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Family Medicine

Preparation for Family Medicine Shelf

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
At what induration is a PPD considered positive in a patient with HIV? Greater than or equal to 5 mm
What common medical condition disqualifies drivers from commercial interstate driving? Insulin-dependant DM
How do thiazides affect serum Ca? Exacerbate hypercalcemia by increasing distal tubular Ca reabsorption.
How does furosemide affect serum Ca? Lowers serum Ca
In a small child a marked decrease in bone age relative to height age and chronological age is likely due to? Hypothyroidism
What are two causes of delayed height age relative to chronological and bone age in a small child? Down Syndrome & Fetal Alcohol Syndrome
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.
A woman over 65 years with low TSH is at increased risk for what? Osteoporosis (hip and vertebral fractures)
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)
An asymptomatic pregnant female with no h/o DM should be screened for gestational diabetes at what gestational age? 24-28 weeks
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.
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
What are causes of thyrotoxicosis with decreased 24-hour radioactive iodine uptake (RAIU)? Subacute thyroiditis Thyrotoxicosis facititia
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
What are the signs of barbiturate withdrawal? Early withdrawal signs include anxiety, insomnia, orthostatic hypotension and gastrointestinal complaints. Grand mal seizures may occur.
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.
What is DOC for penicillin resistant gonorrhea? Tetracyclines for 10 days. Also cures non-gonococcal urethritis
What are the classes of acute pancreatitis? Acute pancreatitis Relapsing acute pancreatitis Relapsing chronic pancreatitis Chronic pancreatitis
How does acute pancreatitis present? Abdominal pain ranging from mild-severe. Lying in fetal position relieves pain. Low grade fever, tachycardia, hypotension, leukocytosis
How is acute pancreatitis diagnosed? Serum amylase > 200
Created by: bunnywithscalpel