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Family Medicine COMAT > U world Missed #1 > Flashcards

U world Missed #1 Flashcards

1
Q

Ottawa Ankle Rules

A

X ray is required if there is pain at the malleolar zone and one of the following

  1. tenderness at the posterior margin of the medial malleolus
  2. tenderness at the posterior margin of the lateral malleolus
  3. inability to bear weight for 4 steps
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2
Q

Ottawa Foot Rule

A

X-ray is required if there is pain at the mid foot along with one of the following

  1. tenderness at the navicular
  2. tenderness at the base of the 5th metatarsal
  3. unable to bear weight 4 steps
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3
Q

What is a cluster headache

A

a headache that has a predilection for males that typically has an onset during sleep. The pain is localized behind one eye and it is sharp. It lasts about 15-90 minutes and can be associated with autonomic manifestations (sweating, flushing, nasal congestion, lacrimation, pupillary changes)

-100% oxygen can help in acute cases

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4
Q

What is a migraine

A

a headache that has a predilection for females and a family history can be present. Onset is variable and it is unilateral. It is a pulsating/throbbing pain that lasts for about 4-72 hours. It is associated with aura, photophobia, nausea, and phonophobia.

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5
Q

What is a tension headache

A

a headache that has a predilection for females that is common under stress it has a band like pattern of distribution and is dull, tight and persistent. It lasts for about 30 minutes to 7 days and can be associated with muscle tenderness in the shoulder, neck , and head.

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6
Q

Tinea Corporis

A

slowly expanding, pruritic rash that has a raised border and central clearing caused by trichophyton rubrum (a fungus)

transmitted from contact with skin, animal or fomites

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7
Q

How is Tinea Corporis Diagnosed?

A

typically general inspection but potassium hydroxide on a skin scraping can confirm the diagnosis

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8
Q

Tinea Corporis Treatment

A

With topical Antifungals (terbinafine or miconazole)

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9
Q

What are lifestyle risk factors for colon cancer

A

frequency consumption of red/processed meat

tobacco or alcohol use

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10
Q

what are medical risk factors that increase risk for colon cancer

A

family history of adenomatous polyps or colon cancer

inherited colon cancer syndromes

ulcerative colitis, diabetes, obesity, radiation

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11
Q

how are obesity and type 2 diabetes associated with an increased risk of colorectal cancer

A

hyperinsulnemia leads to increased levels of insulin like growth factor 1 which inhibits colorectal epithelial cell apoptosis and promotes neoplastic progression

obesityL increased inflammatory cytokines

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12
Q

protective factors against colorectal cancer

A

high fiber diet, aspirin/NSAID use, high coffee and tea intake

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13
Q

what is gonococcal proctitis

A

Neisseria gonorrhoeae a gram negative diplococci bacterium is a STD that can have direct speed from the vagina or from anal intercourse.

Symptoms of tenesmus, mucopurulent discharge, rectal pain and itchiness, constipation

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14
Q

diagnosis of gonococcal proctitis

A

Nucleic Acid Amplification test of rectal swab

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15
Q

treatment of gonococcal proctitis

A

ceftriaxone + doxycycline

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16
Q

what is the difference between primary and secondary nocturnal enuresis

A

primary is when there is nighttime incontinence at the age of 5 or greater without a prolonged period of continence

secondary is when there is nighttime incontinence a the age of 5 or greater with prolonged period of continence before hand >6 months

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17
Q

what is the cause of primary nocturnal enuresis

A

brain maturation delay and or genetics

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18
Q

what is the cause of secondary nocturnal enuresis

A

an underlying medical condition like diabetes/UTI or psychological stressors

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19
Q

what is the initial evaluation of nocturnal enuresis ?

A

urinalysis

20
Q

what is the management of nocturnal enuresis primary vs. secondary

A

primary: reassurance, behavioral modifications, bed wetting alarm

secondary: treat the underlying condition, behavioral modification

*behavioral modifications can include: evening fluid restriction

21
Q

what medications can lower blood pressure and minimize left ventricular hypertrophy

A

Ace inhibitors, Angiotensins Receptor Blockers, Calcium Channel blockers and thiazide diureteics

22
Q

what medication that is used for hypertension can raise uric acid and precipitate gout?

A

thiazide diuretics

23
Q

what is the preferred medication for antihypertensive patients with gout

A

Angiotensin II receptor Blockers (ARBs)

24
Q

Enuresis medical causes

A

Constipation, UTI, bladder dysfunction, CKD, diabetes, OSA

25
Q

Chronic Kidney Disease in children are most commonly due to?

A

a posterior urethral valve which blocks the outflow or urine from the bladder

causes symptoms of urinanary incontience day and night ; damages the kidneys and causes recurrent UTIs and proteinuria

26
Q

Enuresis due to CKD should have what type of workup

A

evaluate the serum creatinine level

renal ultrsound, voiding cysteaurethrogram

27
Q

what type of vaccine is the diphtheria-tetanus-acellular pertussis vaccine?

A

combined vaccine containing acellular pertussis antigen with diphtheria and tetanus toxoids

safe and effective

28
Q

what is the DTaP immunization scheduling

A

5 does of inactivated DTap vaccine at 2 months, 4 months, 6 months, 15-18 months and 4-6 years

29
Q

adverse reaction to the DTap?

A

generally low minor symptoms like erythema at the injection site

seizures caused by the pertussis vaccine is RARE

30
Q

Is a family history of seizures or personal history of seizures a contraindication to the DTaP vaccine?

A

No

benefits outweigh the risks

31
Q

what is the DTap vaccine contraindicated in?

A

anaphylaxis, unstable neurological disorders like infantile spasms, and encephalopathy

32
Q

thin walled ovarian cyst with pelvic free fluid is?

A

a ruptured ovarian cyst

33
Q

a ruptured ovarian cyst that is hemodynamically stable is managed how?

A

observation and reassurance

if they are hemodynamically unstable then surgery is required

34
Q

what is mittelschmerz

A

recurrent unilateral mid cycle pain prior to ovulation that lasts hours

35
Q

Pelvic inflammatory disease symptoms and ultrasound findings

A

fever/chills, vaginal discharge, lower abdominal pain and cervical motion tenderness

imaging: tuboovarian access

36
Q

ovarian torsion symptoms and ultrasound findings

A

ovarian torsion: uniltateral sudden lower abdominal pain with N/C

unilateral tender adnexal mass on examination

enlarged ovary with decreased or absent blood flow

37
Q

Nonalcoholic fatty liver disease

A

liver steatosis on imaging that is common in people with metabolic syndrome, an AST/ALT less than 1 and hyper echoic texture on US

mostly asymptomatic until liver cirrhosis occurs

38
Q

management of nonalcoholic hepatic steatosis

A

weight management and control of metabolic risk factors

39
Q

what is the prognosis of nonalcoholic fatty liver disease

A

increased risk of hepatic fibrosis, cirrhosis and liver related death

40
Q

autoimmune hepatitis

A

marked elevation in AST and ALT and bilirubin with arthranglia, anorexia, and fatigue

41
Q

common causes of mechanical obstruction in patients with GERD

A

esophageal stricture

esophageal adenocarcinoma

42
Q

what is a esophageal stricture

A

reflux of gastric acid contents cause mucosal damage and collagen deposition in the esophagus

they are no malignant and imaging will show a symmetric concentric narrowing of the distal esophagus

43
Q

what is esophageal adenocarcinoma

A

barretts esophagus can scause this from intestinal metaplasia of the distal esophagus

imaging will show an asymmetrical and irregular narrowing of the distal esophagus

44
Q

treatment of an esophageal stricture

A

endoscopic dilation

45
Q

achalasia

A

a esophageal motility disorder with dysphagia to solids and liquids at onset

peristalsis and dilation of the esophagus proximal to the LES with a bird beak appearance

46
Q

vascular rings

A

uncommon congenital anomalies in which the aortic arch vessels compress the trachea or esophagus at the level of the aortic arch (by rib 2)

Family Medicine COMAT (3 decks)

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