F-med Flashcards
(126 cards)
1
Q
The drug of R.I.P.E Tuberculosis tx that can cause Paresthesias in fingers/toes
A
Isoniazid
2
Q
RIPE regimen
A
Rifampin
Isoniazid
Pyrazin
Ethambutol
3
Q
SE of Ethambutol
A
Optic Neuritis
If taking Ethambutol, should have regular eye checkups
4
Q
Peripheral neuropath SE a/w Isoniazid are dose dependent, pts taking this should co-administer _______ to help
A
Vit B6- Pyridoxine
5
Q
After two months of RIPE tx, what meds do you KEEP TAKING?
A
Rifampin and Isoniazid- the first two out of the regimen
ctd for the entire 6 mo
6
Q
Pott’s dz
A
TB of the vertebrae, manifesting as:
Osteomyelitis and Arthritis
7
Q
Vit D deficiency
A
Rickets (kids)
Osteomalacia
Tetany
8
Q
Night vision loss, dry skin, growth delay, Bitot spots on conjunctiva of eye are a/w deficiency of WHAT vitamin?
A
Vit A
9
Q
Vit B6
A
Pyridoxine
10
Q
Vit B12
A
Cobalamin
11
Q
Vit B2
A
Riboflavin
12
Q
Vit B1
A
Thiamine
13
Q
Vit B3
A
Niacin
14
Q
Pts w Cholestatic Jaundice have
A
decreased total bile salt pool size
15
Q
GGT level
A
gamma-glutamyl transferase, enzyme mostly found in liver. when liver is damaged, leaks out into blood
16
Q
Signs of Cholestasis
A
Elevated:
Bilirubin
Alk phos
GGT
17
Q
Charcot’s triad
A
RUQ pain
Fever
Jaundice
18
Q
Which type of PUD ulcer is more common
A
Duodenal ulcer
19
Q
Triple drug therapy for H. Pylori
A
Amoxicillin
Clarithromycin
PPI- Omeprazole
20
Q
Dosing of H. Pylori tx
A
Amoxi 1000 mg
Clarithro 500 mg
Omeprazole 20 mg
everything BID x14d
21
Q
When to do test of cure for H. Pylori?
A
at least 4 weeks after pt has completed therapy
22
Q
What do you need to monitor if pt is on Allopurinol therapy?
A
It’s excreted by kidneys
Measure KIDNEY FX, with Cr levels
23
Q
Kidney fx test
A
Cr
24
Q
How often to measure Creatine level w pt on Allopurinol?
A
every 2-4 weeks
25
1st line PROPHylaxis for Gout
Allopurinol
26
Ideal Uric Acid level in someone with Gout
< 6 mg/dL
27
Needle shaped crystals with NEG birefringence
Gout
28
Tx of Acute Gout
NSAIDs
Steroids
Colchicine
29
What things can trigger/ make worse Gout?
Loop diuretics
| Thiazide diuretics
30
Recommendations for long term f/u of pts with Hodkin's lymphoma who have been treated to remission
Annual Mammogram at age 40, OR
5-7 yrs after Radiation
31
Clinical sx of Hodkin Lymphoma
```
Painless cervical swollen lymph nodes
Itching
Fever
Night sweats
Weight loss (b sx)
Frequent infections
```
32
Cells pathognomic for Hodkins lymph
Reed- Sternberg
33
Reed Sternberg cell looks like
"Owl's eye"
Hodkins lymph
34
Mediastinal mass on CXR
Hodkins lymph!!
Also Hepatosplenomegaly, B sx- night sweats, weight loss, fever
35
After person has received tx (chemo or radiation) for Hodgkin lymph, what secondary CA is likely to develop?
Lung
Breast
GI
36
Reed Sternberg
Hodkin Lymph
37
Tx of Acne vulgaris
Mild-mod: Topical retinoids or abx + peroxide
Mod: add oral Abx
Severe: Isotretinoin "Accutane"
38
Criteria for Hypotension
<90 sys
| <60 diast
39
Most common location for Esophageal foreign body
Level of Cricopharyngeus muscle- C6
40
Antibodies specific for SLE (Lupus)
Anti-dsDNA
| Anti-Smith
41
Other sx that can be a/w Lupus
```
Fever
Low wbc
Thrombocytopenia
Hemolysis
Delirium, Psychosis
Alopecia
Oral ulcers
Pericarditis
Pleural or Pericardial effusion
Arthralgia
Proteinuria
```
42
Most common way that Lupus can affect your lungs
Pleuritis- inflammation of the pleura- the lining that covers the outside of the lungs
43
Tx of Lupus
Hydroxychloroquine
Steroids
Immunosuppressant
NSAIDs
44
Drug inducing lupus
HIPPS
```
Hydralazine
Isoniazid
Phenytoin
Procainamide
Sulfa
```
45
Stages of Lyme Disease (Borr Burgdorf)
I: Erythema migrans "bullseye", fever, fatigue, myalgia, HA
II: Myocarditis, Bells palsy
III: Chronic arthritis, chronic encephalopathy
46
Tx of Lyme dz
Doxy
Pregnant: Amoxicillin
47
What is diff about the Bell Palsy a/w Lyme disease?
It's BILATERAL!
pathognomic for Lyme dz
48
Avoid this type of DM drug if family or personal hx of THYROID cancer
GLP-1 RA, "tides"
Victoza, Saxenda, Trulicity
49
Most common cause of Cushings syndrome
Excess steroid use
| exogenous
50
Most common ENDOGENOUS cause of Cushings syndrome is
Cushings dz- excessive secreation of ACTH by pituitary tumor
most commonly a Benign Pituitary Tumor
51
Diagnosing Cushings Syndrome
Dexamethasone suppression test
52
Tx of Cushing syndrome
Transphenoidal removal of tumor
53
Helpful meds as adjunct in dealing w Cushings syndrome
Lower BP
Lower glucose
Lower chol
54
Other signs of Cushings syndrome
```
Amenorrhea
Depressive sx
Easy bruising
Pruple striae
Buffalo hump
```
55
If the cause of Cushings syndrome is the pituitary tumor, then it's called
Cushing's dz
56
Drugs known to cause SJS/TEN
```
"Lamictal" (Lamotrigine)
Sulfas
Phenobarbital
Carbamazepine
Allopurinol (gout)
NSAIDs
```
57
____ increases the risk of Fibrocystic Conditions of breast
Frequent alcohol consumption
58
Fibrocystic breast
d/t fluctuating levels of Estrogen during menses
Tx: apply heat, wear supporting bras,
Pharm: Danazol
59
Murmur a/w:
CP
Dyspnea
Syncope
Aortic Stenosis
60
Aortic stenosis
Prominent 4th heart sound
61
Why is there an audible 4th heart sound with Aortic Stenosis
The L Ventricle must work harder during contraction to eject its blood volume and becomes Hypertrophied
62
Aortic Stenosis typical pt
Older
Hx of DM and HTN
c/o CP, LOC, and dyspnea
63
Tx of Meneire dz
Restrict sodium intake
to 2-3 g daily
64
Meniere dz
- Episodic vertigo
- Sensorineur HEARING LOSS
- Tinnitus
65
How long does the Vertigo last with Meniere dz?
up to 24 hours
66
Ear fullness
Pressure
Machinery or Roaring sound in ear
Meniere dz
67
Tx of Meniere dz
Avoid triggers
Antihistamine
Benzos- Diazepam (Valium)
Diuretic (HCTZ)
68
What causes Meniere dz?
Too much pressure in the inner ear
d/t Ear Endolymph
69
What causes the S4 in Aortic Stenosis?
LV has become hypertrophied, making it harder for LA to pump blood into it
The S4 is the result of the Atrial contraction against a noncompliant L ventricle
70
S3 heart sound
Can be normal, OR
Dilated CM
Systolic HF
71
What is S1?
Mitral and Tricuspid valve closing
the valves b/w Atria and Ventricles
72
What is S2?
Aortic and Pulm valve closure
the valves leaving the ventricles
73
S3 is large amt of blood striking a VERY compliant Left ventricle
This is normal in:
Kids
| Pregnant women
74
What type of Hep only exists with Hep B?
Hepatitis D
75
Tx of Suppurative Parotitis
| firm, red swelling of pre and post ear areas, extends to angle of mandible
Nafcillin + Metro OR Clinda
76
Tx of Supp Parotitis
Nafcillin + Metro
OR
Nafcillin + Cinda
77
If there is bilateral Parotitis in a YOUNGER pt, be thinking
Mumps
78
Tramdol (Ultram)
Mild narcotic with low abuse potential
50-100 mg up to 4x per day prn for OA
79
Most common form of Arthritis
OA
Knees and Hips
Joint space narrowing, osteophytes
80
Worry about Salmonella localizing in JOINTS or BONES in what population of ppl?
Sickle cell dz
81
Smoking can increase risk of
INFERTILITY
82
Tx of Gonorrhea
Rocephin 250 mg IM
+
Azithro 1g PO
83
If you have 1 relative w Colon CA, when to start screening
Age 40, OR
| 10 yrs before fam member was diagnosed
84
FAP- Familial Adenomatous Polyposis
Sigmoidoscopy at 12 YO
then every 1-2 yrs
85
Which dz does screening start earlier for- FAP or HNPCC?
FAP
| Sigmoidoscopy at 12 yo
86
Type I Osteoporosis d/t
Postmenopause loss of Estrogen
87
Type II Osteoporosis d/t
Age >75 yo
| Not enough Zinc or Calcium
88
Two ways someone can be dx w Osteoporosis
T score -2.5 or lower
| Fragility fx
89
What advice can you give to someone newly dx w HTN?
Dietary intake of K+ may lower both Systolic and Diastolic BP
90
Stage 1 HTN
S: over 130
D: over 80
91
Stage 2 HTN
S: over 140
D: over 90
92
Tx of Vulvovaginal Candidiasis "yeast infection"
Topical azole
| Oral Fluconazole "Diflucan"
93
Diflucan is used to treat
Yeast infection,
brand name for Fluconazole
94
Tx of SEVERE PID
| in a pt w NKDA
Cefoxitin 2g IV q6hr
+
Doxy 100 mg q12hr
95
Tx of Severe PID
IV Cefoxitin
+
Oral Doxy
96
All pts suffering acute MI are given this at HIGH DOSES despite baseline levels
Statin
- Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
97
Lateral Wall STEMI
Lead I, avL, 5-6
98
Inferior Wall STEMI
II, III, avF
99
Anterior Wall STEMI
V1-V4
100
Back pain worse after sitting, better w improvement
Stiff for >30 minutes in the morning
Ankylosing Spondlyitis
should be tx by Rheum
"Cant see, cant pee, cant climb a tree"
101
Other manifestations of Anklyosing Spondylitis
```
Anterior Uveitis (EYE)
IBD
Psoriasis
Aortic regurg
Restrictive Pulm dz
```
102
Someone has acute back pain, how long should they "bed rest"
Only 2 days, followed by progressive ambulation back to normal activity
103
Common cause of Ankylosing Spong
presence of HLA-B27 gene
104
Someone has HF, can see a ____ heart sound
S4, d/t noncompliant Left ventricle
105
RSV Bronchiolitis
kid <2 YO
Fever, cough, resp distress
Tx if severe: Inhaled bronchodilator, High flow nasal cannula, CPAP, Intubation
106
How to distinguish b/w CVA or Bells
If eye canNOT aBduct- CN 6 "Abducens" is damaged, and the cause is prob CVA-Stroke
107
NSAIDs that are rec for Dysmenorrhea
Ibuprofen
| Naproxen
108
Achalasia
Birds beak appearance of Esophagus
bottom of esoph is too tight- regurg food
109
Sialadenitis
inflammation and swelling of Salivary glands
RF: dehydration, chronic illness
110
ASA sensitivity, polyps, Asthma
Samter's triad
111
RF for Frozen shoulder
DIABETES
Thyroid dz
stroke
Auto-immune dz
112
Tx of Acute Cystitis
Macrobid 3-5 days
113
High int Statin
Atorvastatin 40-80 mg
| Rosuvastatin 20 mg
114
Prostatitis
| Tender, boggy prostate
Tx:
Bactrim or FluoroQ
6 weeks!!!
1.5 months
115
Mammary Paget's dz
Eczema like dz of nipple and Areola
| a/w Underlying CA of breast
116
Most common type of breast CA
Invasive Ductal Carcinoma
117
Menopausal labs
Elevated FSH
| Decreased Estrogen
118
Tx of menopause sx
No uterus aka have had hysterectomy: Unopposed Estrogen is ok
intact uterus: Combo estrog and prog
119
Most common type of Lung CA
Adenocarcinoma
| + CEA antigen
120
Screen for Lung CA in
High risk
- 55-80 YO
- 30 PPY hx
- currently smoke or quit within the past 15 yrs
Low dose Helical CT
121
Itching after warm bath
| JAK2 mutation
Polycythemia vera
elevated RBC mass
high Hgb
Fatigue, itching, burning pain and redness, engorged retinal veins, Thrombosis, Gouty arthritis
Tx: Hydroxyurea, Phlebotomy, Aspirin
122
Goal hct level in pt being treated w Phlebotomy for Polycythemia Vera
<45%
123
What congenital abnormality puts you at increased risk of getting Testicular CA?
Cryptorchidism-
1 or both of testes fail to descend into scrotum
124
Janeway lesions
non tender red nodules on PALMS AND SOLES a/w Endocarditis
125
Inferior leads on EKG: II, III, avF correlate with what Coronary Artery?
Right Coronary Artery
126
Anterior leads V1-V4 correlate with what Coronary Artery?
Left Anterior Descending- LAD
