Family Med Aquifer Test Questions And Answers
Verified 100% Correct
Recommended duration of anticoagulation for 1st provoked or unprovoked DVT or PE -
ANSWER- 3 months
(may consider 6 months for for unproked with low-mod bleeding risk)
Recommended duration of anticoagulation for 1st DVT and PE with associated active
CA - ANSWER- extended treatment (ie, indefinitely)
Criteria for recommended screening for inherited thrombophilia - ANSWER- -
initial
thrombosis occurring prior to age 50 w/o an immediately identified risk
factor
- a FHx of VTE
- recurrent venous
thrombosis
- thrombosis occurring in unusual vascular beds such as portal, hepatic, mesenteric,
or
cerebral
veins
How long does it take to reach the steady state for warfarin - ANSWER- the half life is
~40 hrs; takes 5-7 days to reach the therapeutic INR above 2
Duration of migraine headaches - ANSWER- 4-72 hrs
Number of episodes needed to diagnose migraine headaches - ANSWER- 5 episodes
Duration of symptoms of tension headaches - ANSWER- 30 min to 7 days
Number of episodes needed to dx tension headaches - ANSWER- 10 episodes
Associated symptoms of cluster HAs - ANSWER- rhinorrhea, lacrimation, facial
sweating, miosis, eyelid edema, conjunctival injection, ptosis
Tension headaches: quality of pain - ANSWER- several unilateral orbital, periorbital,
supraorbital, or temporal pain
duration of symptoms of tension headaches - ANSWER- 15-180 min
,- needs 5 episodes to dx
Causes of serious secondary headaches - ANSWER- - meningitis (feever, mental
status changes, stiff neck)
- ICH (sudden onset, severe, recent trauma, elevated BP)
- brain tumor (cognitive impairment, weight loss or other systemic sxs, abnml neuro
exam)
- TBI (head injury with subsequent confusion and amnesia; LOC, dizziness, n/v; over
hrs-days; mood and cognitive disturbances, sensitivity to light and noise, and sleep
disturbances)
GAD-2 (screening tool for anxiety) - ANSWER- Over the last 2 weeks, 1) feeling
nervous, anxious, or on edge? 2) not being able to stop or control worrying
A positive screening test is >3 pts
Signs of increased ICP - ANSWER- -Papilledema
-AMS
Kernig's sign - ANSWER- Severe stiffness of the hamstrings causes an inability to
straighten the leg when the hip is flexed to 90 degrees. Sign of meningitis
Brudzinski's sign - ANSWER- Severe neck stiffness causes a patient's hips and knees
to flex when the neck is flexed
Meds or substances that can trigger HAs - ANSWER- -Estrogen
-Tobacco caffeine, or alcohol
-Aspartame and phenylalanine (From diet soda)
Migraine treatment - ANSWER- Triptans
Ergot alkaloids - ergotamine (Ergostat), ergotamine/caffeine (Cafergot),
dihydroergotamine (DHE)
-Can't use the two concurrently; both contraindicated in pregnancy
Triptans contraindications - ANSWER- -Hx of heart dz, stroke, or uncontrolled HTN
-Combo with SSRI can cause serotonin syndrome
Migraine prophylaxis - ANSWER- -Pts with migraines >2/wk
-Beta blockers, TCAs, neurostabilizer, herbal (butterbur)
Beta blockers for migraines - ANSWER- -FLT: Metoprolol, propranolol
-2nd: atenolol, nadolol
TCAs for migraines - ANSWER- -FLT: amitriptyline
,-excellent efficacy, cheap
-also good for fibromyalgia and tension-type HA
Neurostabilizer for migraines - ANSWER- -second line: divalproex sodium, topiramate
- good efficacy, expensive
Opioid use disorder - ANSWER- • opioids taken in larger amounts than intended
• unsuccessful efforts to control use
• significant time spent in opioid-related activities
• craving
• use results in unmet obligations at work, school, or home
• continued use despite significant interpersonal problems related to use
• other activities neglected due to use
• use in physically hazardous situations
• continued use despite physical or psychological problems related to use
• tolerance
• withdrawal
Criteria for diagnosing HTN - ANSWER- 2 elevated measurements - 5 min apart, one in
each arm - made on 2 or more visits
-pts shouldn't be acutely ill
The ACC/AHA guidelines say the goal BP for all pts is - ANSWER- 130/80
Low-dose vs high-dose thiazides - ANSWER- low-dose thiazides showed improved
health outcomes with marked reduction in morbidity and mortality; high-dose were
found to be inferior
Starting dose for thiazide diuretics for HTN - ANSWER- 25 mg/d
older adults should be started at lower doses 6.25 mg or 12.5mg/d
ACEi, ARBs can cause what electrolyte imbalance - ANSWER- hyperkalemia
Thiazides side effects - ANSWER-
hyponatremia hypokalemia high uric acid
hypercalcemia
ACEis shouldn't be used with - ANSWER- ARBs or direct renin inhibitor
ACEis side effects - ANSWER- hyperkalemia (esp in CKD pts or those on K+
supplement or K+ sparing drugs)
cough
, avoid in pregnancy
ARBs side effects - ANSWER- hyperkalemia (esp in CKD pts or those on K+
supplement or K+ sparing drugs)
angioedema (pts who get this with an ACEi can receive an ARB beginning 6 wks after
ACEi is d/ced)
The USPSTF strongly recommends lipid screening for what age for men and women -
ANSWER- men >35 yo
women >45 yo
treat suboptimal lipids
PQRST - ANSWER- provocative/palliative, quality, region/radiation, severity, timing
Panic attack symptoms - ANSWER- abrupt, reaches a peak within minutes
4/13 of the following:
-palpitations, heart pounding, accelerated HR
- sweating
- trembling or shaking
-sensations of SOB or smothering
-feelings of choking
-CP or discomfort
-nausea or abd distress
-feeling dizzy, unsteady, light-headed, or faint
-chills or heat sensations
- paresthesias (numbness or tingling)
-derealization or depersonalization
- fear of losing control or "going crazy"
-fear of dying
DSM-V Criteria for panic disorder - ANSWER- A. recurrent unexpected panic attacks
B. at least 1 attack followed by >1 mo of: persistent worry about panic attacks,
maladaptive changes related to the attacks
C. The disturbance not attributable to other things
D. The disturbance not better explained by other mental disorder
Midsystolic click with a holosystolic murmur is suggestive of - ANSWER- MVP (most
common structural heart abnormality with palpitations)
Systolic murmur at the LSB increased with Valsalva would suggest - ANSWER-
hypertrophic obstructive cardiomyopathy
harsh crescendo-decrescendo radiating to the carotids would suggest - ANSWER-
Verified 100% Correct
Recommended duration of anticoagulation for 1st provoked or unprovoked DVT or PE -
ANSWER- 3 months
(may consider 6 months for for unproked with low-mod bleeding risk)
Recommended duration of anticoagulation for 1st DVT and PE with associated active
CA - ANSWER- extended treatment (ie, indefinitely)
Criteria for recommended screening for inherited thrombophilia - ANSWER- -
initial
thrombosis occurring prior to age 50 w/o an immediately identified risk
factor
- a FHx of VTE
- recurrent venous
thrombosis
- thrombosis occurring in unusual vascular beds such as portal, hepatic, mesenteric,
or
cerebral
veins
How long does it take to reach the steady state for warfarin - ANSWER- the half life is
~40 hrs; takes 5-7 days to reach the therapeutic INR above 2
Duration of migraine headaches - ANSWER- 4-72 hrs
Number of episodes needed to diagnose migraine headaches - ANSWER- 5 episodes
Duration of symptoms of tension headaches - ANSWER- 30 min to 7 days
Number of episodes needed to dx tension headaches - ANSWER- 10 episodes
Associated symptoms of cluster HAs - ANSWER- rhinorrhea, lacrimation, facial
sweating, miosis, eyelid edema, conjunctival injection, ptosis
Tension headaches: quality of pain - ANSWER- several unilateral orbital, periorbital,
supraorbital, or temporal pain
duration of symptoms of tension headaches - ANSWER- 15-180 min
,- needs 5 episodes to dx
Causes of serious secondary headaches - ANSWER- - meningitis (feever, mental
status changes, stiff neck)
- ICH (sudden onset, severe, recent trauma, elevated BP)
- brain tumor (cognitive impairment, weight loss or other systemic sxs, abnml neuro
exam)
- TBI (head injury with subsequent confusion and amnesia; LOC, dizziness, n/v; over
hrs-days; mood and cognitive disturbances, sensitivity to light and noise, and sleep
disturbances)
GAD-2 (screening tool for anxiety) - ANSWER- Over the last 2 weeks, 1) feeling
nervous, anxious, or on edge? 2) not being able to stop or control worrying
A positive screening test is >3 pts
Signs of increased ICP - ANSWER- -Papilledema
-AMS
Kernig's sign - ANSWER- Severe stiffness of the hamstrings causes an inability to
straighten the leg when the hip is flexed to 90 degrees. Sign of meningitis
Brudzinski's sign - ANSWER- Severe neck stiffness causes a patient's hips and knees
to flex when the neck is flexed
Meds or substances that can trigger HAs - ANSWER- -Estrogen
-Tobacco caffeine, or alcohol
-Aspartame and phenylalanine (From diet soda)
Migraine treatment - ANSWER- Triptans
Ergot alkaloids - ergotamine (Ergostat), ergotamine/caffeine (Cafergot),
dihydroergotamine (DHE)
-Can't use the two concurrently; both contraindicated in pregnancy
Triptans contraindications - ANSWER- -Hx of heart dz, stroke, or uncontrolled HTN
-Combo with SSRI can cause serotonin syndrome
Migraine prophylaxis - ANSWER- -Pts with migraines >2/wk
-Beta blockers, TCAs, neurostabilizer, herbal (butterbur)
Beta blockers for migraines - ANSWER- -FLT: Metoprolol, propranolol
-2nd: atenolol, nadolol
TCAs for migraines - ANSWER- -FLT: amitriptyline
,-excellent efficacy, cheap
-also good for fibromyalgia and tension-type HA
Neurostabilizer for migraines - ANSWER- -second line: divalproex sodium, topiramate
- good efficacy, expensive
Opioid use disorder - ANSWER- • opioids taken in larger amounts than intended
• unsuccessful efforts to control use
• significant time spent in opioid-related activities
• craving
• use results in unmet obligations at work, school, or home
• continued use despite significant interpersonal problems related to use
• other activities neglected due to use
• use in physically hazardous situations
• continued use despite physical or psychological problems related to use
• tolerance
• withdrawal
Criteria for diagnosing HTN - ANSWER- 2 elevated measurements - 5 min apart, one in
each arm - made on 2 or more visits
-pts shouldn't be acutely ill
The ACC/AHA guidelines say the goal BP for all pts is - ANSWER- 130/80
Low-dose vs high-dose thiazides - ANSWER- low-dose thiazides showed improved
health outcomes with marked reduction in morbidity and mortality; high-dose were
found to be inferior
Starting dose for thiazide diuretics for HTN - ANSWER- 25 mg/d
older adults should be started at lower doses 6.25 mg or 12.5mg/d
ACEi, ARBs can cause what electrolyte imbalance - ANSWER- hyperkalemia
Thiazides side effects - ANSWER-
hyponatremia hypokalemia high uric acid
hypercalcemia
ACEis shouldn't be used with - ANSWER- ARBs or direct renin inhibitor
ACEis side effects - ANSWER- hyperkalemia (esp in CKD pts or those on K+
supplement or K+ sparing drugs)
cough
, avoid in pregnancy
ARBs side effects - ANSWER- hyperkalemia (esp in CKD pts or those on K+
supplement or K+ sparing drugs)
angioedema (pts who get this with an ACEi can receive an ARB beginning 6 wks after
ACEi is d/ced)
The USPSTF strongly recommends lipid screening for what age for men and women -
ANSWER- men >35 yo
women >45 yo
treat suboptimal lipids
PQRST - ANSWER- provocative/palliative, quality, region/radiation, severity, timing
Panic attack symptoms - ANSWER- abrupt, reaches a peak within minutes
4/13 of the following:
-palpitations, heart pounding, accelerated HR
- sweating
- trembling or shaking
-sensations of SOB or smothering
-feelings of choking
-CP or discomfort
-nausea or abd distress
-feeling dizzy, unsteady, light-headed, or faint
-chills or heat sensations
- paresthesias (numbness or tingling)
-derealization or depersonalization
- fear of losing control or "going crazy"
-fear of dying
DSM-V Criteria for panic disorder - ANSWER- A. recurrent unexpected panic attacks
B. at least 1 attack followed by >1 mo of: persistent worry about panic attacks,
maladaptive changes related to the attacks
C. The disturbance not attributable to other things
D. The disturbance not better explained by other mental disorder
Midsystolic click with a holosystolic murmur is suggestive of - ANSWER- MVP (most
common structural heart abnormality with palpitations)
Systolic murmur at the LSB increased with Valsalva would suggest - ANSWER-
hypertrophic obstructive cardiomyopathy
harsh crescendo-decrescendo radiating to the carotids would suggest - ANSWER-
