Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Internal Medicine > General Medicine > Flashcards

General Medicine Flashcards

(64 cards)

Start Studying
1
Q

AAA screening

A

One time abdominal ultrasound for AAA in men between 65-75 in anybody who has ever smoked (100 cigarettes)

Decreases risk of death by 14% over 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lung cancer screening

A

Annual low dose CT in patients 55-80 with 30-pack-year history, who currently smoke of quit within 15 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pneumococcal vaccine

A

PPSV23 rec for all adults >65yrs of with other risk factors (asthma, DM, cirrhosis, asplenia). Dual vaccination provides best risk reduction.

PVC13 first, PSSV23 6-12 months later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Colonoscopy screening

A

If average risk, colonoscopy every 10 years starting at age 50
OR
Flex sig and fecal occult blood testing every 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Zoster vaccine

A

Recommended for imunocompetent adults >60YO, regardless of history of chickenpox, shingles, or prior vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

STD screening (Chlamydia/Gon, HIV, and HPV)

A

Chlamydia: women under 25YO, men or women with high risk practices
HIV: all persons b/w 13 and 64 yrs
HPV: all women 9-26YO, men 11-21YO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blood pressure targets

A

If 60YO: less than 150mmhg systolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which four groups of people should be on a statin?

A
  1. Known atherosclerotic disease
  2. 10-year risk of developing atherosclerotic disease >7.5%
  3. LDL>190
  4. Diabetes

Tx with high intensity atorvastatin (40mg or 80mg) or rosuvastatin (20mg or 40mg) if

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What antidepressants are associated with weight loss?

A

Buproprion - contraindicated in patients taking MAO-i inhibitors or with seizures, eating disorders, psychiatric illness
Topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is it indicated to get bariatric surgery?

A

BMI >40

or BMI 35-40 with DM, OSA, or joint disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for cocaine-induced chest pain?

A

Calcium channel blockers and benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management algorithm for influenza A?

A

Early antiviral treatment, within 2 days of symptom onset, in hospitalized pts; severe illness; risk factors incl CV dz, CKD, cancer, liver disease, immunosuppression

Oseltamivir or zanamivir- influenza A, B, or unknown

Amantadine and rimantadine - Influenza A only. Widespread resistance, not recommended for community circulating strains.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the Wells Criteria for PE?

A

3 - signs and symptoms of DVT
3 - PE most likely
1.5 - HR >100
1.5 - 3 days immobilization or surgery in past 4 weeks
1.5 - previous PE or DVT
1 - hemoptysis
1 - malignancy, palliative or treated in last 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mallory-Weiss Tear vs Boerhaave syndrome

A

MW: Upper GI mucosal tear, caused by forceful retching, may have submucosal bleeding. Dx by EGD.

Boerhaave: esophageal transmural tear, caused by forceful retching, with esophageal air or fluid leakage into pleura. CT wiht gastrografin confirm dx. Amylase in pleural fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hereditory spherocytosis

A

Autosomal dominant
Lack of spectrin

Tx with oral folate, blood transfusions, splenectomy if refractory

If splenectomy, vaccinate with pneumococcal, hemophilus, and meningococcus, and daily penicillin prophylaxis for 3-5 years, as risk of sepsis present for 30 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pseudogout

A

Acute calcium pyrophosphate crystal arthritis
Most common in knee
Inflammatory (15K-30K cells), with CPPD crystals (rhomboid, positive birefringent)
Chondrocalcinosis or chronic calcification on imaging

Tx glucocorticoid injections, NSAID, colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gout

A

uric acid arthritis
Inflammatory (<50K), crystal (needle-shaped, negatively birefringent), in ankle or toe.

Tx NSAID, colchicine, corticosteoids

Chronic prophylaxis if >2 attacks per year or presence of tophus: with allopurinol (xanthine oxidase inhibitor), febuxostat (XO inhibitor), or probenecid (uricosuric, use in underextreters, risk of stones), decrease intake of meat, alcohol, seafood, avoid diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What therapies can be used for BPH?

A

Alpha1 blockers: doxazosin, tamsulosin

5-alpha reductase inhibitors: finasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Babesiosis

A

Babesia microti, of Ixodes tick
Sc anemia, thrombocytopenia, flu-like sx

Labs show intravascular hemolysis (indirect high bilirubin, high LFT, high LDH, reticulocytosis)

Blood smear shows intracrythrocytic rings (Maltese cross)

Tx 7-10 days atovaquone + azithromycin OR quinine + clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rocky Mountain spotted fever

A

Fever, HA, myalgia, rash that spreads centripetally and includes palms and soles

Most prevalent rickettsial illness in the US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who is treated for hepatitis B?

A

Acute liver failure, cirrhosis, high serum HBV DNA, positive HBeAg and elevated ALT, or to prevent reactivation during chemotherapy/immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are treatments for HBV?

A

Interferon – short term, use in younger compensated patients, not in decompensated cirrhosis

Lamivudine – use in HIV patients

Entecavir – use in decompensated cirrhosis

Tenofovir – potent, low resistance, 1st line tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatemtn for HCV?

A

Pegylated interferon plus ribavirin, +/- telaprevir for genotype 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Statins

A

HMG-CoA reductase inhibitor: reduce conversion of HMG CoA to mevalonic acid, and increase number of LDL receptors

myalgias in 2-10% of patients (symmetrical, proximal) via decreased coqnzyme Q10 synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
G6PD deficiency
molysis after infection or medication (sulfa drugs, antimalarial, nitrofurantoin, TMP-SMX) Lab +Prussian blue stain for hemosiderin Smear Heinz bodies in RBC membrane
26
What metabolic abnormalities are associated with hypothyroidism?
``` Hyperlipidemia Hyponatremia Elevated CK Elevated LFTs Normocytic, normochromic anemia Thyrotoxicosis may cause hypercalcemia ```
27
How do you manage hypothyroidism in pregnancy?
T4 requirements increase 30-50% Increase in first, possibly second trimester, then repeat measurement in 2-4 weeks Estrogen decreases TBG clearance, increasing TBG total, which decreases free T4 and increases TSH
28
What are the two main diseases causing hypothyroidism, and what is the clinical sx of the thyroid gland?
Hashimoto - autoimmune - nontender thyroid | Subacute/lymphocytic - post-viral/post-partum - tender thyroid
29
What are the screening recommendations for type 1 and type 2 diabetes?
Type 1 - fasting lipid panel Type 2 - retinopathy, neuropathy, nephropathy, dyslipidemia
30
DKA is associated with what electrolyte abnormality?
Hyperkalemia, 6-7mEq with treatment (insulin), rapidly develop hypokalemia (4-4.5) due to depleted intracellular K in total body, effective tx should add K to IV fluids
31
DKA is associated with what acid-base status?
High Anion gap metabolic acidosis Increased H, decreased HCO3
32
What are the screening recommendations for osteoporosis?
DEXA for women 65 or older, or younger women with risk factors Risk factors: family history, low BMI, smoking history, steroid use, antiseizure meds Treat if risk of fracture in 10 years is 20%, or 3% risk of hip fracture In men or younger patients, screen for secondary cause (celiac, hypogonadism, malabsorption, hyperPTH, multiple myeloma)
33
What is the definition of osteoporosis?
DEXA < -2.5 or presence of fragility fractures (compression fractures of vertebra, fracture of femoral neck, colles fracture of distal radius)
34
What are the electrolyte imbalances associated with primary adrenal insufficiency?
Hyperkalemia Hyponatremia (loss of aldosterone)
35
Waldenstrom macroglobulinemia
IgM spike smear: rouleaux formation biopsy: >10% clonal plasma cells sx: hyperviscosity, neuropathy, bleeding, hepatosplenomegaly, lymphadenooopathy
36
Multiple Myeloma
osteolytic lesions, anemia, hhypercalcemia, renal insufficiency IgG, IgA, or light cahin spikes smear: rouleaux biopsy: >10% clonal plasma cells
37
Hereditary spherocytosis
Sx hemolytic anemia, jaundice, splenomegaly complication pigment gallstones, aplastic crises with b19 Lab high mean corpuscular hemoglobin, spherocytes on sphere increased osmotic fragility negative Coombs (positive in autoimmune hemolytic anemia) abnl eosin-5-maleimide tx folic acid, transfusion, splenectomy
38
What are dietary, medical and surgical therapy options for kidney stones?
Diet: low protein diet, increase dietary calcium, low oxalate diet If stone <5mm, fluids >2L/day for conservative management ``` Alpha blocker (tamsulosin) Calcium channel blocker (nifedipine) For stones less than 10mm with sx controlled ``` Extracorporeal shock wave lithotripsy is widely used, noninvasive, tx proximal ureter or intra-renal stones
39
What are the guidelines for treating anemia in CKD?
Initiate EPO in CKD patients with hemoglobin <10 | Target hemoglobin 10-11
40
What are the screening guidelines for CKD?
In patients with T1D: yearly urine albumin-creatinine after 5 years of T1D In patients with T2D: yearly urine albumin-Cr at time of diagnosis In patients with FHx only: serum Cr, estimated GFR, UA Diagnosis requires elevated Al-Cr ratio on 2 or 3 random samples over 6 months
41
How do thiazide diuretics interact with calcium and uric acid?
(Recall: thiazides inhibit reabsorption of sodium (Na+) and chloride (Cl−) ions from the distal convoluted tubules in the kidneys ) Decrease uric acid excretion, causing hyperuricemia and may potentiate gout Lower urinary calcium excretion, making them useful in preventing calcium-containing kidney stones
42
Obesity hypoventilation yndrome
BMI>30, awake hypercapnia Restrictive PFTs, chronic respiratory acidosis Phys: alveolar hypoventilation Tx with NPPV, weight loss
43
What are the extrahepatic manifestations of chronic hepatitis C?
Essential mixed cryoglobulinemia Membranoproliferative GN Porphyria cutanea tarda or lichen planus Increased risk of diabetes
44
Neutropenic fever
ANC <1500 Usually pseudomonas or GNOs Tx with antipsueodomonal beta-lactam: cefepime, meropenem, piperacillin-tazobactam (
45
AIN
Caused by penicillin, TMP-SMX, cephalosporin, NSAIDs maculopapular rash, fever, AKI urinary eosinophils
46
What is the treatment for syphilis? What about in a penicillin allergic patient?
Primary or secondary: Penicillin IM x1 or Doxycycline PO x 14 days If latent: penicillin IMx3 or doxy x28 days If tertiary: Penicillin IV x 14 days or ceftriaxone x 14 days If penicillin allergic: if early syphilis, choose doxy. If CNS or pregnancy, go with penicillin desensitization.
47
How do you manage hypercalcemia?
If symptomatic or calcium >14: Short term: NS, avoid loop diuretics (volume depletion Long term: bisphosphonate If moderate or asymptomatic: Avoid thiazide, lithium, volume depletion, and bed rest
48
What do you treat Bell's palsy with?
Prednisone PO
49
How do you manage hypertension in ischemic stroke?
Maintain BP of less than 220/120
50
When do you admit a TIA patient to the hospital?
``` Age >60 =1 BP >140/90 =1 Hemiparesis=2 Duration 60min=2 Diabetes=1 ``` If score is 3 or greater, admit to hospital
51
What is conservative, nonmedical management for essential tremor?
Increase sleep, decrease caffeine
52
When do you treat gout prophylactically?
>2 attacks in 1 year = recurrent Start colchicine (antiinflammatory) and allopurinol or febuxostat (urate-lowering)
53
What is acanthosis nicgracans associated with?
Younger individuals, in groin/axilla/neck: insulin resistance or diabetes or PCOS older individuals, in uncommon areas, or with weight loss: GI and GU cancer
54
What is pyoderma gangrenosum associated with?
Inflammatory bowel disease
55
What are the derm manifestations of Hep C?
Porphyria cutanea tarda | Curaneous leukocytoclastic vasculitis (palpable purpura) 2/2 cryoglobulinemia
56
Dermatitis herpetiformis is associated with what?
Celiac disease
57
What skin manifestations are asssociated with HIV?
Sudden onset severe psoriasis | Disseminated molluscum contagiosum
58
Squamous cell carcinoma
Keratinized nodules with rough surface, thickened, ulcerated, crusting, bleeding. Most common malignancy of lip May have early perineural invasion leading to numbness and paesthesia Biopsy shows keratin pearls
59
Basal cell carcinoma
Pearly, flesh-pink nodule, with telangiectasia, on head or neck May also have open sore that bleeds or crusts, central ulceration
60
Pemphigus vulgaris
Flaccid bullae, mucosal erosions Path: intraepidermal cleavage, acantholysis, intercellular IgG
61
Bullous penphigoid
Pruritic bullae, tense Path: subepidermal cleavage, IgG at basement membrane
62
Sebhorrheic keratosis
"stuck on" benign epidermal tumor; tan or brown, well-demarcated border tx not usually required
63
Seborrheic dermatitis
Fine, yellow, greasy-looking scales Associated with Parkinsons and HIV Topical ketoconazole/selenium sulfide
64
Iron deficiency vs chronic disease iron labs
Iron deficiency: low iron, high TIBC, low ferritin, high RDW Chronic disease: low iron, low TIBC, high ferritin, normal RDW If mixed, will have low iron but may have normal TIBC/trasferrin and normal ferritin

Internal Medicine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions