All The Stuff Flashcards
(173 cards)
1
Q
Tx for TCA OD
A
Sodium bicarbonate
Prolonged QTi
2
Q
Opioids OD TX
A
Naloxone/naltrexone
3
Q
BZD OD TX
A
Flumazenil
4
Q
BB OD TX
A
glucagon
5
Q
Theophylline OD TX
A
BB
6
Q
Warfarin OD TX
A
vit k and FFP
7
Q
Heparin OD TX
A
protein sulfate
8
Q
MS is a/w with what other condition
A
Thymoma
9
Q
Lamber Eaton vs MS
A
Related to Ach receptors
MS presynaptic
LE post synaptic
10
Q
Which lung cancer presents with high Ca and what is that called
A
NSCLC — squamous cell carcinoma
Pancoast syndrome
11
Q
Linear lesions on UGD
Tx
A
Candida
Fluconazole
12
Q
What type of acidosis does metformin cause
A
Lactic acidosis
Discontinue 48hrs before iv contrast to avoid kidney damage
13
Q
1st line tx in nephrotic syndrome
A
Prednisone
14
Q
Signs of TCA overdose
A
Anticholinergic SE
SLUDD C opposite
Avoid TCA they have high potential for OD
15
Q
Anti arrhythmic medications
A
Class 1 block Na — procainamide
Class 2 block adrenaline — BB
Class 3 block K — amiodarone
Class 4 block Ca — CCB
Na Lol K Ca
16
Q
What electrolyte is low if PTH is low
A
Ca and Mg
Mg is needed to make PTH which responds to Ca
17
Q
Anti DS DNA
A
SLE
18
Q
Anti centromere
Anti scl
A
Scleroderma
19
Q
Anti mi 2
A
Dermatomyositis
20
Q
Tension pneumo management
A
Needle decompression then thoracostomy
21
Q
PaCO2 levels
A
35-45
Lung levels same as acid levels
22
Q
Best Tx to lower LDL, HDL, TG
A
LDL — statins
HDL — niacin
TG — fibrates
23
Q
Alpha thalassemia peripheral smear
A
Heinz bodies
24
Q
PE for pna
A
Dullness to percussion
Increases tactile fremitus
Egophony
25
Primary biliary cirrhosis must know
Antimitochondrial antibodies
Jaundice pruritis fatigue
Tx of choice is ursodiol
26
Primary sclerosing cholangitis
A/w ulcerative colitis
+ panca o
27
Maculopapular rash Starts at wrists and ankles and moves to trunks
RMSF
Ricketssia rickettsi
Tx doxy
28
1. Erythema multiforme
2. Erythema nodosum
3. Erythema infectiosum
4. Erythema marginatum
5. Erythema migrans
1. Target lesions
2. Inflammatory nodules
3. Slapped cheek, parvovirus
4. Rheumatic fever
5. Lyme disease
29
High cortisol
High cortisol 2mg
Low cortisol 8 mg
Cushing disease
Pituitary ACTH hypersecretion
30
High cortisol
2mg high cortisol
8 mg high cortisol
Cushing syndrome
Adrenal source — adrenalectomy
31
Beta thalassemia hemoglobin chains
Hgb A (adult)
Hgb F (fetal) — will be increased
Hgb A2 (delta chains)
32
Morning joint stiffness lasting <30 mins
OA
TOC Tylenol then NSAIDs
33
PPD test results
INDURATION not erythema
>5mm for HIV, incarcerated, homeless
>10 mm for healthcare workers
>15 mm no risk factors
34
Loop diuretics work by ___
Can lead to ___
Inhibiting Na/K/Cl transport to excrete water, Na, Ca, Mg, and Cl
Metabolic alkalosis
35
What electrolyte do thiazide diuretics effect
Increase calcium
36
Tylenol overdose tx
< 4 hr — activated charcoal
> 4 hr — NAC
Best to administer within 8 hrs
37
Partial molar vs complete molar pregnancy
Partial has fetal parts
Complete is a cluster of grapes or snow storm appearance — risk of developing gestational trophoblastic neoplasia
38
Elevated AFP level is concerning for
Hepatocellular carcinoma
39
What level is low if you have night blindness and dry eyes
Vit A
40
Bleeding gums and non healing wounds
Vit C
41
Diarrhea dementia and dermatitis
(Pellagra)
Niacin
Vit B 3 (3 Ds)
42
Vit B 2
Glossitis
Cheliosis
Seb derm
43
IgATTG is positive in
Celiac disease
+ dermatitis herpetiformis
Needs dudodenal bx by EGD
44
Vit b3 toxicity
Flushing of skin
45
Courvoisier sign
Enlarged gallbladder that is NTTP
A/w pancreatic cancer
46
Courvoisier sign
Enlarged gallbladder that is NTTP
A/w pancreatic cancer
47
Pencil in a cup a/w
Psoriatic arthritis
48
Ranson criteria is for what and what is it
Mortality in pancreatitis
“Ransom is against GA LAW”
Glucose >200
WBC > 16
Age > 55
LDH > 350
49
MC neoplastic colon polyp
Adenomatous > villous > tubular
50
MC non neoplastic colon polyp
Hyperplastic
Serrated has malignant potential tho
51
PCOS hormones and tx
LH:FSH ratio elevated
OCP
Metformin
52
What nerve is responsible for referred shoulder pain
Phrenic nerve
53
Cocaine induce MI tx
BZD
54
Cocaine induce MI tx
BZD
55
Foot drop is due to injury to
Peroneal nerve
Anterolateral leg and 1&2 toes
56
Crest syndrome is in what
What is it
Scleroderma
Limited, less mortality
Calcinosis
Raynauds
Esophageal dismotility
Sclerodactly
57
Abx for UTI in pregnancy
Complicated UTI
Amoxicillin
Augmentin
Bactrim
Keflex
58
Lisinopril is contraindicated in
Pregnancy
ACEI inhibitors are category D
Oligohydramnios, kidney agensis, fetal skull deformity
59
Sjorgens puts you at risk for
B cell NH lymphoma
60
Gram + bacteria
S aureus
Myco TB
Enterococci
Strep pneumonia
C botulinum
MESS-C
61
What arrhythmia is common in someone who heavily drank
A fib
Self resolves
62
Kaposi sarcoma is defining illness for
HIV
63
Pertussis presentation and tx
CPC — catarrhal, paroxysmal, convalescent
Can’t last a really long time
Treat with macrolides like azithromycin
MUST TREAT to prevent pna
64
Otitis externa tx
Topical abx
1. Ciprofloxacin/dexamethasone : abx and anti inflammatory effect
2. Ofloxacin: FQ for psuedomonal coverage
3. Neomycin/polymyxin b/hydrocortisone: both inflammation and infection but AVOID IN PERFORATED OR TUBES
65
Hypercalcemia cause and Tx
1° hyperparathyroidism
Parathyroidectomy
66
Tx if malignant pleural effusion
Indwelling pleural catheter > pleurodesis > pleurectomy if failed
67
Lights criteria
1 or more = exudative
Pleural fluid protein:serum protein >0.5
Pleural fluid LDH:serum LDH >0.6
Pleural fluid LDH > 2/3 ULN LDH
PROTEIN !!! Indicates infection
68
Pleural effusion vs consolidation on lung exam
DECREASED tactile fremitus vs increased
69
Epiglottis tx
IV rocephin + vanc
70
Multiple myeloma must know
CRAB:
HyperCa — inc osteoclast activity
Renal disease
Anemia
Bone pain — MC presenting sx
Peripheral smear: rouleaux formation
XR: many lytic lesions
MY OH MY MR CRABS
71
HPV dosing guidelines
Initial 9-14 — 2 doses (0, 6-12mo)
Catch up
15-24 — 3 doses (0,2,6mo)
27-45 — 3 doses (0,2,6mo)
72
Fundoscopic exam for
1. Acute AC glaucoma
2. Papilledema
3. CRAO
4. CRVO
1. Cupping of optic nerve
2. optic nerve cupping obscured, flame/splinter hemorrhages & cotton wool spots
3. Cherry red macula & afferent pupillarydefect
4. Blood & thunder retina, dilated tortuous veins
73
Tx of ICH
BP control with nicardipine and reverse all coagulapathies
74
Optic neuritis in a young woman should raise concern for
MS
75
What is optic neuritis
Demyelinating inflammatory condition of the optic nerve a/w MS
Often have preceding viral illness
76
Margus Gunn pupil, swollen optic disc, varying degree of vision loss is found in
Optic neuritis
77
MC kidney stone
Calcium oxalate
78
Radiopaque kidney stones
struvite — staghorn calculi
Ca oxalate — MC type
Ca PO4 — 1° hyperPTH
79
Radiolucent kidney stones
Cystine — children
Urice — gout
80
Characteristic of large VSD
Newborns with fatigue, sweating during feeds, poor weight gain
Loud holosystolic murmur at LLSB
81
Tx for OCD
Seetraline (SSRI)
82
Infective endocarditis causes
Native valve
IVDU
Prosthetic valve
IV VANCO FOR EVERYONE EMPIRICALLY
Native valve — staph aureus, strep viridans ; affects MV
IVDU — staph aureus affects TV
Prosthetic — s epidermis
83
JVP elevated, gallop heart sound, DOE, fatigue, CO
RVH
Pulmonary HTN
Right heart cath is definitive
84
Angina at rest in a young male
Prinzmental angina — nitrate responsive
SMOKING cessation
CCB
85
Screen for ___ in pts with celiac disease
Bone density
86
Why is early pregnancy a protective factor against breast cancer
Less exposure to estrogen + progesterone
Changes breast tissue
87
ACh release blocked by antibodies at presynaptic ca channels
Autoantibodies bind to ACh receptors at the NMJ
LE
MS
88
Erythema multiforme MC precipitant
Herpes simplex virus
89
Management for sexual assault
Ceftriaxone 500 mg IM
doxycycline 100 mg bid
Metronidazole 2g single dose
Within 72 hrs
Levonorgestrel and HIV PEP
90
Describe Tram track sign
Lack of tapering of the enlarged bronchi and bronchial wall thickening
91
LBBB on ekg
Wide QRS with slurred R wave in V5 and V6 and deep S wave in V1
92
MC cause of meningitis in <18 yo
Neiserria meningitidis
Is Pen G
93
Referred right shoulder pain, aka ___, in acute chole is due to what nerve
Boas sign
Phrenic nerve
94
Staph aureus on gram stain
Gram positive cocci in clusters
95
Atropine is an ____ agent
Anticholinergic
Opposite of SLUDD-C —like miosis
96
Tx for ITP in kids vs adults
Kids Observe vs IVIG
Adults corticosteroids
97
Absence of ganglion cells in the distal colon and rectum is in
Hirschprungs disease
A/w trisomy 21
98
WBC casts
RBC casts
Waxy cast
AIN — drug induced MC
GN — nephrotic syndrome
Waxy — CKD
99
Gram negative diplococci
Gonorrhea
100
Tx of
1. First idiopathic DVT
2. 1st DVT/PE with reversible factor (post op)
3. Recurrent DVT/PE or continue risk factor
1. Heparin + warfarin for 6 months
2. Heparin + warfarin for 3-6 months
3. Heparin + warfarin for >12 months
101
Alzheimer’s pathology, tx
Beta amyloid plaques and neurofibrilliary tangles
Donepizil memantine
102
Alzheimer’s pathology, tx
Beta amyloid plaques and neurofibrilliary tangles
Donepizil, memantine
103
Parkinson’s disease pathology and tx
Decrease in dopaminergic neurons in susbtantia nigra
Levodopa carbidopa (crosses BBB)
104
Essential tremor tx
Propranolol
105
Early and rapid progressive dementia with alpha synuclein aggregates inside cortex and substantia nigra
Lewy body
Lewy is seeing bodies
106
Huntington disease pathology and sx
Mutation of HTT gene on ch4 with repeat CAG proteins
Middle age men
Chorea
Men dance when they hunt
107
Pick disease pathology and sx
Fronterotemporal atrophy due to pick bodies (tangles of tau proteins)
Behavior/language impairment
108
List what each part of the spinal cord is responsible for
From posterior to anterior
1. Dorsal — vibration/propriocetion
2. Cortical — motor
3. Spinothalamic — pain/temp
109
ACS presentation
Flexing injury
Pain, temp, and motor is affect (complete paralysis)
Bad prognosis
110
Posterior cord syndrome presentation
Loss of vibratory sense and proprioception only
111
Brown sequard PE
Gun shot wound
Same side vibratory, proprioception, motor deficits
Opposite side pain & temp deficits
112
Central cord presentation
BILATERAL Upper extremity deficits > lower extremity deficits
113
Neovascularization
Amsler grid “lines bent”
Macular degeneration
114
Atropine is contraindicated in
Glaucoma
Worsens it
115
CRVO
Painless
Decreased IOP ⬇️
Blood and thunder (red eye with veins)
116
CRAO
Painless
Increased IOP ⬆️
Cherry red spot
Emergency !! Remove clot with massage, reduce IOP
117
Build up of RBCs in eye
Build up of WBcs in eye
Vitreous hemorrhage
Anterior uveitis
118
Diabetic vs hypertensive retinopathy
Diabetic
- non proliferative with flame shaped hemorrhage
- proliferative with neovascularization >> VEGF
HTN
AV nicking, can progress to papilledema
119
Shafers sign
Retinal detachment
120
Abx for eye infections
Topical erythromycin
Pseudomonas coverage if contact lens wearer
121
MC blindness
Cataracts
Lens opacifies
Can’t drive at night, no red reflex
122
Optic nerve swelling from increased intraocular pressure
Glaucoma
Halos around light
123
Optic neuritis tx
IV methylprednisolone
124
Acute narrow angle closure glaucoma
EMERGENCY
Decreased drainage of aqueous humor
Caused by pupillary dilation
PAINFUL UNILATERAL PERIPHERAL VISION LOSS
Increased IOP
Timolol + Acetazolamide
125
Open angle glaucoma
PAINLESS CHRONIC PERIPHERAL VISION LOSS
Tx with latanoprost
126
Management of pheochromocytoma
Alpha blockers x2 weeks before beta blockers to prevent severe HTN
Alpha blockers — phenoxybezamine or phentolamine (AMINE)
127
Gynecomastia and testricular atrophy
Klinefelters syndrome
128
Nephrogenic DI
Due to kidneys not responding to ADH
Tx indomethacin
129
TTP patho
Antibodies against ADAMTS13 —> large vWB multimers (Adam cleaves willie) cause platelet activation
large von Willebrand factor multimers accumulate and promote excessive platelet aggregation, leading to the formation of microthrombi
130
TTP patho
Antibodies against ADAMTS13 —> large vWB multimers (Adam cleaves willie) cause platelet activation
vWB is the glue mesh that sticks to platelets. If it it’s not cleaved, continues to grow and aggregate into a bigger platelet clot
131
Factor V Leiden
MC Bleeding disorder
Mutated factor 5 does not get broken down by protein C
132
DIC
Activation of the coagulation system leads to many thrombi and decrease in platelets
133
HUS
Platelet activation due to exotoxins (shiga toxin or E. coli)
The hamburger scenario
134
Aplastic crisis causes
Parvovirus B 19 (slapped cheek)
135
Virus causing kaposi sarcoma
HHV 8
136
Red man syndrome
Flushing of skin with rapid infusion of vanco
137
L:S < 2:1 indicates
Fetal lung immaturity
Give tocolytics (terbutaline or MgSo4) for 48hrs to delay delivery
Allows for steroid administration —> help with surfactant
138
Fern test +
Rupture of membranes
139
Administration of prostaglandins in labor does what
Increase progression of labor
140
Administration of prostaglandins in labor does what
Increase progression of labor
141
Primary adrenal insufficiency has
Low cortisol AND low aldosterone
Addison disease— Need to ADD more
Secondary insufficiency just low cortisol
142
Central DI vs nephrogenic DI
Central —Not enough ADH being made
Nephrogenic — kidneys don’t respond to circulating ADH
143
How to differentiate Nephrogenic from central DI
Water deprivation test to confirm it is not polygenic polydipsia (drank too much water)
Then DDAVP (desmopressin and ADH analog) challenge
No change = nephrogenic
144
Which medication is a/w hypothyroidism
Amiodarone because of the iodine
145
Tx of hyperthyroidism
PTU & methimazole
PTU in pregnancy
They cause agranulocytosis (low neutrophils <100)
146
Congenital hypothyroidism
6 Ps
Pot belly
Protruding belly button
Pallor
Puffy face (myedema)
Protuberant tongue
Poor brain development
147
Esophageal Candidiasis
AIDS DEFYING ILLNESS cd4<200
148
MC childhood cancer
ALL
149
Components of ALL
Anemia Lumpy Limping
Pancytopenia
Bone marrow bx is definitive >20% lymphoblasts
Prophylaxis with intrathecal methotrexate
150
MC heme malignancy in adults
AML
151
AML must know
Middle Aged adults
APL or M3 variant
Auer rods on peripheral smear
“A rod plays for NY in the big APL”
Pancytopenia
Bone marrow bx >20% myeloblasts
152
CLL need to know
Accumulation of monoclonal B lymphocytes
Asx
Lymphocytosis >5000
Smudge cells on PS
“Crushed little lymphocytes”
If they’re old just observe, not gonna kill them
If they’re young — chemo
153
CML need to know
Translocation between Ch9 and Ch 22 leads to PHILADELPHIA chromosome (over expression of tyrosine kinase)
Leukocytosis with neutrophilia
Tyrosine kinase inhibitors - Nib
154
Hodgkin =
Presence of reed sternberg cells
155
Patho of Hodgkin’s lymphoma
Mature B cells have abnormal gene and don’t die
Enlarge the lymph nodes
156
Describe Reed Sternberg cells and what they’re found in
Hodgkin lymphoma
2 nuclei fuse together — owl eye appearance
157
What has better prognosis in Hodgkin lymphoma
Continuous spread to local lymph nodes
158
Risk factor for Hodgkins
EBV **
159
Diagnosis of Hodgkin lymphoma
EXCISIONAL bx of lymph node
NOT FNA
160
6 B for Hoskins lymphoma
All about the Bs
B cell malignancy
B sx common in advanced age
Bimodal distribution
Binucleated cells (owl eyes)
BV infection
Bound in place (local lymph nodes better)
161
Most important thing to know about NHL
ABSENCE OF REEDN STERNBERG CELLS
162
NHL need to know
No reed sternberg cells
Non continuous spread through blood — poor prognosis
Diffuse large B cell is MC type
Burkitt lymphoma is with EBV
R CHOP tx (rituxamab)
163
Polycythemia is a
Blood cancer — too many RBCs
High EPO
164
Types of PV and tx
1: mutations of jak2 gene
2: underlying condition
Phlebotomy, increase fluids, asa
165
What preparation would be used for do of HSV or varicella
Tzanck smear
166
Rapid acting insulins are used when
Name example
After meals
Lispro, aspart
167
Regular insulin is
Short acting
168
Regular insulin is
Short acting
169
Intermediate acting insulin is aka
NPH
170
Intermediate acting insulin is aka
NPH
171
Long acting insulin name example
Glargine
Detemir
Degludec
24 hr duration
172
Basal insulin is aka
Long acting insulin
173
Basal bolus Math for 70kg with TDD of 0.8
Long acting (basal) + rapid acting (bolus)
0.8units/day X 70kg = 56 units/say
56/2 = 28 units basal
28/3 = 9 units bolus
