Family Medicine High Yield


AAA screening-Males 65-75 y/o who have ever smoked
-Abdominal ultrasound
Breast Cancer screening-50-74 y/o
-Mammogram q2yr
Cervical Cancer screening-21-65 y/o
-21-29: Cytology q3yr
-30-65: Cytology + HPV co-testing q5yr
Chlamydia/gonorrhea testingFemales <24 y/o
Colon Cancer screening-50-85 y/o
-If FH in 1st degree relative before 60 y/o, 10 years before age of diagnosis or 40 y/o (whichever comes first)
-FOBT q year
-FIT q year
-FIT DNA q 1-3 years
-Sigmoidoscopy q 5 years with FIT q year
-Colonoscopy q 10 years
Hep C screeningall adults from 18-79 y/o
HIV screening15-65 y/o
Lung cancer screening-50-80 y/o
-20 pack year history
-Current smoker or quit within 15 years
-Low-dose CT q1yr
Osteoporosis screening-Females >65 y/o
-DEXA scan
Pregnancy screening1st trimester screening tests:
-Hepatitis B
-Pap smear
-Blood typing

2nd trimester screening tests:
-Gestational diabetes
-Rhogam shot

3rd trimester screening tests:
-GBS (vaginal/rectal swab)
Note: If positive, give penicillin 4 hours before delivery


Flu Vaccine6 months
HPV Vaccine9-26 y/o
TdapTetanus vaccine administered during pregnancy: 27-36 weeks
Zoster Vaccine>60 y/o


Breast FeedingCI:
Emergency ContraceptionMost Effective: Copper IUD
Side Effect MC: Menorrhagia

-Adenosine (stable)
-Cardioversion (unstable)
Ventricular TachycardiaTx:
-Amiodarone (stable)
-Cardioversion (unstable)

Diseases and Disorders

Actinic KeratosisTx:
-Topical 5-FU
-Topical Imiquimod
Acute bacterial diarrheaAvoid Loperamide
-Supplemental oxygen
-PO/IV steroids
Atopic DermatitisTx:
-Topical steroids, UV light
Bariatric SurgeryTreat stromal stenosis (dumping syndrome):
-Small meals with high protein
Basal Cell CarcinomaDx: full thickness excisional bx
Tx: Excision w/3-5mm margin or Mohs
BiteDog/Cat bite:
-Pasturella multicoda

Human bite:

Note: HIV and Hepatitis B prophylaxis for human bite
Blood TransfusionIndication: Hb <7
Boerhaave syndromeDx:
-Gastrograph and swallow (shows dye extravasating out of esophagus)
Breast CancerRisk Factor:
1. Age
CellulitisBug: Staph aureus (purulent), GAS (non-purulent)
Dx: clinical, may culture, MRI to r/o bone involvement
Tx: oral cephalexin, dicloxacillin, or clindamycin – may consider IV if real bad
CholesterolDecrease Triglycerides: Fibrates
Best to increase HDL: Niacin
Chronic Heart FailureDecrease Mortality:
-B-blocker (carvedilol, metoprolol succinate, bisoprolol)
-Sacubitril/valsartan (Entresto)
-SGLT-2 Inhibitors
Chronic Kidney Disease#1 cause of death: CVD
Chronic venous insufficiencyPx:
-Medial malleolus ulcer
COPD classificationsMild: FEV1 >80% = SABA
Moderate: 50-80% = LABA
Severe: 30-50% = ICS
Very severe: <30% = Supplemental Oxygen (Indications: PaO2 <55, SaO2 <88%)

-Supplemental oxygen
-PO/IV steroids
Note: Only COPD gets antibiotics
Coronary Artery DiseaseTIMI score: determine if UA and STEMI need Cath
Dermatitis herpetiformisTx: Dapsone
-LLQ pain
Abdominal CT
-Metronidazole (flagyl)
-Fluoroquinolones (Cipro)
Erythema MultiformeBugs: HSV, hepatitis, mycoplasma, Yersinia
Tx: abx & NSAIDs
FolliculitisBug: staph, strep, gram neg
Dx: clinical
Tx: topical abx mupirocin (I&D if develops into carbuncle/furuncle)
-Microcytic anemia
-Weight loss
GoutAcute Gout:
-NSAID (indomethacin, colchicine)
-Intra-articular steroid (if renal disease)

Gout ppx:
-Allopurinol (if urine uric acid is high)
-Probenecid (if urine uric acid is low)
Huntington DiseaseTx: Tetrabenazine
HypercalcemiaElevated calcium > 10
Normal calcium level (8-10)
1st line: IV fluids
-Calcium gluconate
Hyperglycemiahypertonic hyponatremia
1st line:
-ACE-i (MOA in kidney: Vasodilation of efferent arteriole)
HyponatremiaNormal serum osmolarity: 275-295
Eq serum osmolarity: 2Na+ + Glucose/18 + BUN/3

Hypertonic hyponatremia: Hyperglycemia

Isotonic hyponatremia: Elevated protein and fat

Hypotonic hyponatremia, hypervolemic:

Hypotonic hyponatremia, euvolemic:
-Primary polydipsia
Tx: Fluid restriction

Hypotonic hyponatremia, hypovolemic:
-Normal saline
-Severe and symptomatic: Hypertonic saline 3%
ImpetigoBug: nonbullous (GAS or staph) or bullous (staph)
Dx: clinical
-mild: topical mupirocin or retapamulin
-severe: oral cephalexin or dicloxacillin
-MRSA: bactrim, clindamycin or doxycycline
Jointseptic: >50k WBC
inflammatory: <50k WBC
Meinere’s diseasePx:
-Hearing loss
MeningitisMC causes:
-S. pneumoniae
-H. influenzae
-Neisseria meningitis

Myocardial Infarction Decrease Mortality:

Indications for LHC:
-New left BBB with symptoms of MI
Dietary changes- small frequent meals, don’t get hungry, don’t get too full, avoid high sugar and high fat, ginger and mint may help
Medication: vitamin B6 (pyridoxine)
NoduleHyperthyroid nodule: benign
Next step: Radioactive iodine uptake study

Euthyroid nodule: malignant
Next step: FNA (Note: If >1 cm)
OsteopeniaDEXA: -1 to -2.5
OsteoporosisDEXA: <-2.5

Risk Factor:
1. Age
Otitis ExternaMC cause: Pseudomonas
-Alcohol-acetic acid ear drops
-Addition of corticosteroids to dilution May be beneficial
-Other agents: neomycin, polymyxin B, ciprofloxacin
PancreatitisMC cause:
Pancreatic CancerCourvoisier’s sign:
-Painless jaundice
-Palpable gallbladder
Peritonsillar abscessPx: Uvular deviation
Pilonidal cystBug: folliculitis w/repetitive trauma = staph, strep, Gram Negs
Dx: clinical
Tx: I&D – sterile packing of wound w/good hygiene and shaving of skin to prevent
Note: aka sacrococcygeal abscess
PolypMost dangerous: Villous
Pregnancy TermTerm: 37-42 weeks
Post Term: >42 weeks
PneumoniaTypical PNA MC:
-S. pneumoniae
-H. influenzae
-M. catarrhalis

Atypical PNA MC:

Legionella pneumonia:

Aspiration PNA:

Adm for PNA: >2 on CURB-65
PolyneuropathyTx: Duloxetine, pregabalin, gabapentin, amitriptyline, nortriptyline
RhabdomyolysisBlood on urine dipstick without RBC on microscopic analysis
Rheumatoid Arthritis#1 cause of death: CVD
Ring Enhancing Lesions-Primary CNS lymphoma
-Brain abscess
Sinusitis-S. pneumoniae
-H. influenzae
-M. catarrhalis
Squamous Cell CarcinomaDx: punch or excisional bx
Tx: surgical excision or mohs
StrokeRisk Factor:
1. Hypertension
TineaBug: trichophyton, microsporum, and epidermophyton species

tinea corporis, capitis, unguium, pedis or cruruis = KOH prep shows hyphae, may do woodlamp to confirm microsporum over trichophyton

Corporis – topical miconazole/ketoconazole
Capitis – PO griseofulvin
Unguium – PO terbinafine, griseofulvin, -azole
Pedis – Topical antifungal
Cruris – Topical antifungal
Tinea versicolorBug: malassezia furfur
KOH prep shows spaghetti & meatballs

-topical ketoconazole and selenium sulfide, or oral azole
Ulcerative ColitisAssoc:
-Toxic megacolon
-Primary sclerosing cholangitis
Umbilical HerniaTx:
-Surgery (Mesh)


2 monthsLift head to prone position
4 monthsRoll over
6 monthsSit up

Can use Toothpaste
First flu shot
9 monthsCrawl/cruise
12 monthsStart going to dentist
MMR – First live vaccine
4 years oldAudiometry and vision testing begin
5 years old-Tie shoes
-Write name
6 years old-Dress self
-Identify left and right
Normal Fetal Heart Rate110-160
Fetal tachycardiaMaternal infection
Fetal heart rate to be sinusoidalFetal anemia
Fetus has complete heart block, mother is likely to haveLupus
Fetal acceleration15-15-2-20

Heart rate increases by 15 bpm and lasts >15 seconds twice within 20 minutes on non-stress test
AtresiaDuodenal atresia:
-Caused by failure of recanalization
-Associated with down syndrome
-Double bubble sign

Jejunal atresia:
-Caused by vascular accident in utero
-Associated with maternal cocaine use
-Triple bubble sign

-Abdominal X-ray (R/o perforation)
-Upper GI series (to see double/triple bubble sign)
Tx: Horse-derived antitoxin
Child AbuseFractures MC:
-Posterior rib
-decrease in UTIs in 1st yr of life
-prevention of phimosis and modest reduction in penile cancer
-reduction in penile inflammatory disorders
-reduction in HIV and HPV, especially in countries where HIV is endemic

-infection, inadequate skin removal, urethral injury.
-Complication rate is low <1%
-Racemic epinephrine
ErysipelasBug: GAS (superficial dermis + lymphatic tissue)
Dx: portal of entry identifiable, clinical
Tx: oral cephalexin, dicloxacillin, or clindamycin – may consider IV if real bad
LiceBug: parasite
Dx: lice & eggs (nits) seen w/naked eye
Tx: remove, + topical (permethrin, pyrethrin, benzoyl alcohol)
IntussusceptionTelescoping of ileum into cecum
-Colicky abdominal pain
-Currant jelly stools

-Henoch-Schonlein purpura
-Contraindication for rotavirus vaccine

air enema
Tx: Vitamin A
MeningitisInfant MC:
-E. coli

Tx: Ampicillin-Gentamicin
Midgut VolvulusPx:
-Constant abdominal pain
-Bilious emesis
Molluscum ContagiosumBug: Poxvirus (skin-skin contact)
Dx: clinical, see under microscope
Tx: self-resolves or local destruction
Note: spares palms and soles
Otitis MediaMC causes:
-S. pneumoniae
-H. influenzae
-M. catarrhalis

For children > 6 mo: amoxicillin 90 mg/kg for 10 days
-Use Augmentin: If child has had amoxicillin in last 30 days, has purulent conjunctivitis, or hx of AOM unresponsive to amoxicillin
-PCN allergy: Cefdinir, cefuroxime, cefpodoxime, or ceftriaxone
ScabiesBug: sarcoptes scabie
Dx: scrape of intact tunnel and look under microscope
Tx: pt & contacts – 5% permethrin
from neck down (head to toe for infants) or oral ivermectin
Slipped capital femoral epiphysisTx:
Surgical pinning
Tourette’s syndromeTx:
-a2 agonists (clonidine, guanfacine)
-atypical antipsychotics


Intranasal steroidsSide Effect: Epistaxis
-Renal disease
Note: Can cause lactic acidosis
OCPsDecrease Risk of:
-Endometrial cancer

Increase Risk of:
Breast Cancer

-Migraine w/ aura
-Smokers >35 y/o
SSRIsLength of time to work: 4-6 weeks
Continue for: 9 months
ThianomidesSide Effect: Agranulocytosis

1st line:
Avoid B-blocker (Note: Can cause unopposed a-adrenergic vasoconstriction)
Smoking Tx Cessation:
1st line