Term
| What percent of women who have abortions had used a contraceptive the month they became pregnant? |
|
Definition
| 1) 54%; 76% on pill and 49% on condom were using inconsistently |
|
|
Term
What is trisomy 21 effect on maternal levels of
hCG
estriol (unconj)
inhibin A
aFP |
|
Definition
1) high
2) low
3) high
4) low |
|
|
Term
| What ist he most likely cause of bronchitis in the fall? winter? |
|
Definition
1) parainfluenza, enterovirus, rhinovirus
2) influenza, RSV, coronavirus |
|
|
Term
| What are the effects of TCA overdose? |
|
Definition
- respiratory depression
- cardiac arrhythmias (QTc prolongation is highly suggestive of TCA OD)
- hypothermia
- seizures
- hallucinations
- hypertension |
|
|
Term
| Which SSRIs are most commonly associated with drug-drug interactions |
|
Definition
- fluoxetine; paroxetine
- cause inhibition of P450 system |
|
|
Term
What are hte major s/e of the following drug class:
bile acid sequestrants |
|
Definition
- GI distress
- constipation
- decreased absorption of other drugs |
|
|
Term
What is the effect of the following drug class on the LDL/HDL/TG levels:
bile acid sequestrants |
|
Definition
1) dec
2) inc
3) no change/inc |
|
|
Term
What is the effect of the following drug class on the LDL/HDL/TG levels:
fibric acids |
|
Definition
1) dec (inc w/ high TG)
2) inc
3) dec |
|
|
Term
What is the drug class and typical starting dose for the following type of drug:
cholestyramine
colestipol |
|
Definition
bile acid sequestrants
1) 4-16g qd
2) 5-20g qd |
|
|
Term
What are absolute contraindications in pts for use of the following drug class:
bile acid sequestrants |
|
Definition
- dysbeta-lipoproteinemia
- TG 400+ |
|
|
Term
What are absolute contraindications in pts for use of the following drug class:
fibric acids |
|
Definition
- severe renal disease
- severe hepatic disease |
|
|
Term
| Describe tx of elevated TG (150+) |
|
Definition
- reach LDL goal
- intensify weight management
- increase physical activity
- if TG200+ after LDL goal reached, set secondary goal for non-HDL cholesterol to 30mg/dL higher than LDL goal |
|
|
Term
| Describe treatment of low HDL cholesterol |
|
Definition
- first reach LDL
- intensify weight management and inc physical activity
- TG 200-500, achieve non-HDL goal
- TG0-200, consider nicotinic acid/fibrate |
|
|
Term
What is the effect of the following on colon cancer risk:
obesity
fat intake
red meat
fiber
NSAIDS
Calcium
Vitamin D
antioxidants
statins |
|
Definition
1) inc RR w/ inc BMI
2) inc RR w/ inc fat intake
3) conflicting evidence
4) failed to show benefit**
5) dec RR w/ use; balance w/ s/e profile
6) modest reduction
7) dec RR; NOT chemoprevention
8) no benefit**
9) dec RR after 5yrs; need randomized trial |
|
|
Term
| What are the micro-vascular complications of DM and the appropriate therapy for these in the PCP setting? |
|
Definition
1) retinopathy - annual visit w/ ophthalmologist
2) nephropathy - annual screen for microalbuminuria, ACEi for HTN, Cr follow for microalbuminuria
3) neuropathy - pt education, inspection, podiatry PRN |
|
|
Term
| What are the MACRO-vascular complications and the appropriate treatment for pt's w/ DM in PCP setting? |
|
Definition
1) hypertension - BP less than 130/80
2) Lipids - LDL=0-100mg/dL or if TG inc; non-HDL cholesterol = 0-130mg/dL
3) CAD/CVA prevention: omega3, vitamin D, ASA (w/ RFs), dec stress, nutrition, QUIT SMOKING |
|
|
Term
| What are causes of secondary HTN |
|
Definition
- pheochromocytoma
- RAS (bilateral)
- renal parenchymal dz
- polycystic kidneys
- OSA
- hyperthyroidism
- hyperparathyroidism
- primary aldosteronism
- cushing syndrome
- aortic coarctation |
|
|
Term
| What are the major complications from HTN |
|
Definition
- CVA
- CAD
- CHF/Cardiomyopathy
- PVD
- kidney disease
- retinopathy |
|
|
Term
What are the major benefits/uses of the following drug:
Beta-blocker |
|
Definition
- CAD/post-MI/angina
- CHF
- tachy-arrhythmias
- Performance anxiety
- H/a prophylaxis
- glaucoma |
|
|
Term
What are the major benefits/uses of the following drug:
CCB |
|
Definition
- CHF (diastolic)
- tachy-arrhythmias
- angina
- h/a prophylaxis
- raynauds |
|
|
Term
What are the major benefits/uses of the following drug:
diuretics |
|
Definition
- osteoporosis
- kidney stones
- peripheral edema
- synergistic w/ other meds
- cheap |
|
|
Term
What are the major cons/contraindications of the following drug:
ACEi |
|
Definition
- inc BUN/Cr
- RAS
- dry cough
- angioedema
- hyperkalemia
- less effective in AA |
|
|
Term
What are the major cons/contraindications of the following drug:
BB |
|
Definition
- asthma/COPD
- depression/fatigue/decreased stamina
- sexual dysfunction
- w/d
- heart block
- less effective in AAs |
|
|
Term
What are the major cons/contraindications of the following drug:
CCB |
|
Definition
- systolic CHF
- leg edema
- constipation
- deadache
- GERD |
|
|
Term
| What are hte prenatal labs recommended for some patients |
|
Definition
- Hb electrophoresis
- CF screening
- TSH
- hep C screen
- HCG quantitative
- PPD
- genetic carrier testing |
|
|
Term
| What are the standard and special prenatal tests for third trimester pts |
|
Definition
1) GBStrep screen
2) HIV/STI; U/S w BPP; repeat CBC |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
paragard (Cu IUD) |
|
Definition
1) 99%
2) 12yrs; return to fertility quickly
3) cramps and heavy periods |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Mirena (progestin IUD) |
|
Definition
1) 99%
2) 7yrs; improved cramps and bleeding; fertility returns quickly on d/c
3) no period at all |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Implanon |
|
Definition
1) 99+%
2) 3yrs; return to fertility quickly
3) irregular bleeding; no period |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
The Pill |
|
Definition
1) 92-99%
2) improve acne/PMS sx/regularity; fast return to fertility
3) nausea, weight gain, h/a |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Nuvaring |
|
Definition
1) 92-99%
2) no "fitting" required
3) increase vag d/c |
|
|
Term
| What are the major adverse effects of HRT |
|
Definition
- vaginal bleeding
- breast tenderness
- bloating (NOT weight gain)
- headache
- need to increase synthroid tx |
|
|
Term
| What are the major risks associated with HRT |
|
Definition
- thromboembolic events
- risk of stroke
- breast CA (nl after 5yrs d/c
- ovarian CA
- gallbladder disease (stones) |
|
|
Term
| What are risk factors for premature final menstrual periods |
|
Definition
- smoking
- low SES
- age of menarche
- parity
- previous OCP
- BMI
- ethnic origin
- FHx |
|
|
Term
| By what factor does BP decrease during the night? |
|
Definition
- 10-20%
- will not decrease in pts at increased risk for cardiovascular events |
|
|
Term
| If a pt comes in reporting that self-measured BP mean of greater than what number is indicative of hypertension? |
|
Definition
|
|
Term
| What should the physical examination of a pt w/ hypertension include? |
|
Definition
- appropriate measurement of BP w/ verification in contralateral arm
- examin optic fundi
- BMI calculation
- auscultation of bruits
- palpation of thyroid
- heart and lung exam
- abd exam
- palpation of lE edema and pulses
- neuro assessment |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
chlorthalidone
hydrochlorothiazide |
|
Definition
thiazide
1) 12.5-25 qd
2) 12.5-50 qd |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
furosemide (lasix) |
|
Definition
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
amiloride (midamor) |
|
Definition
potassium-sparring diuretics
1) 5-10mg/d; qd/BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
spironolactone (aldactone) |
|
Definition
aldosterone-receptor blockers
1) 25-50mg/d; qd/BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
atenolol
metoprolol (lopressor) |
|
Definition
beta-blockers
1) 25-100mg/d; qd
2) 50-100mg/d; qd/bid |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
acebutolol (sectral) |
|
Definition
BB w/ ISA
1) 200-800mg/d; BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
labetalol |
|
Definition
combined alpha and beta blockers
1) 200-800mg/d; BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
captopril
lisinopril |
|
Definition
ACEi
1) 25-100mg/d; BID
2) 10-40mg/d; qd |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
losartan |
|
Definition
- antiotensin II antagonists
1) 25-100mg/d; qd/BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
diltiazem ER
verapamil SR |
|
Definition
CCB-nondihydropyridine
1) 180-420mg/d; qd
2) 120-360mg/d; qd/BID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
amlodipine |
|
Definition
- CCB- dihydropyridine
1) 2.5-10mg/d; qd |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
prazosin |
|
Definition
alpha-1 antagonist
1) 2-20mg/d; BID/TID |
|
|
Term
What is the class and usual dose (mg/d) and frequency of the following drug:
hydralazine |
|
Definition
- direct vasodilator
- 25-100mg/d; BID |
|
|
Term
| What are the potential unfavorable s/e of HTN tx? |
|
Definition
1) gout, hyponatremia (thiazide)
2) asthma, RAD, 3deg heart block (BB)
3) teratogenic (ACEi/ARB)
4) angioedema (ACEi)
5) hyperkalemia (Aldosterone antagonist, K-sparring) |
|
|
Term
| What ar ethe major causes of resistant hypertension |
|
Definition
- improper BP measurement
- volume overload/pseudotolerance (excessive Na, volume retention, inadequate therapy)
- nonadherence
- inadequate dosease
- COX-2i
- illicit drugs
- OCP
- EPO
- icorice
- obesity
- excess alcohol intake
- causes of HTN |
|
|
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?
nicotine gum |
|
Definition
1) 2mg (0-24cig/d); 4mg (25+cigs/day); 1piece q1hr; up to 12weeks
2) mouth soreness, stomach ache
3) no food/drink 15minutes prior/during use |
|
|
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?
nicotine lozenge |
|
Definition
1) 2mg (30+min after waking first cig); 4mg (0-30min after waking); 1lozenge q1hr w/ taper; 3-6mo total
2) hiccups, cough, heartburn
3) no food/drink 15minutes before or during use |
|
|
Term
| Describe the use of Sibutramine in weight loss |
|
Definition
- acts centrallky to inhibit serotonin and norepinephrine reuptake and increase satiety
- may inc BP
- 6-8kg lost |
|
|
Term
What is the net dietary change promoted by the following fad diet:
aktins
ornish
south beach
the zone |
|
Definition
1) low carbs, high protein, high fat
2) low fat, high fiber
3) moderate carb; moderate fat
4) low carb, high protein, moderate fat |
|
|
Term
What is the basic regime promoted by the following diet:
the zone |
|
Definition
1) carbohydrate intake of 40% stabilizes insulin le3vels and avoids weight gain
- protein intake of 30% is necessary for correct insulin/glucagons ratio for optimum weight loss
- fat intake of 30% for satiety |
|
|
Term
| What are the flags for cancer in low back pain? |
|
Definition
- age 50+
- hx of cancer
- unexplained weight loss**
- failure to improve (1+mo sx) |
|
|
Term
What is the affected root, reflex, muscles,and sensation of the following disc herniation:
L3-L4 |
|
Definition
1) L4
2) patellar
3) anterior tibialis
4) medial leg and medial foot |
|
|
Term
What is the affected root, reflex, muscles,and sensation of the following disc herniation:
L4-L5 |
|
Definition
1) L5
2) --
3) extensor hallicus longus
4) lateral leg and dorsum of foot |
|
|
Term
| What are the red flags for assessment of lower back pain |
|
Definition
- abd pain
- recent trauma
- pain unrelieved by rest
- saddle anesthesia
- acute urinary/fecal incontinence
- age greater than 50
- h/o cancer
- fever
- other infectious sx
- rheumatologic sx
*checks for Ca, infection, AAA, cauda equina, fracture* |
|
|
Term
| What are the components of the social history that are particularly important for children? |
|
Definition
1) living situation
2) diet
- physical activity
- DAILY SCREEN TIME
- hrs of sleep
- dental care
- helmets/seat belts |
|
|
Term
What is the recommendation for the following at HM visits for children:
counseling to prevent STD
Chlamydia screening
Gonorrhea Screening |
|
Definition
1) pts who are sexually active or 11+y/o
2) females younger than 25y/o sexually active
3) female sexually active and high risk |
|
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