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Family Medicine > Textbook charts > Flashcards

Textbook charts Flashcards

1
Q

Stage 0 COPD

A

Patient has cough and sputum production but normal spirometry results

Tx: Vaccines and risk factor assessment

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2
Q

Stage 1 COPD

A

Pt. has a FEW1/FVC <0.7

FEV1 = > 80% of predicted

Can be with or without symptoms

Tx: SABAs

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3
Q

Stage 2 COPD

A

FEV1/FVC < 0.7

FEV1 = 50-80% predicted

Can be with or without symptoms

Tx: LABAs

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4
Q

Stage 3 COPD (severe)

A

FEV1/FVC < 0.7

FEV1= 30-50% predicted

With or without symptoms

Tx: Inhaled steroids

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5
Q

Stage 4 COPD

A

FEV/FVC < 0.7

FEV 1 <30% of predicted OR FEV1 < 50% predicted with chronic hypoxemia

Tx: Long term O2 therapy and surgical intervention

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6
Q

First time lipid screening recommendations in children and adolescents

A

FH of dyslipidemia

FH of premature CVD or dyslipidemia (<55 years or <65 years in woman)

Unknown FH

Other CV risk factors

BMI >85th percentile

HTN (>95th percentile)

Cigarette smoking

Diabetes mellitus

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7
Q

Empty can test

A

Pt has arm abducted and elbow extended while elevating their arm against resistance

Tests supraspinatus for a rotator cuff injury

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8
Q

External rotation test

A

Tests infraspinatus and teres minor for injury

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9
Q

LIFT OFF TEST

A

Pt places hand on lumbar back and attempts to lift hand off back

Tests subscapularis for injury (also could just do internal rotation)

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10
Q

Hawkins impingement

A

Pain with internal rotation when the arm is flexed to 90 degrees with the elbow bent to 90 degrees

Tests for subacromial impingement of the supraspinatus tendon

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11
Q

Drop arm test

A

Patient cannot lower arm slowly from raised position

Test for large and extensive rotator cuff tears

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12
Q

Anterior drawer test at ANKLE

A

Tests fnxn of the anterior talofibular ligament

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13
Q

Inversion stress test of ankle

A

Tests calcaneofibular ligament, positive test is a “clunk”

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14
Q

Squeeze test of ankle

A

Examiner compresses tibia and fibula at midcalf

+= Pain at the anterior ankle joint below where the examiner is squeezing

-Indicates syndesmosis (high ankle injury)

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15
Q

Introduction of solid food for infants

A

4-6 months

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16
Q

Plantar fasciitis tx

A

Shoe inserts, NSAIDs, icing, rest

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17
Q

Polymyalgia rheumatica

A

Inflammatory disorder that presents as pain and stiffness in the shoulder and pelvic girdle

Typically has an elevated ESR

*Tx: Corticosteroids

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18
Q

Refeeding Syndrome

A

Fatal shifts in electrolytes that occur in patients who were previously malnourished

***Patients will have hypophosphatemia

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19
Q

Initial tx of hypercalcemia of malignancy

A

IV fluids; will enhance excretion

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20
Q

Brown to black leopard spotting of the colonic mucosa

A

Melanosis coli

Benign condition resulting from abuse of laxatives; resolves after discontinued use

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21
Q

Colonoscopy in a person who has a first degree member with colon cancer

A

Screen at 40 and repeat every 5 years

Also do if they have 2 second degree members with colonocarcinoma

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22
Q

Drugs that can cause lupus pleuritis or drug induced pleuritis

A

Hydralazine

Procainamide

Quinidine

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23
Q

DOC in WPW

A

Procainamide; other drugs slow AV conduction and can paradoxically in WPW cause tachycardia

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24
Q

Metformin has to be stopped prior to what imaging study

A

CT angiography (or anything w/ contrast) due to increased stress on the kidneys

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25
Q

Pt w/ nursing home pneumonia tx

A

Ceftazidime + Levofloxacin + Vancomycin

First two covered gram pos, gram neg, BOTH cover pseud, and last for MRSA

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26
Q

SSRI you cant use in pregnancy

A

Paroxetine; assoc. w/ cardiac defects

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27
Q

Treatment resistant osteoporosis can be treated with…

A

Teriparatide; its intermittent use activates osteoblasts more than osteoclasts

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28
Q

When to treat for the flu

A

As soon as it is suspected; many rapid tests can be negative so look at community trends to test for

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29
Q

Aspirin age recommendations

A

In Men 45-79 and women 55-79

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30
Q

Mitral valve prolapse tx

A

BBs

Severe? =» Surgery

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31
Q

Pt w/ sulfa allergy who wants to climb a mountain

A

Dexamethasone

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32
Q

Natural remedy for varicose veins

A

Horse chestnut seed

-Contains some escin, which reduces edema and lowers fluid exudation by decreasing vascular permeability

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33
Q

Most common cause of erythema multiforme

A

HSV

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34
Q

Pyogenic tenosynovitis

A

Typically presents in a trigger finger like presentation

Treat w/ antibiotics and splinting or potentially surgical drainage w/ antibiotics

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35
Q

Postural orthostatic tachycardia syndrome

A

Rise in hr by >30/min when standing up

Sx: Position dependent headaches, abdominal pain, lightheadedness, palpitations, sweating, and nausea

-Most patients will not pass out; usually a female

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36
Q

CAGE screening

A

Cut down
Angry
Guilty
Eye opener

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37
Q

PCP tx.

A

Haldol

Acidify urine to excrete

***These pts. have vertical AND horizontal nystagmus as well as their aggressive psychosis

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38
Q

Trazadones use in practice today

A

Actually used to help people go to sleep

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39
Q

Mirtazapine

A

SNRI assoc. w/ weight gain

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40
Q

TCA side effects

A

Convulsions, Cardiac probs (QT prolongation), and coma

-Also have anticholinergic ADRs

Amitryptyline, nortriptyline, imipramine, desipramine

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41
Q

Pt. on an MAOI and suddenly has severe HTN

A

HTN crisis probably precipitated by eating wine or cheese (Hypertensive crisis)

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42
Q

Lithium ADRs

A

Teratogen

Nephrotoxic

Nephrogenic DI

Narrow TI

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43
Q

Ativan

A

Lorazepam (short acting)

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44
Q

Valium

A

Diazepam (medium acting)

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45
Q

Clonidine

A

Clonazepam (long acting)

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46
Q

Pt on fluphenazine w/ fever, rigidity, and AMS

A

NMS
=»Treat w/ dantrolene

Other ADRs of typical antipsychotics include gynecomastia, galactorrhea, amenorrhea (anti-dopaminergic), and extrapyramidal symptoms

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47
Q

Last antipsychotic to try if all else has failed

A

Clozapine

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48
Q

Extrapyramidal sx

A

Akasthesia (restlessness)

Acute dystonia (involuntary spastic contractions, torticollis, hammering)
   -treat w/ anticholinergics

Dyskinesia

Tardive dyskinesia (irreversible sensitization leading to facial tics)

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49
Q

Atypical antipsychotics

A

Olanzapine, quetiapine, risperidone, ariprazole

Treats both positive and negative psychotic sx

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50
Q

Indications for thyroid nodule biopsy

A

Greater than 1cm

Symptomatic

History or thyroid cancer

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51
Q

Acute cervical Radiculopathy Tx

A

Conservative (NSAIDS, ice)

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52
Q

Treatment for an acute hemorrhoid presenting at <24 hours

A

Hemorrhoidectomy in office

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53
Q

Patellofemoral pain

A

Usually in females and presents with pain moving on hilly terrain as well as with hip abduction

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54
Q

Pioglitazone

A

Thiazolodine drug that increases the sensitivity of the peripheral tissues to insulin via PPAR activation

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55
Q

Repaglinide

A

Nonsulfonylurea drug that also stimulates insulin secretion

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56
Q

Acarbose

A

A-glucosidase inhibitor that ️Decreases the absorption of carbs

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57
Q

Labs to monitor on E. coli O 157 patients

A

Renal labs, be on the lookout for HUS

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58
Q

Anterior talofibular ligament

A

Most common sprained ligament on the lateral malleolus; could also be the calcaneofibular ligament or the posterior talofibular ligament

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59
Q

Pt has a positive stick of 3-5 RBCs…what do you do next?

A

Repeat UA in 6 weeks

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60
Q

Risk factors for bladder cancer

A

Smoking

Benzene dyes

Aromatic amines

History of urologic disease

Analgesic abuse

Pelvic irradiation

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61
Q

Doc for hyperthyroidism

A

Radioactive iodine

⭐️Can’t use in pregnant ladies though

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62
Q

Tx of thyroid storm

A

PTU/methimazole + BBs

May also give hydrocortisone to prevent an adrenal crisis

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63
Q

Child with asthma exacerbation and already received Albuterol and steroids

A

Can try magnesium sulfate before Iv steroids

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64
Q

Ethylene glycol toxicity

A

Patient presents with a metabolic acidosis with an increased anion gap and subsequent renal failure

Urine will have calcium oxalate crystals, patient will appear acutely intoxicated and have Hypocalcemia

Tx: Fomepizole

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65
Q

Baby born to hep b mom

A

Give hep B and Hep B IG

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66
Q

Rotavirus contraindication

A

Kid with history of intusussusception

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67
Q

Young toilet trained female who develops a beefy red rash on her perineum

A

Strep pyogenes infection; usually from improper hygiene

Will be from the perineum and down to the anus

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68
Q

Latex allergies can cross react with what foods?

A

Avocados, bananas, chestnuts

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69
Q

Anticoagulation for A-fib

A

Low risk (no other comorbidities) = Aspirin

Anything else= Warfarin

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70
Q

DOC for pneumocystis pneumonia

A

Bactrim

Could also add corticosteroids

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71
Q

Patient who presents with urethral discharge but has not improved with azithromycin and ceftriaxone

A

Prescribe metronidazole; could be trichonomas vaginalis

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72
Q

Treatment for otitis media

A

Amoxicillin; 10 days

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73
Q

Breastfeeding with bilateral nipple pain, erythema, and swelling

A

Probably a candida infxn

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74
Q

what drug can ppt Angioedema

A

ACEIs

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75
Q

Cat scratch disease treatment

A

Azithromycin

76
Q

Drugs that can induce ovulation in PCOS patients

A

Clomiphene

Metformin

Rosiglitazone

77
Q

Treatment for HIT

A

Discontinue heparin and start a different anticoagulant

78
Q

What must be monitored while on Vancomycin?

A

Trough serum levels; too low and resistance will develop

79
Q

SSRIs and cough syrup

A

Possible cause of serotonin syndrome

80
Q

Test to rule out adrenalcortical insufficiency

A

Morning cortisol

81
Q

Patient with frequent PVCs but is otherwise healthy

A

Needs evaluation and possible treatment for CAD

82
Q

Tx for sudden sensorineural hearing loss in an elderly patient

A

Corticosteroids

Possibly O2

83
Q

Subacute thyroiditis

A

Painful gland, hyperthyroidism, elevated ESR

Tx: Corticosteroid

84
Q

Perinephric abscess

A

Collection of the puss in the tissue surrounded by the kidney; diagnosis made when patient with pyelonephritis has a persistent fever and flank pain that is unresponsive to IV antibiotics

RFs: Urinary tract abnormalities, DM,

Tests: CT

85
Q

Imaging for septic arthritis in a child

A

US

86
Q

Female athlete triad

A

Amenorrhea

Osteoporosis

Disordered eating

87
Q

Treatment of hyponatremia w/ <125meq/Na

A

Use 3% saline

88
Q

EKG findings w/ hypokalemia

A

ST segment depression

Flattened T waves

Prominent U waves

89
Q

EKG findings w/ hyperkalemia

A

Peaked T waves

Flattend P waves

Widened QRS

90
Q

Tx of hyperkalemia

A
  1. IV calcium (stabilizes the myocardium)
  2. Glucose and insulin (shifts K+ into cells)
  3. Kayexalate (do this last)
91
Q

Centor Criteria

A

Absence of cough

Enlarged/tender anterior cervical adenopathy

Fever of 100.4 or higher

Tonsillar swelling/exudates

Age 3-14

Score 2-3 =» Rapid strep test

Score 4 =» Empiric treatment

92
Q

Features of malignant pulmonary nodules

A

Size >10mm

Irregular shape

“Ground-glass” appearance

No calcification/eccentric calcifications

Double the size of a previous image

93
Q

Pt with well controlled hypothyroidism and is pregnant

A

Still need to increase their thyroid medication as thyroid dysfunction is assoc. w/ pregnancy

94
Q

Complete rotator cuff tear in a young patient management

A

Surgery

95
Q

Best imaging study for osteomyelitis

A

MRI

96
Q

Treatments for coronary artery stenosis

A

Aspirin

BBs (after MI)

ACEIs (at high risk after MI)

ARBs (CAD)

Amiodarone (coexisting arrhythmias)

97
Q

Painkiller prescribed for ESRD pts

A

Fentanyl; because it is metabolized in the liver

98
Q

Drugs to give patient with a confirmed MI

A

Aspirin and Heparin

Clopidogrel if there is an aspirin allergy

99
Q

Drugs that are CI’d in new onset chest pain

A

CCBs

100
Q

Gottron’s papules

A

Sign of dermatomyositis; appears a purple-wart like features on the hands but usually appear quickly

101
Q

Prophylactic for traveler’s diarrhea

A

Rifaximin

102
Q

Gestational diabetes glucose goal

A

<100

103
Q

Dupuytren’s contracture

A

Progressive thickening and nodule formation on the palmar fascia leading to a contracture of the associated finger

Commonly seeing pitting of the skin right before the contracture

104
Q

Tx for status epliepticus

A

Lorazepam

Follow w/ phenytoin

105
Q

Tx for acute dystonia

A

Diphenyhydramine

Benztropine

Typically occurs after taking a medication

106
Q

Tx for ingrown nails

A

Nail avulsion followed by phenolization or direct surgical excision of the nail matrix

107
Q

B-quant eval for ectopic pregnancy

A

<1500 =» Get a repeat in 48 hrs =» Still hasn’t risen =» Probably an ectopic

108
Q

Epididymitis tx

A

Ceftriaxone and doxycycline

MCC are Neisseria and Chlamydia

109
Q

Fibroid surgery

A

Wants kids? =» Myomectomy

Doesnt? =» TAH

Wants kids but it’s too big to cut out? =» Leuprolide to shrink it

110
Q

Telogen effuvium

A

Shredding hair loss that occurs after a stressful event (illness, surgery, pregnancy) and occurs about 3 months after the event

Will go away 6 months after the event

111
Q

Screening of asymptomatic patients for COPD pts

A

Not recommended

112
Q

Erythema infectiosum

A

“Fifth disease”

Caused by parvovirus B19; presents with a slapped cheek appearance and an exanthem that spreads to the trunk and the extremities as a diffuse macular rash; will eventually become lacy and reticulated

113
Q

Fracture that occurs with hyperextension of the wrist

A

Triquetral fracture; tenderness will be noted on the dorsal wrist of the ulnar side

Radiograph will show a bony avulsion

114
Q

DOC for supraventricular arrhythmia

A

Adenosine

115
Q

Post thrombotic syndrome

A

Chronic pain, swelling, and skin changes in the affected limb of a DVT

-Compression stockings help to prevent

116
Q

Albumin as an acute phase reactant

A

Decreases

117
Q

Treatment of PMS

A

Luteal-phase spironolactone

118
Q

Contrast media to use in patients with kidney disease

A

Iso-osmolar or hyposomolar

Rather than the normal, high osmolar

119
Q

Urge incontinence

A

Patients who suddenly realize they reallllyyy have to go to the bathroom and are usually unable to reach it in time

120
Q

Atypical antipsychotic NOT ASSOCIATED with weight gain

A

Aripiprazole

121
Q

Augmentin plus side

A

Covers anaerobes

122
Q

SCFE s/s

A

Pain with physical activity, usually in the upper thigh

*****Limited internal rotation of the hip

123
Q

Preop eval in RA patient

A

Cervical spine imaging to detect atlantoaxial subluxation

-Would make intubation difficult

124
Q

Blood pressure in stroke patients

A

Do not treat HTN unless it is <220/<120

-HTN is thought to be a protective mechanism to preserve cerebral blood flow

125
Q

Behcet’s syndrome

A

Recurring genital and oral ulcerations alongside relapsing uveitis

More common in Asian peopl

Can lead to arthritis, vasculitis, intestinal manifestations, or neurologic probs

Usually have the development of sterile pustules that are slightly painful

126
Q

Stress incontinence

A

Stretching of the cardinal ligament after multiple births =» cystocele formation

Dx: (+) Q-tip test (>30 degrees rotation)

Tx: Kegel exercises, pessaries, surgery

127
Q

Overactive/hypertonic bladder

A

Random spasms or detrusor instability

Dx: Patients have increased urge and leak, usually need to run to the bathroom

Tx: Antispasmodics (oxybutinin) `

128
Q

Overflow incontinence

A

Absent detrusor detractions

Often assoc. w/ MS, trauma, or antispasmodic meds

Incontinence occurs once pressure in the bladder exceeds that of the sphincter

Dx: Distended bladder, focal neurologic deficits

129
Q

Anticoagulant monitoring methods

A

Anti-factor Xa levels =» LMWH

aPTT =» Unfractionated heparin

INR =» Warfarin

130
Q

Follow up on a positive PPD

A

CXR

131
Q

First work up in a patient with possible septic arthritis

A

CBC and ESR, then do an aspiration

132
Q

Alopecia areata

A

Localized AI reaction to hair follicles; can spread to cover the entire scalp or body

Tx: Intralesional corticosteroid injections, usually will recover in 6 months

133
Q

Test to perform before removing an adrenal mass

A

Renal vein sampling

Turns out, the abnormal values are found opposite the mass sometimes

134
Q

Using other drugs in addition to Chantix

A

Is not beneficial and can in fact increase incidence of nausea and headache

135
Q

Tx for Raynaud’s

A

CCBs

136
Q

First study in a patient with a syncopal episode

A

EKG

137
Q

High risk angina associations

A

ST segment changes

Hypotension

Mitral regurgitation murmur that has worsened

New S3

Prolonged pain at rest

Pulmonary edema

138
Q

Contrast media to use in patients with kidney disease

A

Iso-osmolar or hyposomolar

Rather than the normal, high osmolar

139
Q

Urge incontinence

A

Patients who suddenly realize they reallllyyy have to go to the bathroom and are usually unable to reach it in time

140
Q

Atypical antipsychotic NOT ASSOCIATED with weight gain

A

Aripiprazole

141
Q

Augmentin plus side

A

Covers anaerobes

142
Q

SCFE s/s

A

Pain with physical activity, usually in the upper thigh

*****Limited internal rotation of the hip

143
Q

Preop eval in RA patient

A

Cervical spine imaging to detect atlantoaxial subluxation

-Would make intubation difficult

144
Q

Blood pressure in stroke patients

A

Do not treat HTN unless it is <220/<120

-HTN is thought to be a protective mechanism to preserve cerebral blood flow

145
Q

Behcet’s syndrome

A

Recurring genital and oral ulcerations alongside relapsing uveitis

More common in Asian peopl

Can lead to arthritis, vasculitis, intestinal manifestations, or neurologic probs

Usually have the development of sterile pustules that are slightly painful

146
Q

Stress incontinence

A

Stretching of the cardinal ligament after multiple births =» cystocele formation

Dx: (+) Q-tip test (>30 degrees rotation)

Tx: Kegel exercises, pessaries, surgery

147
Q

Overactive/hypertonic bladder

A

Random spasms or detrusor instability

Dx: Patients have increased urge and leak, usually need to run to the bathroom

Tx: Antispasmodics (oxybutinin) `

148
Q

Overflow incontinence

A

Absent detrusor detractions

Often assoc. w/ MS, trauma, or antispasmodic meds

Incontinence occurs once pressure in the bladder exceeds that of the sphincter

Dx: Distended bladder, focal neurologic deficits

149
Q

Anticoagulant monitoring methods

A

Anti-factor Xa levels =» LMWH

aPTT =» Unfractionated heparin

INR =» Warfarin

150
Q

Follow up on a positive PPD

A

CXR

151
Q

First work up in a patient with possible septic arthritis

A

CBC and ESR, then do an aspiration

152
Q

Alopecia areata

A

Localized AI reaction to hair follicles; can spread to cover the entire scalp or body

Tx: Intralesional corticosteroid injections, usually will recover in 6 months

153
Q

Test to perform before removing an adrenal mass

A

Renal vein sampling

Turns out, the abnormal values are found opposite the mass sometimes

154
Q

Using other drugs in addition to Chantix

A

Is not beneficial and can in fact increase incidence of nausea and headache

155
Q

Tx for Raynaud’s

A

CCBs

156
Q

First study in a patient with a syncopal episode

A

EKG

157
Q

High risk angina associations

A

ST segment changes

Hypotension

Mitral regurgitation murmur that has worsened

New S3

Prolonged pain at rest

Pulmonary edema

158
Q

Back up to use if you cannot use Vancomycin for MRSA

A

Linezolid

159
Q

CAP tx

A

Ceftriaxone, Azithromycin (combo in hospital)

Azithromycin (outpatient)

Possibly Moxifloxacin if needed (PROBS WRONG ON TEST)

160
Q

HCAP

A

Vancomycin and Piperacillin/Tazobactam

Cover MRSA and Pseudomonas

161
Q

Meningitis tx

A

Ceftriaxone, Vancomycin, Steroids

162
Q

UTI tx

A

Amoxicillin (pregnant ladies)

Nitrofurantoin

Bactrim (can’t use if in renal failure)

Cerftiaxone (IV, for pyelonephritis)

Ciprofloxacin (outpatient pyelonephritis)

163
Q

NSAID you can use with a history of MI

A

Naproxen

164
Q

Acute paronyhcia

A

Local trauma to the nail fold or cuticle followed by an infxn

Tx: Topical antibiotics

165
Q

Bacterial vaginosis diagnostic criteria

A
  1. Thin, homogenous vaginal discharge
  2. Vaginal pH >4.5
  3. Positive KOH test
  4. Presence of clue cells on a wet mount
166
Q

Acute diverticulitis tx

A

Bowel rest, quinolone, and metronidazole

-If diverticulitis is asymptomatic, just treat with a high-fiber diet

167
Q

Tympanoplasty indication

A

> 3 ear infxns in 6 months or >4 in one year

168
Q

Baby who turns blue with feeds and snores

A

Choanal atresia

Dx: Try to pass a catheter thru the nose

Tx: Surgery

169
Q

Pregnant woman with a HepB exposure and who is unvaccinated

A

Give HBIG and vaccine right away; there are no contraindications

170
Q

Other findings in Legionella pneumonia

A

Hyponatremia

Diarrhea

Elevated liver enzymes

171
Q

Pneumonia tx in patients with chronic disease

A

Levofloxain, moxifloxacin

172
Q

Organism assoc. w/ COPD assoc. pneuonia

A

H. influenza

173
Q

Tx of normal pneumonia

A

3rd generation cephalosporin (Ceftriaxone) + Macrolide (Azithromycin)

or

Moxifloxacin

174
Q

CURB 65

A

Confusion of new onset
Urea > 19mg/dL (BUN)
RR >30
Bp <90/<60

65 or older

-Any one of these positive =» Admit

175
Q

Organism assoc. w/ COPD assoc. pneuonia

A

H. influenza

176
Q

Tx of normal pneumonia

A

3rd generation cephalosporin (Ceftriaxone) + Macrolide (Azithromycin)

or

Moxifloxacin

177
Q

CURB 65

A

Confusion of new onset
Urea > 19mg/dL (BUN)
RR >30
Bp <90/<60

65 or older

-Any one of these positive =» Admit

178
Q

Noncontraceptive benefits of OCPs

A

️Decreased incidence of benign Breast disease

Relief from menstrual disorders

Reduced risk of uterine leiomyomata

Protection from ovarian cysts

Reduction of acne

Improvement of BMD

️Decreased risk of colorectal cancer

Protection against ovarian cancer, endometrial cancer, iron deficiency anemia, PID, and Fibrocystic Breast diseAse

179
Q

Concerning murmurs during pre athletic screens

A

Diastolic murmurs

Grade 3/6 or louder

HCM or MARFAN possibility

180
Q

Secondary action of Lasix

A

Bronchodilator

181
Q

MCC of CHF

A

Cad

182
Q

Cardio thoracic ratio greater than 50%

A

Systolic dysfunction likely due to CHF

183
Q

PSVT Tx

A

Adenosine

184
Q

Tarsal tunnel syndrome

A

Entrapment of the posterior tibial nerve as it courses behind the medial malleous

Pain with probation of the foot and parasthesia in the medial ankle and heel and sometimes the plantar surface

185
Q

What would the parathyroid hormone look like with Hypercalcemia in Hyperparathyroidism?

A

Normal

It should be suppressed

186
Q

Workup of Horner’s

A

Need a CXR to rule out a Pancoast tumor

Family Medicine (6 decks)

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