IM Flashcards
(388 cards)
1
Q
Score for afib anticoagulation
A
CHADSVAS if 1 or less ASA, 2 or more blood thinner
CHF
HTN
Age over 75
Diabeetus
Stroke
Vascular disease
Age 64-75
Sex is female
2
Q
Strep pharyingitis treatment
A
Amoxicillin/ PCN
3
Q
Migraine criteria
A
POUND
Pulsitile
One day duration
Unilateral
Nausea
Debilitating
4
Q
Pneumonia criteria for inpatient treatment
A
CURB65
Confusion
Urea >7
RR over 30
BP below 90
65 years or older
5
Q
Typical pneumonia abx first line
A
Amoxicillin
6
Q
Atypical pneumonia first line abx
A
Azithromycin
7
Q
SIRS Criteria
A
Fever
Tachycardia
Tachypnea (or low EtCO)
White count
8
Q
Pleural effusion transudate characteristics
A
less than .5 protein
less than .6 LDH
9
Q
Pleural effusion exudate characteristics
A
more than .5 protein
more than .6 LDH
10
Q
COPD long term oxygen if
A
SpO2 less than 88
PaO2 less than 55
11
Q
Lab value to cue in to infection in ascites
A
Neutrophils over 250
12
Q
Stable angina next step
A
Stress test: EKG, if abnormal ECHO
13
Q
Pharamacologic stress test drug
A
Dypiridamole
14
Q
First line treatment stable angina
A
Nitro
ASA
Beta blockers
15
Q
Indication for CABG
A
Proximal LAD or 3 vessel disease
16
Q
Prinzmetal angina precipitated by
A
acetylcholine
17
Q
Drugs with mortality benefit in MI
A
Aspirin
Beta blockers
ACE inhibitors
18
Q
Post MI pericarditis AKA
A
Dressler syndrome
19
Q
Dressler syndrome (+time frame)
A
Autoimmune pericarditis post MI
2 weeks
20
Q
Dressler syndrome treatment
A
Aspirin
21
Q
Viral pericarditis treatment
A
NSAIDs
22
Q
Restrictive cardiomyopathy causes
A
Hemocrhomatosis
Amyloidosis
Sarcoidosis
23
Q
Restrictive cardiomyopathy presentation
A
Diastolic heart failure w reduced EF
24
Q
Hemochromatosis sx
A
Diabetes, bronze skin, elevated LFTS
25
CHF drugs with mortality benefit
ACE inhibitors
Beta blockers
Spiranolactone
26
Metformin contraindications
Renal disease, CHF
bc lactic acidosis
27
Constrictive pericarditis imaging
Calcifications on XRAY
28
Constrictive pericarditis causes
TB or LUPUS
29
Treatment for constrictive pericarditis
Pericardiectomy
30
Main cause of acute pericarditis
Cocksackievirus
Treat w NSAID
31
Kussmaul sign
JVD worse on inhalation
32
Mitral stenosis causes
Rheumatic
33
Aortic stenosis progresses to
Dilated cardiomyopathy
34
Aortic stenosis sound
Soft S2
35
Tricuspid endocarditis causes
IV drug use or carcinoid syndrome
36
Carcinoid syndrome symptoms
Bronchospasm
Flushing
Diahrreah
R heart murmur
37
Causes of holosystolic murmur
Mitral regurg
Tricuspid regurg
VSD
38
Infective endocarditis empiric treatment
Vanc + aminoglycoside (gentamycin, tobramycin, neomycin, streptomycin)
39
Hypertensive emergency treatment
Hydralazine
Nitroprusside
Labetalol
40
SAH suspected but CT is negative
Lumbar pucture to look for billirubin (xanthochromia)
41
Aortic disection type A treament
Surgery
42
Aortic dissection type B treament
Beta blockers
B B B B B B B B B B
43
Peripheral artery disease diagnosis if
Ankle brachial index
BP ratio less than 0.9
Severe if less than 0.4
44
Peripheral artery disease symptoms
Claudication
45
Peripheral vascular disease treatment (if not severe)
Excercise
46
Peripheral artery disease treatment (severe)
Vascular intervention
47
Acute limb ischemia treatment
Heparin or embolectomy
48
LaRouche syndrome
Clot at aortic bifurcation
Bilateral and buttock leg pain
49
IVC filters placed when
Heparin or warfarin contraindicated or not effective
50
PE suspected first step
Heparin then CT angio
51
LMW contraindicated in
renal disease
52
Medial malleolus ulcer think
Venous insufficiency
53
Cardiogenic shock first treatment
Dobutamine
54
COPD variations
Chronic bronchitis: too much mucous
Emphysema: alveolar destruction
55
Things that decrease COPD mortality
Home oxygen
Quitting smoking
56
COPD stages
FEV1 >80 mild
FEV1 50-80 moderate
FEV1 30-50 severe
FEV1 <30 very severe
57
COPD treatment by severity (outpatient)
Mild: albuterol
Moderate: duoneb
Severe: duoneb + steroids
Very severe: duoneb+ steroids+ home oxygen
58
COPD exacerbation treatment in hospital
NIPPV
steroids
ABX (azithromycin or floroquinolone)
59
COPD w/ pneumonia abx
Cefepime or zosyn
60
COPD w/ pneumonia most common bug
Psedomonas
61
Acute asthma with increased PCO2 next step
intubate
62
Asthma stages
Intermittent: less than 2x a week
Mild: 3-7 a week
Moderate: daily
Severe: more than daily
63
Outpatient asthma treatment by severity
Intermittent: albuterol
Mild: albuterol +low dose steroid
Moderate: albuterol + medium dose steroid
Severe: albuterol + high dose steroid
64
Acute asthma exacerbation tx
Albuterol, IV steroids, Oxygen
65
Bronchiectasis caused by
Recurrent infections
66
Most common cause of bronchiectasis
Cystic fibrosis
67
Cystic fibrosis infection bug by age
Less than 20: staph aureus
More than 20: pseudomonas
68
Pancoast tumor complications
Phrenic nerve palsy
Horner syndrome
Recurrent laryngeal nerve palsy
69
Smoker lung tumor most common location and types
Central
Squamous and small cell
70
Squamous cell carcinoma produces ___ leading to ____
PTHRP
hypercalcemia, hypophosphetemia (low pth)
71
Lambert eaton vs myasthenia gravis
Lambert eaton better with use
Myasthenia worse with use
72
Adenocarcinoma of lung associated with
Non smokers
73
Nodule on chest xray next step
Compare to previous chest Xray
CT if changed or cant find prior xray
74
Interstitial lung disease causes
Asbestosis : also pleural plaques
Beryllium: aircraft workers
Coal: seen in miners, black lung
Silicosis: eggshell calficications, upper lobe
Sarcoidosis: hypercalcemia, elevated ACE
75
Pulmonary hypertension cuttoff
Pulmonary artery pressure >25mmhg
76
Normal lactate
Less than 1
77
Aspiration pnuemonia seen in
Bad gag reflex or mechanical ventilation
78
Aspiration pneumonia treament
Clyndamycin
79
P. jiroveci treatment
Bactrim TMP-SMX
Steroids if PaO2 less than 70
80
P. jiroveci presentation
Fever, non productive cough, interstitial pneumonia
81
Who gets p. jiroveci prophylaxis (with what drug)
CD4 <200
with bactrim
82
Cancer best next step after diagnosis
CT for staging
83
Diverticulosis diagnosis via
barium enema
84
Diverticulitis diagnosed by
CT w/ contrast
85
Acute mesenteric ischemia diagnosed via
Angiogram
86
Mesenteric ischemia symptoms
sudden onset severe pain w normal exam
87
Post op ileus vs ogilvie syndrome
Post-op affects colon and intestine, no bowel sounds
Ogilvie colon only
88
Esophageal varices first line med
Ocreotide
89
Esophageal varices prohylaxis
Beta blockers
90
Cihrrosis with fever, diffuse abd pain think
SBP
Spontaneous bacterial peritonitis
91
Spontaneous bacterial peritonitis diagnosis
Paracentesis w/ neutrophil >250
92
Spontaneous bacterial peritonitis tx
ceftriaxone
93
New liver mass in young female on birh control think
hepatic adenoma
94
When to resect a hepatic adenoma
Greater than 5 cm
95
Hydatid cyst caused by (pathogen)
Echinococcus
Latin america w/ dog contact
96
Hydatid cyst in liver treatment
Mebendazole resection
97
Hydatid cyst imaging
Lots of cysts seen on ultrasound
98
Pyogenic liver absess is a complication of
ascending cholangitis
99
Pyogenic liver absess most common bug
e. Coli
100
Liver absess with fever, RUQ pain, diahrreah think
Entomoeba histolytica
101
Amoebic liver abscess treatment
Metronidazole
102
Physiologic jaundice vs pathologic
Physiologic few days after birth
Pathologic at birth (needs coombs test)
103
Crigler najar due to
Glucoronyl transferase deficiency
104
Gilbert vs crigler najjar
Gilbert only presents when patient is under stress
105
Dubin johnson syndrome pathology
Black liver
Can conjugate but not get rid of billirubin
106
Cholecystitis next best step
U/S
107
if ultrasound is normal with suspected cholecystitis
HIDA scan
108
Diagnosis of cholecystitis w/ U/S requires
2/3:
-Pericolycystic fluid
-Wall thickening
-Gallstones
109
RUQ, fever and jaundice triad
Charcot’s triad for ascending cholangitis
110
Ascending cholangitis tx
IV fluids
IV antibiotics
ERCP
111
Pancreatitis best imaging step
RUQ U/S to look for stone as source
112
Pancreatitis due to gallstone also requires
cholecystectomy to prevent reoccurence
113
Gallstone ileus findings
Air in gallbladder +SBO
114
ICU patient on TPN is predisposed to
Acalculus cholecystitis (no stone)
115
Acalculus cholecystitis treatment
Percutaneous drain
116
Primary sclerosing cholangitis associated with
Ulcerative colitis
117
Primary biliary cholangitis antibody + buzzword symptom
Anti-mitochondrial
ITCHY ITCHY
118
Primary billiary cholangitis treatment
Ersodiol
119
Apendicitis next best step
Surgery if obvious, CT if unsure
120
Carcinoid tumor secretes
Serotonin
121
Carcinoid tumor patients suceptible to ____ deficiency
niacin B3
122
Niacin deficiency sx
Diahreah
Dermatitis
Dementia
123
Carcinoid tumors presentation
BFDR
Bronchospasm
Flushing
Diahrreah
Right heart failure
124
Pancreatic pseudocyst timeline
2-3 weeks post pancretitis
125
Pancreatic pseudocyst steps
Observe if less than 5cm
Drain if more than 5 cm
126
Chronic pancreatitis vs acute
Chronic has calcifications
127
Patient post aorta surgery with GI bleed
aorto-enteric-Fistula
128
Achalasia mechanism
Failure of lower esophageal sphincter to relax
129
Problems swallowing next best step
Barium swallow
130
Most common peptic ulcer causes
H. pylori or NSAIDs
131
GERD/gastritis symptoms next best step
PPI if north american
H. pylori test if third world (urease breath)
If alarm symptoms, endoscopy
132
Older than 50yo microcytic anemia next best step no known bleed
Colonoscopy
133
Colonoscopy screening by age
50yo
unless family hx then 40years or 10 years before family
134
Chron’s characteristics ()
Skip lesions
Oral mucosa
Associated w/ stricture and fistula
Transmural
135
Ulcerative colitis characteristics
Continous lesions
Down to rectum
Mucosal
136
IBD treatment
Sulfasalzine
Steroids if acute
137
Pyoderma gangrenosum
Sterile wound associated with IBD
Treat w steroids
138
New thyroid nodule next step
TSH and ultrasound
139
Euthyroid nodule cancer risk
Euthyroid are malignant
140
U/S of thyroid is cystic think
Cancer
141
Hyperthyroid nodule next step
Radioactive iodine uptake
142
Radioactive iodine takeup is diffuse think
Graves
143
Radioactive iodine takeup single area think
Toxic adenoma
144
Radioactive iodine takeup multiple area think
Nodular toxic goiter aka plummer
145
Euthyroid nodule next step
more than 1cm biopsy
less than 1cm wait for followup
146
Excess estrogen thyroid effect
Estrogen binds thyroid to cause defficiency, hypothyroid patients are affected
147
Thyroid lymphoma associated with
Hashimotos
148
Hyperthyroid patient with painful thyroid and recent infection
Subacute dequervain thyroiditis
149
Dequervain thyroiditis treatment
Aspirin or NSAID
150
Medullary thyroid cancer think of
MEN2a or MEN2B
151
Medullary thyroid cancer next step
Check for MEN2a/b (PHEOCROMOCYTOMA- urine metanephrine)
THEN surgery
152
Diagnose pheochromocytoma via
Urine metanephrines
153
Acromegaly first test
IGF-1
154
SIADH first line treatment
Water restriction
155
Cushing syndrome first step
Overnight dexamethasone or cortisol level
156
Adrenal insufficiency tests (and what they say)
Urine cortisol and ACTH stimulation
If cortisol goes up, pituitary
if stays low then adrenal (adison’s disease)
157
Patient w hypernatremia, hypokalemia and HTN next step
Renin/Aldosterone ratio to see if its due to perfusion or renal issue (high Renin in renal artery stenosis)
158
Renal artery stenosis classic patient
Older patient w/ HTN, refractory to treatment
159
Young female with subauricular bruit, HTN, renal bruit think
Fibromuscular displasia
160
Metformin contraindicated in
CHF and kidney failure
Creat greater than 1.5
161
Metformin effects
Increases insulin sensitivity
Blocks gluconeogenesis
Blocks GI glucose absorption
162
Most common cause of death in DM
MI
163
Most common cause of death in rheumatoid arthritis
MI
164
DKA vs HHS
DKA anion gap metabolic acidosis
HHS much higher BGL
165
DKA treatment
Insulin, IV fluids, Potassium if below 5.2
166
Zollinger ellison tumor secretes
Gastrin
167
Zollinger ellison diagnosis
Gastrin levels over 1000, does not reduce with secretin challenge
168
Zollinger ellison treatment
Surgery or PPI
169
Hyperglycemia w/ rash (necrotizing erythema) think
Glucagonoma
170
Fetus w/ congenital heart block associated with
Lupus
171
Rheumatoid arthritis treatments
NSAID (mild)
Methotrexate (disease modifying
Steroids (flairs)
172
Lupus treatments
NSAID (mild)
Hydroxchloroquine (disease modifying)
Steroids (flairs)
173
Rheumatoid arthritis diagnosis
Proximal joint, worse in morning, spares DIPs
Anti-CCP
174
Female with recurrent miscarriage and thrombosis think
Anti-phospholipid syndrome
175
VDRL elevated in
Syphilis and anti-phospholipid syndrome
176
Gout next step
Arthrocentisis
177
Neg vs pos birefringent joint crystal
Neg gout
Pos pseudogout
178
Patient with gout and CKD treatment
Intraarticular steroids (colchicine and NSAID contraindicated)
179
Symetric weakness with elevated CPK, orbital or hand rash think
Polymyositis
180
Polymyositis associated with
Underlying malignancy
181
Elderly patient with hip and shoulder stiffness, normal CPK, elavated ESR think
Polymyalgia rheumatica
182
Polymyalgia rheumatica treatment
Steroids
183
Polymyalgia rheumatica associated with
Temporal arteritis (elevated ESR)
184
Pain over pressure points, constant think
Fibromyalgia
185
Sudden onset of psoriasis associated with
HIV (test for HIV as next step)
186
WBC casts in urine think
Acute interstitial nephritis
or
Pyelonephritis
187
Uremia manifestations that are indication for dialysis
-Hemolytic uremic syndrome
-Pericarditis
-Platelet dysfunction
-Confusion w/ asterixis
188
2 causes of CKD
HTN or diabetes
189
Acute interstitial nephritis presentation
FEAR
Fever
Eosiniphilia
Azotemia
Rash
Recent medication, hematuria w WBC casts, rash
190
Acute tubular necrosis causes
Hypoxia (hypoperfusion)
Toxins
191
Prerenal azotemia criteria
BUN/Creat ratio more than 20
192
Non-anion gap acidosis causes
Diahrreah (poop out bicarb)
Renal tubular acidosis
193
RTA 1 caused by
Under excretion of H+
stONEs
194
RTA type 2 cause
BI carb pissed out too much
195
Type 4 RTA caused by
Hypoladosterone
Hyponatremia, hyperK,
**Not enough H+ excretion**
196
Metabolic alkalosis next best step
Check urine chloride
(if high then kidneys not reabsorbing it)
(if low then from vomitting)
197
Kidney stone diet
Low salt, low fat, high calcium
198
Elderly smoker with painless hematuria think
Bladder cancer or Renal cell carcinoma (flank pain)
199
Suspect renal cell carcinoma next step
CT abdomen, then surgery
200
Suspect bladder cancer next step
Cystoscopy
201
Young male w painless mass in testicle next step
U/S scrotum
202
Testicular mass cancer suspect next step
Orchiectomy
(dont biopsy b/c seeding)
203
Testicular tortion cremasteric reflex
Gone
204
Epydidimitis features
Tender spermatic cord, improves with testicular elevation
205
Epidydimitis next step
Scrotal U/S
206
Testicular torsion next step
orchiectomy
207
Orchitis/prostatitis causes by age
Young: std
old: e coli
208
orchitis/prostatitis treatment by age
Young: rocephin/azithromycin
Old: florouquinolone
209
Hyponatremia interpretation first step
Look at osmolality
210
Hyponatremia types
Isotonic, hyperosmolar, hyposmolar
211
Hyperosmolar hyponatremia cause
Glucose
212
isotonic or pseudohyponatremia caused by
Protein
213
Hypo osmolar hyponatremia next step
Check volume status
214
Hypervolemic hyponatremia causes
(fluid overload) CHF, nephrosis
215
Isovolemic hyponatremia causes
SIADH and primary polydipsia
216
Hypovolemic hyponatremia causes
Vomit, diarrhea, diuretics
217
Urine sodium tells you what
High: poor concentration
Low: normal kidney
218
SIADH vs polydipsia
SIADH high urine sodium
Polydipsia low urine sodium
219
Hypervolemic hyponatremia urine sodium
High: CKD or AKI
Low: CHF, cirrhosis, nephrotic syndrome
220
Hyponatremia treatment
No symptoms NSS
priority symptoms give hypertonic saline
221
hypervolemic hypernatremia treatment
-free water
222
Blood transfusion hypocalcemia why
Binds to citrate
223
First step in hypocalcemia treatment
IV fluids
224
Treatment of hyperK
Calcium gluconate if abnormal EKG
Insulin/glucose
225
Hypermagnesemia signs
loss of reflexes
226
Hyper mag treatment
Calcium gluconate
227
Parathyroid hormone actions (3)
1) pulls calcium and phos from bones
2) works on kidney to increase calcium absorption, decreased phos reabsorption
3) Calcitriol-D3 in gut
228
High pth net electrolyte effect
Hyper Calcemia
hypophosphatemia
229
primary hyperparathyroidism treatment
Parathyroid-ectomy
230
Hypoparathyrodism net electrolyte
Low calcium
High phos
231
Kidney failure calcium/ phos effects
elevated PTH
Low calcium (cant absorb)
High phosphate (cant excrete)
232
Vitamin d deficiency net effect
Low calcium
Low phos
High PTH
233
anion gap cutoff
16
234
NAGMA causes
RTA or diarrhea
235
Metabolic alkalosis next step
urine chloride
236
Metabolic alkalosis urine chloride interpretation
Low: GI problem
High: Renal problem
237
B12 vs folate deficiency
B12 upper motor neuron problems, increased methymalonic acid
Folate does not
238
Macrocytic anemia without segmented neutrophhils think
alcohol
239
ABO hemolytic reaction treatment
IV fluids
240
Febrile reaction post transfusion due to and prevention
Cytokine release
prevent with leukoreduction
241
Hemolytic reaction 3 days post transfusion next step
its self limiting, no treatment
242
high red cell distribution width think
iron deficiency anemia
243
high mchc think
heriditary spherocytosis
244
beta thalassemia ethnicity, imaging and lab finding
crew cut xray
elevated hemoglobin A2
245
alpha thalassemia ethnicity
asians
microcytic anemia
246
sideroblastic anemia vs hemochromatosis
Sideroblastic: iron leaks, caused by lead
Hemochromatosis: caused by excessive iron absorption, bronze diabetes, elevated LFTs
247
anemia of chronic disease labs
high ferritin
low serum iron
low tibc
248
aplastic crisis vs aplastic anemia
Crisis: low RBCs
Anemia: pancytopenia
249
Aplastic crisis common cause
parvovirus
250
parvovirus causes ____ in fetus
hydrops fetalis
251
autoimmune hemolytic anemia types
Warm vs cold
252
TTP due to
excess von willebrand factor
due to adamst3 (breaks down vwf) deficiency
253
TTP causes increased ____
Platelet adhesion
254
TTP labs
Schistocytes
thrombocytopenia (platelet consumption)
hemolytic anemia
255
Fever, anemia, thrombocytopenia, renal, neuro think
TTP
256
Hemolytic uremic syndrome caused by
EHEC
undercooked beef
257
Heparin induced thrombocytopenia tx
Stop heparin
Start dabigatran, argotraban
258
Von willebrands disease due to
VWF deficiency
259
Reduced ristocetin actitivity think
von willebrand disease
(no coagulation w/ ristocetin)
260
VWF labs
elevated bleeding time and PTT
261
PTT is measure of ____ pathway
intrinsic
262
PT is a measure of ____ pathway
extrinsic
263
Bleeding time is measure of ______
platelet activity
264
clinical signs of VWF
gingival bleeding, mennorhagia, epistaxis
265
VWF treatment
desmopressin
266
DIC vs TTP/HUS
(labs)
also consumes coagulation factors
pt, ptt, bleeding all elevated
lotta bleeding
267
Hypercalcemia treat with
IV fluids
268
spinal cord compression treat with
steroids
269
tumor lysis syndrome treat with
IV fluids
270
hogkin vs non hodkin
Hogkin reed-sternberg owls, clustered
271
lymph node more than 1cm w/ no infection next step
biopsy
272
acute leukemias due to
increased labs
273
chronic labs due to
elevated mature cells
274
auer rods seen in
AML
275
CML vs CLL
myelogenous: elevated basophils
276
CML treatment
Imatanib
tyrosine kinase inhibittor
277
polycythemia next step
check erythropoetin
if low polycythemia vera
if high due to kidney hypoxia
278
Typical pneumonia bugs
strep pneumo
h flu
moraxella
279
atypical pneumonia bugs
mycoplasma
chlamydia
legionella
280
hospital acquired pneumonia bugs
e coli
pseudomonas
s aureus
281
typical vs atypical pneumonia
typical lobar
atypical interstitial
282
aspiration pneumonia imaging
air fluid levels (abscess)
right lower lobe
283
outpatient typical pneumonia abx
amoxicillin
284
outpatient atypical pneumonia abx
azythromycin
285
inpatient pneumonia abx
flouroquinolone
286
aspiration pneumonia abx
clindamycin
287
hospital acquired pneumonia abx
Zosyn (pipercillin-tazobactam)
or cefepime
(pseudomonas coverage)
288
tuberculin test positive by demographic
15mm in healthy
10mm in incarcerated, homeless, healthcare worker, foreign
5mm in HIV or exposure
289
tuberculin positive next step
CXR
290
RIPE tb
Rifampin
izoniazid (with B6)
pyrizinamide
ethambutol
291
TB abx
RIPE 2 months
RI 4 more months
292
negative Cxr but positive tuberculin tx
izoniazid 9 months
293
pyrazinamide major AE
gout
294
ethambutol side effect
E eyes
295
rifampin ae
orange sweat and tears
296
izoniazid ae
neuropathies, hepatitis
297
meningitis by age bugs
under 3 mo: B. strep, ecoli, listeria
3mo-50y: s. pneumo, h flu, neisseria menigitis
50+:
298
menigitis by age tx
under 3 mo: vanc, rocephin, ampicillin
3mo-50y: vanc and rocephin
50+: vanc, rocephin, ampicillin
299
300
CSF findings by meningits bug type (cell type /glucose)
viral: lymphocyte normal glucose
bacterial: neutrophil, low glucose
fungal:, india ink, lymohocytes low glucose
301
tb meningitis imaging
basilar enhancement
302
uti empiric tx
TMP/SMX
nitrofurantoin
floroquinolones
303
uti in pregnant
nitrofurantoin
amoxicillin
cephalosporin
304
complicated uti if
pregnant
male
diabetic
immunosuppressed
305
more than 2 utis per year prophylaxis
TMP SMX or nitrofurantoin
306
HIV c section if
viral load over 1000
307
HIV pjp prophylaxis if (and with what)
if CD4 under 200
with TMP-SMX
308
HIV with colitis, esophagitis, retinitis, bloody diarrea bug
CMV
309
HIV
310
watery diarrhea with HIV think
cryptosporidium
311
cryptococcus meningitis treatment with
amphotericin
312
HIV diarrhea with fever think
MAC
mycobacterium avian complex
313
HIV pt what vaccines
pneumovax
flu
hep b
314
big painful red inguinal nodes think
lymphogranuloma venirium
315
ulcerated inguinal nodes think
granuloma inguinale
316
syphillis progression
primary: painless chancre
secondary: palmar rash, condyloma
tertiary: tabes dorsales, meningitis, granulomas
317
Cellulitis bug
s. pyogenes
318
abscess bug
s aureus
319
necrotizing fasciitis bugs
s pyogenes
clostridium perfringens (gas gangrene)
320
Tetanus with clean wound tx
If 3+ vax, give if last was 10+ years ago
if less than 3 vax give vaccine
321
Tetanus w tetany tx
diazepam
322
dirty wound tetanus shot
if 3+ vax give if last was 5+ year
if less than 3 vax give vaccine and antibody
323
septic arthritis bugs
healthy: s. aureus
sickle cell: salmonella
IV drug user: pseudomonas
324
osteomyelitis bugs
healthy: s. aureus
sickle cell: salmonella
IV drug user: pseudomonas
325
swollen painful joint next step
aspiration
326
lyme disease treatment
8yo+ doxycycline
6yo+ amoxicillin
327
malaria types differentiation
by fever intervals
q72 malariae
q48 vivax/ovale
constant: falciparum
328
malaria treament
methyloquine
+primaquine if vivax/ovale
329
rabies tx
wound irrigation
antibodies
vaccine
330
cat scratch dx bug and tx
bartonella henslea
macrolide or doxycycline
331
invasive aspergillis imaging
hemoptysis with halo sign
tx w amphotericin
332
dimorphic fungi types
HIS : histoplasma
COC: cocciodes
BLASTS: blastomysis
SPORES: sporothrix
333
bats, caves w/ bilateral hilar adenopathy think
histoplasma
334
midwesterner with fungal infection think and purple skin lesions
blastomyces
335
southwest fungal infection think, unilateral hilar adenopathy
cocciodes imitis
336
ascending lymphadenopathy plus thorn think
sporothrix
337
anal worms on child with eggs on tape think (plus tx)
enterobius vermicularis
albendazole
338
t soleum comes from what animal
pork
339
t. sagina animal
beef
340
middle easterner with bladder hemaaturia think
schistosoma (from snail)
341
toxic shock syndrome desquamation via
s aureus exotoxin
342
neutropenic fever treated w and bug
zosyn (pip-tzm)
pseudomonas
343
bloody diarreah next step
stool analysis for WBC
if positive culture
344
c diff next step
c diff toxin
345
acne tx progression
1) benzyl peroxide or topical retinoid
2)topical abx
3) oral abx
4)isotrentinoin/acutane
346
keratocanthoma tx
reassurance
347
seborrheic dermatitis treament
selenium sulfide or azoles
348
middle aged woman with red face think
roscea
tx with metronidazole
349
seborrheic dermatitis asssociated w
HIV and parkinsons
350
contact dermatitis hypersensistivity type
type 4
351
contact dermatitis tx
topical steroids
352
bullous pemphigoid vs pemphigous vulgaris
bullous: no mucosal involvement
vulgaris: mucosal
tx w steroid
353
shingles vax age
60yo
354
tinea capitis tx
oral griseofulvin
355
scabies tx and presentation
blisters in hand creases
permetherin topical tx
wash all shit on high heat
356
work outside with scaly lesion think (plus tx)
actinic keratosis
topical 5-flurouracil
-biopsy bc can become SCC
357
SCC vs basal cell
basal cell: pearly telangectasia (pearly lesion with blood vessels visible)
SCC: atypical
358
cherry red macula think
retinal artery occlusion
359
blood and thunder retina think
retinal vein occlusion
360
ckd w protenuria first line
ACE inhibitor
361
lower tryglycerides with
fibrates
362
to increase HDL
niacin
363
who gets statin
1) ascvd
2) ldl over 190
3) 40-75 yo w diabetes with LDL 70-190
4) ascvd risk in 40-75yo
364
cluster headaches first line
oxygen
also verapamil
365
tension headache tx
tx supportively
366
migraine headache tx and prophylaxis
sumatriptan
prophylaxis w beta blocker or TCA
367
post nasal drip w/ cough tx
antihistamine
368
allergic rhinitis tx
intranasal steroids
369
bloody stoll +fever next step
stool WBC
if elevated culture
370
disc herniation next step
PT
371
disc herniation w neuro symptoms next step
MRI
372
spine mets tx w
opioids and radiation
373
rheumatoid vs osteoarthritis
rheumatoid gets better, osteo gets worse
374
osteoperosis tx
bisphosphonates
375
rock hard eye with nonreactive pupils
acute angle closure glaucoma
376
bacterial conjunctivitis tx
macrolides
377
indications for bari surgery
BMI over 40
BMI. over 35 w comorbidities
378
blepharitis tx
scrubbing with water, compress
379
stress incontinence tx progression
1) kegels
2) pessary
3) urethral sling
380
urge incontinence tx
1) bladder training
2) oxybutinin
381
varanecline AE
suicide
382
dont give to bupriprion
alcoholics or eating disorders
383
colon cancer screen at age
50-75
40/ or ten years before family member dx
384
385
dexa scan age
65
386
AAA screening for
male smoker over 65
387
pneumovax age
60
388
hep a and b vax for (4)
IV drug users
HEP C
gays
chronic liver dx
