Board Studying AAFP Questions and answers. 100% pass rate. Graded A+

Board Studying AAFP Questions and answers. 100% pass rate. Graded A+ Document Content and Description Below Board Studying AAFP Questions and answers. 100% pass rate. Graded A+ Treatment of BPH - 1) Tamsulosin (flomax) (and other "osin" drugs like doxazosin and silodosin) - first line 2) Tadalaf il (cialis) - especially if they have comorbid ED 3) Finasteride (ONLY if there's evidence of significant prostate enlargement - on physical exam or b/c of elevated PSA1.5) (prevents progression) 4) Oxybutynin (or other anticholinergics) as an adjunct if they also have overactive bladder Someone has symptomatically low testosterone - what's the first step in workup? - FSH and LH to distinguish primary hypogonadism (proceed to karyotype) vs secondary hypogonadism (MRI head to check the pituitary) Someone is on amiodarone cause they OLD. What do you check periodically? - TSH - amiodarone can cause hypo or hyperthyroidism What is "dysmenorrhea"? What is primary dysmenorrhea - Dysmenorrhea means painful periods Primary dysmenorrhea is physiologic pain during the period. There is no pathology. First line treatment in NSAIDs What are the functions of the muscles of the rotator cuff? - Subscapularis - Internal rotation Suprascapularis - Abduction Infrascapularis (and teres minor) - External rotation Screening of asymptomatic kids with sickle cell disease - 1) Hypertension - Screen frequently (every visit) 2) Stroke risk - Transcranial doppler annually from 2-16. If positive for high risk, they'll need chronic transfusions 3) Retinopathy - Eye exam annually for 10 years and older 3) Asthma - Spirometry annually until adulthood 4) Pulmonary hypertension - Measure tricuspid jet regurgitant velocity on ECHO with doppler. Debated whether to do once in childhood (when the measurement may be inaccurate) or whether to just start in late adolescence / early adulthood When do you NOT give kids antibiotics for otitis media? - 2 yo, healthy kid, mild symptoms, unilateral (In real life, it seems like outcomes are much better if you give antibiotics, but for the exam and per strict guidelines, you shouldn't) Treatment of low back pain - First line: NSAIDs (not tylenol, studies show it isn't very effective) Second line: NSAIDs + flexeril -- Steroids do NOT have proven efficacy First line treatment for hypertrophic cardiomyopathy - Beta-blockers Family wants to keep an aggressive demented loved one at home. What do you prescribe him? - Atypical antipsychotic (including aripiprazole) If someone has subclinical (asymptomatic) hyperthyroidism, you should check for the following 3 conditions, and treat if they have any of them - 1) Osteoporosis 2) Atrial fibrillation 3) Heart failure Also treat if TSH0.1 or the patient is 65 Someone with PTSD keeps waking up from nightmares despite SSRI therapy. What can you add? - Prazosin. Blocks the sympathetic response to nightmares, so they don't wake them up Looks like she has a fungal infection under her breasts, but the antifungals didn't work. What does she have, and how can you confirm? (or could if you had all the gadgets) - Erythrasma (bacterial infection, specifically Corynebacterium minutissimum) Under wood's lamp, it will be coral, instead of yellow/green like tinea Hypertensive emergency in the office. You can't send them home. You're hoping not to send them to the ER. What can you do? - You can recheck the pressure in 30 minutes. For 30% of people, this will save them an ER visit Treatment for metatarsal stress fractures of the foot (assuming they're NOT Jones fractures) - No weight bearing for a few days (can be w/ posterior splint), then walking boot, then rigid sole shoe for 4-6 weeks. Athletic teens sometimes get mild proteinuira. How do you confirm it's benign? - Early morning spot protein/Cr ratio Weak evidence supports adding ezetimibe to high dose statins in which group? - Those who have had ACS First line treatment for motion sickness for people who want to stay awake - Scopolamine How does pityriasis rosea affect pregnancy? - Increases risk of spontaneous abortion Infertility workup (female) steps for the primary care physician - 1) Progesterone level on day 21 of LMP to check if ovulating -Progesterone 5 (ovulating) - Hysterosalpingogram to look for tubal patency -Progesterone 5 (not ovulating) - TSH, estrogen, FSH, prolactin If any of the above are abnormal, fix the problem. If all of the above is normal, try clomiphene. If clomiphene fails, refer out. How do you treat diarrhea that occurs after resection of the terminal ileum? - Cholestyramine The diarrhea is caused by excess bile acids. Most commonly occurs after resection of the terminal ileum for Crohn's disease How does donepezil affect cardiac rhythm? - Causes bradycardia and heart block What are some of the long term side effects/risks of PPI use? - Hip/wrist/spine fractures, hypomagnesemia, pneumonia, C diff When can kids with lice go back to class? - Immediately. The idea being that by the time you find them, it's too late anyway. And you really do have to touch your head to someone else's How is hypertension defined in the pediatric patient? - 95% Treatment for ITP - First line: Steroids First 1/2 line: Rituximab, IV Ig Second line: Thrombopoietin receptor agonists, splenectomy Prescribe naloxone when someone surpasses __ MME/day - 50 Explain CKD-MBD - Chronic kidney disease-mineral and bone disorder Step 1: Decreased GFR means the body can't get rid of phosphate Step 2: In response, PTH increases to try to decrease phosphate Step 3: PTH causes break down of bones (bone disease) and increased calcium What is charcot neuropathy and how is it treated? - Chronic inflammation and damage to the foot of a diabetic patient. Looks like cellulitis, but doesn't respond to antibiotics, and they don't have any systemic signs of infection. Treat by casting (by which I mean, refer to ortho or PMNR) NSAIDs all increase risk of cardiovascular disease and MI except which one? - Naproxen (and I imagine, aspirin) Which GERD patients should be tested for H pylori? - Patients with bloating, nausea, or fullness. Do NOT test routinely for H pylori in everyone with GERD, because treating H pylori in patients who just have regular GERD can increase symptoms of GERD and worsen esophagitis (in some studies) What is first line treatment for GERD? - PPIs are recommended as first line instead of H2 blockers because they're more effective (the idea is that starting with the less effective drug just means they're spending more money on meds) For how long should someone who had an MI be on DAPT? - It's very complicated, highly debated, and patient specific. But IN GENERAL, somewhere from 6-12 months. (And you may be able to do part of that course as DAPT, then switch to aspirin) Who gets lung cancer screening? - Patients aged 55-8