General Medicine Flashcards
What is the treatment for urge incontinence?
Bladder Training for timed voiding
If a patient has statin resistance, no reduction despite statin max and eztimibe therapy. What is the next best step?
PCSK9
Patient has constant dizziness, 30 hours, multiple vascular risk factors, older patient, what should be done?
MRI brain
A patient has a high risk for breast cancer, mom and sister have breast cancer, what should be done?
Genetic Counseling
If a patient has sertraline and venlafaxine depression resistance, what is the next best step?
Intranasal esketamine
If a patient has routine dyspnea on exertion, with no cardio/pulmonary cause or reason, what is the next best step?
Cardiopulmonary Exercise Testing
Acute cough less than 3 months is typically what?
Viral infection
What is another name for code status evaluation?
Advance Care planning
Cervical Radiculopathy can be treated how?
Conservative management, exercises, will have a positive Spurling Test (Neck pain on the side of forced rotation)
Meclizine in the elderly can cause what problems after 4 weeks?
Ataxia, they can fall over easier, should d/c if able
Scaphoid fracture after an accident, what is the next best step?
MRI/CT scan, thumb splinting
PTSD, ex-Iraq soldier, what is the best medication?
SSRI, prazosin can help with sleep, but SSRI is much better
Cervical Radiculopathy is what?
Nerve Root Impingement, nerve off of the spinal cord
Cervical Myelopathy is what?
Spinal cord impingement, at that level, is usually worsened with neck flexion
Myofascial Neck Pain is what?
Point tenderness of a muscle
Left Hip pain, pain that radiates down the leg, worse with straight leg test, pain is sharp and shooting, pregnant, what is the most likely cause?
Sciatic nerve radiculopathy
Meniere’s disease does not present with what?
Constant Vertigo
If a patient recently had a URI, persistent vertigo, hearing loss, what is this?
Labrithyinitis, treat with steroids
Elevated triglycerides, ASCVD score is 4.3, drinks less than 2 drinks a day, what is the best recommendation?
Diet and exercise
If a patient has a chronic dry cough, greater than one month, no tobacco, seasonal rhinitis, what is the next best test?
Spirometry, think about asthma
Flexion, adduction, and internal rotation of the hip cause pain, 68 year old male, back pain, what else do you suspect?
Hip Osteoarthritis
Chronic Venous stasis ulcers, what should be given?
Compression Therapy
A paraplegic is bed bound, what is the best opition to decrease a pressure wound?
Static matress therapy
Sudden onset urinary incontinence, what is the first step for evaluation?
UA
Comfort care, patient has delirium and not responding with delirium and haldol, what is the treatment?
Give Lorazepam
Greater Trochanteric pain, what is the hallmark sign?
Laying on the affected side
A patient has Flexion, Abduction, and External rotation pain (of the leg/hip), what is this?
Sacroiliac Joint Pain
Chronic pain and treatment, what is the next best step?
Opiod Risk Assessment
Opioid induced constipation requires treatment, what is the treatment of choice?
Senna
A snuffbox fracture, the original xray is wnl, what is the next best step? (Patient and doctor do not want to wait two weeks to repeat an xray)
MRI hand
If a patient has a chronic cough, that can not be explained, what medication can be given for symptom relief?
Gabapentin
2 or more episodes of vertigo lasting 20 minutes to 12 hours and fluctuating or nonfluctuating hearing loss, tinnitus, or ear pressure, what could this be?
Meniere’s Disease
Asian patient with gout, what is the first initial step of treatment?
HLAB*58:01 genotyping
If a patient has dementia and inability to get to the toilet in time, what is the best recommendation?
Prompted Voiding
What is the best treatment for cervical radiculopathy?
Neck Exercises
If you are over 40 years old and have DM, what should most people be placed on?
Statin
Swelling and pain in the patient’s elbow, works as a Gardner, what would be the treatment recommendations?
Rest, Ice, and protection
Positive Dix Hall Pike manuever, what is the next best step?
Canalith repositioning manuever
Receiving Benzos and Opiods at the same time has an increased risk of what?
Death
First line treatment for geratic insomnia patients, what is the best treatment?
Behavior related therapy
All syncope patients should have what test done?
Orthostatic BP
If taking Olanzapine, what blood test should be ordered as well?
Lipid Panel
A patient has a URI, he is given codeine-guaifenesin, then he borderline codes, what is the underlying problem?
Polymorphism of his CYP 450 gene
Severe COPD, oxygen saturation is stable with rest and ambulation, what is the next best step?
Pulmonary Rehabilitation
Statin treatment that shows resistance, what should be given?
PCSK9 monoclonal antibody
Lateral Femoral Condyle pain that is worse with palpitation to the area, runner that has pain, what is the most likely scenario?
IT band syndrome
Calcaneal stress fracture, what is the proper treatment?
Walking boot
When a seasonal disease occurs, test that detects this disease will have what?
Increased PPV
Besides doxycycline, what other treatment can help with hidradenitis suppurativa? (looking for a -mab)
Adalimumab
Biotin, Fish Oil, Beta Carotene, and vitamin E in an A-fib patient should be continued or stopped?
Stop all supplements, no cardiovascular benefit
Bacterial Conjunctivas should be treated with what?
Trimethoprim-polymyxin
A young patient without any past medical history has dysmenorrhea, what would be the first line treatment?
Oral OCPs
A young 30 year old patient with a 1cm non-tender breast lump should receive what treatment?
Ultrasound
A Rheumatoid Arthritis patient would like to go for knee surgery. She takes methotrexate and adalimumab. What should be done with her medications?
Adalimumab can be given, hold methotrexate
Post operative ilieus after a hysterectomy, air fluid levels are seen on the xray, the patient is asymptomatic, what is the next best step?
Decrease opioid use
A patient has Vitiligo, what should be tested?
TSH
Patient does not take all his medications as prescribed, what should be done?
Patient Education
Seborrheic Keratoses can be treated in what way?
Cryotherapy
Tinea Pedis, can be best treated, how?
Terbinafine
Chronic Bacterial Prostatitis is treated with what? How long?
4-6 weeks of antibiotics
Low Testosterone levels need to have what evaluated?
Repeat 8:00am serum total testosterone measurement, need two measurements
After a patient has a PCV23 vaccine what should they have next?
The PCV20 vaccine or another PCV vaccine
Acute otitis externa, is seen how?
Treatment?
Tenderness upon pulling on the ear
Ciprofloxacin-dexamethasone otic drops
Melasma, skin darkening during pregnancy, what is the most likely cause?
Sun light, limit exposure
Hepatitis C is associated with what rash?
Lichen Planus
Rheumatoid arthritis patient, takes prednisone daily, is going to have elective surgery, what is the best steroid treatment?
Give an increased prednisone dose on day of surgery only, this will help avoid an adrenal crisis
Allergic contact dermatitis, what should be given?
Triamcinolone Cream
A small missing patch of hair is called?
Alopecia Areta, exclamation point hairs
Rivaroxaban should be held until how far in advance of the patient’s surgery?
3 days before the procedure
What can be used to treat atopic dermatitis?
Topical Tacrolimus and Pimecrolimus, can help patients, do not have the skin atrophy, striae, and telangiectasia that steroids have
Plavix and ASA before an elective surgery, what should be done?
Hold Plavix, keep Aspirin
High risk of CVD disease between 40 to 70 years old, what is the best treatment?
Aspirin may be given for treatment
All patients over the age of 50 should have what vaccine spaced 6 months apart?
Herpes Zoster Vaccine
Young woman with acne, what are two good treatment options?
OCPS and Spironolactone
Scleritis is inflammation of the eye, and what is a hallmark sign?
Eye pain
Treatment of Genitourinary syndrome of menopause is what?
Topical Vaginal Moisturizers
How long should warfarin patients be without their warfarin? How long s/p surgery should they wait to restart?
Withhold 5 days, restart in 12 hours
What is a great way to prevent COPD s/p surgery issues?
Perioperative prophylatic respiratory therapy
A patient needs an Aortic Valve replaced and aortic-femoral bypass surgery performed, which should be done first?
Aortic Valve Surgery
Suspected Epiglotittis, a young patient, what is the next best step? Severe Salivation, what should be done next?
ICU admission
Urticarial Vasculitus is characterized by urticarial lesions that last longer than how long?
24 hours
Exthanemous drug reaction happen low long after a new drug starts?
1-2 weeks
A patient has menopause and not feeling well. She has HTN, and moderate cardiac risk factors. What should be given?
Transdermal Estrogen
Porphyria Cutanea Tarda has what disease associated with it?
Hepatitis C
Erythema covering 80% of the body, is what?
Erythroderma
Superficial Fungal Infection, what is the best diagnostic test?
Potassium Hyroxide Preparation of skin scrapping
What oral endocrine medications can help a patient lose weight?
Liraglutide
Seborrheic Dermatitis, what should be given?
Zinc pyrithone
Two or more centor criteria, what should be done?
Rapid Group A strept antigen testing
If a woman is considering pregnancy, what should she be assessed for?
Varicella Antibody Risk
Women with a history of gestational diabetes, what should be screened, even if no acute complaints?
HbA1c
Acute epididymitis, older male, no STD concerns, what is the treatment (usually)?
Oral Levofloxacin
Trichomonas positive, not pregnant, what should be given?
Oral Metronidazole
When a patient wants to improve their life, what should be done?
Behavioral Counseling
After a patient has bariatric surgery, what should be withheld if the patient’s diabetes is being evaluated?
Hold the patient’s lantus
A patient has superficial skin infection that has mild puritis, what should be done for evaluation?
Wood’s lamp
What vitamin or supplement has show Cardiovascular benefits?
None
A patient with known CAD and CAGB x 4, what should be given to help Erectile Dysfunction?
Slidenafil, Phosphodiesterase-5 inhibitors
Patient with blistering rash, oral/mucosal involvement, no new antibiotic, what should be considered?
Pemphigus Vulgaris
When a patient has new vaginal discharge concerns, what should be done?
Saline and Potassium Hydroxide Wet mounts
What should be done for AC s/p uterine surgery? Assuming no problems
LMWH for 30 days
After a stroke, how long should patients wait before surgery?
9 months
What is emergency contraception for a young women, without any big concerns?
Ulipristal Acetate
Increased screening for prostate cancer can lead to what kind of problem?
Overdiagnosis
What shot be considered in patients, ages 18-26, especially if TDAP and Flu are given?
HPV vaccine
