Mixed Deck — All FMCLA Topics Flashcards

Which antiarrhythmic drug is the most commonly used for long-term maintenance of sinus rhythm in atrial fibrillation?

Answer: Amiodarone

Amiodarone is the most effective antiarrhythmic for maintaining sinus rhythm in AF and is widely used despite its side effect profile.

What is the pathophysiology underlying hypoxemia in pulmonary embolism?

Answer: Ventilation-perfusion (V/Q) mismatch

PE causes dead space ventilation (ventilated but unperfused alveoli), resulting in V/Q mismatch and subsequent hypoxemia.

What defines severe preeclampsia apart from hypertension?

Answer: Severe-range BP (≥160/110) plus end-organ damage

Severe preeclampsia is defined by BP ≥160/110 mmHg or evidence of end-organ damage (renal, hepatic, neurologic, hematologic).

A patient presents with heel pain that is worst with the first steps in the morning. The most likely diagnosis is:

Answer: Plantar fasciitis

Plantar fasciitis causes pain at the calcaneal insertion of the plantar fascia, characteristically worst with the first steps after rest.

Which type of urinary incontinence is most common in elderly women?

Answer: Urge incontinence

Urge incontinence (overactive bladder) is the most prevalent type of incontinence in older women and is characterized by sudden intense urge to void.

A 75-year-old patient is found to have an ABI (ankle-brachial index) of 0.65. What does this indicate?

Answer: Moderate-to-severe peripheral arterial disease

An ABI of 0.4–0.69 indicates moderate-to-severe peripheral arterial disease with significant arterial occlusion.

Which vaccine is recommended at birth for all newborns?

Answer: Hepatitis B

The Hepatitis B vaccine is recommended at birth for all newborns, ideally within 24 hours of delivery. This early vaccination is crucial for preventing perinatal transmission of the virus from an infected mother to her baby. It is part of a series that provides long-term protection against Hepatitis B infection, which can lead to serious liver disease.

Which behavioral intervention has the strongest evidence for effectiveness in treating insomnia?

Answer: Cognitive-behavioral therapy for insomnia (CBT-I)

Cognitive-behavioral therapy for insomnia (CBT-I) has the strongest evidence for effectiveness in treating chronic insomnia and is considered the gold standard non-pharmacological treatment. CBT-I addresses the underlying thoughts and behaviors that contribute to insomnia, including sleep restriction, stimulus control, and cognitive restructuring. It provides more durable improvements in sleep than medication alone.

A 72-year-old woman with osteoporosis sustains a hip fracture from a minor fall. Which bisphosphonate is commonly used for fracture prevention in this setting?

Answer: Alendronate

Alendronate (a bisphosphonate) reduces fracture risk and is first-line pharmacotherapy for osteoporosis in postmenopausal women.

A patient presents with anaphylaxis after a bee sting. What is the first-line treatment?

Answer: Epinephrine 0.3 mg IM

Intramuscular epinephrine in the anterolateral thigh is the first-line and life-saving treatment for anaphylaxis.

A 35-year-old presents with well-demarcated, erythematous plaques with silvery scales on the elbows and knees. The most likely diagnosis is:

Answer: Psoriasis vulgaris

Psoriasis vulgaris classically presents with well-demarcated erythematous plaques covered with silvery-white scales on extensor surfaces such as elbows and knees.

What is the first-line pharmacological treatment for managing hypertension in adults according to current guidelines?

Answer: Thiazide diuretics

According to current guidelines, including those from the American College of Cardiology/American Heart Association (ACC/AHA) and the Eighth Joint National Committee (JNC 8), thiazide diuretics are recommended as first-line pharmacological treatment for managing hypertension in most adults. They are effective, well-tolerated, and have been shown to reduce cardiovascular morbidity and mortality. Other classes like ACE inhibitors, ARBs, and calcium channel blockers are also considered first-line options, but thiazide diuretics are often preferred initially.

Which seronegative spondyloarthropathy is strongly associated with HLA-B27 and causes inflammatory back pain in young adults?

Answer: Ankylosing spondylitis

Ankylosing spondylitis is most strongly associated with HLA-B27 and presents as chronic inflammatory back pain and stiffness in young men.

What is the first-line pharmacologic treatment for major depressive disorder in adults?

Answer: Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line pharmacologic treatment for major depressive disorder in adults. They are generally well-tolerated, effective, and have a relatively safer side effect profile compared to older antidepressants like TCAs and MAOIs. SSRIs work by increasing serotonin levels in the brain, which helps regulate mood.

Which feature best distinguishes Lewy body dementia from Alzheimer's disease?

Answer: Visual hallucinations and fluctuating cognition

Lewy body dementia is distinguished by recurrent visual hallucinations, fluctuating cognition, and Parkinsonism, which are atypical in Alzheimer's.

A geriatric patient taking five or more medications daily is at risk for which condition?

Answer: Polypharmacy

Polypharmacy is defined as the concurrent use of five or more medications and is associated with increased risk of adverse drug interactions and falls in the elderly.

A pregnant woman at 36 weeks is found to have GBS colonization on vaginal-rectal culture. What is the appropriate management?

Answer: IV penicillin G during labor

Intrapartum IV penicillin G is given to GBS-positive mothers during labor to prevent neonatal early-onset GBS disease.

A 60-year-old male presents with sudden painless vision loss in one eye. Which diagnosis must be ruled out immediately?

Answer: Central retinal artery occlusion

Central retinal artery occlusion is an ophthalmic emergency requiring immediate treatment within hours to restore vision.

A 35-year-old female presents with right lower quadrant pain, nausea, and fever. The Alvarado score is 8. What is the next step?

Answer: Urgent surgical consultation

An Alvarado score of 7–10 indicates high likelihood of appendicitis and warrants urgent surgical consultation.

Which finding on physical exam is a 'red flag' in a patient presenting with low back pain?

Answer: Bilateral lower extremity weakness and saddle anesthesia

Bilateral weakness, saddle anesthesia, and bowel/bladder dysfunction suggest cauda equina syndrome, a surgical emergency.