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Family Medicine > Marty's Study Guide > Flashcards

Marty's Study Guide Flashcards

1
Q

Recommendations on breast self-exam

A

USPSTF - does not recommend
ACS - BSE is an option beginning at 20y

Either way, women should be trained on how to do it if they decide that they are going to

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2
Q

Clinical breast exam recommendations

A

USPSTF - insufficient evidence outside of mammography

ACS - clinical breast exam Q3y for 20y-40y and yearly for >40y

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3
Q

Waist circumference cutoffs for increased risk

A

Men >40in

Women >35in

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4
Q

Who needs to have more frequent PAPs?

A

Immunocompromised
HIV+
History of CIN2, CIN3, Cancer
in-utero exposure to DES

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5
Q

Skin exam recommendations

A

USPSTF - insufficient evidence

ACS - part of yearly health maintenance

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6
Q

Endometrial cancer screening recommendations

A

No routine screening

Women with HNPCC - annual screening with endometrial biopsy beginning at 35y

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7
Q

Lung cancer screening recommendations

A

Screen in patients 55-65y with a 30+ pack year history, if quit within past 15y

Done with low-dose CT

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8
Q

Breast cancer screening recs

A

USPSTF - biennial starting at 50y

ACS - annual starting at 40y

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9
Q

DDx of nipple discharge

A 
Physiologic:
-Pregnancy
-Breast stimulation
Pathologic:
-Prolactinoma
-Cancer
-Hormone imbalance
-Trauma
-Breast abscess
-Medications
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10
Q

Definition of osteopenia

A

T-Score from -1 to -2.5

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11
Q

Dosing of calcium in females

A

Premenopausal = 1000mg daily

Postmenopausal = 1500mg daily

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12
Q

Recs for Calcium & Vit D supplementation

A

USPSTF recommends against supplementation in healthy pre or postmenopausal females. Instead, get it through diet & incorporate weigh-bearing exercise

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13
Q

Osteoporosis screening

A

DEXA if >65y or FRAX risk is >9.3% over 10y

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14
Q

Diabetes screening recs (adults)

A

ADA:
Screen if BMI >25 and a risk factor

USPSTF - Screen all adults with HTN

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15
Q

HbA1c cutoffs for screening

A

5.7-6.4% = prediabetes

> 6.5% = DM

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16
Q

Bethesda system reports

A
  1. Specimen adequacy
    - -Over 5,000 squamous cells with endocervical cells
  2. General
    - -Is there intraepithelial lesion or cancer?
  3. Interpretation
    - -ASC, LSIL, HSIL, SCC
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17
Q

Pt with ASC-US & negative HPV

A

Repeat cotesting in 3y

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18
Q

Ages for HPV vaccination

A 
Gardasil = 9-26
Cervarix = 10-25
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19
Q

Indications for statins

A

1) Clinical ASCVD (ACS, CVA/TIA, PVD)
2) 40-75y with DM
3) >21y with LDL >190
4) 40-75y with 10y ASCVD risk >7.5%

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20
Q

How often to screen fasting lipids

A

Every 4-6y in adults 20-79y

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21
Q

Adult immunizations

A

One-time TDaP booster for ages 11-64 then Td booster every 10y

Zoster vaccine at 60y

Pneumococcal vaccine at 65y (or earlier if risk factors)

Influenza yearly

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22
Q

Reasons for pneumococcal vaccine before 65y

A 
Chronic lung dz
Chronic renal dz
Chronic liver dz
Asplenia
Immunocompromised
Smokers
Long-term care facilities
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23
Q

Characteristics of a good screening test

A

1) Can be treated
2) Latent phase of dz
3) Screen acceptable to pts and reasonable cost

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24
Q

Screening for HepC

A

One-time screening for adults born between 1945-1965

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25
Q

Target BP

A

Normally 140/90
If over 60y 150/90
All ages with DM or CKD: 140/90

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26
Q

Antihypertensives in blacks

A

Must contain thiazide or CCB

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27
Q

Antihypertensives in CKD

A

Include ACEi or ARB (regardless of race)

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28
Q

Antihypertensives in non-blacks

A

Thiazide
CCB
ACEi
ARB

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29
Q

When to get next c-scope based on findings

A

1-2 small tubular adenomas = 5-10y

3+ tubular adenomas = 3y

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30
Q

Advanced sleep phase syndrome

A

Internal clock is set to sleep from early evening to very early morning

Seen in the elderly

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31
Q

Most effective treatment for insomnia

A

CBT-I

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32
Q

Minimum length for MDD

A

2 months

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33
Q

Assessing suicide risk

A 
Sex (male)
Age (45)
Depression
Previous attempts
EtOH or other substance
Rationality impaired (psychosis)
Social support lacking
Organized plan
No significant other
Sickness

Score of 7+ = hospitalization

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34
Q

SE’s of SSRI’s

A

Headaches
Insomnia or Sedation
Nausea/Diarrhea

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35
Q

Presentation of depression in hispanics

A

More often somatic complaints

Immigrant hispanics have 50% lower depression rates. US born hispanics are similar to other ethnic groups.

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36
Q

Suicidality in relation to age

A

Attempts do not increase, but completion rates do

Drug overdose is most common means of suicide in the elderly

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37
Q

Presentation of compartment syndrome

A

6 P’s:

  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia
  • Paralysis
  • Perishing cold
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38
Q

DDx of traumatic ankle pain

A 
Lateral ankle sprain
Peroneal tendon tear
Fibular fracture
Talar dome fracture
Subtalar dislocation
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39
Q

Most commonly sprained medial ankle ligament

A

Deltoid ligament

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40
Q

Sprained ligaments with inversion & plantar flexion

A

Anterior talofibular**
Calcaneofibular
Posterior talofibular

**most often injured ligament

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41
Q

Ankle anterior drawer test

A

Tests anterior talofibular ligament

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42
Q

Ankle inversion stress test

A

Tests calcaneofibular ligament

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43
Q

Sprained ligaments with eversion & dorsiflexion

A

Deltoid ligament

Anterior tibiofibular ligament

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44
Q

Grading sprains

A

Grade I = little/no impairment
Grade II = some impairment & some stretching on exam
Grade III = complete tear, no weight bearing, no definite stretch endpoint

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45
Q

Ottawa ankle rules

A

1) Malleolar pain

2) Pain in either distal posterior malleolus or non-weight bearing (immediately & in ED)

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46
Q

Ottawa foot rules

A

1) Midfoot pain

2) Navicular bony tenderness or base of 5th metatarsal or inability to bear weight (immediately & in ED)

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47
Q

Negative inversion test

A

Inversion of ankle shows laxity of the calcaneofibular ligament

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48
Q

Crossed-leg test

A

Cross legs, apply pressure to medial knee

Pain at the ankle indicates high ankle (syndesmotic) sprain

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49
Q

Effect of thyroid on periods

A

Hypothyroid = heavy periods

Hyperthyroid = light periods

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50
Q

Most common symptoms of hyperthyroidism

A

Tachycardia
Sweating
Heat intolerance
Fatigue

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51
Q

Causes of hyperthyroidism

A

Graves’ Disease (toxic diffuse goiter)
Toxic nodular goiter (single or multinodular)
Thyroiditis
Drug-induced (amiodarone, lithium)

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52
Q

Risk factors for thyroid nodule to be malignant

A 
Male gender
Extremities in age
Rapid growth
Local invasion (dysphagia, hoarseness)
History of head/neck radiation
FH of thyroid cancer
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53
Q

Causes of hypothyroidism

A

Hashimoto’s thyroiditis

Postpartum thyroiditis

Subacute thyroiditis (de QuerPAIN)

Riedel thyroiditis

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54
Q

What is considered normal RAIU?

A

15-30%

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55
Q

Ways to evaluate the thyroid

A

Nodule - US

Hyperthyroidism - RAIU or US

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56
Q

RAI vs. thyroidectomy

A

RAI - less permanent hypothyroidism

Surgery - less recurrence of dz

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57
Q

Restrictions after RAI treatment

A

No pregnancy for 6mo
No getting someone pregnant for 4mo
No close contact with young kids or pregnant women

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58
Q

Follow up for RAI treatment

A

Follow TSH every 2mo

Teach symptoms of hypothyroidism

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59
Q

Fundoscopic findings of non-proliferative retinopathy

A

Retinal hemorrhages
Cotton wool spots (previous infarction)
Microaneurysms

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60
Q

Fundoscopic findings of proliferative retinopathy

A

Neovascularization

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61
Q

SE’s of metformin

A

Renal insufficiency

B12 deficiency

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62
Q

T2DM Treatment algorithm

A

1) Lifestyle change + metformin
2) Add sulfonylurea or basal insulin
3) Intensify insulin regimen

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63
Q

Vaccines for DM patients

A

Influenza
Pneumococcal
HBV if unvaccinated

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64
Q

When to get first eye exam in DM patients

A

T1DM - 5y after diagnosis

T2DM - at diagnosis

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65
Q

Optimal blood glucose range

A

Fasting: 80-120
Postprandial:

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66
Q

Grades of ulcers

A

1: Superficial
2: Involves ligament, tendon, or fascia
3: Deep with abscess or osteomyelitis
4: Gangrene of forefoot
5: Extensive gangrene

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67
Q

Duration of anticoagulation after DVT

A

Provoked: 3mo
Unprovoked: extended if low-moderate bleeding risk
Active cancer: Extended

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68
Q

Highest dose of HCTZ

A

Doses >25mg don’t provide added efficacy

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69
Q

Labs to get on newly diagnosed HTN patients

A

Urinary albumin/Cr

Serum Calcium

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70
Q

When to initiate aspirin

A

Men 45-79 (for MI risk)
Women 55-79 (for CVA risk)

*Only once BP is under control, to minimize hemorrhagic stroke risk

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71
Q

SE’s of ACEi

A

Up to 35% Cr increase
Angioedema
Chronic cough

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72
Q

CCB SE’s

A

Leg edema

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73
Q

ECG abnormalities suggestive of paroxysmal afib

A

Abnormal P wave
PAC’s
Bradycardia

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74
Q

Delta wave

A

WPW

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75
Q

Findings in HOCM

A

LVH

Q waves in I, AVL, V4-V6

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76
Q

Most common causes of back pain

A

Lumbar strain
Age-related DJD
Herniated disc

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77
Q

Pain with back flexion

A

Hernation
Osteoarthritis
Muscle spasm

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78
Q

Pain with back extension

A

Degenerative disease

Spinal stenosis

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79
Q

Pt unable to heel walk

A

L5 disc herniation or peroneal n. injury

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80
Q

Pt unable to walk on toes

A

S1 disc herniation or tibial n. injury

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81
Q

Nerve route of DTR’s

A

Ankle - S1, S2
Patella - L3, L4
Biceps - C5, C6
Triceps - C7, C8

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82
Q

Passive straight leg raise (Lasegue’s sign)

A

Differentiates tight hamstring vs. sciatic nerve pain

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83
Q

FABER test

A

Positive if pain is in the hip joint or SI joint

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84
Q

How often can a joint receive a steroid injection?

A

Only once per month & only 3 max per year

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85
Q

What steroid is used in joint injections?

A

Triamcinolone

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86
Q

Indications for carpal tunnel syndrome electrodiagnosis

A

1) Symptoms fail to improve
2) Motor dysfunction present
3) Thenar atrophy present

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87
Q

AAA screening

A

One-time abdominal US in MEN 65-75 who have any history of smoking

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88
Q

Synovial fluid PCR can diagnose septic arthritis infection due to:

A 
Yersinia
Chlamydia
Gonorrhea
Ureaplasma
Lyme dz
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89
Q

NSAIDs effect on other drugs

A

Decreases antihypertensive effectiveness

Increases anticoagulant & sulfonylurea effectiveness

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90
Q

Chlamydia screening guidelines

A

All sexually active women

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91
Q

Recommended folic acid supplementation

A

All fertile women 400-800mg daily

DM or epilepsy = 1mg
Previous NTD = 4mg

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92
Q

Chadwick’s sign

A

blue-purple hue of cervix & vaginal walls during pregnancy

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93
Q

When to start fetal heart tones

A

10-12w

aka when the uterus is above the pubic symphysis

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94
Q

When can fetal movement be detected?

A

18-20w

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95
Q

When is abortion legal?

A

Up to 22w

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96
Q

Ectropion definition

A

Central cervix is red due to endocervical epithelium protrusion. Occurs in women on OCP’s. Means nothing.

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97
Q

Results of progesterone testing in a pregnant patient

A

> 25 = likely sustainable pregnancy

98
Q

At what hCG level is an IUP detectable by US?

A

TVUS >1500

Transabdominal >5000

99
Q

Reliability of US in dating

A 
1t = 1 week
2T = 2 weeks
3T = 3 weeks

Do not change dates due to a 3TUS

100
Q

Options for incomplete abortion

A

1) Expectant mgmt
2) D&C (1T) or D&E (2T)
3) Vaginal misoprostol

101
Q

Nonasthmatic eosinophilic bronchitis

A 
Chronic cough (>8w)
Better with inhaled steroids
Normal spirometry

Dx with induced sputum or lavage showing eosinophils

102
Q

Acute sinusitis vs. chronic sinusitis

A

Acute: >7-10d
Chronic: >12w

103
Q

When to give abx for acute bacterial sinusitis

A

Fever > 101
Moderate-severe pain
Worsening/Failure to improve after 7d

104
Q

Diagnosis of asthma

A

1) Obstructive spirometry

2) Improvement of FEV1 by 12% or percent predicted FEV1 by 10% after bronchodilator

105
Q

When to screen for asymptomatic bacteruria in pregnant pts?

A

12-16w

106
Q

When to administer Rhogam

A
  • 28 weeks
  • Any prenatal bleeding
  • Within 72h postpartum
107
Q

When to get structural US

A

18-20w

108
Q

BP cutoffs for severe preeclampsia or sever gHTN

A

SBP >160 or DBP > 110 for at least 6h

109
Q

Diagnosis of gDM

A

2 out of 3 glucose measurements abnormal

110
Q

When to start OCP’s postpartum

A

Progestin-only can be started immediately postpartum

COC’s should wait 4 weeks (may suppress initial milk & possible DVT)

111
Q

When to screen for gDM

A

GTT at 24-28 weeks

112
Q

PE signs of acute pancreatitis

A

Grey-Turner’s sign - flank bruising

Cullen’s sign - periumbilical bruising

113
Q

Which dermatophyte infx must be treated orally?

A

Tinea capitis

Tinea unguium

114
Q

Tx for tinea unguium

A

Oral terbinafine or itraconazole pulse therapy

115
Q

Tx for Tinea capitis

A

Oral griseofulvin

116
Q

Margins for SCC excision in the clinic

A

If lesion is 2c, refer

117
Q

What drugs should pts with enlarged prostate avoid?

A

Caffeine
Anticholinergics:
-Decongestants
-Antihistamines

118
Q

HRT effect on breast cancer

A

Combined Estrogen & Progesterone use for >3y increases breast cancer risk

119
Q

Uterine bleeding with HRT

A

Bleeding within first 12m can be normal (physiologic)

After 12m of therapy always requires evaluation

120
Q

Endometrial thickness in postmenopausal women

A

If

121
Q

Calcium & Vit D requirements for women over 50y

A

1200mg Ca

600 IU Vit D

122
Q

Duration of different headache types

A

Migraine: 4-72h
Tension: 30m-7d
Cluster: 15m-3h

123
Q

Number of HA’s needed to diagnose by HA type

A

Migraine & Cluster: 5

Tension: 10

124
Q

How often should prenatal visits be?

A

1T & 2T: Q4wks
29w-35w: Q2w
36w-birth: Q1w

125
Q

When to offer prenatal testing?

A

Triple screen & CVS: 9-14w

Quad screen & amniocentesis: 15-22w

126
Q

Increased maternal serum AFP is associated with:

A

NTD
Gastroschisis, Omphalocele
Multiple gestation
Wrong dating

127
Q

Decreased maternal serum AFP is associated with:

A

Trisomy 18 & 21
Fetal demise
Wrong dating

128
Q

Quad screen results for Trisomy 18 & 21

A

All down Edward

T21: MSAFP & Estriol down

129
Q

Migraine prophylaxis drugs

A

Propranolol
Divalproex, Topiramate, Gabapentin
Amitryptiline
Verapamil

130
Q

What is considered controlled HA?

A

Less than 2 HA’s per week or 8 per month. And they are relieved with acute treatment.

131
Q

What % of PUD is malignant?

A

2% so refer any known PUD to a specialist

132
Q

Workup for dyspepsia

A

1) Rule out warning signs
2) Empiric PPI trial
3) H. pylori testing

133
Q

Fecal immunochemical testing vs. FOBT

A

FIT only for occult lower GI bleeding

134
Q

First line treatment for H. pylori

A

Triple therapy:

  • PPI
  • Amoxicillin
  • Clarithromycin

Quadruple therapy

  • PPI
  • Flagyl
  • Tetracycline
  • Bismuth
135
Q

Salvage therapy for H. pylori

A

PPI
Amoxicillin
Levofloxacin

136
Q

HIV screening recs

A

Patients 15-65 and those at increased risk. All pregnant women

137
Q

Syphilis screening recs

A

Those at increased risk

138
Q

Criteria for strep throat

A

One point for each:

  • Fever >38
  • Absence of cough
  • Tonsillar exudates
  • Anterior cervical LAD
  • Age
139
Q

Indications for abx in AOM

A

1) Children under 2y
2) Children >2y with fever >39, otalgia for >48h, bilateral AOM, otorrhea, toxic appearance

So normal children >2 with unilateral mild AOM can be observed

140
Q

Empiric pneumonia abx therapy in children

A

0-3w: Amp & Gent
3w-5y: Amp or Ceftriaxone IP; Amox if >3mo as OP
5y-adolescence: Azithromycin

141
Q

DM screening in children

A

All children with BMI>85th percentile at age 10y and then Q2y

142
Q

Lipid screening in children

A

All children with BMI >85th percentile

143
Q

Lipid goals for children

A

Total

144
Q

Indications for lipid medications in children

A

LDL > 190
LDL > 160 with risk factors

Only in children over 10y & have achieved Tanner stage 2 or menarche

145
Q

Indications to screen for hepatic steatosis in children

A

At 10y if BMI >95th percentile or >85th with risk factors.

Refer to GI if AST or ALT are >2x normal

146
Q

Weight mgmt for obese children

A

If under 7y:

  • Maintain weight
  • If complications present, lose 1lb/mo until 85th percentile

If over 7y:
-Weight loss until 85th percentile

147
Q

Best test for UE weakness

A

Pronator drift

148
Q

Tests to get for suspected CVA

A 
Accucheck
CT/MRI
Renal function/Lytes
ECG
Trops
CBC
Coags
SpO2
149
Q

Criteria for immediate afib cardioversion

A
150
Q

Mgmt of Afib patients

A

High risk - anticoagulation

Low-Mod risk - ASA, ASA+Plavix, or anticoagulation

151
Q

Cause of viral croup

A

Parainfluenza

152
Q

Complications of strep throat

A 
Post-strep GN
Rheumatic fever
Peri-tonsillar abscess
Mastoiditis
Meningitis
153
Q

Vaccines required prior to starting school

A

2 Varicella & MMR
3 HBV
5 DTaP & Polio

154
Q

When can rotavirus vaccines be given?

A

15 weeks-8 months

155
Q

Indications for annual PPD testing in children

A

HIV+ children

Incarcerated adolescents

156
Q

Criteria for ADHD

A

Child >6y
Symptoms more frequent or severe than other children of same age
Behaviors present in 2+ settings
Behaviors present for >6mo

157
Q

Definition of colic

A

Crying for:
>3h per day
>3d per week
>3 weeks

Child must be otherwise healthy child age 2w-4mo

158
Q

Fever workup in newborn

A

If under 2mo:

  • CSF
  • Urine
  • Blood
159
Q

Arm adducted & internally rotated

A

Posterior dislocation

160
Q

Actions of the rotator cuff muscles

A

Subscapularis = IR
Infrapinatus = ER
Teres minor = ER
Supraspinatus = initiates ABduction

161
Q

Tests for biceps tendonopathy

A

Speeds or Yergason’s tests

162
Q

Tests for rotator cuff pathology

A

Forced IR & ER
Empty beer can test
Apley’s Scratch test (impingement)

163
Q

Criteria for chronic fatigue syndrome

A

> 6mo of disabling fatigue plus 4 of:

  • Impaired memory/concentration
  • Post-exertional malaise
  • Tender LAD
  • Sore throat
  • HA
  • Myalgias
  • Arthralgias
164
Q

Lab workup of fatigue

A

CBC
ESR
Iron studies
TSH

165
Q

What to get after diagnosis of CRC

A

CT abd/pelvis
CXR
CEA
Surgical/Onc consult

166
Q

HEEADSS

A 
Home
Education/Employment
Eating
Activities
Drugs
Sexuality
Safety/Violence
Suicide/Depression
167
Q

Signs indicative of testicular torsion

A

Blue dot sign

Absent cremasteric reflex

168
Q

Sign indicative of epididymitis

A

Prehn sign

Physical lifting of the testes relieves pain.

169
Q

Symptoms of HSP

A 
Nonthrombocytopenic purpura
Arthralgia
Abdominal pain
GI bleeding
Nephritic syndrome
\+- scrotal pain
170
Q

What intraabdominal pathology can cause referred scrotal pain?

A

Retrocecal appendicitis

171
Q

Viability of torsed testi based on time

A 
6h = 90%
12h+ = 50%
24h+ = 10%
172
Q

When is the meningococcal vaccine given?

A

1st dose at 11-12y

2nd at 16y

173
Q

Types of testicular tumors

A 
Germ cell tumors:
-Seminoma
-Yolk sac (kids)
-Embronal cell tumor
-Teratomas
-Mixed GCT's
Choriocarcinoma

Non germ-cell tumors

  • Leydig
  • Sertoli
174
Q

Acute vs chronic bronchitis

A 
Acute = under 3w
Chronic = at least 3mo for the past 2y
175
Q

Spirometric Dx of COPD

A

FEV1/FVC ratio

176
Q

COPD severity (FEV1)

A 
>80% = mild
50-79% = mod
20-49% = severe
177
Q

Therapy for moderate COPD

A
  • Inhaled anticholinergics (ipratropium/tiotropium)

- SABA

178
Q

Therapy for sever COPD

A
  • Inhaled steroids
  • LABA
  • Anticholinergic
  • SABA
179
Q

Indications for abx in a COPD exacerbation

A

1) dyspnea, ^sputum, purulence
2) purulence & one of the above
3) requiring intubation

180
Q

Dementia DSM-IV criteria

A

Acquired impairment in memory & one of more cognitive domains:

  • Executive function
  • Language
  • Praxis (motor)
  • Gnosis (recognition)
181
Q

Labs to get in pt suspected of dementia

A 
CBC
BMP
Calcium
TSH
B12 (no folate)
\+/- RPR
\+/- Neuroimaging
182
Q

Most common causes of dementia

A

Alzheimer’s
Vascular dementia
Lew body dementia

183
Q

Symptoms of Lewy body dementia

A

Dementia
Delirium
Parkinsonian Sx
Hallucinations

184
Q

DDx corneal arcus

A

Arcus senilis = benign

Arcus juvenilis = HLD & possible CAD

185
Q

Causes of delirium in a demented patient

A 
Elelctrolyte disturbance
UTI
Respiratory infx
Urinary retention
Pain
186
Q

Normal post-void residual

A

200cc = abnormal

187
Q

SE’s of Haldol

A

Sedation
Constipation
EPS & TD
QT prolongation

188
Q

What medications can precipitate or worsen delirium?

A

Sedating meds

Anticholinergics

189
Q

Medications to treat dementia

A 
AchE inhibitors (Donepezil)
Memantine (NMDA receptor antagonist)
Olanzapine & Resperidone
190
Q

`When to give peripartum GBS prophylaxis

A

1) Women who screened positive for GBS

2) Unknown GBS status and preterm or PROM

191
Q

Normal fetal HR

A

110-160

192
Q

Normal FHT variability

A

6-25 bpm

193
Q

What is considered a reactive FHT?

A

2+ accels over 20 mins

Accels must be 15bpm and last 15 seconds

194
Q

Definition of active labor

A

Strong regular contractions Q3-5m and cervical dilation of 4-5cm

195
Q

Thickness of a non-laboring cervix

A

3cm

Can base % effacement off of this value

196
Q

Contraindications to digital cervical exam

A

Patient-reported vaginal bleeding
Undocumented placental location
PPROM

197
Q

Stages of labor

A

First Stage:

  • Latent = contractions
  • Active = 4cm dilated

Second stage:
Full dilation to birth

Third stage:
Baby to placenta

198
Q

FHT tracing categories

A

Cat I:
Moderate variability, no late or variable decels

Cat III:
No variability, recurrent late or variable decels

199
Q

Mgmt for late decels

A

Place pt on her l side
Monitor maternal BP
Supplemental O2

200
Q

Definition of failure to progress in labor

A

No cervical change for 2h during the active phase of labor

201
Q

What are the cardinal movements of labor?

A 
Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Expulsion
202
Q

Postpartum hemorrhage causes

A

4T’s

  • Tone
  • Trauma (perineal or cervical)
  • Tissue (retained placenta)
  • Thrombin (coagulopathy)
203
Q

When it betamethasone appropriate for fetal lung maturity?

A

24-34w

204
Q

Age of MI in relative that gives increased risk for CAD

A

Male relative

205
Q

What drugs lower mortality in systolic CHF?

A

ACEi
Carvedilol
Eplerenone

206
Q

Criteria for menorrhagia

A

> 80cc of blood loss

207
Q

Treatment options for PMS

A

Danazol (androgenic/progesterone)
OCP’s
SSRI during menses

208
Q

Types of “dizziness”

A

1) Presyncope
2) Disequilibrium
3) Vertigo

209
Q

Meniere’s dz triad

A

1) Unilateral hearing loss
2) Tinnitus
3) vertigo

210
Q

Head thrust test

A

Positive - peripheral lesion

Normal - central lesion

211
Q

Treatment for BPPV

A

Epley maneuver

212
Q

Treatment for Meniere’s disease

A

Diuretics

Low salt diet

213
Q

Classic signs of a TORCH infx

A

Microcephaly
Hepatosplenomegaly
Purpuric rash

214
Q

Dx of congenital rubella

A

Anti-rubella IgM

215
Q

Dx of congenital toxoplasmosis

A

Anti-toxo IgM

216
Q

Dx of congenital CMV

A

Urine culture

217
Q

Symptoms of congenital CMV

A 
Microcephaly
Sensorineural hearing loss
IC calcifications
Purpuric rash
HSM
218
Q

What are mandatory on the newborn metabolic screen?

A

PKU

Hypothyroidism

219
Q

PKU symptoms

A

Vomiting
Hypotonia
Musty odor
Decreased hair/eye pigmentation

220
Q

Symptoms of homocystinuria

A

Marfanoid body habitus

Hypercoagulable state

221
Q

Niemann-Pickk symptoms

A 
Heptatomegaly
Ataxia
Seizures
Developmental delay
Cherry-red macula
222
Q

Hurler syndrome symptoms

A

HSM
Corneal clouding
Developmental delay

223
Q

Von Gierke’s disease symptoms

A

Hypoglycemia
HSM
Metabolic acidosis

224
Q

When to screen for autism

A

18m & 2y

225
Q

Calorie requirements of neonates

A

Normal: 100-120 cal/kg/day

Preterm: 115-130 cal/kg/day

226
Q

Most common neoplasm in infants

A

Neuroblastoma

227
Q

Which infant tumor crosses the midline?

A

Neuroblastoma can

Wilms’ (nephroblastoma) cannot

228
Q

Workup of suspected neuroblastoma

A

Urine or serum catecholamines (VMA & HVA)
CXR - for mets
Skeletal survey
Abdominal US

229
Q

When for children to first go to the dentist?

A

Within 6mo of first tooth eruption

230
Q

When can a child ditch their booster seat?

A

At 4’9”

231
Q

When can a child face forward in the car?

A

2y or when they outgrow their small carseat

232
Q

When should a bottle be stopped for children?

A

By 12-15mo

233
Q

When to screen for anemia?

A

12mo & prior to kindergarten

234
Q

SE’s of stimulant use to treat ADHD

A

Appetite suppression
Tic disorders
Insomnia
Decreased growth velocity

235
Q

HTN classes in children

A

99th+5 = Stage 2 HTN

236
Q

Secondary causes of HTN

A 
Umbilical artery/venous access
UTI w/ parenchymal scarring
Catecholamine excess
FH of renal dz
Coarctation of the aorta
237
Q

Criteria for positive PPD test

A

> 5mm in high risk
10mm in mod risk
15mm in low risk

238
Q

Normal I:E ratio

A

Inspiration:Expiration

Normal is 1:2 or 1:3

239
Q

What does stridor signify?

A

Inspiratory: Laryngeal obstruction

Expiratory: Tracheobronchial obstruction

Both: Glottic or subglottic obstruction

240
Q

Weekly albuterol need in well-controlled asthma

A

Less than 2x per week

241
Q

Definition of unstable angina

A

1) Chest pain at rest
2) New onset angina (past 4-6w)
3) Angina that is worsening

Family Medicine (1 decks)

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