medicine questions Flashcards
(347 cards)
1
Q
G6pd
A
Bite cells, low haptoglobin
2
Q
Nitrous oxide
A
B12 Def, Megaloblasit anemia
3
Q
AERD
A
Asthma, nasal polyps, NSAIDs sensitivity,
4
Q
Hypothyrodism and adrenal insufficiency
A
Hypothyroid can mask adrenal insuff start steroids with levothyroxine
5
Q
GLP-1 eventide side effect
A
pancreatitis
6
Q
Factor V Leiden
A
MC hypercoagulible in caucasians; AD
7
Q
Kausmall Sign
A
increase in JVD on inspiration; Constrictive pericarditis
8
Q
Good Pasture
A
anti GBM, type IV collagen, glomerulonephritis and pulmonary hemorrhage
9
Q
PSA when to stop
A
70yo and > don’t order
10
Q
Food allergy
A
Oral challange a gold standard
11
Q
HSP (Henoch…)
A
Abdominal pain, Rash, glomerulonephritis
12
Q
Warfarin
A
epoxide reductase inhibitor, 2 7 9 10
13
Q
Tacrolimus and electrolytes
A
Hyper K, Hypo Mg and P04
14
Q
Peutz Jegher Syndrome
A
abd pain, pigmentation eyes/lips, pigmented polyps, risk for colon cancer
15
Q
ITP
A
auto antibodies to anti_GpIIb/IIIa
16
Q
ttp
A
ADAMTS13
17
Q
HUS
A
Microangiopathic hemolytic anemia; don’t use antibiotics, don’t give platelets
18
Q
CRAO
A
MC from carotid artery emboli, cherry red spot
19
Q
Pulmonary Histoplasmosis dx
A
Urine histoplasma antigen
20
Q
Strep Viridens
A
Dental procedure endocarditis
21
Q
ASD
A
when progressed to left to right shunt; first treat pulmonary hypertension prior to surgery
22
Q
Aortic regurgitation and pulses
A
Bounding pulses
23
Q
AS and pulse
A
Parvus a Tardus: low amplitude carotid pulse
24
Q
+ PPD
A
Rifampin for 4 months preferred
25
Mild arthritis knee tx
topical steroids
26
Hepatic abscess after procedure what bacteria
Staph Aureus
27
APKD also associated with
diverticular disease and perforation
28
DM type 1, what else to screen for
Autoimmune thyroditis
29
OCP don't use if
smoker>35 yo, HTN >160/100
30
Leser Trelot syndrome
Rapidly appearing seborrheic keratosis: look for cancer: : GI or lymphoid
31
SAH (hemorrhage) ; dx
CT first if still suspects LP
32
Staghor calculus bug
proteus mirabalis
33
IBS
Rome criteria for diagnosis
34
GPA is the same as
Wegners; c Anca
35
Omalizumab
For severe refractory asthma/decreases IgE
36
Drug induced lupus antibody
Anti histone antibody
37
Uremic pericarditis and EKG
ST elevations may not be there
38
Prinzmetal angina tx
Calcium channel blocker
39
Pityriasis Rosea presentation
Harold patch, then rash Christmas tree, KOH prep
40
IgA nephropathy
Hematuria and upper respiratory infection
41
Relapsing Hep A
within 6 months, acute illness 2-6 wks post
42
tumor lysis syndrome tx
IV fluids and allopurinol
43
Polymyalgia Reumatica a/w
Giant cell arteritis
44
IgA deff and blood
severe reaction to blood transfusion
45
babesiosis Tx
Clinda and quinine
46
HCTZ mechanism of action/stones
Na/Cl cotrasporter; convoluted distal tubule, helps with Ca+ stone
47
Protein c and s def risk for
warfarin induced skin necrosis
48
Cryptococcal meningitis tx
Amphothericin B
49
AS gradient and LV function
Severe LV dysfunction may underestimate AS gradient
50
Acute AR don't use what meds
B blocker, Intraaortic balloon pump
51
Chancroid
H Ducrey; painfull !!!, tx: azithromycin, ceftriaxone
52
LGV
Painless ulcer, few weeks later LAN, tx: Doxy, inclusion bodies, tx partners for past 60 days
53
Syphillis
Painless ulcer. Chancre, Later 2nd Syphillis: fevers/myalgias, rash trunk and extremities
54
Leukemoid reaction
wbc>50 000, smear: left shift, bands, metamyelocytes, myelocytes
55
Perimembraneous VSD
The only that causes diastolic murmur; may lead to AR, aortic valve caps gets pulled to VSD
56
Losartan and uric acid level
Losartan reduces uric acid levels
57
Severe oral candidiitis
IV flucanazole
58
Fungal sinusitis
Dematiacus Fungi
59
Interferon Alpha (tx for bladder ca) when using what to check for
unmasks autoimmune disease; check TSH
60
Cushings diagnosis
1)DSt overnight 1mg. 2)late night salivary cortisol 3)24 hour urine cortisol
61
Corticosteroids for meningitis: benefits?
Reduce hearing loss, likely survival benefit
62
Apixiban/Rivaroxaban reversal agent
Andexanet; factor Xa
63
Dabigatran reversal agent
Idarucizumab
64
Dengue
Break bone fever, severe joint pain, --> may progress to Dengue hemorrhagic fever
65
Organophosphates poisoning/ presentation
cholinergic: salivation, urination, lacrimation
66
Tick paralysis/Lambert Eaton pathophys
inhibition of pre synaptic Ca+ channels
67
Sarcoid hypercalcemia pathophysiology
increased activity of 1-alpha hydroxyls activity
68
Porphyria Cutanea Tarda
bulla formation on sun exposed skin, milia small white papule, linked to hep B, hep C
69
Pituitary hypoplexy what to start first
steroids
70
Polycythemia vera tx
Hydroxyurea
71
Autoimmune pancreatitis
IGg-4, salivary glands, dry mouth
72
Altitude sickness; ABG?
Ph up; PC02 down, 02 down, bicarb down
73
Type I reaction
IgE mediated; anaphylaxis, allergies
74
Type II reaction
IGg, IgM, Good pastures, autoimmune hemolytic anemia
75
Type III reaction
immune complexes: PSGN, lupus nephritis, serum sickness
76
Type IV reaction
PPD, contact dermatitis, poison Ivy
77
Cowdens Syndrome
Trichelemmomas, hamartomas, polyps GI, fibrotic breast disease, breast and thyroid cancer
78
Polymyocytis and CPK
Greatly elevated CPK
79
Inclusion body myosytis
Assymetric and distal involvement, grip affected
80
Achalasia
dysphagia to both solids and liquids, regurgitation of undigested food
81
Chagas Disease tx
parasite: Trypanozoma Cruzi; tx: benznidasole, nifurtimox
82
ASD
fixed split s2
83
Early signs of hypoglycemia may be masked by
B blockers
84
Apthous Ulcer; seen with? tx:
IBD, Behcets, HIV, Celian
85
Adrenal Crisis tx
IV hydrocortisone
86
Hypocalcemia and reflexes
Hyperreflexia
87
Myotonic macular dystrophy
MC cause of mascular dystrophy in adults, can't release hand shake
88
Restless leg syndrome; 2nd causes
DM, hypothyrodism
89
Methemoglobinemia causes
dapsone, topical anaesthetic, lidocaine
90
Dermatomyocytis tx
Gottrons papule, tx: steroids + azathioprine or methotrexate
91
Polycythemia Vera: what to order if suspected
EPO and JAK 2
92
Arsenic Poisoning
Well water; white lines on patients nails, leukonychiai
93
Folate can correct B12 def; but what about physical exam
Neurologic symptoms don't go away
94
Erythema nodosum: MC causes, when to bx
Strep MC (check antistreptolysin), if TB prevalent bx may be diagnostic of TB
95
Anti-U1 RNP antibodies? what disease
Mixed connective tissue disease
96
Anti Jo-1 antibody ?
ILD in dermatomyocytis and polymyositis
97
Sensitivity
Few false negative; positive test and has disease/all patients
98
Specificity
Few false positives; Negative test and no disease/all patients
99
Vitiligo: treatment for mild disease
topical steroids
100
Sweet syndrome
febrile neutrophilic dermatosis; strong association with leukemia
101
Meralgia Parasthetica
Numbness along outer thigh, lateral femoral cutaneous nerve, tight belt/obesity
102
Prasugrel; don't give to
prior CVA, TIA (plavix preferred)
103
Iga vasculitis another name
HSP
104
PNH
Thrombosis abd veins; Coombs negative, tx: eculizimab
105
Dronaderone don't use in
NYHA 3, NYHA 4
106
Nitrofurantoin don't use in
advanced CKD
107
Pregnancy and thyroid
any hypothyroid treat; usually in pregancy: TSH goes down and t3 t4 up
108
Most specific for RA
CCP
109
RTA type I
Distal; not absorbing bicarbonate, Sjogrens, Glue sniffing
110
Tamponad and pressures on swan ganz
High RA pressure and equalization of pressures; RA, PA and wedge pressure.
111
Anxiety least side effects tx
SSRI, SNRI, and buspirone
112
Hypocalcemia and reflexes
HYPERreflexia
113
Sotalol
Negative inotrope; don't give if EF<35%; prolonged QT
114
Ehrlichisis; causes, and tx
E chaffeensis, Amblyomma Americanum; tx; doxycyclin
115
Acute Eosoniphilic pneumonia; tx
Steroids, (can be caused by cocaine)
116
Eosinophilic Esophagitis tx
PPI first line then topical steroids
117
Hemmorhagic shock tx:
1) whole blood, 2)LR 3)NS
118
Lemierris syndrome
Jugular vein thrombophlebitis, Fusobaterium Necrophorum, septic emboli to the lung--> abscess/cavitaiton lung
119
Poison Ivy
severe rash tx with oral steroids 14-21 days
120
Nitroprusside can cause what toxicity
Cyanide toxicity: tx: sodium nitrate, sodium thiosulfate
121
Split s2
RBBB
122
Paradoxical S2
AS, LBBB
123
SCC charasteristics
ulcerated, irregular, crusted over
124
Differentiate Celiac disease from Whipple
Both villous atrophy; lymphocytic infiltration of lamina proper in Whipple
125
Cowdens syndrome
hamartomas
126
Trousseau Syndrome
Migratory superficial thrombophlebitis
127
Macular degeneration
Central vision loss
128
H pylori; after tx confirm irradication, when
4 weeks post treatment; urea breath test or stool antigen
129
Galcanezumab
Prophylaxis for cluster headache
130
Recent MI dont use
Amytriptiline
131
Acyclovir and renal failure
Crystal induced AKI stones
132
Exercise
Decreases systemic vascular resistance
133
Fbn1 mutation
Marfans syndrome
134
PNH diagnosis
Flow cytometry
135
Steroids induced acne
No comedos
136
E coli 0157
NO antibiotics, supportive care
137
Sweet syndrome
Neutrophilia, fever, painful erythematous plaques
138
Dyspepsia
First test for H pylori and tx if positive, (not trial of ppi)
139
Scromboid
histamine release, minutes after eating
140
Ciguatera toxin
reef fish, perioral parasthesias, hot cold sensation, hours after eating
141
Tetrodotoxin
puffer fish; minutes after eating, weakness, ascending paralysis, SOB
142
Amoebic colitis
Flask shaped ulcers
143
Celiac sprue; what they need to supplament
Vid d
144
Post bariatric surgery long term complications
def in: Vit D, B12, copper, iron
145
Infective endocarditis; how to establish diagnosis
blood cultures
146
Contact lens conjuctivitis
pseudomonas
147
Treatment of metabolic syndrome
Use fibrates
148
Disseminated gonncocal infection, tx
IV ceftriaxone
149
Oral mucosa burns: what illicit drug?
Meth
150
Nitrofurantoin side effect
Pulmonary fibrosis
151
Thiamine def: besides ETOH ?
TPN
152
B blockers
Increase systemic vascular resistance
153
What drugs elevate glucose
Olanzapine, statin, steroids, bb, hctz
154
PE; PFTs
Only decreased DLCO
155
Ankylosing spondylitis
hla27; unilateral anterior uveitis
156
Anterior Uveitis cuses
Ankylosing spondylitis, Reactive arthritis, Sarcoid
157
Coronary Microvascular disease
Female, reversible defect but clean coronaries; ranalozine helps with angina
158
Causes of uveitis
Bescets, Reiters Syndrome, ankylosing spndylitis
159
Pituitary Hyperplasia
Primary hypothyroidism not treated for a long time (presents like pituitary adenoma)
160
Statins and A1c
Can increase HA1c
161
Hypothyroidism and lipids
Elevates lipid levels
162
Exanatide
Cant be used as monotherapy
163
Colestipol
reduces LDL, used with statin, interupts bile acid reabsorption
164
Ezetimibe
as adjunct to statin
165
Thyroglobulin level decreased causes
Exogenous thyroid, thyroidectomy, radioactive iodine ablation
166
Sideroblastic anemia can be caused by what medications
INH, linezolid, chloramphenical
167
Primary Biliary Cirrhosis tx;
Ursodeoxycolic acid
168
Pyrodixine is tx for what:
Sideroblastic anemia from INH resulting in B6 def
169
Pressure ulcer not healing
May convert to malignant; not healing ulcer; induration
170
Tumor lysis syndrome
Besides: allopurinol and IV hydration; rasburicase and febuxostat can also be used
171
cannon a waves
3rd degree av block, pulmonary htn, VT
172
Inferior wall infarct
Acute mitral regurgitation from papillary muscle rupture
173
Rapid onset of nausea/vomiting after ingestion of food; what bugs
B Cereus, Staph Aureus
174
If using Ca channel blockers in heart failure; which ones
Amledopine and felodipine
175
Inappropriate sinus tachycardia; tx
BB or CCB
176
Radiation therapy fo prostate cancer, side effects profile
Lowest risk for ED and urinary incontinence up to 5 years
177
Pleaural fluid with >80% of lymphocytes; etiologies
TB, Chylothorax, lymphoma, RA, Sarcoid, trapped lung
178
HUS; what is the treatment
Supportive, no antibiotics, no platelets
179
Barrets can lead to what cancer
adenocarcinoma (vs etho smoking risk factor for squamous cell carcinoma)
180
Carcinoid is associated with ?
Vitiligo
181
Prolong use of metranidazole side effect
peripheral neuropathy
182
Sulfasalazine: not effective in?
Small bowel disease, (broken in the colon into active metabolites)
183
String sign
Narrowing of the distal ileum from Crohns (everywhere else called apple core -> Ca)
184
UC
P anca, arthtitis, ankylosing spondylitis, uveitis, Erythema nodosum, Primary sclerosing cholangitis
185
Sarcoid and vit d
elevation of 1,25 (OH) D3
186
IV fomepizole for treatment of what?
Ethylene glycol and methyl alcohol
187
AERD
pseudo allergic reaction, polyps
188
Graves Orbitopathy ; what can make it worse
Radioiodine therapy makes it worse; if chosen for treatment use steroids; Radioiodine should not be used in severe orbitopathy.
189
When using methotrexate; what else to prescribe
Folic acid
190
Hydrochychloroquine: what needs to be monitored
Retinal exam; at baseline and every 5 years
191
Diverticulosis is painless
True
192
Dronedarone; should be avoided in patient with ?
EF<35 % avoid it
193
Cocaine induced chest pain: tx
1)Benzo 2)Nitrate 3) ASA, and to prevent chest pain in the future CCB
194
Only gastric varices
Splenic vein thrombosis. (ex: chronic pancreatitis)
195
HD can rarely lead to what?
Hemolysis and hyperkalemia
196
Methimazole
Don't use during pregnancy
197
PTU
Aplastic anemia, agranulocytosis, hepatotoxic
198
Ziel-Nielsen stain
same as acid fast stain
199
Arteriol Clots
antiphospholipid antibodies: lupus anticoagulant, anticardiolipin, also in HIT
200
Inhalation Anthrax
Hemorrhagic mediastanitis. CXR with wide mediastinum, tx: Cipro IV + clindamycin
201
IBD screen
best fecal Calprotectin
202
UC
smoking makes it better, crypt abscesses
203
Crohns
ASCA, granulomas on bx, Ca oxalate stones, perianal fistula
204
Listeriasis
Soft Cheese
205
Whipple disease
Arthritis, weight loss, neurologic symptoms, hyperpigmentation
206
Celiac sprue
Bullous skin disease, dermatitis herpetiformis, Howell jolly bodies
207
Howell jolly bodies
asplenia or spleen dysfunction, (blue dot inside RBC), Celiac, MDS, Megaloblastic anemia, radiation, hemolytic anemia, spherocytosis
208
Tropical sprue
Megaloblastic anemia
209
#1 cancer risk in Lupus
NHL
210
After diagnosis of DM or PM what to do next
ILD screening (chest xray, pfts, CT), cancer screening
211
Daptomycin
Don't use for pneumonia
212
Post herpetic neuralgia
desipramine or gabapentin
213
Isolated reduction in DLCO
PE, Anemia, PAH
214
Dexa who gets it
Women over 65 yo
215
Quinidine: side effect
class 1 antiarrythmic, can cause drug induced hemolytic anemia
216
Leptospirosis
Markedly elevated T bili when compared to AST, ALT
217
Tularemia
Ulcers and glands; hunting, tx: streptomycin 7-10 days
218
Ring enhancing lesion in the brain causes:
abscess, toxoplasmosis, lymphoma
219
Brucella associated with
cryoglobulin +, endocarditis with negative cultures
220
Macroadenoma and pregnancy
formal visual field testing every trimester
221
HIV patient what statin not to use
simvastatin (increase level of HIV meds)
222
Venous ulcer tx
compression stocking and leg elevation
223
LAM
spontaneous PTX, interstitial marking, chylothorax (chylothorax also in lymphoma)
224
Acute AR: what meds to avoid
b blocker or intraaortic balloon pump
225
MS and atrial fibrillation
start anticoagulation CHADs don't matter
226
Cataract
Loss of red feflex
227
Atrial Myxoma asucultation
May mimics mitral stenosis
228
Cilostazol; for PAD, don't use...
with heart failure with low EF
229
Metastatic tumors to the heart
Melanoma, malignant thymoma, germ cell tumors
230
Psoriasis
Don't treat with systemic steroids
231
Extensive seborrheic dermatitis aw
HIV
232
Pregnancy and resistence
Decreased peripheral and systemic resistance
233
Ramsey Hunt syndrome
VZV, vesicles in the ear, diminished taste anterior 2/3 of the tongue, ipsilateral facial paralysis
234
Keratoacanthoma
Form of SCC, looks like a volcano
235
Acral lentigenous Melanoma
dark skin patients, feet/hands
236
Utricaria: wheals around the mouth
Monitor for airway compromise
237
Jarish Herxheimer
Atibiotics for syphillis/lyme can precipitate it; dying spirochete releasing toxin, Tx: supportive, continue antibiotics
238
Celiac dz associated with
Dermatitis herpitiformis(Iga deposits)
239
Porphyria cutnae tarda
aw, hep c, vesicles and bullae on sun exposed areas
240
Dermatitis Herpetiformis tx:
Always with gluten free diet, may add dapsone(though check for G6PD def)
241
Dengue
south east Asia, rtetroorbital pain, maylgia, arthralgia, and rash, low platelets, leukopenia, elevated liver enzymes
242
Alpha 1 antitrypsin what is the location of emphysema
Lower lobes
243
If pheochromocytoma suspected/diagnosed what else to do
further imaging: MIGA scan or Valium-68 DATATATe to locate other possible regions
244
Coarctation of the aorta; what else to screen for?
10% have berry aneurysms; cranial imaging would be indicated
245
CO poisoning aw ?
Acute myocardial injury
246
Alzheiemers disease
APOE 4 on chromosome 19
247
Tyramine hypertensive crisis
tyramine rich foods(meats, cheese) + MAO inhibitor: ex: Phenelzine
248
Phenylephrine for seasonal allergies can lead to
urinary retention (alpha agonist; opposite of alpha blocker)
249
OA why falls happen?
Impaired postural stability from partial weight bearing
250
Migraine with Aura what med not to use
OCPs
251
PCOS with acne what med could be could here for acne
Aldactone:
252
Sjogrens and thyroid
HYPOthyrodism
253
Osteoporosis and thyroid
HYPERthyrodism is a risk factor not Hypo
254
WPW aw what heart defect
Ebstein anonomoly(tricuspid regurgitation, nakedly enlarged right atrium)
255
PDA and prophylaxis for dental procedures
Yes
256
Triptans avoid in
CAD, vasculitis
257
Labetolol side effect
throat burning, scalp tingling
258
PDA
left to right flow---> pulmonary hypertension, infection can occur and lead to septic emboli in the lungs!!!!
259
Melanosis Coli
Factitious diarrhea due to laxative abuse
260
Gold standard to r/o asthma
Methacoline challange
261
Gardners syndrome?
FAP with extra colonic manifestations, cutaneous cyst/epidermoid cysts, dental issues, Desmoid tumors, malignancies: thyroid, liver, CNS
262
Melanoma
s-100 cells, BRAF gene mutation
263
Basal cell carcinoma
basophilic palisading cells
264
#1 cause of occupational asthma
Latex
265
Icosapent ethyl (purified fish oil)
add for high TB in heart failure...... (not vibrate)
266
celiac disease bx
increased intraepithelial lymphocytes, crypt hyperplasia
267
Nummular eczema
coin lesions, extremities, very itchy,
268
Hgba1c falsely low in ...?
hemolytic anemia, renal failure, eco administration
269
Metformin aw? besides GI, lactic acidosis
Vit B12 def
270
Acne Rosacea tx;
topical metronidazole vs topical sulfacetamide
271
pubic lice tx:
topical permethrin
272
Statins teratogenic?
yes
273
Ezetimibe se
hepatotoxicity
274
Niacin se
acanthuses nigricans
275
Fibrates se
cholelithiasis and myopathy
276
Celiac if suspecting what to order
TTG antibodies and IGa level (IgA def will make TTG negative)
277
Lofflers Endocarditis
Eosinophilia---> restrictive cardiomyopathy
| long term untreated eosinophilia from intestinal worms/parasites as ex
278
Hypoparathyrodism
MC from surgical injury; low Ca, Low PTH, increased Ca extortion(lack of PTH activity on distal renal tubules)
279
Cardiac Contusion may lead to
Ventricular pseudoaneurysm
280
AERD and desensitization
To maintain desentisisation must use minimum 325 mg asa
281
Kartegener Syndrome
AR, impaired ciliary clearance, sinusitis, bronchiectasis, sinus inverses totalis, inversion of thoracic and abdominal organs
282
IE prophylaxis for GU/GI procudures?????
Not recommended
283
Diverticular bleed
band ligation high rate of hemostasis
284
Amiodarone and the eye
Corneal micro deposits
285
Bladder cancer risk
smoking, stones, schistosome, Not NSAIDs(may be protective)
286
Methemoglobenemia: and Pa02
normal Pa02 (after use of anesthetic: benzocaine)
287
Carbon Monoxide poisoning:
normal Pa02
288
Aortic Stenosis
delayed carotid upstroke
289
Lichen Planus
Associated with hep C, 6 ps,
290
Strep Bovis same as
Strep Gallolyticus
291
After balloon angioplasty; delay elective sx for ??
14 days at least
292
Sheehans syndrome
Post partum pituitary necrosis
293
Melfloquine and EKG:
sinus Brady and prolonged QT interval
294
Clostridium septicum and cancer
Colon cancer, relapse of leukemia
295
Sjogren's, Diagnosis:
Lip bx
296
Glaucoma
Enlarged cup to disk ratio
297
Pt on methimazole of PTU; presents with fevers/sore throat: diagnosis:
Agranulocytosis
298
Decreased levothyroxine absorption with these drugs:
ppi, iron, calcium, celiac disease
299
pt treated for non seminoma; later can present with
teratoma
300
COPD vs asthma DLCO
DLCO decreased in COPD; normal or increased in ASTHMA
301
Alveolar hemorrhage and PFTS
Increased DLCO >140%
302
LOW TLC and normal DLCO?
Extra pulmonic source of restriction: ex: pleural effusion, NM problem, kyphosis, pleural thickening
303
Normal DLCO examples
Asthma, CO poisoning
304
Hepersensitivity pneumonitis--> eos and IgE
Eosinophils and IgE are NORMAL
305
Dexamethasone and cortisol level
Dexa does not interfere with cortisol level
306
Pheochromocytoma aw?
MEN 2, Hippel Lindau dz, Neurofibromatosis type 1
307
CKD which medications slows progression
Sodium bicarbonate, ace/arb, SGLT -2
308
Thiazide diuretics also good for
kidney stones; Ca oxalate stones
309
Berryliosis looks like
Sarcoidosis
310
Pleural fluid for TB
Increased ADA
311
High osmolar GAP, but normal Anion gap
Isopropyl ETOH
312
High osmolar GAP and high Anion gap
Ethyolene glycol, Methanol
313
Cyonide poisoning antidote?
Hydroxycobalamin first line, then: Sodium nitrate, sodium thiosulfate
314
Pt with stemi; no Cath lab; gets asa, b blocker, thrombolysis; what other med you add
Plavix
315
Milrinone vs dobutamine
can’t use Milrinone with AKI
316
Eosonophilic esophagitis:
mc presentation food impaction; rings, >15 eosinophils, tx: first pip 8 weeks then inhaled steroids swallowed
317
Sausage shaped pancrease:
Igg4/outoimmune pancreatitis
318
HBV treatment when to start
treat only active inflammation, life long tx, no cure
319
Wilsons: on labs
low ALk phos!!!!, low cerulplasmin
320
Cirrhotic pts; what meds not to use
don’t use ace inhibitors or arbs; —> may predispose to renal failure (hepatorenal
321
Imatinib: for CML, se
prolonged QT
322
Suspect acute leukemia: Aml or ALL; first diagnostic test
first test to order flow cytometry (bone marrow to slow…can still get it) ALL vs AML: ALL usually presents with massive LAN
323
LADA
latent autoimmune diabetes in adults: check GADA
324
Serum 1,5-anhydroglucitol level;
good for assessment of glycemic control over the past 2 wks (even in hemoglomapathies)
325
Labyrinthitis vs vestibular neuritis
labyrinthitis has hearing loss (tx with steroids both?)
326
Chronic cough:
first chest X-ray; stop meds/smoking; then tx: post nasal drip: inhaled steroids, then r/o asthma; last resort is ppi
327
Breast lump palpable:
always US; may add mammogram if> 30 yo. (But always do US for palpable lump)
328
Sumatriptan:
dont give to pregnant, also if migraine with weakness (can cause vasoconstriction) also in CVA....and so on
329
Headache prophylaxis:
migraine: topiramate; tension ha: amitryptiline; cluster: verapamil.... for prophylaxis
330
Bupropion:
lowers seizure threshold... commonly used for depression, smoking cessation
331
Topiramate SE
kidney stones
332
Meningitis bacterial when to give steroids
if steroids given, must before antibiotics; ampicillin >50 yo
333
West Nile: physical exam
flaccid paralysis
334
Gram negative bacteremia:
can only maybe tx for 7 days.... don’t have always extend
335
Mac:
greatly elevated alk phos
336
Rifampin:
add it if hardware present to penetrate bio films (ex: osteomyelitis in vicinity of prior hardware on the foot)
337
Rocky mountain spotted fever:
starts distal/palms/ and then moves central
338
glaucoma:
loss of peripheral vision; cup to disk ratio increased
339
High altitutude: ABG:
respiratory alkalosis; ph up; everything else down
340
Duloxetine:
can use with PUD; or if can’t tolerate NSAIDs
341
Lupus nephritis:
Mycophenolate Mtotefil
342
MCTD:
associated with pulmonary hypertension (Not ILD)
343
Polymyositis:
anti-Jo antibody (ILD association strong with that antibody)
344
Inclusion body myositis (vs polymyositis: )
both DISTAL and proximal weakness and may be asymmetric
345
SIBO:
small intestinal bacterial overgrowth: dsimotily; blind loops; ppi, gastroentritis….crest
346
Lofgren syndrome:
arthritis, hilar LAN, erythema nodosum; no diagnostic test; self resolving, may give NSAIDs.
347
Heerfordt Syndrome:
anterior uveitis; parotiditis, fevers, +/_ facial nerve palsy: no diagnostics tests
