Fam Med Step 2 6-24

ruhland1's version from 2016-06-23 15:19

Section 7

Question Answer
alpha thallhypochromic microcytic cells with central color spot in the area of pallor (target cells)
cross-sectional studygroup of individuals are being examined at one point in time, relative and absolute risk calculated
medical records of many different individuals are studied in people with the same illness looking for related risk factorsretrospective cohort study
Open reductionwhere frx fragments are exposed surgically by dissecting the tissues.
Closed rudctionmanipulation of bone fragments without surgical exposure of the fragments
acute infective endocardlook for F and new murmur and nonspecifics
OSAup polycythemia, pulm htn, CHF, CV dz
duodenal ulcernocturnal sx and dn sx with food
lower stomach and duodenumT7-9
byettaexenatide injection (GLP-1 injxn)

Section 8

Question Answer
Metabolic Syndromeneed 3 of 5 criteria
abomen men>40in
abdommen female>35in
HDL men<40
HDL woman<50
BP noteor on anti HTN med and <130/85
fasting glc>100
txdn lb, exercise, optimize chole and BP, use Metformin to slow onset of DM in hi-risk
chantixaka varencycline, like the methadone of nictoine (partial agonist)
latudalurasidone, a AAP

Section 9

Question Answer
victozaGLP 1 (liraglutide)
Invokanacanagliflozin, SGLT-2 inhibitor
GLP-1 ag s/eGI upset, pancreatitis
GLP-1 ag MOAup insulin sec, dn glucagon sec, slows down gastric empty
sitagliptinDPP-4 inh
DPP-4 inh MOAup incretins * dn glucaon and up insulin
DPP-4 inh S/Eheadache, nausea, skin reactions
TZD moaactivate PPARs * repress DNA transcription of genes that increase storage of fatty acids
TZD effectsdn insulin resistance
TZD s/eperiphreal edema, hepatitis
InvokanaSGLT 2 inh (canagliflozin)
JardianceSGLT2 inh (empagliflozin)
SGLT2 s/eUTI, ketoacidosis
entry A1c less than 7.5%Metformin > GLP1 > SGLT2 > DPP4i > AGi (monotherapy)
acarbosealpha glucosidase inh
miglitolalphaglusidase inhibitor
entry A1c less than 7.5%Metformin and 1 of the above
colesevalambile acid sequestrants used in entry >7.5%
sulfonurea MOAblock K ch * up Ca ch * up Ca influx * up insulin release
entry >9.0% and no sxdual or triple therapy
entry >9.0% and sxinsulin + other
flow of things if less than 7.5% entrymonotherapy 3 mo -> dual (metf + 1) 3 mo -> Metf +2 3mo -> add or intensify insulin

Section 10

Question Answer
tinea pedisnystatin
mild non-inflamatory acnetopical retinoids
mild inflamatory acnetopical erythro
meralgia parestheticapainful do to lateral femoral cutaneous nerve compression as it passes under inguinial ligament
actinicreaction do to light (actin- light ray)
phak-lens of eye
APO E4up risk Alz Dz (CHR 19)
APO B100an LDL
APO C-IIType 1 hypercholesterolemia

Section 11

Question Answer
MRI Alzhippocampus and medial temporal lobe
pre-renal azotemiahallmark is 20 to 1 BUN to Cr, normal creatine, no urine casts, FeNa<1%
intrinsic refnal failureBUN to CR less than 20 to 1, granular casts, FeNa>1%
etiologies prerenal azotemiablood loss, blunt trx, sepsis, excess diuresis and NSAIDs
subarachnoid hemmruptured berry aneurysm, HA dizzi, vomit, evidence of uncontrolled htn
uncontrolled HTNretinal hemmorhage, cardiac D, papilledema, CN VI never palsy, * look down and in, subhyaloid retinal hemmorhages
posterior communicating artery strokeCNIII paralysis
anterior communicating artery strokeMC site of aneurysm formation, results in paralysis/wk of lower ext, babinski +, frontal lobe D
middle cerebral arterycontralateral hemiparesis and hemmisensory loss, apahsia, apraxia, hemispatial neglect, anosognosia
Posterior Inferior Cerebellar Arteryleads to wallenberg synd
wallenberg synddn pain / temp ipsi face and contra body, also dysphagia, slurred speech, vertigo, nystygmus
CT w/o contrastfor SAH
Budd Chiarihepatic venous outflow obstruction (cirrhosis, varices)
CLLWBC 50-200k, 0 px LAD, smudge cells
protein aggregates in caudate and putamenhuntingtons
PCKDup cerebral aneurysms
SAH txendovascular coiling favored over clipping
SAH78% risk of re-bleed
mannitolcontra in poor kidneys
elevated PTHincreases conversion of 25 vit D to 1,21 Vit D (calcitriol) through activation of 1-alpha-hydroxylase
vit D acute intoxsx due to hyper calcemia which are confusion, polyuria, polydipsia, anorexia, vomit, wk.

Section 12

Question Answer
chronic Vit D intoxbone demineralization and px
loss pain temp on one side of body and opposite side of facedx for wallenberg syndrome (PICA infarct)
ASA and acute isch strokegive w/in 48 hours
Carotid/OphthalmicAmaurosis fugax (monocular blind)
MCAAphasia, neglect, hemiparesis, gaze preference, homonymous hemianopsia
ACA Leg paresis, hemiplegia, urinary incontinence
PCAhomonynmous hemianopsia
basilar arteryComa, cranial nerve palsies, apnea, drop attach, vertigo
lacunar Silent, pure motor or sensory stroke, "Dysarthria-Clumsy hand syndrome", ataxic hemiparesis
lateral medullary infarctoss of pain and temp on ipsilateral face and contralateral body, vestibulocerebellar impairment, Horner's syndrome
insomnia and RLSlow ferritin
neurontinperipih edema
TZDperiph edema
chronic bronchitischronic productive cx for >3mo for 2 year "blue bloater", monitored via FEV1
chronic bronch lung bxup reid index (gland layer >50% of total bronchial wall)
meneieres= vestib neuritis (excess endolymph in cochlea)
meneires dxaudiometry (low freq pure-tone hearing loss)
menieres txlow salt, avoid ETOH nicotine caffeine, HCTZ anti-ch anti hist, refract unil CNVII abaltion
vertigoMRI internal auditory canal
FOOSHFall On OutStretched Hand