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Fam med exam > Med - u cases > Flashcards

Med - u cases Flashcards

1
Q

Patient has increased risk of breast cancer if __________ degree relative has had it

A

First degree relative

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2
Q

Does the USPTF recommend self breast exams?

A

No

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3
Q

Cervical cancer screening guidelines

A

Start at 21 years

21-29 every 3 years

30-65 every 5 if co tested with HPV or every 3 with cytology alone

Stops at 65 if 10 years of normal prior

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4
Q

Characteristics of good screening test

A

Highly sensitive and specific

Detect disease in asymptomatic phase

Minimal risk

Reasonable cost

Acceptable to patient

Available treatment

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5
Q

Is ovarian cancer screening recommended?

Skin cancer?

Lung?

A

No

No

Yes, 55-80 with 30 pack year hx

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6
Q

Tetanus immunization adults

A

Single dose Tdap instead of Td. 19-64

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7
Q

Calcium recommendation

Pre and post menopause

A

Pre - 1000 mg daily

Post - 1200

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8
Q

Osteoporosis screening

A

Women over 65

DEXA

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9
Q

Bethesda System for Reporting cervical cytology

3 categories

A

Specimen adequacy

General categorization of results

Interpretation of results - ASC, LSIL, HSIL

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10
Q

Mammography has more ______ in young women

A

False negatives

Dense breast tissue = harder to find lesions

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11
Q

Recommended screening for ASCUS

A

3 years with HPV co testing

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12
Q

RISE mnemonic for preventive visits

A

Risk factors
Immunization
Screening tests
Education

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13
Q

ASCVD screening recs

A

Every 4-6 years

20-79 years who are free of ASCVD

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14
Q

A or B screening recs in 55 year old male smoker

A 
Colorectal cancer
Obesity
DM
Lipid disorders
Tobacco
HTN
Alcohol misuse
Lung cancer - smokers
Hep C - born 1945-1965
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15
Q

Three C of addiction

A

Compulsion to use
Lack of Control
Continued use despite adverse outcomes

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16
Q

Five As of counseling for behavior change

A 
Ask or address behavior 
Assess for interest in change
Advise on methods
Assist with motivation
Arrange follow up
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17
Q

BMI

A

Weight in kg/ height in meters (squared)

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18
Q

BMI categories

Below 18.5 =
18.5-24.9
25-29.9
30 and above

A

Underweight

Normal

Overweight

Obese

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19
Q

Annual quit rate for smokers without medical intervention

A

2-3%

Oral meds increase 1.5 to 3x the placebo quit rate

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20
Q

Appropriate steps for managing high risk ASCVD include

A

Aspirin and high intensity statin

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21
Q

Common causes of insomnia in the elderly

A 
Environment 
Sleep apnea
Restless leg 
Depression/anxiety
Cardio respiratory disorders
Pain/pruritus
GERD
Hyperthyroidism
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22
Q

Two recommended dementia screen tools

A

MMSE

MINI COG

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23
Q

Depression is identified less or more in Hispanics than whites?

A

Less

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24
Q

Lab eval of depression/fatigue

A

CMP
TSH
CBC

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25
Q

Most common manifestation of Graves

Primary symptoms of graves related to?

A

Eyelid retraction + Exopthalmos

Corneal irritation from eyelid retraction

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26
Q

High radioactive iodine uptake

A 
Graves
Multinodular goiter
Toxic solitary nodule
TSH secreting pituitary tumor
HCG secreting tumor
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27
Q

Low Radioactive iodine uptake

A 
Sub acute thyroiditis
Silent thyroiditis
Iodine induced
Exogenous thyroxine
Struma ovarii 
Amiodarone
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28
Q

Most common med for hyperthyroid

Dangerous side effect

A

Methimazole

Agranulocytosis

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29
Q

Test to obtain before radioactive iodine

A

Pregnancy test

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30
Q

Diabetes screening

A

Asymptomatic adults with BP >135/80

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31
Q

Dx criteria for diabetes

A

Random glucose over 200

Fasting > or equal to 126

A1c of 6.5 or greater

OGTT is more sensitive than fasting

Need to be confirmed on a different day

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32
Q

Optimal range for blood glucose

A

<120 fasting

<180 post prandial

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33
Q

USPSTF recommendations for aspirin in diabetics

A

50-59 with >10% 10 year ASCVD risk score

60-69 with >10%

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34
Q

Wagner ulcer grading

1-5

A

1 superficial
2 extension into ligament, tendon, joint capsule, fascia

3 deep with abscess or osteomyelitis

4 partial gangrene

5 extensive gangrene

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35
Q

Main causes of palpitations

A 
Arrhythmia
Structural heart disease
Psychosomatic
Systemic
Medical or recreational drugs
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36
Q

USPSTF chlamydia screening recs

A

All sexually active women 24 and younger

25 and over if high risk

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37
Q

Folic acid rec for women capable of becoming pregnant or who are planning to

A

400 to 800 micrograms daily

1 mg for diabetics or epileptics

4 mg for those who bore a child with NTD

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38
Q

Naegeles rule

A

Add a year
Subtract 3 months
Add 1 week

=Estimated date of delivery

39
Q

First trimester Estimation of gestational age method

Accuracy

A

Crown rump length

+/- 1 week

40
Q

HEEADSSS adolescent interview

A 
Home
Education
Eating
Activities
Drugs
Sex
Suicide
Safety
41
Q

Beta hcg level to detect intrauterine pregnancy

How often does it double?

A

> 1500

Should double every 48 hours in normal pregnancy

42
Q

Moderate persistent asthma treatment

Step?

A

Step 3

Low dose inhaled corticosteroid + long acting Beta agonist (preferred)

OR

Medium dose inhaled corticosteroid alone

43
Q

19-64 with chronic heart, lung, liver disease or diabetes or alcoholism

Pneumonia vax?

A

PPSV 23

44
Q

Recommended pregnancy weight gains according to BMI

A 
18-25 = 25-35lbs
25-30 = 15-25 lbs
30+ = 11-20lbs
45
Q

Placenta previa is more likely to resolve if detected when?

A

Earlier in pregnancy

46
Q

3 hour OGTT positive if?

A

2 or more of:

Fasting > 95
1hr > 180
2hr > 155
3hr > 140

47
Q

Only type of IUD approved for post partum?

A

Copper

48
Q

Macular

A

Flat lesion

Less than 1cm

Basically a change in color of the skin

49
Q

Patch

A

Flat lesion

Greater than 1cm

50
Q

Papule

A

Solid raised lesion

Distinct borders

Less than 1cm

51
Q

Plaque

A

Solid, raised, flat topped lesion

Greater than 1cm

52
Q

What two tinea require systemic treatement?

A

Capitis and Unguium

53
Q

Most common symptoms of menopause

A

Hot flashes

Vasomotor symptoms

54
Q

Most women should consume ______ mg calcium and _____IU vitamin D daily

A

1200

800-1000

55
Q

When to initiate pharmacological tx for migraines

A

At least 6 headache days per month

4 headaches days with some impairment

At least 3 headaches with severe impairment

56
Q

of episodes needed for

Migraine dx

Tension dx

Cluster dx

A

5 migraine

10 tension

5 cluster

57
Q

Migraine prophylaxis

A

Beta blockers

TCA’s

Divalproex, Topirimate

58
Q

Center criteria

A

One pt each for:

Tonsillar exudate or erythema
Anterior cervical adenopathy
Cough absent
Fever present
      3-14 years +1
       15-45 = 0
       45 and over = -1
59
Q

Centor 2-3

A

Rapid strep

60
Q

Centor 4-5

A

Treat with antibiotics

61
Q

Two most common complications of influenza

A

Bacterial pneumonia

Otitis media

62
Q

Strep treatment 1sr line

DOSAGE

A

Amoxicillin

90 mg/kg/day - 3 doses

63
Q

Diabetes screening in children

A

All children with risk factors and >85% of BMI

All children >95% of BMI without risk factors

64
Q

Children younger than 7 with >95%ile BMI and NO secondary complications should______

A

Maintain their weight

With complications should drop to <85%ile

65
Q

Cholesterol guidelines for kids

A

<170 total

<130 LDL

66
Q

80% of strokes caused by _________

A

Thrombosis

67
Q

Hours/day healthy infant cries

A

2 weeks = 2 hours

6 weeks = 3 hours

3 months = 1 hour

68
Q

Clinical staging of colorectal cancer

Tests

A

CT abd pelvis
Chest X-ray

CEA maybe

69
Q

Most common type of testicular tumor

A

Germ cell

70
Q

Two types of germ cell tumors

A

Seminomatous

Non-seminomatous - embryonal, mixed, teratoma, yolk sac, choriocarcinoma

71
Q

Non germ cell tumors?

A

Leydig

Sertoli

72
Q

Major benefit of quitting smoking in COPD occurs when?

A

In the first year

73
Q

FEV1/FVC ratio diagnostic of COPD

A

<5th %ile or < 70%

74
Q

COPD levels

Mild
Moderate
Severe
Very severe

A

FEV1
<80%

50-79%

30-49%

<30%

75
Q

Dementia with Lewy body

Differences from Alzheimer’s

A

Visual hallucinations

Parkinsonism

76
Q

Cholinesterase inhibitors for dementia

A

Donepezil
Rivastigmine
Tacrine
Galantamine

77
Q

Average cervical dilation speed

Multi

Nulli

A

2cm/hr

1cm/hr

78
Q

Failure to progress

A

No cervical change for 2 hours in active phase

Fetal presenting part fails to descend in the pelvis after 2 hours (3 if epidural)

79
Q

Cardinal movements of labor

A 
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation
Expulsion
80
Q

4 T’s of Post Partum Hemorrhage

A

Tone
Trauma
Tissue
Thrombin

81
Q

Category III fetal tracing

A

No variability +

Bradycardia OR
Recurrent late deceleration OR
Recurrent variable decels OR

Sinusoidal HR pattern

82
Q

SGA

A

Weight below 10th %ile

83
Q

Microcephalic

A

Head circumference less than 10th%ile

84
Q

Average cal/kg/day requirement of

Term

Pre term

Very low birth weight

A

100-120

115-130

Up to 150

85
Q

Moro reflex disappears by

A

4 months

86
Q

Over first 5 years
Number of doses of

DTaP
IPV
HIB
PCV13
MMR
VARICELLA
ROTA
HEP A
HEP B
A 
5
4
3-4
4
2
2
2-3
2
3
87
Q

Double birth weight by?

Triple by?

Double birth length by?

A

4-5 months

1 year

4 years

88
Q 
6 month developmental
Gross
Fine
Language
Social
A

Rolls, sits unsupported, no head lag

Reaches for objects, looks for dropped items

Turns toward voice, babbling

Feeds self, stranger recognition

89
Q

12 month developmental

Gross
Fine
Language
Social

A

Stands alone, many walk

Neat pincer grasp

Mama and dada, 1-2 other words

Hands parent a book to read, points to things they want, imitates activities, plays ball

90
Q

Most frequently diagnosed neoplasm in infants

A

Neuroblastoma

91
Q

3 year old developmental

Social
Communication
Cognitive
Physical

A

Brushes teeth with assistance, feeds self

2-3 world sentences, 75% understandable

Name and use of cup, ball, crayon, spoon

Tower of 6-8 cubes, throws a ball overhand, tricycle, copies a circle

92
Q

4 year old developmental

Social, communication, cognitive, physical

A

Knows gender and age, friendly with other kids, fantasy play

First and last name, most speech understandable

Names colors, board games, draws person with 3 parts, copies a cross

Hops on one foot, balances for 2 secs, pours, cuts, mashes food, brushes teeth

93
Q

5 year old developmental

Social, communication, cognitive, physical

A

Listens and attends, tell difference between real and make believe, sympathy and concern for others

Tells simple story, proper tense and pronouns, counts to 10

Draws a person with 6 parts. Copies square, some letters and numbers

Balances on one foot, hops and skips, mature pencil grasp, undresses/dresses with minimal assistance

94
Q

4 groups benefitting from statin therapy

A

Current ASCVD

LDL >190

DM type I or II age 40-75

ASCVD Risk > 7.5%

Fam med exam (1 decks)

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