Reproductive Health
The most effective treatment for abnormal uterine bleeding.
Hysterectomy
Treatment and duration - patient with L leg cast due to fibular fracture is found to have a L DVT (iliac vein).
Anticoagulation x3 months for provoked DVT.
First line oral treatment for your uncomplicated little old lady - aka cutie pie- who has a dexa score of -2.5.
Alendronate (oral bisphophonate) for 5 years + calcium + vitamin D
Diagnose Foosh, TTP over snuff box
Likely a scaphoid fracture.
At what age do you recommend paps?
21 - 65 (as long as they still have a cervix; special cases for ladies who had cancer and then hyst)
The most effective medical (non-surgical) treatment for heavy menstrual bleeding or AUB.
Mirena IUD (levonorgestrel)
a harsh systolic murmur heard in young patients at the lusb does not radiate and lessens/disappears with valsalva.
Pulmonary flow murmur (innocent)
Treat - a postmenopausal pt w vertebral compression fracture and a history of breast cancer.
Raloxifene (estrogen modulator, oral 60mg daily)
Treatment of scaphoid fracture
Thumb spica splint
Age for colon cancer screening; A&B recommendation.
A: 50-75
B: rec is starting at 45-49
Full infertility work up. (before moving on to treatment)
Treatment for a young female with recurrent DVT, recurrent miscarriages, who is positive for anti-phospholipid antibodies. She is not currently pregnant.
Warfarin (DOACs not preferred in anti-phospholipid syndrome due to increase risk for intra-arterial thrombotic events.)
Treatment for cutie pie's twin sister who comes in for hospital follow up after a repaired hip fracture but she has CKD with a CrCl <30.
Denosumab (60mg SQ every 6 mo)
Treatment for distal phalanx fracture not involving the joint.
refer, splint in extension for 4-6 weeks, RICE + gentle mobilization
splint in extension for 4-6 weeks
AAA recs
MEN 65-75 who have ever smoked.
B recommendation from AAFP for women battling infertility (the only A or B recommendation AAFP has on this topic). Think family medicine!
Women with BMI >30 should be counseled on loosing weight which may restore ovulation.
#1 medication that will interfere with testing for primary hyperaldosteronism.
Mineral corticoid receptor blockers like spironolactone. (hold for four weeks before testing)
Monitoring for your patient on therapy for osteoporosis. Labs and or imaging if needed.
Dexa every 1-2 years till stable T score, Vitamin D, calcium, (for rank ligand renal function panel, and mag, for raloxifene mammo and lipids)
DX - pt with trochanteric bursitis (greater trochanteric pain syndrome) not better with NSAID and PT could have ...
Gluteus medius tendon tear.
STD recs
sexually active WOMEN 24 and <; WOMEN 25 and older and increased risk...men is a level I (indeterminate)
Letrozole (aromatase inhibitor)
A patient with history of dilated cardiomyopathy now recovered/improved heart failure wants is on entresto, farxiga, lasix, coreg, and spironolactone. Which medication can be de-prescribed?
None; according to tred-hf trial patients who stopped pharmacotherapy relapsed and EF worsened.
Treat you grandmother's best friend who has a t score <3.1, has a FRAX score <4.5, and has had multiple fractures in the last 12 months
Teriparitide (parathyroid analog 20mg SQ daily x2 years ) high risk category.
treatment - buckle fracture of the distal radial metaphysis
pre-fabricated splint vs cast
3 weeks vs 6 weeks
or refer
Prefabricated splint 3 weeks
BRCA1/2 screening - is it recommended? yes or no
yes! with a brief assessment tool of family history. Then if positive test, and if test positive genetic counseling.