Clinical Medicine

Front 1

HTN is the most common risk factor for ___ and ___.

Back 1

heart attack and stroke (and intracerebral hemorrhage)

Front 2

T or F: most patients with HTN is due to essential HTN

Back 2

T (not secondary)

Front 3

How are you supposed to measure BP in-office?

Back 3

1. two readings 5 mins apart
2. sitting in chair
3. confirm elevated reading in contralateral arm

Front 4

Hypokalemia, hyperlipidemia, gout attack and arrhythmias are all side effects of what med?

Back 4

thiazide diuretics

Front 5

ACE inhibitors:
1. what are SEs?
2. contraindicated in ___ and ____.

Back 5

1. cough, angioedema, hyperkalemia
2. pregnancy and bilateral renal artery stenosis

Front 6

What can be taken in patients who cannot tolerate the cough with ACEI-s?

Back 6

ARBs (angiotensin receptor blockers) and DRI (direct renin inhibitors)

Front 7

Avoid beta blockers in patients with ___ or ___ (for the tx of ___).

Back 7

bronchospasm or depression; HTN

Front 8

What med may be preferred in african american patients or those with COPD/asthma for the tx of HTN?

Back 8

calcium channel blockers

Front 9

What BP signifies a:
1. HTN urgency?
2. HTN emergency?

Back 9

1. SBP>220 and DBP>125
2. DBP >130

Front 10

T or F: in a HTN emergency, you want to decrease the blood pressure to around 140/90

Back 10

F (no more than 25% in 1-2 hours then BP towards 160/100 within 2-6 hours)

Front 11

For people over 50, which BP reading is more important as a CVD risk factor? SBP or DBP?

Back 11

SBP

Front 12

T or F: there is no treatment necessary for pre-hypertensive people

Back 12

F; lifestyle modification (if they have compelling conditions, also use drugs for those)

Front 13

What are normal triglyceride values?
High?

Back 13

Normal is <150 (or <1.7)

High is 200-499 (2.26-5.65)

over this is very high

Front 14

What are desirable cholesterol levels? High?

Back 14

Desirable= <200mg/dL (or <5mmol/dL)

High >= 240 (or 6.2)

Front 15

What are Low HDL levels? High?

Back 15

Low= <40 (or <=1)

High= >=60 (or 1.6) but for women >50 is good

Front 16

What are optimal levels for LDL?
High?

Back 16

<100 (<2.5)= optimal

high= 160-189 (4.1-4.8)

Front 17

Chronic heart disease risk factors:
1. family history of MI, CHD or sudden death before ___ years of age in father or first degree male relative and ___ years in mother or first degree female relative

2.HTN: SBP>____ or DBP> ____ on 2 separate occasions or person is taking anti-HTN meds

3. Diabetes: FBG > ___ measured on 2 occasions

4. dyslipidemia: TC> ___
HDL< ___
LDL > _____ or on lipid lowering meds

5. Obesity (based on __ and __)

Back 17

1. 55; 65

2. 140; 90

3. 110

4. 200; 40; 130

5. BMI and waist circumference

Front 18

T or F: there is a positive correlation between plasma cholesterol concentration and coronary heart disease risk AS WELL AS mortality due to CHD

Back 18

T

Front 19

T or F: if your HDL level is >60, you can REMOVE one risk factor from the total count when performing step 3 of the NCEP risk assessment

Back 19

T (negative factor)

Front 20

A person without CHD who has 1 risk factor for CHD does/doesn't need to be assessed using the Framingham risk tables for 10-year CHD risk.

Back 20

doesn't (need two or more risk factors OTHER THAN LDL because their 10 year risk is less than 10%)

Front 21

The non-HDL goal should be calculated for people with ___ greater than 200 mg/dL.

Back 21

triglycerides

(should be less than 30 mg/dL above a person's LDL cholesterol goal)

Front 22

What are the five families of viruses responsible for the common cold?

Back 22

Rhinovirus, Parainfluenza, Coronavirus, Adenovirus, Influenza

Front 23

T or F: sinusitis is mostly seen in children

Back 23

F adults

Front 24

What is the Tx for sinusitis?

Back 24

Antibiotics: Amoxicillin (Augmentin) or a cephalosporin or Ampicillin or SinuNEB nasal spray)

Front 25

What's the key sign for mumps?

What's the key sign for measels?

With Rubella, what ocular condition can the child be born with if the mother has the infection?

Back 25

Swollen parotid gland

Koplik spots (grayblue spots on inside of cheek against red background) and skin rash

Salt and pepper fundus

Front 26

What family of viruses do measels, mumps and rubella belong to?

Back 26

Paramixovirus

Front 27

What is the etiology of Rheumatic fever?

What is the name of the rash assoc with this?

What are the other two major symptoms?

Back 27

Group A Strep. Pyogenes

erythema marginatum

carditis and chorea

Front 28

What's the most common symptom caused by group A strep. pyogenes?

Back 28

pharyngitis (strep throat)

Front 29

What's the Tx of rheumatic fever?

Back 29

Analgesics, ASA/prednisone p.o.

Front 30

What is the pathogen called in tuberculosis?

Back 30

Mycobacterium tuberculosis

Front 31

T or F: humans are the only reservoir for tuberculosis

Back 31

T

Front 32

What test needs to be run in order to Dx someone with active TB?

Back 32

sputum smears staining for acid fast bacilli culture

Front 33

What are the 4 drugs used for active TB disease?

Back 33

1. Rifampin
2. Isoniazide (prevention too)
(these first 2 for 9 months...other two are about 2 months)
3. Pyrazinamide
4. Ethambutol

Front 34

What are the signs of the two forms of Leprosy?

Back 34

1. tuberculoid: (mild): hypopigmented anesthetic plaques

2. lepromatous (severe): involves skin nodules full of mycobacterium and plaques, loss of eyebrows/lashes

Front 35

What is the Tx for leprosy?

Back 35

Dapsone and Rifampin combo then lifetime maintenance of Dapsone

Front 36

What is a major cause of blindness in the middle east and third world countries? What fraction of the population does it effect?

Back 36

Trachoma; 1/7