Review Questions Flashcards
1
Q
S1 means closure of what valves? Where are those heard?
A
AV valves – tricuspid, mitral
Apex
2
Q
Where do you hear S4 heart sounds? What exact location?
A
- Apex
- 5th ICS, left midclavicular line
- *All s4 People (base) Take Money (apex)
3
Q
S2 means closure of what valves? Where are those heard?
A
- Semilunar valves – aortic, pulmonic
- Base
4
Q
When do you hear S4 sound? Is it always normal?
A
- LV hypertrophy and uncontrolled HTN
- May be normal in the elderly
5
Q
When do you hear S3?
A
- Pregnancy, HF
6
Q
Aortic Regurgitation – What kind of murmur? Characteristic? Location?
A
- Diastolic
- High pitch blowing, decrescendo
- 3-4 ICS, left sternal border
7
Q
Where does aortic stenosis murmur radiate? Mitral regurgitation?
A
- MR –> Left armpit
- AS –> Neck
8
Q
Cranial Nerves sensory/motor pneumonic
A
Some Say Money Matters But My Brother Says Big Brains Matter More
9
Q
What does Rinne Test look at? What is abnormal?
A
- Conductive hearing loss
- **Bone conduction vs. Air conduction
- Abnormal: BC > AC
10
Q
What does Weber test look at? Lateralization?
A
- Sound lateralization
- Conductive: Sound will lateralize to the affected ear
- Sensorineural: Sound will lateralize to the unaffected ear
- Normal: Sound will be heard equally in both ears (no lateralization)
11
Q
What kind of tremor is associated with Parkinson’s? What meds?
A
- Resting tremor
- Requip then Sinemet
12
Q
What medications are used with Essential Tremor? What makes them worse? What makes them better?
A
- Beta Blockers, Botox
- Worse with caffeine
- Better with regular physical activity and alcohol
13
Q
3 letters to remember Parkinson’s symptoms
A
- BTR
- Bradykinesia, Tremor (resting), Rigidity
14
Q
Metformin: Long term SE? When do we need to adjust dose? When to stop?
A
- B12 deficiency
- GFR < 46 Cut dose in half
- GFR <30 Discontinue
15
Q
Peak Flow is affected by what?
A
- HAG: Ht, age, gender
16
Q
Bacteria of Otitis Externa? Tx med?
A
- Pseudomonas
- Ofloxacin drops
17
Q
PNA Treatment – no comorbidities vs not
A
- MAD Lung: Macrolide, Amoxicillin, Doxycycline
- Chronic: Levaquin OR Augmentin PLUS a macrolide
18
Q
First line tx Pertussis
A
- Azithromycin
- Stops the spread, not the symptoms
19
Q
Obturator Sign – what does it look for? How to do it?
A
- Appendicitis
- Internal rotation of the RIGHT hip at 90 degrees causes RLQ pain
20
Q
Psoas Sign – what does it look for? How to do is?
A
- Appendicitis
- Patient raises leg up against resistance (put hand on their thigh)
21
Q
Rovsing’s Sign – what does it look for? How to do it?
A
- Appendicitis
- Palpate LLQ inflicts pain on RLQ (think rovsing/reverse/right pain)
22
Q
What FEV1/FVC ration indicated COPD?
A
- <0.7 or 70%
23
Q
What is tactile fremitus? When do you hear it?
A
- Palpated vibration
- Increased in PNA
24
Q
What virus causes fifth’s disease? Sixths disease?
A
- Fifth’s: Parvovirus (also called Erythema Infectiosum)
- Sixth: HSV
25
What labs to check with atypical antipsychotics?
What to check if the patient is >40? Contraindications?
High risk of what?
- Lipids, glucose
- EKG if >40
- Contraindication: metabolic syndrome
- High risk of OD
26
What findings indicate need for colposcopy?
- Positive LSIL, HSIL, HPV
27
What to do if positive ASCUS? Then what?
- HPV co testing
- Positive HPV: colposcopy
- Negative HPV: repeat HPV testing in 3 years
28
When to start Pap smears? When to repeat? When to absolutely start HPV testing?
- Age 25 regardless of sexual activity
- Every 3 years if no HPV testing
- Every 5 years if HPV was checked
- Age 30
29
Normal CD4 count? When to start anti-retroviral drugs?
- > 500
- < 350 start drugs
30
What SSRI is good for menopause?
- Paxil
31
Which herbal supplements are good for menopause?
- Black cohosh, gingko, soy isoflavones, evening primrose
32
What do you do if a patient has recurrent UTI symptoms after finishing abx?
- Prescribe same abx for longer
33
When is AFP testing for neural tube defects done? What do high or low levels mean?
- 15-20 weeks (think FETO=fifteen)
- High = neural tube defects (think hIgh = spIne) or multiple gestation
- Low = down syndrome
34
Long term PPI use risks
- OP, B12 deficiency, C diff
35
Meniscus Tests
- McMurray and Apley
36
First Line Treatment Croup
- Decadron
37
DPP4 meds
Contraindicated with what?
How do these work?
- History of pancreatitis
- Impacts postprandial levels
Gliptans
38
What patients can’t be on triptans?
Uncontrolled HTN/CAD or taking serotonin meds
39
What type of hearing loss is otosclerosis?
- Conductive
40
What meds can treat absence seizures?
- Zarotin, Depakote, Dilantin, Lamictal
41
Side Effects of Depakote?
Avoid in what organ problem?
Need to monitor what?
- Weight gain and hair loss
- Avoid in liver problem
- Monitor Depakote levels
- Toxicity >100mc
42
Side Effects of Dilantin? (2)
Something to consider?
Avoid in what organ problem?
- Gingival hyperplasia, hirsutism
- Can decrease levels of birth control
- Avoid in liver problems
43
Tegretol used to treat what?
Big side effect? (2)
Need to monitor what?
- Trigeminal Neuralgia
- Anti-cholinergic and Bone marrow suppression, monitor CBC every 3 months during first year
44
LT use of methotrexate can lead to what?
Folic acid deficiency
45
LT use of allopurinol can lead to what?
Bone marrow suppression
46
LT use of metformin can lead to what?
B12 deficiency
47
Alcoholics have LT effects of what?
B1 deficiency (thiamine)
48
Supplements good for immune support
Echinacea and Gingseng
49
Abx biggest risk for c.diff?
Clindamycin
50
Which patients should avoid Topamax?
Those with liver and kidney problems
51
Giant Cell Arteritis is closely related to what? treated how?
Polymyalgia Rheumatica (lots of muscle pain)
LT steroids
52
What are the 2 signs for meningitis?
Kernigs and Brudzinski
53
Common condition that occurs with MS? how to treat?
Optic Neuritis
- Steroids
MS- treat with DMARDs
54
Retinal arteries and veins - normal
Retinal veins larger and darker
55
Optic disc with blurred margins
Papilledema
56
Amblyopia - what is it? Also called?
Tx?
Decrease is visual acuity
Also called lazy eye
Wearing a patch over well functioning eye
57
Allergic conjunctivitis treatment
Antihistamine drops with mast cell effects
58
Never use what kind of drops without ophthalmologist?
Steroid drops
59
4 things to help with macular degeneration? Diet?
How to help with vision loss?
Mediterranean diet
Weight loss
BP control
Smoking cessation
Use large print
60
Iritis symptoms (4)
Commonly associated with what?
How to diagnose?
Acute vision changes
Photophobia
Eye pain
Hyphema (bloody parts)
Rheumatologic disorders
Slit lamp
61
Hpv vaccine
Age 15 and < Age 15
How many doses?
15 or >15: Need 3 doses within a 6mo period
9-14: 2 doses at least 6mo apart
62
LT use of Pepcid risk of what?
Thrombocytopenia
63
How do respiratory steroids work?
Involves chronic inflammatory suppression to prevent asthma exacerbations
64
How long to stop NSAIDs before surgery?
4 days
65
What med can increase kidney stones?
Acyclovir
66
Ginkgo caution
Bleeding
67
2 meds with bone marrow suppression as side effect
Tegretol and allopurinol
68
Amblyopia vs strabismus
Strabismus - muscle issue
Amblyopia - acuity issue
