GEN IM Flashcards
(134 cards)
1
Q
Treatment of PAD
A
Supervised exercise > Cilostazol > pentoxyfylline
2
Q
In PAD, which med has decreased coronary events?
A
ACE-I
3
Q
Criteria for PAD
A
ABI
4
Q
Metabolic syndrome
Criteria for waist circumference
A
Men > 40 asian > 35
Women > 35 asian > 31
5
Q
Metabolic syndrome
Criteria for TGAs
A
> 150
6
Q
Metabolic syndrome
Criteria for low hdl
A
Men
7
Q
Metabolic syndrome
Criteria for BP
A
BP > 130/85
8
Q
Metabolic syndrome
Criteria for FBS
A
> 100
9
Q
Treatment for obese stage 1
A
BMI > 30
Reduce diet by 500-1000 kcal/day then exercise
10
Q
Treatment for obese stage 2
A
BMI > 35, If with risk factor (HTN, DM, Dyslipidemia, CHF, OSA)
BARIATRIC SURGERY
11
Q
Treatment for morbid obesity
A
Bariatric surgery
12
Q
vit deficiencies associated w/ bariatric surgery
A
Vit D (supplement w/ 5000 u/day), vit B12, copper, iron
13
Q
T/F obesity increases risk of CA
A
Endometrial > breast, prostate, colon
14
Q
Post bariatric px develops fever?
A
Consider anastomotic suture/staple leak
15
Q
Post bariatric px starts gaining weight?
A
Consider gastrogastric fistula
16
Q
How to feed bariatric px
A
ABW
1.2 g/kg of protein
11-14 g/kg of carbohydrates
17
Q
Streaks/showers of floaters
A
Retinal detachment
18
Q
Cherry red spot
A
CRAO
19
Q
Multiple hemorrhages on fundoscopy in a hypercoagulable px
A
CRVO
20
Q
Central vision blurry, peripheral vision spared
A
Macular degeneration
Tx:
Quit smoking
Antioxidant vitamins
magnefying glass
21
Q
Mid dilated fixed pupil
A
Glaucoma
Tx: urgent referral; put pilocarpine before transfer
22
Q
Hypopyon
A
Endophthalmitis
23
Q
HSV 1 keratitis tx?
A
Trifluridine
Dendritic ulcer on fundoscopy
24
Q
Pathology of chalazion
A
Obstruction of meibomian glands
25
Dxtic for cavernous sinus thrombosis
CT. If negative do MRV if suspicion high
26
AIDS px with cheese & ketchup appearance on fundoscopy
CMV retinitis
TX: ganciclovir
27
Tx of otitis externa
Polymyxin drops
28
Tx for malignant otitis externa
Cefepime + amikacin/tobramycin
29
Most common cause of viral conjunctivitis
Adenovirus
30
Tx for otitis media
Amoxicillin
31
Which med can cause delirium in elderly postop
Meperidine (demerol)
32
What to give for postop delirium?
Haldol
33
In alcoholics, + ataxia, nystagmus, confusion, diplopia
Wernicke's syndrome
TX: Thiamine before glucose
34
In alcoholics, + confabulation, amnesia
Korsakoff's syndrome
35
Tx for delirium tremens
Lorazepam - haldol - phenobarbital - propofol
36
At risk for alcoholism
Men: 4 drinks in one occasion
Women: 3 drinks
CAGE and AUDIT questionnaire
37
Best strategy for alcohol abuse
SBIRT
| Screen, brief intervention, referral gor treatment
38
Best screening for chronic alcoholism
Carbohydrate free transferrin
39
Best tx for alcohol addiction in support group
Naltrexone
40
Whitish/grayish spots in conjunctiva
Vit A def
41
Nausea, vomiting, blurring of vision, hyperCa, blurring of disc margins on fundoscopy
Vit A toxicity
42
Constipation, dry mucous membranes, hyperCa
Vit D toxicity
43
Dementia, dermatitis, diarrhea
Pellagra
| Niacin def
44
Diarrhea w/ Vertical lines on nails
Arsenic poisoning
45
Alopecia, hyperkeratotic rash, anemia
Zinc def
46
Cheilosis, glossitis, dermatitis
B2 def
47
Goiter/hypothyroidism
Iodine
48
Tea & toast diet, bleeding gums
Scurvy
| Vit c def
49
Vit Deficiency causing cardiomyopathy, CHF
Hypophosphatemia, thiamine, selenium
50
MVP shows increased incidence in what psych d/o?
Panic disorder
51
Tx for generalized anxiety disorder
Buspirone
52
Tx for panic disorder
SSRI
53
Tx for OCD
SSRI: fluoxetine, fluvoxamine
TCA: clomipiramine
54
Tx for PTSD
SSRI, psychotherapy
55
Tx of conversion d/o
Suggestible therapeutic modality
56
Deliberate production of signs and symptoms
Factitious d/o
57
Pathologic lying
Munchaussen's syndrome
58
Reproduction of symptoms for secondary gain
Malingering
59
PE does not match multiple complaints
Somatization d/o
60
SSRI with low lethal potential
Citalopram
61
Duration of sx of depression to be classified as depression
> 2 weeks
If > 2 yrs, dysthmic d/o
62
Most common cause of suicide
Depression
63
First episode depression, duration of tx?
4-9mos
64
When to expect effect of antidepressants
2-6weeks
65
When to shift antidepressants
6-8 weeks
66
If depression recurrent
2 or more years
67
Depression + enuresis tx
Imipramine
68
Tx for panic disorder
Alprazoloma then SSRI
69
OC disorder
Fluoxetine, fluvoxamine, chlomipramine
70
Depression + chronic pain
Amitripryline
71
Depression at insomnia
Amitriptyline
72
Side effect of TCAs
Antichoinergic sx
| Orthostatic hypotension
73
Side effect of MAOis
HTNsive crisis
74
Antidepressant to avoid in bulimia
Bupropion
75
Depression + insomnia tx
Amitriptyline
76
T/F SSRI can cause suicidal ideation
T
d/c drug
77
Tx of hypothermia
Passive rewarming
78
Tx of heat stroke
Evaporative cooling
79
Px wants to quit but no quit date?
Begin varenecline
80
Side effect of varenicline
Depression, suicidal ideation, psychosis
81
Px has tried nicotine patches?
Try 2 methods; if ineffective-- bupropion
82
Side effect of bupropion
Seizures
*also never drug for bulimia
83
T/F px with parhologic psych condition can be treated against their will
T
84
Re Syphilis:
| RPR +, manual FTA neg
No tx
85
3 cardinal signs of brain death
Coma
Apnea
Absence of reflexes
86
Palliative px w/ coarse rales
Give Glycopyrolate
87
When not to use OCP
```
Hx of DVT
CAD
HTN
Migraines
Smoker > 35 (use progestin only)
Breast CA
Chronic hepatitis
```
88
Peliosis hepatis
Complication of OCP; blood filled cavities may rupture causing shock
Dx: CT
Tx: surgery
89
OCP failure may occur w/ use of other drugs like
St John's wort
Rifampicin
Tocilizumab
90
Mild midcycle spotting w/ OCP
Continue
91
Mod to severe midcycle bleeding w/ OCP
D/C and try IUD; or use higher dose of estrogen
92
Classification of MS
Valve area
Mild > 1.5 cm
Mod 1-1.5 cm
Severe
93
Px w/ ASD wants to get pregnant
If shunt > 2:1 -- surgery first
94
Contraindications to pregnancy
```
Eisenmenger syndrome
Pulmonary HTN
Severe AS
Dilated CMP with CHF
marfan's w/ dilated aortic root
```
95
T/F can hocm and MVP get pregnant
T
96
Anti-HTN drugs for pregnancy
Labetalol
Hydralazine
Methyldopa
97
Anti-seizure medicine NOT to use in pregnancy
Valproic acid
98
Drug for Grave's dse in pregnancy
PTU
99
Which drugs to use for itching in pregnancy
Hydroxyzine
| Chlorpheniramine
100
Best time to fly when pregnant
2nd trimester
101
Tx for intrahepatic cholestasis of pregnancy
Cholestyramine
| Ursodeoxycholic acid
102
Tx for acute fattly liver of pregnancy
Delivery will resolve ab(N)
*inc LFTs, Bili, ammonia
103
Antiseizure med safe in pregnancy
Carbamazepine, MgSO4
104
What dose of warfarin is safe in pregnancy?
105
Most aminoglycosides are unsafe in preg except
Gentamicin
106
Most common cause of mortality in pregnancy
Postpartum endometritis
107
Agent in postpartum endometritis?
Grp b strep
108
When to give Ig in measles/varicella
W/in 1 week in measles
| W/in 10 days in varicella
109
Can an HIV mother breastfeed her baby
No
110
Who should not receive live vaccines
```
Immunocompromised pxs like
HIV
CLL/nonHodgkins lymphoma
CKD
Asplenia
Those on TNF alfa agents
```
111
T/F if px is allergic to eggs can you give flu vaccine?
Yes as long as in hospital or MDs clinic
If w/ anaphylaxis, non-egg flublok
112
Pressure ulcer st 2?
Shallow ulcer w/ pink bed
Tx: occlusive or semi-permeable dressing
113
Tx for st 3-4 ulcers
Debridement & Antibiotics
114
BPH + hematuria med
Finasteride
115
Pathology of urge incontinence
Detrussor overactivity
```
Tx:
Weight loss
Timed bathroom breaks
Kegels
Anticholinergics (oxybutinin, tolterodine)
```
116
Pathology of stress incontinence
Poor sphincter tone
Tx:
Weight loss
Kegel's
117
Pathology of overflow incontinence
Urethral obstruction/BPH
Detrussor underactivity
Tx:
Prostate vol 1.8 -- finasteride + alfa blocker
Bethanechol
118
Tx of vertebral compression fracture
Rehab + Analgesia
If no improvement in 1month, vertebroplasty
119
Fall w/ nondisplaced femoral neck fracture
Surgery with pinning
120
Fall w/ displaced femoral neck fracture
Total hip arthroplasty
121
Fall w/ intertrichanteric fracture
Hip compression screws
122
Major predictor of fracture fr fall
Osteoporosis
123
Best test to predict mobility & falls
Timed get up and go test
-- > 14 sec high risk of falls
124
Normal MMSE score
> 23
125
Tx for beta blocker poisoning
Glucagon
| Epinephrine
126
Tx for Ca channel poisoning
Calcium
127
Dxtic for organoPO4 poisoning
RBC cholinesterase level
128
Tx for organoPO4 poisoning
Atropine
| Pralidoxime
129
Diff bet methamphetamine & ecstasy
Meth agitated but alert, ecstasy has mental status changes
Ecstasy has hypoNa
130
Indications for electroconvulsive tx
Refractory depression
Suicidality
Catatonic state
Psychotic features
131
Relative CI for ECT
MI
CHF
Aneurysm
COPD
132
Tx of manic depressive
Lamotrigine
133
Tx of bipolar
Lithium, valproic acid, atypical
| Antipsychotic
134
Side effect of lithium
Diabetes insipidus
Hypothyroidism
Hypercalcemia
Tremors
