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FAMILY MED AQUIFER/345 QUESTIONS AND ANSWERS (A+)
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FAMILY MED AQUIFER/345 QUESTIONS AND ANSWERS (A+)
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FAMILY MED AQUIFER/345QUESTIONS AND ANSWERS (A+)
When is a patient at risk for hereditary breast cancer? -
√Answer :1st relative has it: parent or sibling
Quiz :Recommendations for breast exams: -
√Answer :self: meh. no discernable advantage
clinical: USPTF = Insufficient
ACS = every three years if 20-40 and every year if >40
Quiz :Cervical cancer screening 30-65: -
√Answer :every three years if cytology alone
5 years if cytology plus HPV screening
Quiz :21-29 year old cervical cancer screening: ` -
√Answer :every 3 years
Quiz :women older than 65 cervical cancer screening: -
√Answer :can opt out if had adequate screening within
last 10 years = 3 normal paps or 2 consecutive normal
with negative HPV
Quiz :who should get more frequent cervical cancer
screening? - √Answer :compromised immunity, are HIV
positive, have a history of cervical intraepithelial
neoplasia grade 2, 3 or cancer
Quiz :cancer screening: - √Answer :annual low dose CT
in patients who have smoked more than 30 yrs and and
55-80 years old
,NOTE: must have been smoking within last 15 years or
currently smoking
Quiz :diagnostic tests for found breast masses: -
√Answer :cystic = FNA
Solid = mammography
NOTE: can use US to determine solid vs cystic. If
benign, follow with mammography and exams
Quiz :Advanced sleep phase syndrome: -
√Answer :patient becomes drowsy at 6 or 7 pm, sleep a
normal 8 or so hours, then wake around 3-4 am.
if they STAY UP, then they still awaken at 3-4, and it
can be difficult to distinguish from insomnia
Quiz :When is napping OK? - √Answer :limit to 30-45
mins and are STILL able to sleep at night
Quiz :WHy does alcohol not help you sleep? -
√Answer :initially has sedative effect followed by
stimulant like effect => wakes you up after a couple
hours
Quiz :Snacks that may help with sleep when eaten
before bed: - √Answer :warm milk, bananas, light foods
that have tryptophan in them
Quiz :risk factors of suicide in elderly: -
√Answer :widowed/alone
lack confidante
,poor health
poor sleep
stressful events
NOTE: 75% of elderly that committed suicide had been
to PCP in last month and were not caught
Quiz :Contrast suicide rates by age: -
√Answer :attempts do NOT increase, but completions
DO increase
Quiz :Which ethnic group in the US is at highest risk for
suicide? - √Answer :American indian/native alaskan
1.5X the normal rate, 8th leading cause of death in
these two groups aged 15-35
Quiz :Requirements to Dx major depression: -
√Answer :5/9 of the SIGECAPS for 2 weeks or more
MUST HAVE: depressed mood or loss of interest in
things to be considered
Quiz :assessing severity of suicidal ideation: -
√Answer :SAD PERSONS
Sex - male
Age < 19 or > 45
Depression Dx
Previous attempts
Ethanol or substance abuse
Rational thinking impaired
Social supports not present
, Organized plan for suicide
No significant other
Sickness
4-6 = outpatient is okay option
7-10 = hospitalization is warranted
Quiz :Who should be screened for depression? -
√Answer :all adults, but especially diabetics or others
with chronic diseases
Quiz :Major limiatation to the geriatric depression
screen: - √Answer :it does not work well in demented
patients, so also screen for dementia as well
Quiz :two ways to screen for dementia: -
√Answer :MMSE
Mini Cog exam -- faster and more specific than MMSE
Quiz :Most common side effects of SSRIs -
√Answer :Headaches
sleep disturbances
GI problems (diarrhea)
Sexual dysfunction
hyponatremia, Serotonin syndrome, GI bleeds can also
occur
NOTE: increased risk of fall in elderly, and can
adversely affect bone density
Quiz :two antidepressants that prolong QT -
√Answer :citalopram, escitalopram
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