Misc Flashcards
(206 cards)
1
Q
Most effective drug for allergic rhinitis
A
intranasal steroids
2
Q
Tx for peritonsillar abscess
A
amp/sulbactam
3
Q
dacroadenitis:
A
lacrimal gland (above)
4
Q
dacrocystitis:
A
nasolacrimal gland (below)
5
Q
RF for retinal detachment
A
myopia, cataracts
6
Q
+ sign seen with retinal detachment
A
Shafer’s sign
7
Q
Shafer’s sign
A
clumping of brown colored pigment cells in the anterior vitreous humor resembling tobacco dust
8
Q
When can you patch a corneal abrasion?
A
if >5 mm, but not more than 24 hours and not in contact wearers
9
Q
pH of eye?
A
7.0-7.3
10
Q
Pre-septal cellulitus tx
A
amoxicillin
11
Q
Orbital cellulitis tx
A
vanco
12
Q
What drop is ok in a TM perforation?
A
ofloxacin
13
Q
placenta over os
A
placenta previa
14
Q
sudden painless bleeding in pregnancy
A
placenta previa
15
Q
adherent placenta
A
placenta accreta
16
Q
Premature separation of placenta
A
placental abruption
17
Q
dark 3rd trimester bleeding; severe pain
A
placental abruption
18
Q
MCC of placental abruption
A
maternal HTN
19
Q
fetal vessels transverse the fetal membrane over cervical os
A
vasa previa
20
Q
abortion: termination <
A
20 weeks
21
Q
Abortion is MC in the ?
A
7th week
22
Q
MCC of 1st trimester bleeding
A
threatened abortion
23
Q
Cervical os closed; bloody vaginal d/c
A
threatened
24
Q
cervical dilation > 3 cm; bleeding
A
inevitable abortion
25
some POC expelled, some retained; heavy bleeding/cramping/boggy uterus
incomplete abortion
26
all POC expelled; cervical OS closed
complete
27
fetal demise but remains in uterus >6 weeks
missed
28
Only potentially salvageable abortion?
threatened
29
Dysfunctional uterine bleeding in premenopausal women is likely d/t?
anovluation
30
Dysfunctional uterine bleeding in perimenopausal women is likely d/t ?
consider hyperplasia/carcinoma
31
Acute severe vaginal bleeding?
high dose IV estrogen or high dose OCPs; D&C if estrogen fails
32
Primary dysmenorrhea is due to increase in?
prostaglandins
33
MCC of secondary dysmenorrhea in young
endometriosis
34
MCC of secondary dysmenorrhea in older
adenomyosis
35
Tx of dysmneorrhea
NSAIDS; vitamin E
36
Herniated disc MC @
L5-S1
37
Sciatica:
back pain radiating to thigh/buttock --> lower leg (below knee)
38
Pain: L4
anterior thigh
39
Pain: L5
lateral thigh, hip/groin
40
Pain: S1
posterior leg/calf, gluteus
41
Sensory loss: L4
median ankle
42
Sensory loss: L5
dorsum foot (between 1-2 toes)
43
Sensory loss: S1
plantar foot
44
Weakness: L4
ankle dorsiflexion
45
Weakness: L5
big toe extension; walking on heels difficult
46
Weakness: S1
plantar flexion; walking on toes difficult
47
Reflex diminished: L4
knee jerk; weak knee extension
48
Reflex diminished: L5
normal
49
Reflex diminished: S1
loss of ankle jerk
50
Tx cauda equina:
neurosurgery and corticosteroids
51
Spinal stenosis is worse with?
extension (prolonged standing/walking)
52
Spinal stenosis is better wtih?
flexion (sitting/walking uphill)
53
Spinal stenosis tx:
lumbar epidural injection of corticosteroids
54
Gout is MC d/t
under excretion of uric acid
55
Which ARB does not cause gout?
Losartan
56
What HTN meds increase risk of gout?
ARB/diuretics/ACE
57
CXR gout:
mouse-bite or punched out erosions
58
only drug used in acute and chronic gout?
colchicine
59
MC site of pseudogout
knee
60
Tx of pseudogout
intraarticular steroids (1st), NSAIDs, colchicine (chronic: colchicine)
61
Tietze syndrome
localized palpable edema, heat, and erythema --> MC at 2nd and 3rd costochondral junctions
62
85% of ankle sprains involve?
collateral ligaments
63
MC ligament impacted by ankle sprain?
anterior talofibular
64
Main stabilizer during ankle inversion?
ATFL
65
injured with ankle eversion?
deltoid
66
Bell Palsy is a CN?
VII (7)/facial palsy
67
What virus has a strong association with Bell Palsy?
herpes simplex virus
68
Bell Palsy is MC on which side?
right
69
Bell palsy progression?
sudden onset of painless ear pain 24-48 hours --> unilateral facial paralysis (unable to wrinkle forehead), loss of nasolabial fold, decreased lacrimation
70
Bell phenomenon?
eye on affected side moves laterally and superiorly when eye closure attempted
71
Trigeminal neuralgia tx:
carbamazepine (tegretol)
72
cluster prophylaxis
verapamil
73
essential tremor inheritance
AD
74
What type of tremor is an essential tremor?
intentional
75
Essential tremor MC location?
UE and head
76
What tremor is relieved with alcohol?
essential tremor
77
Parkinson's is d/t
dopamine depletion; failure to inhibit acetylcholine in basal ganglia
78
What type of tremor is assoc with Parkinson's?
resting tremor ("pill rolling"); worse at rest
79
Gait associated with Parkinson's?
shuffling gait; festination (increased speeding with walking)
80
Myerson's sign
tapping bridge of nose repetitively causes sustained blink in Parkinson's
81
Tx of Parkinson's
Levodopa/carbidopa
82
Seizure assoc with bilateral symmetric 3 Hz spike
absence
83
Tx of absence seizures
1st line: ethosuximide
| 2nd line: valproic acid
84
Tonic =
rigid
85
clonic =
jerking
86
HIV conditions requiring abx, treat with?
bactrim
87
HCM treated with?
BB
88
"drop attack" seizures
atonic
89
Status epilepticus treatment
1) BZD (lorazepam, diazepam)
2) add AED if refractory to BZD (phenytoin)
3) Phenobarbitol
+ thiamine, followed by dextore if hypoglycemia
90
amaurosis fugax is associated with TIA of?
iCA
91
Initial test for TIA
CT
92
Scoring system for TIA?
ABCD2
93
ABCD2 for TIA
```
Age 60+ (+1)
BP >140/90 (+1)
Clinical features
Unilateral weakness (+2)
Speech disturbances w/o weakness (+1)
Other symptoms (0)
Duration
<10 minutes: 0
10-59 minutes: +1
60+: + 2
History of DM (+1)
```
94
ABCD2 for TIA scoring
0-3: low risk
4-5: mod risk
6-7: high risk
95
Tx of TIA
ASA +/- dipyridamole or clopidogrel
96
Eczema treatment (alt to steroids)
calcineurin inhibitors (tacrolimus) is an alternative to steroids (no skin breakdown)
97
Tacrolimus assoc with
lymphoma/skin cancer
98
Hypersensitivity reaction: I
IgE mediated
99
Hypersensitivity reaction: II
cytotoxic, Ab-mediated
100
Hypersensitivity reaction: III
immune antibody-antigen complex
101
Hypersensitivity reaction: IV
delayed, cell mediated
102
Hypersensitivity reaction: urticaria
I
103
Hypersensitivity reaction: angioedema
I
104
Hypersensitivity reaction: bullous pemphigoid
II
105
Hypersensitivity reaction: drug mediated vasculitis
III
106
Hypersensitivity reaction: morbilliform
IV
107
Hypersensitivity reaction: EM
IV
108
MC drug reaction
morbilliform
109
EM is MC associated with
herpes simplex
110
Scabies TOC
permetherine from neck to soles for 8-14 hours before showering, repeat 1 week
111
Lindane SE
seizures, if after shower
112
Alt option for scabies tx for infants and pregnant women
sulfur in petroleum jelly
113
Spider bite associated with local burning/erythema/hemorrhagic bullae?
brown recluse
114
spider biter associated with muscle pains, spasms, rigidity?
black widow
115
Primary Adrenal insufficiency
Addison's, adrenal gland destruction
116
MCC of primary adrenal insufficiency in industralized countries
AI
117
MCC of primary adrenal insufficiency worldwide
infection
118
Secondary Adrenal Insufficiency
primary failure of ACTH secretion
119
MCC of secondary adrenal insufficiency
stopping exogenous steroid use
120
Adrenal insufficiency pathway
Hypothalamus (CRH) --> anterior pituitary (ACTH) --> adrenal cortex (cortisol)
121
Tertiary adrenal insufficiency
hypopituitarisim
122
Labs associated with adrenal insufficiency
hyponatremia, hypotension, hypoglycemia
123
High dose acth stimulation test: addisons
little or no increase in cortisol (<20)
124
CRH stimulation test: primary
increased ACTH, but low cortisol
125
CRH stimulation test: secondary (pituitary)
low ACTH, low cortisol
126
CRH stimulation test: tertiary (hypothalamus)
exaggerated ACTH response
127
Tx for addrenal insufficiency:
Addisons: glucocorticoids (hydrocortisone) and mineralocorticoids (fludrocortisone)
Secondary: only glucocorticoids
128
First line depression tx:
psychotherapy
129
second line depression meds
1st: SSRI
2nd: bupropion, mirtazipine
130
Name some SSRIs:
citalopram, escitalopram, paroxetine, fluoxetine, sertraline, fluoxamine
131
What SSRI is avoided in long QT syndrome?
Citalopram
132
SSRIs inhibit?
CNS uptake of serotonin
133
Name some SNRIs:
venlafaxine, desvenlafaxine, duloxetine
134
SNRIs inhibit?
serotonin, norepinephrine, and dopamine uptake
135
AIDS: CD4 count
200
136
HIV testing:
ELISA + --> confirm with western blot
137
Which type of influenza is most likely to cause a pandemic?
Influenza A
138
Antivirals for flu within?
48 hours
139
Kernig's:
inability to straighten knee with hip flexion
140
CSF for acute bacterial meningitis:
100-10,000 PMN
decreased glucose <45
Increased total protein
Increased CSF pressure
141
Post-exposure for meningitis
cipro 500 mg po x 1
142
1 mo -18 yo MC bacterial meningitiis
n. meningitidis
143
1 mo -18 yo bacterial meningitiis tx
ceftriaxone + vanco
144
18 yo- 50 ys MC bacterial meningitis
s. pneumo
145
18 yo -50 ys bacterial meningitis tx
ceftriaxone + vanco
146
>50 bacterial meningitis tx
ampicillin + ceftriaxone +/- vanco
147
MC viral meningitis
enterovirus (echo, coxsackie)
148
MRI for viral meningitis
diffuse enhancement of the meningies
| frontal or temporal enhancement with HSV-1
149
MC valvular disease
Aortic stenosis
150
MC congenital cause of aortic stenosis
bicuspid AoV
151
aortic stenosis becomes symptomatic when AoV
1 cm
152
MC symptom of aortic stenosis
Dyspnea
153
Aortic stenosis complications
Angina, syncope, CHF
154
Where does aortic stenosis radiate to?
carotids
155
definitive test for aortic stenosis?
cardiac cath
156
Tx for aortic stenosis?
replacement
157
Where does aortic regurgitation radiate to?
left sternal border
158
What murmur can be associated wtih AR?
Austin-Flint: mid-late diastolic rumble at apex secondary to retrograde regurgitant jet competing with antegrade flow from LA into ventricles
159
Wide pulse pressure signs seen in?
Chronic AR/AI
160
Sift upstroke and rapid fall of radial pulse accentuated with wrist elevation
water hammer
161
Like WHP but specific to cartoid
Corrigan's
162
Popliteal artery systolic > brachial artery by 60 mmHg
Hill's sign
163
Most sensitive sign for chronic AR/AI?
Hill's sign
164
Gradual pressure over femoral --> systolic and diastolic bruits
Durozeiz sign
165
Double sound heard at femoral artery with compression of femoral
Traube's sound
166
head bobbing with heart beat
De musset
167
Visible systolic pulsations of uvula
Muller's
168
Visible fingerbed pulsations with light compression of nailbed
Quinckes
169
Double pulse carotid upstroke
Pulses bisferiens (combined AR, AS)
170
Mitral stenosis MC d/t
rheumatic heart disease
171
Mitral stenosis AKA
fish mouth valve
172
MC symptom of Mitral stenosis
dyspnea
173
Valve disorder associated with ruddy (flushed) cheeks with facial pallor
mitral stenosis
174
Opening snap with
mitral stenosis
175
Tx of mitral stenosis?
percuatenous valvuloplasty/valvotomy
176
MCC of mitral regurgitation?
MVP
177
MR radiates to?
axilla
178
Tx of MR?
repair preferred over replacement
179
MVP symptoms?
anxiety, atypical chest pain, panic attacks, palpitations, syncope, dizziness, fatigue
180
What valve disorder is closely related to CT disease and is AD?
MVP
181
Valvular disorder --> posterior bulging leaflets
MVP
182
MVP tx
reassurance, BB
183
Valvular disorders that's almost always congenital and a disease of the young?
pulmonic stenosis
184
pulmonic stenosis radiates to?
neck or base of heart
185
Tx pulmonic stenosis
balloon valvuloplasty
186
Murmur associated with pulmonic regurg?
Graham Steel murmur: brief decrescendo early diastolic murmur at LUSB with full inspiration
187
MC primary cause of tricuspid regurg
infective endocarditis
188
MC secondary cause of tricuspid regurg
pulmonary HTN
189
Sign associated with tricuspid murmur
Carvallo's sign: increased murmur intensity with inspiration
190
Murmur associated with pulsatile liver
tricuspid regurgitation
191
Nosocomial UTI treatment
cipro or levo 7 -14 d
192
MCC of urethritis
gonorrhea
193
MCC of scrotal pain
epididymitis
194
MCC of epididymitis if <35
chlamydia
195
MCC of epididymitis if >35
e.coli
196
If epididiymitis likley d/t G/C -->
ceftriaxone 250 mg IM x 1 + Azithromycin 1 gm x 1 (can sub doxy)
-If MSM, ceftriaxone 250 mg IM x 1 + levo 500 mg x 10 days
197
MC complication of mumps
orchitis
198
Orchitis viral or bacterial?
viral
199
MCC of balanitis in adults
DM
200
MCC of obstructive uroopathy in men?
BPH
201
Normal urine output
800 mL - 2 L/day
202
oliguria:
<400 mL
203
MCC of renal artery thrombosis
a. fib
204
What lab may be elevated in renal artery thrombosis?
LDH (increased in ischemia)
205
Test for renal artery thrombosis
non-con CT (renal US NOT useful)
206
tx renal artery thrombosis
anticoagulate
