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Family medicine Review

USPTFS recommendation
Bacterial vaginosis and bacteriuria in asymptomatic pregnant women TREAT. BUT NOT IN NONPREGNANT WOMEN
Cervical cancer: 21-65 q 3years or 30-65 with HPV q 5 years. If HIV positive: every 6 months.
-cholesterol screen: men >35 yo. Women>45 yo

Centor criteria for sore throat
Myxedema coma
Advance directives: patient mentioned to his neighbor that if something happens to him and something happens to
him, and does not desire life support. Does the neighbors info count? IS ENOUGH AS AN ADVANCE DIRECTIVE

Do not do circumcision: hypospadias/anatomical problem
-urethritis in men: gonococcal (250 ceftriaxone with azithro/doxy) vs. nongonococcal (metronidazole, azithro)
-varicocele vs. hydrocele. Get Doppler

-peyronies disease: painful erection, plaque, get a Doppler

Urinary retention: due to meds, anticholinergics, nsaid, decongestants, neurologic...

Nephrotic syndrome: fluid restriction and decrease sodium

AAP does not recommend routine circumcision but decreases rate of UTI< squamous cell and phimosis and HIV

UTI in children: all males with UTI. VCUG for reflux.
Female <36 mo: get image
Male: image

Syphilis: highest prevalence in Louisiana. Penicillin G IM
Late/latenet: penicillin X3
Neurosyphilis: 14 days IV penicillin

+RPRconfirm with FT-ABS

Vulvodynia: r/o fungal infection. Use lidocaine/TCA/gabapentin. Test with a cotton swab.

Acute interstitial nephritis: caused by NSAIDs

Hypospadias: get u/s, dont circumcise

Herpes zoster: had shingles before then wait 2 years before giving them vaccine.

N&V at end of life: odansetron or metoclopramide (if need to get gut moving)

Aspiration pneumonia: putrid sputum

Splenic infarct: due to trauma. OPSI: overwhelming postsplenectomy infection. Increased risk of malaria

CT colongraphy: prep pt fully, .

Children and firearms: more common in blacks.

DM1 in kids: check hypothyroidism yearly.
HIV patients: more prone to osteoporosis
Needlestick injuries: keep drawing blood, get HIV, hepatitis tests. If they are HIV positiveget HAART for 4 weeks.

Dermis. Net:
Blue nevus
Erythema multiforme
Erythema migrans
Squamous cell carcinoma: more likely to recur if on face.

CHADS2 criteria: for afib . .anticoagulate if score>2

Wolff Parkinson white
H. pylori

Statin: dont stop unless LFT rise 3x above normal

AAA: if greater than 5 cm then check often
4-5: check every 6 months

DVT risk: highest with hip fracture/leg fracture. Arthroscopic knee/hip. If someone is preop and they are on
warfarin, and high risk of dvt.then bridge with lovenox. Then start again 24-48 hours later

Cancer associated venous thromboembolism: LMWH superior to Coumadin

Hirsutism: check dhea-s, dhea, 17 hydroxyprogesterone


Ortho: knee injury associated with trauma-40yo lady playing soccer collided. Pain with thalasse maneuver?

Cruise ship infection: norovirus
Lyme disease

Legg perthes disease