Term
| What are the micro-vascular complications of DM and the appropriate therapy for these in the PCP setting? |
|
Definition
1) retinopathy - annual visit w/ ophthalmologist
2) nephropathy - annual screen for microalbuminuria, ACEi for HTN, Cr follow for microalbuminuria
3) neuropathy - pt education, inspection, podiatry PRN |
|
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Term
| What are the major blood sugar control factors to be addressed in PCP setting and appropriate tx for each? |
|
Definition
1) A1c - check q3-6mo; goal 0-8
2) lifestyle - nutrition, activity counseling
3) medications - metformin (1st line); OHA as insulin dec; insulin (last line) |
|
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Term
| What are the MACRO-vascular complications and the appropriate treatment for pt's w/ DM in PCP setting? |
|
Definition
1) hypertension - BP less than 130/80
2) Lipids - LDL=0-100mg/dL or if TG inc; non-HDL cholesterol = 0-130mg/dL
3) CAD/CVA prevention: omega3, vitamin D, ASA (w/ RFs), dec stress, nutrition, QUIT SMOKING |
|
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Term
| What are the major vaccinations to be given to DM patients in the PCP setting? |
|
Definition
1) flu
2) tetanus
3) pneumovax |
|
|
Term
| What are the major factors that should lead to consideration of secondary HTN? |
|
Definition
1) young pt
2) very high BP
3) HTN difficult to control |
|
|
Term
| What are causes of secondary HTN |
|
Definition
- pheochromocytoma
- RAS (bilateral)
- renal parenchymal dz
- polycystic kidneys
- OSA
- hyperthyroidism
- hyperparathyroidism
- primary aldosteronism
- cushing syndrome
- aortic coarctation |
|
|
Term
| What are the CAD risk factors? mnemonic? |
|
Definition
- Cidgarettes
- Diabetes
- Epidemiology (M45+; F55+)
- FHx
- Glycerides (hyperlipidemia)
- Hypertension
*CDEFGH* |
|
|
Term
| What are the major complications from HTN |
|
Definition
- CVA
- CAD
- CHF/Cardiomyopathy
- PVD
- kidney disease
- retinopathy |
|
|
Term
| What is the AB/CD rule or medical tx of HTN |
|
Definition
- initial drug should either be A/B OR C/D
- second drug should be C/D OR A/B respectively
A - ACEi/ARB/alpha-blocker
B - BB
C - CCB
D - Diuretic |
|
|
Term
What are the major benefits/uses of the following drug:
ACEi |
|
Definition
|
|
Term
What are the major benefits/uses of the following drug:
Beta-blocker |
|
Definition
- CAD/post-MI/angina
- CHF
- tachy-arrhythmias
- Performance anxiety
- H/a prophylaxis
- glaucoma |
|
|
Term
What are the major benefits/uses of the following drug:
CCB |
|
Definition
- CHF (diastolic)
- tachy-arrhythmias
- angina
- h/a prophylaxis
- raynauds |
|
|
Term
What are the major benefits/uses of the following drug:
diuretics |
|
Definition
- osteoporosis
- kidney stones
- peripheral edema
- synergistic w/ other meds
- cheap |
|
|
Term
What are the major cons/contraindications of the following drug:
ACEi |
|
Definition
- inc BUN/Cr
- RAS
- dry cough
- angioedema
- hyperkalemia
- less effective in AA |
|
|
Term
What are the major cons/contraindications of the following drug:
BB |
|
Definition
- asthma/COPD
- depression/fatigue/decreased stamina
- sexual dysfunction
- w/d
- heart block
- less effective in AAs |
|
|
Term
What are the major cons/contraindications of the following drug:
CCB |
|
Definition
- systolic CHF
- leg edema
- constipation
- deadache
- GERD |
|
|
Term
What are the major cons/contraindications of the following drug:
diuretics |
|
Definition
- hypokalemia (monitor lytes, Cr)
- gout
- slight inc in glucose intolerance
- slight inc in lipids |
|
|
Term
| What are some major methods to enhance patient compliance |
|
Definition
- emphasize patient education
- schedule regular follo-up visits
- explore patient reasons in event of noncompliance
- use pt-centered communication
- encourage pts to bring fam to appointments
- ask pts about potential tx s/e
- choose less-frequent dosing for medications when possible
- offer less-expensive alternatives
- ensure pt is not "asserting control" through noncompliance |
|
|
Term
| What are the standard prenatal labs recommended for all patients |
|
Definition
- CBC
- type and Rh-screen
- Hep B testing
- HIV
- rubella and vericella
- RPR
- urine culture
- testing for conorrhea and chlamydia
- PAP |
|
|
Term
| What are hte prenatal labs recommended for some patients |
|
Definition
- Hb electrophoresis
- CF screening
- TSH
- hep C screen
- HCG quantitative
- PPD
- genetic carrier testing |
|
|
Term
| What is a first trimester test for aneuploidy? |
|
Definition
| - ERA w/ nuchal translucency and PAPP |
|
|
Term
| What ar ethe standard, special, and other prenatal second trimester tests to order? |
|
Definition
1) CBC, 1hr GTT
2) Ab screen if Rh negative; HIV/STI; AFP tetra screen
3) U/S fetal survey; amniocentesis |
|
|
Term
| What are the standard and special prenatal tests for third trimester pts |
|
Definition
1) GBStrep screen
2) HIV/STI; U/S w BPP; repeat CBC |
|
|
Term
| What are exceptions to medical consenting of minors without a parent's consent |
|
Definition
1) married, widowed, divorced
2) parenting a child (for care of child)
3) in armed forced
4) pregnant/believes herself to be pregnant
5) living separate and apart from parents
6) STD
7) mature minor rule - mature enough and in best interest to not notify parent
- drug addiction, family planning services, STD tx
- mental health treatment
- emergency situation |
|
|
Term
| When must a physician break confidentiality with a teen? |
|
Definition
- abuse (Child protective sercives
- teen in suicidal/homicidal (legal guardian and or police
- teen has a medical condition that is threat to life or limb (contact legal guardian) |
|
|
Term
| What are the major components of the adolescent interview? mnemonic? |
|
Definition
1) Home situation
2) Education
3) Activities
4) Drugs
5) Sex
6) Emotional Health
HEADS |
|
|
Term
| What is the only contraceptive type that protects against HIV and other STIs |
|
Definition
| 1) male and female condoms |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
paragard (Cu IUD) |
|
Definition
1) 99%
2) 12yrs; return to fertility quickly
3) cramps and heavy periods |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Mirena (progestin IUD) |
|
Definition
1) 99%
2) 7yrs; improved cramps and bleeding; fertility returns quickly on d/c
3) no period at all |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Implanon |
|
Definition
1) 99+%
2) 3yrs; return to fertility quickly
3) irregular bleeding; no period |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Depo-Provera |
|
Definition
1) 97-99%
2) 12wks; prevents cancer
3) delay in pregnancy after d/c; wt gain; depression; changed sex drive |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
The Pill |
|
Definition
1) 92-99%
2) improve acne/PMS sx/regularity; fast return to fertility
3) nausea, weight gain, h/a |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
Nuvaring |
|
Definition
1) 92-99%
2) no "fitting" required
3) increase vag d/c |
|
|
Term
What is the effectiveness, pros, and cons of the following contraceptive method:
male condom |
|
Definition
1) 85-98%
2) easy access; prevent early ejaculation; PROTECTS against STDs
3) decreased sensation, loss of erection, break/slip |
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