Q&A | Family Primary Care I | Peds, ENT, Cardio,
Respiratory, GI, Women’s Health & Geriatrics
What are examples of extracolonic disease found in Crohn's disease? - ANSWER -
uveitis, arthritis, dermatitis, joint swelling, hepatosplenomegaly
By what age does colic typically resolve? - ANSWER -3-4 months
Patient presents with severe right upper quadrant abdominal pain with nausea and
vomiting. She has a positive Murph's sign, and is running a low grade fever. This
episode has lasted for the last 8 hours and occurred following eating a high fat
dinner. What diagnosis do you suspect? - ANSWER -Cholecystitis
Patient with suspected cholecystitis, what diagnostic study should be ordered first?
- ANSWER -Abdominal ultrasound
If patient is suspected to have cholecystitis, but the abdominal ultrasound came
back negative, what study would you order next? - ANSWER -HIDA scan
For patient who is diagnosed with acute cholecystitis, what is the plan for
management and care? - ANSWER -NPO, nausea medications, and surgery within
72 hours of diagnosis
In a patient who is suspected to have acute appendicitis, what 4 physical exam
maneuvers will you perform? - ANSWER -McBurney's point, posts sign, Rovsing
sign, and obturator sign
How do you evaluate for possible retrocecal appendicitis? - ANSWER -Rectal
exam
What 2 gastroenteritis causative organisms do we not suggest the use of antibiotics
in treatment? - ANSWER -S. Aureus, and salmonella
What antibiotic would you prescribe for a patient positive for shigella? -
ANSWER -Bactrim
,What antibiotic would you prescribe for a patient with gastritis that is positive for
E. Coli? - ANSWER -Bactrim
What are two antibiotic choices for outpatient management of a patient with C.
Difficile - ANSWER -Flagyl or Vancomycin
What two medications should be prescribed for management of acute
gastroenteritis? - ANSWER -Promethazine and zofran
In elderly or infant patients with acute gastroenteritis, what labs would you order
to assess for dehydration? - ANSWER -BUN, specific gravity and electrolytes
Most common cause of community acquired pneumonia in adults - ANSWER -
Mycoplasma pneumonia
Second most common cause of community acquired pneumonia in adults -
ANSWER -Streptococcus pneumonia
2 most common causes of bacterial community acquired pneumonia in children -
ANSWER -Streptococcus pneumonias, and haemophilus influenza
What are the 2 most common viral agents to cause community acquired
pneumonia in children and infants? - ANSWER -RSV, adenovirus
What is first line treatment for outpatient treatment of pneumonia in a previously
healthy patient with no recent antibiotic use? - ANSWER -Macrolids (ex:
azithromycin) or doxycycline
What treatment choice would you prescribe for treatment of a previously healthy
individual who has pneumonia, but admits to recent antibiotic use? - ANSWER -
Respiratory fluoroquinolone or azithromycin with high dose amoxicillin
Most common cause of atypical pneumonia - ANSWER -Mycoplasma pneumonia
What two antibiotics should be avoided for treatment of pneumonia in
pregnant/lactating women? - ANSWER -doxycycline and quinolone
A young child presents to the clinic with a cough that has been ongoing for the last
3 weeks and is diagnosed with pertussis. What would you prescribe for
, management of this patient and close contacts? - ANSWER -Antibiotics for the
patient, and prophylactic antibiotics for other household contacts
A mother brings in her 2 year old child with complaints of a progressing cough
with a described "whooping" sound. She admits to not vaccinating her child. What
is your suspected diagnosis? - ANSWER -Pertussis
What type of genetic disorder is Cystic Fibrosis - ANSWER -Autosomal-
recessive
Characteristics of Cystic fibrosis - ANSWER -chronic respiratory infections,
pancreatic enzyme insufficiency, elevated chloride concentration in sweat, and
COPD
What are diagnostic requirements for cystic fibrosis? - ANSWER -Positive
genetic testing OR positive sweat chloride test AND one of the following: COPD,
exocrine pancreatic insufficiency, positive family history.
A child with suspected cystic fibrosis presents for a sweat chloride test. His results
come back as 55mmol/L, what is your interpretation of those results and what is
your next step? - ANSWER -That is a borderline result, I would order a retest
What are the normal, borderline and positive results ranges for sweat chloride
parameters for cystic fibrosis? - ANSWER -Normal: <40
Borderline: >40, <60 (do a retest)
Positive CF: >60
In a patient with known cystic fibrosis, what PFT results would you expect to be
demonstrated? - ANSWER -Airway Obstruction
In a neonate with a meconium ileus, what test should be run to rule out CF? -
ANSWER -pancreatic enzyme (immunoreactive trypsinogen)
A 4 year old patient presents to the clinic with his father who is describing a resent
onset of night time barking cough with periodic stridor and a low grade fever.
What condition do you suspect? - ANSWER -Croup
What is the most common cause of croup? - ANSWER -Parainfluenza