Family Medicine Shelf (USPSTF + Blueprints
- AAFP Questions & Answers)
Screening for AAA Correct Ans - Men 65-75 who have ever smoked (A) Test used to screen for AAA Correct Ans - Abdominal duplex ultrasonography Treatment for AAA Correct Ans - >5.5 cm --> surgery 3.0-5.4 cm --> repeated surveillance Q3-12 months Growth >1.0 cm/yr --> surgery Screening for Alcohol Misuse Correct Ans - Persons older than 18 years Screening Tests for Alcohol Misuse Correct Ans - AUDIT, AUDIT-C, or number of times person drank >5 (4 if woman or older than 65) drinks in the past year Treatment for Alcohol Misuse Correct Ans - Behavioral Counseling interventions Recommendation for Aspirin Usage Correct Ans - Men 45-79 years old (MI protection) Women 55-79 (Stroke protection) *Benefit of MI reduction must outweigh the risk of GI hemorrhage Risk Factors For GI Hemorrhage Correct Ans - Men Other NSAID usage Hx of GI ulcer Uncontrolled HTN Anticoagulation Screening for Asymptomatic Bacteriuria Correct Ans - Women at 12- 16 weeks of pregnancy or first prenatal visit if farther along 1 / 4
Screening Test for Asymptomatic Bacteriuria Correct Ans - Urine culture Dipstick and microscopy have poor PPV and NPV Treatment for Asymptomatic Bacteriuria Correct Ans - Nitrofurantoin Prophylactic Aspirin for the Prevention of Colon Cancer Correct Ans - The USPSTF DOES NOT recommend this due to risk of GI hemorrhage Bacterial Vaginosis Screening in Pregnant Women Correct Ans - The USPSTF DOES NOT recommend this due to lack of evidence that it reduces mortality or morbidity
Amsel Criteria Correct Ans - Need 3/4:
- Fishy odor with addition of KOH
- Vaginal pH >4.7
- Clue cells on wet mount
- Thin, homogenous discharge
Treatment of BV Correct Ans - Oral Metronidazole or oral Clindamycin or Vaginal Metronidazole or Vaginal Clindamycin creams Screening for Bladder Cancer Correct Ans - The USPSTF DOES NOT recommend this due to lack of accurate screening methods Screening for HTN Correct Ans - Adults > 18 years Diagnosis of HTN Correct Ans - >140 systolic or >90 diastolic Must have 2 different BP readings that are elevated over a period of 1-several weeks Categories of BP Correct Ans - Normal = <120/<80 PreHTN = 120-129/80-89 Stage 1 HTN = 140-159/90-99 Stage 2 HTN = 160+/100+ Major CV Risk Factors Correct Ans - HTN 2 / 4
Obesity Dyslipidemia DM Cigarette smoking Inactivity Age >55 (men) or >65 (women
Family History of premature CVD: <55 (men) and <65 (women)
Causes of HTN Correct Ans - Sleep Apnea Drug-induced (diuretics, cyclosporine, glucocorticoids, amiodarone) Chronic kidney disease Primary Aldosteronism (Conn's Syndrome) Cushing's Syndrome Pheochromocytoma (MEN II and III) Coarctation of aorta (Turner's) Thyroid/Parathyroid disease Goal BPs for Treatment (JNC8) Correct Ans - <140/90 for adults <60 years without CKD <150/90 for adults >60 years without CKD <140/90 for all ages with DM, but no CKD <140/90 for all ages with CKD +/- DM Treatment of HTN for Non-Black without CKD Correct Ans - Thiazide Diuretic ACE-I ARB CCB Treatment of HTN for Black without CKD Correct Ans - Thiazide Diuretic CCB Treatment of HTN for All Races with CKD +/- DM Correct Ans - ACE-I ARB BRCA-Related Cancer Screening Correct Ans - All women with family members who had breast, ovarian, tubal, and/or peritoneal cancers 3 / 4
Medications for Breast Cancer Risk Reduction Correct Ans - Offer tamoxifen or raloxifene to women at high risk with low risk for adverse side effects
Mammography Screening Correct Ans - Women 50-74: biennial (every
other year)
Women under 50: Take the patient's factors into context and weigh benefits
and risks
Women >75: not recommended to get screening
Breastfeeding recommendations Correct Ans - Interventions to educate and encourage women during pregnancy and postnatal period to breastfeed Carotid Artery Stenosis Screening Correct Ans - USPSTF DOES NOT recommend screening for the general population for asymptomatic carotid stenosis Diagnostic Test for Carotid Artery Stenosis Correct Ans - Ultrasonography of Carotid Artery with Doppler flow High Intensity Statin Correct Ans - Lowers LDL-C by >/=50% Atorvostatin 40-80 mg Rosuvostatin 20-40 mg Medium Intensity Statin Correct Ans - Lowers LDL-C by 30-50% Atorvostatin 10-20 mg Rosuvostatin 5-10 mg Simvastatin 20-40 mg Provastatin 40-80 mg Lovastatin 40 mg Fluvastatin 40 mg BID Low Intensity Statin Correct Ans - Lowers LDL-C by
- / 4