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Medicine > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

organisms for comm acquired pneumonia

A

strep pneumo, moraxella, h flu, atypicals

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2
Q

Tx of comm acquired pneumonia

A

outpt: azithromycin or doxycycline.
inpt: moxifloxacin or levofloxacin
? aspiration: add clindamycin

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3
Q

Tx of mucormycosis

A

debridement + IV amphotericin B

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4
Q

term for sensorineural high frequency hearing loss seen in aging

A

presbycusis

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5
Q

define pulsus paradoxus

A

drop in systolic BP by >10 with inspiration. a/w tamponade

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6
Q

AE of hydralazine

A

salt retention, reflex tachycardia, lupus-like syndrome

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7
Q

AE of metoprolol

A

impotence, bradycardia, AV node block

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8
Q

AE of verapamil

A

constipation, dizziness, flushing, gingival hyperplasia

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9
Q

AE of enalapril

A

hyperkalemia, cough, decreased GFR, rash, angioedema

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10
Q

AE of digoxin

A

NVD, blurry yellow vision, arrhythmias

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11
Q

Tx of QRS widening (as in TCA overdose)

A

sodium bicarb - alleviates depression of fast Na channels caused by TCAs

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12
Q

Tx of fibromuscular dysplasia causing renal artery stenosis

A

angioplasty with stent placement

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13
Q

meds that improve mortality in CHG

A

ACE/ARBs, B-blockers, spironolactone

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14
Q

pathogenesis of tumor lysis syndrome

A

intracellular phosphate/potassium -> hyperphosphatemia, hyperkalemia, and hypocalcemia (binded up by phosphate). Release of proteins -> high uric acid (allopurinol used to reduce urate nephropathy)

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15
Q

SIRS criteria

A

temp >38 or 90
RR >20 or PaCO212
WBC >12 or 10% bands

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16
Q

top cause of primary adrenal insufficiency in developed world? undeveloped?

A 
autoimmune adrenalitis
adrenal tuberculosis (others: fungal infxns, CMV)
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17
Q

sign of PE on EKG

A

sinus tach with nonspecific ST/T changes. S1Q3T3 (S in I, Q in 3, inverted T in 3), transient RBBB, inverted T in v1-v4

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18
Q

prophylactic tx of migraines

A

used if pt has Sx at least 2x per week
evidence based: topiramate, valproic acid, amitriptyline, metoprolol, propranolol, timolol, butterbur root petasites hybidus, relaxation therapy and biofeedback

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19
Q

Tx of alzheimers

A

mild (MMSE 20-25): acetylcholinesterase inhibitors: donepezil (aricept), rivastigmine, galantamine
mod-sev (MMSE 0-10 - 11-20): add memantine

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20
Q

Tx of drug induced dystonia

A

diphenhydramine, benztropine mesylate, or biperiden

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21
Q

non surgical management of gall stones

A

ursodeoxycholic acid and avoidance of fatty foods

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22
Q

hepatic adenoma a/w?

complications?

A

OCPs

hemorrhage (40% of symptomatic pts), malignant transformation (10%)

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23
Q

drugs that cause hyperkalemia

A

potassium sparing diuretics (amiloride, spironolactone, eplerenone)
ACE-Is / ARBs
NSAIDs
Succinylcholine
Non selective B blockers
TMP-SMX, Heparin, Cyclosporine, Digitalis

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24
Q

Tx of hyperkalemia with EKG changes, muscle paralysis, or K>6.5

A 
C:calcium gluconate
B: B2-agonists, Bicarb
I: insulin
G: glucose
K: kayexalate
D: dialysis, diuretics(furosemide)
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25
Q

causes of microcytic anemia

A

iron deficiency
anemia of chronic disease
thalassemia
lead poisoning, sideroblastic anemia

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26
Q

test for rapidly developing virilazation in female

A

testosterone/DHEAS
high testost:ovarian source
high DHEAS:adrenal source

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27
Q

indications of chest tube drainage of parapneumonic effusion

A

glucose<60, or positive gram stain (signs of empyema)

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28
Q

causes of pulseless electrical activity

A

hypovolemia, hypoxia, hydrogen ions (acidosis), hypothermia, hypoglycemia, hyper/hypokalemia
tamponade, tension pneumonthorax, thrombosis (MI/PE), trauma (hypovolemia), tablets (drugs), toxins

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29
Q

antihypertensives safe with pregnancy

A

b-blockers and hydralazine

not safe: thiazides, ACEI/ARBs, CCBs

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30
Q

goals for antihypertensive tx in diabetic/renal insufficiency

A

<130/80

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31
Q

screening for lipids

A

every five years starting at age 20.

earlier/more freq if obese or with strong FHx

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32
Q

signs of constrictive pericarditis

A

volume overload due to decr CO

sharp “x” and “y” descents on central venous tracing along with pericardial knock (sound heard soon after S2)

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33
Q

types of crigler najjar

A

1 is severe with infantile kernicterus. no change with phenobarbital
2 is milder with survival into adulthood. phenobarbital lowers bilirubin

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34
Q

AE of amiodarone

A

pulmonary fibrosis (assoc w cumulative drug dose)
elevated LFT (discontinue if 2 fold increase)
Thyroid: hypo(85%) hyper (15%)
corneal deposits (dont have to discontinue)
blue gray skin discoloration

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35
Q

MEN 1

A

pituitary adenoma
pancreatic islet cell tumor
parathyroid tumor (hyperparathyroid)

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36
Q

MEN 2a

A

Medullary thyroid cancer
pheochromocytoma
parathyroid tumor

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37
Q

MEN 2b

A

Medullary thyroid cancer
pheochromocytoma
mucosal neuromas and marfanoid habitus

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38
Q

Tx of molluscum contagiosum

A 
umbillicated nodules (sexually transmitted or seen with CD4<100)
curretage or liquid nitrogen
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39
Q

tests for screening for acute hep B

A

HBsAg and IgM anti-HBc (covers window period)

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40
Q

use of handgrip with murmurs

A

AS: decreases
MR: increases

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41
Q

Dx of ARDS

A

acute dyspnea
inciting incident (sepsis, severe bleed, trauma, toxic injury)
bilat infiltrates on CXR
PCWP < 200

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42
Q

electrolyte changes with CKD

A

hyper K, hyperphosphatemia, hypocalcemia, metabolic acidosis

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43
Q

Tx of meniere’s disease

A

avoid triggers that incr endolymphatic retetion: alcohol, caffeine, nicotine, high salt.
diuretics, antihistamines, anticholinergics

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44
Q

bone pain, renal failure, hypercalcemia

A

multiple myeloma

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45
Q

narcotic used in acute pancreatitis

A

meperidine or fentanyl

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46
Q

source of A-fib

A

ectopic foci in pulmonary vein (myocardial sleeves)

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47
Q

source of atrial flutter

A

rentrant circuit that rotates around the tricuspid annulus

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48
Q

Tx of polymyalgia rheumatica

A

low dose prednisone followed by taper as tolerated. methotrexate is effective steroid sparing agent.

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49
Q

Sx of hypokalemia

A

weakness, fatigue, muscle cramps
severe: flaccid paralysis, hyporeflexia, rhabdo, arrythmias
EKG: broad flat T waves, u waves, ST depression, PVCs

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50
Q

Multiple myeloma signs/Sx

A 
CRAB: calcium(hyper), renal impairment(myeloma kidney), anemia, bones (back pain, lytic lesions/fractures)
paraprotein gap (total protein-albumin>4)
recurrent infections (ineffective antibodies produced)
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51
Q

Sx of heat stroke? Tx?

A

temp >40.5(105), AMS, HA, dizziness, dry skin, hypotension, tachycardia, tachypnea.
systemic damage: rhabdo, ARF, DIC
evaporative cooling: spray with luke warm water and run fans.

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52
Q

cause of acute necrotizing mediastinitis

A

spread of infection from retropharyngeal abscess into posterior mediastinum

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53
Q

differential for thrombocytopenia

A

bone marrow: aplastic anemia, heme malignancies, megaloblastic anemia, alcohol, myelodysplasia
non bone marrow: ITP, HIT, hypersplenism, DIC, sepsis, viral infection, HIV, SLE, TTP, HUS

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54
Q

Tx of legionella pneumonia

A

macrolides (azithromycin) or newer generation fluoroquinolones (levofloxacin/moxifloxacin)

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55
Q

antiarrythmics more efficacious at higher heart rates due to use dependence

A

class I (especially IC i.e. flecanide) and class 4 (CCBs)

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56
Q

correction for hypocalcemia in liver disease

A

0.8(normal albumin(4.0) - measured albumin) + measured Ca

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57
Q

goal for LDL level in pt with Hx of stroke/TIA

A

<100 mg/dl

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58
Q

medical Tx of graves disease

A

b-blocker + methimazole/propylthiouracil

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59
Q

Dx of aortic dissection

A

TEE or chest CT with contrast

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60
Q

asymptomatic alk phos elevation

A

pagets disease of bone

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61
Q

Tx of V-tach

A

hemodynamically stable: amiodarone (DOC) or lidocaine

unstable: cardioversion

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62
Q

requirements for 2 sample t-test

A

means, variances, samples sizes

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63
Q

major side effect of hydroxychloroquine

A

retinopathy

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64
Q

AE of cyclophosphamide

A

hemorrhagic cystitis and bladder ca (prevent w/ fluids and mesna)
others: sterility, myelosuppression

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65
Q

when is goal INR 2.5-3.5?

A

prosthetic heart valve, prophylaxis of recurrent MI, Tx of antiphospholipid antibody

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66
Q

AE of b-agonists (ie albuterol)

A

tremor, palpitations, headache, hypokalemia (->weakness, arrhythmia, EKG changes)

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67
Q

arrhythmia specific for digitalis toxicity

A

atrial tachycardia (increased ectopy) with AV block (increased vagal tone)

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68
Q

AE of trastuzumab

A

cardiac toxicity

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69
Q

pentad of thrombotic thrombocytopenic purpura

A 
fever
microangiopathic hemolytic anemia (schistocytes, reticulocytosis, increased LDH)
thrombocytopenia (w normal coagulation)
CNS Sx
renal failure
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70
Q

Tx of pyelonephritis in non pregnant?

A

fluoroquinolones 7-14 days

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71
Q

distinguishing normal anion gap metabolic acidosis of extrarenal vs renal origin

A

extrarenal: largely negative urine anion gap
renal: positive urine anion gap
gap = urine NA+K-Cl

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72
Q

predicted compensation in respiratory acidosis

A

acute: incr bicarb by 1 for every 10 increase in PCO2
chronic: incr in bicarb by 4 for every 10 increase in PCO2

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73
Q

predicted compensation in respiratory alkalosis

A

decr bicarb by 2 for every 10 decrease in PCO2

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74
Q

Tx of mycobacterium avium complex

A

clarithromycin + ethambutol

prophylaxis: azithromycin

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75
Q

preferred Tx of hyperthyroidism

A

radioactive iodine (with pretreatment of methimazole to avoid thyrotoxicosis as thyroid cells are destroyed)

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76
Q

Sx of hypocalcemia

A 
neuromuscular irritability
perioral tingling/numbness
muscle cramps
tetany
carpopedal spasms
seziures
prolonged QT
77
Q

loss of hearing in HIV pt

A

serous otitis media (due to obstruction of lymph flow due to lymphoma or lymphadenopathy) - not infectious

78
Q

Tx of psoriatic arthritis

A

NSAIDs, anti-TNFs, methotrexate. corticosteroids relatively contraindicated

79
Q

a thyroid nodule is (in order of decr frequency)

A

colloid nodule, follicular adenoma, papillary carcinoma, follicular carcinoma, anaplastic, medullary. (less than 10% of nodules are cancer)

80
Q

Tx of restless leg syndrome

A

dopamine agonists - roperinole, pramipexole

levodopa

81
Q

physical exam test for differentiating between hepatic and cardiac source of BLE edema

A

hepatojugular reflex - pos in cardiac, neg in liver

82
Q

smoker who develops clubbing, sudden onset joint arthropathy

A

hypertrophic osteoarthropathy - assoc w/ lung cancer, TB, bronchiestasis, emphysema

83
Q

systemic effects of heat stroke

A

seizure, ARDS, DIC, hepatic/renal failure

84
Q

indications for dialysis

A

a - refractory Acidosis
e - refractory Electrolyte abnormality (hyperK)
i - intoxication (ethylene glycol, methanol, ASA)
o - fluid Overload
u - uremic symptoms (pericarditis, seizure, coma)

85
Q

Sx of acute rheumatic fever

A 
group A BHS pharyngitis 2-4 weeks prior
migratory arthritis of large joints
erythema marginatum rash
subcutaneous nodules
carditis
syndenham chorea
86
Q

Tx of essential tremor

A

propranolol
primidone (antiepileptic that may precipitate acute intermittent porphyria)
gabapentin
topiramate

87
Q

empiric Tx of bacterial meningitis

A

vanc + ceftriaxone - covers neisseria and penicillin resistant strep pneumo
ampicillin - covers listeria
dexamethasone

88
Q

medications that turn the stool black

A

iron

bismuth (pepto bismol)

89
Q

define orthostatic hypotension

A

lightheaded/dizziness
>20 systolic or >10 diastolic drop
>20 increase in HR

90
Q

pts with hemochromatosis at risk for which infections?

A

listeria monocytogenes (cirrhotics too)
yersinia enterocolitica
vibrio vulnificus septicemia

91
Q

measurement used in guillian barre to monitor for respiratory compromise

A

vital capacity (downward trend falling below 15 ml/kg)

92
Q

treatment of bacterial vaginosis

A

metronidzole 500 mg 2x daily for 7 days

93
Q

Tx of trichomoniasis

A

single dose of 2 g metronidazole

94
Q

Tx of cat scratch disease (Bartonella)

A

5 days of azithromycin

95
Q

Sx of retropharyngeal abscess

A

fever, dysphagia, neck pain worse with extension, trismus (inability to open mouth)

96
Q

Tx of acute COPD exacerbation

A

O2, inhaled bronchodilators (B2 agonists and anticholinergics), broad spectrum abx, 2 week corticosteroid taper

97
Q

Tx of wolf parkinson white

A

cardioversion or antiarrhythmic like procainamide.

AV nodal blocers (B-blockers, CCBs, digoxin, adenosine) avoided due to worsening WPW accessory pathway

98
Q

differential for mediastinal mass

A

4 T’s: thymoma, teratoma (and other germ cell tumors), thyroid neoplasm, terrible lymphoma

99
Q

anticoagulation in A-Fib

A 
depends on CHADS2 score:
CHF, HTN, Age>75, DM - 1 pt each
Prior stroke - 2 pts
0 - aspirin alone
1-2 - either aspirin or warfarin
2+ - warfarin
100
Q

AE of cyclosporine

A

Nephrotoxicity, hyperK, hyperglycemia, hyperuicemia, htn, gum hypertrophy, hirsutism, tremor, gi sx
Tacrolimus the same minus gum hypertrophy and hirsutism

101
Q

AE of azathioprine

A

Diarrhea, leukopenia, hepatotoxicity

102
Q

AE of mycophenolate

A

Marrow suppression

103
Q

Sx of primary hyperaldosteronism? Dx?

A

Htn, muscle weakness, numbness
High aldosterone/renin ratio is used for screening. non suppressibility of aldosterone with NaCl loading confirms Dx. f/u with adrenal imaging.

104
Q

Dx of PBC? Tx?

A

antimitochondrial Abs

ursodeoxycholic acid. advanced cirrhosis: liver transplant

105
Q

Tx of TTP-HUS?

A

plasma exchange

106
Q

indications for home O2 therapy in COPD

A

any one of:

  1. PaO2< 88%
  2. hematocrit > 55%
  3. cor pulmonale / pulmonary hypertension
  4. nocturnal hypoxia
107
Q

Tx options for acute glaucoma

A 
IV mannitol (first line, works immediately)
topical pilocarpine
topical timolol
acetazolamide
AVOID atropine and epinephrine
108
Q

Tx of toxoplasmosis

A

Sulfadiazine plus pyrimethamine and folinic acid

109
Q

Tx of fibromyalgia

A

TCA

cyclobenzaprine (flexeril)

110
Q

Sx of niacin deficiency

A

diarrhea, dermatitis, dementia, death

111
Q

AE of succinylcholine

A

can cause lifethreatening hyperkalemia
contraindicated in pts with hyperkalemia or at high risk of developing it: crush injuries, burns, guillain-barre, tumor lysis syndrome. use non depolarizing agents (vecuronium)
Can cause malignant hyperthermia

112
Q

Tx of acute migraine

A

triptans
NSAIDs
antiemetics - chlorpromazine, prochlorperazine, metoclopramide

113
Q

Tx of babesiosis

A

quinine-clindamycin

atovaquone-azithromycin

114
Q

causes of secondary htn

A

renal - stenosis, CRF, polycystic disease
endocrine - hyperaldosteronism, thyroid/parathyroid disease, cushing, pheo, acromegaly
meds - OCPs, NSAIDs, decongestants, appetite suppressants, steroids, TCAs
coarctation of aorta
cocaine, other stimulants
sleep apnea

115
Q

Tx of hepatic encephalopathy

A

lactulose
reduced protein diet
antibiotics: rifaximin, neomycin, metronidazole

116
Q

Dx of acromegaly

A

growth hormone level after oral glucose load

117
Q

Tx of wilson’s

A

chelators: d-penicillamine, trientine
oral zinc (decreases copper absorption)
liver transplant if decompensated or fulminant

118
Q

Tx of hypercalcemia in sarcoidosis

A

prednisone - decreases number of activated macrophages responsible for producing 1a-hydroxylase

119
Q

AE of lidocaine anesthetic

A

Seizure

120
Q

Drugs causing methoglobulinemia? Tx?

A

dapsone
local anesthetics (bezocaine spray, lidocaine)
Tx: methylene blue

121
Q

Opioids that you don’t give to crf pts

A

Codeine and morphine

122
Q

pt with hand weakness and mild motor aphasia. localize lesion

A

basal pons - dysarthryia-clumsy hand syndrome

123
Q

hemisensory deficit. localize lesion

A

VPL nucleus of thalamus

124
Q

unilateral motor/coordination deficit LE>UE. localize lesion

A

ant limb of internal capsule

125
Q

unilateral motor deficit UE>LE. localize lesion

A

post limb of internal capsule

126
Q

what’s in cryoprecipitate?

A

rich in factor VIII, fibrinogen, vWF, factor XIII. used if pt is deficient in any of these

127
Q

Sx of trichinellosis (parasitic roundworm infection)

A 
phase 1(invasion into intestinal wall): eosinophilia, abd pain, NVD
phase 2(hypersensitivity due to larval migration): splinter hemorrhages, retinal hemorrhages, periorbital edema, chemosis
phase 3(muscle invasion): muscle pain, weakness
128
Q

marker for androgen producing adrenal tumor

A

DHEA-S (other androgens made in gonads and adrenals)

129
Q

1st and 2nd line Tx of status epilepticus

A

1st- benzos

2nd- phenytoin

130
Q

Tx of hypercalcemia due to malignancy

A

bisphosphonates

131
Q

lead poisoning Sx? Tx?

A

abd pain, constipation, diff concentrating, myalgias, anemia, renal failure, neurological dysfunction often with extensor weakness
EDTA or succimer

132
Q

infxn of tear duct

A

dacryocystitis

133
Q

cause of bleeding in CRF? Tx?

A

uremia -> decr platelet function (normal platelet count but prolonged bleeding time)
Tx: desmopressin (DDVAP) - releases factor VIII and vWF multimers from storage sites

134
Q

Tx of cellulitis

A

w/ systemic Sx: nafcillin or cefazolin
mild: dicloxacillin
if MRSA suspected: vanc or TMP-SMX

135
Q

Tx of guillain barre?

A

IVIG or plasmapharesis

136
Q

test for de quervain tenosynovitis

A

flex thumb into palm, close fingers around it, bend wrist towards ulnar side. Stretches extensor pollicus brevix and abductor pollicus longus

137
Q

Tx of human/dog bite

A

amox clav. need to cover mixed flora (gram +, -, anaerobes)

138
Q

metabolic derangement caused by vomiting

A

hypokalemic hypochloremic metabolic alkalosis

139
Q

COPD pt develops clubbing

A

lung cancer

140
Q

bugs causing malignant otitis externa? Tx?

A

pseudomonas. typically seen in poorly controlled DM. can invade -> osteomyelitis or destruction of facial nerve.
Tx: Ciprofloxacin
if fungal, aspergillus

141
Q

differentiate leukemia vs leukemoid rxn

A

leukocyte alkaline phosphatase is high in leukemoid rxn, low in leukemia

142
Q

Tx of diabetic peripheral neuropathy

A 
DOC: TCAs (may worsen autonomic neuropathy - urinary retention, orthostatic hypotension, gastroparesis, etc)
Gabapentin
NSAIDs (avoid in renal disease)
143
Q

AE of macrolides

A

QT prolongation

cholestasis

144
Q

drug that causes artificial rise in creatinine

A

TMP-SMX. inhibits creatinine clearance but doesn’t change GFR

145
Q

Sx of acute intermittent porphyria? Dx?

A

abd pain, neuro and psych abnormalities

presence of urine porphobilinogen

146
Q

adverse effects of hctz

A

adverse effect on glucose, LDL, and triglyceride levels

hyponatremia, hypokalemia, hypercalcemia

147
Q

screening for AAA is required for …?

A

male pt’s 65-75 w/ hx of smoking - one time US

repair if greater than 5.5 cm, rapidly growing(1cm/yr), or symptomatic

148
Q

Dx of measles

A

Maculopapular rash w cough, conjunctivitis, coryza

149
Q

hepatic hydrothorax due to cirrhosis occurs on the…

A

right

150
Q

Tx of hypertrophic cardiomyopathy

A

B-blockers or cardiac acting CCBs (diltiazem, verapamil)

151
Q

metabolism of non depolarizing neuromuscular blocking agents

A

pancuronium and mivacurium - excreted unchanged in urine (effect prolonged in renal failure)
rocuronium - cleared by liver
atracurium - metabolized in plasma. DOC if renal and liver dysfunction

152
Q

Tx of htn due to pheo

A

alpha blocker, then b-blocker. or labetalol, which has a and b activity. giving b-blocker alone INCREASES BP (unapposed alpha vasoconstriction)

153
Q

tx of hypertensive aortic dissection

A

iv labetalol

154
Q

Tx of right ventricle infarct

A

IV fluids to increase preload. avoid nitro and diuretics which decr preload

155
Q

Tx of early rheumatoid arthritis

A

ibuprofen + either hydroxycholorquine or methotrexate (contraindicated w regular alcohol use due to hepatotoxicity)

156
Q

Tx of scabies

A

5% permethrin cream

157
Q

ECG finding in pericardial effusion

A

electrical alterans (beat to beat variation in QRS) with compensatory tachycardia. can also see low voltage.

158
Q

Tx of neuroleptic malignant syndrome

A

dantrolene (DOC)
bromocriptine (dopamine agonist)
amantadine (has dopaminergic properties)

159
Q

Dx of cystinuria

A

hexagonal cyrstials. positive urine cyanide nitroprusside test.

160
Q

when does odds ratio best approximate relative risk?

A

rare disease

161
Q

Tx of cryptococcal meningitis

A

induction tx: amphotericin + flucytosine

after clinical improvement, maintenance therapy with oral fluconazole

162
Q

Drugs that cause hyperlipidemia

A

Glucocorticoids, estrogen, thiazide diuretics, b blockers

163
Q

Tx of myelodysplastic syndrome

A

azacitidine - cysteine analog that delays progression to leukemia

164
Q

Tx of raynaud’s phenomenon

A

gloves, avoidance of cold

amlodipine

165
Q

differentiating seminoma vs nonseminomatous germ cell tumor

A

HCG positive in both. AFP only positive in nonseminoma

Teratomas are neg for HCG and AFP

166
Q

Tx of tinea versicolor

A

selenium lotion and ketoconazole shampoo

167
Q

Tx of acne

A

from mild to severe (scarring) - topical retinoids, topical abx, oral abx, oral isotretinoin

168
Q

Tx of dermatitis herpetiformis (other than avoid gluten)

A

dapsone

169
Q

AE of metformin

A

lactic acidosis - espec in pt w/ renal failure, liver failure, or sepsis

170
Q

predicted respiratory compensation in metabolic acidosis

A

PCO2 = 1.5 * bicarb + 8 +/- 2

171
Q

tx of prolactinoma

A

cabergoline or bromocriptine - dopamine agonists

172
Q

Tx of organophosphate poisoning

A

atropine

removing clothes and cleansing skin (stop more poison from being absorbed)

173
Q

Sx of osler weber rendu

A

aka hereditary telangectasia

diffuse telangectasias, reccurent epistaxis, widespread AVMs

174
Q

Indications for bariatric surgery

A

BMI of 35 with obesity related comorbidities or 40 without after failing other methods of wt loss

175
Q

Cutoffs for obesity for BMI and waist circumference

A

BMI overwt is 25-30, obese is >30

Waist >40 in in men and >35 in in females

176
Q

Tx of tb

A

Active - Four drug therapy for 2 months (RIPE) followed by de-escalation usually to isoniazid + rifampin (depending on sensitivity report) for 7 months.
Latent - 9 months of isoniazid

177
Q

AE of orlistat (obesity drug)

A

common: GI Sx-abd pn, incr defecation freq, steatorrhea
serious: liver failure, oxalate nephropathy w/ renal failure

178
Q

Tx of diabetes inspidius

A

central: intranasal desmopressin (DDAVP)
nephro: NSAIDs, indomethacin. if due to lithium: amiloride

179
Q

Tx of anorexia due to advanced cancer

A

progestin (megestrol acetate / medroxyprogestereone) or steroids

180
Q

Dx of chronic pancreatitis

A

stool elastase

181
Q

abnormal grid test (straight lines appear wavy)

A

macular degeneration. will see drusen deposits in macula on ophtho exam

182
Q

AE of erythropoietin

A

worsening of HTN(30%)
headaches(15%)
flu like Sx (5%)
red cell aplasia (rare)

183
Q

causes of transient, reversible incontinence

A

DIAPERS: drugs, infection, atrophic vaginitis, psych (depression, delirium, dementia), endo (hyperglycemia, hypercalcemia), restricted mobility, stool impaction

184
Q

Dose for fluid bolus for peds

A

20 ml/kg. in trauma give 2 then packed rbcs

185
Q

Tx of urge urinary incontinence

A

anticholinergics oxybutynin or tolterodine

186
Q

drugs to avoid w/ coronary vasospasm (cocaine or prinzmetals)

A

b-blockers, aspirin

187
Q

Tx of hairy cell leukemia

A

purine analog cladribine

188
Q

parkinsonism + autonomic Sx (orthostatic hypotension, impotence, incontinence)

A

consider Dx of multiple system atrophy (shy drager syndrome)

189
Q

Tx of travelers diarrhea

A

1st line is cipro or other fluoroquinolonea. 2nd is Bactrim or azithromycin.

Medicine (6 decks)

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