ABFM Family Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Hypertension first-line in Black adults

For Black adults without CKD or diabetes, initial therapy is a thiazide diuretic or a calcium channel blocker rather than an ACE inhibitor, which has lower blood pressure efficacy in this group.

SGLT2 inhibitor in type 2 diabetes

In type 2 diabetes with heart failure, chronic kidney disease, or atherosclerotic cardiovascular disease, an SGLT2 inhibitor or GLP-1 receptor agonist is added regardless of the A1c value.

COPD spirometric diagnostic criterion

A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow limitation and establishes the diagnosis of COPD in a symptomatic adult with compatible exposure history.

CHA2DS2-VASc anticoagulation threshold

Anticoagulation is recommended for atrial fibrillation when the score is 2 or higher in men and 3 or higher in women; a score of 1 in men is reasonable to consider.

Febrile infant 28 days or younger

Any infant 28 days old or younger with a temperature of 38.0 C or higher requires full sepsis evaluation including blood, urine, and CSF cultures, plus empiric antibiotics and hospital admission.

Bronchiolitis routine management

Bronchiolitis care is supportive with oxygen and hydration; routine bronchodilators, corticosteroids, and antibiotics are not recommended because they do not shorten illness or reduce hospitalization rates.

Croup dexamethasone dose

A single dose of dexamethasone 0.15 to 0.6 mg/kg orally or intramuscularly reduces croup symptoms and return visits; nebulized epinephrine is added for stridor at rest.

ADHD diagnosis age criterion

DSM-5 requires several ADHD symptoms present before age 12, lasting at least six months, and causing impairment in two or more settings such as home and school.

Preeclampsia diagnostic criteria

New hypertension after 20 weeks gestation plus proteinuria or end-organ dysfunction such as thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or visual symptoms.

Rh immune globulin timing

Rh-negative pregnant patients receive anti-D immune globulin at about 28 weeks and within 72 hours postpartum if the newborn is Rh positive, preventing maternal alloimmunization.

Folic acid after neural tube defect

Patients with a prior pregnancy affected by a neural tube defect should take 4 mg of folic acid daily starting at least one month before conception and through the first trimester.

Postpartum hemorrhage uterotonic sequence

Uterine atony is the most common cause; oxytocin is first-line, followed by methylergonovine, which is avoided in hypertension, and carboprost, which is avoided in asthma.

Beers criteria purpose

The Beers criteria list potentially inappropriate medications for adults 65 and older, including benzodiazepines, anticholinergics, and long-term NSAIDs, which raise fall, confusion, and bleeding risk.

Delirium versus dementia

Delirium has acute onset with fluctuating attention and awareness, while dementia is chronic and progressive; delirium is identified at the bedside using the Confusion Assessment Method.

Osteoporosis screening thresholds

DEXA screening is recommended for women 65 and older and men 70 and older; a T-score of -2.5 or lower at the hip or spine defines osteoporosis.

Annual fall risk screening

Ask all adults 65 and older yearly about falls; a positive screen warrants assessment of orthostatic blood pressure, vision, gait, balance, and medications that contribute to fall risk.

PHQ-9 score interpretation

The nine-item PHQ-9 scores depression severity from 0 to 27; scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression respectively.

SSRI onset and duration

Selective serotonin reuptake inhibitors typically require four to six weeks for full antidepressant effect, and treatment continues six to twelve months after remission to prevent relapse.

Antidepressant monotherapy in bipolar disorder

Antidepressant monotherapy in bipolar disorder can precipitate mania or rapid cycling, so a mood stabilizer is required and antidepressants are used cautiously and for limited periods.

Medication for opioid use disorder

Buprenorphine, methadone, and extended-release naltrexone are effective for opioid use disorder; buprenorphine and methadone reduce overdose mortality and buprenorphine can be started in office settings.

Ottawa ankle rules

Ankle radiography is indicated only with malleolar pain plus bone tenderness at the posterior malleolus or navicular, or inability to bear weight for four steps in the emergency department.

Low back pain imaging

Imaging is not indicated within the first six weeks of nonspecific low back pain without red flags such as saddle anesthesia, bowel or bladder changes, fever, cancer history, or trauma.

Lachman test

The Lachman test assesses the anterior cruciate ligament by pulling the tibia forward with the knee flexed 20 to 30 degrees; it is the most sensitive examination for ACL tear.

Knee osteoarthritis first-line treatment

Exercise, physical therapy, and weight loss are core treatments for knee osteoarthritis; topical NSAIDs are preferred over oral agents, and intra-articular glucocorticoid injection provides short-term relief.

Anaphylaxis epinephrine dose

Give epinephrine 0.3 to 0.5 mg of the 1 mg/mL concentration intramuscularly into the anterolateral thigh, repeating every 5 to 15 minutes as needed; antihistamines are adjuncts only.

Sepsis antibiotic timing

In septic shock, broad-spectrum antibiotics should be given within one hour of recognition, along with blood cultures and lactate measurement, after rapid fluid resuscitation is started.

Hypoglycemia treatment

For blood glucose below 70 mg/dL with intact consciousness, give 15 to 20 g of fast-acting oral carbohydrate and recheck in 15 minutes; unconscious patients need IV dextrose or glucagon.

Hyperkalemia with ECG changes

When hyperkalemia produces ECG changes such as widened QRS complexes or peaked T waves, give intravenous calcium first to stabilize the myocardium, then shift potassium with insulin and glucose.

USPSTF grade A and B

Grade A means high certainty of substantial net benefit and grade B means moderate certainty of substantial benefit; both warrant offering or providing the preventive service to eligible patients.

Number needed to treat

Number needed to treat equals one divided by the absolute risk reduction; it estimates how many patients must receive an intervention for one additional patient to benefit.

Positive predictive value and prevalence

Sensitivity and specificity are test properties, but positive predictive value rises as disease prevalence increases, so a test performs differently in high-risk versus general populations.

Measles herd immunity threshold

Measles requires roughly 95 percent population immunity to interrupt transmission, which is why two MMR doses are recommended and why vaccine refusal can produce community outbreaks.