ABFM In training Exam pearls Latest Update
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
ANSWER Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated
hep B can lead to liver disease
entry to balloon time for PCI! - ANSWER 120 minutes
time limit from onset of MI to balloon time - ANSWER should get it done
w/in 12 hours
Absolute contraindications to Fibrinolysis - ANSWER Previous hemorrhage
stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
acute cholecystitis - ANSWER Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators
(PDE5?) - ANSWER NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - ANSWER Calcaneal apophysitis, also called Sever's disease,
is a common cause of heel pain in young athletes, especially those who participate
in basketball, soccer, track, and other sports that involve running. Typically the
heel apophysis closes by age 15. Treatment options include activity modification,
the use of ice packs and/or moist heat, stretching, analgesics, and orthotic devices.
The use of therapeutic ultrasound on the active bone growth plates in children is
contraindicated.
in pressure ulcers what solutions to avoid, and what to use! - ANSWER
,recommended that pressure ulcers not be cleaned with povidone/iodine, Dakin's
solution, hydrogen peroxide, wet-to-dry dressings, or any solutions that may
impede granulation tissue formation. These sites should be cleaned with either
saline or tap water and covered with hydrocolloid, foam, or another nonadherent
dressing that promotes a moist environment.
Chronic paraoxysmal hemicrania - ANSWER resembles cluster headache but
has some important differences. Like cluster headaches, these headaches are
unilateral and accompanied by conjunctival hyperemia and rhinorrhea. However,
these headaches are more frequent in women, and the paroxysms occur many
times each day. This type of headache falls into a group of headaches that have
been labeled indomethacin-responsive headaches because they respond
dramatically to *indomethacin.*
normal spirometry but low DLCO - ANSWER chronic pulmonary embolus
Antibiotic ppx for dental procedures - ANSWER give amoxicillin only if prior
endocarditis, prosthetic valve, heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - ANSWER Current guidelines
recommend referral to a nephrologist if a patient's renal disease is either of
unknown etiology, is deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2
per year), or is severe. Thresholds used to define severe chronic kidney disease
include an eGFR <30 mL/min/1.73 m2, a urine albumin to creatinine ratio >300
g/mg, persistent acidosis or potassium imbalance, non-iron deficiency anemia
with a hemoglobin level <10 g/dL, and evidence of secondary hyperparathyroidism.
Causes of peripheral neuropathy - ANSWER common treatable causes of
peripheral neuropathy, which include *diabetes mellitus, hypothyroidism, and
nutritional deficiencies*. Additional causes of peripheral neuropathy include
*chronic liver disease and renal disease*. It is important to consider medications
as a possible cause, including *amiodarone, digoxin, nitrofurantoin, and statins.
Excessive alcohol* use is another important consideration. In addition think
*MGUS, and Multiple Myeloma*
Failure rates of contraception - ANSWER The annual failure rate of
combined oral contraceptive pills with typical use is 9%. Typical failure rates for
other contraceptive methods are 0.2% for the levonorgestrel IUD, 6% for injectable
progestin, 18% for male condoms, and 22% for the withdrawal method.
, mental status exam for acute changes like delerium - ANSWER Confusion
Assessment Method (CAM)
to diagnose adult ADHD, symptoms must be present before what age? -
ANSWER Age 12
Complications of GERD in infants - ANSWER Gastroesophageal reflux
accounts for a significant number of cases of failure to thrive, crib death, and
recurrent pneumonia. Features of gastroesophageal reflux include a history of
recurrent pneumonia, a low growth curve, a family history of sudden infant death
syndrome, and normocytic anemia.
coining "sickness leaving body" - ANSWER it's a south asian thing, kids have
multiple red welts and superficial abrasions scattered on chest and upper back
thyroid replacement in the setting of gastritis - ANSWER need to increase by
30% because gastritis decreases absorption of thyroid. ex: h. pylori, treat h.pylori
to negate this effect
cubital tunnel syndrome - ANSWER irritation, compression, and
entrapment of the ulnar nerve
in ages 5-16, what is the most common agent that causes pneumonia - ANSWER
mycoplasma - treat with azithromycin
what halts the worsening of thyroid complications such as myxedema and
exophthalmos - ANSWER treating with methimazole
If MRSA bacteremia, when do you get repeat blood cultures? - ANSWER 2-4
days
community acquired pneumonia - ANSWER a type of pneumonia that
results from contagious infection outside of a hospital or clinic ie hotel stay or
cruise ship
Polymyalgia Rheumatica (PMR) - ANSWER a geriatric inflammatory disorder
of the muscles and joints characterized by pain and stiffness
hallmark of this condition is the rapid and often dramatic response, typically
within a few days, to low-dose corticosteroids. In fact, the lack of response to
low-dose prednisone in such a case should prompt the physician to consider
another diagnosis
Post exposure prophylaxis for meningitis - ANSWER ciprofloxacin, 500 mg
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
ANSWER Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated
hep B can lead to liver disease
entry to balloon time for PCI! - ANSWER 120 minutes
time limit from onset of MI to balloon time - ANSWER should get it done
w/in 12 hours
Absolute contraindications to Fibrinolysis - ANSWER Previous hemorrhage
stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
acute cholecystitis - ANSWER Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators
(PDE5?) - ANSWER NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - ANSWER Calcaneal apophysitis, also called Sever's disease,
is a common cause of heel pain in young athletes, especially those who participate
in basketball, soccer, track, and other sports that involve running. Typically the
heel apophysis closes by age 15. Treatment options include activity modification,
the use of ice packs and/or moist heat, stretching, analgesics, and orthotic devices.
The use of therapeutic ultrasound on the active bone growth plates in children is
contraindicated.
in pressure ulcers what solutions to avoid, and what to use! - ANSWER
,recommended that pressure ulcers not be cleaned with povidone/iodine, Dakin's
solution, hydrogen peroxide, wet-to-dry dressings, or any solutions that may
impede granulation tissue formation. These sites should be cleaned with either
saline or tap water and covered with hydrocolloid, foam, or another nonadherent
dressing that promotes a moist environment.
Chronic paraoxysmal hemicrania - ANSWER resembles cluster headache but
has some important differences. Like cluster headaches, these headaches are
unilateral and accompanied by conjunctival hyperemia and rhinorrhea. However,
these headaches are more frequent in women, and the paroxysms occur many
times each day. This type of headache falls into a group of headaches that have
been labeled indomethacin-responsive headaches because they respond
dramatically to *indomethacin.*
normal spirometry but low DLCO - ANSWER chronic pulmonary embolus
Antibiotic ppx for dental procedures - ANSWER give amoxicillin only if prior
endocarditis, prosthetic valve, heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - ANSWER Current guidelines
recommend referral to a nephrologist if a patient's renal disease is either of
unknown etiology, is deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2
per year), or is severe. Thresholds used to define severe chronic kidney disease
include an eGFR <30 mL/min/1.73 m2, a urine albumin to creatinine ratio >300
g/mg, persistent acidosis or potassium imbalance, non-iron deficiency anemia
with a hemoglobin level <10 g/dL, and evidence of secondary hyperparathyroidism.
Causes of peripheral neuropathy - ANSWER common treatable causes of
peripheral neuropathy, which include *diabetes mellitus, hypothyroidism, and
nutritional deficiencies*. Additional causes of peripheral neuropathy include
*chronic liver disease and renal disease*. It is important to consider medications
as a possible cause, including *amiodarone, digoxin, nitrofurantoin, and statins.
Excessive alcohol* use is another important consideration. In addition think
*MGUS, and Multiple Myeloma*
Failure rates of contraception - ANSWER The annual failure rate of
combined oral contraceptive pills with typical use is 9%. Typical failure rates for
other contraceptive methods are 0.2% for the levonorgestrel IUD, 6% for injectable
progestin, 18% for male condoms, and 22% for the withdrawal method.
, mental status exam for acute changes like delerium - ANSWER Confusion
Assessment Method (CAM)
to diagnose adult ADHD, symptoms must be present before what age? -
ANSWER Age 12
Complications of GERD in infants - ANSWER Gastroesophageal reflux
accounts for a significant number of cases of failure to thrive, crib death, and
recurrent pneumonia. Features of gastroesophageal reflux include a history of
recurrent pneumonia, a low growth curve, a family history of sudden infant death
syndrome, and normocytic anemia.
coining "sickness leaving body" - ANSWER it's a south asian thing, kids have
multiple red welts and superficial abrasions scattered on chest and upper back
thyroid replacement in the setting of gastritis - ANSWER need to increase by
30% because gastritis decreases absorption of thyroid. ex: h. pylori, treat h.pylori
to negate this effect
cubital tunnel syndrome - ANSWER irritation, compression, and
entrapment of the ulnar nerve
in ages 5-16, what is the most common agent that causes pneumonia - ANSWER
mycoplasma - treat with azithromycin
what halts the worsening of thyroid complications such as myxedema and
exophthalmos - ANSWER treating with methimazole
If MRSA bacteremia, when do you get repeat blood cultures? - ANSWER 2-4
days
community acquired pneumonia - ANSWER a type of pneumonia that
results from contagious infection outside of a hospital or clinic ie hotel stay or
cruise ship
Polymyalgia Rheumatica (PMR) - ANSWER a geriatric inflammatory disorder
of the muscles and joints characterized by pain and stiffness
hallmark of this condition is the rapid and often dramatic response, typically
within a few days, to low-dose corticosteroids. In fact, the lack of response to
low-dose prednisone in such a case should prompt the physician to consider
another diagnosis
Post exposure prophylaxis for meningitis - ANSWER ciprofloxacin, 500 mg
