Fam Med Random

Front 1

How long to tx depression

Back 1

1st time - 1 year
subsequent - 2-3 years

Front 2

stage III ankle sprain

Back 2

can't do more than 4 steps and swelling >4cm around fibula.

Front 3

Peroneal tendon tear - where is the pain

Back 3

Inversion and pain is posterior to lateral malleolus

+/- swelling

Front 4

Talar fx - most concerned with...

Back 4

interruption of blood supply

Front 5

Which tendon gets tendonitis in ankle

Back 5

posterior tibial tendon

Front 6

Subtalar injury - how and which joints

Back 6

high-energy injury

disloc involves talocalcaneal or talonavicular injury

Front 7

pain with tarsal tunnel

Back 7

pain/parasthesia along medial ankle and bottom of foot

Front 8

achilles tendon rupture - pain and loss of motion where?

Back 8

pop/snap at time of inj (rare time that is helpful with ankle)

immed pain/swelling. can't plantar flex or ambulate.

Front 9

Ottawa rules - when to radiograph ankle

Back 9

malleolar pain and bony tenderness along distal 6cm of posterior edge of either malleolus

or can't do 4 steps at time of inj and in ED

Front 10

Ottawa rules - when to radiograph foot

Back 10

midfoot pain and tenderness at navicular bone or base of 5th metatarsal

or can't do 4 steps at time of inj and in ED

Front 11

Homan's sign

Back 11

pain with passive dorsiflexion - not v. specific for DVT

Front 12

dull ache in leg that is worse with standing and better with elevation

Back 12

venous insuff

Front 13

when to use d0dimer to dx DVT

Back 13

if probability of it is low

Front 14

wells criteria to dx DVT

Back 14

if >3, high probability

Front 15

how long to tx isolated calf thrombophlebitis

Back 15

6-12 wks

Front 16

how long to tx first time provoked dct (trauma/surg) vs. idiopathic vs recurrent

Back 16

3 months
6 months
12 months

Front 17

GFR < ___ is a cardiac risk factor

Back 17

60

Front 18

do nsaids increase bp?

Back 18

yes

Front 19

how BP cuff should be -

Back 19

length >80% of arm circ and width at least 40% of arm circ

Front 20

second best px factor for anyone for death

Back 20

LVH

Front 21

stroke prev - which antihypertensives to use?

Back 21

thiazides or ace

Front 22

afr americans respond well to which antihypertenisves

Back 22

thiazides and CEBs

Front 23

___ can cause resistant HTN

Back 23

excess alcohol

Front 24

CHD risk equivalents and LDL goal

Back 24

DM, AAA, PAD, symptomatic carotid artery dz

<100

if you have one of these, 20% chance of CV event in next 10 years.

Front 25

risk factors that change LDL goals

Back 25

if >=2, get ldl<130

cigs
htn
low hdl
premat chd in fam hx
male>45 or female over 55

Front 26

premature ages for CHD in fam history

Back 26

males < 55
females < 65

Front 27

MV prolapse murmur increased with...

Back 27

valsalva

Front 28

low risk female - what kind of stress test to get?

Back 28

exercise

if higher risk, do thallium

Front 29

when for man and woman to start taking asa

Back 29

man - 45-79
woman - 55-79

Front 30

back pain is worse with sitting/bending and better with lying/standing

Back 30

disc herniation?

Front 31

lumbar flexion pain - causes (3)?

Back 31

OA, spasm, herniation

Front 32

lumbar ext pain - causes (2)?

Back 32

DJD or stenosis

Front 33

pt feels better with back pain when going from standing to squatting

Back 33

central spinal stenosis

Front 34

L3
reflex, sensation, motor and test?

Back 34

Patellar
lat thigh or med fem condyl
extend quad
squat and rise

Front 35

l4
reflex, sensation, motor and test?

Back 35

patellar
med leg and ankle
dorsiflex ankle
walk on heels

Front 36

l5
reflex, sensation, motor and test?

Back 36

medial hamstring
lateral leg and foot dorsum
dorsiflex big toe
walk on heels

Front 37

s1
reflex, sensation, motor and test?

Back 37

achilles
post calf, sole of foot, lat ankle
stand on toes
walk on toes

Front 38

tight hammy vs. sciatica

Back 38

if dorsiflex foot at max leg raise causes pain - sciatica

Front 39

straight leg raise test/lasegue's sign is + at...

Back 39

40-70 degrees
(highly sensitive)

Front 40

cauda equina pain

Back 40

pain worse with movement/sitting and better when supine

Front 41

can't squat vs. duck waddle - which is lig inj, which is meniscal inj

Back 41

squat - lig inj
waddle - meniscal

Front 42

lachmans test

Back 42

for acl - pt supine and knee at 30 deg then to ant drawer basically

Front 43

valgus tests...

Back 43

lat meniscus

Front 44

xray views of knee to order

Back 44

standing ap, lat, merchant

Front 45

order of tx of OA

Back 45

acetamin
nsaids
cox-2 inh
tramadol
steroid inj (max is 3/yr and 1/month)

Front 46

chronic pain tx in pt with oa

Back 46

1.) tramadol
2.) short acting opioids (if they don't need daily use)
3.) long opioids
4.) TCAs
5.) Anticonvulsants

Front 47

when to screen lipids in pt with cv risk factors

Back 47

45

Front 48

abortion legal until...

Back 48

22 weeks

Front 49

fev1 values in intermitt to severe asthma

Back 49

int and mild - >80%
mod - 60-80%
severe <60%

Front 50

dx chronic sinusitis

Back 50

need >=2:
nasal cong
mucoopur drainage
facial pressure/pain
poor smell
lasts >12 weeks

Front 51

pfts of non asthmatic eosinophilic bronchitis

Back 51

normal - so is cxr

Front 52

pfts of vocal cord dysfunc

Back 52

flattening of insp loop

Front 53

roal steroids assoc with cataracts?

Back 53

yes

Front 54

wait btwn puffs with beta agonist or steroids?

Back 54

beta agonist

Front 55

yellow zone of peak flow and how often to do it

Back 55

2x/day
yellow is 50-70% of personal best

Front 56

placenta rpevia risk factors

Back 56

prior preg
>35
smoker
previous multiparity
uterine surg

Front 57

cullens sign

Back 57

periumbilical discoloration with pancreatitis

Front 58

whne to use ursodiol

Back 58

biliary colic and sx are atypical or stones are there and not sure if they are causing the sx - tx for 3 month duration

Front 59

annular macules seen with...

Back 59

drug eruptions, secondary syph, lupus erythem.

Front 60

melanoma - does it bleed? where commonly found

Back 60

yes
legs in females

Front 61

polygonal papules on flexor wrists or above ankles

Back 61

lichen planus

Front 62

poor urine flow rate

Back 62

<15ml/sec

Front 63

how to dx actinic keratosis

Back 63

easily felt, not easily seen

Front 64

what has best penetration of medicine (derm thing)

Back 64

ointment

Front 65

which derm thing is cosmetically most acceptable

Back 65

creams

Front 66

what is good for poison ivy/exudative inflammation

Back 66

lotion/gel

Front 67

betamethasone or halobetasol good for what

Back 67

group 1 - so strongest - psoriasis, lichen planus, severe hand eczema, alopecia areata

Front 68

group II - weakest derm meds

Back 68

desoximetasone/fluconimide

triamcinolone

aclometasone or desonide

hydrocortisone

Front 69

tx tinea capitis

Back 69

oral griseofulvin

Front 70

tx oncyhomycosis

Back 70

terbinafine( 12 weeks of toes/6 weeks of fingers) and itraconazole for pulse therapy

or griseofulvin (long term)

Front 71

migraine dx

Back 71

5 episodes
last 4-72 hours
>=2: unilat, pulsates, mod-severe, exac with activity

there is n/v, photo/phonophobia

Front 72

weird things that can cause HA

Back 72

progesterone, aspartame, phenylalanine

Front 73

abortive meds for migraines

Back 73

triptans (contraind with hemiplegic or basilar migraine), ergots (more severe AEs), butalbital combos

Front 74

can't use butalbital wit history of...

Back 74

porphyria

Front 75

AEs of divalproex

Back 75

pancreatitis, wt gain

Front 76

AEs of topiramate

Back 76

renal stones and wt loss

Front 77

ppx of migraines

Back 77

beta block, divalproex, topiramate, tcas, feverfew, mg, b12

Front 78

meds causing gerd

Back 78

beta and alpha agonists, CEBs

Front 79

red flag GI sx - need consult immediately

Back 79

dysphagia/odynophagia
new sx in >55
early satiety
hematochezia
iron def anemia
recurr vom/wt loss

Front 80

outpt mgmnt of diberticulitis

Back 80

bactrim plus metro or levoflox and mtero

Front 81

tx functional dyspepsia

Back 81

ppis are good, h2 blockers not so much/ eradicating h pylori not so helpful.

Front 82

quad therapy

Back 82

metro, tetracycline, ppi, bismuth

Front 83

tx of h pyloori gastritis

Back 83

triple therapy - if stool test is (+) - salvage therapy, and last line is endoscopy/egd and prolonged ppi

if stool was negativew but still sx - do urease breath test and if that is negative refer to gi

Front 84

strongest rf for htn in a child -

Back 84

obestiy

Front 85

rales or rhonchi indicate consolidation?

Back 85

rales

Front 86

who gets which pnas?

Back 86

typical - age extremes
atypical - not young children
viral - mainly just kids

Front 87

crackle pattern in typical vs atypical pna

Back 87

typical - pan insp crackles
atypical - late insp crackles

Front 88

which pnas have constitutional sx

Back 88

atypical and viral
typical has abrupt onset

Front 89

flu - give ibuprofen or tylenol first?

Back 89

ibuprof

Front 90

tx pna in child - algorithm

Back 90

>5 - azithro
3mo - 5 yo - amoxicillin

Front 91

when to admit <3 weeks, 3wk-3mo, 3mo-5yo, >5yo

Back 91

<3wks - always if pna - give amp and gent
3wk-3mo - if febrile, give cefotaxime or cefuroxime
3mo-5yo - admit if RR>70 - give amox
>5 - if RR > 50; give IV cefuroxime then oral

Front 92

if <___ y.o., just try to maintain weight until bmi < 85%

Back 92

7

Front 93

kids - normal ldl and chol

Back 93

ldl < 130
chol < 170

Front 94

vaccines needed for school

Back 94

hep b, dtap, polio, mmr, varicella (note not HIB)

Front 95

lead questions

Back 95

living in house < 1950 or refinishing house before 1978 or someone with lead pois.

Front 96

can dx adhd after age ___

Back 96

6

Front 97

rash appears after tx a child with amox/amp

Back 97

dx is mono

Front 98

palatine petechiae - specific for...

Back 98

gas

Front 99

what abx to use for strep pharyngitis in pt with mild pcn allergy

Back 99

cephalexin or cephadroxil

macrolides if severe

Front 100

fever over 101/38 in ___mo needs extensive workup

Back 100

2 month old

Front 101

normal newborn pulse rate

Back 101

100-165

Front 102

rooting reflex disppears when?

Back 102

4 months

Front 103

peak of infant colic

Back 103

at 6 weeks

Front 104

tx of pedi colic -

Back 104

both not effective
simethicone (elim gas) or dicyclomine (less gut peristalsis)

Front 105

which muscles attaches to lesser tuberosity of shoulder

Back 105

subscapularis

Front 106

adhesive capsulitis associated with...

Back 106

DM or limited shoulder movement

Front 107

tx tinea pedis

Back 107

tolnaftate

Front 108

sulcus sign

Back 108

inferior glenohumeral instability

Front 109

shoulder apprehension test -

Back 109

anterior GH instability

Front 110

obrien test

Back 110

for superior labral tear, but false positive with acromioclavicular pathology or tendinitis

Front 111

when to do subacromial injection for shoulder inj

Back 111

last line

Front 112

is dm a risk factor for colorectal ca

Back 112

yes

Front 113

chronic fatigue syn dx

Back 113

last over 6 mo and >=4 of folowing:

poor cognition
post-ex malaise
tender lad
st
myalgias
arthralgias

Front 114

et ebv titers in initial w/u of fatigue?

Back 114

no

Front 115

if > 50 yo, butt bleed, normal colo, next step?

Back 115

uper endoscopy

Front 116

atypical squam cell of undet significance - screen for hpv?

Back 116

no - wont change mgmt

Front 117

prehn's sign

Back 117

lifting testicles relieves pain in epididymitis but not torsion

Front 118

appendage torsion - in prepubertal boys or post?

Back 118

pre

Front 119

copd dx if fev1/fvc is <___

Back 119

70% and not resp to albut

Front 120

orthopnea can also be seen with...

Back 120

asthma or bronchitis

Front 121

maximum laryngeal height < 4cm - dx?

Back 121

copd

Front 122

fev1s of mild, mod, severe, and v severe copd

Back 122

>80%
50-80% with sx on exertion
30-50%
<30%

Front 123

tx of copd

Back 123

1.) SABA
2.) antichol or LABA

ing steroids only if fev1<50%

Front 124

when to give abx in copd exac

Back 124

more dysp, more prod or purulence of sputum, need ventilation

Front 125

pt has delirium, vz hallucin, tremor

Back 125

dementia with lewy bodies

Front 126

pt with dementia/delirium - uti mgmt

Back 126

iv ceftriacone

Front 127

chronic alz tx

Back 127

mild - anticholinesterase - donepezil, rivastigmine, tacrine, galantamine

severe - nmda antag (memantine)

vit e and atypical antipsychotics are up in the air

Front 128

new onset afib is less than __ hours total duration

Back 128

72

Front 129

Early infarction in a pt with stroke on CT will have higher rates of...

Back 129

hemorrhage after tpa

Front 130

whin __ hours get tpa into the pt

Back 130

3 - only no if they have hemorrhagic stroke.

if you suspect heme issue or you don't know if they are on anticoag, get blood tests before tpa

Front 131

middle cerebellar infarct affecting R parietal hemisphere - where affected?

Back 131

L hemiplegia, neglect of stroke sx, misjudgement of distances, reads books upside down, L vz field neglect

Front 132

brain stem stroke - where affected?

Back 132

poor BP, resp finc, P, consciousness

Front 133

L middle cerebral artery stroke - where affected?

Back 133

expressive and receptive aphasia and L facial weakness

Front 134

orthstatic change definition

Back 134

tom was wrong

at least 20 decrease in systolic and 10 in diastolic

Front 135

timed up and go - normal values

Back 135

avg 3 trials

<20 is mostly indep
20-29 is variable mobility
>20 is impaired mobility

Front 136

romberg sign - where is lesion?

Back 136

vertebrobasilar system affected

Front 137

fast test for stroke

Back 137

face - smile
arms - pronator drift
speech - repeat simple sentence
time - get to hospital fast

Front 138

sudden extreme elev of BP assoc with papilledema

Back 138

could be a sz

Front 139

hypokalemic periodic paralysis

Back 139

occurs while resting - since childhood - episodes of weakness

Front 140

hemiplegic migraines

Back 140

not present after mid adulthood - HA with hemiparesis and stroke like sx

Front 141

can lp find subarachnoid hemorrhage?

Back 141

yes

Front 142

post-stroke - better to have ASA or asa with ER dipyramidole

Back 142

asa with dipyramidole

Front 143

ticlopidine

Back 143

slightly better htan asa for post-stroke pts - but expensive and lots of AEs.

Front 144

htn therapy post stroke

Back 144

diuretics alone or with an ace

Front 145

maximum waist circ in post-stroke pt

Back 145

<40 males, <35 females

Front 146

key aspects to a preventive exam

Back 146

RISE
risk factors for serious med conditions
immunizations
screening tests
education

Front 147

quickest way to determine nutritional deficiencies and excesses

Back 147

food freq questionnaire

Front 148

acceptable colon ca screenings

Back 148

annual testing of 3 stools/year for blood

flex sig or double contrast enemas every 5 years

Front 149

target heart rate calculation

Back 149

(220-age) * 07.-0.8

Front 150

borg level of exertion scale

Back 150

pts should be at 12-14

Front 151

colo reveals tubular adenoma with low grade dysplasia - next step?

Back 151

repeat colo in 5-10 yeras