Gen Medicine Flashcards
(337 cards)
1
Q
4 intsances when to Tx Paracetamol toxicity empirically
A
- 8 or more hours after ingestion
- serum level not available in 8 hrs
- uncertain timing
- unconscious pt with suspected OD
2
Q
CPR Protocol
A
DRS ABCD
Danger
Responsive
Send for Help
3
Q
effects of ACEI and NSAID on kidneys?
A
Decrease: 1. vasoconstriction (Efferent)
2. vasodilation (affarent)
4
Q
MC complication of TURP?
A
UTI
Followed by bleeding
5
Q
ejection systolic murmur radiate to carotid
A
AS …
6
Q
first-line treatment for CMV pneumonia
A
IV foscarnet or ganciclovir
7
Q
seizure prophylaxis med?
A
Phenobarbitone
alternatives: phenytoin or valproate
8
Q
Tx steps of duodenal Atresia (4)
A
NPO
Nasogastric decompression
Intravenous fluids
Surgery—duodenoduodenostomy
9
Q
1 st step in management of cyanotic spells in TOF…
A
Squatting position
10
Q
1 st step in management of TGV…
A
PG infusion (to maintain patency of PDA)
11
Q
1st line Tx acute pericarditis in Australia?
A
NSAIDS + Colchicine
12
Q
1st line tx of GBS? guillain barre
A
IVIG
13
Q
1st line tx of shigella?
A
Cipro
14
Q
1st step in managemnt of RDS in neonates?
A
CPAP
15
Q
1st trimester serum screening for downs?
A
PAPP —-low
BHCG……..high
16
Q
2 hpoglycemics that can be used in pregnancy?
A
- Metformin
2. Insulin
17
Q
2nd hyperparathyroidism is associated with?
A
hypocalcemia
18
Q
2 protective and 2 detrimental effects of tamoxifen?
A
breast and bone protector
Causes DVT and endometrical CA
19
Q
2nd complication of nephrotic syndome
A
Renal vein thrombosis (thrombophilia)
20
Q
3 big organisms causing meningitis
A
strep pneumo
H influenza
Neisseria meningitides
21
Q
3 day child with symptoms of HF and shock…what is wrong with his heart?
A
hypoplastic ventricle
22
Q
3 signs need to dx lewy body dementia
A
- Hallucination
- Parkinsonism
- Fluctuating mental status
23
Q
Is a CD4 count less than 350 indication to start HIV tx?
A
yes
24
Q
viral load > 100000 indication for HIV tx?
A
yes
25
Hep B infection indication for HIV tx?
yes
26
Hep C infection indication for HIV tx?
NO
27
Neuropathy indication for HIV tx?
NO
28
Nephropathy indication for HIV tx?
yes
29
Tx of strep endocarditis?
beta lactam plus gent
30
Tx of staph endocarditis?
beta lactam, gent and rifampin
31
4 breech presentations
1. complete ....completely flexed hip and knee
2. Frank.....flexed hip extended knee
3. kneeling....extended hip flexed knee
4. footling...completely extended
32
5 year old with 5 day fever, skin and mouth and hand manisfestations, think?
Kawasaki Disease
33
5 year old, mother has FAP, when to screen?
| for how long? Then what?
start screening at 12
| screen until 35 yearly. then q 3yrs after 35
34
<5 years, wat to give for prevention of athsma?
SCG sodium chromoglycate
35
>40 year old pt...solitary incidental lung nodule, wat to do? (2)
Previous xray
| CT
36
when to use wafarin to prevent stroke
CHA2DS2 VASc score =>2
37
A baby is failing to thrive and has clay-coloured stools and jaundice which suggest
an obstructive lesion (biliary Atresia)
38
Ab for sclereoderma
Anti SCL70
39
Ab to detect CREST?
Anti Centromere
40
Abx producing similar disturbance to Botulism?
| What is the disturbance?
Gentamicin...muscle paralysis
41
acute asthma attack, how many puffs kids? adults?
<6 ....6 puffs
| Adults 12 puffs
42
Acute cerebral hemorrhage,how to tx pt on warfarin?
Give FFP,,,,vit k takes time
43
acute confusional state, is called wat?
delirium
44
acute gout management in pt with CKD?
Steroids...prednisolone
45
acute gout plus renal failure, tx?
Steroids
46
Acute Messenteric ischemia, what investigation to do?
i know it as CT Angio
Serum lactate (non specific marker seen lata)
47
Agent of choice for malignant HTN?
IV Nitroprusside
48
Ages of chlamydia screening?
15 - 29 yrs
49
Air in the biliary tree, think?
cholelithiasis
50
air-fluid level on radiography and the presence of foul-smelling sputum, indicates what?
Abscess is draining
51
All household contacts of pts with pertusis should be treated with?
10 day course of erythromycin
if allergic : Cotrimoxazole
52
All pts with egg anaphylactic reaction should recieve following in split doses under supervision:
Q fever
Yellow fever
Influenza
53
Anemia, High INR, Low ca, think
Celiac disease
54
Antibodies for Greaves Disease?
Anti TSH
55
Antibodies for Hashimotos (Hypothroid) (2)
Anti TPO
| Anti Microsomal
56
Anticholinergic effects, think? DDRY
Dry, constipation retention
| DRY .....Dry, Dilation Retention, constYpation
57
Antipsychotic with least side effect profile?
Quitapine
58
Appearance of vascular calcification in breast?
lines of calcification in both breasts....b9
59
Arrhythmia…….most common in Hyperthroidism is?Arrhythmia
Afib
60
Arterial disease with ABI<0.3?
CT Angio
61
Arterialdisease with ABI >= 0.5
Doppler US
62
At wat age do u start screening fo DM (in pts with no risk), how frequent?
40
| q3 yrs
63
At what age do u screen for cholesterol?
45
64
B4 starting Azathioprine, what test should be done?
Thiopurine enzyme activity
low activity = good chance of side effect of azathioprine
no activity = severe reaction
65
Back pain + red eye, think?
Ankylosis spondylitis with Uveitis
66
Bed bound elderly with constipation and cramping pain, think?
Sigmoid Volvulus
67
Best diagnostic test for acromegaly
OGTT with serial growth hormones
68
Best dx modality for MS?
MRI of brain
69
best initial test for acromegaly
IGF 1
70
Best screening test for developmental dysplasia in the first 6 months of life?
After 6 months?
US
| Xray
71
pt presents with acute gout, cant use NSAID or steroids, what to use?
Colchicine
72
best initial tx for ASpondylitis
NSAID
73
Major cause of erectile dysfunction? (2)
alcohol
| smoking
74
drugs causing significant increase in HDL (2)
Nicotinic acid
| Gemfibrozil
75
risk of dev. breast CA in old?
Old = Obesity = CA
| OBESITY
76
Tx of vTach in stable pt?
amiodarone
77
Test to diagnose hemachromatosis?
iron studies (ferritin and transferrin sat)
78
Best test for diagnosing sliding hiatus hernia?
barium swallow
79
Best test to confirm aortic dissection? (3)
Spiral CT(angio)...MR Angio...TEE(fastest)
80
Best way to avoid HIV…………
condom
81
Bilatreal duct discharge, think?
mammary duct ectasia
82
mammary duct ectasia tx?
excision
83
Bilious vomiting without abdominal distention on first day of life
Duodena Atresia
84
Boy with anger problem, think?
| TX?
```
oppositional defiant disorder.. ODD
Psychological strategies (parent management training)
```
85
boy with LE cyanosis, dx?
R to L shunt
86
Breast mass in a 20 year old is likely?
| Inv of choice
fibroadenoma or cyst
| US
87
Bronchiolitis is seen in wat age? 12 words
<1yr old
88
brown sequard?
VP on my side Vibration N propriception Ipsi
| motor ...ipsi
89
VP on my side Vibration N propriception Ipsi
| motor ...ipsi
Depression
90
cancer associated with High ACTH?
small cell ca of lungs
91
Ottawa knee rules for requesting xray?
```
WAIT
W==weight bearing difficulty
A==age greater than 55
I==inability to flex at 90
T== tenderness at isolated patella or fibula head
```
92
Classic sign of ischemic hepatitis?
Elevated liver enzymes and normal bilirubin
93
Asthma pt resistant to initial tx, what to do?
Give IV Mag Sulfate
94
Canon A waves is related to what?
Complete heart block
95
Meds Causing angioedema? (2)
ACEI
| Amoxicillin
96
Central lung lesions are dx by?
bronchoscopy
97
central vs nephrogenic DI, wat to see?
In central....Vasopressin cause increase in urine osmolality
In Nephrogenic...nephrons are not responsive to Vasopressin
98
child sexual abuse should be reported to?
Child protection agency
99
Child protection agency
report to child protection services
100
child's frequent vomiting and microcytic anaemia suggest?
hiatus hernia with reflux
101
Cholinergic (organophosphate) poisoning results in?
```
DUMBELS
Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Salivation
```
102
classes of hypovolaemic shock
```
NAC_L
Normal =1
Anxious = 2
Confused =3
Lethargic = 4
```
103
classic enzyme sign of ischemic hepatitis?
elevated liver enzymes with normal bilirubin
104
Common cause of unilateral tumor?
Graves Disease(thyrotoxicosis)
105
Compression stockings are contraindicated in 2 instances...
1. diabetics
| 2. ABI< 0.8
106
Confirmatory test for SLE
dsDNA
107
Contributing factors for Dupuytrens contracture (3)
Family Hx
DM
Epilepsy
108
cranial nerves
OOOTTAFVGVAH
109
CURB 65 ....3/5
```
Confusion
Urea >7
Resp >30
BP<90/60
age > 65 need admission and tx if >3 points
```
110
Cyanosis since birth (at 1 st day of life)…
TOGVs
111
Cyanotic spells in pt with TOF occur when (age)
childhood (not directly after birth)
112
How long before warfarin becomes active?
at least 5 days
113
Tx of GBS Buillean Barre ==1st line
| == 2nd line
IVIG
| Plasmapheresis
114
Blood volume lost in Motor vehicle accident determined as?
Pulse <100 = 15%
Pulse 100 - 120 = 15-30%
pulse 120 - 140 = 30 -40%
pulse >140 = >40%
115
Ursodeoxycholic acid will relieve symptoms of?
PBC (primary Biliary cirrohsis
116
Ab predicitive for poor clinincal outcome in Auto immune hepatitis?
Anti LKM
117
Ab present in Chronic auto immune hepatitis?
Anti Smooth muscle
118
Ab present in PBC
Anti Mitochondrial
119
Ab present in Churg Strauss?
PANCA
120
Cyst with cholesterol crystals, think?
Dermoid cyst
121
Diabetic Drug associated with increased risk of cancer
Pioglitazone
122
Diagnose polyarteritis Nodosa with?
Muscle biopsy
123
Diagnosis of herpes zoster?
Tzanck prep or viral culture
124
Diagnosis of Pyloric stenosis with?
US
125
MCC of ACS?
Acute thrombosis
126
Discharge pt with acute asthma on?
oral steroids......tapered down
127
DKA pt, first thing to check?
ABG
128
Drug of choice for essential tremor?
propanolol
129
drug of choice for opiate overdose?
Naloxone
130
Drug of choice for partial seizures
Carbamazepine
131
drugs to stop 1 week prior to suregery (4) WAAN
1. WArfarin
2. Amitryptilline
3. Antiplalets
4. NSAIDS
132
Glasgow Coma Scale Memory
| https://www.youtube.com/watch?v=gE5gSU_8oHs
EVM (4, 5, 6)
133
Glasgow Coma Scale Memory - EYE
```
EYES (4)= ESPN
EYE OPENS SPONTANEOUSLY =4
SOUND=3
PAIN = 2
NOTHING = 1
```
134
Glasgow Coma Scale Memory - VOICE
```
VOICE (5) = Our Country WIN
O= Oriented (5)
C= Confused (4)
W = Words inappropriate (3)
I= inappropriate sound (2)
N = Nothing
```
135
Glasgow Coma Scale Memory- MOTOR
```
Cant Live Without FANs
C = commands obeyed
L = localizes pain
W = Withdrawal to pain
F=Flexion abnormal (decorticate)
A= Abnormal extension (decelebrate)
N = Nothing
```
136
Diabetic pt controlled on diet, what driving restriction?
None
137
Diabetic pt controlled on insulin, what driving restriction?
condition, reviewed 2 yearly
138
MCC allergy in kids in Australia?
food
139
Major side effect of Sulfasalazine? (2)
Thrombocytopenia and Agranulocytosis
140
screening and monitor of hepatoma (liver Cancer), use?
Alpha Fetoprotein
141
Testicular cancer screening with whcih 3?
AFP, BHCG, LD...Lactate dehydrogenase... all elevated
142
DA is related to what disease?
Downs Syndrome
143
Dx of adenocarcinoma and Large cell Ca (peripheral Lesion) is by?
Fine Needle aspiration
144
dysphagia b4 hoarsness, think?
Esophageal
145
Earliest sign of carbamazepine toxicity?
Diplopia
146
early dumping u find ?
hypovolemia
147
Early sign of snake bite envenomation
Nausea and vomiting
148
Ecg presentation of acute pericaditis?
Diffuse ST segment elevation
149
Ekg changes in Hyperkalemia? (3)
Tall T waves
Short qt interval
Increased PR interval
150
epiglotitis and croup age range?
6mths - 6 years
151
Erythema multiforme is often associated with which pnuemonia?
Mycoplasma pneumoniae infection.
152
Factor for chronic pain syndrome
Being a woman
153
Pt with rheumatic heart disease and Afib, what to give?
WARFARIN.....important CHADSVASC does not APPLY
| to valvular afib
154
How long does Vit K take to reverse Warfarin?
6 - 12hrs
| use FFP in that case of quick reversal
155
Hypercarbia or Hypocarbia, which causes ICP
Hyper...increased...Cabia
156
Factors predisposing to central sleep apnea? (2)
CHF
| Neurologic condition ....stroke
157
First indication of Pagets Disease?
Elevated Serum Alk Phos
158
First investigation to any patient with AF…..
thyroid functions
159
first line tx of bipolar
Antipsychotics
160
first line of inv of scrotum mass
USG
| then AFP
161
First line tx for AS? 2nd line
NSAIDs
| Infliximab (biologicals)
162
First line Tx of trigeminal Neuralgia?
Carbamazepine
163
First test for salmonella? Best
Stool culture
| Blood culture
164
First time seizure, isolated...advice to pt?
Do not drive for 6 months
165
formula fed white first born male with family hx and maternal smoke hx is at risk of?
Infant Hyperthropic Pyloric stenosis
166
MCC of death 24 hrs after MI in prehospital setting?
Vfib.....fibrillating heart cant do NOTHING
167
Drug class that commonly causes HYPONATREMIA
Thiazides
168
Condition not commonly associated with clubbing?
COPD
169
Management of superficial Thrombophlembitis?
NSAIDs
170
What is elevated in Pagets disease
Alk Phos
171
What to measure in PCOS plus results ?
LH/FSH ratio 2:1
LH Increased
FSH normal/low
Testotsterone Increased
172
1st line tx of BVaginosis
| 2nd line?
Clindamycin
| Metronidazole
173
Major risk factor for Ovarian cancer?
Obesity (increaded BMI)
174
tx choice for adhesive capsulitis (frozen shouder)
Oral presdisone
175
what to do in a case of accidental additional paracetamol dosing? (2)
1. Take blood sample within 30 mins
| 2. Contact poison center for advise
176
initial treatment of complete heart block?
Atropine
177
treatment of choice for complete heart block?
Transcutaneous pacing
178
tx of moderate to severe allergic rhinitis?
Intranasal steroids
179
what would cause syncope, carotid sinus hyper or hypo sensitivity?
hypersensitivity
180
how do you link SVT to diagnosis and tx?
sVt .....A..narrow complex with v upside down
V for vagal maneuver
A for adenosine
181
Unproven risk factors for PUD?
DACa --Diet
Alcohol
Corticosteroids
182
Initial presentation of myocarditis?
Dyspnea
183
When does risk of cardiac arrest increase with hypothermia?
temp <32
184
Frozen shoulder is? what to do?
progressive loss of active and passive ROM of shoulder.
1 st line ....NSAIDS
2nd line..Intra-articular steroids
185
ROSC, check?
Pulse and Pupil
Carotid pulse
Femoral Pulse
Pupils size and reaction to light
186
Goodpasture syndrome. wat organs are involved?
Lungs + Kidneys
187
hallmarks of BCS. hepatic vein thrombosis (Budd-Chiari syndrome [BCS])
Tender hepatomegaly
188
Health risk for obesity?
Waist Hip ratio
189
Heart failure symptoms few days after birth…
hypo-plastic left heart $
190
Heavy drinker + smoker with confusion post surgery, what to check?
ABG
191
Hematuria, inc urea and creatine, arthralgia and foot drop, think?
do?
Vaculitis
| biopsy
192
Hemianopia is due to damage of?
optic tract
193
hoarsness b4 dysphagia, think?
Larynx
194
HOCM is associated with what arrythmias?
Vtach
| VFib
195
How do u detect pheochromocytoma?
24 hr urine cathecolamines and metanephrines
196
how do u determine if it is viral meningitis?
look for monocytes
197
how do u prevent Hyperuricemia in tumor lysis syndrome? (2)
Hydration and allopurinol
198
How do u test for Legionella
The urinary antigen test for Legionella
199
how do you confirm pagets disease?
Punch biopsy
200
How do you know pt has aspergillosis?
positive Galactomannan
201
how long do u give clopidogrel for in STEMI?
4 weeks
202
how long do u give clopidogrel for in NSTEMI?
12 months
203
How long to be on Clopridogrel after MI?
4 weeks
204
How long to keep pt on HRT for?
5 years, then stop
| but continue if osteoporosis
205
How to follow Pt with DKA?
HbA1c
206
How to monitor respiratory function in any neurological disorders that can affect the respiratory muscles (e.g. GBS, myasthenia gravis).
FVC
207
HTN and unilateral renal tenosis, use wat?
| HTN and bilateral renal stenosis, use what?
ACEI or ARBS
| CCB or BB
208
Hx of DVT and Hyterectomy,use wat HRT?
Transdermal estrogen
with hysterectomy no need for progesterone
with DVT, use transdermal
209
Hx of hyperthyroid and AFib, use?
Carbimazole
210
Hx of recent MI, acute abd pain and metabolic acisosis, think?
Mesenteric Iscaemia
211
chronic cough and sputum production is classic symptoms of?
bronchioectsis
212
Anterior dislocation of shoulder damages which nerve?
Axillary "anterior--Axillary"
213
Drug of choice to reduce ICP?
steroids
| Dexa
214
primary phenomenon in aspirin toxicity?
primary respiratory alkalosis
215
HTN in PKD is caused by?
increased activity in Renin angiotensin sytem
216
Vit A def is not seen in?
IBS
217
Ostenecrosis of jaw is commonly seen in?
IV Bisphosphonate. (not oral)
218
Most common presentation of arthritis in SLE?
Symmetric arthritis of hand joints
219
relationship of FSH/LF to testosterone?
LH Increases Testosterone
220
Long term use of SSRI can lead to?
Hyponatremia
221
Hypercalcemia is primarily seen in which Ca
Squamous cell Ca
222
Hypoalbuminemia equals ascites, give what?
spironolactone
223
Hypocellular or Empty fatty bone marrow, think?
Aplastic aneamia
224
Hypochondriasis vs somatization
Hypo believe he has serious illness
| somatization is merely symptoms
225
immediate relief for a pt with depression
ECT
226
Important indication for obstructive jaundice?
ERCP
227
important risk factor for obesity?
waist circumference
228
In essential tremor which medication is better, primidone vs propanolol?
propanolol....less side effects
229
In cough due to bronchitis, expect what?
Productive cough
230
In esophagitis, Alendronate vs Zolendronic acid?
Zolendronic Acid
231
In MM best Investigation
Bone marrow exam
232
In MM, next investigation
X ray
233
In symptomatic bradycardia, wat to do? And if that fails?
Give Atropine
| Then Transcutaneous pacing
234
In which disorder would you find concrete thinking?
Schizophrenia
235
Increased TSH , think also
Pituitary Adenoma
236
Indication for CT in acute pancreatitis?
Evidence of clinical deterioration
or
complications
237
The best initial tests in acute pancreatitis?
amylase and lipase.
238
The most specific test in Acute pancreatitis is?
CT scan.
239
Initial choice of investigation for Hemachromatosis is?
Serum Transferrin Saturation
240
Initial investigation in Myasthenia gravis?
```
Serum Antibodies (anti acetylcholine)
AChR antibody test (most specific test)
```
241
initial investigation of DKA
urine ketones
242
Initial mechanism of hypokalemia in DKA?
K loss due to osmotic diuresis
243
Initial test for SLE?
ANA
244
Initial test of choice for asthma pt?
Siprometry (PFT)
245
Meds of choice to prophylax contacts of meningitis?
Rifampicin (contraindicated in pregnancy, liver disease,alcoholism)
Cipro (avoid in under 12yrs and pregnancy)
246
clean wound cant remember doses of vaccination, give
Toxoid
247
Dirty wound, cant remember or incomplete vaccination, give
IVIG, Toxoid and abx
248
Investigation Acute Leukemia
Bone marrow apiration
249
Investigation for Obstructive sleep Apnea?
Sleep study
250
Investigation of stress incontinence?
Urodynamic studies
251
Iraqi pt with sytolic murmur, Think?
Rheumatic fever
252
Ischemic rest pain vs Muscular cramping
IRP---felt on foot and toes...burning&throbing
| Muscular cramping----calfs
253
Joints involved in OA?
Carpometacarpal joint
254
Joints involved in RA?
MCP
| PIP
255
Key clinical feature of orbital floor fracture?
Diplopia
256
Late dumping u find ?
Hypoglycemia
257
Leukotriene inhibitor use is associated with an increased incidence of which disease?
Churg-Strauss syndrome
258
Long term management of cluster headache is (2)?
CCB
| Lithium
259
Long term management of SLE
Hydrochloroquin
260
Long term use of what medication causes Gynaecomastia?
Cimetidine
261
Low TSH and normal T3?T4 is called what?
| Associated with what?
Subclinical Hyperthroidism
| Afib
262
Main ttt of prolonged itching after scabies……..
steroid
263
Malaria prophylaxis to regions? CDM
Chloroquin .......Central America
Doxycycline.......Thai
Mefloquin.......S America and Africa
Primaquine if allergic to Mefloquine
264
Malignant HTN in pregnancy , use?
Hydralazine
265
Man afraid of prostate cancer but symptomatic 1st 3 steps?
1 st step……….DRE
2 nd step………PSA
3 rd step……..US and biopsy
266
Man afraid of prostate cancer but
| asymptomatic what to do?
reassure even if (+) family history
267
Management of Acute Pulmonary Oedema?
MONa_D
| Morphine O2 Nitrates and Diuretics
268
MC cardiac defect in turners syndrome is?$
Bicuspid aortic valve
then
Coarctation
269
Mc cause of death in hemachromatosis...
Liver
270
MC complication of GERD
esophagitis
271
what increases risk of pseudogout?
hypothyroidism
272
what is the aim of initial treating NSTEMI?
prevent new thrombus from forming?
273
what is the aim of treating STEMI?
Break formed Thrombus
274
Initial Tx of NSTEMI
CAH.....clopidogriel 600mg
Aspirin 300mg
Heparin (therapeutic dose)
275
MC symptom of pagets?
Bone pain
276
botulism binds where? b4?
presynapse
277
long standing GERD, what to do?
scope pt
278
Initial diagnosis of GERD?
24 Hr PH monitoring
279
confirmation of Graves disease, do?
Anti TSH Recepto Ab
280
Elevated BNP is found in what organs?
Heart and Kidney diseases
281
what is the target HBA1C for persons with recurrent hypogylcemic episodes?
<8 (not <7 as with everyone else)
282
first line tx of diabetic Neuropathy
Amitrptyline
283
MCC of anaphylaxis in Australia?
Drugs
284
Pt started on antisychotics, start recurrent fainting what to think?
Long QT syndrome
285
pt with positive screening for pheochromocytoma( serum or urine), what to do next?
CT to localize tumor
| MIBG next
286
which drug most commonly induces hirsutism?
Sodium Valproate
287
Pt with Hypercalcemia, not responding to fluids, what to give?
```
IV Bisphosphonate (ZeePee) not Alendronate which is oral
Zelendronate or pamidronate
```
288
After an episode of MI, a systolic murmur develops, think?
Papillary muscle Dysfunction>>Mitral Regurgitation (NOT RUPTURE)
MR ___MI
289
Most reliable screening test for Hemachromatosis?
Transferrin saturation (serum)
290
pt with glicazide induced hypogycemia was stabilized, what to do next?
iv dextrose for 24-48 hrs
291
tx of acidemia in cardiac arrest?
chest compression
292
How do you assess severity of chronic airway disease in a stable pt
Hx and bedside spirometry
293
How long wouls asplenic pt without other comorbid conditions take abx for?
6 months
294
Pts with leukemia and thrombocytosis are prone to what kind of bleeding? Remeber girl with Leukemia at GPHC
Mucocutaneous
295
when do we use new oral anticoagulants? (2)
1. Non valvular afib
| 2. elective hip and knee surgery prophylaxis
296
Tx of meningitis caused by Listeria Monocytogens
Amp And Gent (always add amp in Listeria)
297
what to check for in hereditary angioedema
c1 and c4 low
298
what to check for in acquired angioedema
c1q low ( q for aQuired)
299
Contraindication to use of Thiazolinedione?
Heart and liver
| Liver is relative contra
300
mode of action of sulphonyureas?
stimulate insulin secretion
301
Pt on levodopa, later develops xs involutary movement, what to do?
Decrease dose of drug
302
what vessel is affected in left lateral meduallary syndrome (wallenberg)
PICA
303
Difference between lateral and medial medullary syndrome?
Medial = medium = preserved Pain and Temperature/facial sensation
304
Drug that does not cause SLE
Nitrofurintoin
305
Mechanism of action of exenatide?
release insulin from pancreas.....glucose dependent
306
What do u find in euthyroid sick syndrome?
everything normal...T3 LOW
307
First step in DKA
Fluids fluids fluids
308
Ptosis and miosis?
Horners syndrome
309
Ptosis and dilated pupil?
3rd cranial nerve....down and out
310
Ptosis and diplopia?
Myasthenia Gravis
311
Adult with pyloric stenosis when does he vomit?
within 1 hour
312
tx of HTN in pheochromocytoma?
Phenoxybenzamine
313
Tx of Salmonella
Cipro or zmax
314
Vit A toxicity leads to hepato or Nephro toxicity?
Hepato......stored in the liver
315
pagets disease most commony affects?
pelvis ppp pagets pelvis palmindronate
316
prognosis of systolic chf
jvp
| s3 (presence or absence
317
Lab Presentation of Legionnaires?
Hyponatremia and deranged liver function
318
Analogue of Niacin?
ISoniazide
| Iso suppresses endogenous niacin and B3 should be given to prevent Pellagra (DDDD) dementia, diarrhea, dermatitis death
319
What condition increases risk of acute renal failure?
Advanced Liver cirrhosis
320
Mnemonic for stroke...Stroke is a TA BEFAST
TX: TA Thrombolytics Antiplatelets
BEFAST: Balance Eye Face Arms Speech Time to call
321
How do u remember exudate fluids?
executives think high of themselves --High levels
| They are toxic -- Acidic fluid
322
Causes of exudative fluids?
Caused by infection and cancer
323
Causes of transudate Fluid
cirrhosis, CHF , Nephrotic, Hypoalbumin
324
mc symptom of addisons disease?
weakness
325
Vertigo and dizziness, think all 4 and distinguish
Mean LGBTnooooo LVBT
Meniere Disease chronic similar to Lab.
Labrynitis --with hearing loss
Vestibular neuritis (post inf similar to BPPV but negative Dix Hallpike test...NO HEARING LOSS)
BPPV- Positive Dix Hallpike
326
Pt presents 3 weeks post MI fever and pericardial rub, what is it?
Tx?
Dresslers syndrome
Aspirin
327
Pt <30 years , positive TB skin test , what to do?
INH for 12 months (chemoprophylaxis with isoniazide for 12 months)
328
Pt with poor response to Levodopa, think?
Parkinson plus syndrome
329
when does pt need OGTT (2)
Fasting blood glucose 5.5 - 6.9
Random glucose 5.5 - 11.0
>7.0 = Diabetes
>11.1= Diabetes
330
First step in diabetic obese patient….
lose weight and diet
331
First step in diabetic thin patient……
metformin
332
Type of carbohydrate……
complex not simple
333
Never give K to DKA patient except
after passing urine
334
First step in DKA…..
normal saline not insulin
335
Most imp inv in DKA……
…ABG
336
Most common complication during ttt of DKA…..
hypoglycemia
337
Most serious complication during ttt of DKA….
.cerebral edema
