Group Hug (Family Practice) Flashcards
At what value is a PSA considered high?
>4.0
For which patient is pneumococcal vaccine not beneficial? a. 15 month w HIV b. 20 yr old undergone a splenectomy secondary to TTP c.5 year old with sickle cell disease d. 10 year old w nephrotic syndrome
A- not recommended for
What do white blood cell casts in urine represent?
Acute pyelonephritis
What is phimosis?
Foreskin cannot be retracted because of adherence or fibrosis w/ inflammation
What electrolyte do you have to monitor when prescribing spirinolactone?
Monitor for hyperkalemia
What is the difference between oxycontin and oxycodone?
Same drug (I feel like this should be added to… any takers?)
What electrolyte are you most concerned about w furosemide usage?
Monitor for hypokalemia
What are the first immunizations a child needs after birth?
Hep B at birth
What immunizations are done at the 2 month well child check up?
Hep b #2, rotavirus,DTaP, Hib,pcv13, ipv
At what age would you start pneumococcal polysaccharide vaccine?
Anyone 65 or older and repeat every 5 years. If immunocompromised(age 19-64 yo) they should receive 1-2 doses, 5 years apart before age 65.
A 21 y.o. woman presents for her first Pap smear. She received the full HPV vaccine at age 19. Assuming that her exam and Pap smear are normal, when would you recommend that she return for a follow-up Pap smear? A. 6 months, as the first Pap smear should be followed up soon to reduce the false-negative rate associated with this screening test B. 1 year, as she should have at least three normal smears before going to a longer interval C. 3 years, as the Pap smear was normal D. 5 years, as she is low risk because she received the HPV vaccine
B
Which of the following provides the greatest fracture risk reductions and greatest increases in bone mineral density in postmenopausal females with osteoporosis? A. Alendronate B. Calcitonin C. Estrogen D. Raloxifene E. Vitamin D
A
A 28 y.o. woman with type 2 diabetes has maintained good control with metformin treatment in addition to diet and exercise. She expresses that she would like to become pregnant. What is the best advice for this patient regarding treatment of her diabetes? A. Continue current treatment with metformin B. Change oral therapy to rosiglitazone C. Change to insulin therapy D. Discontinue medical therapy and continue aggressive diet and exercise
C
A 2 y.o. child presents with mild but obvious cross-eyes since birth. Unless this is treated, what is the likely outcome? A. Amblyopia B. Esotropia C. Exotropia D. Hypophoria E. Strabismu
A
A 73 y.o. woman presents to the E.D. following a fall in her home. She tripped over a throw rug, fell forward, and landed with her arms extended and hand outstretched. She presents complaining of left wrist pain. Radiographs reveal a dorsally angulated and displaced distal radius metaphyseal fracture. What is the most likely Dx? A. Barton Fx B. Colles Fx C. Smith Fx D. Boxer Fx
B
A 54 y.o. woman is taking glyburide, a second generation sulfonylurea, to control her type 2 DM. Which of the following is the most likely mechanism of the therapeutic effect of glyburide on this pt’s disease? A. Increase pancreatic insulin secretion, in part by acting on K+ channels B. Delay postprandial carbohydrate and glucose absorption C. Reduce hepatic glucose production by suppressing gluconeogenesis D. Inhibit cholesterol synthesis and carbohydrate uptake
A
Which of the following requires drug-free periods to avoid tolerance when used as prophylaxis for chronic stable angina? A. Digoxin B. Diltiazem C. Metoprolol D. Isosorbide dinitrate E. Propranolol
D
A 63 y.o. woman presents with SOB, cough, and proximal muscle weakness of 1-month duration. On clinical exam, she is noted to have a BP of 156/102, facial flushing, mild hirsutism, truncal obesity, marked proximal muscle weakness of both the upper and lower extremity, and hyperpigmentation over the palms and back of the neck. Laboratory results reveal hypercortisolism and increased ACTH. Which of the following would be the most likely primary Dx in this pt? A. Lymphoma B. Ovarian cancer C. Renal cell carcinoma D. Small cell lung carcinoma
D
At what value do we treat hypertriglyceridemia and why?
Trig >500 we treat to prevent pancreatitis.
Patient A has an incidental finding of hypercalcemia, you draw a PTH and that’s high. What is the diagnosis and what labs/imaging are to be done next? (this was seen in my rotation, we called endocrine for a consult)
Hyperparathyroidism- labs to order as 1,25 Vitamin D, phosphate level and 24 hour urine calcium. For imaging a technetium sestamibi reuptake scan.
Patient B has been using her SABA 3-4 times a week, no night time symptoms or ER visits. What medication do we need to add for better asthma control?
Low dose ICS example is Flovent 1-3 puff twice daily (dependent on age)
Which is the most prevalent STI in USA, it also accounts for the many complications like PID, infertility, ectopic pregnancy and chronic pelvic pain? A) Syphilis B) Chlamydia C) Herpes simplex D) Gonorrhea
B
Which factor is most closely related to the spread of TB? A) Poverty B) Alcoholism C) Poor hygiene D) Crowding
D
At what age can you stop screening women for breast cancer?
Begin at age 40-unless risk factors or FH. Screen yearly as long as the woman is in good health.
What is the goal blood pressure for a patient with diabetes or chronic kidney disease?
<130/80
What is the best treatment for a pt with HTN and BPH?
Alpha-1-Blocker (Ex:…)
List the steps in the “Return to Play Protocol” for concussions
- No activity, complete rest; Once asymptomatic proceed to step 2* 2. Light aerobic exercise, no resistance training 3. Sport-specific exercise, progressive addition of resistance training in steps 3 and 4 4. Noncontact drills 5. Full contact, after medical clearance 6. Game play *If symptoms relapse, the athlete must revert back to most recent asymptomatic step and wait 24 hours until progressing again
What is the likely Dx?
Tinea versicolor
What is this?
Actinic keratosis
What is this, and what disease has it been associated with?
Cafe au lait spots; Neurofibromatosis
What is the name of this rash, and what condition is it linked to?
Heliotrope rash; Dermatomyositis
What is this?
Keloid
What is this?
Vitiligo
What is the likely Dx?
Pityriasis rosea
A flat, non-palpable lesion
Macule/patch
Raised lesions
Papule/Nodule
A plateu-like lesion, confluent papules
plaque
Cicumscribed, elevated lesions containing fluid
Vesicle/Bulla
Elevated lesion containing pus
Pustule
Transient, elevated, edematous lesion often with cleared center
Wheal
A pt. has a rash that she describes as painful. What is on your DDx?
Zoster
Cellulitis
Necrotizing fasciitis
Erythema multiforme
Erythema nodosum
Endocarditis
A pt has a rash that he describes as itchy. What is on your DDx?
Scabies
Pityriasis rosea
Contact dermatitis
Varicella
Urticaria
What should you consider with a rash that has the feature of “pain out of proportion”?
Necrotizing fasciitis
_______ is characterized by the inability to retract the foreskin over the glans penis
Phimosis
_________ is defined as entrapment of the foreskin behind the glans penis
Paraphimosis
A soft, nontender fullness in the hemiscrotum that transilluminates is found. What is the treatment plan?
Elective repair (hydrocelectomy) as clinically indicated.
Nephrotic syndrome is characterized by
Proteinuria, hypoalbuminemia, edema
____________ or extreme generalized edema, is a medical condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space
Anasarca
____________ is the most common cause of nephrotic syndrome in children
Minimal Change Disease (MCD)
____________ is the most common cause of nephrotic syndrome in adults
Focal segmental glomerulosclerosis (FSGS)
What are the 3 phases of Pertusis infection?
- Catarrhal –> Cold type symptoms
- Paroxysmal –> “Whooping” phase. Paroxysmal with possible emesis
- Convalescent Phase –> Lingering Cough. “Cough of 100 days”
