Step 2 Fam Med 1 (10-29-15)

ruhland1's version from 2016-06-19 18:59

Section 1

Question Answer
lumbagolower back pain
PITYriasis roseaherald pity during christmas (herald patch followed by christmas tree skin rash)
L positive seated R base and R ILA posterior what is L5sacrum rotated R so L5 rot L, L positive seated = R-oblique axis = R side bent, Since rot and sb are opposite L5 must be Neutral (not flexed/extended)
got PCV and >65 yoget PPSV23 in 6-12mo
Got PPSV23must wait a year until get PCV13
got PPSV23 before 65 yo and now 65atleast one year following shot get PCV13 then six-twelve months later get PPSV
peripheral arterial occlusionclaudication, pale cool extremity, decreased distal pulses.
thrombophlebitissuperficial vein thrombus, warmth/swelling, lower extreme
Fingolimodimmunomodulator for MS
thrombophlebitis txwarm compresses, elevate extremity, compression stockings, analgesics/anti-inflamm
chronic venous insufficiencybil L ext swell, varic
stocking gloveperiph NP
periph NPTCA SNRI gabapentin/pregabalin
duloxetineqSNRI (indic in neuropathic pain) = Cymbalta
ABI <0.9 in periph artery dzconsult vasc srx

Section 2

Question Answer
cervical pain initial mxup ROM, isometric training, ergonomics, exercise/stretch
cervical vertb pathos neurosrx consultsensory loss/wk/change reflex/ incontinence
on knees alot and tenderness present ant to kneecapprepatellar bursitis
prepatellar bursitis txNSAID compressive wrap, aspirate bursa to r/o inf
patellar tendinitisjumpers knee
focal anterior knee pain inf border patella + kidpatellar tendinitis
patellar tendinitis txrest,ice,activity mod, NSAID
medial sided knee painpes anserine bursitis
pes anserinesartorius,gracilis,semitendinous
pes anserine bursitis risksside to side mvmt, valgus knee, trauma, tight hamstrings ( things that increas pressure on medial knee)
pes anserine bursitis txactivity mod, ice, NSAID, no need to rest
X-ray inferior traction spurchronic patellar tendinitis
bakers cyst=semimembranous bursitis
eldery, up in knee arth, pain in posteriomedial knee(where the muscle inserts onto medial proximal tibia)semimembranous bursitis
semimembranous bursitis(bakers cyst) txactive mod, ice, NSAID, PX therapy
chronic bakers cyst txif pain >2 mo get corticosteroid inj
suprapatellar bursabeneath patella and quad femoris tendon
anterior knee pain above patella may radiate into quadricepssuprapatellar bursitis
suprapatellar bursitistrouble bending knee when walking down stairs.
rest NSAID ice and knee bracesuprapatellar bursitis tx

Section 3

Question Answer
hand foot and mouthcoxsackie A
furuncledeep folliculitis
boil bugstaph a
bronchiolitislo F runny nose cough and periods of apnea
bronchiolitis workupcxr and ELISA of nasal washings for RSV
bronchiolitis txif need to be hospitalized -> contact isolation, hydration, O2 and nebulizer
scattered wheezingbronchiolitis finding
CAP txCAP CALories (Ceftriaxone AZT Levoflox)
selegilineMAOI-B for parkinsons
memantine(NMDA antag)moderate/severe dementia in combo with cholinesterase inhibitors
doneptazilcholinesterase inhibitor
tacrinecholinesterase inhibitor
galantinecholinesterase inhibitor
rivastigminecholinesterase inhibitor
omega 3for parkinsons dz (reduces incidence not progression)

Section 4

Question Answer
Out-pt CAPDoxycycline/Macrolide
NYHA ICHF sx at vigourous activities
NYHA IICHF sx at prolonged/moderate act
NYHA IVsx rest
CHFdyspnea,orthopnea,paroxysmal nocturnal dyspnea
CHF auscdisplaced MI, pathological S3, an S4
vesicoureteral refluxMC cogen cause for febrile UTI
dx vesicoureteral refluxvoiding cystourethrogram

Section 5

Question Answer
deposition monosodium urate crystalgout
goutneedle shape neg birefringence (vs psuedogout which has poistive Birefringence ie makes 2 colors depending on how light hits it, yeLLow paraLLel, blue perpindicular
tx gout flareindomethacin/NSAID
xanthine oxidase inhibitorallopurinol
allopurinoltx of chronic gout
colchicine moadn acute gout by preventing PMN migration to affected joint, indic if unable to tolerate NSAID
colchicinenarrow therapeutic index, up N/V
high purinesardine,anchovie,liver,bacon,trout,salmon,turkey
probenecidfor long term tx of hyperuricemia (pro uric acid excretion)
best initial modality most SENSITIVE for H PyloriSerology (ELISA)
when to bx for H Pyloribleeding,anemia,early satiety, unexplained weight loss, progressive dysphagia, odynophagia, recurrent vommiting, hx of GI cx,
confirm H Pylori eradicationstool assay = most cost effective, best= urea breath test
dx H Pylori, confirm eradication H Pyloriserology(ELISA), Urea Breath test(best) or stool assay(cheaper)

Section 6

Question Answer
(mobic) meloxicam NSAID
Hidradenitis SuppurativePainful recurrent boils
Suppurationformation and disch of pus
Hidraasenitis suppurativeonly occurs in areas of APOCRINE glands (groins and armpits)