PA Family Medicine EOR Exam Questions And Answers
Verified 100% Correct
Community Acquired Pneumoniae - ANSWER >40 y/o
Sudden onset of rigors, rusty colored sputum
PE: Dullness to percussion
CXR: *Splinting lobar infiltrate*
Labs: ↑ WBC
- S. pneumo (MC)
Tx: PCN > Azithro > Amox > Levaquin (COPD)
*Bullous Myringitis*
Atypical Pneumonia - Legionella - ANSWER Colonize in water condensers/ air-
conditioners
CXR: Unilateral patchy alveolar lower lobe infiltrates
Labs: Hyponatremia
Pontiac Fever, *Bradycardia, Watery Diarrhea,* then Pulmonary Sxs
Dx: Immunofluorescent Ab & ELISA or Direct Fouorescent Ab
Tx: *Azithro*> Levoquin> Tetracycline
Atypical Pneumonia - Chlamydia psittaci - ANSWER Close contacts w/ Birds
Extra-pulmonary minifestations (Enceph, Guillan-Barre, Reiter's)
Hepatosplenomegaly
CXR: Patchy Perihilar infiltrates
Sore throat, hoarseness, "staccato-cough"
Tx: *Doxy*> Azithro
Acute bronchitis in adults - ANSWER MC: viral
*Productive cough <1wk* w/ wheezing & rhonchi
Few systemic Sxs
MCC of minor hemoptysis
CXR: Bronchial wall thickening in both lower lobes
Supportive - NSAIDs/Tylenol, cough-suppressants
Post-Viral Pneumonia - ANSWER Pt w/ Hx of recent Influenza
Fever, Productive cough, bloody sputum, SOB
CXR: *Cavitary lesions*
- S. aureus (Gram + cocci in clusters)
,Tx: Penicillans
Tuberculosis PPD Skin Reaction - ANSWER *>5mm* - HIV, Contact w/ active TB pt,
Nodes or Fibrosis on CXR, Organ transplant
*>10mm* - Immigrant, IVDA, Healthcare workers, Kids, Immunosuppressed
*>15mm* - Pts w/ no known risk factors to TB
Kaposi sarcoma - ANSWER Purple, brown, or black macules, plaques, or nodules
HIV or immunosuppressed pts
Tx: Observe → Surgery → Chemo → Intralesional injection
Herpes Simplex Labialis - ANSWER Painful oral lesions
Vesicles and erosions on the tongue/buccal mucosa/lips
*Multinucleated Giant Cells* on *Tzanck Smear*
Dx: PCR for HSV Type 1 (MC)
Tx: Acyclovir > Valcyclovir > Famciclovir
Basal cell carcinoma - ANSWER MC cutaneous CA
Superficial: pink, thin plaque w/ pearly border
Nodular: *pearly papule* w/ overlying telangiectasias
Rarely metastasizes
Tx: Imiquimod (superficial), surgical excision, Mohs, ED&C
Melanoma - ANSWER *A*symmetry
*B*order irregularity
*C*olor variations
*D*iameter
*E*volution
Dx: Bx of lesion + local lymph node
Tx: Excision, Mohs
Melanoma in the nailbed - ANSWER Hutchinson's time
Burns - ANSWER 1st Degree: Sunburn
2nd Degree: Sunburn w/ painful, *partial thickness* blisters
3rd Degree: Full-Thickness, painless
4th Degree: Black, Charred, Eschar
Cleansing= Water and mild soap
Chemical Burn= Irrigate 20 mintues
,Antibiotics= Silver Sulfadiazine
IV Fluid= Parkland Formula
Androgenic Alopecia - ANSWER Balding - hair follicle stopped in falling-out phase
4 phases (grow, mature, fallout, rest) & 3 cycles
Tx: Minoxidil, Finasteride
*Black-dot Alopecia*: tinea capitis; tx: griseofulvin > terbinifine
Raised Boggy lesion w/ purulent nodules
Painful, Hair loss, fever, lymphadenopathy
Trichopyton or Microsporum sp - ANSWER Kerion
Tx: PO Griseofulvin
Onychomycosis - ANSWER Thickened & discolored toenails
Dx: KOH prep of nail scraping
Tx: Oral *Terbinafine*
Monitor liver enzymes
Tx of fungal infection
Hepatotoxic - ANSWER Terbinafine
Paronychia w/ abscess - ANSWER Erythema & swelling of proximal/lateral nail folds
Tx: 11 blade I&D w/ simple dressing
Rx: Keflex > Bactrim > Clinda > Doxy
Condyloma acuminatum - ANSWER Genital lesions (flesh-colored, exophytic,
verrucous)
Cauliflower-like lesion
HPV 6 & 11
MC: STD
Tx: Cryotherapy > Imiquimob
Pityriasis Rosea - ANSWER Hx of a larger lesion 1 wk prior *Herald Patch* c/o
rash on back
Diffuse papulosquamous rash on the trunk
Langer's Lines distribution *christmas tree-like pattern*
Tx: Antihistamines
Molluscum contagiosum - ANSWER Poxvirus
Self-limiting
Discrete, dome-shaped, skin-colored papules w/ central umbilication
Tx: Cyrotherapy, curettage, cantharidin
, *Test for other STI's (HIV)
Cellulitis - ANSWER Infection of deep dermis & subQ fat
Manage to prevent systemic spread
Well-demarcated border
Cover for MRSA (TMP-SMX) + Cefazolin or Cephalexin
Twitching
Tremors
Convulsions
Bradycardia
Hypotension
Cardiac arrest - ANSWER Signs of lidocaine toxicity
Max dose: 5mg/kg
Max dose w/ Epi: 7mg/kg
LET on open wounds
Oral Abx for MRSA - ANSWER TMP-SMX
Rifampin
Clindamycin
Tetracyclines
Linezolid
Cat Bite - ANSWER MCC: Pasteurella multocida
Tx: Irrigate + leave wound open + *Augmentin*
Complications: Osteomyelitis, Tenosynovitis
Erysipelas - ANSWER MCC: Streptococcus pyogenes
Sx's: Well-demarcated, slightly raised butterfly pattern
Tender & intensely erythematous plaque
Tx: IV cefazolin or ceftriaxone then *PO pcn or amox*
Impetigo - ANSWER Staph or Strep
vesiculopustular honey colored crust
Tx: Mupirocin
Acanthosis nigricans - ANSWER Velvety, verrucous, thick *darkening* of the neck skin
Obesity, Diabetes, Endocrine disorders
GI or GU malignancy, Lymphoma
Hidradenitis suppurativa - ANSWER Chronic disease affecting *apocrine* sweat glands
Female w/ Hx of lesions that come & go
Verified 100% Correct
Community Acquired Pneumoniae - ANSWER >40 y/o
Sudden onset of rigors, rusty colored sputum
PE: Dullness to percussion
CXR: *Splinting lobar infiltrate*
Labs: ↑ WBC
- S. pneumo (MC)
Tx: PCN > Azithro > Amox > Levaquin (COPD)
*Bullous Myringitis*
Atypical Pneumonia - Legionella - ANSWER Colonize in water condensers/ air-
conditioners
CXR: Unilateral patchy alveolar lower lobe infiltrates
Labs: Hyponatremia
Pontiac Fever, *Bradycardia, Watery Diarrhea,* then Pulmonary Sxs
Dx: Immunofluorescent Ab & ELISA or Direct Fouorescent Ab
Tx: *Azithro*> Levoquin> Tetracycline
Atypical Pneumonia - Chlamydia psittaci - ANSWER Close contacts w/ Birds
Extra-pulmonary minifestations (Enceph, Guillan-Barre, Reiter's)
Hepatosplenomegaly
CXR: Patchy Perihilar infiltrates
Sore throat, hoarseness, "staccato-cough"
Tx: *Doxy*> Azithro
Acute bronchitis in adults - ANSWER MC: viral
*Productive cough <1wk* w/ wheezing & rhonchi
Few systemic Sxs
MCC of minor hemoptysis
CXR: Bronchial wall thickening in both lower lobes
Supportive - NSAIDs/Tylenol, cough-suppressants
Post-Viral Pneumonia - ANSWER Pt w/ Hx of recent Influenza
Fever, Productive cough, bloody sputum, SOB
CXR: *Cavitary lesions*
- S. aureus (Gram + cocci in clusters)
,Tx: Penicillans
Tuberculosis PPD Skin Reaction - ANSWER *>5mm* - HIV, Contact w/ active TB pt,
Nodes or Fibrosis on CXR, Organ transplant
*>10mm* - Immigrant, IVDA, Healthcare workers, Kids, Immunosuppressed
*>15mm* - Pts w/ no known risk factors to TB
Kaposi sarcoma - ANSWER Purple, brown, or black macules, plaques, or nodules
HIV or immunosuppressed pts
Tx: Observe → Surgery → Chemo → Intralesional injection
Herpes Simplex Labialis - ANSWER Painful oral lesions
Vesicles and erosions on the tongue/buccal mucosa/lips
*Multinucleated Giant Cells* on *Tzanck Smear*
Dx: PCR for HSV Type 1 (MC)
Tx: Acyclovir > Valcyclovir > Famciclovir
Basal cell carcinoma - ANSWER MC cutaneous CA
Superficial: pink, thin plaque w/ pearly border
Nodular: *pearly papule* w/ overlying telangiectasias
Rarely metastasizes
Tx: Imiquimod (superficial), surgical excision, Mohs, ED&C
Melanoma - ANSWER *A*symmetry
*B*order irregularity
*C*olor variations
*D*iameter
*E*volution
Dx: Bx of lesion + local lymph node
Tx: Excision, Mohs
Melanoma in the nailbed - ANSWER Hutchinson's time
Burns - ANSWER 1st Degree: Sunburn
2nd Degree: Sunburn w/ painful, *partial thickness* blisters
3rd Degree: Full-Thickness, painless
4th Degree: Black, Charred, Eschar
Cleansing= Water and mild soap
Chemical Burn= Irrigate 20 mintues
,Antibiotics= Silver Sulfadiazine
IV Fluid= Parkland Formula
Androgenic Alopecia - ANSWER Balding - hair follicle stopped in falling-out phase
4 phases (grow, mature, fallout, rest) & 3 cycles
Tx: Minoxidil, Finasteride
*Black-dot Alopecia*: tinea capitis; tx: griseofulvin > terbinifine
Raised Boggy lesion w/ purulent nodules
Painful, Hair loss, fever, lymphadenopathy
Trichopyton or Microsporum sp - ANSWER Kerion
Tx: PO Griseofulvin
Onychomycosis - ANSWER Thickened & discolored toenails
Dx: KOH prep of nail scraping
Tx: Oral *Terbinafine*
Monitor liver enzymes
Tx of fungal infection
Hepatotoxic - ANSWER Terbinafine
Paronychia w/ abscess - ANSWER Erythema & swelling of proximal/lateral nail folds
Tx: 11 blade I&D w/ simple dressing
Rx: Keflex > Bactrim > Clinda > Doxy
Condyloma acuminatum - ANSWER Genital lesions (flesh-colored, exophytic,
verrucous)
Cauliflower-like lesion
HPV 6 & 11
MC: STD
Tx: Cryotherapy > Imiquimob
Pityriasis Rosea - ANSWER Hx of a larger lesion 1 wk prior *Herald Patch* c/o
rash on back
Diffuse papulosquamous rash on the trunk
Langer's Lines distribution *christmas tree-like pattern*
Tx: Antihistamines
Molluscum contagiosum - ANSWER Poxvirus
Self-limiting
Discrete, dome-shaped, skin-colored papules w/ central umbilication
Tx: Cyrotherapy, curettage, cantharidin
, *Test for other STI's (HIV)
Cellulitis - ANSWER Infection of deep dermis & subQ fat
Manage to prevent systemic spread
Well-demarcated border
Cover for MRSA (TMP-SMX) + Cefazolin or Cephalexin
Twitching
Tremors
Convulsions
Bradycardia
Hypotension
Cardiac arrest - ANSWER Signs of lidocaine toxicity
Max dose: 5mg/kg
Max dose w/ Epi: 7mg/kg
LET on open wounds
Oral Abx for MRSA - ANSWER TMP-SMX
Rifampin
Clindamycin
Tetracyclines
Linezolid
Cat Bite - ANSWER MCC: Pasteurella multocida
Tx: Irrigate + leave wound open + *Augmentin*
Complications: Osteomyelitis, Tenosynovitis
Erysipelas - ANSWER MCC: Streptococcus pyogenes
Sx's: Well-demarcated, slightly raised butterfly pattern
Tender & intensely erythematous plaque
Tx: IV cefazolin or ceftriaxone then *PO pcn or amox*
Impetigo - ANSWER Staph or Strep
vesiculopustular honey colored crust
Tx: Mupirocin
Acanthosis nigricans - ANSWER Velvety, verrucous, thick *darkening* of the neck skin
Obesity, Diabetes, Endocrine disorders
GI or GU malignancy, Lymphoma
Hidradenitis suppurativa - ANSWER Chronic disease affecting *apocrine* sweat glands
Female w/ Hx of lesions that come & go
