Theory Flashcards
What are the main characteristics of family practice?
1) Definitive care
2) One-person responsibility
3) Problem oriented
4) Continuous
5) Lasts of a lifetime
6) Independent from age, gender, social status
7) Complex, somatic, psychic, social
8) Integrative
9) Situative office home
10) Preventive approach
What is the core competencies of family practice?
1) Primary care management
2) Person-centered care
3) Specific problem solving skills 4) Comprehensive approach
5) Community orientation
6) Holistic modeling
What are the components of the primary care team?
1) GPs and specialists working in primary care
2) Nurses – practice, district, psychiatric
3) Midwifes
4) Social workers
5) Health visitor
6) Practice managers
7) Receptionists
What is the European definition of family practice?
1) First medical contact
2) Coordination with other professions
3) Person-centered approach
4) Relationship over time
5) Longitudinal continuity of care
6) Community-based decision making
7) Management of acute and chronic problems
8) Management of undifferentiated illnesses at an early stage 9) Preventive therapy and promotion of health
What is the definition of BMI?
weight (kg) / height (m)2
What are the categories for BMI?
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Cost of overweight on the health system
2-8% or 5-10% of all health expanses
Stepped care approach to obesity
1) Lifestyle intervention
2) Hypocaloric diets
3) Pharmacotherapy
4) Intragastric devices
5) Gastric pacemakers
6) Adustable gastric banding
7) Roux-N-Y Gastric bypass
8) Biliopancreatic diversion
True for waist circumference and risk of heart disease
The higher the waist circumference the highter the risk for CV disease. Men > 102
Women >88
True for primary hypertension and therapy
Idiopathic. Risk factors: smoking, obesity, family history.
Treatment: α2 receptor agonists (clonidine), β-blockers, diuretics (hydrochlorothiazide), ACE-I, renin inhibitors, angiotensin blockers, Ca2+- blockers, direct vasodilators.
Hypertensive patient with increased creatinine, what do we expect?
Renal arterial stenosis
What is correct for Diabetes Mellitus and family practice
1) Screening
2) Diagnosis
3) Treatment
4) Control
5) Teaching, education
How do you diagnose DM?
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Which is true for OGTT?
1.75 g/Kg = 75 gr glucose
Check before exam, 30’ min, 1 hour, 90’ min, 2 hours. Simple, cheep, useful
What are the Signs of DM?
1) Polydipsia
2) Polyuria
3) Exhustion
4) Rapid weight loss
5) Increasing short-sightedness 6) Ketosis
7) Nausea, vomiting 8) Abdominal pain 9) Glucosuria
Primary treatment objectives for DM:
1) Relief symptoms
2) Improve quality of life
3) Prevent acute and chronic complications 4) Reduce mortality
5) Treat accompanying disorders
Therapy of Diabetes Mellitus?
Oral antidiabetics or insulin
Emergencies in family medicine
1) Cardiac
2) Asthma exacerbation
3) Psychiatric
4) Impaired consciousness
5) Hypoglycemia
6) Anaphylaxis
7) Seizure
8) Shocks
9) Poisoning/OD
Basic life support, the protocol
Shake and ask are you ok? Call for help Free airways and check breathing call ambulance start CPR 30x2.
True for ECG of a person with ACS
1) Transient ST elevation
2) Dynamic T wave changes
3) ST depression
4) Normal or unchanged ECG doesn’t exclude ACS
Treatment of unstable angina
Aspirin – 500 mg PO Clopidogrel – 300 mg PO Metoprolol – 25 mg PO
What are the first line drugs used for acute heart failure
10) Nitroglycerin spay – 1 spray every 5-10 minutes. Max 3 times 11) Furosamide IV – 40-80 mg
12) Morphine – 5-10 mg
13) Nitroglycerine – 5 mg into 500 ml infusion
14) Dopamine – 50 mg into infusion
Hypovolemic shock
Mechanism: fluid loss hypoperfusion MOF
Signs: tachycardia, delay capillary refill, tachypnea, low pulse pressure, cold skin, anxiety, low systolic BP, oliguria, mental status changes.
Treatment: ABCD, OMV
Which is true for the life expectancy of smokers?
Reduce survival in average of 10 years
What is the correct for the causative relationship between death and
smoking?
Death from lung cancer, ischemic heart disease and COPD. Reduces survival in average of 10 years.
Quitting at any age will increase life expectancy.
True for second-hand smoking and health risk
20-30% increase for lung cancer.
25-30% increase risk for heart disease. Cause and worsen asthma, COPD, emphysema. Increase risk for nonfatal acute MI.
Higher risk for children hospitalization.
What is true for pregnancy and smoking.
Increased risk for miscarriage, stillbirth, SIDS.
4 fold risk for low birth weight.
Impaired infant lung function.
Association with cognitive and developmental syndromes.
True for smoking withdrawal and side effects
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Criteria for insomnia
At least 6 months. All must have day time consequences
1) Difficulty initiating sleep
2) Difficulty maintaining sleep
3) Early morning awakening
4) Non restorative sleep
DSM-IV definition of parasomnias
1) Nightmares 2) Night terrors 3) Sleepwalking
OSAS
> 15 apnea / hour OR 5 apnea/hour + symptoms Complications: HT, DM, MI, CVA, depression
OSAS therapy
1) Weight control
2) Avoidance of alcohol
3) Smoking secession
4) CPAP
5) Oral appliances
6) Surgery
Which is true for major depression?
At least 2 weeks with 5 symptoms: At least one main feature: 1) Persistent sad mood 2) Loss of interest or pleasure Rest from minor features: 1) Change in appetite or weight 2) Change in sleep 3) Psychomotor agitation or retardation 4) Fatigue 5) Worthlessness or guilty feelings 6) Concentration difficulties or indecisiveness 7) Recurrent thought of death or suicide
Life time prevalence of major depression
4.6-15.7%
Risk factors for suicide
1) Elderly
2) Male
3) Caucasian
4) Living alone
5) Prior suicide attempt
6) Family history
7) Medically ill
8) Psychosis
9) Alcohol or other substance abuse
Lower back pain from musculoskeletal origin
1) Felt from erector spinea or gluteal muscles
2) Will affect the ability to sit stand and walk
3) Agonizing pain, worse in certain movements
4) Tenderness over the back
5) Muscle spasms
Lower back pain and bed rest therapy
When painful – bed rest.
When pain gradually decrease – start physical activity.
Prevention of lower back pain
1) Screening and early recognition of static disorders and anatomic abnormalities
2) Encouragement of physical activity of the whole population – develop and strengthen trunk musculature, flexibility and body endurance
Therapy of chronic lower back pain
1) Medications – pills, injections, infusions
2) Physiotherapy
3) Massage
4) Balneotherapy
5) Supervised gymnastic
6) Psychological guides
