Dr. High Yield

Rule for screening age when there’s a family history?

-screen the person 10 years before the age of the person that was diagnosed

When can you give a female, who’s at increased risk of breast cancer, meds?

-if they’re 35 or older

Zoster vaccine age?

-60 years old

HPV vaccine age range?

-9-26 years old

Main metric for prognosis of COPD?

-FEV1

COPD treatment based on FEV1

Negative birefringence crystals?

Positive birefringence crystals?

-gout

-pseudogout

1st thing you do with a hot and swollen joint?

-aspirate it

What crystal types are seen in pseudogout?

-calcium pyrophosphate that are rhomboid shaped

First-line gout treatment?

When do you not use these? What do you use instead?

Chronic treatment depends on what? Elaborate?

-NSAIDs(indomethacin or colchicine)

-in cases of CKD; steroid injections

-uric acid levels; high levels indicate use of allopurinol, low levels indicate use of probenecid

Diagnostic test for septic arthritis?

What are you looking for?

Treatment?

-arthrocentesis

-WBCs over 50k

-IV antibiotics

What is given 4 hours before delivery of a child? When?

-prophylactic penicillin; if there’s a positive group B strep test

When is TDAP vaccine given?

-27-36 weeks

Milestones

Exclusively breastfeed until when?

-6 months, then solids

First flu shot when?

-6 months

The first live vaccine an infant gets is?

When?

-MMR

-at 1 year old

When do dentist appointments/toothbrushing start?

-1 year old

First line treatment for runny nose due to allergies?

Side effect? Why?

-intranasal steroids

-epistaxis; causes mucosal atrophy

Most common cause of folate deficiency?

-alcohol abuse

What hemoglobin level needs a transfusion?

-below 7

Diagnostic test for chronic diarrhea?

-stool ova and parasite test

Gastroenteritis/inflammatory diarrhea rehydration method?

-IV fluids if hypertensive; oral fluids if normo-tensive

Common culprits of gastroenteritis/inflammatory diarrhea?

Why would you not wanna use an anti-diarrheal?

-shigella, Yersinia, salmonella, and campylobacter

-anti-diarrheals like loperamide trap the bacteria

If a patient has EHEC diarrhea and you give antibiotics, it can cause HUS. What does the patient need now?

-dialysis

Common causes of viral watery diarrhea?

-rotavirus or norovirus

DEXA scan T-scores?

Treatment?

-between -1 and -2.5 mean osteopenia, less than -2.5 mean osteoporosis

-bisphosphonates

Ankle injury

A lot of blood on dipstick but no red blood cells?

What is the “blood”?

-rhabdomyelosis

-myoglobin

Main side effect of hyperthyroid meds?

-agranulocytosis

What does a woman being pregnant have to do with her hypothyroid meds?

What can come of the child if the mom is hypothyroid?

-you need to increase dose due to the high levels of estrogen causing TBG to increase

-cretinism

Normal fetal HR?

-110-160

A sinusoidal pattern on fetal heart indicates what?

-anemia

Complete heart block on fetal heart indicates what?

-maternal lupus

Are accelerations in the fetal HR good?

Rule? Rules out?

-yes!

-increase of 15 bpm for 15 seconds, twice in 20 minutes; hypoxia

If the baby has a biophysical profile score of less than 4, then you __

-deliver now

Treatment for hypercalcemia?

-IV fluids

Hypokalemia treatment?

Hyperkalemia treatment?

-potassium

-calcium gluconate, then insulin

Otitis media treatment?

-amoxi

Most common cause of otitis externa?

-Pseudomonas

Decreased mortality meds for MIs?

-aspirin, beta blockers, and ACE Is

Most common cause of death in CKD?

This is also true for __

-cardiovascular causes

-RA

Women with DM associated with what infection type?

Treatment?

-candidiasis

-azoles

Patient has STABLE hematochezia?

Patient has UNSTABLE hematochezia?

-colonoscopy

-IV fluids followed by EGD

Diverticulitis imaging?

Treatment?

-CT

-fluoroquinolones and metro

If a patient has anemia, they need a __ to rule out cancer

-colonoscopy

Inpatient treatment for pneumonia?

Outpatient treatment?

-fluoroquinolones(to cover pseudomonas)

-amoxi(unless it’s atypical, then a macrolide)

CURB-65 criteria for admitting a pneumonia patient?

How long can a woman that just gave birth expect to vaginally bleed?

-up to 1 month

2 main contra-indications to breastfeeding?

-HIV positive or chemotherapy

Treatment for mastitis?

-dicloxacillin

Patient has a breast abscess that shows fluctuance on palpation?

-I&D and antibiotics or FNA

Diagnostic test for CHF?

-echo

Treatment for acute CHF exacerbation?

Regular treatment, based on classification?

-furosemide

Contra-indications to OCPs?

-migraines with aura, smokers over 35

What cancer-related benefit do OCPs have?

-protect against ovarian and endometrial cancers

Most effective form of contraception?

When is it contraindicated?

-copper IUD

-menorrhagia

Why are ACE Is not recommended for African Americans with HTN?

-they’re more prone to angioedema

First line for proteinuria from HTN?

-ACE Is

Patient has abdominal pain with current jellyfish stools and colicky pain?

Diagnostic imaging?

Treatment?

What vaccine can cause this?

-intussusception

-X-ray to rule out perforation

-air enema

-rotavirus

Double bubble or corkscrew sign seen on X-ray?

What also shows a double bubble sign?

What has a triple bubble sign? What is known to cause this?

-midgut volvulus

-duodenal atresia

-jejunal volvulus; mother used cocaine

Patient had recent endoscopic procedure, and now has pneumomediastinum and crepitus on palpation of the skin?

Diagnostic test?

-Boerhaave’s

-gastrografin swallow

If lifestyle modifications fail for weight loss, what meds do patients try?

What if the patient has PCOS?

When is bariatric surgery recommended? Complications?

Treatment for dumping syndrome?

-orlistat

-metformin

-patient has BMI over 40, or over 35 with comorbidities; stomal stenosis and/or dumping syndrome

-eating small, high-protein meals

Migraine prophylaxis?

-beta blockers or TCAs

Best drug to increase HDL?

Best to decrease triglycerides?

-niacin

-fibrates

Test for assessing ankylosing spondylitis?

Next?

-FABER test

-lumbar/sacral X-ray

Aspiration pneumonia treatment, that covers anaerobes above the diaphragm?

Best for anaerobes below the diaphragm?

-clindamycin

-metro

DVT care

RSV treatment?

-supportive

Croup is caused by?

Treatment?

What can it progress to? What happens now?

-parainfluenza virus

-epi of steroids

-bacterial tracheitis; intubate

2 types of IBS?

Constipation-type treatment?

Diarrhea-type treatment?

-constipation and diarrhea

-increase fiber in diet

-loperamide

What is avoided in cocaine overdoses?

Treatment instead?

-beta blockers

-benzos

Alcohol cessation meds?

-acamprosate or naltrexone

Sign of VT on EKG?

Treatment?

-wide QRS

-amiodarone

Besides amoxi-clav, what should someone receive if bitten by a human?

-Hep B and HIV prophylaxis

First scan for stroke?

Diagnostic imaging?

Ischemic stroke treatment?

Hemorrhagic stroke treatment?

-head CT w/o contrast

-echo, EKG, or carotid doppler

-TPA within 4.5 hours

-maintain BP, and CCBs

Patient with HIV/AIDS has CD4 less than 200?

Less than 50?

-TMP-SMX(against pneumonia)

-azithro(against MAC)

Painless jaundice can be a sign of?

-pancreatic cancer

Chronic PPI use is linked to __

-Clostridium difficile infection and osteoporosis

If an infant less than 30 days old is suspected of meningitis or pneumonia, treatment is __

If it’s an adult, treatment is __

-ampicillin and gentamicin

-cef and vanco

Measles treatment?

-vitamin A

For breast masses in those less than 30?

Greater than 30?

-US

-mammography

Treatment for a breast cyst?

If the fluid is yellow?

If the fluid is bloody?

-aspirate and drain

-1 month follow-up

-send for cytology

Initial lab test for PCOS?

Diagnostic test? It shows?

-pregnancy test

-US; multiple cystic follicles

Metformin is contra-indicated in __

-CKD and CHF

Essential tremors improve with __

Treatment?

-rest

-propranolol

Treatment for Tourette’s?

Diagnosis requires what?

-clonidine/guanfacine or atypical antipsychotics

-vocal and motor tics for over a year

Asthma treatment regiment?

Diagnosis for sleep apnea?

Treatment for sleep apnea?

-sleep study

-CPAP

Untreated OSA can cause __

-right-sided heart failure

Greatest risk factor for osteoporosis?

For breast cancer?

For stroke?

-age

-age

-HTN

First line pain med for cancer and sickle cell patients?

-opioids

Medial malleolus ulcers?

-thick chronic venous insufficiency

Umbilical hernia in child under 5 years old?

-reassure

Colon cancer screening if a polyp is found and removed?

-follow-up in 3 years

Ménière’s disease tried?

Treatment?

-tinnitus, vertigo, and hearing loss

-diuretics