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Pg1,2 screening vaccination
Study
1
Question
PCV vaccines
Answer
PCV 13: less than 18; PCV 15: if older than 65 or immunocompromised and 19-64; if you got PCV 15 then you need to follow with PCV 23 after 1 year; PCV 20 for anyone over 65 or under 65 and immunocomp/asplenia/chronic renal failure/asthma/smoker (and no need for a subsequent vaccine)
2
Question
HPV vaccination
Answer
All adolescents, regardless of sexual orientation, should receive HPV vaccination before the onset of sexual activity. It is a 2-dose regimen 6 months apart for patients 9-14 years old and a 3-dose 0, 2, and 6 months regimen for patients 15-26 years old.
3
Question
PCV 13 indicated for
Answer
Pneumococcal Conjugate Vaccine 13 (PCV13) is indicated for patients up to 18 years of age.
4
Question
Hib Vaccine recommendation
Answer
Recommended for children under 5 years and for patients with sickle cell disease, asplenia, or history of bone marrow transplantation, and for patients ages 5-18
5
Question
Intimate Partner Violence (IPV) screening recommendation for all women of reproductive age
Answer
All women of reproductive age should be screened for IPV
6
Question
When to start giving influenza vaccine
Answer
Influenza Vaccine is recommended for all individuals 6 months of age at the start of the flu season.
7
Question
What are the screening recommendations for diabetes mellitus (DM)?
Answer
Screening for diabetes mellitus (DM) should be done on individuals 35-70 years of age who are overweight, with fasting blood glucose, HbA1c, or oral glucose tolerance test. Individuals 35 years of age with either overweight or obesity and at least one additional risk factor for T2DM (first-degree family history, certain race or ethnicity, hypertension).
8
Question
Who should undergo a low-dose CT scan of the chest for lung cancer screening?
Answer
Low-dose CT scan of the chest is indicated for lung cancer screening in adults aged 50-80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
9
Question
Meningococcal ACWY Vaccine recommendation
Answer
Recommended for children at 11-12 and 16 years of age, as well as for individuals at risk for meningococcal infections
10
Question
Dual-energy x-ray absorptiometry screening recommendation for osteoporosis
Answer
Women over the age of 65, or those under 65 at increased risk of osteoporosis, should undergo screening
11
Question
Who gets shingles vaccine
Answer
The Shingles Vaccine is recommended for all immunocompetent individuals 50 years of age and for immunocompromised individuals 19 years. It is administered in two doses 2 to 6 months apart.
12
Question
Cervical cancer screening recommendation for women over 30 years of age
Answer
Undergo pap smear every 5 years
13
Question
At what age is the Shingles Vaccine recommended for immunocompromised individuals?
Answer
19 years and older
14
Question
Osteoporosis risk fx
Answer
Individuals under 65 who are at increased risk of osteoporosis are female, of advanced age, excessively consume alcohol, smoke, and have a low BMI.
15
Question
At what age is the 3-dose HPV regimen administered for patients?
Answer
15-26 years old
16
Question
What are the guidelines for mammogram breast cancer screening in women?
Answer
Mammogram breast cancer screening: Every 1-2 years in women over age 40.
17
Question
Mammogram Breast Cancer Screening recommendation for women over age 40 with no family history of breast cancer
Answer
Undergo mammogram screening every 1-2 years
18
Question
At what age is the Shingles Vaccine recommended for all immunocompetent individuals?
Answer
50 years of age
19
Question
At what age is the 2-dose regimen administered for patients before onset of sexual activity?
Answer
9-14 years old
20
Question
Risk factors for IPV screening
Answer
Risk factors include the postpartum period, pregnancy, low SES, and a history of abuse
21
Question
What are the screening recommendations for PSA in men?
Answer
Men PSA Screening: Shared decision making for men 55-69 years of age. Men 65-75 years of age who are current or former smokers should receive a one-time screening with ultrasonography for an abdominal aortic aneurysm (AAA).
22
Question
Who gets Hib
Answer
Hib Vaccine is recommended for children under 5 years, patients with sickle cell disease, asplenia, or a history of bone marrow transplantation, and patients ages 5-18 with HIV.
23
Question
What are the USPSTF guidelines for colorectal cancer screening in asymptomatic adults?
Answer
Screening in all asymptomatic adults between 45 and 75 years of age. 1 colonoscopy every 10 years for general population, every 5 years in patients with a first-degree relative with a history of colorectal cancer.
24
Question
How many doses is the recombinant vaccine administered in for shingles?
Answer
Two doses
25
Question
Urine culture screening recommendation for pregnant individuals
Answer
Recommended for screening of asymptomatic bacteriuria in pregnant individuals
26
Question
Cervical cancer screening recommendation for women between 21 and 30 years of age
Answer
Undergo pap smear every 3 years
3,4 vaccine smoking cess HTN
Study
1
Question
What is the recommended interval for hypertension screening in healthy people aged 18-39 years?
Answer
Every 3-5 years.
2
Question
How often is a tetanus booster required?
Answer
Every 10 years.
3
Question
What do ACE Inhibitors block?
Answer
Conversion of Angiotensin I to Angiotensin II.
4
Question
What are the most common side effects of ACE Inhibitors?
Answer
Dry cough, angioedema, and hyperkalemia.
5
Question
What does Angiotensin Receptor Blocker (ARB) block?
Answer
AT1 receptor, decreasing the binding of Angiotensin II.
6
Question
What are the first-line treatment options for patients with hypertension and no other comorbidities?
Answer
Thiazide diuretics, ACEs, ARBs, and calcium channel blockers.
7
Question
Which type of diuretics is recommended as a first-line treatment for patients with hypertension and no other comorbidities?
Answer
Thiazide diuretics
8
Question
What has been shown to reduce systolic blood pressure by about 11 mm Hg and also shown to reduce levels of LDL cholesterol?
Answer
DASH diet.
9
Question
How often should hypertension diagnosis screening be performed in adults aged 40 years and those at increased risk?
Answer
Every 1 year
10
Question
What patients should avoid using bupropion for smoking cessation?
Answer
Patients with predisposing conditions that increase the risk of seizures, such as seizure disorder, anorexia or bulimia nervosa, alcohol withdrawal, and abrupt discontinuation of benzodiazepines.
5,6 htn drugs, hld, statin
Study
1
Question
What are the indications for statin therapy?
Answer
40-75 y/o AND with T2DM, 10-year ASCVD risk of 7.5% (or clinical risk fx of smoking or HTN o, OR an LDL of 190 mg/dL.
2
Question
What are the common side effects of Calcium Channel Blockers?
Answer
Peripheral edema, headaches, dizziness, facial flushing, reflex tachycardia.
3
Question
What # LDL for starting statin therrapy?
Answer
An LDL of 190 mg/dL
4
Question
Where do Calcium Channel Blockers cause vasodilation predominantly?
Answer
In the precapillary vessels.
5
Question
What is the indication for low-dose aspirin therapy?
Answer
Patients 40-59 with a 10-year ASCVD risk of 10 and a low risk of bleeding
6
Question
What is the leading cause of death in men in the US?
Answer
Coronary heart disease.
7
Question
What is the preferred first-line treatment for isolated hypertension in African American patients?
Answer
Thiazide diuretics, specifically clorthalidone.
8
Question
What is the clinical presentation of statin-associated myopathy?
Answer
Generalized symmetric weakness of proximal muscles and elevated serum creatinine kinase activity
9
Question
What are the most common side effects of Thiazide Diuretics?
Answer
Orthostatic hypotension, hypokalemia, hyponatremia, hypercalcemia, hyperglycemia, and hyperlipidemia.
10
Question
What is the treatment for statin-associated myopathy?
Answer
Discontinue statin patient is currently on and begin treatment with low-dose pravastatin or fluvastatin
11
Question
What are the first-line agents for high-intensity statin therapy?
Answer
Atorvastatin and Rosuvastatin.
12
Question
What are the subsequent treatment options if treatment goals are not met with high-intensity statin therapy?
Answer
Ezetimibe, PCSK9 inhibitors (e.g. evolocumab or alirocumab), Bile acid sequestrants (e.g. colesevelam)
7,8 diabetes
Study
1
Question
What are the risk factors for Type II Diabetes?
Answer
High-calorie diet, sedentary lifestyle, obesity, positive family history, race/ethnicity, dyslipidemia, metabolic syndrome
2
Question
How does obesity increase the risk of Type II Diabetes?
Answer
Obesity increases the risk of T2DM by intensifying peripheral insulin resistance, inhibiting glucose uptake from the bloodstream, and impairing anabolic metabolism
3
Question
What is the relationship between increased abdominal fat and insulin resistance in Type II Diabetes?
Answer
Increased abdominal and visceral fat is associated with increased lipolytic activity and increased levels of serum free fatty acids. Increased levels of fatty acids induce insulin resistance by decreasing peripheral insulin-mediated glucose uptake
4
Question
What is the earliest diagnostic sign of diabetic nephropathy?
Answer
Microalbuminuria is the earliest diagnostic sign of diabetic nephropathy
5
Question
What are the manifestations of diabetic nephropathy as it progresses?
Answer
Progression of glomerular damage leads to increased urinary loss of albumin, which can manifest as nephrotic syndrome. Laboratory values show elevated creatinine and BUN levels, arterial hypertension, and electrolyte abnormalities
6
Question
What lab values are usually normal in the early stages of diabetic nephropathy?
Answer
Creatinine and BUN levels are usually normal in the early stages of diabetic nephropathy and only rise once glomerular filtration rate significantly deteriorates
7
Question
What is the recommended treatment for diabetes that can cause weight loss and control hyperglycemia with less risk of medication-induced hypoglycemia?
Answer
Glucagon-like peptide-1 (GLP-1) receptor agonists (incretin mimetic drugs) such as exenatide. Metformin is also recommended as it reduces liver production of glucose, increases insulin sensitivity, and induces weight loss
8
Question
What class of drugs are recommended in patients with Type II Diabetes and Diabetic Kidney Disease (DKD) regardless of HbA1c as they slow the progression of renal disease?
Answer
Sodium-glucose cotransporter 2 (SGLT2) inhibitors such as canagliflozin and dapagliflozin (flozins)
9
Question
What are the usual Creatinine and BUN levels in early stages of diabetic nephropathy?
Answer
Normal
10
Question
What rises once glomerular filtration rate significantly deteriorates in diabetic nephropathy?
Answer
Creatinine
11
Question
Name the treatment for diabetes that reduces liver production of glucose, increases insulin sensitivity, and induces weight loss.
Answer
Metformin
12
Question
What class of drugs is recommended in patients with T2DM and DKD, regardless of HbA1c, as they slow progression of renal disease?
Answer
Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors)
13
Question
What is the effect of GLP1 receptor agonists in the treatment of diabetes?
Answer
They can cause weight loss and control hyperglycemia
14
Question
Which medication is contraindicated in patients with recurrent urinary tract infections due to its glycosuric effect?
Answer
SGLT2 inhibitors
9,10 sore throat, resp
Study
1
Question
when is it likely viral tonsilopharyngitis
Answer
cough, no fever, coryza, conjunctivitis
2
Question
When should you throat culture after a negative rapid strep?
Answer
When less than 3 or adolescent
3
Question
What are features of bacterial tonsilitis?
Answer
exudates, fever, no cough, lymphadenitis
4
Question
What does spirometry show in the diagnosis of asthma?
Answer
Obstructive lung pattern, decreased FEV1, decreased A FEV1FVC ratio that reverses with bronchodilation
5
Question
Gold standard for diagnosing bacterial tonsillitis
Answer
Throat culture
6
Question
What is the clinical presentation of asthma?
Answer
Episodic dyspnea, nonproductive coughing, and wheezing that worsens during exertion and at night
11,12 asthma bronch copd
Study
1
Question
Chronic Obstructive Pulmonary Disease (COPD) Clinical Features
Answer
Dyspnea, productive cough, decreased FEV1, decreased FEV1/FVC ratio, increased total lung capacity. Airway obstruction is primarily caused by long-term smoking. Smoking cessation is the single most important measure to slow the decline in lung function. Other treatment includes inhaled corticosteroids and bronchodilators, with the greatest impact on survival in COPD.
2
Question
What has the greatest impact on survival in COPD?
Answer
Long-term oxygen therapy and smoking cessation.
3
Question
What does spirometry show in patients with chronic bronchitis?
Answer
obstructuve lung pattern = decreased FEV1; decreased FEV1/FVC ratio)
4
Question
What is an example of an empirical antibiotic therapy used for community-acquired pneumonia?
Answer
An example is amoxicillin.
5
Question
Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) Clinical Presentation
Answer
Worsening of dyspnea, increased frequency and severity of cough, increased volume and/or purulence of sputum. May have distant heart sounds due to pulmonary hyperinflation.
6
Question
What therapy is recommended for acute exacerbation of COPD?
Answer
Short course of systemic corticosteroids, nebulization of a short-acting B2 adrenergic agonist with or without a short-acting muscarinic antagonist bronchodilator, and supplemental oxygen. Empiric antibiotic therapy is indicated if the patient has 3 cardinal symptoms or requires mechanical ventilation.
7
Question
Acute Bronchitis Clinical Presentation
Answer
Productive cough, sometimes chest pain, typically resolves within 2-3 weeks. Most common condition for which antibiotics are unnecessarily prescribed.
8
Question
What is the preferred inhaled corticosteroid for pregnant women with asthma?
Answer
Budesonide
9
Question
What is the symptom frequency for severe persistent asthma?
Answer
Daily throughout the day, waking up every night
10
Question
What is the treatment for acute bronchitis?
Answer
Supportive, adequate hydration, and symptomatic relief; NO ABX
11
Question
What is the treatment for acute exacerbations in moderate persistent asthma?
Answer
Systemic glucocorticoids (oral methylprednisolone)
12
Question
How is acute bronchitis typically resolved without any specific treatment?
Answer
Within 2-3 weeks
13
Question
Chronic Bronchitis Treatment
Answer
Lifestyle modifications (counseling on smoking cessation) and pharmacology (inhaled corticosteroids such as budesonide, fluticasone, or beclomethasone, which should be used in combination with long-acting bronchodilators).
14
Question
What is the recommended treatment for AECOPD?
Answer
Short course of systemic corticosteroids for 4-7 days, nebulization of a short-acting B2 adrenergic agonist (e.g., albuterol) with or without a short-acting muscarinic antagonist bronchodilator (e.g., ipratropium), and supplemental oxygen. Empiric antibiotic therapy is indicated if the patient has 3 cardinal symptoms or requires mechanical ventilation.
15
Question
What can be used for long-term management of mild persistent asthma but does not help with acute asthma attacks?
Answer
Oral Leukotriene-receptor antagonist (montelukast)
16
Question
What is the main risk factor for chronic bronchitis?
Answer
Smoking
17
Question
Glucocorticoids ex oral methylprednisolone
Answer
Used in acute bronchitis to provide symptomatic relief and supportive care. Can increase the risk of congenital malformation, preeclampsia, neonatal adrenal insufficiency, and low birth weight when used in pregnant women.
18
Question
What is the symptom frequency for moderate persistent asthma?
Answer
Daily
13,14 emphysema general msk
Study
1
Question
What are the clinical features of Emphysema?
Answer
dyspnea, productive cough, expiratory wheezing
2
Question
What does decreased DLco in emphysema reflect?
Answer
The reduction of gas exchange due to a loss of diffusion area and destruction of alveolar walls
3
Question
What are the risk factors for Emphysema?
Answer
smoking, air pollution, inhalation of chemical fumes and dust. Nonsmokers and individuals 50 years of age who present with COPD and emphysema should be tested for alpha1antitrypsin deficiency.
4
Question
What are the clinical features of a1Antitrypsin Deficiency?
Answer
Characterized by early-onset emphysema and liver involvement (hepatitis, cirrhosis, hepatocellular carcinoma). Spirometry shows obstructive lung pattern (decreased FEV1, decreased FEV1/FVC ratio). X-Ray would show basilar emphysema. Liver disease due to intrahepatic accumulation of AAT would also be expected. Treatment: IV AAT replacement therapy in patients with severe deficiency.
5
Question
What is the treatment for Acute Bacterial Rhinosinusitis?
Answer
Give Penicillin beta lactamase inhibitor. (Develops following an acute viral rhinosinusitis, usually caused by Strep Pneumo or H. influenzae).
6
Question
What are the clinical presentations of Secondary Bacterial Infection in Acute Bacterial Rhinosinusitis?
Answer
Fever, facial pain, nasal congestion, bilateral purulent nasal discharge, and maxillary sinus tenderness that has persisted for greater than 10 days without improvement.
7
Question
What is Reactive Arthritis and how does it develop?
Answer
It develops 1-4 weeks after a chlamydial infection and causes joint pain. The condition typically manifests with acute polyarthritis, asymmetric and migratory in nature.
8
Question
What should be evaluated in Synovial Fluid Analysis for Reactive Arthritis?
Answer
Evaluate for septic arthritis and gout. Intraarticular pathology including erythema, joint effusion, and local warmth should be assessed.
9
Question
What may provide modest symptomatic relief in patients with lumbrosacral radiculopathy that persists for 6 months?
Answer
Epidural Glucocorticoid Injection.
10
Question
Secondary Bacterial Infection Clinical Presentation
Answer
Fever, facial pain, nasal congestion, bilateral purulent nasal discharge, and maxillary sinus tenderness that has persisted for greater than 10 days without improvement
11
Question
General Reactive Arthritis
Answer
Develops 14 weeks after a chlamydial infection and causes joint pain. Condition typically manifests with acute polyarthritis, asymmetric and migratory in nature.
12
Question
Synovial Fluid Analysis
Answer
Evaluate for septic arthritis and gout. May indicate intraarticular pathology, erythema, joint effusion, local warmth.
13
Question
What muscle relaxants can be used for acute musculoskeletal lower back pain?
Answer
Cyclobenzaprine or tizanidine can be used alternatively or in conjunction with NSAIDs.
14
Question
How long does it take for almost all cases of musculoskeletal lower back pain to resolve on their own?
Answer
Within 6 weeks.
15
Question
What is recommended for long-term treatment and recovery phase of musculoskeletal lower back pain?
Answer
Physical therapy.
16
Question
When should further testing (e.g., MRI) be considered for patients with lower back pain?
Answer
In patients whose symptoms have not improved after 6 weeks.
15,16 ankle
Study
1
Question
Ankle X-rays indication
Answer
Pain in malleolar region AND eitherr Tenderrness over DISTAL malleolas OR inability to walak 4 steps both after injury and in ED
2
Question
What does a positive Thompson's Test imply?
Answer
lack of motion with calf squeeze, indicates achilles teendon rupture
3
Question
Foot X-rays indication
Answer
An indication for obtaining foot x-rays if there is pain in the midfoot region AND EITHER tendreness over baase of the 5th metatarsal or navicular bonee OR inability to bear weight after a foot injury.
4
Question
Spurling's Maneuver
Answer
A clinical test for cervical radiculopathy in which the neck is extended and rotated to one side, then downward pressure is applied to the head, reproducing pain or other symptoms if there is nerve compression.
17,18 knee
Study
1
Question
What is the recommended treatment for Patellofemoral Pain Syndrome in the recovery phase?
Answer
Physical therapy is recommended.
2
Question
What is the treatment for Patellofemoral Pain Syndrome during the acute phase?
Answer
Pain control and rest, analgesia, and avoidance of pain-inducing activities.
3
Question
What is the clinical presentation of Iliotibial Band Syndrome?
Answer
Knee pain over the lateral femoral epicondyle and a positive Noble Test.
4
Question
What are the causes of Patellofemoral Pain Syndrome?
Answer
Caused by multiple factors including overuse and malalignment of the knee joint.
5
Question
What is the clinical presentation of Patellofemoral Pain Syndrome?
Answer
Retropatellar or peripatellar pain that worsens with activity or after prolonged sitting. Sometimes with an audible popping sound after prolonged sitting or when ascending or descending stairs. often worsens with extension
6
Question
What is Noble Test B for Illiotibial Band Syndrome?
Answer
Patient lies in a lateral position with the injured knee facing upward. Knee is passively flexed while exerting constant pressure on the lateral femoral epicondyle with the thum
19,20 knee shoulder
Study
1
Question
What does the empty can test (Jobe test) assess in the shoulder?
Answer
Supraspinatus muscle
2
Question
What is the clinical presentation of medial collateral ligament injury?
Answer
Tenderness on the medial joint line of the knee, positive valgus stress test
3
Question
How is the Hawkins-Kennedy Test performed?
Answer
The examiner places the patient's arm in 90-degree anteversion and flexes the elbow to 90 degrees.
4
Question
What is the clinical presentation of lateral collateral ligament injury?
Answer
Positive varus stress test
5
Question
What is the clinical presentation of posterior cruciate ligament injury?
Answer
Posterior drawer sign
6
Question
What is the clinical presentation of anterior cruciate ligament injury?
Answer
Anterior drawer sign
7
Question
What is a positive result in the Hawkins-Kennedy Test?
Answer
Internal rotation is a nonspecific indication of subaacromial impingement syndrome.
8
Question
What muscle and/or tendon manifests with pain triggered by overhead motion?
Answer
Supraspinatus tendon and/or muscle
9
Question
What is the procedure for performing the Hawkins-Kennedy test?
Answer
Examiner places the patient's arm in 90° anteversion and flexes the elbow to 90°
10
Question
How should a patient with injury to the supraspinatus tendon and/or muscle manifest pain?
Answer
Pain triggered by overhead motion.
11
Question
What does Neer's test assess in the shoulder? How is it done?
Answer
The presence and degree of a rotator cuff impingement. Elevate the patient's internally rotated and outstretched arm with the simulations stabilization of the scapula. Pain upon eliciting this maneuver indicates narrowed subacromial space and impingement, particularly of the supraspinatus muscle and tendon
21,22 shoulder
Study
1
Question
Liftoff Test
Answer
4. A test used to assess the function of the subscapularis muscle by having the patient lift their hand off their back.
2
Question
Drop Arm Test
Answer
5. A test for assessing rotator cuff integrity, where the patient is unable to hold up their arm at 90 degrees of abduction.
3
Question
Lidocaine Injection Test
Answer
1. A diagnostic test for evaluating patients with undifferentiated shoulder pain. Pain relief from injection suggests subacromial impingement (rotator cuff tendinoapthy, subacromaill bursitis) syndrome as opposed to glenohumerol joint pathology
4
Question
Conservative Treatment for Subacromial Impingement Syndrome
Answer
1. First-line treatment with analgesia and physical therapy, followed by subacromial glucocorticoid injections if conservative measures fail.
5
Question
Advanced Imaging for Suspected Rotator Cuff Tear
Answer
2. MRI should be obtained to rule out rotator cuff tear if the patient fails to improve with physical therapy and analgesics.
6
Question
Clinical Presentation of Adhesive Capsulitis
Answer
1. Progressive unilateral shoulder pain and stiffness, often with a history of shoulder injury.
7
Question
Initial Treatment for Adhesive Capsulitis
Answer
2. Movement restriction, NSAIDs, and physical therapy for shoulder range-of-motion exercises.
8
Question
Risk Factors for Adhesive Capsulitis
Answer
3. Patients with previous shoulder injuries and/or surgeries, diabetes mellitus, and other systemic diseases are at increased risk.
9
Question
Cause of Elbow Lateral Epicondylitis (Tennis Elbow) -> txt
Answer
1. Repetitive wrist extension and forearm pronation/supination. -> txt with NSAIDS and rest anad PT (conservative)
10
Question
Aftere positive drop arm test aand suspcion of rotator cuff tear
Answer
Musculoskeletal ultrasound and/or MRI should be performed to confirm diagnosis.
11
Question
Distal Biceps Tendon Rupture
Answer
abnroomal biceps squeeze test. Surgical repair is recommended, especially in patients who are younger, active, and/or who require rapid restoration of elbow function (e.g., athletes, manual laborers). Early intervention is crucial and should be carried out within 2-3 weeks to avoid complications such as contracture, nerve injury, and functional limitation.
12
Question
Musculocutaneous Nerve Injury
Answer
Innervates the biceps brachii and can manifest with decreased flexion at the elbow. clinically loss of sensation of lateral arm. ---> conduction nerve study
23,24 pain opiod
Study
1
Question
Why is Clonidine not recommended in pregnancy?
Answer
Due to its alpha adrenergic blockage effects, risks of hypotension, and fetal hypoperfusion
2
Question
What is the treatment for opioid overdose?
Answer
Naloxone, a competitive opioid receptor antagonist with a rapid onset of action (2-3 minutes).
3
Question
What is Methadone?
Answer
Methadone is a long-acting full opioid agonist that causes less euphoria than short-acting opioids, making it effective at controlling symptoms and minimizing craving in patients with opioid withdrawal. It also decreases the rate of relapse.
4
Question
What is Buprenorphine-Naloxone?
Answer
Buprenorphine-Naloxone is a medication used for opioid dependence treatment. It is a combination of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist, used to discourage misuse. used sublingually but when injected, naloxone takes effeeect.
5
Question
What is the preferred medication for Opioid Use Disorder in pregnancy?
Answer
Buprenorphine
6
Question
What are the clinical features of Basal Cell Carcinoma?
Answer
Slow-growing, nontender, pearly nodule with a rolled border and central ulceration. It is the most common malignant skin tumor and rarely metastasizes.
7
Question
What is the recommended diagnosis for Basal Cell Carcinoma?
Answer
Undergo a full-thickness biopsy of the edge of the lesion to confirm the diagnosis.
8
Question
What are the manifestations of opioid overdose?
Answer
Respiratory depression or distress, bradycardia, hypotension, lethargy or stupor, bilateral miosis (pinpoint pupils)
9
Question
What is the medication effective at controlling symptoms and minimizing craving in patients with opioid withdrawal?
Answer
BuprenorphineNaloxone
10
Question
What are the clinical presentations of opioid withdrawal?
Answer
GI symptoms (abdominal pain, nausea, vomiting, diarrhea), CNS stimulation (anxiety, sympathetic hyperactivity, mydriasis, tachycardia, hypertension), and flu-like symptoms (diaphoresis, piloerection).
11
Question
Manifestation of nerve injury affecting the lateral aspect of the forearm
Answer
Loss of sensation in the lateral aspect of the forearm
12
Question
What are the DSMV criteria for Opioid Use Disorder?
Answer
Opioid use that exceeds prescribed duration, unsuccessful attempts to reduce opioid use, and taking opioids to avoid withdrawal symptoms
13
Question
What nerve injury affects the biceps brachii and is typically proximal and commonly results from brachial plexus injuries?
Answer
Conduction nerve study
14
Question
What is the recommended analgesia for a patient with Opioid Use Disorder (OUD) experiencing severe acute pain?
Answer
Sufficient analgesia to alleviate severe acute pain, which may include a short-acting full opioid agonist if nonopioid analgesics and regional anesthesia methods are not suitable.
15
Question
What are the effects of Clonidine in patients with opioid withdrawal?
Answer
Decreases rate of relapse
16
Question
What should be considered when converting between opioids for pain management?
Answer
New opioid should be given at a lower dose (25-50% lower) and adjusted according to the patient's pain score
17
Question
Describe the characteristics of Basal Cell Carcinoma.
Answer
Slow growing, non-tender pearly nodule with a rolled border and central ulceration
18
Question
What are the manifestations of opioid overdose?
Answer
Respiratory depression or distress, bradycardia, hypotension, lethargy or stupor, and bilateral miosis (pinpoint pupils).
19
Question
Is Basal Cell Carcinoma a common malignant skin tumor?
Answer
Yes, it is the most common malignant skin tumor
20
Question
What pain management approach is recommended for individuals with Opioid Use Disorder?
Answer
Sufficient analgesia to alleviate severe acute pain, consideration of regional anesthesia or short-acting full opioid agonist if nonopioid analgesics are not effective
21
Question
What is the recommended diagnostic procedure for Basal Cell Carcinoma?
Answer
Undergo full thickness biopsy of the edge of the lesion
22
Question
Does Basal Cell Carcinoma metastasize?
Answer
it rarely metastasizes
23
Question
What is the treatment for opioid overdose?
Answer
Naloxone, a competitive opioid receptor antagonist
25,26 derm
Study
1
Question
What type of condition is Lichen Planus?
Answer
Lichen Planus is a Tcell mediated condition with altered immune response.
2
Question
What are the characteristics of Seborrheic Dermatitis?
Answer
Pruritic rash affecting areas of high sebaceous activity (face, eyelids, scalp). Increased in HIV infection, underlying neurological conditions (Parkinson's, stroke), and intestinal malabsorption (Celiac Disease).
3
Question
What are the treatment options for patients with central scale and rough surface?
Answer
actinic keratoosisisolated lesion of ac = cryotherapy5FU, imiquimod, or photodynamic therapy in patients with multiple lesions.
4
Question
Where is Lichen Planus commonly found and which surfaces does it primarily affect?
Answer
Lichen Planus commonly involves hands and primarily affects flexor, not extensor surfaces.
5
Question
When is Seborrheic Keratosis concerning?
Answer
Sudden appearance of multiple lesions, Leser-Trelat sign.
6
Question
How is a Dysplastic Nevus assessed?
Answer
Assessed based on ABCDE criteria: Evolving lesion with asymmetric shape, irregular borders, inconsistent color, and diameter greater than 6 mm.
7
Question
What are the characteristics of Solar Lentigo?
Answer
Flat, brown macules; a benign skin condition in older individuals with light skin; as a result of overproduction of melanin by existin
8
Question
What is Solar Lentigo?
Answer
Solar Lentigo is a benign skin condition in older individuals with light skin.
9
Question
What derm condition is increased in those with HIV, underlying neurologic conditions like Parkinsons/storke, and intestinal malabsorption like Celiac?
Answer
seborrheic dermatitis
10
Question
When is Seborrheic Keratosis concerning?
Answer
Sudden appearance of multiple lesions, Leser-Trelat sign, or associations with malignancies such as lung or GI cancers.
11
Question
What are the treatment options for Actinic Keratosis?
Answer
Cryotherapy for isolated lesions, 5FU, imiquimod, or photodynamic therapy for patients with multiple lesions.
12
Question
What are the characteristics of Dermatofibroma?
Answer
Benign skin condition characterized by fibroblast proliferation, leading to the development of small (3-10 mm) skin-colored or brown fibrous nodules, most commonly on the lower extremities. Patients are asymptomatic and require no treatment. Surgical excision may be considered for cosmetic reasons, symptomatic lesions, or suspicion of malignancy.
13
Question
What are the characteristics of a Strawberry Angioma?
Answer
Benign vascular lesion that bleeds with trauma, develops within the first 2 weeks of life, and regresses by 5-8 years.
14
Question
What is histopathological confirmation of a lesion?
Answer
Surgical excision with safety margin, or Mohs surgery if on the face.
15
Question
What are the yeasts that play a role in the pathogenesis of scalp conditions like Atopic Dermatitis and Eczema?
Answer
Malassezia furfur and globose yeasts
16
Question
Where does Actinic Keratosis occur and who does it affect?
Answer
Occurs on sun-exposed skin (scalp, face, dorsal aspect of hands or arms) and affects light-skinned people over 50.
17
Question
What are the characteristics of a Cherry Angioma?
Answer
Benign vascular lesion that bleeds with trauma, does not regress.
18
Question
Describe the symptoms and characteristics of Lichen Planus.
Answer
Symmetric, well-demarcated, severely pruritic papules with a polygonal shape that commonly involve the hands. Primarily affects flexor surfaces.
27,28 derm
Study
1
Question
What is Melasma characterized by?
Answer
Irregular patchy hyperpigmentation of the skin, triggered/exacerbated by exposure to sunlight.
2
Question
What depigmenting agent can be used in severe Melasma?
Answer
Topical Hydroxyquinone
3
Question
What causes Plantar Warts?
Answer
Caused by HPV, most often HPV1, result of direct skin contact with an infected person or contaminated surface.
4
Question
What are the treatments for Plantar Warts?
Answer
Salicylic acid or fluorouracil cream, cyrotherapy with liquid nitrogen, surgical excision.
5
Question
What characterizes a Pyogenic Granuloma?
Answer
Solitary lesion following physical trauma, bright red papule less than 1 cm in diameter profusely bleeding due to minor trauma.
6
Question
How are Psoriasis plaques treated with topical medications and moisturizers?
Answer
First-line corticosteroids combined with topical Vitamin D derivatives (calcipotriene tar preparations), anthralin, or keratolytic tazarotene. For skin areas susceptible to corticosteroid-induced atrophy (intertiginous and facial areas), topical calcineurin inhibitors can be used. Patients with greater than 5% body surface area covered or decreased quality of life may receive UVB phototherapy or systemic treatment (methotrexate, retinoids, cyclosporine, and biological agents).
7
Question
What is the first line of treatment for psoriasis plaques?
Answer
Topical corticosteroids combined with topical Vitamin D derivatives (calcipotriene tar preparations, anthralin, or keratolytic tazarotene)
8
Question
What can be used for skin areas susceptible to corticosteroid-induced atrophy, intertiginous, and facial areas in psoriasis treatment?
Answer
Topical calcineurin inhibitors
9
Question
What treatment is recommended for patients with greater than 5% body surface area covered or decreased quality of life due to psoriasis?
Answer
UVB phototherapy or systemic treatment (systemic meds: methotrexate, retinoids, cyclosporine, and biological agents)
10
Question
What are topical steroids used to treat?
Answer
Various skin conditions, including psoriasis, eczema (atopic dermatitis), and lichen planus