Common Medical Problems | The National Family Medicine Board Review Course
The Center for Medical Education・52 minutes read
Craig Boss, a medical professional, highlights the importance of common medical issues and treatments, such as weight loss strategies and bariatric surgeries. He also discusses various medical conditions like heat-related illnesses, visual problems, dental care, gastrointestinal issues, and urological concerns, emphasizing the importance of preventative care and timely treatment.
Insights
- Nutrient deficiencies post-bariatric surgery are common, necessitating dietary supplementation to address issues like iron, B12, and calcium deficiencies.
- Treatment for heat exhaustion involves fluid replacement, rest, and cooling measures, while severe cases of heat stroke may require cooling measures, rest, and IV fluids to prevent severe symptoms and high mortality rates.
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Recent questions
What are the categories of Body Mass Index (BMI)?
Ideal weight, overweight, obese, morbidly obese.
What are the common drug classes for weight loss?
Sympathomimetics, serotonin receptor agonists, combination drugs, lipase inhibitors, diabetes drugs.
What are the surgical treatments for obesity?
Roux-en-Y, sleeve gastrectomy, gastric banding, biliopancreatic duodenal switch.
What are the nutrient deficiencies post-bariatric surgery?
Iron, B12, calcium.
What are the symptoms and treatment for heat exhaustion?
Sweating, sub-104 temperature, agitation, fatigue. Treatment involves fluid replacement, rest, cooling measures.
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Summary
00:00
"Weight Loss Strategies and Surgical Treatments"
- Craig Boss, a host for the neurology and pulmonology sections, is from northern Michigan and is board certified in family medicine and sleep medicine.
- He emphasizes the importance of the common problem section in medical practice and board exams.
- 50% of medical visits are related to pain, upper respiratory symptoms, or somatic complaints, which are often self-limited.
- Body Mass Index (BMI) categories: less than 25 (ideal weight), 25-29.9 (overweight), 30-39.9 (obese), over 40 (morbidly obese).
- Caloric intake reduction by 500-1000 calories a day can lead to weight loss, despite challenges in perception and consistency.
- Various drug classes for weight loss include sympathomimetics, serotonin receptor agonists, combination drugs, lipase inhibitors, and diabetes drugs.
- Surgical treatments for obesity include Roux-en-Y, sleeve gastrectomy, gastric banding, and biliopancreatic duodenal switch, each with different mechanisms and risks.
- Nutrient deficiencies post-bariatric surgery include iron, B12, and calcium, necessitating dietary supplementation.
- Complications post-bariatric surgery can include vomiting, dumping syndrome, gallstones, and skin issues due to rapid weight loss.
- Unexplained weight loss over 5% in 6-12 months warrants investigation for underlying causes like malignancy, infection, or chronic disease, especially in the elderly.
16:10
Managing Heat-Related Illnesses: Symptoms and Treatment
- Heat cramps can occur due to fluid and salt loss, affecting various body parts.
- Heat tetany can result from hyperventilation causing respiratory alkalosis and paresthesias.
- Heat exhaustion symptoms include sweating, sub-104 temperature, agitation, and fatigue.
- Treatment for heat exhaustion involves fluid replacement, rest, and cooling measures.
- Heat stroke is characterized by the inability to maintain cardiac output due to fluid loss.
- Heat stroke can lead to severe symptoms like high temperature, agitation, and sweating.
- Cooling measures, rest, and IV fluids may be necessary for severe heat stroke cases.
- Heat stroke mortality can reach 40%, with severe consequences like rhabdo and DIC.
- Hypothermia involves core temperatures below 95°F, with severe cases risking coma and cardiovascular issues.
- Treatment for hypothermia includes gradual rewarming, monitoring, and avoiding core after drop.
32:02
Visual Health: Diagnosis and Treatment Overview
- Vasovagal syncope frequency and underlying causes are examined through EKG, looking for ischemia, chemistry, or hematologic issues.
- Exam, history, and diagnostic testing are conducted, with tilt table testing and echocardiogram for syncope cases.
- Visual testing every two years after age 50 is recommended, with refractive testing and dilated exam if needed.
- Acute visual loss is an emergency, with amarosis fugax linked to embolic phenomenon and anterior ischemic optic neuropathy to blood pressure changes.
- Optic neuritis is common in demyelinating diseases like MS, while retinal detachment is associated with trauma, viral infections, or diabetes.
- Dry eyes can result from medications, sleep issues, or underlying conditions like Sjogren's syndrome, treated with topical supplements and diagnosis via Schirmer's test.
- Excessive tearing is often due to lacrimal duct issues or exposure, with treatment based on the cause.
- Conjunctivitis is commonly caused by adenovirus, with bacterial cases linked to strep pneumo, staph aureus, or H flu, treated with erythromycin or fluoroquinolones for high-risk patients.
- Subconjunctival hemorrhage is a minor issue often resolving in two weeks, linked to blood pressure or anticoagulant use.
- Episcleritis and scleritis differ in pain and visual loss, with neo-synephrine drops helping distinguish them, while uveitis can be part of ankylosing spondylitis and requires prompt ophthalmologist evaluation.
48:32
Eye Pressure Reduction and Macular Degeneration Overview
- Acetazolamide or emergency iridotomy can be used to reduce pressure in the eye by allowing aqueous humor to drain.
- Age-related macular degeneration can lead to central vision loss, with dry and wet types distinguished by different characteristics.
- Dry macular degeneration involves drusenoid buildup between the retina and choroid, while wet macular degeneration is linked to neovascular growth.
- Amsler grid can help detect macular degeneration by checking for wavy lines, especially in moderately severe to severe cases.
- Treatment for dry macular degeneration is not always beneficial unless changes are moderately severe to severe, with antioxidant therapy potentially helpful.
- Wet macular degeneration can be treated with laser therapy or injections like Lucentis to inhibit neovascular growth.
- Dental anatomy includes primary teeth appearing from six months to two years, with 20 teeth, and permanent teeth starting at six years, totaling 32 teeth.
- Dental care involves early dental visits, fluoride supplementation, and varnishes, with attention to preventing dental caries caused by sugars and microorganisms.
- Pulpitis can result from enamel wear into the pulp due to cavities, requiring root canal treatment, while oral hygiene is crucial for preventing periodontal issues.
- Gas production varies among individuals, influenced by food digestion and bacterial overgrowth, with remedies like enzyme systems, avoidance, and external devices available for severe cases.
01:05:21
Elderly Urinary Retention: Causes and Treatment
- Acute urinary retention is more common in elderly individuals aged 70 and above, presenting with significant pain and fullness, often caused by BPH.
- Treatment involves lowering bladder tone, inserting a catheter temporarily, and then trying medications like five alpha reductase inhibitors in combination with other drugs for effective results.
