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Step 2 CK > Family medicine > Flashcards

Family medicine Flashcards

1
Q

age range gardisil is approved for

A

9-26

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2
Q

gardisil recommended for age range

A

11-18

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3
Q

normal range for BMI

A

18.5-25

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4
Q

zoster vax recommended at what age?

A

60

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5
Q

birth years for 1 time hep C screening

A

1945-1965

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6
Q

BMI range for morbid obesity

A

40+

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7
Q

diameter suspicious for melanoma

A

> 6 mm

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8
Q

5 of 9 criteria for depression

A 
SIG E CAPS
Sleep
Interest (loss of)
Guilt
Energy 
Concentration
Appetite
Psychomotor
Suicidal ideation
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9
Q

SSRI most likely to cause SSRI discontinuation syndrome

A

paroxetine

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10
Q

SSRI for GAD

A

Escitalopram

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11
Q

SSRI w/strong anti-anxiety effects

A

Paroxetine

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12
Q

SSRI with long half life

A

fluoxetine (prozac)

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13
Q

good SSRI for panic, OCD and PTSD

A

Sertraline

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14
Q

SSRI good for OCD, but Greater frequency of emesis

A

fluvoxamine

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15
Q

herb to tx depression

A

st. john’s wort

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16
Q

time cutoff for bereavement vs MDD

A

2 months

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17
Q

positive ankle squeeze test

A

Syndesmotic sprain

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18
Q

3 lateral ankle ligaments

A

all end with fibular

Atf Cf Ptf

anterior talofibular, calcaneofibular, and posterior talofibular ligaments

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19
Q

ottawa ankle rule

A

There is pain in the malleolar zone AND either bony tenderness along the distal 6 cm of the posterior edge of either malleolus OR inability to bear weight 4 steps both immediately after the injury and in the emergency department (C).

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20
Q

ottawa foot rule

A

There is pain in the midfoot region AND one of the following: (a) bony tenderness at either the navicular bone or base of the 5th metatarsal OR (b) inability to bear weight four steps immediately after the injury and in the emergency department.

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21
Q

A1C diagnostic of DM

A

> 6.5

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22
Q

posprandial glucose target 1-2 hours after meal

A

should be < 180 mg/dl

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23
Q

fasting glucose target

A

80 -120 mg/dl

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24
Q

if sugars are >200, what else needed to dx DM?

A

sx

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25
Q

Dx of PAD

A

ankle-brachial index <.9

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26
Q

pretest probability formula for DVT

A

Wells criteria

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27
Q

Wells criteria for DVT: width of leg circumference that is positive

A

greater than 3 cm

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28
Q

grade of ulcer with abscess or bone involvement

A

grade 3

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29
Q

length of time to use heparin in DVT to transition to warfarin

A

5 days

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30
Q

htn if >60 years old

A

150/90

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31
Q

BP cuff L and W requirements (2)

A

bladder of the cuff should be at least 80% of the arm circumference , and the width of the cuff must be at least 40% of the arm circumference

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32
Q

anti-hypertensive NOT to use in blacks

A

ACE inhibitors

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33
Q

reasons for ASA in men vs women

A

men to prevent MI

women to prevent ischemic stroke

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34
Q

myotome of dorsum of foot, lateral foot

A

L5, S1

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35
Q

cutoff for cervical cancer screening if negative paps

A

age 65

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36
Q

zoster offered at what age?

A

60

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37
Q

pneumovax at what age?

A

65

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38
Q

NSAIDS effect on warfarin

A

increase effectiveness

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39
Q

age at which NSAIDs increase GI bleeding risk

A

65

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40
Q

group to be screened for chlamydia

A

sexually active 24+ younger

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41
Q

naegele’s rule for EDD (3)

A

add 1 year
subtract 3 mos.
add 1 week

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42
Q

definition mab

A

abortion w/o dilation of cervix

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43
Q

rubella titer (non-immune and immune)

A 
non-immune = 1:3
immune = 1:10
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44
Q

sensitivity of Down’s screening in triple screen and quad screen, respectively

A

70, 80

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45
Q

liver percussion 5-7-9 rule

A

upper borders

5th intercostal space in the midclavicular line
7th intercostal space in the midaxillary line
9th intercostal space in the scapular line

46
Q

Obturator sign

A

Passively internally rotate hip

47
Q

2 ways to elicit psoas sign

A

Have patient flex hip agains your resistance
Or
Passively extend hip

48
Q

problem drinking vs risky/hazardous drinking

A

problem is problems in daily life

risky hazardous is >4 drinks/sitting

49
Q

2 signs of portal htn

A

SPLENOMEGALY and VENOUS PATTERNS(veins away from umbilicus)

50
Q

abdominal veins going up

A

IVC obstruction

51
Q

patch

A

macule greater than 1 cm

52
Q

bulla

A

fluid-filled, greater than 1 cm

53
Q

1st line adult tx for tinea capitis

A

griseofulvin

54
Q

2 meds besides HRT, SSRIs for hot flashes

A

clonidine

gabapentin

55
Q

GERD/PUD sx w/o warning signs.

1st step?

A

4-8 week PPI trial

56
Q

Center criteria of strep 5

A

NFALT

Fever
Tonsillar exudate
Lymphadenopathy
Age less than 15
No cough
57
Q

infant return to birthweight at (time)

A

2 weeks

58
Q

colic rule of 3

A

3 hours day
3X/week
over 3 weeks

paroxysmal

59
Q

postpartum blues resolve by

A

10 days

60
Q

age of infant where fever MUST be evaluated

A

under 2 months

61
Q

external shoulder rotation with elbows down tests (2)

A

infraspinatous

teres minor

62
Q

internal shoulder rotation with elbows down tests (1)

A

subscap

63
Q

shoulder impingement testing (2)

A

neer/hawkins

  1. pronate wrist and raise arm in front passively while holding AC joint.
  2. flex elbow to 90 degress, push hand down slightly
64
Q

sign to distinguish epididymitis from torsion

A

prehn sign

lifting testicle relieves epididymitis, not torsion pain

65
Q

blue dot sign on scrotum

A

testicular appendix torsion

66
Q

Dx of COPD (2)

A

Fev1/fvc less than 70% or below 5th percentile.

67
Q

2 high intensity statins

A

Atorvastatin 40-80 mg

Rosuvastatin 20-40 mg

68
Q

age must treat otitis media

A

less than 6 months

69
Q

3 types of dizziness

A

vertigo
presyncope
disequilibrium

70
Q

vertigo with hearing changes, tinnitus

most likely dx

A

meniere’s

71
Q

HEEADSSS interview

A

Home
Education/Employment
Eating disorder screening
Activities / Affiliations /Aspirations
Drugs (including alcohol, tobacco, steroids)
Sexuality
Suicidal behavior (along with depression and mental health concerns)
Safety (abuse, fights, weapons, seatbelts, etc.)

72
Q

Asymmetrical Tonic Neck Response of infant

A

Turning the newborn’s head to one side causes gradual extension of arm toward direction of infant’s gaze with contralateral arm flexion–like a fencer.

73
Q

TORCH infections

A

Toxoplasmosis, Other transplacental infections, including HIV, hepatitis B, human parvovirus, and syphilis, Rubella, Cytomegalovirus and Herpes virus type 2.

74
Q

sheets of lymphocytes with interspersed macrophages

A

Burkitt Lymphoma

75
Q

newborn with sensorineural deafness, eye abnormalities (retinopathy, cataracts), and patent ductus arteriosus.

A

congenital rubella

76
Q

newborn with microcephaly, jaundice, hepatosplenomegaly, low birth weight, and petechiae at birth.

A

CMV

77
Q

Marfanoid body habitus, a hypercoaguable state, and possible developmental delay. The condition can be diagnosed by testing for increased methionine in a patient’s urine or blood

A

homocystinuria

78
Q

Children present by six months of age with hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula

A

defect in sphingomyelinase occurs in Niemann-Pick disease

79
Q

inherited in an autosomal recessive pattern. Individuals present with hypoglycemia, hepatomegaly, and metabolic acidosis

A

defect in glucose-6-phosphatase occurs in Von Gierke’s disease

80
Q

Age for mmr, hepA

A

1 yr

81
Q

Age cutoff Dtap vs Tdap

A

DTap until 7 yrs

82
Q

random sugar cutoff for DM2 (with sx present

A

200

83
Q

2 hour GTT cutoff for DM2

A

200

84
Q

error with a BP cuff too large

A

too low BP

(cuff should span 2/3 of arm circumference

85
Q

Calorie deficit to drop 1 pound?

Reasonable goal = .5 to 1 pound/week

A

3500

86
Q

quantitative pilocarpine iontophoresis testing

dz?

A

CF

87
Q

exhaled NO test

dz?

A

primary ciliary dyskinesia

88
Q

bruton tyrosine kinase gene sequencing

dz?

A

X-linked agammaglobulinemia

89
Q

most effective postcoital birth control

A

copper IUD

90
Q

2 shots for all pts with chronic liver dz

A

hep A

hep B

91
Q

4 screenings if PID

A

HIV, syphilis, cervical cancer, hep B

92
Q

normal JVD pulse

A

less than 3 cm

93
Q

pulmonary nodules are not cancer if stable for?

A

over 2 years

94
Q

risk of not treating hyperthyroidism

A

bone loss

95
Q

3 labs to order in a female with amenorrhea, -BHCG

A

PRL, TSH, FSH

96
Q

osteomyelitis pathogen after stepping on nail

A

pseudomonas

97
Q

acute tx (2) of central retinal artery occlusion

A

ocular massage

high flow O2

98
Q

odynophagia

A

pain with swallowing

99
Q

endopthalmitis

A

infection of aqueous or vitrious humor

100
Q

hypopyon

A

WBCs in anterior chamber eye

101
Q

Direct vs indirect Coombs

A

Direct if autoimmune hemolytic anemia (ig on rbc)

Indirect if checking serum for unbound ig. Trx or maternal

102
Q

while testing for gestational DM, abnormal 1 hour test cutoff

A

140

103
Q

gestational DM 3 hr GTT cutoffs at 1,3 hours

A

180, 140

104
Q

timeline concerning for rebound headaches (time analgesics used)

A

3 months

105
Q

timeline for tPA

A

3 hours

106
Q

age for dexa in women

A

65

107
Q

Td vs TDap in adulthood

A

Tdap once as an adult

them td q10 yrs

108
Q

pneumonia shot regimen for 65+

A

PCV13

PPSV23 6-12 mos. later

109
Q

pneumonia shot regimen for very high risk adults

A

PCV13

PPSV23 6-12 mos. later

110
Q

pneumonia shot regimen for under 65 w/risk (DM, COPD, etc)

A

PPSV23 alone

Step 2 CK (12 decks)

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