Wrong AAFP Questions Flashcards

1
Q

Absolute contraindications to ECT

A

None

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2
Q

Treatment of pneumonia in children

A
  • Outpatient abx appropriate if child does not have toxic appearance, hypoxemia, signs of respiratory distress, or dehydration
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3
Q

Management of midshaft posteromedial stress fractures

A
  • Relative rest from running and avoiding other activities that cause pain
  • Pneumatic stirrup leg brace during treatment
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4
Q

Most appropriate screening test for late-onset male hypogonadism

A

Serum total testosterone

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5
Q

Management of low TSH in patient being treated for hypothyroidism

A

Decrease levothyroxine dosage

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6
Q

Management of plantar fasciitis

A

First-line: NSAIDs and ice, over-the-counter heel inserts

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7
Q

Most accurate test for detecting ACL tear

A

Lachman test

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8
Q

Colon cancer screening for patients with one first-degree relative diagnosed with colorectal cancer or adenomatous polyps before age 60, or at least 2 second-degree relatives with colorectal cancer

A
  • Begin at age 40 or 10 years before the earliest age at which an affected relative was diagnosed
  • Rescreen every 5 years
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9
Q

Medications associated with drug-induced pleuritis

A
Amiodarone
Bleomycin
Bromocriptine
Cyclophosphamide
Methotrexate
Minoxidil
Mitomycin
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10
Q

Treatment of wide-complex tachycardia in patients with WPW syndrome

A

Procainamide

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11
Q

Treatment of nursing home-acquired pneumonia

A

Antipseudomonal cephalosporin, extended-spectrum beta lactam, or antipseudomonal carbapenem
+
Antipsuedomonal fluoroquinolone or aminoglycoside
+
Anti-MRSA agent (linezolid, vancomycin)

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12
Q

Treatment of depression in pregnancy

A

SSRIs (except paroxetine)

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13
Q

Dysuria, frequency, and pyuria with no bacterial growth on culture

A

STI such as Chlamydia

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14
Q

Cautious gait with abducted arms and legs, careful “walking on ice” movements, wide-based stance, and “en-bloc” turns

A

Visual impairment

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15
Q

Intervention for anorexia nervosa

A

Family-based treatment

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16
Q

Aspirin use for reduction of ischemic strokes

A

Recommend in women ages 55-79 when potential benefit outweighs potential harm

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17
Q

Aspirin use for reduction of MIs

A

Recommend in men ages 45-79 when potential benefit outweighs potential harm

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18
Q

Asthma medication that should not be used as monotherapy

A

Long acting beta2-agonists

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19
Q

Primary treatment for symptomatic mitral valve prolapse

A

Beta blockers

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20
Q

Prophylaxis for acute mountain sickness in patients with sulfa allergy

A

Dexamethasone

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21
Q

Most commonly implicated drug in interstitial nephritis

A

Antibiotics (penicillins, cephalosporins, and sulfonamides)

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22
Q

Supplement useful in treating varicose veins

A

Horse chestnut seed extract

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23
Q

Contraindications to breast feeding

A
  • Active HSV lesions on the breast
  • Active maternal TB
  • Administration or use of radioactive isotopes, chemotherapeutic agents, “recreational” drugs, or certain prescription drugs
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24
Q

Most common cause of erythema multiforme

A

Herpes simplex virus

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25
Q

Treatment of pyogenic tenosynovitis

A

Splinting and oral antibiotics

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26
Q

Greatest risk factor for AAA

A

Cigarette smoking

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27
Q

Which tinea infection in children requires systemic antifungals?

A

Tinea capitis

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28
Q

Adverse effects of PPIs

A
  • Increased risk of CAP and C. diff
  • Decreased absorption of vitamin B12
  • Decreased calcium absorption
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29
Q

Most effective treatment of chronic plaque psoriasis

A

High-potency corticosteroids

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30
Q

Most effective adjunctive therapy for patients with unipolar depression who fail to respond with single antidepressant

A

Lithium bicarbonate

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31
Q

Presentation of malaria

A
  • Recent travel history, prodrome of delirium or erratic behavior, unarousable coma following a generalized convulsion, fever, and lack of focal neurological signs in presence of diffuse, symmetric encephalopathy
  • Peripheral blood smear: normochromic, normocytic anemia with P. falciparum trophozoites and schizonts involving erythrocytes
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32
Q

Recommendations for induction of labor based on fetal size

A
  • 4500 g in women without diabetes

- 5000 g in women with diabetes

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33
Q

Treatment of cutaneous erythasma

A

Topical or oral erythromycin

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34
Q

Treatment of chronic paronychia

A
  • Topical corticosteroids
  • Avoiding immersion of hands in water
  • Emollients
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35
Q

management of thrombosed external hemorrhoid

A

Thrombectomy under local anesthesia

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36
Q

Hemoglobin goal in patients with CKD and anemia

A

10-12 g/dL

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37
Q

Symptoms of asthma with normal pulmonary function tests except for flattening of inspiratory loop

A

Vocal cord dysfunction

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38
Q

Empiric antibiotic regimen for Neontal sepsis

A

Ampicillin + cefotaxime

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39
Q

Next step in asthmatic child receiving albuterol and corticosteroids with no improvement

A

IV magnesium sulfate

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40
Q

Safe medication to treat patient with diabetes who also has renal impairment

A

Glipizide (Glucotrol)

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41
Q

Treatment of essential tremor in patients intolerant to beta blockers

A

Primidone (Mysoline)

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42
Q

First-line treatment for urge incontinence

A
  • Pelvic muscle exercises

- Anticholinergic therapy

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43
Q

What symptom is consistent with spinal stenosis but not herniated vertebral disc?

A

Pain relieved by sitting and worsened with standing (opposite for disc herniation)

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44
Q

Vitamin D recommendation in infants, children, and adolescents

A

400 IU/day starting within first 2 months of birth in infants

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45
Q

Effect of weight reduction on cardiovascular mortality

A

None

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46
Q

Effective strategy shown to increase success of voiding trial in hospitalized patients with urinary retention

A

Initiation of alpha blocker at time of urethral catheter insertion

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47
Q

Most common infectious agent in cat bites

A

Pasteurella multocida

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48
Q

Management of pneumothorax <20%

A

If patient has few symptoms, followup should include CXR at 24-48 hours

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49
Q

Other allergies associated with latex allergy

A

Avocados, bananas, chestnuts, and kiwi

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50
Q

Which cardiac arrhythmia ha s been associated with high-dose methadone use?

A

Torsades de pointes

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51
Q

Treatment of a-fib

A

Low risk: aspirin

Moderate-high risk: warfarin

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52
Q

Treatment of persistent urethritis in males

A

Azithromycin or doxycycline
+
Metronidazole

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53
Q

Bilateral nipple pain with and between feedings after initial soreness has resolved

A

Candida infection

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54
Q

Treatment of Bartonella henselae infection

A

Azithromycin, rifampin, ciprofloxacin, TMP-SMX, or gentamicin

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55
Q

Causes of macroglossia

A
  • Developmental conditions (Down syndrome)
  • Tumor (hemangioma or lymphangioma)
  • Metabolic diseases (amyloidosis)
  • Endocrine disturbances (acromegaly or cretinism)
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56
Q

Treatment of mild-moderate allergic rhiniits

A

Intranasal corticosteroids

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57
Q

Treatment of bronchiolitis

A

Supportive care

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58
Q

Management of prostate cancer in men >65 wth small-volume, low-grade disease and 10-15 year life expectancy

A

Watchful waiting

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59
Q

Threshold for prophylactic platelet transfusion

A

10,000

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60
Q

Which medications have the best evidence for preventing hip fracture?

A
  • Zoledronic acid
  • Risdronate
  • Alendronate
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61
Q

Which medications have been shown to be an effective adjunctive therapy for venous ulcers?

A
  • Pentoxifylline (Trental)

- Aspirin

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62
Q

Initial treatment of acute low back pain without sciatic features

A

Return to normal activities

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63
Q

Initial study for patient of any age with chronic neck pain and no history of trauma, malignancy, or surgery

A

Complete cervical spine series

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64
Q

Which NSAID should be avoided in older patients according to the Beers Criteria?

A

Indomethacin

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65
Q

Preferred initial test for renovascular hypertension in patients with impaired renal function

A

Duplex Doppler ultrasonography

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66
Q

Initial dose of warfarin in elderly or patients who have conditions such as heart failure, liver disease, or history of recent surgery

A

Max dose = 5 mg

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67
Q

Treatment of medial third clavicular fractures in pediatric patients

A

Sling and swathe (figure-of-8 apparatus)

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68
Q

Treatment of boxer’s fracture

A

Ulnar gutter splint

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69
Q

Target glucose level in critically ill diabetic patient

A

140-180 mg/dL

70
Q

Treatment of cholestasis of pregnancy

A

Ursodiol

71
Q

Management of rosacea

A
  • Avoidance of precipitating factors
  • Use of sunscreen
  • Oral metronidazole, doxycycline, or tetracycline
72
Q

Prognostic factor for neurologic recovery in comatose patient

A

Myoclonic status epilepticus at 24 hours

73
Q

First-line treatment for osteoarthritis in patient with renal impairment

A

Acetaminophen

74
Q

Initial treatment of tendinopathy of the posterior tibial tendon

A

Immobilization in cast boot or short leg cast

75
Q

Infant 1-3 months old with tachypnea, staccato cough, and no fever + eosinophilia

A

Chlamydial pneumonia

76
Q

Management of heparin-induced thrombocytopenia

A

Discontinuation of heparin and treatment with non-heparin anticoagulation

77
Q

Reliable test to rule out adrenal insufficiency

A

Morning serum cortisol

78
Q

Presentation of polymyalgia rhuematica

A

Bilateral shoulder or hip stiffness and aching for at least one month

79
Q

Topical postprocedure care for surgical wounds

A

Petrolatum ointment

80
Q

Treatment of chronic back pain

A

Analgesics, multidisciplinary rehab, acupuncture

81
Q

Treatment of idiopathic sudden sensorineural hearing loss

A

Oral corticosteroids; hyperbaric oxygen therapy within 3 months of diagnosis

82
Q

Preoperative tests for low-risk surgeries

A

None

83
Q

Criteria for mild persistent asthama

A
  • Symptoms more than 2 days per week but not daily

- Use of inhaler more than 2 days per week but not daily

84
Q

Diagnosis criteria for diabetes mellitus

A
  • Hemoglobin A1c 6.5% or higher
  • Fasting plasma glucose level of 126 mg/dL or higher
  • 2 hour plasma glucose level 200 mg/dl or higher
  • Random blood glucose 200 mg/dl PLUS symptoms of diabetes
85
Q

Dizziness exacerbated by scuba diving, sneezing, coughing, heavy weight bearing, or straining

A

Perilymphatic fistula

86
Q

Recommended imaging study for possible septic arthritis

A

Ultrasonography

87
Q

Definition of female athlete triad

A
  • Energy deficiency with or without disordered eating
  • Amenorrhea/menstrual disturbances
  • Bone loss/osteoporosis
88
Q

Diagnostic test for renal colic

A

CT

89
Q

Management of asymptomatic aortic stenosis

A

Watchful waiting

90
Q

Treatment of lichen sclerosus

A

High-potency topical corticosteroids

91
Q

Most accurate imaging study for assessing early osteomyelitis

A

MRI

92
Q

Preferred treatment for venous thrombosis during pregnancy

A

LMWH

93
Q

Effective medications for secondary prevention of cardiac events

A
  • Aspirin
  • Beta blockers (after MI)
  • ACE inhibitors in patients at high risk after MI
  • ARBs in those with CAD
  • Amiodarone in those who have had an MI and have high risk of death from arrhythmias
94
Q

Exposure of hantavirus comes from excretion of what animal?

A

Mice

95
Q

Recommended age limit for over-the-counter cough and cold products

A

2 years and older

96
Q

Diagnosis of whooping cough

A

Nasopharyngeal culture + PCR testing

97
Q

Preferred opioids for use in patients with ESRD

A

Fentanyl & methadone

98
Q

Centor Criteria

A

1) absence of cough
2) swollen, tender, anterior cervical lymph nodes
3) Temperature >38.0
4) tonsillar exudate and swelling
+ 1 point for patients ages 3-14
-1 point for patients over age 45

99
Q

How do you estimate glucose level from hemoglobin A1c?

A

Hgb A1c of 6.0% = 120, then add 30 mg/dl for each % point increase

100
Q

Treatment of stable person with supraventricular tachycardia

A

Adenosine 6 mg by rapid IV push

101
Q

Treatment of unstable person with supraventricular tachycardia

A

Synchronized cardioversion

102
Q

Lab for diagnosing vitamin D deficiency

A

25-hydroxyvitamin D

103
Q

Ottawa Ankle Rules

A

X-rays required if:

1) pain in malleolar zone and bone tenderness of either distal 6 cm of the posterior edge or the tip of either the lateral or medial malleolus
2) Inability to bear weight for 4 steps immediately and in the ER

104
Q

Prophylaxis for traveler’s diarrhea

A

Rifaximin

105
Q

Next step following identification of adrenal mass

A

Adrenal function assessment with overnight dexamethasone suppression test; 24-hour fractionated metanephrines and catecholamines

106
Q

Decontamination treatment of choice for most medication ingestions

A

Single dose of activated charcoal within 1 hour of ingestion

107
Q

Indications for gastric lavage, cathartics, or whole bowel irrigation for medication ingestions

A
  • Medications that are poorly absorbed by activated charcoal

- Medications in sustained-release or enteric-coated formulations

108
Q

Best pharmacologic treatment of gestational diabetes

A

Twice daily combination of intermediate-acting insulin and short-acting insulin while continuing diet & exercise program

109
Q

Empiric treatment of endocaritis by gram-positive coccus

A

Vancomycin + gentamicin (if patient has no prosthetic valves)

110
Q

Diagnostic criteria for polycythemia vera

A

Major criteria

  • increased red cell mass
  • normal O2 saturation
  • presence of splenomegaly

Minor criteria

  • elevated vitamin B12 levels
  • Elevated leukocyte alk phos
  • Platelets >400,000
  • WBC >12,000
111
Q

What does Medicare Part A cover?

A

Inpatient care in hospitals and skilled nursing facilities, hospice, and home health services (but not custodial or long-term care

112
Q

What does Medicare Part B cover?

A

Outpatient physician services, including office visits and home health services

113
Q

What does Medicare Part C cover?

A

Combines part A and B coverage, offered by private companies

114
Q

What does Medicare part D cover?

A

Prescription drugs (D for drugs!)

115
Q

Nodule at fourth finger with pitting or dimpling of the skin

A

Dupuytren’s contracture

116
Q

Indications for venous thromboembolism prophylaxis in hospitalized patients

A

Patients over age 40 who have limited mobility for 3 days or more and have at least one of the following: acute infectious disease, NYHA class III or IV heart failure, acute MI, acute respiratory disease, older age, recent surgery or trauma, immobility or paresis, obesity, central venous catheterization, inherited or acquired thrombophilic disorders, varicose veins, or estrogen therapy

117
Q

Initial treatment of status epilepticus

A

Lorazepam followed by phenytoin

118
Q

Physical exam finding of head and neck associated with diabetes mellitus

A

Sialadenosis (bilateral noninflammatory enlargement of the parotid gland)

119
Q

Treatment of acute dystonic reaction

A

Diphenhydramine or benztropine

120
Q

Most appropriate route of epinephrine administration in anaphylactic reactions

A

Intramuscular

121
Q

Management of asymptomatic placenta previa seen on ultrasound at 20 weeks gestation

A

Repeat ultrasound at 28 weeks

122
Q

Small bony avulsion visiible on lateral view of wrist x-ray

A

Triquetral fracture

123
Q

Treatment of drug-induced vasculitis

A
  • Supportive care if mild

- Corticosteroids if severe

124
Q

Treatment of narcolepsy

A

Methylphenidate and other stimulant drugs

125
Q

Most common causes of hypercalcemia

A
  • Hyperparathyroidism

- Malignancy

126
Q

Lab for monitoring LMWH therapy

A

Anti-factor Xa levels

127
Q

First-line treatment for alopecia areata that affects <50% of the scalp

A

Intralesional corticosteroid injections

128
Q

Treatment for alopecia areata that affects >50% of the scalp or children <10

A

Topical minoxidil

129
Q

First-line antibiotic treatment for community-acquired pneumonia in a young adult in the ambulatory setting

A

Azithromycin

130
Q

Best treatment for lateral epicondylitis

A

Expectant/conservative management

131
Q

Treatment of acute paronychia

A

Topical antibiotics +/- topical corticosteroids

132
Q

Risk factors for Dupuytren’s disease

A

Diabetes mellitus

133
Q

What is Carnett’s sign?

A

Easing of pain of abdominal palpation with tightening of abdominal muscles

134
Q

Treatment regimen for HIV positive patients with latent TB infection

A

Isoniazid daily for 9 months

135
Q

Treatment of hemodynamically stablePSVT

A

IV adenosine

136
Q

Treatment of chronic orthostatic hypotension

A

Fludrocortisone
Midodrine
Physostigmine

137
Q

Initial treatment of peripheral artery disease without CHF

A

Cilostazol

138
Q

Osteoporosis medication with best evidence for prevention of both vertebral and hip fractures

A

Zoledronic acid

139
Q

Most common cause of proteinuria in children

A

Orthostatic proteinuria

140
Q

Most effective treatment of head lice

A

Malathion

141
Q

How is scabies predominantly transmitted?

A

Direct personal contact

142
Q

Treatment of acute otitis externa

A

Ciprofloxacin 0.3%/dexamethasone 0.1% topically

143
Q

Treatment of group B strep in penicillin-allergic patients

A

Cefazolin

144
Q

Which osteoporosis medication can be used to treat pain associated with acute or chronic vertebral fractures?

A

Calcitonin-salmon (Miacalcin)

145
Q

First-liine therapy of gestational hypertension

A

Labetalol

146
Q

Treatment for hypoactive sexual desire disorder

A

Topical testosterone

147
Q

Treatment of Bell’s palsy

A

Corticosteroids

148
Q

Prevention of opioid-induced constipation

A

Polyethylene glycol
Lactulose
Magnesium hydroxide
Senna

149
Q

Normal time required for Get Up and Go test

A

10 seconds

150
Q

Most common cause of stillbirth

A

Placental abnormalities and obstetric complications

151
Q

Target uric acid goal for patients with gout

A

5-6 mg/dL

152
Q

What parameters is blood pressure classification in children based on?

A

Sex, height, and age

153
Q

Indications for tympanostomy tubes in child with recurrent otitis media

A

3 episodes of AOM in the past 6 months
OR
4 episodes within the pats year with at least one episode in the past 6 months

154
Q

Prophylaxis of Lyme disease

A

200 mg of doxycycline within 72 hours of tick removal if tick is engorged or is suspected to have been attached for at least 36 hours

155
Q

Vilaceous, polygonal papules that are pruritic and affect skin and oral mucosa in patient with hepatitis C

A

Lichen planus

156
Q

American Geriatrics Society recommends HbA1c goal of __ for individuals with very complex health problems or poor health

A

<8.5%

157
Q

Opioid choice in patients with end stage renal disease

A

Fentanyl

158
Q

Medical conditions that decrease responsiveness to warfarin

A

Hypothyroidism, visceral carcinoma, increased vitamin K intake, diabetes mellitus, and hyperlipidemia

159
Q

Conditions that increase responsiveness to warfarin, the INR, and the risk of bleeding

A

Vitamin K deficiency caused by decreased dietary intake, malabsorption, scurvy, malnutrition, cachexia, small body size, hepatic dysfunction, moderate to severe renal impairment, hypermetabolic states, fever, hyperthyroidism, infectious disease, heart failure, and biliary obstruction

160
Q

TB screening test in patient with history of BCG vaccinatino

A

Interferon-gamma release assay

161
Q

Antidepressant indicated for both depression and chronic pain

A

Duloxetine

162
Q

If you suspect pityriasis rosea, what other disease should you rule out first?

A

Syphilis

163
Q

Antibiotic choice for neonatal sepsis

A

Ampicillin + cefotaxime

164
Q

Treatment of ueitis

A

Topical corticosteroids

165
Q

Treatment of chronic midsubstance Achilles tendinopathy

A

Eccentric exercise

166
Q

What EKG abnormality would dictate use of pharmacologic stress test as opposed to an exercise stress test?

A

Left bundle branch block

167
Q

Oxygen duration recommendations in patient with COPD exacerbation who did not require oxygen therapy prior

A

Reassess in 3 months

168
Q

Contraindication for methylergonovine in postpartum hemorrhage

A

Hypertension

169
Q

Contraindication for carboprost tromethamine in postpartum hemorrhage

A

Asthma, hepatic disease, renal disease, or cardiac disease

170
Q

Colon cancer screening recommendations for patiens with ulcerative colitis

A

Screening starting 10 years after initial diagnosis and continuing every 2-5 years (based on findings)