ABFM In Training exam Pearls Questions With Answers

ABFM In Training exam Pearls Questions With Answers Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? - CORRECT 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! - CORRECT ANSWER- 120 minutes Time limit from onset of MI to balloon time - CORRECT ANSWER- should get it done w/in 12 hours Absolute contraindications to Fibrinolysis - CORRECT 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 - CORRECT ANSWER- Acute inflammation of the gallbladder wall Patient with pulmonary HTN due to left heart failure, can they have vasodilators (PDE5?) - CORRECT ANSWER- NO! can make things worse -maximize heart failure treatment! Server’s Disease - CORRECT ANSWER- Calcaneal apophysitis, also called Sever's disease, and 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 apophasis 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! - CORRECT ANSWERrecommended 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 no adherent dressing that promotes a moist environment. Chronic paroxysmal hemicranias - CORRECT ANSWER- resembles cluster headache but has some important differences. Like cluster headaches, these headaches are unilateral and accompanied by conjunctiva 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 - CORRECT ANSWER- chronic pulmonary embolus Antibiotic ppx for dental procedures - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER- Confusion Assessment Method (CAM) to diagnose adult ADHD, symptoms must be present before what age? - CORRECT ANSWER- Age 12 Complications of GERD in infants - CORRECT 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