AAFP Family Med Shelf Review| 403
QUESTIONS| WITH COMPLETE SOLUTIONS
______ is a metabolite of codeine that can be found in urine of someone taking a codeine-
containing medication Correct Answer: morphine
Initial management of hypercalcemia of malignancy Correct Answer: fluid replacement with NS
Symptomatic uterine fibroid treatment for woman who wants to get pregnant Correct Answer:
myomectomy
Benign condition resulting from abuse of anthraquinone laxatives (cascara, senna, or aloe) -->
leopard spotting of colonic mucosa Correct Answer: melanosis coli
HCM becomes louder during this maneuver, due to decreased venous return to heart -->
decreasing cardiac output Correct Answer: Valvalsa
Limping and pain w/ limited rotation in overweight boys Correct Answer: slipped capital
femoral epiphysis
Percutaneous endoscopic gastronomy (PEG) tubes associated w/ Correct Answer: increased use
of restraints
Best for diagnosis of COPD Correct Answer: spirometry
Pain with eye movement Correct Answer: orbital condition
Drugs causing drug-induced lupus pleuritis Correct Answer: -Hydralazine
-Procainamide
-Quinidine
Treatment of choice for Wolff-Parkinson White syndrome Correct Answer: Procainamide
Why Metformin should be stopped temporarily before CT angiograms Correct Answer:
temporary reduction in renal function (like during pyelography or angiography) can cause lactic
acidosis in pts on metformin
______ except for Paroxetine are most safe during pregnancy, compared to other psychiatric
medications Correct Answer: SSRIs (like Fluoxetine)
Children under age of 2 with paroxysms of colicky abdominal pain, with a palpable mass in 2/3s
of patients Correct Answer: Intussusception
Indicated for tx of severe osteoporosis, for pts w/ multiple osteoporosis risk factors, or with
failure of bisphosphonate therapy Correct Answer: teriparatide
,ASA rec guidelines Correct Answer: men 45-79 w/ risk reduction
women 55-79 w/ risk reduction
insufficient evidence beyond 80+
Medication that should never be used as monotherapy in asthma Correct Answer: long-acting
B2 agonists
Preliminary testing for IBD Correct Answer: -CBC
-Chem panel
-ESR
Primary treatment for symptomatic mitral valve prolapse Correct Answer: beta blockers
Prophylactic tx for altitude sickness with no contra-indication for those w/ sulfa allergy Correct
Answer: dexamethasone
Most common drug-related cause of interstitial nephritis Correct Answer: antibiotics
Describe scromboid poisoning Correct Answer: Rxn from improperly stored fish (tuna,
mackerel, wahoo, and bonito)
Next step in management for woman > 35 yo with abnormal vaginal bleeding Correct Answer:
endometrial assessment to exclude endometrial hyperplasia or cancer
Adding what to SSRI for tx resistant depression Correct Answer: lithium of low dose T3
Test for proteinuria on dipstick w/ no obvious underlying problem Correct Answer: urine
protein/creatinine ratio
Initial treatment of choice for cervical radiculopathy Correct Answer: NSAIDs
Travel hx, prodrome of delirium/erratic behavior, unarousable coma, generalized convulsion,
fever, lack of focal neurologic signs, symmetric encephalopathy Correct Answer: malaria
Interference with skilled movements, usually from stroke Correct Answer: apraxia
Tx for cutaneous erythrasma Correct Answer: erythromycin
Tx for chronic paronychia Correct Answer: topical corticosteroid and avoidance of contact
irritants/hands in water
Inadequate hip abductor and core strength in adolescent females Correct Answer: patellofemoral
pain
, Associated with vacuum-assisted delivery Correct Answer: higher rates of neonatal
cephalhematoma and retinal hemorrhage compared to forceps; increased incidence of shoulder
dystocia
Best initial imaging study for acute pelvic pain in women Correct Answer: transvaginal
ultrasound
Supplement to take orally when hx of calcium oxalate stones Correct Answer: potassium citrate
(increases urinary pH and urinary citrate)
Standard 1st line imaging for stress fractures Correct Answer: plain radiograph
Ethylene glycol poisoning antidote Correct Answer: Fomepizole (Antizol)
Tx for preventing stent thrombosis Correct Answer: ASA 162-365 mg/day, plus clopidogrel,
12mo
First line tx for urge urinary incontinence Correct Answer: behavioral therapy and
anticholinergics
Daily recommended intake of Vitamin D for infants, children & adolescents Correct Answer:
400 IU/day
Broadest range of efficacy for PTSD Correct Answer: SSRIs
Increases success of voiding trial at time of insertion of urethral catheter Correct Answer: alpha
blocker (tamsulosin)
Comatose, decreased breathing, slow pulse, miotic pupils Correct Answer: narcotic overdose
Beefy red rash on child perineum Correct Answer: Group A Strep
Tx for <15% pneumothorax Correct Answer: Observation, f/u radiograph in 24-48 hours
Foods with cross-reactivity with latex allergy Correct Answer: avocados, bananas, chestnuts,
kiwi
Cardiac arrhythmia associated w/ high-dose methadone Correct Answer: torsades de pointes
Best choice for initial tx of RA Correct Answer: MTX
Tx adjunct with TMP-SMX for Pneumocystis pnuemonia Correct Answer: corticosteroids
TDZs (pioglitazone) contraindicated in this population Correct Answer: heart failure patients
Bilateral nipple pain and soreness between feedings Correct Answer: Candida infxn
QUESTIONS| WITH COMPLETE SOLUTIONS
______ is a metabolite of codeine that can be found in urine of someone taking a codeine-
containing medication Correct Answer: morphine
Initial management of hypercalcemia of malignancy Correct Answer: fluid replacement with NS
Symptomatic uterine fibroid treatment for woman who wants to get pregnant Correct Answer:
myomectomy
Benign condition resulting from abuse of anthraquinone laxatives (cascara, senna, or aloe) -->
leopard spotting of colonic mucosa Correct Answer: melanosis coli
HCM becomes louder during this maneuver, due to decreased venous return to heart -->
decreasing cardiac output Correct Answer: Valvalsa
Limping and pain w/ limited rotation in overweight boys Correct Answer: slipped capital
femoral epiphysis
Percutaneous endoscopic gastronomy (PEG) tubes associated w/ Correct Answer: increased use
of restraints
Best for diagnosis of COPD Correct Answer: spirometry
Pain with eye movement Correct Answer: orbital condition
Drugs causing drug-induced lupus pleuritis Correct Answer: -Hydralazine
-Procainamide
-Quinidine
Treatment of choice for Wolff-Parkinson White syndrome Correct Answer: Procainamide
Why Metformin should be stopped temporarily before CT angiograms Correct Answer:
temporary reduction in renal function (like during pyelography or angiography) can cause lactic
acidosis in pts on metformin
______ except for Paroxetine are most safe during pregnancy, compared to other psychiatric
medications Correct Answer: SSRIs (like Fluoxetine)
Children under age of 2 with paroxysms of colicky abdominal pain, with a palpable mass in 2/3s
of patients Correct Answer: Intussusception
Indicated for tx of severe osteoporosis, for pts w/ multiple osteoporosis risk factors, or with
failure of bisphosphonate therapy Correct Answer: teriparatide
,ASA rec guidelines Correct Answer: men 45-79 w/ risk reduction
women 55-79 w/ risk reduction
insufficient evidence beyond 80+
Medication that should never be used as monotherapy in asthma Correct Answer: long-acting
B2 agonists
Preliminary testing for IBD Correct Answer: -CBC
-Chem panel
-ESR
Primary treatment for symptomatic mitral valve prolapse Correct Answer: beta blockers
Prophylactic tx for altitude sickness with no contra-indication for those w/ sulfa allergy Correct
Answer: dexamethasone
Most common drug-related cause of interstitial nephritis Correct Answer: antibiotics
Describe scromboid poisoning Correct Answer: Rxn from improperly stored fish (tuna,
mackerel, wahoo, and bonito)
Next step in management for woman > 35 yo with abnormal vaginal bleeding Correct Answer:
endometrial assessment to exclude endometrial hyperplasia or cancer
Adding what to SSRI for tx resistant depression Correct Answer: lithium of low dose T3
Test for proteinuria on dipstick w/ no obvious underlying problem Correct Answer: urine
protein/creatinine ratio
Initial treatment of choice for cervical radiculopathy Correct Answer: NSAIDs
Travel hx, prodrome of delirium/erratic behavior, unarousable coma, generalized convulsion,
fever, lack of focal neurologic signs, symmetric encephalopathy Correct Answer: malaria
Interference with skilled movements, usually from stroke Correct Answer: apraxia
Tx for cutaneous erythrasma Correct Answer: erythromycin
Tx for chronic paronychia Correct Answer: topical corticosteroid and avoidance of contact
irritants/hands in water
Inadequate hip abductor and core strength in adolescent females Correct Answer: patellofemoral
pain
, Associated with vacuum-assisted delivery Correct Answer: higher rates of neonatal
cephalhematoma and retinal hemorrhage compared to forceps; increased incidence of shoulder
dystocia
Best initial imaging study for acute pelvic pain in women Correct Answer: transvaginal
ultrasound
Supplement to take orally when hx of calcium oxalate stones Correct Answer: potassium citrate
(increases urinary pH and urinary citrate)
Standard 1st line imaging for stress fractures Correct Answer: plain radiograph
Ethylene glycol poisoning antidote Correct Answer: Fomepizole (Antizol)
Tx for preventing stent thrombosis Correct Answer: ASA 162-365 mg/day, plus clopidogrel,
12mo
First line tx for urge urinary incontinence Correct Answer: behavioral therapy and
anticholinergics
Daily recommended intake of Vitamin D for infants, children & adolescents Correct Answer:
400 IU/day
Broadest range of efficacy for PTSD Correct Answer: SSRIs
Increases success of voiding trial at time of insertion of urethral catheter Correct Answer: alpha
blocker (tamsulosin)
Comatose, decreased breathing, slow pulse, miotic pupils Correct Answer: narcotic overdose
Beefy red rash on child perineum Correct Answer: Group A Strep
Tx for <15% pneumothorax Correct Answer: Observation, f/u radiograph in 24-48 hours
Foods with cross-reactivity with latex allergy Correct Answer: avocados, bananas, chestnuts,
kiwi
Cardiac arrhythmia associated w/ high-dose methadone Correct Answer: torsades de pointes
Best choice for initial tx of RA Correct Answer: MTX
Tx adjunct with TMP-SMX for Pneumocystis pnuemonia Correct Answer: corticosteroids
TDZs (pioglitazone) contraindicated in this population Correct Answer: heart failure patients
Bilateral nipple pain and soreness between feedings Correct Answer: Candida infxn
