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PGY-3 and 4 > Primary Care > Flashcards

Primary Care Flashcards

1
Q

Hemoglobin A

A

two alpha chains

two beta chains

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2
Q

Hemoglobin F

A

two alpha chains

two gamma chains

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3
Q

Corrected Reticulocyte Count

A

Reticulocyte count X pt hct/normal hct

should be more than 2%

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4
Q

Target Cells

A

thalassemia or liver disease

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5
Q

Teardrop Cells

A

myelodysplastic cause

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6
Q

Howell-Jolly Bodies

A

asplenia

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7
Q

Bite Cells

A

G6PD deficiency

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8
Q

DDx Hypoproliferative Microcytic Anemia

A 
Fe Deciency
Lead Toxicity
Anemia of Chronic Disease
Thalessemia
Sideroblastic Anemia
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9
Q

Transferrin

A

glycoprotein that delivers iron to tissue

INCREASED in IDA

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10
Q

TIBC

A

Available binding sites for Fe on transferrin

INCREASED in IDA

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11
Q

Transferrin Saturation

A

Serum Fe/ TIBC

DECREASED in IDA

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12
Q

Ferritin

A

storage protein for iron, but also AFR
<100 consistent with IDA
>100 rules out IDA

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13
Q

Soluble transferrin receptor

A

increased in IDA, normal in ACD

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14
Q

Time phase for correction of anemia in IDA on oral iron

A

6 weeks

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15
Q

Sideroblastic anemia causes

A

zinc, lead, alcohol
copper or pyroxidine deficiency
MDS

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16
Q

Differential for normocytic anemia

A

H A R M

  • ACD
  • RF
  • Hypothyroidism
  • MM, myeloplastic, aplastic anemia, etc
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17
Q

Aplastic Anemia =

A 
pancytopenia w/ hypoproliferative normocytic anemia
congenital cause (Fanconi) versus acquired
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18
Q

Pernicious anemia

A

antibody to parietal cells > ab to intrinsic factor

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19
Q

Homocysteine and MMA

A

both elevated in B12 def
only homocysteine = folate def
but MMA unreliable in CKD

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20
Q

Extravascular Hemolysis

A

RBCs removed prematurely by liver and spleen

spherocytes on smear, negative hemoglobin and hemosiderin in urine

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21
Q

Intravascular Hemolysis

A

RBCs lysed within circualation

positive hemologbin and hemosiderin in urine

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22
Q

Tests for hemolysis

A
  • reticulocyte count >2%
  • LDH, haptoglobin
  • Direct bili
  • urine hemoglobin, hemosiderin
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23
Q

Spherocytes on smear

A

either hereditary spherocytosis of AIHA

DAT+ means AIHA

24
Q

Treatment of Osteopenia

A

hip fracture risk of 3%

any fracture risk of 20%

25
Daily Calcium Requirement``
1200mg
26
Daily Vitamin D Requirement
800-1000 IU
27
DEXA re-assessment following treatment
1-2 years later
28
Interval screening for osteoporosis
every 2 years
29
Risk Factors for Osteoporosis
alcohol use, tobacco use | thin body habitus, Caucasian
30
FRAX score for those on chronic steroids for treatment
10%
31
denosumab
mab that targets osteoclast activator
32
teriparatide
recombinant PTH
33
Patellar Reflex
L3-L4
34
Ankle Reflex
L5-S1
35
Spondylosis
degenerative changes of the spine
36
Spondylolisthesis
anterior displacement of vertebrae
37
Spondylolysis
Non union or fracture or pars intermedia
38
meds that delay progression of proteinuria
Lisinopril losartan non-dihydropyridine CCB (verapamil, dilt)
39
resistant HTN diagnosis
uncontrolled BP on three medications (one being a diuretic)
40
SPRINT trial
reduction in major adverse CV events if SBP less than 120 but... more hypotension, AKI, electrolyetes, etc did not include DM
41
MMR- who not to vaccinate
adults before 1957 pregnant women cancer pts high doses of steroids (20mg+ prednisone)
42
When to treat subclinical hyperthyroidism
over 65 | under 65 w heart disease, osteoporosis, symptoms
43
Risk of subclinical hyperthyroidism
A fib | bone loss
44
When to treat subclinical hypothyroidism
TSH 10+ positive TPO symptoms, HF, risk factors for CVD (chol 240+)
45
Hep B exposure - how it is spread
serum semen saliva
46
Quick Start of birth control- how long to use backup method
for at least 7 days
47
Example of DPP4 Inhibitors (names of medications)
oral medications! - gliptins ex: sitagliptin, saxagliptin, etc
48
Januvia
sitagliptin
49
DPP-4 Inhibitors MOA
enzymes produces incretin which will increase insulin secretion
50
DPP-4 Inhibitors AE
can potentially cause pancreatitis | adjust dosage for CKD
51
LMWH After Orthopedic Surgery
Total of 35 days preferred
52
Triptan MOA
inhibit vasoactive peptides | --> vasoconstriction
53
Triptan Contraindications
Avoid in hemiplegic or basilar migraine Avoid in ischemic heart disease, stroke, uncontrolled HTN Avoid in pregnancy
54
Dose of levothyroxine
1.6mcg/kg | decrease in elderly, cardiac disease
55
TSH/T4 Recheck
4-6 weeks

PGY-3 and 4 (13 decks)

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