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Medicine > Step 3 > Flashcards

Step 3 Flashcards

1
Q

Step 3 IBS workup

A
  • stool guiac, fecal leukocytes, culture, ova, parasite
  • colonoscopy
  • abdominal CT
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2
Q

diverticulitis diagnosis

A

abdominal and pelvic CT scan

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3
Q

volume loss in GI bleeder that’s tachy and has low pressure

A

30 percent

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4
Q

orthostatic definition

A

drop in systolic of 20 or more OR rise in pulse of 10 BPM or more

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5
Q

transfusion thresholds on step 3

A

Less than 30 in older person

20-25 in younger person

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6
Q

platelet transfusion threshold

A

Below 50,000

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7
Q

problem with PPI’s

A

increased risk of pneumonia and c diff colitis

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8
Q

most common complication of TIPS

A

hepatic encephalopathy

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9
Q

use of MRCP

A

detects causes of biliary and pancreatic duct obstruction not found on CT

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10
Q

hep A treatment

A
  • give vaccine if healthy, immune globulin also if young and old or chronically sick with liver disease or HIV
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11
Q

management of hep B vaccinated person with needle stick?

A

Check for surface antibody and if present, then NTD

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12
Q

hepatic encephalopathy treatment

A

lactulose or rifaximin

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13
Q

paracentesis indications

A

1) New ascites
2) pain, fever, or tenderness
3) therapeutic

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14
Q

Wilson’s diagnosis

A

Slit lamp + ceruloplasmin

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15
Q

hemochromatosis DDX

A

MRI of liver + HFe gene mutation

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16
Q

AIHA demographic

A

young woman with atopy

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17
Q

best test for AIHA

A

ANA + antismooth muscle antibody test

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18
Q

AIHA treatment

A

prednisone

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19
Q

NASH RF’s

A

obesity + DM + HLD

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20
Q

cutoff for change in FEV after inhaled bronchodilaters with asthma and reactive airway disease

A

greater than 12% increase in FEV1

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21
Q

when you need methacholine stimulation test

A

patient needs RAD/asthma eval but is not currently SOB

22
Q

caveat about steroids

A

take 4-6 hours to be effective

23
Q

orders for asthma treatment

A 
albuterol
methyl pred bolus 
inhaled ipratropium
O2
magnesium
24
Q

long acting beta agonists

A

Salmeterol

Formeterol

25
Q

home O2 indication

A

pO2 less than 55, or O2 sat less than 88

26
Q

ILD management

A

Steroids → if no response → azathioprine for long term treatment → if no response trial cyclophosphamide

27
Q

drugs for IPF

A

perfenidone and nintedanib

28
Q

BOOP

A

bronchiolitis obliterans organizing pneumonia, also known as COP, cryptogenic organizing pneumonia

29
Q

BOOP/COP presentation

A

cough, rales, SOB, fever, malaise, myalgias

30
Q

BOOP/COP workup

A

CXR + CT + open lung biopsy

31
Q

BOOP/COP treatment

A

steroids

32
Q

BOOP/COP vs. ILD

A

shorter onset, fever/myalgias/malaise

33
Q

pulmonary HTN meds

A

Bosentan
Epoprostenol
Sildenafil
Riociguat

34
Q

CXR in PE

A

most commonly normal but can see atelectasis

35
Q

EKG in PE

A

most commonly sinus tach, most common abnormality is nonspecific ST-T wave changes

36
Q

ABG in PE

A

hypoxia + increased AA gradient + mild respiratory alkalosis

37
Q

management of high concern for PE

A

STAT CXR + ABG + assess contraindications to anticoagulation –> START HEPARIN → if hypotensive –> start tPA

38
Q

pleural exudate features

A 
high protein (greater than 40 percent of serum level)
LDH high (greater than 60 percent of serum level)
39
Q

transudative pleural fluid features

A

low protein, low LDH

40
Q

decortication

A
  • treatment for recurrent effusions that fail pleurodesis

- you strip off pleura from the lung so it will stick to the interior chest wall.

41
Q

other potential OSA options

A 
Consider acetazolamide (causes a metabolic acidosis to encourage respiration)
Consider medroxyprogesterone (central respiratory stimulant)
42
Q

ABPA treatment

A

oral steroids + itraconazole in refractory cases

43
Q

ABPA diagnosis

A

aspergillus skin testing
IgE
Circulating precipitins
A fumigatus specific antibodies

44
Q

ABPA classic patient

A

asthmatic with worsenign symptoms who is coughing up brownish mucous plugs with recurrent infiltrates, peripheral eosinophilia + high serum IgE + central bronchiectasis.

45
Q

ARDS diagnosis

A

1) bilateral pulmonary interstitial infiltrates on CXR
2) normal wedge pressure
3) pO2/FIO2 less than 200

46
Q

cardiac output in septic shock

A

High

47
Q

wedge pressure in septic shock

A

low

48
Q

TB demographics

A

HIV-positive
homeless
prisoners
alcoholics

49
Q

TB presentation

A

Fever, cough, sputum production, weight loss, night sweats

50
Q

5 mm PPD group

A

close contacts, steroid users, HIV-positive

51
Q

10 mm PPD group

A

homeless, immigrants, alcoholics, health care workers, prisoners

52
Q

15 mm PPD group

A

everyone else

Medicine (71 decks)

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