GIM - KPs Flashcards
Study that determines prevalence of disease?
Cross-sectional study
Study that Compares past exposures in patients with and without disease
Case-control study
Absolute risk reduction?
(a/(a+b)) - (c/(c+d))
Relative Risk
Reliative RIsk reduction?
(a/(a+b))/(c/(c+d))
1-RR
biennial screening mammography for which women?
PAP?
50-74
21-65
Influenza vaccine without eggs? Caveat?
Influenza vaccine for immunosuppresed and pregnant women?
Recombinant infelunza vaccine (only 18+)
Inactivated influenza vaccine
All flu vaccines should be avoided if?
All vaccine formulations should be avoided in persons who previously developed Guillain-Barré syndrome within 6 weeks of receiving the influenza vaccine.
Who gets inactivated (recombinant) herpes zoster vaccine?
Everyone 50+ (regardless if they have had prior zoster)
Purpose of the Lean Model?
eliminate waste
Purpose of Six Sigma?
reduce cost, variation, or defects
Peripheral v Central Vertigo:
Latency? Duration? Severity? Fatigability (decreased intensity with repeated maneuvers)? Direction of nystagmus?
2-40s v no latency <1 min v >1 min Severe v less severe yes v no upbeat + torsional with some horizontal v may be purely vertical or horizontal
Labyrinthitis?
Vestibular neuronitis + hearing loss
Meniere tirad?
Vertigo, hearing loss, tinnitus
Perilymphatic fistula?
vertigo and hearing loss with history of straining or trauma
Test not necessary in peripheal vertigo?
Test for central vertigo?
Neuoimaging
MRI (not CT)
ertebrobasilar stroke as a cause of vertigo is usually accompanied by?
ysarthria, dysphagia, diplopia, weakness, or numbness
initial treatment of insomnia?
CBT (sleep hygene, beharioal interventions)
initial treatment for patients with acute or subacute low back pain?
superficial heat, massage, acupuncture, or spinal manipulation
first-line pharmacotherapy for acute, subacute, and chronic low back pain?
NSAIDs
Surgery has been shown to have definite benefits only for patients with low back pain due to?
- disk herniation causing persistent radiculopathy,
- patients with painful spinal stenosis, and those with
- cauda equina syndrome.
Rotator cuff disorders?
Rotator cuff tendinitis, rotator cuff tears, and subacromial bursitis
A positive painful arc test result suggests?
subacromial impingement syndrome due to subacromial bursitis or rotator cuff tendinitis.
When to do surgery for a rotator cuff tear?
Full thickness tear
partial tears who do not respond to conservative therapy
beneficial in the treatment of adhesive capsulitis?
Glucocorticoid injections into the glenohumeral joint
epicondylosis - imaging study?
None
Surgery in carpal tunnel syndrome is reserved for which patients?
- intolerable pain,
- have severe disease on nerve conduction testing
- evidence of muscle wasting on examination.
medial-lateral grind tests on knee examination suggests?
Acute meniscal injury
prepatellar bursitis - treatment?
aspiration
For asymptomatic Non-Diabetics - when to start low-to-moderate statin therapy?
If no hx of atherosclerotic disease, 40 to 75 years with one ASCVD risk factor and a calculated 10-year ASCVD event risk of 10% or higher.
when to start low dose aspirin?
Metabolic syndrome and 10-year CV risk of 10%
Phosphodiesterase type 5 inhibitors are contraindicated if? Can be used with caution if?
pt on nitrates;
pt on a-blockers
First-line pharmacotherapy for benign prostatic hyperplasia?
a-blockers (-osin)
5a-Reductase inhibitors are most effective in?
BPH with large prostates, severe symptoms, and elevated PSA
Treatment of infectious epididymitis?
If pt is old or has anal sex?
ceftriaxone plus doxycycline
ceftriaxone and a fluoroquinolone
initial imaging modalities for evaluating a palpable breast mass?
When is one preferred?
are mammography and ultrasonography;
ultrasonography is often preferred in women younger than age 35 years and pregnant women
first-line short-term therapy for most women with moderate chronic pelvic pain?
NSAIDs
Contraindications to oral combination estrogen-progestin contraceptives? (6)
uncontrolled HTN Breast cancer Venous thromboembolism Liver disease Migraine with aura Smoking >15 cigarettes/daily if over 35
Two methods of emergency contraception? Effective until?
ver-the-counter levonorgestrel and prescription ulipristal
5 days after sex
initial therapy for primary dysmenorrhea?
If symptoms do not resolved completely after initial therapy?
NSAIDs and cyclooxygenase-2 inhibitor
combined hormonal contraceptive therapy
Do not measure these during perimenopause?
Hormones
most effective treatment of moderate to severe vasomotor symptoms during menopause?
Systemic hormone therapy
All women with an intact uterus who are treated with estrogen therapy must also receive?
progestin
When does HRT increase risk of breast cancer and necessitate individualized risk assessment?
After 5 years
Alternatives to hormone therapy for management of menopausal symptoms?
low-dose antidepressant agents and gabapentin
three of four characteristics to diagnose BV?
- pH > 4.5
- positive whiff test
- thin homogenous vaginal discharge
- 20% clue cells on microscopy
treatment of uncomplicated vulvovaginal candidiasis?
intravaginal imidazole or fluconazole
gold standard for diagnosis of Trichomonas?
Treatment?
Nucleic acid amplification
Single dose oral metronidazole
Allergic conjunctivitis - treatent?
oral or topical antihistamines, artificial tears
Episcleritis v scleritis?
Episcleritis is painless and involves no vision changes, whereas scleritis is painful and associated with visual impairment.
Corneal abrasions are managed with?
Do not give?
topical antibiotic ointments and topical NSAIDs
Topical anesthetics or eye patches
Primary open angle glaucoma presents with?
Bilateral peripheral visual loss
Acute angle closure glaucoma presents with?
severe eye pain, decreased visual acuiry, non-reactice pupul
Progression to advanced dry age-related macular degeneration may be slowed with?
smoking cessation and the use of zinc or antioxidants
Sudden sensorineural hearing loss requires?
MRI and urgernt referral to ophthomology
f acute sinusitis, antibiotics are recommended only for those with?
3 to 4 days of severe symptoms (fever, purulent drainage, and facial pain), worsening of symptoms that were initially improving, or failure to improve after 10 days
Allergic rhinitis - treat with (3)?
intranasal glucocorticoids, antihistamines, or cromolyn
Antibiotics should be used to treat streptococcal pharyngitis only if?
+Rapid strep test or throat culture
primary treatment for obsessive-compulsive disorder?
CBT
For smokers not ready to quit,- treatment?
Motivational interveiwing
Most effective therapy for schizophrenia? Caveat?
Clozapine; CBC for agranulocytosis
Drug that decreases fall risk?
vitamin D
first-line therapy for stress urinary incontinence?
Pelvic floor muscle training
first-line therapy for urge urinary incontinence?
Bladder training
recommended for urge urinary incontinence when bladder training is unsuccessful?
Antimuscarinic medications
Treatment for urinary incontinence if obese?
weight loss
may enhance healing rates of pressure ulcers?
Air-fluidized beds and surgical or nonsurgical debridement
Pt’s who do not require preoperative coronary evaluation?
major adverse cardiac event risk of <1% or with a functional capacity ≥4 metabolic equivalents
Preoperative spirometry should be performed only for?
dyspnea or hypoxia of uncertain cause.
In patients with coronary artery disease who are being treated with dual antiplatelet therapy after percutaneous coronary intervention, elective noncardiac surgery should be delayed how long?
30 days after bare metal stent implantation and optimally at least 6 months after drug-eluting stent implantation
Insulin management of surgery day?
short-acting insulins should usually be withheld on the morning of surgery, and long-acting insulins should usually be continued at two thirds to 100% of the usual dose.
Elective surgeries based on MELD?
Safe if MELD<8; not recommended if MELD>15
Pain with flexion abduction and external rotation of the hip?
Sacroilieitis
