AAFP questions with accurate answers. Graded A+, 2022.

Criteria for hyperaldosteronism, which is found in up to 20% of HTN patients and more often in women - ✔✔Plasma Aldo/Renin ratio >20 and Aldo >15 ng/dL How might you manage a non toxic lobar pneumonia in a 15 month ol ...

Criteria for hyperaldosteronism, which is found in up to 20% of HTN patients and more often in women - ✔✔Plasma Aldo/Renin ratio >20 and Aldo >15 ng/dL How might you manage a non toxic lobar pneumonia in a 15 month old? - ✔✔High dose oral amoxicillin at 90 mg/kg/day and out patient followup pneumatic stirrup leg brace might be used to tx what? - ✔✔Stress fracture from running In a patient recieving synthroid, below normal TSH means what? - ✔✔Over replacement of thyroid hormone. Need to decrease dosage OCPs decrease the risk of what cancer by 50% - ✔✔Ovarian NOT cervical or breast How can you treat pain and stiffness in shoulder and pelvic girdle that may be accompanied with fever and normal ESR and is occasionally seen with temporal arteritis? - ✔✔Steroids Expect response within 48-72 hrs This is polymyalgia rheumatica btw Refeeding syndrome has characteristically what electrolyte abnormality? - ✔✔Hypophosphatemia Should RHOGAM be given for a woman with ectopic pregnancy who is Rh neg? - ✔✔Yes, due to risk of fetomaternal hemorrhage. Before 12 weeks gestation, 50 ug is given and afterwards, 300 ug is given Most sensitive method for determining is someone is at risk for a bleed during surgery - ✔✔Find out about bleeding history :) Contraindications to the use of electrosurgery? - ✔✔Pacemaker use and Melanoma skin lesions (should not be excised with electrosugery) Which seizure drug can lead to secondary osteoporosis? - ✔✔Phenytoin Is hyper or hypo thyroidism a risk factor for OA of hip? - ✔✔Hypothyroid What else do you want to give to a pt started on prednisone for >3 months at a dosage of >5mg per day - ✔✔Bisphosphonate along with Ca and Vit D A 19-year-old white male with a history of fever, fatigue, weight loss, and mild diarrhea of 2 months' duration is found to have a palpable mass in the right lower quadrant of the abdomen. The most likely diagnosis is - ✔✔Crohn's disease Maximum daily dosage for all acetaminophen preparations - ✔✔4,000 mg Risk of sudden cardiac death may be prevented with what anti-inflammatory, anti platelet aggregation and anti-arrhythmic substance? - ✔✔Omega 3 fatty acid The sequence of meds in managing SVT includes - ✔✔Carotid massage -> adenosine -> IV verapamil or beta blocker -> flecainide or propafenone Monotherapy for HTN in AAs is more likely to consist of - ✔✔Diuretics or CCBs HTN in African americans is less likely to be Angiotensin II dependant Subclinical thyroid disease has what associations - ✔✔Hyper (TSH < 0.1) = atrial fib, bone density drops, cardiac dysfunction Hypo (TSH >10) = increased LDL How does Lithium affect PTH? - ✔✔Can cause increased PTH secretion and jack up Calcium levels. Brown to black spotting of colonic mucosa may be what? - ✔✔Melanosis Coli 2/2 to absue of laxatives like cascarea, senna, aloe You find a clot in femoral vein of an old man. In addition to LMWH, how long do you give coumadin - ✔✔3 months Pain relief for osteoporotic vertebral compression fracture can include what hormone? - ✔✔Calcitonin Recombinant activated protein C is shown to improve survival in what patients? - ✔✔Septic shock Which treatment option for childhood nocturnal enuresis has highest cure rate and lowest relapse rate? - ✔✔Bed wetting alarm Aspirin in people with no cardiac risk does more harm than good including increased bleeding and risk. Who might it benefit however? - ✔✔Decreased MI in men and decreased ischemic stroke in women Frequency of colonoscopy includes - ✔✔Every 10 years if healthy Every 5 years if family hx Every 3 years if polyps are found A less toxic option than Lindane for tx of head lice in 8 year old child - ✔✔Malathion What NSAID is not recommended in older pts due to adverse effects on CNS? - ✔✔Indomethacin Emergent management of WPW can be done with what drug? - ✔✔Procainamide Antibiotics to deal with community acquired pneumonia in 82 year old who is admitted - ✔✔Ceftazidime, Levofloxacin and vanco Unlike bulimia which responds to anti-depressants, anorexia nervosa best responds to - ✔✔Family based treatment First and second line therapies for pertussis - ✔✔(1) Macrolides (2)TMP-SMX What fetal measurement on US is most reliable estimate of gestational age up to 14 weeks? - ✔✔Crown-Rump length Pathological dryness of skin in elderly preseting as itchy rash and red, scaly plaques is what - ✔✔Xerosis How would you minimize pain from infiltration of local anesthetic - ✔✔The pain from infiltration of local anesthetics can be decreased by using a warm solution, using small needles, and performing the infiltration slowly.It is also helpful to add sodium bicarbonate to neutralize the anesthetic since they are shipped at an acidic pH to prolong shelf life. Middle aged hairdresser presents with a complaint of soreness of the proximal nail folds of several fingers on either hand, - ✔✔Chronic paronychia Topical betamethasone dipropionate Randomized, controlled trials found that luteal-phase spironolactone improved ___________________ - ✔✔psychological and physical symptoms of premenstrual syndrome What is the diagnostic test for vit D deficiency? - ✔✔25 hydroxy and NOT the 1, 25 hydroxy How would you manage gestational diabetes? - ✔✔Human insulin ideally. Oral agents all cross the placenta Which groups might you exclude from giving ASA - ✔✔Those below 45 age and those above 80 For those in between, avoid in individuals with risk of GI hemorrhage Which asthma drug can't you use as monotherapy - ✔✔LABA What drug could you use for prophylaxis of mountain sickness in someone allergic to sulfa drugs? - ✔✔Dexamethasone Horse chestnut seed extract has been shown to have some effect when used orally for.... - ✔✔Varicose veins In patients with pes anserine bursitis, tenderness is most likely to be noted: - ✔✔along the medial proximal tibia (where the bursa is located) Bronchiolitis therapy in kids includes - ✔✔Trial of inhaled bronchiodilator and continue if helpful Don't use antibiotics unless other infections (like otitis media) are present 75 year old man without aortic valve gradient exceeding 50 and valley area less than 1 cm square. What's the next step? - ✔✔Valve replacement Preferred test is 66 year old male with hypertension and the elevated BUN level- two evaluate renal vascular hypertension - ✔✔Duplex Doppler ultrasound Medications to decrease nausea and vomiting associated with pregnancy - ✔✔Vitamin B6 and doxylamine What drug is most valuable in treatment of social phobia with speech issues - ✔✔Beta-blocker - propranolol In an eighty year old female with the atrial fibrillation, what is the initial dose of warfarin - ✔✔Less than 5 mg Treatment of most medication poisonings requires administration of what within 1 hour - ✔✔activated charcoal What drug has been useful in slowing progression of rheumatoid arthritis? - ✔✔Hydroxychloroquine Is nicotine replacement therapy useful? - ✔✔Yes, doubles the chance of quitting The biggest risk for death after bariatric surgery is due to - ✔✔Pulmonary embolism T or F Postoperative depression increases the risk for subsequent cardiovascular events - ✔✔true An important characterisitic of noise induced hearing loss is - ✔✔it is accompanied with tininuts Radiographs should be obtained for all patients with an acute ankle injury who meet any of the following criteria: - ✔✔inability to take four steps, either immediately after the injury or when being evaluated; localized tenderness of the navicular bone or the base of the fifth metatarsal; or localized tenderness at the posterior edge or tip of either malleolus. In addition to propranolol, what else is found to be useful in essential tremor tx - ✔✔Topiramate What drug is most effective in alcohol dependance tx? - ✔✔Naltrexone` CHADS2 score - ✔✔history of congestive heart failure (C), hypertension (H), age≥75 (A), and diabetes mellitus (D). Two points are assigned for a previous stroke or TIA (S2 ) Gradually worsening anterolateral hip joint pain that is sharply accentuated when pivoting laterally on the affected hip or moving from a seated to a standing position is consistent with femoroacetabular impingement. How do you test? - ✔✔Reproduction of the pain on range-of-motion examination by manipulating the hip into a position of flexion, adduction, and internal rotation (FADIR test) is the most sensitive physical finding. Guy with COPD has COPD exacerbations on proventil and tiotropium. What can you give him next? - ✔✔Steroid inhaler What treatment is supported by evidence for tx of acute sinusitis. - ✔✔Oral analgesics Antiobiotics though given, are not needed most of time as up to 98% of cases resolve spontaneously. What antibiotic is preferred for tx of community acquired pneumonia if patient recieved other Abx therpy within last 3 months? - ✔✔Levofloxacin Causes for fetal tachy (>160 for 15 mins) include, - ✔✔maternal fever, fetal hypoxia, hyperthyroidism, maternal or fetal anemia, medication effects of parasympatholytic or sympathomimetic drugs, chorioamnionitis, fetal tachyarrhythmia, and prematurity In what condition is bone age delayed compared to height or chronological age> - ✔✔Hypothyroidism Indications for parathyroid surgery include - ✔✔kidney stones, age less than 50, a serum calcium level greater than 1 mg/dL above the upper limit of normal, and reduced bone density Best initial therapy for atrial fib - ✔✔Calcium channel blocker or beta blocker to control ventricular rate + warfarin Initial tx of choice for severe HTN during pregnancy - ✔✔IV hydralazine, labetalol or nifedipine