AMCB Memorization Exam Questions With Correct Answers

Diaphragm of Stethoscope - Answer Used to listed to high pitch sounds-S1, S2, heart sounds Big and flat Bell of Stethoscope - Answer Used to listen to low pitch sounds Bruits, murmurs concave Underweight BMI - Answer <18.5 Wt gain in preg: 28-40lbs Normal Weight BMI - Answer 18.5-24.9 Wt gain in preg: 25-35lbs Overweight BMI - Answer 25-29.9 Wt gain in preg: 15-25lbs Obese BMI - Answer 30-39.9 Weight Gain in preg: 11-20lbs Extreme Obesity BMI - Answer >40 RBCs - Answer 4.2-5.4 Hematocrit - Answer 33% in 1st and 3rd trimester 32% in 2nd trimester -2% for Black women Hemogobin - Answer 11 in 1st and 3rd trimester 10.5 in 2nd -0.8 for Black Women MCV - Answer Average volume or size of a single RBC 80-100 WBC - Answer 3,900-12,500 Up to 16,900 is normal in 3rd trimester HbA1c - Answer <5.7 >6.5%=DM ADA Criteria for DX of DM (primary care) - Answer Random glucose > 200 + s/s of Hyperglycemia Fasting of 126 or greater Two hr PP of 200 or greater Total cholesterol - Answer <200 mg/dL May be elevated in pregnancy Triglycerides - Answer 35-135 May be elevated in pregnancy HDL - Answer "Happy" Removes cholesterol from peripheral tissues and transports to liver 40 or greater LDL - Answer "Lowsy" <130 BUN - Answer 10-20 Indirect measure of kidney and liver function Creatinine Clearance - Answer Calculated from serum 24hr, reflects GFR- which is determined bases on age, gender and race Serum Creatinine- 0.5-1.1 24 hr Urine >300=Proteinuria, normal <150 Urine Protein/Creatinine Ratio (PC Ratio) - Answer >0.3= Proteinuria TSH - Answer 0.4-4.1 1st trimester 0.1-4.0 2nd trimester 0.2-4.0 3rd 0.3-4.0 AST - Answer 0-35 ALT - Answer 12-38 Sickle Cell - Answer + Hgb S indicates disease or trait Hgb electrophoresis is the definitive test to determine ANA (autoantibodies/antinuclear antibodies) - Answer + 95% indicates SLE Treatment for HTN - Answer General Population at > 60 y/o for 150/90 <60 y/o 140/90 HTN +DM 140/90 regardless of age Meds for HTN - Answer Should be started for calculated 10-yr risk >10% or with CVD, DM or chronic kidney disease Non-Black-thiazide direuritic, ca channel blocker, ACE or ARB Blacks Thiazide diuretic or Ca Channel Blocker Reassess in 1 month, if no change add another medication **ACEs and ARBs not OK in Preg Murmur Referral - Answer For all diastolic above grade 3 IDA - Answer microcytic, hypochromic MCV <80, low MCH, Low HCHV low RBCs, Ferratin <10, high TIBC TX: Ferrous sulfate for 4-6mos Thalessemia - Answer microcytic, hypochromic Usu asymptomatic if mild MCV <80, RBC> 5.5, normal ferratin Hbg electrophoresis- Alpha all normal, beta abnormal Refer for all MAJOR B12 Anemia - Answer Macrocytic, normochromic MCV >100, B12 <100 could be d/t deficiency or intrinsic factor--> pernicious anemia s/s sore swollen tongue, fatigue, weakness, dyspnea, paresthesias TX: Vit B12 IM daily for one week, then weekly Folate Anemia - Answer Macrocytic, normochromic, MCV >100, B12 normal, Folate <3, elevated homocysteine, normal methylmalonic acid d/t malabsorption, pregnancy, ETOH, PPIs, elderly, metformin S/S similar to B12, but not neural involvement TX: dietary first, then folic acid supplement RA - Answer chronic, possible autoimmune, multi system disease, SYMMETRICAL JOINT involvement, joint inflammation and loss of synovial fluid and joint anatomy (pannus) +RF TX: PT and rest, NSAIDs REFER for Meds-DMARDs, hydroxychloroquine Basal Cell Carcinoma - Answer Rolled "B"oarders, waxy nodule Squamous Cell Carcinoma - Answer Most common Atinicic keratoses at first reddish brown, papule, surface is crusted Psoriasis - Answer Clear defined boarders, red-plaques, silvery scales, chronic immune mediated, associated with RA Refer for severe disease or mild relief GDM Diagnosis - Answer Non fasting 50g, 1hr GTT >130-140 100g, fasting with two of the four values elevated Fasting >95 1hr >180 2hr >155 3hr> 140 PP DM Screening - Answer Done with 75g OGTT at 4-12 weeks PP >126 fasting =DM >200 at 2 hrs=DM Hyperthyroid - Answer Low TSH, elevated Free T4, high serum T3, +anti-TPO(graves) REFER for meds Bacterial Conjunctivitis - Answer Acute start, mucupurulent discharge, eyes stick together TX: topical Erythromycin Otitis Externa - Answer Inner ear canal inflammation Pain with palpation of tragus or pinna may be d/t hearing aids, q-tip use, cerumen Tx: removal, ETOH/Vinegar drops or antifungals/antibiptocs for Otitis Media - Answer Infection of middle ear May precede URI, HA, fever, N/V, dizziness, BULDGING TM, pain with palpation of tragus Tx: With different antibiotic if one had already been taken for URI Treat for mod/severe pain, temp>39 OR no improvement for 48-72hrs Amoxicillin or Augmentin, Azithromycin Sinusitis - Answer Acute-95% of the time it is viral Chronic after prolong infection from URI lasting longer than 30 days Tx: Start with OTC decongestants and analgesics for 10 days or more of s/s, worsening after 6 days or fever >102 for 3 days treat with Augmentin or Doxycycline