Test Bank For Family Practice Guidelines 5th Edition By Jill C.
Cash; Cheryl A. Glass; Jenny Mullen
Type I Hypersensitivity Reaction - ANSWER: *IgE mediate* (sec-min)
-anaphylaxis
-asthma
-hayfever
-hives
-food allergies
-eczema
Type II Hypersensitivity Reaction - ANSWER: *cytotoxic: RBCs* (mins-hrs)
-blood transfusion rxns
-erythroblastosis fetalis
-autoimmune hemolytic anemia
Type III Hypersensitivity Reaction - ANSWER: *immune complex mediated* (hrs)
-serum sickness
-necrotizing vasculitis
-glomerulonephritis
-SLE
-RA
Type IV Hypersensitivity Reaction - ANSWER: *delayed hypersensitivity* (days)
-contact dermatitis
-tubercular lesions
-graft rejection
s/s required for dx of anaphylaxis - ANSWER: skin/mucosal involvement
respiratory compromise
hypotension
meds involved in tx of anaphylaxis - ANSWER: *IM epi*
*antihistamines*: diphenhydramine, hydroxyzine
*H2 blockers*: cimetidine, ranitidine, famotidine
*bronchodilators*: albuterol
*CCS*: methylprednisolone, prednisone
*positive ionotropic agents*: glucagon
*vasopressors*: dopamine
T/F: Serum tryptase levels are elevated in anaphylactic rxn. - ANSWER: True
2 types of incomplete fx - ANSWER: Torus (buckle)
Greenstick
,most common fracture of elbow in adults - ANSWER: radial head fx
most common injury of wrist - ANSWER: Colles fx (dinner fork deformity)
vasculature of concern if supracondylar humerus fx - ANSWER: brachial artery
nerve of concern if humeral shaft fx - ANSWER: radial nerve
nerve of concern if humeral head fx - ANSWER: axillary nerve
MC type of fracture in children & adolescents - ANSWER: clavicle fx
Imaging used to assess stress fx? What else is it used for? - ANSWER: -radionuclide
bone scan
-metastatic disease
What types of fractures is a CT the best imaging for? - ANSWER: carpal bones
elbow
tibial plateau
pelvic
facial
intra-articular
IV abx to be used for open fx - ANSWER: 1st, 2nd generation cephalosporins &
aminoglycosides
tx for femur fx - ANSWER: *Neck fx*: percutaneous screws/hemiarthroplasty
*Shaft fx*: intramedullary rods/plates
*Intertrochanteric fx*: sliding hip screw fix or long gamma nail
most common sites of joint dislocations - ANSWER: shoulder (anteriorly)
hip (posteriorly)
elbow (posteriorly)
BP considered a hypertensive crisis - ANSWER: systolic > 180 or diastolic > 120
hypertensive emergency vs. urgency - ANSWER: *emergency*: where severe
elevation in BP is accompanied by end-organ damage
*urgency*: where severe elevation in BP occurs wo end organ damage (most pts
asymptomatic)
tx of hypertensive urgency - ANSWER: *Nicardipine* (20-40 mg PO q 8-12 h)
*captopril* (25 mg PO q 8-12 h)
*labetalol* (initial dose 200 mg PO, then 200-400 mg dose after 6-12 h as needed)
,Normalize BP gradually over 24-48 h as rapid BP decreases may result in dangerously
reduced organ perfusion
tx of hypertensive emergency - ANSWER: *ICU for IV meds:*
Nicardipine
sodium nitroprusside
labetalol
esmolol
Most pts: aim to lower the BP by 10-15% over the first hour
complications of hypertensive urgency/emergency - ANSWER: AAA, acute ischemic
stroke, acute intracerebral hemorrhage, HTN encephalopathy, acute MI, acute
postoperative HTN
examples of morphologies of dermatologic drug eruptions - ANSWER: morbilliform
urticarial
papulosquamous
pustular
bullous
epidermis sloughs with lateral pressure - ANSWER: Nikolsky sign
What are "fixed" drug eruptions? - ANSWER: *lesions recur in the same area when
offending drug is given*; circular, violaceous, edematous plaques that resolve w
macular hyperpigmentation is characteristic, occur 30 m - 8 h after drug
administration
mgmt of SJS & TEN - ANSWER: burn unit & IVIG
abx with good MRSA coverage - ANSWER: Vancomycin
linezolid
clindamycin
daptomycin
doxycycline
TMP-SMX
tx of cellulitis - ANSWER: dicloxacillin 250 mg or cephalexin 500 mg QID x5-10 days
cellulitis vs. erysipelas - ANSWER: *Cellulitis* - Strep pyogenes or Staph. aureus;
involves deeper subcutaneous tissue; if untreated, necrosis can supervene
*Erysipelas* - Strep. pyogenes; sharply demarcated; involves upper subcutaneous
tissue & lymphatic vessels; self-limited
honey-colored crusts that when removed leave denuded red areas
, tx? - ANSWER: *impetigo*
small areas: Topical bacitracin, mupirocin, & retapamulin
large areas: Keflex, doxy
pathophys of asthma - ANSWER: -Inflamed & thickened mucosa & submucosa
-Increased mucus production by inflamed Goblet cells
-Bronchospasm secondary to contracted muscularis (hypertrophy of bronchial
smooth muscle is also common)
-Increased local WBC presence
expected spirometry if asthma - ANSWER: decreased FEV1
decreased or normal FVC
*FEV1/FVC ratio < 0.7*
What is considered a positive bronchodilator response? - ANSWER: >12% increase in
FEV1 & 200 mL increase in FVC
(confirms dx of asthma)
examples of general strengths of inhaled CCS - ANSWER: beclomethasone >
fluticasone > mometasone > budesonide > triamcinolone
How can peak flow readings be used by patients with asthma to determine use of a
rescue inhaler? - ANSWER: If peak flow is:
-80-100% (green): use SABA as prescribed (1-2 puffs q4-6 hrs PRN)
-50-80% (yellow): quick relief protocol should be initiated, SABA up to 2 tx of 2-6
puffs (or 2 neb tx) 20 minutes apart
-<50% (red): Use SABA, call clinician, go to ER
classification of asthma severity - ANSWER:
MCC of acute bronchitis - ANSWER: Viral: rhinovirus, coronavirus, influenza A/B, RSV,
Parainfluenza
CXR results if acute bronchitis - ANSWER: normal
CXR used more to r/o pneumonia
tx of acute bronchitis - ANSWER: -Generally resolves within 1-3 weeks, *reassure*
pts of this
-abx not needed but are generally overprescribed
-*Supportive* measures → hydration, expectorants (dextromethorphan or
guaifenesin), SABAs, antitussives, rest, APAP
Cash; Cheryl A. Glass; Jenny Mullen
Type I Hypersensitivity Reaction - ANSWER: *IgE mediate* (sec-min)
-anaphylaxis
-asthma
-hayfever
-hives
-food allergies
-eczema
Type II Hypersensitivity Reaction - ANSWER: *cytotoxic: RBCs* (mins-hrs)
-blood transfusion rxns
-erythroblastosis fetalis
-autoimmune hemolytic anemia
Type III Hypersensitivity Reaction - ANSWER: *immune complex mediated* (hrs)
-serum sickness
-necrotizing vasculitis
-glomerulonephritis
-SLE
-RA
Type IV Hypersensitivity Reaction - ANSWER: *delayed hypersensitivity* (days)
-contact dermatitis
-tubercular lesions
-graft rejection
s/s required for dx of anaphylaxis - ANSWER: skin/mucosal involvement
respiratory compromise
hypotension
meds involved in tx of anaphylaxis - ANSWER: *IM epi*
*antihistamines*: diphenhydramine, hydroxyzine
*H2 blockers*: cimetidine, ranitidine, famotidine
*bronchodilators*: albuterol
*CCS*: methylprednisolone, prednisone
*positive ionotropic agents*: glucagon
*vasopressors*: dopamine
T/F: Serum tryptase levels are elevated in anaphylactic rxn. - ANSWER: True
2 types of incomplete fx - ANSWER: Torus (buckle)
Greenstick
,most common fracture of elbow in adults - ANSWER: radial head fx
most common injury of wrist - ANSWER: Colles fx (dinner fork deformity)
vasculature of concern if supracondylar humerus fx - ANSWER: brachial artery
nerve of concern if humeral shaft fx - ANSWER: radial nerve
nerve of concern if humeral head fx - ANSWER: axillary nerve
MC type of fracture in children & adolescents - ANSWER: clavicle fx
Imaging used to assess stress fx? What else is it used for? - ANSWER: -radionuclide
bone scan
-metastatic disease
What types of fractures is a CT the best imaging for? - ANSWER: carpal bones
elbow
tibial plateau
pelvic
facial
intra-articular
IV abx to be used for open fx - ANSWER: 1st, 2nd generation cephalosporins &
aminoglycosides
tx for femur fx - ANSWER: *Neck fx*: percutaneous screws/hemiarthroplasty
*Shaft fx*: intramedullary rods/plates
*Intertrochanteric fx*: sliding hip screw fix or long gamma nail
most common sites of joint dislocations - ANSWER: shoulder (anteriorly)
hip (posteriorly)
elbow (posteriorly)
BP considered a hypertensive crisis - ANSWER: systolic > 180 or diastolic > 120
hypertensive emergency vs. urgency - ANSWER: *emergency*: where severe
elevation in BP is accompanied by end-organ damage
*urgency*: where severe elevation in BP occurs wo end organ damage (most pts
asymptomatic)
tx of hypertensive urgency - ANSWER: *Nicardipine* (20-40 mg PO q 8-12 h)
*captopril* (25 mg PO q 8-12 h)
*labetalol* (initial dose 200 mg PO, then 200-400 mg dose after 6-12 h as needed)
,Normalize BP gradually over 24-48 h as rapid BP decreases may result in dangerously
reduced organ perfusion
tx of hypertensive emergency - ANSWER: *ICU for IV meds:*
Nicardipine
sodium nitroprusside
labetalol
esmolol
Most pts: aim to lower the BP by 10-15% over the first hour
complications of hypertensive urgency/emergency - ANSWER: AAA, acute ischemic
stroke, acute intracerebral hemorrhage, HTN encephalopathy, acute MI, acute
postoperative HTN
examples of morphologies of dermatologic drug eruptions - ANSWER: morbilliform
urticarial
papulosquamous
pustular
bullous
epidermis sloughs with lateral pressure - ANSWER: Nikolsky sign
What are "fixed" drug eruptions? - ANSWER: *lesions recur in the same area when
offending drug is given*; circular, violaceous, edematous plaques that resolve w
macular hyperpigmentation is characteristic, occur 30 m - 8 h after drug
administration
mgmt of SJS & TEN - ANSWER: burn unit & IVIG
abx with good MRSA coverage - ANSWER: Vancomycin
linezolid
clindamycin
daptomycin
doxycycline
TMP-SMX
tx of cellulitis - ANSWER: dicloxacillin 250 mg or cephalexin 500 mg QID x5-10 days
cellulitis vs. erysipelas - ANSWER: *Cellulitis* - Strep pyogenes or Staph. aureus;
involves deeper subcutaneous tissue; if untreated, necrosis can supervene
*Erysipelas* - Strep. pyogenes; sharply demarcated; involves upper subcutaneous
tissue & lymphatic vessels; self-limited
honey-colored crusts that when removed leave denuded red areas
, tx? - ANSWER: *impetigo*
small areas: Topical bacitracin, mupirocin, & retapamulin
large areas: Keflex, doxy
pathophys of asthma - ANSWER: -Inflamed & thickened mucosa & submucosa
-Increased mucus production by inflamed Goblet cells
-Bronchospasm secondary to contracted muscularis (hypertrophy of bronchial
smooth muscle is also common)
-Increased local WBC presence
expected spirometry if asthma - ANSWER: decreased FEV1
decreased or normal FVC
*FEV1/FVC ratio < 0.7*
What is considered a positive bronchodilator response? - ANSWER: >12% increase in
FEV1 & 200 mL increase in FVC
(confirms dx of asthma)
examples of general strengths of inhaled CCS - ANSWER: beclomethasone >
fluticasone > mometasone > budesonide > triamcinolone
How can peak flow readings be used by patients with asthma to determine use of a
rescue inhaler? - ANSWER: If peak flow is:
-80-100% (green): use SABA as prescribed (1-2 puffs q4-6 hrs PRN)
-50-80% (yellow): quick relief protocol should be initiated, SABA up to 2 tx of 2-6
puffs (or 2 neb tx) 20 minutes apart
-<50% (red): Use SABA, call clinician, go to ER
classification of asthma severity - ANSWER:
MCC of acute bronchitis - ANSWER: Viral: rhinovirus, coronavirus, influenza A/B, RSV,
Parainfluenza
CXR results if acute bronchitis - ANSWER: normal
CXR used more to r/o pneumonia
tx of acute bronchitis - ANSWER: -Generally resolves within 1-3 weeks, *reassure*
pts of this
-abx not needed but are generally overprescribed
-*Supportive* measures → hydration, expectorants (dextromethorphan or
guaifenesin), SABAs, antitussives, rest, APAP
