USPSTF
What are the current guidelines for Pap smears?
21 q3 until 30 yo. Then every 5 years until 65 with HPV testing.
Give me 2 indications for statin
1. LDL >190
2. cardiac/ neurologic event (stroke, MI, PAD)
3. 40-74 yo ASCVD 10% and one additional risk factor
4. Diabetes >40 yo
If a PCP was screening you with a STOP BANG questionnaire, what are you being screened for?
sleep apnea
What are 3 causes of pancreatitis?
I GET SMASHED
idiopathic, gallstones, ethanol, trauma, steroids, autoimmune, scorpions, hyper Ca, Tri, ERCP, drugs medications
What is the lowest duration of community acquired pneumonia treatment that is non inferior to longer courses?
5 days, typically with ceftriaxone and azithromycin/doxycycline
Osteoporosis screening per USPSTF?
all women >65 yo. Women who are postmenopausal and have other fracture risk factors or a ten year FRAX >93%. Screen with DEXA
Give me one indication for bariatric surgery (specific bmi, can't just say big)
1. BMI >40
2. BMI >35 with medical comorbidities.
This medication has a NNT of 6 for smoking cessation at 6 months.
Varenicline- 6
bupropion 21
A patient declines colonoscopy screening. They elect to do cologuard. They have a negative result, when is their next screening?
3 years.
This test has a high negative predictive value and should be ordered in all patients being treated for hospital acquired pneumonia. If negative, it is absolutely safe to discontinue MRSA coverage.
MRSA nares/ pcr.
What is the a1c cutoff for pre diabetics?
5.7
Name the only drug class with mortality benefit in both heart failure with preserved and reduced ejection fractions?
SGLT- jardiance superior to farxiga. See Emperor Preserved Trial for further reading.
What is SMART therapy in regards to anyone > 12 yo with asthma?
When compared with standard therapy, SMART is associated with a reduced risk of acute asthma exacerbations in patients 12 years and older.
A cirrhotic patient has 10 L drained off by paracentesis. How much albumin should be replaced?
6-8 per liter pulled off so practically 75 or 100 doses one time would be appropriate.
What combination of major and minor Duke criteria can be used to diagnose endocarditis?
2 major
1 major 3 minor
5 minor
Who should be screened for AAA?
All men 65-75 who have ever smoked.
What was the SPRINT trial?
Intensivist group bp treated to <120 vs <140. Trial was stopped early due to lower rates of fatal and nonfatal major cardiovascular events, although significantly higher rates of adverse events.
What is the treatment for bronchiolitis in kids?
Supportive therapy (oxygen and fluids)
No benefit for steroids, albuterol, antibiotics etc.
In Barrett's esophagus, someone who does not have dysplasia should be screened every how many years?
3 years.
Give me one treatment course, drug and duration, for latent TB.
rifampin 4 months
isoniazid 9 months
RI for 3 months
What is the lung cancer screening in the US per USPSTF guidelines?
B recommendation. Age 50-80 who currently or formerly smoke and have a 20 pack year history. Recommend yearly screening with low dose Ct scan.
What is an indication for ICD in regards to heart failure ejection fraction?
<35% EF persisting after 3 months of GDMT
What is the REDUCE trial and it's implications on COPD management?
5 days treatment superior to 14
IV=oral
standard treatment is 5 days oral prednisone 40 mg
Screening recommendation for hepatocellular carcinoma for patient who already have diagnosis of cirrhosis.
Liver US and AFP every 6 months.
For non pregnant patients, what are the SIRS criteria and what constitutes sepsis?
HR>90
RR>20
wbc>12 or less than 4 or 10% bands
T >38 C or <36
Sepsis is 2 SIRS and source of infection