deck 30

Question 1

treatment of campylobacter diarrhea

Answer 1

azithromycin

Question 2

abx for salmonella and shigella

Answer 2

ciprofloxacin

Question 3

only NSAID that doesn’t increase risk of MI

Answer 3

naproxen

Question 4

first line for keloid scars

Answer 4

intralesional corticosteroid injections

Question 5

drugs that can cause a false-positive urine drug screen for opioids

Answer 5

Dextromethorphan, diphenhydramine, ibuprofen, and even fluoroquinolones are among the many agents that can cause a false-positive urine drug screen for opioids. Pseudoephedrine can cause a false-positive test for amphetamines

Question 6

how to diagnose cat scratch fever

Answer 6

IgG testing for Bartonella henselae

Question 7

treatments that have evidence for IBS

Answer 7

Exercise, probiotics, antibiotics, antispasmodics, antidepressants, psychological treatments, and peppermint oil

Question 8

problems with stimulants in adults

Answer 8

can aggravate psychosis, tics, or HTN

Question 9

main SE’s of stimulants

Answer 9

insomnia, dry mouth, weight loss, headaches, and anxiety

Question 10

antihypertensive that can also slow bone loss in postmenopausal females and reduce incidence of osteoporosis/hip fractures

Answer 10

thiazide diuretics

Question 11

doxylamine

Answer 11

first generation antihistamine

Question 12

doxylamine use

Answer 12

(unison) sleep aid

Question 13

calcium supplement to use for patient on PPI

Answer 13

calcium citrate

Question 14

rapidly progressing paraparesis and sensory abnormalities in a diabetic patient think…

Answer 14

epidural abscess

Question 15

how to assess RV dysfunction with PE

Answer 15

1) echo (EKG can be normal)

Question 16

initial treatment of chronic fatigue syndrome

Answer 16

CBT or graded exercise therapy

Question 17

hepatorenal syndrome

Answer 17

• renal failure in patients with cirrhosis and elevated pressures in the portal vein system
  (elevated portal vein pressure leads to juxtaglomerular apparatus sensing reduced “effective” blood volume and activating RAAS.

Question 18

labral tear presentation

Answer 18

anterolateral pain, although pain may be deep and poorly localized, and may be associated with instability and a catching sensation

Question 19

posterior shoulder pain

Answer 19

often rotator cuff tendinopathy from teres minor or infraspinatus

Question 20

dermatofibroma

Answer 20

• https://www.google.com/search?q=dermatofibroma&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjWvdzfhpDSAhVJiVQKHY6HBQsQ_AUICCgB&biw=1037&bih=653
• dimple elicited on compression

Question 21

vitals with PE

Answer 21

tachycardia, tachypnea, low-grade fever

Question 22

classic findings of PE on ECG

Answer 22

prominent S in lead I, Q in lead III, and inverted T in lead III (s1q3t3)

Question 23

PE findings on CXR

Answer 23

hampton hump, westermark sign

Question 24

arrhythmia associated with PE

Answer 24

atrial fibrillation (caused by atrial strain from increased right atrial pressure)

Question 25

pleural fluid with empyema

Answer 25

pH less than 7.2 decreased glucose WBC less than 50,000

Question 26

parapneumonic effusion

Answer 26

pleural effusion resulting from effusion, lung abscess, or bronchiectasis

Question 27

pleural fluid analysis with parapneumonic effusion

Answer 27

pH greater than 7.2 decreased to normal glucose WBC count greater than 50,000

Question 28

pleural fluid criteria called

Answer 28

Light criteria

Question 29

pathophys of empyema

Answer 29

Most parapneumonic effusions are uncomplicated and resolve with abx. However, if bacteria cross into pleural space, a complicated parapneumonic effusion or empyema may develop.

Question 30

what will CXR show with empyema?

Answer 30

loculation

Question 31

management of COPD exacerbation

Answer 31

Oxygen inhaled bronchodilators systemic glucocorticoids antibiotics if greater than 2 cardinal symptoms oseltamivir if evidence of influenza NPPV if ventilatory failure tracheal intubation if NPPV failed or contraindicated

Question 32

duration of abx for COPD exacerbation

Answer 32

3-7 days

Question 33

pulmonary capillary wedge pressure significance

Answer 33

measure of pulmonary artery pressure, which is a surrogate for R atrial pressure (because of large compliance of pulmonary circulation)

Question 34

use of pulmonary wedge pressure

Answer 34

- Gold standard for determining the cause of acute pulmonary edema - elevated also suggests LV failure

Question 35

clinical features of pulmonary contusion

Answer 35

- usually happens within 24 hours of blunt thoracic trauma - tachypnea + tachycardia + hypoxia - pulmonary contusion leads to idntraalveolar hemorrhage

Question 36

diagnosis of pulmonary contusion

Answer 36

- rales or decreased breath sounds | - CT or CXR with patchy, alveolar infiltrate not restricted by anatomical borders

Question 37

pulmonary hygiene

Answer 37

nebulizer treatment + chest physiotherapy

Question 38

why does an exudative pleural effusion happen with pulmonary infection?

Answer 38

Cytokines released during inflammation or infection increase capillary permeability, resulting in translocation of cells and fluid from the vasculature into the pericapillary space, which aids in immune response but can also result in exudative pleural effusion

Question 39

criteria for initiating long term oxygen therapy in patients with COPD

Answer 39

1) resting arterial oxygen tension less than 55 mm Hg or pulse ox less than 88% on RA 2) PaO2 less than 59 mm Hg or SaO2 less than 89% in patients with for pulmonate, evidence of RH failure or hematocrit greater than 55%

Question 40

how to determine dose of supplemental oxygen for people on long term oxyen

Answer 40

titrate to 90% on RA during normal walking

Question 41

scoring system for PE risk

Answer 41

Wells score

Question 42

Test of choice for clinically stable patients in whom PE is likely

Answer 42

CT angiography

Question 43

algorithm for suspected PE

Answer 43

stabilize patient with O2 and IV fluids --> evaluate for contraindications to anticoagulation --> if no, then assess clinical suspicion of PE with modified wells --> consider anticoagulation if moderate to severe distress --> obtain diagnostic test and start, continue, or stop anticoagulation