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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
Q

Daily Calcium Requirement``

A

1200mg

26
Q

Daily Vitamin D Requirement

A

800-1000 IU

27
Q

DEXA re-assessment following treatment

A

1-2 years later

28
Q

Interval screening for osteoporosis

A

every 2 years

29
Q

Risk Factors for Osteoporosis

A

alcohol use, tobacco use

thin body habitus, Caucasian

30
Q

FRAX score for those on chronic steroids for treatment

A

10%

31
Q

denosumab

A

mab that targets osteoclast activator

32
Q

teriparatide

A

recombinant PTH

33
Q

Patellar Reflex

A

L3-L4

34
Q

Ankle Reflex

A

L5-S1

35
Q

Spondylosis

A

degenerative changes of the spine

36
Q

Spondylolisthesis

A

anterior displacement of vertebrae

37
Q

Spondylolysis

A

Non union or fracture or pars intermedia

38
Q

meds that delay progression of proteinuria

A

Lisinopril
losartan
non-dihydropyridine CCB (verapamil, dilt)

39
Q

resistant HTN diagnosis

A

uncontrolled BP on three medications (one being a diuretic)

40
Q

SPRINT trial

A

reduction in major adverse CV events if SBP less than 120
but… more hypotension, AKI, electrolyetes, etc
did not include DM

41
Q

MMR- who not to vaccinate

A

adults before 1957
pregnant women
cancer pts
high doses of steroids (20mg+ prednisone)

42
Q

When to treat subclinical hyperthyroidism

A

over 65

under 65 w heart disease, osteoporosis, symptoms

43
Q

Risk of subclinical hyperthyroidism

A

A fib

bone loss

44
Q

When to treat subclinical hypothyroidism

A

TSH 10+
positive TPO
symptoms, HF, risk factors for CVD (chol 240+)

45
Q

Hep B exposure - how it is spread

A

serum
semen
saliva

46
Q

Quick Start of birth control- how long to use backup method

A

for at least 7 days

47
Q

Example of DPP4 Inhibitors (names of medications)

A

oral medications!

  • gliptins
    ex: sitagliptin, saxagliptin, etc
48
Q

Januvia

A

sitagliptin

49
Q

DPP-4 Inhibitors MOA

A

enzymes produces incretin which will increase insulin secretion

50
Q

DPP-4 Inhibitors AE

A

can potentially cause pancreatitis

adjust dosage for CKD

51
Q

LMWH After Orthopedic Surgery

A

Total of 35 days preferred

52
Q

Triptan MOA

A

inhibit vasoactive peptides

–> vasoconstriction

53
Q

Triptan Contraindications

A

Avoid in hemiplegic or basilar migraine
Avoid in ischemic heart disease, stroke, uncontrolled HTN
Avoid in pregnancy

54
Q

Dose of levothyroxine

A

1.6mcg/kg

decrease in elderly, cardiac disease

55
Q

TSH/T4 Recheck

A

4-6 weeks

PGY-3 and 4 (13 decks)

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