Family Medicine Clerkship

Front 1

Two ways to deal with teenage high risk sexual behaviors

Back 1

1. Where do you see yourself in 2 years? What are you going to do with the baby?
2. Do you have any friends that are pregnant?
3. Prescribe prenatal vitamins!

Front 2

An advantage of the pill

Back 2

If you don't do well on it, you can stop it.

Front 3

Counselling people about contraception and confidentiality

Back 3

1. Might show up on parents' insurance bill. Parents can request what meds they've bought.
2. Title 10, planned parenthood. Sliding scale.

Front 4

Birth control and insurance

Back 4

Check insurance to see if they cover contraception. Many don't.

Front 5

How do you tell a teen to start taking contraception?

Back 5

Sunday after next period.
Quick start method. Start right away - may get more spotting this way.

Front 6

Why give triphasic vs. Monphasic?

Back 6

Bc triphasic is a lower dose of meds.

Front 7

Good for UTIs in pregnancy

Back 7

Cephalexin (QID) is safe in pregnancy

Front 8

Very important with abx and birth control

Back 8

Use backup through the whole course.

Front 9

When will people get seasonal allergy relief?

Back 9

After the first frost.

Front 10

Household allergies

Back 10

Take up the carpeting - it breeds dust mites.

Front 11

Pollen season

Back 11

St. Patrick's day until the first frost.

Front 12

Asking about infidelity

Back 12

Any other partners in the past year?
Any concerns about infidelity?

Front 13

How many calories does breastfeeding burn?

Back 13

300-400 cal/day

Front 14

How much weight should a person lose in a week

Back 14

1-3 lbs per week

Front 15

How long does post-partum blues last?

Back 15

10 days

Front 16

Don't take what with metronidazole?

Back 16

Alcohol! Disulfram like effects.

Front 17

Side effects of intranasal steroids

Back 17

No rebound congestion like with afrin. Only absorbed locally. Maybe can stop after first frost. No effect on bones, no Inc in cancer. Some people hate the taste/smell, some bloody noses.

Front 18

When is use of Afrin indicated?

Back 18

Very addictive - use only for people that are flying and need relief.

Front 19

Getting an abortion under 18 in Massachusetts.

Back 19

Need to get parental consent or get a court order. Need to argue that physical or mental health is in danger.

Front 20

Shoulder pain - also check what on PE?

Back 20

Check neck and cervical spine. Do spirling's test for cervical stenosis.

Front 21

Adhesive capsulitis

Back 21

Pain with both active and passive ROM

Front 22

empty can test

Back 22

Supraspinatous. Putting thumb Down takes deltoid out of equation. Positive = pain

Front 23

Instability of shoulder

Back 23

Apprehension test

Front 24

Biceps tendonitis: test

Back 24

Speeds test. Resist forward flexion. Positive = Anterior shoulder pain.

Front 25

Laxity/Instability of shoulder

Back 25

+ Apprehension, < 25, new activity

Front 26

Severe shoulder pain while waiting for surgery

Back 26

Lean forward and swing arm in circles - if leave in sling will get adhesive capsulitis

Front 27

Knee trauma: question to ask about swelling

Back 27

Did it swell up like a big balloon? Yes - dislocatin, ACL/PCL

Front 28

Swellng with ACL/PCL vs meniscal

Back 28

ACL/PCL < 2 hours
Meniscal > 2 hours

Front 29

How do you tell if the shoulder is internally rotated on X-ray?

Back 29

The humeral head looks like a lightbulb.

Front 30

Hill Sachs fracture

Back 30

Anterior dislocation with a fracture. I popped it back but it still hurts.

Front 31

Bankart lesion

Back 31

Fracture inf aspect of the glenoid

Front 32

What radiographs do you want to order for knee injury?

Back 32

AP (weight bearing in older pt)
Sunrise
Tunnel
Lateral

Front 33

What does edema look like on MRI?

Back 33

White on T2 MRI

Front 34

Lipohemarthrosis: sign of

Back 34

Fat-fluid levels often assoc with fractures

Front 35

What color will an ACL be on MRI?

Back 35

It will be a black line

Front 36

When standing, most of weight goes on lateral or medial meniscus?

Back 36

Medial meniscus

Front 37

Ankle injury: what X-rays do you order?

Back 37

AP
Lateral
Oblique

Front 38

Ottowa Rules

Back 38

> 18 and < 55
Can't bear weight
Point tenderness over medial and lateral malleoli, navicular bone, and base of 5th metatarsal

Front 39

What lig of the foot tears first?

Back 39

ATFL

Front 40

Fraction of the base of the fifth metatarsal

Back 40

Jones fracture

Front 41

High ankle sprain

Back 41

Foot plantarflexed and
Squeeze test. Positive if pain in foot. Need to squeeze up high.