Family Medicine: Case Files Flashcards
Generally, when should colon cancer screening begin?
Age 50
When does the USPSTF recommend screening for lipid disorders?
Level A recommendation
- Men > 35 y/o
- Women > 45 y/o
Level B recommendation
- Adults > 20 y/o who are at increased risk for cardiovascular diseases
When is screening for abdominal aortic aneurysm recommended?
Men > 65-75 y/o with a smoking history.
When is the pneumococcal polysaccharide vaccine recommended?
- A single dose is recommended for all adults aged > 65 y/o
- It is also recommended in individuals < 65 y/o who have chronic cardiovascular dz, pulmonary dz, renal dz, hepatic dz, diabetes, immunodeficiency, or asplenia.
Classify this case of COPD and what is the treatment:
- FEV1/FVC < 0.7
- FEV1 > 80% predicted
- With or without symptoms
- Mild (Stage I) COPD
- Treat with short-acting bronchodilators
Classify this case of COPD and what is the treatment:
- FEV1/FVC < 0.7
- FEV1 50-80% predicted
- With or without symptoms
- Moderate (Stage II) COPD
- Treat with long-acting bronchodilators
Classify this case of COPD and what is the treatment:
- FEV1/FVC < 0.7
- FEV1 30-50% predicted
- With or without symptoms
- Severe (Stage III) COPD
- Treat with Inhaled steroids
Classify this case of COPD and what is the treatment:
- FEV1/FVC < 0.7
- FEV1 < 30% predicted or FEV1 < 50% predicted with chronic hypoxemia
- Very severe (Stage IV) COPD
- Oxygen therapy
What period in a woman’s pregnancy is the most optimal for a trisomy screen?
16-18 weeks
It may be performed between weeks 15 and 20 if necessary
What is the daily dose of folic acid recommended to pregnant women?
400 ug
1mg of folic acid is recommended for women with diabetes or epilepsy.. 4 mg is recommended for a woman with a previous child with a neural tube defect.
By what age do most babies begin to say “mama” or “dada”?
6-9 months
It usually becomes specific between ages 8-12 months
At what point in a child’s development is a rear-facing car seat no longer necessary?
When the child is at least 1 yr old and > 20 lbs
What is the leading cause of death in infants < 1 y/o?
Sudden Infant Death Syndrome (SIDS)
What is the leading cause of death in children > 1 y/o?
Accidents and injuries
At what age does the following developmental milestone typically take place:
Laughs and squeals
4 mo
At what age does the following developmental milestone typically take place:
1-3 words, follows 1-step commands
12 mo
At what age does the following developmental milestone typically take place:
Babbles
6 mo
At what age does the following developmental milestone typically take place:
Says “mama/dada” and/or “bye-bye”
9 mo
At what age does the following developmental milestone typically take place:
- Eyes follow object to midline
- Head up when prone
2 mo
At what age does the following developmental milestone typically take place:
Walks and throws objects
12 mo
At what age does the following developmental milestone typically take place:
- Eyes follow object past midline
- Can roll over
4 mo
At what age does the following developmental milestone typically take place:
- Pincer grasp
- Crawls
- Cruises (walks while holding furniture)
9 mo
Pincer grasp at 10 mo
At what age does the following developmental milestone typically take place:
- Sits while unsupported
- Transfers objects from one hand to the other
- Rolls prone to supine
6 mo
At what age does the following developmental milestone typically take place:
Stranger and separation anxiety
12 mo
At what age does the following developmental milestone typically take place:
Recognizes strangers
6 mo
At what age does the following developmental milestone typically take place:
Starts to explore
9 mo
At what age does the following developmental milestone typically take place:
- Walks up and down stairs
- Copies a line
- Runs
- Kicks a ball
2 yrs
At what age does the following developmental milestone typically take place:
- Identifies body parts
- Copies a cross
- Copies a square
- Hops on one foot
- Throws overhand
4 yrs
Copies a square at 4.5 yrs
At what age does the following developmental milestone typically take place:
- Copies a circle
- Pedals a tricycle
- Can build a bridge of 3 cubes
- Repeats 3 numbers
3 yrs
At what age does the following developmental milestone typically take place:
- Speaks in sentences
- 3/4 of speech is understood by strangers
- Recognizes 3 colors
3 yrs
At what age does the following developmental milestone typically take place:
- 2-3 word phrases
- 1/2 of speech is understood by strangers
- Refers to self by name
- Pronouns
2 yrs
At what age does the following developmental milestone typically take place:
- Speech is completely understood by strangers
- Uses past tense to speak of things that happened before
- Tells a story
4 yrs
At what age does the following developmental milestone typically take place:
- Group play
- Plays simple games
- Knows gender
- Knows first and last name
3 yrs
At what age does the following developmental milestone typically take place:
Plays with kids, social interaction
4 yrs
At what age does the following developmental milestone typically take place:
Parallel play
2 yrs
At what age does the following developmental milestone typically take place:
- Copies a triangle
- Catches a ball
- Partially dresses self
5 yrs
At what age does the following developmental milestone typically take place:
Identifies left and right
6 yrs
At what age does the following developmental milestone typically take place:
- Draws a person with 6 parts
- Ties shoes
- Skips with alternating feet
6 yrs
At what age does the following developmental milestone typically take place:
- Writes name
- Counts 10 objects
5 yrs
What is the preferred treatment for severe persistent (continual) Asthma?
- High-dose inhaled steroid, long-acting beta-agonist, and consider omalizumab in patients with allergies.
- If needed, add an oral steroid
What is the preferred treatment for moderate persistent (daily and > 1 night/wk) Asthma?
Low dose inhaled steroid + long-acting beta-agonist or a medium-dose inhaled steroid by itself
Alternatively low dose inhaled steroid + Leukotriene modifier or theophylline or Zileuton
What is the preferred treatment for mild persistent (> 2 d/wk but not daily & 3-4 nights/mo) Asthma?
Low-dose inhaled steroid
Alternatively cromolyn, nedocromil, leukotriene modifier, or theophylline
What two non-nicotine replacement drugs are FDA approved for treating tobacco addiction?
- Bupropion (Wellbutrin)
- Varenicline (Chantix)
What is the most common cause of B12 deficiency anemia?
Pernicious anemia (lack of intrinsic factor)
What is the most common cause of folate deficiency?
Alcohol abuse
Which subtype of melanoma is commonly found on the palms of hands, soles of feet and under the finger/toe nails and is the most common subtype in African Americans and Asians?
Acral Lentiginous Melanoma
What is the treatment of choice for hyperthyroid patients who are not pregnant?
Radioactive iodine
What is the most serious potential side effect of antithyroid drugs such as Propylthiouracil and Methimazole?
Agranulocytosis
What is the treatment for thyroid storm?
- High doses of Propylthiouracil (PTU)
- Beta-blockers - Given to control Tachycardia etc.
- Hydrocortisone - Given to prevent adrenal crisis
In older patients, hypothyroidism can be confused with what disorder?
Alzheimer Disease
What is the indication for biopsy of a thyroid nodule?
Nonfunctioning nodules measuring >1cm require biopsy by fine needle aspiration
Which thyroid malignancy cannot be differentiated from its benign equivalent by fine needle aspiration (FNA)?
Follicular cell malignancy cannot be differentiate by FNA.
Papillary, Medullary, and Anaplastic can be differentiated by FNA
