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Family Medicine > Family Medicine > Flashcards

Family Medicine Flashcards

1
Q

Drugs that commonly cause weight gain

A

Glucocorticoids, TCA’s, some SSRI’s, some antipsychotics and antiepileptics

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2
Q

Cancers for the overweight (increased risk)

A

non-Hodgkins lymphoma
Multiple Myeloma
Organ cancers

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3
Q

Metabolic syndrome haves (and notable have nots (not required))

A 
Fasting blood glucose above 100 mg/dl
BP>130/85
Triglycerides >150 mg/dl
HDL<40 for men, 50 for women
>40'' abdominal waist circumference for men, >35" for women

No mention of LDL, no mention of BMI

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4
Q

What are the physician’s five A’s of behavioral training

A

Assess, Advise, Agree, Assist, Arrange

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5
Q

Who benefits from a statin? (4 patients) – later said to use statins for any cholesterol lowering

A
  1. Current ASCVD
  2. LDL > 190 mg/dl
  3. Diabetes age 40-75
  4. Estimated Risk Poole of >7.5% for 10 year ASCVD risk
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6
Q

What drugs can cause changes in lipid concentrations? (up)

A

Thiazides, beta blockers, oral estrogens, protease inhibitors

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7
Q

Why should you pause when using bile acid sequestrants on a standard metabolic syndrome patient?

A

They can raise triglycerides

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8
Q

Under what age should you treat acute otitis media with antibiotics? What age can you for sure wait? What to do in between?

A

< 6 months for auto antibiotics, 6-24 mo cautious obs, >2 years additional obs

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9
Q

Antibiotics that can cause vertigo?

A

Aminoglycosides (streptomycin)

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10
Q

Distinguish between common peripheral vs central presentations of vertigo

A

Unidirectional vs. multidirectional
Inhibited by focus vs uninhibited
Short lived vs more persistent

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11
Q

Test for identifying BPPV

A

Dix-Hallpike maneuver

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12
Q

How to distinguish central from peripheral?

A

Head thrust maneuver - indicates vestibular issue

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13
Q

Anticholinergic agents for vertigo and safety for pregnancy?

A

Meclizine - occasional is safe for baby, promethazine, short term doses

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14
Q

What types of people are more likely to present with atypical angina? What is considered “anginal equivalents?”

A

Diabetics, women, elderly – weakness or shortness of breath on exertion considered equivalents

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15
Q

Are hypertension and dyslipidemia independent risk factors for PE?

A

NO, but obesity is

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16
Q

What is considered unstable angina?

A

Pain on increasingly less exertion/at rest OR new onset worsening in severity, frequency, duration

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17
Q

What is cardiac syndrome X?

A

angina pain- abnormal stress test, normal cath. Good prognosis, more common in women

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18
Q

Who gets low dose aspirin?

A

50-59, >10% 10 yr risk of CVD, no increased bleed risk, have life expectancy of 10 yrs.

60-69, same criteria plus more tailored

> 70, < 50 - no evidence

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19
Q

What to use for secondary prevention of CVD in high risk groups?

A

First beta-blocker, but if contraindicated, CaCB also effective

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20
Q

What lab test do you need to run before initiating statin?

A

ALT

21
Q

Stages of labor

A

First phase: latent: contractions but less than 6 cm
active: 6cm to fully dilated

Second Stage: Full dilation to baby being delivered

Third stage: begins with birth of baby, ends with delivery of placenta

22
Q

Criteria for pre-eclampsia

A

Two blood pressures >140/90 6 hours apart in a woman who previously had normal blood pressure and >20 weeks gestation AND proteinuria of 300 mg on 24 hours or +1 on dipstick twice

23
Q

What does HELLP syndrome stand for

A

Hemolysis, Elevated Liver enzymes and Low Platelets

24
Q

What qualifies as severe preeclampsia?

A

Any of these

Severe HTN (160/110)
Doubling of serum transaminases or RUQ pain
Platelet count < 100
Pulmonary edema

25
Q

What is the indication of late decelerations?

A

May be utero-placental insufficiency, meaning baby is not receiving enough oxygen during contractions

26
Q

What is labor dytocia

A

Obstructed labor - failure to progress if no change in cervix after 2 hours of active labor (multiparous usually 2cm / hour, uniparous usually 1 cm/hour)

27
Q

Causes of postpartum hemorrhage (4 T’s)

A

Tone, Trauma, Tissue, Thrombin

28
Q

Weight patterns of early infants

A

Slight weight loss at first as mother’s milk comes in, then 1 oz/ day weight gain

29
Q

Reducing menstrual flow with fibroids options?

A

Progesterone releasing IUD, abates bleeding, reduces dysmennorhea

30
Q

How to diagnose delirium?

A

Confusion Assessment Method (CAM)

31
Q

Difference between activities of daily living (ADL’s) and Instrumental activities of daily living (IADL’s)

A

ADL’s basics needed for self care, IADL’s - things needed to live independently (laundry, bills, etc.)

32
Q

Medicines most likely to cause delirium?

A

Meds with anticholinergic effects:

Opiods, benzos, sedating antihistamines, tricyclic antidepressants, some antinausea agents

33
Q

Empirical UTI treatment while waiting for gram stain and culture?

A

Cephtriaxone

34
Q

What is riskier about atypical antipsychotics than typical?

A

More prone to longQT syndrome (but less prone to Tardice)

35
Q

What treatment methods have roles in Alzheimers

A

Vitamin E (controversial), Cholinesterase inhibitors (donazepil, rivastigmine), Memantidine (NMDA antagonist), antipsychotics

36
Q

How common is asymptomatic bactiuria in older patients and what should you do as a result?

A

50%, don’t get a repeat culture to show “cure” after UTI

37
Q

Chronic vs acute bronchitis?

A

Productive cough for 1-3 weeks vs productive cough for at least 3 months for at least 2 years

38
Q

Difference in pathogenesis of COPD and asthma

A

COPD - cytotoxic t cells,leading to irreversible change, asthma, th1 and eosinophils leading to reversible change

39
Q

Diagnostic finding of COPD?

A

Post-bronchodilator PFT of <70% FEV/FVC

40
Q

Stages of COPD

A

FEV1/FVC <0.7 for all

Mild: FEV1>=80% asymptomatic
Moderate: 50

41
Q

Side effects of prednisone

A

osteoporosis, hypothalamus suppression, femur head necrosis, steroid myopathy

42
Q

Treatment order of COPD

A

Start with inhaled anticholinergics (ipratropium, tiotropium) plus short beta agonists. More severe, add glucocorticoids.

43
Q

Should all smoker’s be screened by PFT’s for COPD?

A

No, not asymptomatic ones

44
Q

Who gets antibiotics with COPD?

A

If they have increased sputum purulence and (dyspnea or sputum volume) or if mechanical ventilation is needed

45
Q

What are signs of testicular torsion?

A

Lack of cremasteric reflex, neg Blue dot sign (bluish discoloration at the upper pole meaning appendiceal torsion) and negative Prehn sign (physical lifting of the testes does not relieve pain like it would in epidydimitis)

46
Q

How can diagnosis of testicular torsion be confirmed?

A

Color Doppler ultrasonography or radionucleotide scintigraphy

47
Q

Most common cancer in men 15-35?

A

Testicular cancer - still very rare (1.6/100,000 in AA males, the highest rate)

48
Q

How quickly does testicular torsion need to be addressed if you want to save the testicle?

A

6 hours for 90% saved rate

Family Medicine (1 decks)

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