FAMILY MED COMAT KEY PHRASES QUIZZES
WITH RIGHT ACTUAL ANSWERS.
Lead poisoning, prevention ANS - *Primary prevention* efforts focus on removal of lead from the
environment so that exposure cannot occur. (removal of lead-based hazards from environment)
*Secondary prevention* - to determine the sources of lead and to ameliorate the exposures after they
have been identified.
*Tertiary prevention* reduces morbidity associated with lead intoxication through chelation of lead
from exposed individual. Chelation can reduce the immediate toxicity but has limited ability to reverse
the neurocognitive effects of chronic exposure
Opioid induced constipation (OIC)- Initial Dx tool ANS - Diagnosis — The diagnosis of OIC should be
based upon clinical history, appropriate physical examination (including a rectal examination, unless not
indicated), and limited diagnostic tests. Diagnostic criteria for OIC are available
Sleep disorders, Diagnostic testing ANS -
Panic Disorder, Long term Management ANS - Abort the attack with benzos
*SSRIs for long term management*
(SSRIs more effective than cognitive behavior therapy. but CBT should be started as well, often used to
control or abort the attacks without benzodiazepines rather than
prevent them from occurring.)
Tuberculosis Skin Test Management ANS - *> 5 mm induration* is positive in an immunocompromised,
HIV, or organ transplant patient; and in those with radiographic evidence of primary TB, or who have
had close contact with someone with active TB.
, *> 10 mm induration* is positive in recent immigrants from high-risk areas, healthcare workers,
children <4-years-old or children exposed to high-risk adults, residents of communal or group settings,
the homeless, prisoners, alcoholics, diabetics, or injection drug users.
*> 15 mm induration* is positive in all other patients.
Multiple Sclerosis, Dx/Imaging ANS - The primary complaint is often
blurry vision / diplopia (from optic neuritis).
If suspected, get an *MRI looking for periventricular plaques*, multiple lesions, or lesions on corpus
callosum
Elderly patient on multiple medications, identify potential side effect ANS -
Esophagitis/ Esophageal CA Diagnostic Tool ANS - Endoscopy
Diabetes; identification and management ANS - DM treatments:
DM type 1: insulin tx
DM type 2:
1.) Lifestyle
2.)Metformin
is the by far the best pharmacologic tx
(Metformin contraindicated in CKD, CHF, or liver disease b/c of risk of lactic acidosis. and it should
ALWAYS be held when hospitalized)
3.) 2nd line chosen based on pt preference and side effect prof.
4.) Failure of two oral agents
should prompt insulin.
, Menorrhagia Management ANS - -In premenarchal girls who are bleeding suspect foreign bodies (most
common) and sexual abuse. These girls needs a speculum exam, often under anesthesia.
-For the reproductive aged female with meno, metro, or menometrorrhagiait is far more complicated;
follow the "neumonic "PAD": Pregnancy, Anatomy, Dysfunctional Uterine Bleeding. Start by ruling out
pregnancy with a UPT
-In a post menopausal woman bleeding is cancer until proven otherwise, ruled out with endometrial
sampling. It's usually NOT cancer -simple atrophy is MC. Hormone rep. therapy can also induce bleeding.
.
Conjunctivitis In Infant, Presentation ANS - .
Threatened Abortion, Presentation ANS - .
pneumonia, presentation ANS - fever, productive cough, and consolidation on Chest XRAY
Depression, treatment ANS - combo with SSRIs and psychotherapy is better than either alone. when
starting SSRI, adequate trial of 4-8 weeks at max dosing is required before adding a 2nd agent. IF pt is
failing meds and therapy or if there is catatonia or psychotic features, the ultimate best tx is ECT
Plantar Fasciitis, presentation ANS - heel tenderness with foot dorsiflexion
Acute Coronary Syndrome, Initial management ANS - presentation of ACS: over 20 min of restrosternal
chest pain, SOB, diaphoresis, nausea
*initial test: ECG*
then transfer to ED for full eval
Ankylosing Spondylitis, Presentation ANS - Ankylosing spondylitis is a seronegative
spondyloarthropathy that leads to fusion of the spine and sacroiliac joints. *Radiographs will show
syndesmophytes, which are calcifications of the spinal ligaments creating a "bamboo spine"* as well as
WITH RIGHT ACTUAL ANSWERS.
Lead poisoning, prevention ANS - *Primary prevention* efforts focus on removal of lead from the
environment so that exposure cannot occur. (removal of lead-based hazards from environment)
*Secondary prevention* - to determine the sources of lead and to ameliorate the exposures after they
have been identified.
*Tertiary prevention* reduces morbidity associated with lead intoxication through chelation of lead
from exposed individual. Chelation can reduce the immediate toxicity but has limited ability to reverse
the neurocognitive effects of chronic exposure
Opioid induced constipation (OIC)- Initial Dx tool ANS - Diagnosis — The diagnosis of OIC should be
based upon clinical history, appropriate physical examination (including a rectal examination, unless not
indicated), and limited diagnostic tests. Diagnostic criteria for OIC are available
Sleep disorders, Diagnostic testing ANS -
Panic Disorder, Long term Management ANS - Abort the attack with benzos
*SSRIs for long term management*
(SSRIs more effective than cognitive behavior therapy. but CBT should be started as well, often used to
control or abort the attacks without benzodiazepines rather than
prevent them from occurring.)
Tuberculosis Skin Test Management ANS - *> 5 mm induration* is positive in an immunocompromised,
HIV, or organ transplant patient; and in those with radiographic evidence of primary TB, or who have
had close contact with someone with active TB.
, *> 10 mm induration* is positive in recent immigrants from high-risk areas, healthcare workers,
children <4-years-old or children exposed to high-risk adults, residents of communal or group settings,
the homeless, prisoners, alcoholics, diabetics, or injection drug users.
*> 15 mm induration* is positive in all other patients.
Multiple Sclerosis, Dx/Imaging ANS - The primary complaint is often
blurry vision / diplopia (from optic neuritis).
If suspected, get an *MRI looking for periventricular plaques*, multiple lesions, or lesions on corpus
callosum
Elderly patient on multiple medications, identify potential side effect ANS -
Esophagitis/ Esophageal CA Diagnostic Tool ANS - Endoscopy
Diabetes; identification and management ANS - DM treatments:
DM type 1: insulin tx
DM type 2:
1.) Lifestyle
2.)Metformin
is the by far the best pharmacologic tx
(Metformin contraindicated in CKD, CHF, or liver disease b/c of risk of lactic acidosis. and it should
ALWAYS be held when hospitalized)
3.) 2nd line chosen based on pt preference and side effect prof.
4.) Failure of two oral agents
should prompt insulin.
, Menorrhagia Management ANS - -In premenarchal girls who are bleeding suspect foreign bodies (most
common) and sexual abuse. These girls needs a speculum exam, often under anesthesia.
-For the reproductive aged female with meno, metro, or menometrorrhagiait is far more complicated;
follow the "neumonic "PAD": Pregnancy, Anatomy, Dysfunctional Uterine Bleeding. Start by ruling out
pregnancy with a UPT
-In a post menopausal woman bleeding is cancer until proven otherwise, ruled out with endometrial
sampling. It's usually NOT cancer -simple atrophy is MC. Hormone rep. therapy can also induce bleeding.
.
Conjunctivitis In Infant, Presentation ANS - .
Threatened Abortion, Presentation ANS - .
pneumonia, presentation ANS - fever, productive cough, and consolidation on Chest XRAY
Depression, treatment ANS - combo with SSRIs and psychotherapy is better than either alone. when
starting SSRI, adequate trial of 4-8 weeks at max dosing is required before adding a 2nd agent. IF pt is
failing meds and therapy or if there is catatonia or psychotic features, the ultimate best tx is ECT
Plantar Fasciitis, presentation ANS - heel tenderness with foot dorsiflexion
Acute Coronary Syndrome, Initial management ANS - presentation of ACS: over 20 min of restrosternal
chest pain, SOB, diaphoresis, nausea
*initial test: ECG*
then transfer to ED for full eval
Ankylosing Spondylitis, Presentation ANS - Ankylosing spondylitis is a seronegative
spondyloarthropathy that leads to fusion of the spine and sacroiliac joints. *Radiographs will show
syndesmophytes, which are calcifications of the spinal ligaments creating a "bamboo spine"* as well as
