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Mario's ITE Database V2010.007 Document Copy for the Sole Mario’s ITE database V2010.007 Document copy for the sole personal use of Dr. Mario Alberto Jimenez Mario’s Family Medicine In-Training Examination (ITE) Database One of the most important objectives in creating this database is to help the physician in organizing and associating topics to increase memorization efficiency and retention. Another important objective is to allow the physician to focus on any particular organ systems or clinical category he/she might be interested by using simple search queries. For instance, in order to search for the organ system category of Cardiovascular, you only need to press Shift+Ctrl+F, type the letters “Car” after a “+” sign in the search box, i.e. type: “+Car” (do not include “ ), and click the search button, or to search for the clinical category of Care of Children, you only need to type: “+Cca” in the search box and click the search button. The ITE database was exported to adobe acrobat format to ease portability, readability and searchability. Other search examples include: questions that more than 50% of residents missed, type “>L”. This database is based on memorization techniques described here: http://www.web-us.com/memory/improving_memory.htm, but if you have difficulty memorizing all that is written here, remember the warning from one of the smartest and most creative minds of our times, Albert Einstein: "the spirit of learning and creative thought are lost in strict rote learning." Organ Systems: Respiratory=Res; Cardiovascular=Car; Musculoskeletal=Mus; Gastrointestinal=Gas; Special Sensory=Sen; Endocrine=End; Integumentary=Int; Neurologic=Neu; Psychogenic=Psy; Reproductive: Female=Ref; Reproductive: Male=Rem; Nephrologic=Nep; Hematologic/Immune=Hem; Nonspecific=Non; Population-based Care=Pbc (Recommendations); Patient-based Systems=Pbs; Clinical Category: Adult Medicine=Adm; Care of the Surgical Patient=Csp; Maternity Care=Mac; Community Medicine=Com; Care of Children and Adolescents=Cca; Mental Health=Mhe; Care of the Elderly=Cel; Care of the Female Patient=Cfp; Emergent & Urgent Care=Euc. Question numbers that have a “P” next to them were excluded from scoring for statistical reasons. Although these items did not perform as expected, they still have a correct answer and should still be reviewed for educational purposes. This is a work in progress to facilitate UM/JMH Family Medicine residents to retain important medical facts for the better care and education of our patients, and to help us score among the best programs in the nation in our ITE and Board exams. This is a team effort, so I encourage everyone to send me suggestions and corrections to my e-mail [email protected] . Please, send me the question number, for instance 07-087, and your pertinent comment or suggestion. I am looking to incorporate mnemonics into the database, so if you see a question where we can use a mnemonic, please forward it to me as well. To search for mnemonics, press Shift+Ctrl+F, and type: “Hint:”, and all mnemonics will show in your search result. Let's make the father of family medicine, Dr. Lynn Carmichael, proud!!! So, let us work as a team, encouraging each other to reach our full potentials as family physicians and human beings, empowering every single one of our patients to live longer, healthier, and more enjoyable lives, and always remembering the words of Dr. Carmichael: “The real healers are the patients. The goal of the physician should be to do whatever is necessary to enhance individuals’ abilities to heal themselves. There is a tremendous amount of gratification and satisfaction that can come from this kind of medical practice.” "Talent wins games, but teamwork and intelligence wins championships." Michael Jordan.. "Individual commitment to a group effort - that is what makes a team work, a company work, a society work, a civilization work." Vince Lombardi. 07-087. +Car+Pbc+Adm. Which one of the following screening intervals is most Abdominal aortic aneurysm. 07-087. Recommendations; ANS=C. In 2005 the consistent with U.S. Preventive Services Task Force recommendations regarding U.S. Preventive Services Task Force (USPSTF) recommended one-time screening for abdominal aortic aneurysm? A) Every 5 years in all patients age 65– screening for abdominal aortic aneurysm (AAA) by ultrasonography in men 75 who have ever smoked B) Every 5 years in females age 65–75 who have ever age 65–75 who have ever smoked. The USPSTF made no recommendation for smoked C) One time in males age 65–75 who have ever smoked D) One time in or against screening for AAA in men age 65–75 who have never smoked, because all patients age 65–75 who have ever smoked E) No screening is recommended of its lower prevalence in this group, and recommended against routine screening for AAA in women, because of the lower prevalence of large AAAs in women. 08-138. +Pbc+Adm. According to the U.S. Preventive Services Task Force, which Abdominal aortic aneurysm. 08-138. Recommendation . ANS=B. The U.S. one of the following patients should be screened for an abdominal aortic Preventive Services Task Force has released a statement summarizing aneurysm? recommendations for screening for abdominal aortic aneurysm (AAA). The A) A 52-year-old male with type 2 diabetes mellitus guideline recommends one-time screening with ultrasonography for AAA in B) An asymptomatic 67-year-old male smoker with no chronic illness men 65–75 years of age who have ever smoked. No recommendation was made C) A 69-year-old female with a history of coronary artery disease for or against screening women. Men with a strong family history of AAA should D) A 72-year-old male with a history of chronic renal failure be counseled about the risks and benefits of screening as they approach 65 years E) A 75-year-old female with hypertension and hypothyroidism of age. 09-205. +Car+Adm . A 65-year-old male asks you about an advertisement for Abdominal aortic aneurysm. 09-205. Although screening recommendations for vascular disease screening tests that will be performed at a local retail outlet this abdominal aortic aneurysms vary, a 65-year-old male with a history of smoking Saturday. The cost is minimal, but will be out of pocket. The patient is should be screened by ultrasonography. ANS=C. The other tests are not indicated asymptomatic, but has a 45-pack-year smoking history. Based on U.S. Preventive in asymptomatic patients. Services Task Force guidelines (USPSTF), which one of the following screening tests would you recommend for this patient? A) Duplex ultrasonography of both carotid arteries B) Ultrasonography of the thoracic aorta C) Ultrasonography of the abdominal aorta D) An ankle-brachial pressure index 10-125. +Car+Csp. An asymptomatic 68-year-old male sees you for a health Abdominal aortic aneurysm. 10-125. The U.S. Preventive Services Task Force maintenance visit. He is a former cigarette smoker, but quit 20 years ago. (USPSTF) recommends one-time screening for abdominal aortic aneurysm According to the U.S. Preventive Services Task Force, evidence shows that the (AAA) by ultrasonography in men aged 65–75 who have ever smoked (SOR B, potential benefit exceeds the risk for which one of the following screening tests in USPSTF B Recommendation). ANS=B. The USPSTF found good evidence that this patient? screening these patients for AAA and surgical repair of large AAAs ( ≥≥≥5.5 cm) A) A chest radiograph leads to decreased AAA-specific mortality. There is good evidence that B) Abdominal ultrasonography abdominal ultrasonography, performed in a setting with adequate quality C) Ophthalmic tonometry assurance (i.e., in an accredited facility with credentialed technologists), is an D) A prostate-specific antigen level accurate screening test for AAA. There is also good evidence of important harms E) An EKG from screening and early treatment, including an increased number of operations, with associated clinically significant morbidity and mortality, and short-term psychological harms. Based on the moderate magnitude of net benefit, the USPSTF concluded that the benefits of screening for AAA in men aged 65–75 Copyrighted Material. ITE Personal Notes. Not for Sale. Page 1 of 170 Mario A. Jimenez, M.D., B.S.E.E. “Jesus died for us and teaches us that it is in giving that we receive.” Mario’s ITE database V2010.007 Document copy for the sole personal use of Dr. Mario Alberto Jimenez who have ever smoked outweighs the potential harm. While they may be considered for making the diagnosis in patients who have symptoms, none of the other tests listed have evidence to support a net benefit from their use as routine screening tools in patients like the one described here. 07-171. +Ref+Cfp. A 33-year-old female presents with 3 months of irregular Abnormal vaginal bleeding. ANS=E. In women of childbearing age, the most vaginal bleeding. Prior to this her menstrual periods were normal. Which one of likely cause of abnormal vaginal bleeding is pregnancy ; thus, the most the following is the most appropriate initial laboratory test for this patient? A) appropriate initial test would be an hCG level . Once pregnancy has been Hemoglobin and hematocrit B) TSH C) LH and FSH D) Estradiol E) hCG excluded, patient history would guide further testing. Iatrogenic causes, usually resulting from certain medicines or supplements, are the next most common cause in this age group, followed by systemic disorders. Hemoglobin and hematocrit would be appropriate only if the patient seemed acutely anemic due to the abnormal bleeding. 07-052. +Ref+Mac+Cfp. A healthy 36-year-old female presents with vaginal Abortion. 07-052. S pontaneous . ANS=E. Although heavy caffeine use, bleeding 3 weeks after a missed menstrual period.
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