Download Family Medicine COMAT Combank Questions with answers and more Exams Nursing in PDF only on Docsity!
Amlodipine |- |correct |answer |✔dihydropyridine |calcium |channel |blocker |used |for |HTN.
SE's= |peripheral |edema, |fatigue, |palpitations.
SE's |of |statins |- |correct |answer |✔myopathy, |rhabdomyolysis, |hepatotoxicity.
(follow |LFT's)
glyburide |- |correct |answer |✔sulfonylurea |drug |class |indicated |for |treatment |of |DM |II
major |difference |in |bacterial |vs |viral |conjunctivitis |- |correct |answer |✔bacterial |infection |produces |a |mucopurulent |discharge |(rather |than |clear).
Difference |of |allergic |conjunctivitis |compared |to |adenoviral |conjunctivitis |-
|correct |answer |✔Both |have |bilateral |watery |discharge, |but |allergic |has |pruritis |& |a |foreign |body |sensation.
Most |common |cause |of |epidemic |keratoconjunctivitis |- |correct |answer
|✔Adnovirus; |usually |there's |an |associated |pharyngitis, |fever, |malaise, |& |periauricular |lymphadenopathy.
Most |likely |cause |of |resistant |hypertension |in |a |patient |at |high |risk |for
|atherosclerosis |- |correct |answer |✔renal |artery |stenosis
(note: |may |hear |a |renal |artery |bruit |over |the |site, |and |patient |may |requires |stenting |for |treatment).
Definite |diagnosis |of |renal |artery |stenosis |- |correct |answer |✔Renal |MRI |or |CT |angiography |of |renal |arteries.
Other |tests |to |consider |in |EBV |infection |in |addition |to |monospot |(latex
|agglutination |assay) |- |correct |answer |✔ESR |(elevated, |in |contrast |to |streptococcal |pharyngitis).
Liver |Function |studies |(elevated |aminotransferases |& |bilirubin).
What |antibiotic |should |be |used |if |a |person |has |secondary |bacterial |pharyngitis
|in |addition |to |EBV |mononucleosis? |- |correct |answer |✔Penicillin |or |erythromycin |is |required...avoid |ampicillin |& |amoxicillin |because |it |will |cause |a |diffuse, |erythematous |rash.
Types |of |diabetic |retinopathy |- |correct |answer |✔Non-proliferative |(consists |of |nerve-fiber |layer |infarcts...aka |cotton-wool |spots), |intra-retinal |hemorrhages, |& |macular |edema.
Proliferative |retinopathy= |neovascularization |of |retinal |vessels |(simulated |by |VEGF-vascular |endothelial |growth |factor- |which |is |released |after |initial |cell |death |due |to |ischemic |injury)....proliferative |retinopathy |can |result |in |vitreous |hemorrhage |& |retinal |detachment.
Stages |of |hypertension |- |correct |answer |✔Normal= |systolic |<120, |diastolic |<
Pre-hypertension= |Systolic |120-139, |diastolic |80-
Hypertension, |stage |1= |systolic |140-159, |diastolic |90-
Hypertension, |stage |2= |systolic |>160, |diastolic |>
(you'd |use |the |highest |value |reached |that's |either |diastolic |or |systolic)
Most |appropriate |initial |therapy |in |hypertension |- |correct |answer |✔In |pre- hypertension |or |stage |I |hypertension, |most |appropriate |initial |therapy= |diet |modification |& |exercise.
Stage | 2 |hypertension: |pharmacologic |tx |is |indicated.
Recommended |first |line |therapy |for |black |patients |with |hypertension |- |correct
|answer |✔diuretics |& |calcium |channel |blockers
Endometritis |definition |& |treatment |- |correct |answer |✔Endometritis= |most |commonly |seen |postpartum |infection; |treat |with |IV |clindamycin |& |gentamicin.
Episiotomy |(& |infections) |- |correct |answer |✔Episiotomy= |surgical |incision |w/in |the |perineum |that's |performed |when |there's |high |risk |for |perianal |tearing |& |trauma |during |delivery.
Most |episiotomy |infections |remain |localized |to |superficial |surrounding |tissue |& |can |be |treated |w/suture |removal, |irrigation, |& |debridement |of |debris |& |necrotic |tissue.
Diastolic |heart |failure |- |correct |answer |✔Diastolic |heart |failure |occurs |when |signs |and |symptoms |of |heart |failure |are |present, |but |left |ventricular |function |is |preserved |(ejection |fraction |>45%)
treatment |of |brucellosis |- |correct |answer |✔IM |streptomycin |for | 3 |weeks, |PO |doxycycline |for | 6 |weeks
Brucella |- |correct |answer |✔Gram |negative, |unencapsulated |gram |negative |bacteria
DEXA |scan |definitions |of |osteopenia/porosis |- |correct |answer |✔Osteopenia= |- |to |-2.
Osteoporosis= |less |than |-2.
Normal |bone |density= |DEXA>-
Lesions |producing |vision |loss |in |both |eyes |(bilateral |visual |field |defects) |-
|correct |answer |✔Lesions |in |optic |chiasm, |optic |tracts, |or |visual |cortex.
possible |lesions |producing |vision |loss |in |one |eye |- |correct |answer |✔Lesion |could |be |in |eye, |retina, |or |optic |nerve.
bulging |tympatnic |membrane |- |correct |answer |✔hallmark, |classic |finding |in |AOM.
Leukocytosis
Two |types |of |community-acquired |pneumonia |(CAP) |- |correct |answer
|✔Occurring |in |the |community |or |within |the |first | 72 |hours |of |hospitalization..
Most |common |causes |are |strepn |pneumo |then |H |influenza
Most |common |bacterial |pathogens |that |cause |nosocomial |pneumonia |- |correct
|answer |✔Gram-negative |rods |& |staph |aureues
Empiric |outpatient |antibiotic |therapy |for |patients |with |CAP |- |correct |answer
|✔Macrolides |(clarithromycine, |erythromycin, |azithromycin) |or |doxycycline |to |provide |coverage |against |the |most |common |organisms |including |S |pneumo, |Mycoplasma, |Chlamydia, |& |Legionella.
Role |of |nafcillin |& |oxacillin |in |pneumonia |- |correct |answer |✔provide |coverage |against |MSSA |(methicillin-sensitive |staphylococcus |aureus).
Features |of |hypercalcemia |- |correct |answer |✔Bones, |stones, |abdominal |groans, |& |psychiatric |overtones.
Osteitis |fibrosa |cystica |- |correct |answer |✔brown |tumors |due |to |severe |hyperparathydroidism.
Symptoms |of |hypocalcemia |- |correct |answer |✔Muscle |cramps |or |spasms, |perioral |or |finger |tingling, |wheezing, |seizures.
Spirometry |results |of |COPD |- |correct |answer |✔FEV1 |decreases |to |<80% |predicted |& |FEV1/FVC |ratio |is |<0.7, |with |incomplete |reversal |w/inhaled |bronchodilators.
How |is |FEV1 |& |FVC |different |in |COPD |vs |restrictive |processes? |- |correct |answer
|✔In |restrictivep |rocesses, |FEV1 |& |FVC |& |both |decreased |but |proportionally |so, |so |FEV1 |is |decreased |but |FEV1/FVC |is |normal.
Benefits |of |long-term |oxygen |supplementation |for |tx |of |severe |COPD |- |correct
|answer |✔Improves |survival |& |quality |of |life, |decreases |dysnpea |scores, |& |decreases |pulmonary |artery |pressure.
(supplemental |O2= |only |modality |that |can |improve |pulmonary |artery |pressure, |dysnpea, |survival, |& |quality |of |life)
Definition |of |chronic |hypoxemia |- |correct |answer |✔PaO2< | 55 |mmHg |or |SpO2<80%
(SpO2= |peripheral |capillary |oxygen |saturation; |an |estimation |of |oxygen |saturation |level/concentration |in |blood...measures |percentage |of |hemoglobin |binding |sites |in |the |bloodstream |occupied |by |oxygen).
Which |antibiotic |should |be |used |in |patients |that |have |frequent |COPD |exacerbations |despite |maximal |pharmacological |therapy? |- |correct |answer
|✔Azithromycin |(macrolide) |since |it |has |anti-inflammatory |effects |in |addition |to |its |antibiotic |effect.
Note: |these |can |arise |from |indwelling |catheters |(that |are |associated |with |UTI's).
Only |cephalosporins |that |are |effective |against |pseudomonas |infections |- |correct
|answer |✔Ceftazidime |(3rd |gen) |& |cefepime |(4th |gen)....
Note: |their |use |is |usually |reserved |for |more |critical |infections |like |bacteremia, |endocarditis, |osteomyelitis, |malignant |otitis |externa, |& |CNS |infections.
Which |drugs |could |potentially |cause |elevations |in |serum |calcium |& |parathyroid
|hormone. |- |correct |answer |✔Thiazide |diuretics |& |lithium.
MOA |bisphosphonates |- |correct |answer |✔shut |down |osteoclasts.
Most |likely |location |for |a |chapman |point |in |Crohn's |disease |- |correct |answer
|✔Right |proximal |femur |since |Crohn's |disease |most |often |affects |the |terminal |ileum |(with |or |without |colon |involvement).
When |is |metformin |contraindicated |- |correct |answer |✔Renal |insufficiency |(esp |in |pt's |>80 |yo |w/poor |renal |fxn).
Don't |use |in |males |w/creatinine |>1.5 |or |females |w/creatinine |>1.
Nateglinide |(drug |class: |meglitinide) |- |correct |answer |✔Simulates |insulin |release |from |pancreatic |beta |cells...works |similary |to |sulfonylureas |but |it |can |be |used |in |pt's |w/renal |insufficiency |(unlike |sulfonylureas).
Standards |of |PPD |test |induration |to |be |considered |positive |for |TB |- |correct
|answer |✔ 5 |mm |of |induration= |positive |for |ppl |infected |w/HIV, |recent |contact
|w/person |with |TB, |fibrotic |changes |on |chest |radiograph |consisten |w/TB, |organ |transplant, |& |immunosuppressed.
10 |mm= |positive |for |recent |(<5 |yrs) |immigrants |from |high |prevalence |countries, |IV |drug |abusers, |residents |or |employees |of |high-risk |congregate |settings |(prisons, |military |barracks, |nursings |homes, |hospitals), |mycobacteriology |lab |personnel, |clinical |condition |that |places |them |at |risk, |are |under |age |4, |are |an |infant/child/adolescent |exposed |to |an |adult |in |a |high-risk |category.
15 |mm= |positive |for |all |ppl, |even |those |w/o |risk |factors |for |TB |infection.
First-line |treatment |for |Grave's |dz |- |correct |answer |✔Methimazole |(over |propylthiouracil |since |PTU |is |associated |w/hepatotoxicity).
How |to |diagnose |corneal |abrasions |- |correct |answer |✔Fluorescein |exam |(shows |green |branching |w/cobalt |blue |filter |on |slit-lamp |examination).
Treatment |of |a |simple |corneal |abrasion |- |correct |answer |✔Topical |anti- inflammatories |like |diclofenax |or |detorolac.
Presentation |of |open-angle |glaucoma |- |correct |answer |✔Gradual, |bilateral |loss |of |peripheral |vision... |funduscopic |examination |will |show |cupping |of |the |optic |nerve |& |an |increased |cup:disc |ratio.
Bilateral, |painless |loss |of |central |vision |w/preserved |peripheral |vision |- |correct
|answer |✔Atrophic/non-exudative |("dry") |age-related |macular |degeneration |(seen |in |the |elderly |as |a |result |of |progressive |atrophy |of |the |central |retina).
What |should |be |done |in |patients |with |incontinence |& |hematuria |or |pelvic |pain?
|- |correct |answer |✔Cytoscopy |(to |rule |out |any |irritative |processes |like |stones |or |cancer).
What |pharmacologic |intervention |can |be |taken |for |incontinence |if |bladder
|retraining |isn't |successful? |- |correct |answer |✔Oxybutynin |(aka |anticholinergics) |to |cause |bladder |smooth |muscle |relaxation...can |use |tolderodine |if |dry |mouth |becomes |too |severe.
Type |of |incontinence |that |is |described |as |unpredictable |dribbling |of |urine |or |weak |urine |stream |due |to |underactive |bladder |and/or |outlet |obstruction. |-
|correct |answer |✔Overflow |incontinence
Most |important |intervention |in |patients |with |non-surgical |aortic |aneurysms |-
|correct |answer |✔Smoking |cessation.
Indications |for |surgical |repair |of |abdominal |aortic |aneurysms |- |correct |answer
|✔1) |Lesion |size |>5.5 |cm
|Rapid |enlargement |of |smaller |lesions.
|symptomatic |or |ruptured |aneurysms.
Monitoring |guidelines |for |AAA's |- |correct |answer |✔Monitoring |is |appropriate |for |AAA |in |asymptomatic |patients |for |lesions |<5.5 |cm |in |size.
Smal |aneurysms |(3-4 |cm): |monitor |w/ultrasound |every | 2 |years.
Aneurysms |4-5.4 |cm: |monitor |w/ultrasound |or |CT |every |6-12 |months.
Commonly |seen |eye |lesions |in |patients |with |hypertension |- |correct |answer |✔AV |nicking |& |cotton-wool |patches |(aka |soft |exudates).
When |are |microaneurysms |in |the |eye |most |commonly |seen? |- |correct |answer
|✔Diabetic |retinopathy.
Diagnosis |criteria |of |diabetes |- |correct |answer |✔A1C |greater |than |or |equal |to |6.5%
Fasting |plasma |glucose |> |or |= | 126
oral |glucose |tolerance |test |w/2 |hr |blood |glucose |level |greater |than |or |equal |to | 200
Random |plasma |glucose |greater |than | 200 |in |a |patient |w/classic |symptoms |of |diabetes.
First-line |treatment |of |comodonal |acne |- |correct |answer |✔Topical |retinoid |(like |tretinoin)...can |also |use |cleansers |like |benzoyl |peroxide.
Most |common |causes |of |acute |bacterial |sinusitis |- |correct |answer |✔S. |pneumo
H. |influenza
Anaerobes
New |York |Heart |Association |(HYDA) |Classification |used |to |quantify |degree |of
|functional |limitation |imposed |by |CHF |- |correct |answer |✔Categories |are |based |upon |the |degree |of |effort |needed |to |elicit |symptoms:
NYHA |I= |symptoms |only |occur |w/vigorous |activities...nearly |asymptomatic.
NYHA |II: |symptoms |occur |with |prolonged/moderate...sympatomatic |w/ordinary |exertion |with |slight |limitation |of |activities |(like |climbing |stairs, |carrying |groceries).
NYHA |III: |symptoms |occur |w/usual |activities |of |daily |living...symptomatic |w/less |than |ordinary |exertion, |w/definite |limitation |of |activities. |Ex: |walking |across |room, |getting |dressed.
NYHA |IV: |symptoms |occur |at |rest...symptomatic |mostly |all |the |time; |these |pt's |are |essentially |incapacitated.
Stepwise |approach |for |treating |nicotine |addiction |(helping |someone |quit
|smoking) |- |correct |answer |✔Initially |prescribe |the |nicotine |patch |in |combo |w/group |support...next |step= |initiation |of |bupropion |to |aid |in |cessation |efforts.
Use |of |trazodone |- |correct |answer |✔Treatment |of |depression |w/significant |insomnia
(adverse |effects= |hypotension, |sedation, |& |priapism).
Criteria |for |metabolic |syndrome |- |correct |answer |✔Abdominal |obesity |(defined |as |>40 |in |in |men, |or |>35 |in |in |women)
Triglycerides |>
HDL<40 |in |men, |<50 |women
BP |>130/85 |or |on |hypertensive |medication
Fasting |glucose |>
