BOARD VITALS REVIEW QUESTIONS AND VERIFIED
ANSWERS
Balloon sign - CORRECT ANSWER✅✅✅compress suprapatellar pouch against the femur and feeling
for fluid entering the joint space. Patellar ballotment will be possible in a positive.
For major effusions. Place thumb and index finger or your right hand on each side of the patella; with
the left hand, compress the suprapatellar pouch against the femur. Feel for fluid entering the spaces
next to the patella under your right thumb and index finger.
Bulge sign - CORRECT ANSWER✅✅✅For minor effusions. Extend knee. Place left hand above the
knee and apply pressure on the suprapatellar pouch, displacing or "milking" fluid downward. Stroke
downward on the medial aspect of the knee and apply pressure to force fluid into the lateral area. Tap
the knee just behind the lateral margin of the patella with the right hand. A fluid wave on the medial
side between the patella and femur is considered positive and consistent with effusion.
corticosteroids in pregnancy - CORRECT ANSWER✅✅✅in some studies _________ have been
associated with an increased risk of cleft lip/palate if administered in the first trimester.
bisphosphonates and pregnancy - CORRECT ANSWER✅✅✅category C - unknown and should be
avoided
Crohn's disease flare ups and pregnancy - CORRECT ANSWER✅✅✅UC and Crohn's disease are
approximately equally as likely to flare up in pregnant and non-prenant states if in remission at the time
of conception.
Meningococcal disease - CORRECT ANSWER✅✅✅Neisseria meningitidis. Sudden onset of fever,
headache, and stiff neck. It can start with symptoms similar to influenza (flu), and will often also cause
nausea, vomiting, increased sensitivity to light, rash (lower extremity petechial), and confusion. If known
exposure, prophylaxis with rifampin and/or rocephin or cipro depending on age.
FABER test - CORRECT ANSWER✅✅✅Tests SI joint. Pt supine, places foot on top of other knee. Pain
with this position or inability to reach figure 4 position can indicate problems with SI joint or hip flexors.
Flexion abduction external rotation = FABER
,Beighton scale - CORRECT ANSWER✅✅✅a popular screening technique for hypermobility. This is a
nine - point scale and requires the performance of 5 maneuvers, four passive bilateral and one active
unilateral performance.
hypermobility - CORRECT ANSWER✅✅✅
grind test - CORRECT ANSWER✅✅✅trap patella, grind patella against femur, + pain
Medicare part B coverages - CORRECT ANSWER✅✅✅outpatient coverages. DME, medically
necessary Dr. visits, home health, preventative care.
rheumatic fever - CORRECT ANSWER✅✅✅typically develops two to four weeks after a throat
infection (GABHS). Symptoms include: fever, multiple painful joints with the joints affected changing
with time, involuntary muscle movements, and a characteristic but uncommon non itchy rash known as
erythema marginatum. The heart is involved in about half of cases.
erythema marginatum - CORRECT ANSWER✅✅✅rheumatic fever
auscultating heart during rheumatic fever - CORRECT ANSWER✅✅✅mitral valve most frequently
involved, auscultate at PMI (5th intercostal, left midclavicular line).
gravida - CORRECT ANSWER✅✅✅number of pregnancies
para - CORRECT ANSWER✅✅✅number of 20+ week deliveries (twins count as one)
live vaccines - CORRECT ANSWER✅✅✅MMR, varicella, oral polio, rotavirus, flu LAIV. contraindicate
in pregnancy.
premature baby development - CORRECT ANSWER✅✅✅born prior to 37 weeks. Adjust
developmental age by #weeks premature. Continue age correction for 18-24 months, after infant should
be caught up with peers.
, non-english speaking pts - CORRECT ANSWER✅✅✅must have interpreter present! Reschedule if
there isn't one available (assuming the pt is stable).
risk factors for ectopic pregnancy - CORRECT ANSWER✅✅✅tubal surgery, IVF, use of IUD, hx of PID,
previous ectopic, age
types of incontenence - CORRECT ANSWER✅✅✅
primary (deciduous) teeth - CORRECT ANSWER✅✅✅baby teeth. All should be in by approx 30
months.
Pittsburgh knee rule - CORRECT ANSWER✅✅✅blunt trauma or fall as mechanism of injury and
either <12 or >50 or inability to walk more than four weight bearing steps in ED.
dihydropyridine vs non - CORRECT ANSWER✅✅✅CCB - dihydropyridines (amlodipine,
breast cancer screening - CORRECT ANSWER✅✅✅>40 yearly mammography and CBE, 20-39y.o. 1-
3yr CBE. If family hx or BCRA positive, enhanced screening.
risk factors for peri-partum cardiomyopathy - CORRECT ANSWER✅✅✅increased maternal age,
hypertension, multiparity, hx pre-eclampsia.
chronic antihistamine use - CORRECT ANSWER✅✅✅slow tapering is recommended d/t possible
anticholinergic rebound effect
SSRI side effects - CORRECT ANSWER✅✅✅sexual dysfunction (libido and orgasm) Weight gain
(paroxetine), fatigue and apathy. (Last 3 less common)
Older Americans Act (OAA) - CORRECT ANSWER✅✅✅federal funds are granted to states for a
variety of community-based services, such as nutrition programs for the elderly, case management,
homemaker services, transportation and adult day care services; for those 60 years or older. (Native
americans as well)
ANSWERS
Balloon sign - CORRECT ANSWER✅✅✅compress suprapatellar pouch against the femur and feeling
for fluid entering the joint space. Patellar ballotment will be possible in a positive.
For major effusions. Place thumb and index finger or your right hand on each side of the patella; with
the left hand, compress the suprapatellar pouch against the femur. Feel for fluid entering the spaces
next to the patella under your right thumb and index finger.
Bulge sign - CORRECT ANSWER✅✅✅For minor effusions. Extend knee. Place left hand above the
knee and apply pressure on the suprapatellar pouch, displacing or "milking" fluid downward. Stroke
downward on the medial aspect of the knee and apply pressure to force fluid into the lateral area. Tap
the knee just behind the lateral margin of the patella with the right hand. A fluid wave on the medial
side between the patella and femur is considered positive and consistent with effusion.
corticosteroids in pregnancy - CORRECT ANSWER✅✅✅in some studies _________ have been
associated with an increased risk of cleft lip/palate if administered in the first trimester.
bisphosphonates and pregnancy - CORRECT ANSWER✅✅✅category C - unknown and should be
avoided
Crohn's disease flare ups and pregnancy - CORRECT ANSWER✅✅✅UC and Crohn's disease are
approximately equally as likely to flare up in pregnant and non-prenant states if in remission at the time
of conception.
Meningococcal disease - CORRECT ANSWER✅✅✅Neisseria meningitidis. Sudden onset of fever,
headache, and stiff neck. It can start with symptoms similar to influenza (flu), and will often also cause
nausea, vomiting, increased sensitivity to light, rash (lower extremity petechial), and confusion. If known
exposure, prophylaxis with rifampin and/or rocephin or cipro depending on age.
FABER test - CORRECT ANSWER✅✅✅Tests SI joint. Pt supine, places foot on top of other knee. Pain
with this position or inability to reach figure 4 position can indicate problems with SI joint or hip flexors.
Flexion abduction external rotation = FABER
,Beighton scale - CORRECT ANSWER✅✅✅a popular screening technique for hypermobility. This is a
nine - point scale and requires the performance of 5 maneuvers, four passive bilateral and one active
unilateral performance.
hypermobility - CORRECT ANSWER✅✅✅
grind test - CORRECT ANSWER✅✅✅trap patella, grind patella against femur, + pain
Medicare part B coverages - CORRECT ANSWER✅✅✅outpatient coverages. DME, medically
necessary Dr. visits, home health, preventative care.
rheumatic fever - CORRECT ANSWER✅✅✅typically develops two to four weeks after a throat
infection (GABHS). Symptoms include: fever, multiple painful joints with the joints affected changing
with time, involuntary muscle movements, and a characteristic but uncommon non itchy rash known as
erythema marginatum. The heart is involved in about half of cases.
erythema marginatum - CORRECT ANSWER✅✅✅rheumatic fever
auscultating heart during rheumatic fever - CORRECT ANSWER✅✅✅mitral valve most frequently
involved, auscultate at PMI (5th intercostal, left midclavicular line).
gravida - CORRECT ANSWER✅✅✅number of pregnancies
para - CORRECT ANSWER✅✅✅number of 20+ week deliveries (twins count as one)
live vaccines - CORRECT ANSWER✅✅✅MMR, varicella, oral polio, rotavirus, flu LAIV. contraindicate
in pregnancy.
premature baby development - CORRECT ANSWER✅✅✅born prior to 37 weeks. Adjust
developmental age by #weeks premature. Continue age correction for 18-24 months, after infant should
be caught up with peers.
, non-english speaking pts - CORRECT ANSWER✅✅✅must have interpreter present! Reschedule if
there isn't one available (assuming the pt is stable).
risk factors for ectopic pregnancy - CORRECT ANSWER✅✅✅tubal surgery, IVF, use of IUD, hx of PID,
previous ectopic, age
types of incontenence - CORRECT ANSWER✅✅✅
primary (deciduous) teeth - CORRECT ANSWER✅✅✅baby teeth. All should be in by approx 30
months.
Pittsburgh knee rule - CORRECT ANSWER✅✅✅blunt trauma or fall as mechanism of injury and
either <12 or >50 or inability to walk more than four weight bearing steps in ED.
dihydropyridine vs non - CORRECT ANSWER✅✅✅CCB - dihydropyridines (amlodipine,
breast cancer screening - CORRECT ANSWER✅✅✅>40 yearly mammography and CBE, 20-39y.o. 1-
3yr CBE. If family hx or BCRA positive, enhanced screening.
risk factors for peri-partum cardiomyopathy - CORRECT ANSWER✅✅✅increased maternal age,
hypertension, multiparity, hx pre-eclampsia.
chronic antihistamine use - CORRECT ANSWER✅✅✅slow tapering is recommended d/t possible
anticholinergic rebound effect
SSRI side effects - CORRECT ANSWER✅✅✅sexual dysfunction (libido and orgasm) Weight gain
(paroxetine), fatigue and apathy. (Last 3 less common)
Older Americans Act (OAA) - CORRECT ANSWER✅✅✅federal funds are granted to states for a
variety of community-based services, such as nutrition programs for the elderly, case management,
homemaker services, transportation and adult day care services; for those 60 years or older. (Native
americans as well)
