ABFM In training exam pearls
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
Answer Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated hep B
can lead to liver disease
entry to balloon time for PCI! - Answer 120 minutes
time limit from onset of MI to balloon time - Answer should get it done w/in 12 hours
Absolute contraindications to Fibrinolysis - Answer Previous hemorrhage stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
acute cholecystitis - Answer Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators
(PDE5?) - Answer NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - Answer Calcaneal apophysitis, also called Sever's disease, is a
common cause of heel pain in young athletes, especially those who participate in
basketball, soccer, track, and other sports that involve running. Typically the heel
apophysis closes by age 15. Treatment options include activity modification, the use of
ice packs and/or moist heat, stretching, analgesics, and orthotic devices. The use of
therapeutic ultrasound on the active bone growth plates in children is contraindicated.
in pressure ulcers what solutions to avoid, and what to use! - Answer recommended
that pressure ulcers not be cleaned with povidone/iodine, Dakin's solution, hydrogen
peroxide, wet-to-dry dressings, or any solutions that may impede granulation tissue
formation. These sites should be cleaned with either saline or tap water and covered
with hydrocolloid, foam, or another nonadherent dressing that promotes a moist
environment.
Chronic paraoxysmal hemicrania - Answer resembles cluster headache but has some
important differences. Like cluster headaches, these headaches are unilateral and
accompanied by conjunctival hyperemia and rhinorrhea. However, these headaches are
more frequent in women, and the paroxysms occur many times each day. This type of
headache falls into a group of headaches that have been labeled indomethacin-
responsive headaches because they respond dramatically to *indomethacin.*
, normal spirometry but low DLCO - Answer chronic pulmonary embolus
Antibiotic ppx for dental procedures - Answer give amoxicillin only if prior endocarditis,
prosthetic valve, heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - Answer Current guidelines recommend
referral to a nephrologist if a patient's renal disease is either of unknown etiology, is
deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per year), or is severe.
Thresholds used to define severe chronic kidney disease include an eGFR <30
mL/min/1.73 m2, a urine albumin to creatinine ratio >300 g/mg, persistent acidosis or
potassium imbalance, non-iron deficiency anemia with a hemoglobin level <10 g/dL,
and evidence of secondary hyperparathyroidism.
Causes of peripheral neuropathy - Answer common treatable causes of peripheral
neuropathy, which include *diabetes mellitus, hypothyroidism, and nutritional
deficiencies*. Additional causes of peripheral neuropathy include *chronic liver disease
and renal disease*. It is important to consider medications as a possible cause,
including *amiodarone, digoxin, nitrofurantoin, and statins. Excessive alcohol* use is
another important consideration. In addition think *MGUS, and Multiple Myeloma*
Failure rates of contraception - Answer The annual failure rate of combined oral
contraceptive pills with typical use is 9%. Typical failure rates for other contraceptive
methods are 0.2% for the levonorgestrel IUD, 6% for injectable progestin, 18% for male
condoms, and 22% for the withdrawal method.
mental status exam for acute changes like delerium - Answer Confusion Assessment
Method (CAM)
to diagnose adult ADHD, symptoms must be present before what age? - Answer Age 12
Complications of GERD in infants - Answer Gastroesophageal reflux accounts for a
significant number of cases of failure to thrive, crib death, and recurrent pneumonia.
Features of gastroesophageal reflux include a history of recurrent pneumonia, a low
growth curve, a family history of sudden infant death syndrome, and normocytic anemia.
coining "sickness leaving body" - Answer it's a south asian thing, kids have multiple red
welts and superficial abrasions scattered on chest and upper back
thyroid replacement in the setting of gastritis - Answer need to increase by 30%
because gastritis decreases absorption of thyroid. ex: h. pylori, treat h.pylori to negate
this effect
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
Answer Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated hep B
can lead to liver disease
entry to balloon time for PCI! - Answer 120 minutes
time limit from onset of MI to balloon time - Answer should get it done w/in 12 hours
Absolute contraindications to Fibrinolysis - Answer Previous hemorrhage stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
acute cholecystitis - Answer Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators
(PDE5?) - Answer NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - Answer Calcaneal apophysitis, also called Sever's disease, is a
common cause of heel pain in young athletes, especially those who participate in
basketball, soccer, track, and other sports that involve running. Typically the heel
apophysis closes by age 15. Treatment options include activity modification, the use of
ice packs and/or moist heat, stretching, analgesics, and orthotic devices. The use of
therapeutic ultrasound on the active bone growth plates in children is contraindicated.
in pressure ulcers what solutions to avoid, and what to use! - Answer recommended
that pressure ulcers not be cleaned with povidone/iodine, Dakin's solution, hydrogen
peroxide, wet-to-dry dressings, or any solutions that may impede granulation tissue
formation. These sites should be cleaned with either saline or tap water and covered
with hydrocolloid, foam, or another nonadherent dressing that promotes a moist
environment.
Chronic paraoxysmal hemicrania - Answer resembles cluster headache but has some
important differences. Like cluster headaches, these headaches are unilateral and
accompanied by conjunctival hyperemia and rhinorrhea. However, these headaches are
more frequent in women, and the paroxysms occur many times each day. This type of
headache falls into a group of headaches that have been labeled indomethacin-
responsive headaches because they respond dramatically to *indomethacin.*
, normal spirometry but low DLCO - Answer chronic pulmonary embolus
Antibiotic ppx for dental procedures - Answer give amoxicillin only if prior endocarditis,
prosthetic valve, heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - Answer Current guidelines recommend
referral to a nephrologist if a patient's renal disease is either of unknown etiology, is
deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per year), or is severe.
Thresholds used to define severe chronic kidney disease include an eGFR <30
mL/min/1.73 m2, a urine albumin to creatinine ratio >300 g/mg, persistent acidosis or
potassium imbalance, non-iron deficiency anemia with a hemoglobin level <10 g/dL,
and evidence of secondary hyperparathyroidism.
Causes of peripheral neuropathy - Answer common treatable causes of peripheral
neuropathy, which include *diabetes mellitus, hypothyroidism, and nutritional
deficiencies*. Additional causes of peripheral neuropathy include *chronic liver disease
and renal disease*. It is important to consider medications as a possible cause,
including *amiodarone, digoxin, nitrofurantoin, and statins. Excessive alcohol* use is
another important consideration. In addition think *MGUS, and Multiple Myeloma*
Failure rates of contraception - Answer The annual failure rate of combined oral
contraceptive pills with typical use is 9%. Typical failure rates for other contraceptive
methods are 0.2% for the levonorgestrel IUD, 6% for injectable progestin, 18% for male
condoms, and 22% for the withdrawal method.
mental status exam for acute changes like delerium - Answer Confusion Assessment
Method (CAM)
to diagnose adult ADHD, symptoms must be present before what age? - Answer Age 12
Complications of GERD in infants - Answer Gastroesophageal reflux accounts for a
significant number of cases of failure to thrive, crib death, and recurrent pneumonia.
Features of gastroesophageal reflux include a history of recurrent pneumonia, a low
growth curve, a family history of sudden infant death syndrome, and normocytic anemia.
coining "sickness leaving body" - Answer it's a south asian thing, kids have multiple red
welts and superficial abrasions scattered on chest and upper back
thyroid replacement in the setting of gastritis - Answer need to increase by 30%
because gastritis decreases absorption of thyroid. ex: h. pylori, treat h.pylori to negate
this effect
