Family Medicine shelf NBME Exam Questions And Correct Answers, Verified Child 3-16 weeks old presents with cough for the past 2 weeks, tachypneic, diffuse crackles, wheezes, may have conjunctivitis, chest film shows hyperinflation and diffuse interstitial patchy infiltrates. No fever Chlamydial pneumonia Child had rhinorrhea and pharyngitis for 1-3 days then cough and wheezing.Lungs have diffuse rhonchi, fine crackles and wheezing RSV Cold symptoms (fever, runny nose and cough) develops into severe cough Parainfluenza Recommended treatment for Mallet fracture?Splinting the DIP joint in flexion Vaccines at age 11-12?influenza, meningococcal, HPV and Tdap colorectal screening?Cervical cancer screening?21- 65 stop at 65 if negative results in the past Mammography screening?When should pregnant women receive the Tdap?27-36 weeks gestation regardless of when they last received it Men who have sex with men but are in a monogamous relationship, should be screened for?Hep C and Hep B the Get up and Go test is used for screening?for mobility/risk of falling/ balance or gait impairment 1 / 3
Diagnostic criteria for Sepsis? severe Sepsis?Septic shock?
sepsis: leukocytosis
severe sepsis: increase in creatinine level >0.5, thrombocytopenia, hyperbilirubinemia
Septic shock: hyperlactatemia or hypotension refractory to IV fluids
If a relative has a peanut allergy, when should a baby be exposed to peanuts?early!begin introducing peanuts prior to 12 months of age. If child was high risk, aka severe eczema or had a first degree relative with severe allergy, then allergy testing can be considered first.Who is at risk for acute mountain sickness?those with previous history mountain sickness, fast ascent, lack of acclimatization, female, less than 46 years of age.Most effective medication for motion sickness?Scopolamine Dimenhydrinate? Diphenhydramine? Meclizine? Promethazine?In obese patients what has been shown to be most effective in reducing cardiac risk?Bariatric surgery. Reduces all cause mortality.
- week old infant with a fever and does not appear toxic. How would you
manage?Admit to hospital! Any child 29 days old and younger with a fever should undergo a complete sepsis workup. Obtain urine, blood, CSF culture then start antibiotics.If a patient is allergic to sulfas what can you give them for altitude sickness?dexamethasone rather than acetazolamide What change in the elderly causes a change in pharmicokinetics?increase in the percentage of body fat What Vit D level should be checked? when checking Vit D?25 hydroxyvitmain D level What are the USPSTF recommendations on folic acid?All women capable fo pregnancy take a daily folic acid supplement with 0.4-0.8 mg 2 / 3
What are the USPSTF recommendations on chlamydia?screen all sexually active females 25 and under as well as older individuals at a higher risk USPSTF recommendations on Beta carotene and Vitamin E?Class D, do not recommend. no benefit on cancer or heart disease. One study said E can increase the risk of hemorrhagic stroke and Beta carotene increases the risk of lung cancer in persons already at risk for lung cancer.
- months of pathologic fatigue, post exertional fatigue, impaired
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focus/concentration, orthostatic intolerance and unrefreshing sleep. Headache, diffuse myalgias, tender lymph nodes, GI or GU impairments.???What symptoms would change your diagnosis?Myalgic encephalomyelitis/chronic fatigue syndrome.2) Red Flag symptoms like chest pain, focal neurologic defects, joint erythema/swelling, enlarged lymph nodes, or SOB Outpatient therapy for salpingitis/PID IM ceftriaxone and oral doxy Pneumococcal vaccine regulation?Who gets revaccinated all those 65 or older, all adults with cardiopulmonary diesase, cigarrete smokers, and all immunocompromised individuals. They all get the 23 and 13.Those who are immunocompromised or dont ahve a functioning spleen must be revaccinated after 5 years Patient has pneumonia and a pleural effusion but conintues to have a fever despite appropriate antibiotics?Empyema treat pneumonia 1) outpt 2) in hospital