Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Family Medicine COMAT > U world Missed #2 > Flashcards

U world Missed #2 Flashcards

1
Q

MRI for back pain is only recommended when

A

there is severe neurologic deficits or high risk features that suggest a potentially serious cause (malignancy or infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

recommended first like treatment for noncomplicated lumbosacral radiculopathy

A

NSAIds and acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

clinical signs and symptoms of lumbosacral radiculopathy (nerve root compression)

A

pain in the low back radiating down to the posterior leg or foot

positive straight leg raise or crossed straight leg raise test

dermatomal sensory loss or myotomal weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

evaluation of lumbosacral radiculopathy

A

usually diagnosed clinically
MRI recommended if there is bladder/bladder dysfunction. saddle anesthesia, epidural access etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

treatment go lumbosacral radiculopathy

A

activity modification (NOT bedrest)
NSAIDS first 2 weeks
PT or glucocorticoids after 2 weeks
MRI or surgery after 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is irritant contact diaper dermatitis ?

A

the most common dermatitis in infants that results from a breakdown in the skin due to moisture and friction in the diaper

classically it looks red in the genital area region that is only in the diaper region

painless papule or confluent erythema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment of irritant contact diaper dermatitis

A

frequent diaper changes, diaper free periods, gentle cleansing soap and application of an ointment like petroleum.

refractory cases can use low potency topical corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is candida dermatitis

A

dermatitis that is a yeast superinfection on top of irritant contact dermatitis (skin fold involvement)

there are beefy red confluent plaques that involve the skin folds and satellite lesions

treat with anti fungal therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what its the colon cancer screening recommendations for patients with average risk?

A

start at age 45

colonoscopy every 10 years
gFOBT or FIT every year
FIT-DNA every 1-3 years
CT colonogrpahy every 5 years

Flexible sigmoidoscopy every 5 years or every 10 years with annual fit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the colon cancer screening recommendations for patients with a first degree relative with colorectal cancer history or a high risk adenomatous polyp?

A

colonoscopy at age 40 or 10 years prior to age of diagnosis in FDR which ever comes first

repeat every 5 years (every 10 if the FDR diagnosed after age 60)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the colon cancer recommendation screening for a patient with an adenomatous polyp

A

start screening 8-10 years after diagnosis

colonoscopy every 1-3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is considered an advanced adenomatous polyp?

A

greater than 10mm, high grade dysplasia, villous elements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

buckle fracture

A

a fracture common in young children that have porous bone. This results in a stable incomplete radial or ulnar fracture.

presents as pain and tenderness over the fracture , ROM can be limited and there is no swelling

need an x-ray to diagnose: a cortical bulge is visualized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

treatment of a buckle fracture

A

pain control and prevention of reinjury (heal within a few weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

avascular bone necrosis in children presents with?

A

chronic joint pain and decreased Rom typically in the hip

X-ray shows bony fragmentation and sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

volume and duration of menses is dependent upon?

A

surface area of the endometrial cavity, platelet aggregation and thrombi formation, uterine spiral arteriole constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is tranexamic acid used in the treatment of uterine fibroids

A

it stops heavy menstrual cladding and reduces blood loss by stabalizing the cloths and preventing plasmin formation

it is safe in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

uterine fibroids cause heavy menstrual bleeding by?

A

enlarging the uterus and decreasing the response to vasoactive factors that limit spinal artery vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

contraindication to OCP

A

migraine with aura (increased risk for stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

developmental milestones at age 2 months

gross:
fine:
language:
social and cognitive:

A

gross: lifts head with lying on tummy
fine: opens hands briefly

language: reacts to loud noises, makes noises

social and cognitive: social smile, clams when spoken to, tracks past midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

developmental milestones for a 4 months old

gross:
fine:
language:
social and cognitive:

A

gross: holds head steady and pushes up on forearms
fine: brings hands to midline/mouth and holds toy if put in hand
language: coos and turns to voice
social and cognitive:seeks attention and enjoys looking at hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

developmental milestones of a 6 months old

gross:
fine:
language:
social and cognitive:

A

gross: rolls over and leans hands to support seated position
fine: reaches for toy and puts things in mouth
language:blows raspberries and squeals
social and cognitive: laughs and recognizes familiar faces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

developmental milestones in a 9 month year old

A

gross: gets to sitting unassisted and sits without support
fine: transfers objects between hands , raking grasp
language:babbles (mamma), turns to name
social and cognitive: stranger anxiety and separation anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

developmental milestones for a 12 month old

A

gross: pulls to stand, cruises
fine:pincer grasp
language: mama and dada, understands no
social and cognitive: plays pat-a-cake, looks for hidden object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

every well child examination should include

A

an assessment of developmental milestones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

when do primitive reflexes disappear

A

by 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the only primitive reflex that may persist up to 2 years old but can disappear by age 12 months

A

babinksi reflex

(stroking of the sole of the foot causes the big toe to up turn)

29
Q

the initial evaluation of hypertension focuses on?

A

identifying complications or comorbid conditions that might change management

screen for major atherosclerotic risk factors, lipid panels, and serum glucose or hemoglobin A1C

30
Q

what is adjustment disorder

A

distress or functional impairment within 3 months of an identifiable stressor

emotional or behavioral symptoms that are excessive for a normal stress response

31
Q

management of adjustment disorder

A

psychotherapy

short term pharmacotherapy with a anxiolytic or sleep aid

32
Q

autosomal polycystic kidney disease

A

most patient are asymptomatic until 30-40 years old they will have flank pain, hematuria, hypertension, a palpable abdominal mass and CKD

low gravity urine

33
Q

extra renal features of polycystic kidney disease

A

cerebral aneurysms
hepatic and pancreatic cysts
Mitral valve prolapse, and aortic regurigitation, colonic diverticulosis, ventral and inguinal hernias

34
Q

imaging for autosomal dominant polycystic kidney disease

A

US showing multiple renal cysts

35
Q

treatment of autosomal dominant polycystic kidney disease

A

control CKD, ACE inhibitors, hemodialysis and renal transplant if in end stage renal disease

vasopressin-2 receptor antagonists (stop the growth of the cysts)

36
Q

what is secondary spontaneous pneumothorax?

A

acute onset of SOB with hypoxia and unilaterally decreased breath sounds in a patient with a preexisting lung disease like cystic fibrosis of COPD.

chest pain and hyper resonance on percussion are also possible

37
Q

_ markedly increases the risk of a pneumothorax

A

smoking

38
Q

chronic destruction of alveolar sacs can lead to?

A

alveolar blebs (air pockets) which can rupture and leak air into the pleural space

39
Q

diagnosis of a pneumothorax is made by?

A

chest X-Ray which will demonstrate a visceral pleural line with no pulmonary markings

tracheal deviation

40
Q

bullous impetigo

A

bull with yellow fluid and crusting overlying sites of ruptured bullae

a superficial bacterial infection of the epidermis caused by bacterial invasion through a break in the skin barrier

caused by staph aureus

leaves a collarete scale with overlying crusting, yellow fluid within bullae

41
Q

treatment of bullous impetigo

A

oral antibiotics

42
Q

what is nonbullous impetigo?

A

papules and pustules with a honey crusted lesion caused by staph aureus OR group A streptococcus

it is treated with topical antibiotics first then oral antibiotics

43
Q

what is erythema nodosum

A

2-3 cm tender erythematous or violaceous nodules that usually occurs on the shins but can develop anywhere.

It is a hypersensitivity reaction to various antigens.

44
Q

what are common triggers for erythema nodosum

A

infections like strep

inflammatory bowel disease

sarcoidosis

and malignancy

medications (sulfonamides, penicillins)

45
Q

biopsy of erythema nodosum shows

A

septal panniculitis without vasculitis

46
Q

what is a testicular varicocele

A

a tortuous dilation of the pampinoform plexus that surrounds the testis

it is a soft irregular mass that increases with valsalva and does NOT transilluminate

more common on the left side

bag of worms texture

can present with sub fertility or testicular atrophy

47
Q
A
48
Q

treatment of a varicocele

A

gonadal vein ligation

scroptal support and NSAIDS

49
Q

ultrasound findings of a

  1. varicocele
  2. spermatocele
  3. hydrocele
A
  1. varicocele - retrograde venous flow, tortuous tubules, dilation of pampiniform plexus
  2. Hydrocele- translumination
  3. spermatocele- on the head of the epididymis, fluid filled cyst that transilluminates with a painless pass at the superior pole of the testis (does not change in size)
50
Q

post partum thyroiditis

A

occurs within the first 6 months, with a brief hyperthyroid phase that quickly changes to a hypothyroid phase with fatigue, weight gain, constipation. There will be a nontender goiter , bradycardia, diastolic hypertension, and edema. TSH will be elevated and free T3 will be low

*hypercholesterolemia and hyponatremia can also be a side effect

has elevated titers of anti-thyroid peroxidase autoantibodies

return to euthyroid state in a few months

51
Q

post partum thyroiditis is similar to

A

painless (silent) thyroiditis

52
Q

routine health maintenance in diabetes mellitus included monitoring for?

A

microvascular complications

-annual urine albumin/creatinine ration, annual dilated eye exam, periodic foot examination to test sensation and vibration

53
Q

the earliest sign of diabetic neprhopathy is ?

A

albuminuria

54
Q

in diabetes when should an ACE or ARB be added?

A

if there is hypertension or microalbuminemia

55
Q

the most common cause of travelers diarrhea is?

A

enterotoxigenic EColi

enterotoxin causes diarrhea 1-3 days after ingestion and abdominal pain

usually self resolves, can cause dehydration which can predispose people to decreased urinary output and hypernatremia

56
Q

symptoms of a zenker diverticulum

A

pharyngoesophageal

dysphagia, halitosis, history of regurgitating food-undigested, progressive dysphagia

abnormal spasm or diminished relaxation cricopharyngeal muscles during swallowing with increased pressure and herniation of the mucosa resulting in pushing and a psuedofiverticulum

57
Q

aspiration of regurgitated food may lead to ?

A

recurrent aspiration pneumonia

58
Q

Zenker diverticulum occurs where

A

a zone of weakness between the inferior pharyngeal constrictor

59
Q

chlamydia and gonorrhea in women risk factors

manifestations

A

age less than 25
high risk sexual behaviors

asymptomatic, cervitis, urethritis, perihepatitis

60
Q

test for chlamydia and gonorrhea

A

annual NAAT in patients we have high and low sexual behaviors

61
Q

the measles mumps rubella vaccination is recommended at what ages

A

age 1 and again at age 4

62
Q

what is vaccine strain

A

a fever and maculopapular rash that can present 1-3 weeks after an MMR vaccine that is self limited

people with this rash should avoid immunocompromised individuals until the rash resolves

treat with reassurance

63
Q

the onset of backpain upon walking is known as

A

neurogenic claudication

relieved by leaning forward

lumbar stenosis- MRI of the spine

64
Q

lumbar stenosis better with-

lumbar herniation better with

A

flexion

extension

65
Q

what are the main causes of vitamin D deficiency ?

A

inadequate intake (vegan diet)
malabsorption (chrons, celiac)
inadequate sunlight exposure
metabolic disorders (CKD and chronic liver disease)
increased catabolism (anticonvulsants like carbamazepine)

66
Q

Subgaleal hemorrhage

A

a potentially fatal neonatal injury that is caused by scalp traction during delivery, the veins will shear and there will be an accumulation of blood between the periosteum and the galea aponeurotica , soft swelling

common in vacuum assisted deliveries , presents as scalp swelling across the suture lines that moves with movement.

diagnosis is critical because it can lead to hypovolemic shock, DIC or death

67
Q

cephalohematoma

A

bleeding between the skill and periosteum due to subperiosteal vessel rupture

firm non fluctuant swelling that does not cross the suture lines

68
Q
A

Family Medicine COMAT (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions