Cases

Question 1

H Pylori tx

Answer 1

Amoxicilin AND clarithromycin
Bismouth

Omeprizol

Question 2

Hep C tx (w/ porphyria cutanea)

Answer 2

Ribavarin? or ID consult

Porphyria cutanea: Hydroxychloroquin

Question 3

HIV PEP vs. PrEP

Answer 3

Tenofovir
Emtricitabine
Raltegravir

Tenofovir
Emtricitabine

Question 4

Spontaneous abortion tx

Answer 4

D&C
(misoprostol)

abx: Doxy or metro

Question 5

Myasthenia gravis

w/u
tx

Answer 5

CT chest (thymoma) **
Electromyography **
AcH antibody?

Management:
Prednisone
Pyridostigmine/Neostigmine ***
Surgically remove thymoma (which can resolve MG sx!!! W/out meds!!)

Question 6

Lead toxicity management

Answer 6

EDTA (ethylenediaminetetraacetic acid)
AND dimercaprol
LR/NS
Lorazepam/diazepam/midazolam (control sz)

Question 8

Management pre-E

Answer 8

Labatalol
Magnesium sulfate
dexamethasone (if <34 wks)

W/u
Check Doppler fetal heart rate
Cardiac monitor
24-hr U prot

Question 9

Medication for e. coli prostatitis (or UTI)

Answer 9

floroquinalone
ctx
bactrim

Question 10

intra-abdominal abscess
management

Answer 10

Cefepime, zosyn + metronidazol (not CTX)
Order abscess drainage
Zofran
tylenol

Abscess culture, blood culture, UA and Urine culture, gram stan abscess

Question 11

If LIVER problem, then….

Answer 11

AVOID TYLENOL

Question 12

If suspect ONE sexually transmitted disease, test for ALL!

Answer 12

Chlamydia
Gonorrhea
Trichamonas
HIV
Syphalis
Hep B
Hep C

Question 13

PCOS w/u

Tx

Answer 13

Testosterone level, FSH, LH
lipid panel
HA1c

Diet
Exercise
Birth control (unless TRYING to get preg)

Question 14

Sarcoidosis w/u

Answer 14

Biopsy most available lesion
TB test
HIV test

UA
Vit D level

Question 15

Tx new afib

Answer 15

metoprolol
apixaban

Question 16

Guillan Barre
w/u

tx

Answer 16

EKG, PFT, MRI, nerve conduction study
HIV, Syphalis, CK, TSH/T4
LP w/ CSF studies
Heavy metal screen
consult neuro

Plasma exchange (NO steroids)

Question 17

3rd degree heart block management?

Answer 17

w/u lyme serology

PACE MAKER

Question 18

PSGN tx

Answer 18

Furosemide
low-Na diet
fluid RESTRICTION
nutrition consult

Question 19

PSGN w/u

Answer 19

CXR
anti-neutrophil cytoplasmic ab
glomerular basement memb ab
cryoglobulin
ANA
Abd us

Question 20

acute coronary syndrome meds?

Answer 20

Heparin
Aspirin + Clopedagril
Statin
Beta Blocker

Question 21

Meds for Sickle Cell

Answer 21

Hydroxyurea
Penicillin
Folic Acid

Pneumo vax
Meningitis vax

Question 22

Cardiac concern?
order ALL

Answer 22

Troponin (BNP)
ECG
CXR
Echo
CARDIAC MONITOR!!!!!

Stress test?
Cardiac cath?

Question 23

Treatment alcohol withdrawal

Answer 23

Lorazepam/diazepam
Potassium chloride
Magnesium
B1/thiamine
B6/pyridoxine
B9/folate
LR

Acamprosate/Naltrexone

+/-Haloperidol (hallucination)

Question 24

Tuberculosis tx

Answer 24

Rifampin
Isoniazid (liver fxn pnl)
Pyrazinamide
Ethambutol (Ophtho consult)
Vitamine b6

Ophtho consult
Isolation

Do NOT order bronchoscopy if can diagnose w/o

Question 25

Hypertensive emergency tx (drug and indication)

Answer 25

Hydralazine (pregnancy) Nitroprusside sodium Labatalol (encephalopathy) Labatalol + esmolol (aortic disection) NPO (if nausea) Zofran (if nausea) Remember check Utox!

Question 26

Acute diverticulitis Triad Tx

Answer 26

LLQ pain leukocytosis fever Cefazolin/CTX + metronidazol (got passed on Zosyn) HIGH-fiber diet

Question 27

Meds to avoid R-ventricular MI?

Answer 27

Beta blocker Morphine

Question 28

New cancer dx work up?

Answer 28

CXR CT abdomen/pelvis CT chest council cancer diagnosis

Question 29

Surgery prep

Answer 29

pt/ptt inr type and cross ECG NPO LR Informed consent council cancer diagnosis

Question 30

Infectious work up

Answer 30

CBC ESR/CRP Blood culture Sputum culture Sputum gram stain Urine culture UA CXR ECG

Question 31

orders if pt in shock?

Answer 31

CBC Lactate NS or LR cardiac monitor

Question 32

IBS work up

Answer 32

CBC BMP ESR CRP UA Abd x-ray All the stool studies anti-gliadin, anti-endomysial (celiac) Lactose testing Consult nutrition AVOID colonoscopy

Question 33

SLE TX?

Answer 33

Prednisone hydroxychloroquine Avoid alcohol/smoking/SUN Dexa scan (given longterm steroid use)