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Leslie CNM > Primary Care > Flashcards

Primary Care Flashcards

1
Q

When is the greatest loss on bone mineral density?

A

The first 2 years after menopause

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2
Q

Osteoporosis is defined as…?

A

A T score below -2.5

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3
Q

Etiology of osteoporosis?

A

Tx with glucocorticosteroids, Vit D deficiency, thyroid replacement therapy, active peptic ulcer disease, abnormal kidney and liver function, malabsorption syndromes and estrogen loss.

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4
Q

What is Cholecystitis?

A

Inflammation of the gall bladder.

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5
Q

What is Cholelithiasis?

A

Obstruction of the gall bladder.

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6
Q

Signs and Symptoms of Cholelithiasis and Cholecystitis?

A

RUQ and epigastric pain radiating to upper back and intolerance of fatty foods. Pain can be intermittent or constant. Jaundice = Cholelithiasis. Abdominal pain and fever = Cholecystitis.

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7
Q

What is the diagnosis of Chole (both)?

A

Positive Murphy’s Sign: curl fingers under rib cage over liver and ask pt to exhale. Postivie if inspiration is interrupted or whencing is noticed.

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8
Q

Tx for Chole (both)

A

Drugs may dissolve stones, cholecystectomy may be preferred. For acute disease refer to surgeon.

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9
Q

Non-pharm management of osteoperosis

A

Midwife will consult. Diet with protein, vit D and Calcium. Weight bearing exercise, i.e. walking 30 min 3xs per wk

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10
Q

Pharm management of Osteoporosis

A

Fossamax (bisphosphonate) PO q weekly or Boniva q monthly. Reloxifene (SERM). HRT and Vit D - 800IU + 1200mg Calcium. (Thiazide diuretics for HTN may decrease bone loss by reducing urinary excretion or calcium.

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11
Q

MOA of Fossamax (bisphosphate)

A

Decrease Bone turnover, inhibit resorption, increase formation of bone

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12
Q

MOA of Reloxifine (SERM)

A

acts like Estrogen on bone and heart, but not on breast and uterus, improves bone, lipid profile by decreasing LDL, but has no effect on HDL

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13
Q

Dx for Type 2 DM

A

Fasting > or = 126, random or 2hr 75mg glucola challenge 200 or over; HcbA1C >6.5%

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14
Q

S/S Pyleonephritis (UTI)

A

low grade fever, chills, dysuria, flank pain (CVAT) usually on right side 50%, 25% bilateral.

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15
Q

Tx for acute Pyleonephritis

A

Bactim 160/800mg PO BID 14 days or Cephlosporin (Keflex) 250-500mg PO QID
Consult with pyleo

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16
Q

Genotype is defined as

A

Combination of genetic factors in an individual

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17
Q

Prolonged untreated GERD can cause

A

Barrett’s esophagus

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18
Q

A 40 year old woman comes in for her annual exam. Her BP is 138/85. You recognize this as:

A

Prehypertension and suggest lifestyle modifications

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19
Q

Patient comes into the office after stepping on a rusty nail. she inquires about the tetanus vaccine. had a full series and received last booster about 9 years ago. You advise her to

A

Be revaccinated with a booster as this is an unclean wound and her adult booster was more than 5 years ago.

20
Q

The varicella immunization is only contraindicated in what 2 groups

A

Pregnancy and HIV infections

21
Q

Osteopenia is defined as a T-score between

A

-1.0 and -2.5

22
Q

Recommended daily calcium intake for women 19-50 years old

A

1000 mg

23
Q

A component of the physical exam that suggests metabolic syndrome

A

waist circumference >40inches in men or >35 inches in women

24
Q

Most common type of skin cancer in America is

A

Basal cell carcinoma

25
Q

Daycare worker comes in with honey crusted lesions on her arm. She said that she gotten some mosquito bites. You recognize these lesions as

A

Impetigo

26
Q

19 y/o female, has annular lesions with a raised border on her trunk, mildly pruritic. Skin scraping viewed with KOH under the microscope shows hyphae. What is it

A

Tinea corporis

27
Q

An afebrile 25 y/o female returns from a beach holidday with complaints of left ear pain of 24hrs. The pinna is exquisitely tender with traction. The pt has what

A

Otitis externa

28
Q

A normal weight is defined as a BMI of

A

18.5-24

29
Q

A major goal in the treatment of asthma is to reduce the incidence of

A

Inflammation

30
Q

a non-pregnant female with uncomplicated cystitis, preferred length of antibiotic treatment

A

3 days

31
Q

Recurrent UTI is defined as how many episodes

A

at least 3 per year

32
Q

A 50 yr old overweight female has a blood pressure of 120/90 on routine screening. would you diagnose as HTN

A

To diagnose HTN she should have 2 BP checks on 2 separate occasions.

33
Q

52 y/o obese smoker with BP consistantly ranging from 150-160/90-96. What meds would you recommend

A

Thiazide diuretics

34
Q

Asthma symptoms that occur more than twice/week with exacerbations that may affect activity classified as

A

Mild persistant

35
Q

Headaches that present as severe unilateral, orbital, supraorbital, or temporal pain in nature

A

Cluster headaches

36
Q

HGBa1C >= to 6.5% is diagnostic for

A

Type II DM

37
Q

The single best test to evaluate for hypothyroidism proceeded by thyroid glad failure

A

TSH

38
Q

Fasting glucose of 100-125 or glucose levels of 140-199 at 2 hrs pp indicate what

A

pre diabetes

39
Q

RBCs that are hypochromic and microcytic show increased total iron binding capacity and decreased serum iron suggest what

A

Iron deficiency anemia

40
Q

LDL > 160 and an associated risk factor for CHD is counseled to begin an appropriate trial fo dietary therapy. When to reevaluate

A

3 months

41
Q

An active 25 y/o presents with an 8cm oval shaped area of erythema that blanches with pressure, does not deesdquamate, vesiculate, or have any scale at periphery. They appeared 2 weeks following a camping trip. You suspect

A

Lyme Disease

42
Q

Initial and most important step in the managment of GERD is

A

Lifestyle modification

43
Q

Form of hepatitis is the only acute from, never results in a chronic disease and lifelong immunity is expected from all patients who recover from it

A

Hep C

44
Q

Single most important action you can take with a patient you suspect is the victim of intimate partner violence is what

A

Help develop a safe exit plan

45
Q

When a pt presents with persistent diarrhea following 2 courses of abx you should suspect

A

C. Diff

Leslie CNM (7 decks)

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