45 and no risk factors

[screen beginning at 20 if CAD risk factors]

109
Q

IBD characterized by focal inflammation that may occur anywhere in GI tract

A

Crohns

110
Q

Diabetes screening recommendation

A

Screen all pts >45 every 3 years

111
Q

Gold standard diagnostic modality for CHF

A

Echocardiogram

112
Q

Pulmonary congestion, DOE, PND, orthopnea, wheezing, tachypnea, cough, rales, S3 gallop, Cheyne stokes respiration, pleural effusion, pulmonary edema

Right or left sided heart failure?

A

Left sided

113
Q

Rome consensus committee for IBS requires symptoms for at least _______ weeks (not necessarily consecutive) in the previous ____ months, and pain characterized by at least 2 of the following: relieved by defecation, change in stool frequency, change in form or appearance of stool

A

12; 12

114
Q

Examples of cold thyroid nodules

A

Colloidal cysts

Tumors

Neurofibromas

115
Q

First indication of renal compromise in DM

A

Increase in GFR

[followed by microalbuminuria]

116
Q

Pt presents with unstable angina and EKG changes, what medication class do you give them?

A

Glycoprotein IIb/IIIa receptor inhibitor

117
Q

Medication usually considered for NYHA class III or IV CHF or those with serum K <5

A

Spironolactone

118
Q

Screen for Hep C in persons at high risk and a one-time screening for HCV in adults born between ______-_______

A

1945-1965

119
Q

You find a nonfunctional thyroid nodule in a pt that is >1cm— what do you do next?

A

FNA

[Follicular cell malignancy cannot be distinguished from its benign counterpart]

120
Q

Diabetic drugs that improve insulin sensitivity in muscle and adipose, decrease hepatic gluconeogenesis; result in decreased TGs and increase in HDL

Edema is most common side effect

A

Thiazolidinediones

121
Q

Urinalyses used for screening for DM are highly _____ but have low _________

A

Specific; sensitivity

122
Q

When is herpes zoster vaccine given

A

Age 60+

123
Q

What part of MONA BASH reduces myocardial damage and limits the infarct size?

A

Beta blocker

124
Q

Dyslipidemia tx that is c/i in severe gout

A

Niacin

125
Q

Intermediate acting insulin option

A

NPH

[1-3 hr onset, 7-15 hr peak, 18-24 hr duration]

126
Q

People with clinically important CAD should defer noncardiac procedures until ____ after revascularization

A

6 mos

127
Q

Acute increase in thyroid size; nontender

A

Subacute lymphocytic thyroiditis

128
Q

Most significant issue to consider when using nitrates for stable angina

A

Tolerance (develops rapidly with long acting nitrates)

when using a patch it is important to have 10-12 hrs w/o patch to retain effect

129
Q

Corneal dendrites w/flourescein staining indicates what type of eye infection?

A

Herpes

130
Q

Noradrenergic agonist that allows 3-4 kg weight loss

A

Phentermine

131
Q

What is prehn sign?

A

Relief of pain upon elevation of testicle — rules out torsion as this is positive in epididymitis, hernias, orchitis, or cancer

132
Q

Eye inflammation associated with photophobia, sluggish pupil, cloudy cornea, pain, and pupillary constriction

A

Iritis

133
Q

Gradually increasing thyroid gland that is firm but is nontender

A

Invasive fibrous thyroiditis

134
Q

______ levels are sensitive to undernutrition and would be decreased in a pt with failure to thrive

A

IgA

135
Q

First line therapy for HTN in most settings

A

Thiazide diuretic

136
Q

When do you give antihypertensives to a stroke pt? (What are the BP cutoffs?)

A

Systolic >220 or diastolic >120

[if pt suitable for thrombolytics, give antiHTN to reduce systolic >185 and diastolic <110]

Note — IV labelolol, nicardipine, and sodium nitroprusside are often used

137
Q

Type of melanoma most often in elderly on chronic, sun-damaged skin, least common of the four types and is most common in hawaii

A

Lentigo maligna

138
Q

MCC of acute wheezing in children <2, esp infants 1-3 months old

A

Bronchiolitis

139
Q

What medication reduces short term mortality when started w/i 24 hrs of an MI and prevents cardiac remodeling?

A

ACE inhibitor

140
Q

Abx for diarrhea d/t shigella

A

Fluoroquinolones or TMP-SMX

141
Q

In HIV pts, give PCP prophylaxis with TMP SMX when CD4 <200. Give MAC prophylaxis with ____ or ____ if CD4<50

A

Azithromycin; clarithromycin

142
Q

Lipid screening guidlines for men

A

Screen if >35 if no risk factors

[begin at 20 if CAD risk factors]

143
Q

Locking or catching knee injury

A

Meniscal injury

144
Q

Symptoms with position changes only

A. Acoustic neuroma
B. Vestibular neuronitis
C. BPPV
D. Meniere disease
E. None of the above
A

C. BPPV

145
Q

Heavy menstrual flow or prolonged duration fo flow at irregular intervals

A

Menometrorrhagia

[DUB — indicates problem with HPA]

146
Q

Do not do a mammogram if pt is <30, do _____ instead

A

Ultrasound

147
Q

How do estrogen and SERMs (raloxifene) work to tx osteoporosis?

A

Block the activity of cytokines

148
Q

T/F: Weight loss increases HDL by 5-10 pts

A

T

149
Q

What drug has been shown to help stress incontinence?

A

Pseudophedrine

150
Q

Rapid acting insulin options

A

Lispro/aspart

[15 min onset, 30-90 min peak, 3-5 hr duration]

151
Q

Management of CKD in terms of protein intake, metabolic acidosis, and hyperphosphatemia

A

Reduce protein excretion to <500-1000 mg/day (60% of baseline)

Restrict dietary protein intake to 0.8-1.0 mg/kg/day

Treat metabolic acidosis with sodium bicarb to maintain concentration of 22 mEq/L

Oral phosphate binders if GFR <25-30

152
Q

Screen for chlamydial infection in all sexually active women ages ___ and younger and in older women at increased risk

A

24

153
Q

Macrocytic anemia with increased methylmalonic acid and homocysteine

A

B12 def

154
Q

Beta blockers are all equally effective in treating angina. Dose should be adjusted to achieve a HR of ______ bpm

A

50-60 bpm

155
Q

Tx for IT band syndrome

A

Strengthen hip abductors, internal rotators, and knee flexors

156
Q

Autosomal dominant inherited condition causing progressive conductive hearing loss

A

Otosclerosis

157
Q

Most common type of incontinence in elderly

A

Urge

158
Q

Long acting insulin options

A

Glargine/detemir

[1 hr onset, no peak, 24 hr duration]

159
Q

What labs do you get at first prenatal visit

A 
CBC
HBsAg
HIV
RPR
UA
UC 
Rubella
Blood type
Rh
Pap
GC/chlam
160
Q

Treatment for alzheimers that requires monitoring of liver enzymes

A

Tacrine

161
Q

Latency time for onset of symptoms of vertigo or nystagmus is 3-10 sec, symptoms are severe, direction of nystagmus is fixed, and repeating the manuever lessens the symptoms

Peripheral or central cause of vertigo?

A

Peripheral

162
Q

MOA of antiemetic zofran

A

Serotonin receptor antagonist

AEs include dizziness and headache

163
Q

In pts with decreased sex drive and no other complaints or exam findings, assessment of hormone status is indicated. Testosterone levels should be checked in the morning when they peak, and free testosterone is a more accurate measure of androgen status. If free testosterone is low, workup continues to get FSH, LH, and PRL. Based on the following, what is the dx?

FSH and LH are low, and PRL is high

A

Pituitary adenoma — get a CT or MRI to confirm

164
Q

GERD is a common cause of wheezing in the pediatric population, what is the gold standard test?

A

24 hr pH probe

165
Q

T/f: you can give HPV vaccine to pts who are breastfeeding or immunocompromised

A

True

166
Q

Most commonly reported hepatitis virus

A

Hep A

167
Q

Asymptomatic hematuria with eosinophils in urine; often caused by analgesics or other drugs

A

Interstitial nephritis

168
Q

Most common cause of low back pain in pts <26 years of age, especially athletes

A

Spondylolisthesis

169
Q

Variable decels are caused by

A

Umbilical cord compression during contractions

170
Q

People born before 1957 do not need to be vaccinated with MMR and are considered immune. This vaccine is contraindicated in those with allergy to ________. It is a live attenuated vaccine that should not be given to pregnant or immunocompromised. Wait 3 mo if blood or Ig products given

A

Neomycin

171
Q

Canadian cervical spine rules determine who needs radiography. What are some high risk factors that mean YES radiography?

A

Age >65

Dangerous mechanism (high speed MVA)

N/T in extremities

[low risk factors are simple rear end collision, if pt was ambulatory at the scene, absence of neck pain at scene, absence of C spine tenderness on exam — if answer is no to any of the above - get imaging]

pt should also be able to actively rotate neck 45 degrees left and right regardless of pain

172
Q

Treatment goals for diabetic pts include HbA1c <6.5, fasting glucose <120, 2 hr post prandial sugar < ______, BP <130/80, LDL

A

140; 70

173
Q

Urinary side effect of CCBs seen in elderly

A

Urinary retention

174
Q

Cardinal movements during delivery

A

Flexion
Internal rotation
Extension
External rotation

175
Q

Strongest risk factor for Alzheimers

A

Advancing age

[other RFs are family hx, female gender, low education, CV factors, hx of head trauma]

176
Q

Most common cause of significant GI bleed in children

A

Meckel diverticulum

[presents with painless large-volume intestinal hemorrhage]

177
Q

Define constipation

A

<3 stools per week

178
Q

Patients that are US-born before year ______ are considered immune to varicella, with the exception of healthcare workers and pregnant women

A

1980

179
Q

At what BMI do you initate tx for obesity?

A

BMI >25

180
Q

Pts with a non-hemorrhagic stroke should get _____ in the first 48 hrs

A

Aspirin

181
Q

H pylori triple therapy

A

Clarithromycin/amoxicillin/metronidazole + PPI

182
Q

T/F: the prevalence of dementia doubles every 5 years after the age of 60

A

True

[this is the importance of cognitive screening in geriatrics — do clock draw and 3-item recall]

183
Q

In pts with decreased sex drive and no other complaints or exam findings, assessment of hormone status is indicated. Testosterone levels should be checked in the morning when they peak, and free testosterone is a more accurate measure of androgen status. If free testosterone is low, workup continues to get FSH, LH, and PRL. Based on the following, what is the dx?

FSH and LH are low, but PRL is normal

A

Pituitary or hypothalamic failure

184
Q

C-peptide should be _____ in type I DM

A

Low

185
Q

40% of graves patients that are treated with _________ become hypothyroid; another side effect is agranulocytosis

A

Radioactive iodine

186
Q

Most common cause of sudden cardiac death

A

Dilated cardiomyopathy

187
Q

Pre-HTN

Stage I HTN

Stage II HTN

A

Pre-HTN: 120-139/80-90

Stage I HTN: 140-159/90-99

Stage II HTN: >160/100

[in Stage II, 2 drug therapy is indicated — most commonly thiazide diuretic + ACE inhibitor, ARB, beta-blocker, or CCB]

188
Q

T/F: H.influenzae vaccine decreases rate of otitis media

A

False - most cases are caused by non-typeable Hflue

189
Q

What T score indicates osteoporosis vs osteopenia?

A

Osteoporosis = T < -2.5

Osteopenia = T < -1 to -2.5

190
Q

Pt with primary hyperparathyroidism has a calcium level >12 mg/dL. What do you need to do prior to attempting parathyroidectomy?

A

Lower the serum calcium prior to surgery with loop diuretics and IV saline

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