Untitled Quiz

Antidepressants and Smoking Cessation

• Bupropion is contraindicated in patients with eating disorders.

Tobacco Use

• Leading cause of preventable morbidity and mortality in the US is tobacco usage.

Alcohol Abuse Counseling

• USPSTF recommends counseling and screening for alcohol misuse in adults.

Immunizations During Pregnancy

• Tdap vaccine is safe for administration in pregnant women.

Heart Failure Self-Help

• In NYHA class 2 heart failure, patients should avoid NSAID use while on optimal medications.

Vitamin D Supplementation for Infants

• Breastfed infants require 400 IU of Vitamin D/day during the first month of life.

Newborn Respiratory Complications

• Common cause of elevated respiratory rate in a term infant post-C-section is transient tachypnea of the newborn.

Breastfeeding Jaundice

• Characterized by insufficient feeds during breastfeeding.

SIDS Prevention

• To reduce SIDS risk, infants should be protected from second-hand smoke exposure.

Failure to Thrive in Infants

• Most cases are due to inadequate caloric intake.

Medicare Coverage for Elderly

• Medicare will only cover facility living costs with documented medical necessity.

Medicare Budget Allocation

• The majority of Medicare spending goes to the 20% of recipients with five or more chronic conditions.

Parkinson's Symptoms Management

• Address Parkinson's symptoms by discontinuing risperdone, metoclopramide, and valproate.

Long-Term Parkinson's Therapy

• To reduce dyskinesia risks in Parkinson's, consider a dopamine agonist like ropinirole.

Treatment for C. difficile

• Initiate treatment with oral vancomycin 125 mg QID for C. difficile infection.

Peripheral Vision Loss

• Glaucoma is a common cause of peripheral vision loss.

Hearing Loss

• Presbycusis is associated with increased hearing threshold at higher frequencies.

Polymyalgia Rheumatica Complications

• Patients are at risk for developing giant cell arteritis.

Management of Osteoporosis

• In the case of vertebral compression fracture, assess for secondary causes of osteoporosis.

Analgesic Benefits of Calcitonin

• Calcitonin has shown analgesic benefits in acute osteoporotic fractures.

Decision-Making Capacity

• In the absence of advance directives, a patient's sister is typically next in line for healthcare decision-making.

Capacity and Medical Procedures

• If a patient with dementia refuses a procedure but a DPOA agrees, do not proceed without the patient's consent.

Sexual Activity in Older Couples

• The most common reason for lack of sexual activity in older heterosexual couples is the medical condition of the male partner.

Urinary Tract Infections in Elderly

• Treat urinary tract infections in elderly women with signs of urgency, frequency or dysuria.

Acute Low Back Strain Recovery

• Corticosteroids have not been shown to aid recovery from acute low back strain.

Vitamin D and Calcium in Postmenopausal Women

• USPSTF does not recommend daily vitamin D3 and calcium supplementation for primary fracture prevention.

Surgery for Motor Deficits

• Evidence supports considering surgical intervention for patients with type 2 diabetes and motor deficits.

Eccentric Contractions for Tendinopathy

• Rehabilitation for overuse tendinopathies like lateral epicondylosis should include eccentric contractions.

Running Injury Management

• For non-acute patellar pain, reduce running distance and initiate physical therapy.

Carpal Tunnel Syndrome

• The flick sign is the most sensitive indicator in diagnosing carpal tunnel syndrome.

Tarsal Tunnel Syndrome

• Symptoms include burning medial heel pain and may benefit from orthotic support.

Developmental Screening

• Refer infants who do not follow developmental milestones for further evaluation.

Early Infant Nutrition

• Introduce table food at the 9-month well-child visit.

Bedwetting in Children

• Occurs in 20-25% of boys aged 5, and reassurance is key.

Child Car Safety

• A 7-year-old should be seated in a booster seat using a lap/shoulder belt.

Tanner Stage Assessment

• Tanner stage III indicates small but developed breasts and minimal pubic hair.

Bulimia Nervosa Prevalence

• More prevalent among adolescent females than anorexia nervosa.

Elderly Patient Behavioral Changes

• Review outpatient medications for sudden behavioral changes in elderly patients.

Dementia Diagnosis

• Clinical signs of memory failure and word-finding difficulty indicate dementia.

Most Common Dementia Type

• Alzheimer’s disease is the most prevalent type of dementia.

Risk Factors for Dementia

• Aging is the primary risk factor for developing dementia.

Mild Neurocognitive Disorder

• Patients may exhibit memory issues but retain ability to manage daily activities.

Vascular Dementia Indicators

• Symptoms may include impaired gait and diminished speech volume, often with a medical history of hypertension and diabetes.

Protective Factors Against Dementia

• Higher educational attainment is protective against dementia.

Non-Pharmacological Management of Advanced Dementia

• Non-pharmacological strategies should be explored for managing inappropriate behaviors.

Sepsis Evaluation in Infants

• Newborns with fever should undergo inpatient sepsis evaluations, regardless of the appearance of well-being.

Lethargy in Young Children

• In a lethargic child with fever, a urinalysis with cultures is essential for diagnosis.

Supportive Care for Viral Symptoms

• For sore throat and cough without complications, supportive care is often sufficient.

Croup Treatment

• Nebulized epinephrine and dexamethasone are key in treating croup.

RSV Management in Children

• Supplemental oxygen and fluids are indicated for managing RSV with mild peribronchial cuffing on CXR.

Day Care Return Post-Infection

• A child with a mild rash post-fever can return to daycare immediately.

Kawasaki Disease Management

• Treatment involves rehydration, inpatient immune globulin, and high-dose aspirin.

Elbow Pain Treatment in Children

• Use hyperpronation as an effective treatment for potential elbow injuries due to trauma.

Median Nerve Injury from FOOSH

• Distal radial fractures commonly injure the median nerve.

Scaphoid Fracture Treatment

• Best treatment for scaphoid fracture is a thumb spica cast for 8 weeks.

Management of Mallet Finger

• Referral to a hand surgeon is warranted for significant distal phalanx injuries.

Injury Management for Head-Impacted Fingers

• Immobilization of the distal interphalangeal joint in extension is critical after injury.

Osteoporosis Consequences

• Vertebral compression fractures significantly increase the risk of 15% mortality.

Hip Fracture Diagnosis

• Diagnosis is confirmed with a history of pain and ambulation difficulties after a fall.

Ottawa Ankle Rules Exclusions

• Discrete bony tenderness at the anterior distal fibula is not included in the Ottawa Ankle Rules.

Hypertrophic Cardiomyopathy Indicators

• Crescendo-decrescendo systolic murmur intensifying with Valsalva is a finding in suspected hypertrophic cardiomyopathy.

Heat Illness Diagnosis

• Mental status changes differentiate between heat exhaustion and heat stroke.

Concussion Management

• Physical rest is advised during the first 24-48 hours after a concussion.

Sports Injury Statistics

• Football has the highest overall injury rate among high school sports.

Sensitive Knee Injury Test

• The Thessaly test is the most sensitive for detecting meniscal tears.

ACL Injuries in High School Sports

• Football holds the highest rate of ACL injuries in high school athletes.

Early Range of Motion for Ankle Sprains

• Early range of motion exercises should be recommended post ankle injury.

Aging and Pharmacokinetics

• Absorption of drugs changes least with age.

Lipophilia of Propranolol

• Lipophilia explains worsened bradycardia and confusion when switched from atenolol to propranolol in the elderly.

Active Drug Metabolites

• Prolonged effects of medications in elderly patients are often due to active metabolites.

Pharmacokinetics and Aging

• Drug elimination is significantly altered with age.

Increased Bleeding Risk with Warfarin

• Aging alters pharmacodynamic responses, increasing bleeding risk on warfarin.

Long-term Osteoporosis Medication Impact

• Pantoprazole can contribute to osteoporosis in long-term use.

Diabetes Management in Older Adults

• Discontinuing glimiperide may be advisable in older adults with managed A1c.

Cognitive Functions and Medication Impacts

• Reducing amitriptyline can improve cognitive function and reduce fall risk in the elderly.

Musculoskeletal Conditions in Children

• Duchenne's muscular dystrophy is more commonly diagnosed in males.

Pediatric Bone Tumor Characteristics

• Non-ossifying fibromas typically resolve as the child matures.

Femoral Anteversion Diagnosis

• Inwardly pointed toes and patellae in a clumsy child suggests femoral anteversion.

Slipped Capital Femoral Epiphysis

• Common in overweight children presenting with hip pain; often requires radiographic investigation.

Diagnosis for Abrupt Limps

• Conduct CBC, ESR, and CRP to assess a child presenting with sudden hip pain and fever.

Pitcher’s Elbow Pain

• Tenderness over the medial epicondyle likely indicates an apophysitis due to overuse.

Sever's Disease

• Common in children experiencing heel pain related to activity, signifying stress at the calcaneal growth plate.

Pediatric Obesity Associations

• Pediatric obesity does not decrease the risk of herniated### Case Studies and Definitions

• A patient with a temperature of 100.8°F, purulent rhinorrhea, and minimal tenderness over the frontal and maxillary sinuses should be treated with decongestants and mucolytics.

• A 57-year-old with brief episodes of spinning sensation and dizziness due to quick movements likely has benign paroxysmal positional vertigo (BPPV), with no associated hearing symptoms.

• Among bite wounds, a cat bite to the hand carries the highest risk of infection.

• A 24-year-old male develops a rash over three days with central clearing, likely indicating Lyme disease after a visit to Martha's Vineyard; treatment is doxycycline 100 mg bid for 10 days.

• In cases of allergic reactions presenting with rash, diffuse pruritus, erythema, and facial/oral swelling, the first-line medication is epinephrine.

• A 21-year-old college student who ingested Tylenol and alcohol should be given activated charcoal as immediate treatment.

• A 38-year-old female with a history of laparoscopic cholecystectomy presents with bilateral pitting ankle edema; the initial diagnostic study of choice is a D-dimer test to assess for possible thrombosis.

• A 63-year-old male experiences shortness of breath (SOB) with exertion and pleuritic chest pain, presenting with low SpO2, tachycardia, and tachypnea after returning from Japan; the best initial diagnostic study is CT angiography to evaluate for a pulmonary embolism.