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Medicine Clerkship > General Internal Medicine > Flashcards

General Internal Medicine Flashcards

1
Q

Tdap (Age/freq, appropriate, contraindications?)

A

Everybody, q10 or q5 with wound, no contraindications

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2
Q

Pneumovax (Age/freq, appropriate, contraindications?)

A

Once before 65, once after, given to anybody with comorbid illness, so pretty much everybody

Can’t give with live vaccines (Prevnar, zoster). So give prevnar first, then pneumovax 8 weeks later.

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3
Q

Prevnar (Age/freq, appropriate, contraindications?)

A

Once after 65, everybody, can’t give with pneumovax.

Give prevnar first, then wait 8 weeks, then give pneumovax.

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4
Q

Zostavax (Age/freq, appropriate, contraindications?)

A

Give once at 60, everybody, don’t give with pneumovax

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5
Q

Hep A/B (Schedule, appropriate, contraindications?)

A

Day 1 =A/b
Month 1 = B
Month 6 = A/B

Everybody, no contraindications

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6
Q

Meningococcal vaccine (Age/freq, appropriate, contraindications?)

A

Age 11, college, military, hajj, no contraindication

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7
Q

HPV (Age/freq, appropriate, contraindications?)

A

11-26, everybody, no contraindications

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8
Q

Flu vaccine (Age/freq, appropriate, contraindications?)

A

Everybody, every year, contrainidcation is egg allergy

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9
Q

Colon cancer (Age, method)

A

Once 50, earlier if strong family hx.

Colonoscopy q10
Flex sig q5 with FOBT q3
FOBT q1

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10
Q

Breast Cancer (Age, method)

A

50-74, mammogram every 2 years

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11
Q

Lung Cancer (Age, method)

A

55-74 with 30 pack year history, low dose CT

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12
Q

Cervical Cancer (Age, method)

A

21-65 pap q3

30-65 pap+HPV q5

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13
Q

Ovarian Cancer (Age, method)

A

BRCA 1/2+ Only, Transvaginal US + CA-125.

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14
Q

Dyslipidemia (Age, method)

A

High risk, M @25 F@35

Low Risk M@35, F@45

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15
Q

Hep C (Age, method)

A

If born between 1945 and 1965, ivdu, blood before 1992, cocaine, tattoo, prison

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16
Q

HTN (Age, method)

A

Everybody everytime, diagnose with 2 readings 2 weeks apart

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17
Q

Osteoporosis (Age, method)

A

Females @ 65, 60 if high risk, one time DEXA

18
Q

AAA (Age, method)

A

Male 65 and history of smoking, abdominal US

19
Q

HIV (Age, method)

A

Everybody once or every year

20
Q

DM2 (Age, method)

A

Patients w/persistent BP>135/80
Patients >45 q3y
If obese, HLD, or first degree relatives

21
Q

STI (GC CL)

A

Sexually active females

22
Q

How to diagnose hypertension?

A

2BP checks separated by 2 weeks.

23
Q

What to follow up with when HTN diagnosed?

A

Urinalysis for occult blood/BUN:Cr ratio, BMP, Lipids, EKG

24
Q

Best ways to reduce HTN?

A

Exercise, Dash diet, sodium restriction

25
Q

JNC 8 BP targets

A

Target is 150/90 for pts>60

Target is 140/90 for patients

26
Q

Meds to treat HTN?

A

Don’t use b blockers

Don’t use ace/arb in blacks (use HCTZ), unless CKD

27
Q

How much does a single drug lower BP?

A

About 15/10

28
Q

Causes of secondary hypertension

A 
Hyperthyroid
Hyperaldo
Hypercalcemia
Aortic coarctation
Renovascular Stenosis
Pheochromocytoma
Cushing
OSA
29
Q

Drugs that cause HTN

A 
Glucocorticoids
OCP
NSAIDs
Antidepressants
Decongestants 
Stimulants
30
Q

How to treat hypertensive encephalopathy?

A

Labetalol

31
Q

How to calculate LDL

A

LDL = total cholesterol - HDL - triglycerides/5

32
Q

Secondary causes of hyperlipidemia?

A

Hypothyroidism, nephrotic syndrome, liver disease, alcoholism, diabetes

33
Q

Diagnosis of HDL

A

Based on 2 fasting measurements at least 1 week apart

34
Q

Metabolic syndrome

A

3/5 of following: Abdominal obesity, tg>150, HDL 130/85, fasting BG >110.

35
Q

Treatment for hyperlipidemia if low-medium risk

A

Lifestyle modification and high fiber diet. Should drop cholesterol by 15%

36
Q

Use statins for

A

ASCVD (mi, tia, cva, pad, angina)
LDL>190
Diabetes,age 40-75 and LDL from 70-190
>7.5 ASCVD risk

37
Q

Use high dose statins for

A

ASCVD 7.5, LDL>70

LDL>190

38
Q

Triglyceride levels that cause pancreatitis

A

> 500, start fibrates

39
Q

How to work up back pain

A

See if there are alarm symptoms (focal neuro deficit, weakness, sensory loss, urinary symptoms, fever, IVDU). If so, give high dose dexamethasone, then get xray and MRI

If not, treat conservatively with 4-6 of nsaids.

40
Q

Numbers to diagnose diabetes

A

1 random glucose >200
2 fasting bg >125
1 AIC>6.4

Medicine Clerkship (12 decks)

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