Family Medicine Cram Session

Key Screening Guidelines

• Abdominal Aortic Aneurysm (AAA)
  • Screen with abdominal ultrasound at age 65 for individuals who have ever smoked.
• Lung Cancer
  • Low-dose CT for individuals 55+ with a 30-pack year history of smoking (current or quit within last 15 years).
• Colonoscopy
  • Start at age 50 every 10 years; earlier if there's family history.
• Pap Smears
  • Start at age 21 every 3 years; stop at age 65.
• Mammograms
  • Start at age 40 every 1 or 2 years.
• Osteoporosis
  • DEXA scan at age 65.
• Zoster Vaccine
  • Offer at age 60.
• HPV Vaccine
  • Ages 9 to 26.
• Chlamydia and Gonorrhea Screening
  • Females under 24 who are sexually active.
• HIV Screening
  • Ages 15 to 65.

COPD Staging and Treatment

• Based on FEV1:
  • Mild: >80%, treat with albuterol.
  • Moderate: 50-80%, add a long-acting beta agonist.
  • Severe: 30-50%, add an inhaled steroid.
  • Very Severe: <30%, add oxygen therapy.
• Oxygen therapy if O2 saturation <88% or PaO2 <55.

Gout and Septic Arthritis

• Acute Gout Treatment: NSAIDs (indomethacin), colchicine, or steroids if CKD present.
• Septic Arthritis: Diagnose with arthrocentesis; treat with IV antibiotics.

Chronic Gout Management

• Probenecid: Used when urine uric acid is low (indicating excretion issue).
• Allopurinol: Used when urine uric acid is high (indicating overproduction).

Prenatal Care

• First Visit: CBC, urinalysis, STD, HIV, HBV, pap smear, blood typing, rubella.
• Week 28: CBC, diabetes screening, RhoGAM if Rh-negative.
• Week 35-37: Group B strep test (vaginal and rectal swab).

Pediatric Milestones

• 2 Months: Lift head.
• 4 Months: Roll over.
• 6 Months: Sit up.
• 9 Months: Crawl or cruise.
• 12 Months: Use 1-3 words.
• 2 Years: Use 2-word phrases.
• 3 Years: Thousands of words, 3-word phrases.
• 5 Years: Dress self, write name.
• 6 Years: Tie shoes, identify left/right.
• Vision and Hearing Tests: Start at age 4.

Key Medications and Treatments

• Hypertension: First-line are ACE inhibitors, calcium channel blockers, thiazides.
• MI Mortality Reducing Drugs: ACE inhibitors, beta blockers, aspirin.
• Osteoporosis: First-line is bisphosphonates.

Asthma and COPD Exacerbations

• Asthma Treatment:
  • Intermittent: SABA (e.g., albuterol)
  • Mild Persistent: Add low-dose ICS.
  • Moderate Persistent: Add medium-dose ICS.
  • Severe Persistent: Add high-dose ICS.
• COPD Exacerbation: Oxygen, bronchodilators, steroids, antibiotics (cover Pseudomonas).

Depression Management

• Diagnosis: 5 of 9 symptoms from MD CAPS for >2 weeks.
• Treatment: Start with SSRIs, remember it takes 4-6 weeks for effects.

Stroke Management

• Immediate Action: Head CT without contrast.
• Ischemic Stroke: Administer TPA within 4.5 hours if no hemorrhage.
• Post-Stroke Workup: EKG, echocardiogram, carotid Doppler.

Diabetes Management

• Diagnosis: Fasting glucose >126, random glucose >200 with symptoms, or A1c >6.5.
• Controlled DM: BP <140/90, A1c <7, LDL <100.
• Metformin Contraindications: Renal disease, CHF.

Important Miscellaneous Notes

• Epiglottitis: Caused by H. flu; treat with intubation.
• Croup: Caused by parainfluenza virus; treat with corticosteroids or nebulized epinephrine.
• Breastfeeding: Contraindicated in HIV and chemotherapy.
• Osteoporosis Risk Factor: Age is the greatest risk factor.

Emergency Medicine and Trauma

• MI Suspected: EKG and troponin.
• Hypertensive Crisis: Calcium channel blockers for stroke protection.
• Sepsis: Early identification and management critical.

This summary provides a concise review for family medicine topics, ideal for exam preparation or clinical practice refreshers.