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Family Med EOR > Rosh Review/Week 1 > Flashcards

Rosh Review/Week 1 Flashcards

1
Q

When should adults get pneumococcal vaccine and how should it be administered?

A

age 65 if no risk factors
any age with these risk factors: smoking, immunocompromised, cochlear implant, alcohol use disorder

PSV13 then wait a year then PPSV 23

pneumococcal is inactivated vaccine

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2
Q

when do you do US for AAA

A

65-75 male smoker

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3
Q

don’t use metformin when

A

renal insufficiency - creatinine over 1.4 (F) and 1.5 (M)

also CHF, certain radiographic contrast studies, acidosis, and seriously ill people

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4
Q

alternative recommendation to metformin if contraindications present

A

short acting sulfonurea glipizide

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5
Q

“Cross eyed”

A

stabismus

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6
Q

exotropia

A

one eye looks ahead and the other looks laterally

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7
Q

esotropia

A

one eye looks ahead and the other looks medially

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8
Q

aniscoria

A

different sized pupils

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9
Q

what can stabismus lead to

A

exotropia, esotropia, aniscoria

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10
Q

ectropion

A

outward turning of lower eyelid

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11
Q

what tests for stabismus

A

cover-uncover

light reflex test

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12
Q

someone gets in a motorcycle accident with gravel stuck in cut - what kind of tetanus booster do they get

A

tdap - if no tetanus shot in past 5 years

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13
Q

tx for ITP

A

Glucocorticoids, IVIG and immunosuppressive therapy is used to help patients achieve and maintain safe platelet counts.

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14
Q

new onset thrombocytopenia with no preceding illnesses or med changes is usually

A

ITP - idiopathic thrombocytopenic purpura *can have purpura but don’t have to and low platelets will be only blood finding

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15
Q

tx of cataracts

A

phacoemulsification of the opacified lens followed by implantation of an artificial lens.

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16
Q

tx of severe frostbite

A

place hand in circulating warm water - 90-102 degrees

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17
Q

typical symptoms of sarcoidosis - what will this person look like

A 
black female (40s)
dyspnea, dry cough, painless lymphadenopathy, maculopapular lesions on face, bilateral hilar lymphadenopathy
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18
Q

tx for sarcoidosis

A

oral steroids

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19
Q

Immediate treatment for severe symptomatic hypercalcemia is

A

volume repletion with normal saline. Long-term therapy of hypercalcemia of malignancy involves treatment with bisphosphonates, which may cause osteonecrosis of the jaw. Hypercalcemia of malignancy (driven by PTH related peptide) is most commonly seen as a consequence of squamous cell, renal, breast, or bladder cancer. Hypercalcemia may also be caused by hematologic malignancies via the upregulation of cytokines and vitamin D, as well as via local osteolysis, which is seen in breast cancer and multiple myeloma. In hypercalcemia of malignancy, bisphosphonates are the cornerstone of long-term therapy. Bisphosphonates inhibit osteoclastic activity, reducing both the formation and the resorption of hydroxyapatite. They are used in malignancy-associated hypercalcemia as well as Paget’s disease of the bone and postmenopausal osteoporosis. Important toxicities to remember are corrosive esophagitis nausea, diarrhea, and osteonecrosis of the jaw.

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20
Q

bulging tympanic membrane

A

acute otitis media

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21
Q

first line for acute otitis media

A

HIGH dose amoxicillin

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22
Q

most common cause of viral stomach bug

A

salmonella

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23
Q

retrocele location of appendix - what sign

A

psoas sign

24
Q

tx for patent ductus arteriosis

A

ligation

25
Q

machinery like murmur

A

PDA

26
Q

most common head sign of child abuse

A

retinal hemorrhages

27
Q

what do you do when a healthy 15 month old child is exposed to a contact who has been diagnosed with the flu in the last 24 hours?

A

give tamiflu (osletamivir)

28
Q

4Hs: hemorrhages (petechiae, bleeding gums), hyperkeratosis (rough skin, loose teeth), Hypochondriasis (irritability, emotional changes), hematologic abnormalities (easy bruising) = what type of vitamin def

A

C

results from “tea and toast” diet of elderly

29
Q

A: Night vision loss, dry skin, growth retardation, Bitot spots on the conjunctiva
B1 (Thiamine): Alcoholism, malnutrition, Wernicke-Korsakoff syndrome
B2 (Riboflavin): Cheilosis, corneal vascularization (the 2 Cs of B2)
B3 (Niacin): Dermatitis, dementia, diarrhea, corn-based diet (Pellagra)
B6 (Pyridoxine): Sideroblastic anemia, convulsions, peripheral neuropathy, INH use
B12 (Cobalamin): Megaloblastic anemia + neurological symptoms, hypersegmented neutrophils
C (Ascorbic acid): Scurvy (↑ bleeding, anemia, loose teeth)
D: Rickets (children), osteomalacia, tetany
E: Anemia, peripheral neuropathy, ataxia
K: ↑ bleeding, ↑ PTT, ↑ PT

A

just for reference

30
Q

tricuspid valve stenosis most likely caused by

A

rheumatic fever

31
Q

epiglottitis tx

A

iv antibx and admission

32
Q

apple core sign on x ray =

A

colorectal cancer

33
Q

necrotizing fasciitis tx

A

vanco and clinda

34
Q

4 things you will see on xray with osteoarthritis

A

narrowed joint space
osteophytes
sclerosis
subchondral cysts

35
Q

difference between rickets and osteomalacia

A

rickets - kids

osteomalacia - epiphysis have closed

36
Q

tx of hemodynamically stable a fib and wolff-parkinson-white syndrome

A

ibutilide

37
Q

widened mediastinum on chest xray =

A

aortic dissection

38
Q

avascular necrosis of femoral head

intermittent limp

worse after activity

A

leg calves perthes disease

39
Q

dry cough, bilateral hilar adenopathy, subcutaneous nodules

A

sarcoidosis

40
Q

tetany - hypercalcemia or hypocalcemia

A

hypocalcemia

41
Q

what bacteria is responsible for traveler’s diarrhea and how do you treat it?

A

entertoxigenic e coli

supportive care + 3 days of cipro and maybe antimotility agents

42
Q

how does traveler’s diarrhea present

A

watery diarrhea with abdominal cramping

43
Q

overuse of albuterol inhaler results in what electrolyte abnormality

A

hypokalemia

44
Q

if a child drinks more than 16 oz of milk a day, what are they at an increased risk for

A

iron deficiency anemia

45
Q

compartment syndrome is most commonly assoc with what

A

long bone fractures

46
Q

what is a kerion?

A

delayed hypersensitivity reaction to tinea capitis; can lead to scarring alopecia

47
Q

how do ischemic colitis patients present?

A

mild to severe cramping with acute onset on left side of abdomen, older, rectal bleeding or bloody diarrhea in the first 24 hours, thickening of bowel wall on CT with free peritoneal fluid

48
Q

if pt presents with hair loss consistent with telogen effluvium, which blood test should you run

A

serum ferritin - may be iron deficient

49
Q

rubeola symptoms

A

rash that moves from face to trunk, fever. cough, coryza, conjunctivitis, Koplik spots *pinpoint greyish spots with surrounding red inflammation in lateral buccal mucosa” - pathognomonic

50
Q

hypocortisolism (addison’s disease) = what other two electrolyte abnormalities

A

hyponatremia and hyperkalemia due to aldosterone levels being affected (Na+ not be absorbed correctly and potassium not be excreted properly)

51
Q

which type of medication is used to prevent variceal hemorrhage?

A

non selective beta blockers

52
Q

symptoms of ectopic pregnancy

A

bleeding in first trimester, abdominal pain, amenorrhea

53
Q

what enzyme is elevated in compartment syndrome

A

creatine kinase

54
Q

what should be avoided when children present with bloody diarrhea and no stool culture confirmation

A

DO NOT GIVE ANTIBIOTICS DUE TO INCREASED RISK FOR HUS

55
Q

contraindication to tetanus shot

A

encephalopathy after previous tetanus shot

Family Med EOR (2 decks)

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