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Preparation for Family Medicine Shelf

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
What are red flags for cancer in patients with solitary thyroid nodules?   male Age <20 or >65 rapid growth dysphagia, hoarseness, neck pain (symptoms of local invasion) h/o head or neck radiation family h/o thyroid Ca hard, fixed nodule >4 cm cervical LAD  
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At what induration is a PPD considered positive in a patient with HIV?   Greater than or equal to 5 mm  
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What common medical condition disqualifies drivers from commercial interstate driving?   Insulin-dependant DM  
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How do thiazides affect serum Ca?   Exacerbate hypercalcemia by increasing distal tubular Ca reabsorption.  
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How does furosemide affect serum Ca?   Lowers serum Ca  
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In a small child a marked decrease in bone age relative to height age and chronological age is likely due to?   Hypothyroidism  
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What are two causes of delayed height age relative to chronological and bone age in a small child?   Down Syndrome & Fetal Alcohol Syndrome  
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What is the relationship between bone age, height age and chronological age in a child with CF?   Both bone age and height age lag behind chronological age.  
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A woman over 65 years with low TSH is at increased risk for what?   Osteoporosis (hip and vertebral fractures)  
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How can you differentiate iron deficiency anemia from anemia of chronic disease?   Iron deficiency anemia: high TIBC and low Ferritin Anemia of Chronic Disease: low TIBC and normal/high Ferritin (acute phase reactant)  
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An asymptomatic pregnant female with no h/o DM should be screened for gestational diabetes at what gestational age?   24-28 weeks  
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How do you screen for gestational diabetes?   Oral glucose challenge (OGC) of 50 g. Serum glucose at 1 hour should be less than 130. If greater than 130: Oral glucose tolerance test (OGTT) 100 g oral glucose, check blood glucose at 3 hours. should be less than 140.  
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What are causes of thyrotoxicosis with increased 24-hour radioactive iodine uptake (RAIU)?   Graves' Disease Toxic Multinodular Goiter Solitary hot nodule TSH secreting pituitary tumor  
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What are causes of thyrotoxicosis with decreased 24-hour radioactive iodine uptake (RAIU)?   Subacute thyroiditis Thyrotoxicosis facititia  
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What is an absolute contraindication to ACE inhibitor use?   h/o angioneurotic edema (life-threatening) Relative contraindication: increased serum creatinine (renal insufficiency) Indications: recent MI & low ejection fraction  
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What are the signs of barbiturate withdrawal?   Early withdrawal signs include anxiety, insomnia, orthostatic hypotension and gastrointestinal complaints. Grand mal seizures may occur.  
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How should barbiturate withdrawal be managed?   200 mg of Pentobarbital PO & assess over the next hour. Pt becomes very drowsy or exhibits coarse nystagmus→ ≤600 mg daily. Pt mildly drowsy with fine nystagmus→ ≃ 800 mg daily in divided dose no response → > 1,200 mg daily.  
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What is DOC for penicillin resistant gonorrhea?   Tetracyclines for 10 days. Also cures non-gonococcal urethritis  
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What are the classes of acute pancreatitis?   Acute pancreatitis Relapsing acute pancreatitis Relapsing chronic pancreatitis Chronic pancreatitis  
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How does acute pancreatitis present?   Abdominal pain ranging from mild-severe. Lying in fetal position relieves pain. Low grade fever, tachycardia, hypotension, leukocytosis  
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How is acute pancreatitis diagnosed?   Serum amylase > 200  
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