ABFM ITE 2018
pt who had recently been on CRUISE SHIP
NOW HAS
productive COUGH- sometime bloody
HA
MUSCLE ACHE - Answer LEGIONELLA PNEUMONIA
DIAG= URINE LEGIONELLA ANTIGEN
WHAT increases the risk of developmental dysplasia of the hip in infants - Answer
BREECH PRESENTATION
-
REGARDLESS OF DELIVERY BEING C/S OR NSVD
CARPET LAYER PT HAS LEFT KNEE SWELLING,
MINIMAL TTP
NO ERYTHEMA, WARMTH
NO TRAUMA
DIAGNOSE
TXQ - Answer PRE-PATELLAR BURSITIS
=
TX= REST ICE COMPRESSION
equiv of olecrenon aseptic bursitis
what is ABSOLUTE CONTRAINDICATION TO
USE OF TPA/FIBRINOLYTIC THERAPY - Answer RECENT ISCHEMIC STROKE IN 3
MONTHS
OTHERS:
ANY HISTORY OF INTRACRANIAL HEMMORHAGE
IF SUSPECT ACUTE Acute intracranial hemorrhage
Persistent elevated blood pressure (systolic >185 mm Hg or diastolic >110 mm Hg
Symptoms of subarachnoid hemorrhage
ANY SORTS OF CONCERNS FOR BLEEDS
Use of anticoagulant drug
,Aortic dissection
PT HAS SUDDEN LEFT HEARING LOSS
NO TRAUMA
NO PAIN, NO BLEEDING, DRAINAIGE, , FEVER
EAR EXAM COMPLETELY NORMAL
DIAGNOSE
TX - Answer IDIOPATHIC
sudden sensorineural hearing loss
=
(SSNHL)
TX= PREDNISONE= ORAL
PT TWISTED ANKLE
Able to bear weight but with significant pain.
She reports pain across her right midfoot
.An examination reveals edema over the lateral malleolus and diffuse tenderness,
but she does not have any pain OVER posterior distal lateral and medial malleoli
SHOULD U DO XRAY OR NOT? - Answer NO XRAY
ALTHOUGH LATERAL MALLEOLUS TTP,
DISTAL PART OF LATERAL/MEDIAL MELLEOLUS IS NOT TTP OR PAINFUL
AND ALTHOUGH PT HAS PAIN,
SHE IS ABLE TO BEAR WEIGHT (4 STEPS)
=
CONSERVATIVE MANAGEMENT
D) Lace-up ankle support, ice, compression, and clinical follow-up
ACCORDING TO OTTAWA ANKLE RULES
WHEN SHOULD U DO
ANKLE XRAY
VS FOOT XRAY - Answer DO BOTH ANKLE AND FOOT XRAY IF
=
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
====
ANKLE XRAY
,=
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
+
PAIN OVER "DISTAL MOST" PART OF LATERAL/MEDIAL MELLEOLUS --back of
medial/lateral melloli
=====
FOOT XRAY
=
PAIN/TTP OVER MIDFOOT REGION
=
OVER 2 REGIONS:
NAVICULAR BONE
AND/OR
BASE OF 5TH MTP JOINT
+
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
Which one of the following factors would increase the risk of atrial fibrillation in
thispatient?
A) Alcohol use
B) Treatment with lisinopril (Prinivil, Zestril)
C) Treatment with pioglitazone (Actos)
D) Use of a continuous positive airway pressure (CPAP) device
E) Physical stress3 - Answer ALCHOL USE
best way to assess the patient's response to oral iron? - Answer RETICULOCYTE
COUNT IN
JUST
1-2 WEEKS
PT WITH CHRONIC URTICARIA
ON LORATADINE= CLARITIN
STILL HAS HIVES
TX? - Answer ADD ON H1 BLOCKER
=
RANITIDINE/CIMETIDINE
First- and second-generation H1 antihistamine receptor antagonists are generally
considered first-linetreatment for chronic urticaria
PT WHOSE BRO HAS ACTIVE TB
HIS PPD TEST= 8MM
NO SX, PE NORMAL
, CXR NORMAL
SHOULD U TREAT THIS KID
IF SO WITH WHAT - Answer YES TX DUE TO CLOSE CONTACT TO ACTIVE TB PT
AND
>5MM INDURATION
TX FOR LATENT TX
=
INH FOR 9 MONTHS
TB TEST POSITIVE IF >5MM FOR WHICH POPULATION - Answer An induration of 5
or more millimeters is considered positive in
-HIV-infected persons
-A recent contact of a person with ACTIVE TB disease
-Persons with fibrotic changes on chest radiograph consistent with prior TB
-Patients with organ transplants
-Persons who are immunosuppressed
An induration of 10 or more millimeters is considered positive in - Answer An induration
of 10 or more millimeters is considered positive in
-Recent immigrants (< 5 years) from high-prevalence countries
-Injection drug users
-Residents and employees of high-risk congregate settings
===>
HEALTH CARE WORKERS
PRISONER/ JAIL
HOME LESS SHELTER
NURSING HOME
An induration of 15 or more millimeters is considered positive in - Answer >An
induration of 15 or more millimeters is considered positive in any person, with no known
risk factors for TB.
SHOULD PT WITH SHELLFISH ALLERGY NOT GOT ORAL OR IV CONTRAST -
Answer NO SAFE TO GIVE CONTRAST
PAIN WITH INTERNAL ROTATION OF SHOULDER
WHAT MUSCLE AFFECTED - Answer SUBSCAPULARIS
PAIN WITH EXTERNAL ROTATION OF SHOLDER
WHAT MUSCLE AFFECTED - Answer TERES MINOR
INFRASPINATOUR
==
pt who had recently been on CRUISE SHIP
NOW HAS
productive COUGH- sometime bloody
HA
MUSCLE ACHE - Answer LEGIONELLA PNEUMONIA
DIAG= URINE LEGIONELLA ANTIGEN
WHAT increases the risk of developmental dysplasia of the hip in infants - Answer
BREECH PRESENTATION
-
REGARDLESS OF DELIVERY BEING C/S OR NSVD
CARPET LAYER PT HAS LEFT KNEE SWELLING,
MINIMAL TTP
NO ERYTHEMA, WARMTH
NO TRAUMA
DIAGNOSE
TXQ - Answer PRE-PATELLAR BURSITIS
=
TX= REST ICE COMPRESSION
equiv of olecrenon aseptic bursitis
what is ABSOLUTE CONTRAINDICATION TO
USE OF TPA/FIBRINOLYTIC THERAPY - Answer RECENT ISCHEMIC STROKE IN 3
MONTHS
OTHERS:
ANY HISTORY OF INTRACRANIAL HEMMORHAGE
IF SUSPECT ACUTE Acute intracranial hemorrhage
Persistent elevated blood pressure (systolic >185 mm Hg or diastolic >110 mm Hg
Symptoms of subarachnoid hemorrhage
ANY SORTS OF CONCERNS FOR BLEEDS
Use of anticoagulant drug
,Aortic dissection
PT HAS SUDDEN LEFT HEARING LOSS
NO TRAUMA
NO PAIN, NO BLEEDING, DRAINAIGE, , FEVER
EAR EXAM COMPLETELY NORMAL
DIAGNOSE
TX - Answer IDIOPATHIC
sudden sensorineural hearing loss
=
(SSNHL)
TX= PREDNISONE= ORAL
PT TWISTED ANKLE
Able to bear weight but with significant pain.
She reports pain across her right midfoot
.An examination reveals edema over the lateral malleolus and diffuse tenderness,
but she does not have any pain OVER posterior distal lateral and medial malleoli
SHOULD U DO XRAY OR NOT? - Answer NO XRAY
ALTHOUGH LATERAL MALLEOLUS TTP,
DISTAL PART OF LATERAL/MEDIAL MELLEOLUS IS NOT TTP OR PAINFUL
AND ALTHOUGH PT HAS PAIN,
SHE IS ABLE TO BEAR WEIGHT (4 STEPS)
=
CONSERVATIVE MANAGEMENT
D) Lace-up ankle support, ice, compression, and clinical follow-up
ACCORDING TO OTTAWA ANKLE RULES
WHEN SHOULD U DO
ANKLE XRAY
VS FOOT XRAY - Answer DO BOTH ANKLE AND FOOT XRAY IF
=
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
====
ANKLE XRAY
,=
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
+
PAIN OVER "DISTAL MOST" PART OF LATERAL/MEDIAL MELLEOLUS --back of
medial/lateral melloli
=====
FOOT XRAY
=
PAIN/TTP OVER MIDFOOT REGION
=
OVER 2 REGIONS:
NAVICULAR BONE
AND/OR
BASE OF 5TH MTP JOINT
+
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
Which one of the following factors would increase the risk of atrial fibrillation in
thispatient?
A) Alcohol use
B) Treatment with lisinopril (Prinivil, Zestril)
C) Treatment with pioglitazone (Actos)
D) Use of a continuous positive airway pressure (CPAP) device
E) Physical stress3 - Answer ALCHOL USE
best way to assess the patient's response to oral iron? - Answer RETICULOCYTE
COUNT IN
JUST
1-2 WEEKS
PT WITH CHRONIC URTICARIA
ON LORATADINE= CLARITIN
STILL HAS HIVES
TX? - Answer ADD ON H1 BLOCKER
=
RANITIDINE/CIMETIDINE
First- and second-generation H1 antihistamine receptor antagonists are generally
considered first-linetreatment for chronic urticaria
PT WHOSE BRO HAS ACTIVE TB
HIS PPD TEST= 8MM
NO SX, PE NORMAL
, CXR NORMAL
SHOULD U TREAT THIS KID
IF SO WITH WHAT - Answer YES TX DUE TO CLOSE CONTACT TO ACTIVE TB PT
AND
>5MM INDURATION
TX FOR LATENT TX
=
INH FOR 9 MONTHS
TB TEST POSITIVE IF >5MM FOR WHICH POPULATION - Answer An induration of 5
or more millimeters is considered positive in
-HIV-infected persons
-A recent contact of a person with ACTIVE TB disease
-Persons with fibrotic changes on chest radiograph consistent with prior TB
-Patients with organ transplants
-Persons who are immunosuppressed
An induration of 10 or more millimeters is considered positive in - Answer An induration
of 10 or more millimeters is considered positive in
-Recent immigrants (< 5 years) from high-prevalence countries
-Injection drug users
-Residents and employees of high-risk congregate settings
===>
HEALTH CARE WORKERS
PRISONER/ JAIL
HOME LESS SHELTER
NURSING HOME
An induration of 15 or more millimeters is considered positive in - Answer >An
induration of 15 or more millimeters is considered positive in any person, with no known
risk factors for TB.
SHOULD PT WITH SHELLFISH ALLERGY NOT GOT ORAL OR IV CONTRAST -
Answer NO SAFE TO GIVE CONTRAST
PAIN WITH INTERNAL ROTATION OF SHOULDER
WHAT MUSCLE AFFECTED - Answer SUBSCAPULARIS
PAIN WITH EXTERNAL ROTATION OF SHOLDER
WHAT MUSCLE AFFECTED - Answer TERES MINOR
INFRASPINATOUR
==
