March Deck Flashcards
(82 cards)
Treatment for CML
tyrosine kinase inhibitor
Consider if severely elevated WBC
Philadelphia chromosone (9/22)
Who needs prophylaxis treatment for meningococcal meningitis?
Close contacts: ppl >8 hrs w/in 3ft of him or his oral secretions
Medical staff in close contact w/ saliva
How are OCP’s metabolized?
CYP P-450, therefore can be effected by other meds
Ex: anti-seizure meds may induce, therefore decrease OCP effectiveness –> pregnancy
On warfarin but sub-theraputic INR but with new signs of clots.
Management?
Increase Warfarin dose
Heparin to bridge inpt, enoxaparin to bridge outpt
Bronchiectasis sx
Daily cough
Mucopurulent sputum
recurrent pulmonary infections
hemoptesis (2/2 mucosal inflammation)
Functional vs. absolute iron deficiency anemia
F: normal/high ferritin, low Transferrin sat
(CKD, anemia chronic disease)
A: Low ferritin, low transferrin sat
Bicusped aortic valve may be related to ____ further cardiac complication
Aortic dilation
diagnostic test for pneumothorax
Lung US
Clinical signs of Aortic Stenosis
Soft, single heart sounds
delayed and diminished carotid pulse (parvus et tardus)
Loud, late-peaking systolic murmur
Tourette syndrome: Dx and management
multiple motor and at least one verbal tic >1 year (don’t have to be same tic whole time)
Antipsychotic (ideal 2nd gen: risperidone, aripripizol)
Which diuretic should be used in pts with gout?
Losartan (can help lower uric acid)
Most others (hydrochlorothiazide and loops) decrease uric acid excretion, risking gout
Sx ITP
Immune thrombocytopenia
asymptomatic petichia
mucosal bleeding
Preceeding viral illness
Child!
HIV lipodystrophy sx
Wasting of face and limb fat
Buffalo hump, increased abdominal fat
associated with:
abnormal lipid and glucose metabolism –> insulin resistance and dyslipodemia
(2/2 anti-retroviral therapy)
How do you diagnose (suspected active) TB?
3 sputum samples each submitted in 8-12 hr intervals, one must be early morning
- acid fast smear
- mycobacterial culture
- nucleic acid amplification
(bronchoscopy and lavage reserved for pt with clear sx but negative sputum cx)
Skin testing or interferon gamma release assay can’t differentiate active or latent TB, therefore not truly diagnostic
Initial management of Raynaud’s?
Nifedipine, amlodipine, diltiazem
NOT verapamil
How to prevent C diff infection?
Avoid Abx
Avoid gastric acid suppression (alters microbiome, increases risk of C diff proliferation)
Probiotic yogurt doesn’t help
Pleural effusion w/ elevated adenosine deaminase indicates?
TB
Often pt with HIV has disseminated or lobar or pleural TB infection (not cavitary b/c not enough immune response)
management of tinea capitis?
oral terbinafine or oral grisofulvin
Topical won’t penetrate hair follicles well enough
Transient synovitis
Hip pain
Can bear weight (unlike septic arthritis)
Pain w/ internal rotation
Normal CRP and WBC (unlike septic arthritis)
child, usually after virus
2/2 transient inflammation of synovitis
work up upon finding solitary pulmonary nodule on CXR?
chest CT
(not repeat cxr 2-3 mo)
if solitary pulmonary nodule thought to be malignant, then what?
referral to surgery for biopsy or excision
If lesion is centrally located, may be able to use bronchoscopy to obtain tissue for biopsy, but would not solve excision
preferred medication for awake fiberoptic nasotraceal intubation?
ketamine
(want him to be outta it, but still protecting his own airway)
Intubation fails, what is your emergency airway?
Cricothyrotomy
(not tracheostomy which takes longer)
Management of n/v in pregnancy:
First line: B6 and H1 antihistamine
Oral dopamine and seratonine agonist
IV fluids and anti-emetics
Steroids
TPN
