Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fam med > Panda fam med: 2 > Flashcards

Panda fam med: 2 Flashcards

1
Q

MCCOD <6 m/o

What are some findings on physical exam?

A

SIDS

PE will show signs of “Terminal Activity”

  • Clenched Fists
  • Sero-sanguinous discharge from nose / mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MC Type of Renal Stones

A

Ca Oxalate Stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

6 Aspects of Treatment of kidney stones

A

6 Aspects of Treatment

  1. IVF
  2. Low Na
  3. Normal Ca
  4. Decrease Oxalate Foods (Spinach, Rubarb, Chocolate, Tea)
  5. Decrease Protein
  6. K Citrate To increase pH of urine

Ox stays low likes to ppt at low pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which kidney stones are “envelopes” vs. “coffin lids” vs. “Hexagonal”?

A

Envelope = Ca Oxalate
Coffin Lids = Triple Phosphate (infections)
Hexagonal = cysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MCC Movement Disorder

  • 2 Ways to Distinguish from PD
  • 3 Rx for Treatment
A

MCC Movement Disorder = Benign Essential Tremor

  • vs. PD
    1. BET is a 6-12 Hz tremor while PD is 3-6 Hz
    2. BET is with intention/purposeful movements while PD is at rest
  • 3 Rx for Treatment
    1. Propranolol
    2. Primidone (Phenobarb, Phenylethylmelanomide)
    3. Topiramate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
MSSA Rx (3)
MRSA Rx (6)
A

MSSA: Nafcillin, Oxacillin, Dicloxicillin

MRSA:
1 Vanc
2. Linezolid
3. Bactrim
4. Doxy
5. Clinda
6. Daptomycin (Depolarizes cell membranes; ADE = myopathy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  • Goal for Hb in DM with CKD
  • Goal for A1C for DM
  • Goal for BP in DM / CKD
A

Hb: 10-12
A1C: 7.0
BP: 130/80

DON’T OVERCORRECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pinworm:

A

Enterobius Vermicularis –> Peri-anal itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hookworm

A

Ancylostoma/Necator –> feet on feces-infected soil allowing hook worm to penetrate –> Cutaneous Larva Migrans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Roundworm

A

Toxacar –> ingest feces-infected soil –> Viceral Larva Migrans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Eczema

- 3 Individual Disorders

A

= Contact / Atopic / Seborrheic Dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to tell contact vs. atopic dermatitis in baby

A

atopic affects face / flexural areas. Contact affects diaper area.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Approach to treating eczema flare

A

Approach to flare:

  1. Topical Steroids
  2. Emollients / Antihistamines
  3. IF 2/2 Bacterial = Topical Mupirocen
  4. IF HSV Infection (Eczema Herpeticum) = Acyclovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

4 Rashes of Pregnancy

A
  1. Mesasma/cholesma
  2. Intrahepatic cholestasis of pregnancy
  3. PUPP
  4. Herpes Gestationis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

symm hyperpigmentation of face worse with UV light, resolves with pregnancy

A

Mesasma/cholesma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pruritis and jaundice with NO RASH in 3rd trimester of pregnancy 2/2 increase bile acids.

A

Intrahepatic cholestasis of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Intrahepatic cholestasis of pregnancy: tx

A

Treatment = anti-histamine for itch and ursodiol&raquo_space;> cholestyramine (decrease bile acid resorption, decrease VIT ADEK tho)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

wheals and pruritis on abdomen of pregnant woman

A

PUPP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PUPP tx

A

Topical Steroids and anti-histamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

vesicles and prurits on abdomen of pregnant woman

A

Herpes Gestationis (no relation to actual herpes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Acne Classification + Treatment

A
  1. Noninflammatory / Min Inflammatory: Topical Isotretinoin
  2. Min-Moderate Inflammation: Topical Benzoyl Peroxide
  3. Mod-Severe Inflammation: PO Doxy, Clinda, Erythromycin
  4. Severe/Nodulocystic: PO Isotretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Scabies / Lice

  • Bug for Scabies
  • Location of Scabies on Body
  • Mechanism of Transmission for Scabies / Lice
  • Treatment for Both
A
  • Bug: Sarcoptes Scabeiei
  • Location of Scabies: Kids = Face, Adults = Webbing of hands/feet
  • Transmission: DIRECT CONTACT (≠bedding)
  • Treatment: Permethrin + Malathion (Lindane bad for the brain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Perianal GAS Infection

  • Presentation
  • Mechanism of Infection in these areas
A

P/w with beefy rash of both the GENITAL and ANAL region (r/o trauma or pinworms)

Mechanism: often occurs @same time as GAS pharyngitis; either auto-innoculation or spread through the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Spontaneous PT Management

A

If suspect and negative initial CXR, don’t forget to get the expiratory phase.

Management:
- f/u in 48 hours outpatient with repeat CXR 24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Most sensitive test for HSV?

A

HSV DNA PCR (»> Serology / Tzanck)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CHADS2 Score + Interpretation

A

CHF, HTN, Age>75, DM, Stroke/TIA (2points)

≤1 = Low Risk = ASA
2-3: Intermediate = Coumadin
≥4: high Risk = Coumadin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ADE of Opiates that don’t resolve with time (2)

A

Constipation and Miosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

HIV PCP Pneumonia Management

A

Bactrim + Steroids IF:

1. PaO2 34

29
Q

Venous Ulcers

  • MCC
  • Primary Treatment (2)
  • Adjunctive Treatment (2)
A

MCC = Chronic Venous Insufficiency from Post-phlebitic Syndrome

Primary Treatment = Leg Elevation + Compression Stalkings

Adjunctive Treatment = ASA or Pentoxyfilline (thins blood)

30
Q

Patients with acute LBP are normally managed with ADL +/- NSAID. What situations would you IMAGE (Plain Film > MRI) the back in a person with LBP (5)?

A
  1. Neuro symptoms / rapid development of focal deficits
  2. IVDU
  3. Malignancy
  4. Constitutional Symptoms (cancer / abscess)
  5. Chronic Steroid Use (Concern for Compression Fracture) ~ plain film (≠MRI)

only time to MRI initially = high high high chance of MALIGNANCY, ABSCESS, CAUDA EQUINA (rapid neuro)

31
Q

3 Disorders with “percussion tenderness” / point tenderness on back?

A

Compression Fx, Malignancy (Lytic/blastic) or Abscess

32
Q

Critically ill patient is post-op, no blood loss in OR or now and is currently not responding to fluids (BP remains low). Patient is not septic and does not have anaphylactic or neurogenic shock. DDx?

A

Cortisol Deficiency

If patient is chronic steroid user or has been critically ill for some time, adrenal hormones may be low = cannot maintain BP

33
Q

Prenatal Care: initial visit

A
  • UA (with UCx if needed)
  • Pap
  • CBC with ABO Set Up
  • Infections (GC/CT/RPR/HIV/HBV/Rubella)
34
Q

Prenatal care: 10-13 wk

A

Nuchal Translucency +/- hCG and PAPP, offer CVS

35
Q

Prenatal care: 16-18 wk

A

Quad Screen + Anatomy Scan, offer Amnio

36
Q

Prenatal care: 26-28 Weeks

A

Glucolla for Gestational DM and Repeat Rh testing in Rh- moms to check for alloimmunization +/- RhoGam (if +)
Recall, for mothers at risk of alloimunization, give RhoGAM at 28 weeks and @birth

37
Q

Anticoagulation for DVT / PE

A
  1. Initiate Heparin + Coumadin
  2. Continue for 5 days following INR
  3. DC Heparin after 5 days and if therapeutic for at least 24 hours (INR ≥2.0)

Summary:
DVT/PE –> Heparain/Coumadin –> DC Heparin 5 days later IF INR≥2.0 for at least 24 hours

38
Q

What has been shown to decrease risk of atopy?

A

Breast feeding for at least 4 months

39
Q

Migraine

  • Presentation (3 phases)
  • Treatment for Active Migraine
  • PPx
A

Trigger –> Prodromal Phase (≠Aura) –> Migraine (+/- Aura)

Active Treatment: NSAID –> Triptans (Severe)
*Note ≤12 y/o cannot receive triptans

PPx: Propranolol&raquo_space;> Amitriptyaline

40
Q

HRT (Combined E + P)

  • 4 Benefits
  • 4 Risks
A

4 Benefits:

  1. Decrease ovarian cancer
  2. Decrease endometrial cancer
  3. Decrease colon cancer
  4. Decrease fractures 2/2 osteoporosis

4 Risks:

  1. Increase CVA
  2. Increase CHD
  3. Increase PE
  4. Increase Breast Cancer
41
Q

(T/F) H/o of Major Depressive Disorder is the single greatest risk factor for PP Depression.

A

False, a h/o of PP Depression is #1. #2 = h/o MDD.

42
Q

(T/F) Gestational DM is the most significant risk factor for developing Type II DM (even more than multiple family relatives having Type II DM)

A

True.

43
Q

2 month s/p Lap-chole, 40 y/o female has RUQ pain and jaundice.

  • Diagnosis
  • Underlying mechanism?
A
  • Diagnosis = post-chole pain

- Mech: retained CBD stone (or else wouldn’t be jaundiced)

44
Q

USPSTF Breast Cancer Screening Guidlines

A

≥40: Annual Breast Exam with +/- Mammogram q2 years on personal preference

≥50: Mammogram q2 years

45
Q

Femoral Anteversion vs. Tibial Torsion

  • Presentation
  • Treatment
A

Femoral Anteversion

  • P/w intoing in children
  • Treatment: NO ORTHOTiCS/SHOES; observe until 8-10 y/o –> Surgery. Surgery earlier if significant complications (gait, etc)

Tibial Torsion

  • P/w intoeing in kids who sit on their knees / sleep prone
  • Treatment is same as above
46
Q

Nodes in Hands/Fingers

A

Osler’s (IE) —> Heberdon (DIP = OA) –> Bouchard (PIP = OA) –> MCP (RA) —> Janeway Lesions (IE)

47
Q

N/V Pregnancy Management

A

Best managed with Vit B6 and Doxylamine (1st gen antihistamine)

48
Q

DMD

  • Genetics
  • Presentation
  • MCCOD
  • Confirmatory Test
  • Screening Test
A
  • Genetics: X-linked frameshift mutation in dystrophin
  • Presentation: pseudohypertrophy of calf + proximal muscle weakness
  • MCCOD: respiratory failure
  • Confirmatory Test: IHC for dystropin
  • Screening Test: CPK!
49
Q

3 MCC Knee Pain in PEDS

A
  1. Patellar Subluxation
  2. Patellar Tendinitis
  3. Tibial Apophysitis (Osgood Schlatter)
50
Q

Tramadol

  • MoA
  • Indication
  • ADE
A

MoA: Weak opioid agonist
Indicated: chronic pain
ADE: lower seizure threshold

51
Q

Cilostazol

  • MoA
  • Indication
A

MoA: PDE-3 inhibitor
Indication: intermittent claudication

52
Q

2 Aspects to Management of Ascites

A
  1. Diuretic (Spironolactone&raquo_space; Lasix)

2. Salt restriction

53
Q

Men v. Women ADME, state who is higher for:

  • GFR
  • BMI
  • Fat Stores
  • Gastric Acid Secretion
  • GI Motility
A
  • GFR: higher in men
  • BMI: higher in men
  • Fat Stores: higher in women
  • Gastric Acid Secretion: higher in men
  • GI Motility: higher in men
54
Q

Aging

  • Distribution changes of drug
  • Transdermal
A
  • Distribution: increase fat / low mass

- Transdermal: DOES NOT CHANGE

55
Q

Duration of Dual Anti-Platelet Rx for:

  • Drug Eluting Stent
  • Sirolimus Eluting Stent
  • Bare Metal Stent
A
  • 1 year
  • 6 months
  • 1 month
56
Q

(T/F) Medicare pays for preventative measures and treatments.

A

False, just prevention. Think VACCINES, MAMMOGRAMS, PAP SMEARS. It does NOT pay for hearing aids, dentures, NH care.

57
Q

Herpangina

  • Etiology / Microbiology
  • Presentation
A
  • Etiology / Microbiology: coxsackie / echovirus

- Presentation: Fever / decrease PO intake, PE with shallow posterior pharynx ulcers

58
Q

Compression Fracture

  • Diagnosis
  • Recommendations
  • Rx
A
  • Diagnosis: plain film
  • Recs: REST (only back pain with decrease ADL), NO NO NO NSAID
  • Rx: Intranasal Calcitonin is only thing used for PAIN relief
59
Q

Centor Scoring + Interpretation

A

1: xCough
1: Fever (100.4, 38)
1: Cervical Lymphadenopathy
1: Tonsilar Exudates

1: 3-14
0: 14-44
- 1: >44

Interpretation:
0-1: nothing
2-3: Rapid Strep
≥4: Emperic Abx

60
Q

Well’s Score

A

3: Meets sign/symptoms of DVT
3: No other diagnosis fits
1. 5: HR >100
1. 5: Recent immobilization / surgery
1. 5: H/o DVT
1: Hemoptysis
1: Malignancy

61
Q

PPD Indurations

  • 5mm who’s positive?
  • 10mm who’s positive?
  • 15mm who’s positive?
A

5mm Positive:

  • HIV/IC
  • Recent exposure to TB+ person
  • +CXR findings of TB

10mm Positive: everyone else

15mm Positive: normal healthy adults

62
Q

Functions of HIPAA (4)

A
  1. Sets minimum privacy protection
  2. Requires privacy notices signed at FIRST DELIVERY OF HEALTHCARE
  3. Requires privacy notices in emergency situations, but these can be taken care of after emergent care is given
  4. Allows patient to inspect / obtain medical files WITH EXCEPTION (harm to self / others / psychotherapy)
63
Q

Framingham 10 year Risk for CHD

  • Who qualifies
  • Screening Tools
  • When to start lipid lowering therapy?
A

Qualifies:

  1. Age 30-74
  2. No h/o CHD (otherwise why would you screen?)

Screening ~ SHADDy

  1. Smoking
  2. HTN
  3. Advancing Age (Men >45, Women >55)
  4. DM
  5. Dyslipids

Lipid Lowering Therapy = with risk ≥7.5

64
Q

Hiccups

  • Pathophysiology
  • Treatment
A

Pathophysiology
- Respiratory reflex involving the phrenic, vagus and SNS nerves

Treatment: inhibit the reflex loop

  • Tongue Depression
  • Rx: Chlorpromazine
65
Q

Vanc Trough

  • Goal
  • Interpretation
A

Goal for Vanc Trough >10. This is best level to prevent bacterial resistance.

66
Q

Pyelonephritis in Pregnancy Management

A

Treat with IV Ceftriaxone / IV Amp+Gent (note Amp/Gent is also the emperic treatment for NB with possible sepsis)

Post-treatment PPx with Macrobid

67
Q

Best Screening Test for Adrenal Insufficiency, how to f/u with results?

A

AM Cortisol

  • if NL: no further testing
  • if low: ACTH stimulation
68
Q

Define “Frequent PVC” per Framingham.

What to do with patient with “frequent” PVC?

A

Frequent = ≥30 PVC/HOUR

Patients are at increased risk for SCD / MI, screen these patients for CHD.

Fam med (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions