Mksap 2 Flashcards
(140 cards)
1
Q
Inflammatory breast cancer Rx
A
Chemo, surgery, radiation
2
Q
IBS RX?
A
Rifaximin, tca, antispasmodic
3
Q
Condition associated with vitiligo
A
Thyroid disorder
4
Q
Treatment insomnia after CBT
A
doxepin or non-benzo Benz agonist like zolpidem
5
Q
RA meds during surgery
A
hold biologics (adalimumab), continue MTX
6
Q
Dementia LB vs. Parki
A
Park: dementia “well after” motor sx. Dementia/LB: Motor/dementia within 1-2 years
7
Q
Rx dementia with LB
A
Rivastigmine and donepezil, melatonin for sleep
8
Q
chronic tension headache rx?
A
amitriptyline
9
Q
isofosfamide fanconi syndrome
A
prox renal tubular dysfunction, phos wasting <5%
10
Q
osteoporosis refractory to bisphos
A
denosumab
11
Q
raloxifene contra-indications
A
cardiac disease
12
Q
HCV rash association
A
lichen Plans
13
Q
botulism
A
diplopia, dysphonia, dysarthria, dysphagia
14
Q
BCC appearance
A
nodular, pink, central defect, telangiectasia, ulceration, crusting
15
Q
Surveillance on trastuzumab
A
TTE
16
Q
IgG related disease rx
A
RTX
17
Q
PMR rx
A
12-20 mg prednisone daily
18
Q
Slowly rising PSA after prostatectomy - rx?
A
Androgen receptor blocker
19
Q
COPD with persistent sx add?
A
LABA or LAMA (tiotropium)
20
Q
Dermatomyositis rx
A
start with prednisone, then after response add ritux or azathioprine
21
Q
TLS prevention
A
IVF and rasburicase>allopurinol
22
Q
AI pancreatitis
A
pancreas appears sausage shaped, IgG 4 elevated, responds to steroids
23
Q
normal abdominal aortic diameter
A
<3
24
Q
periop warfarin
A
hold 5 days before, start 12 hrs after
25
timing of TDAP pregnancy
27-36
26
Primary hypogonadism labs/most common cause
low T, high LH and FSH. Klinfelter most common: tall, small testes, infertility, signs of androgen deficiency
27
rx laryngeal ca
radiation, chemo prn
28
latent tb rx
rif/isoniazid x3 mo, alt iso x6-9mo
29
primary hyperaldo
suspect if low K
30
target BP?
<130/80
31
lupus flare preg
rising anti-ds Dan, falling comp, proteinuria, swelling, HTN - rx steroids
32
regions ok to band
esophagus, cardia, not fundus
33
resp compensation for metabolic acidosis
acute: 1 inc bicarb for every 10; chronic 3.5 for every 10
34
incidental aneurysm
anterior <12 mm and posterior <7 mm ok to monitor
35
folate dose preg
0.4 to 0.8 mg folic acid (even if lamotrigine)
36
Sens for and US for NASH
80%!
37
BMD screening?
65 OR younger if high frax score
38
age related macular degeneration
yellow/white mottling
39
Most common hereditary nephrotic syndrome
FSGS - especially in African descent, APOL1 gene
40
anticoagulant for mechanical valve in pregnancy
warfarin in 2nd and 3rd trimesters. warfarin in first in f<5, otherwise IV heparin
41
dx prion disease
"real time quaking induced conversion assay"
42
ecthyma
saucer shaped ulcers, legs or feet, caused by strep
43
rx primary adrenal insufficiency
high acth, low cort with BID hydrocortisone and daily fludrocort
44
rx cap in healthy hosts
doxy or amoxicillin; if comorbidities think about fluoroquinolones but not cipro which doesn't cover S.pneumo
45
Sweet syndrome
reactive febrile skin eruption, "juicy" lesions -
46
rx severe malaria
artesunate
47
precautions shingles immunocompromised
1 dermatome is enough to call it disseminated, put on contact and airborne
48
pregnancy BP goal
<140/<90
49
gallbladder polyp management
>1cm ccy given cancer risk; 5 mm or les can be monitored
50
sepsis if tunneled HD line management
remove! sometimes can rx with lock therapy for staph epi; sometimes can exchange over guide wire if clear cultures in 48h
51
genetic association prostate cancer?
BRCA
52
CAD and DM meds to add?
GLP-1 OR SGLT2
53
PSA arthritis improves or worsens with movement
improves! can have axial and enthesitis
54
CSF bacterial meningitis
white count>1000, NF 90%, high protein 100-500, glucose <40. IF HSV is highly suspected, repeat LP in 3-7 d
55
CTEPH management
a/c+surgery
56
"response" in MDD management
PHQ9<5 or decrease by 50%, continue therapy for 6 months at least
57
ESKD and cystic changes managemnt
yearly US
58
crytoposporidium is leading pool related diarrhea.
rx with nitazoxanide if HIV awaiting immune reconstitution
59
diverticulitis on immunosuppression?
admit. surgery for peritonitis or sepsis
60
Enterovirus meningitis
causes sx but not encephalitis, often get rash; lymphocytic predominance, HSV1/2 confusion and often lesions. West nile can cause meningitis or encephalitis
61
asthma med associated with depression?
montelukast
62
central hypothyroidism how to titrate?
go for mid to upper level for free T4
63
AIP CT findings
diffusely enlarged pancreas with indistinct borders, rx with steroids
64
rx for fibromyalgia, depression, anxiety?
duloxetine
65
alpha thal trait
anemia but normal electrophoresis
66
beta thal trait
reduced Hgb A, increased F and A2
67
NNT
1/ARR (ex, if 30% in one group and 25% in another, it is 1/.05)
68
subdural vs epidural
subdural crescent, epidural bulges more
69
post tia mgmt
asp/plavix x 21days, then asp monotherapy
70
3 year colo if
tubular >10, or 5-10 tubulars <10, or villous/tubulovillous histology
71
gynecomastia workp
AM testosterone, HCG, LH, estradiol
72
test of cure for h pylori
4 weeks after finishing therapy, 2 weeks after d/c PPI, stool Ag
73
tolerable ACE's with breast feeding
enalapril, captopril, benzalapril, quinapril
74
a/c duration DVT
3-6 months (short if) provoked, high risk bleeding, or unprovoked distal leg
75
absence sz:
<15 seconds, the adult, prolonged version is "focal impaired awareness sz" - lasts minutes, has post-octal period
76
treat anal fissures
topical calcium channel blockers
77
retinal arteriosclerosis
associated with HTN, copper wiring, AV knicking
78
when EGD after PPI?
2 months
79
Repeat IGRA after what CD4 count
>200
80
D dimer first if?
low or moderate likelihood, if high likelihood just go to US
81
rx for irritate SKs?
cryo
82
PML appearance compared to toxo or CNS lymphoma
not enhancing, when compared with toxo and lymphoma
83
when to treat PSA in CAP?
if PSA grown in 1 year, or IV abx in the last 3 mo
84
pulmonary nodule eval
if low risk and 6-8, repeat in 6-12 mo; if <6 nothing needed
85
eye drops for allergies
antihistamine/mast cell stabilitzing
86
Recurrent neisseria infections (meningococc+gonorrhea)
screen for C50 deficiency
87
rx JAK mutation
hydroxyurea=aspirin; if >60 yo, rx with those regardless of mutation status if ET
88
microscopic colitis - what causes and how to rx?
NSAIDs, PPIs, SSRIs, intraepithelial lymphocytosis, start by withrdrawing, then budesonide PRN
89
adjunct rx in PAD and conditions that are contraindication?
cilostazol PDE5 inhibitor, contraindicated in CHF
90
chronic cutaneous lupus
discoid, often not systemic
91
cardiac angiosarcoma
usually arise in the R atrium, associated with sanginous pericardial effusion, can met to lung vs. myxoma usually LA, don't met, don't cause effusion
92
drugs that cause lupus?
minocycline
93
Hodgkins appearance vs ebb
owl eye
94
cutoff btw moderate and high statin
20%; 7.5-20 Is intermediate
95
plan B+alternative for elevated BMI
use in BMI<26, works x 3 days, for higher BMI, ulipristal
96
dx allergic asthma
absolute eos
97
ABPA - when to suspect?
difficult to control asthma, productive cough, mucous plugs,
98
inclusion body myositis - how to rx?
prednisone, PT, MTX only if idiopathic
99
external validity=
generalizability
100
rx serotonin syndrome?
benzos
101
internal rewarming?
T<28 or failure with external
102
indications for polysome not at home testing
mission critical workers, cardiac or pulm comorbidities
103
subclinical hyperthyroidism rx -
methimazole
104
rx hydradenitiis
doxy, topical Glinda, adalimumab (TNF alpha inhibitor)
105
abx ppx PJI?
no!
106
rx chemo induced early menopause?
hormone replacement therapy
107
ash leaf spots
tuberous sclerosis, intellectual disability, seizure
108
enteric fever
salmonella enterica or salmonella typhi: fever, arthralgia, myalgia, rash
109
PAN
medium vessel vasculitis - that affects renal vasculature (Dx by MRA, doesn't cause glomerulonephritis), nodular rash, abdominal pain, nononeuritis multiplex.
110
erythasma
superficial skin infection corynebacterium, rx erythromycin - thin, atrophic, pink/brown plaques
111
premenstrual dysphoric disorder
1. ssri 2.ocp
112
opioid use and hyponatremia
secondary adrenal insufficiency
113
bullous pemphigoid vs. pemphigus vulgarius
bullous: widespread and not mucosal; vulgaris is mucosal
114
nodules that don't need follow up
<6 mm in low risk host
115
severe AS
dobutamine stress to tell low flow low gradient AS and pseudo severe AS
116
fibromyalgia rx?
duloxetine or pregabalin, milnacipran
117
junctional
P wave inverted in II, before or after QRS
118
saliva substitute
pilocarpine or cevimeline
119
slow risk of progression in PCKD?
tolvaptan
120
predictor mortality panc
bun
121
adenosine stress c/I?
asthma
122
primary ppx CAD
low dose asa in 50-70 and high risk and low risk bleeding. ?>10%
123
digital ulceration and Raynaud/s?
systemic sclerosis
124
predict steroid responsiveness of asthma?
fractional exhaled nitrous oxide ; predicts if it's eosinophilic and will respond to steorids
125
when to bridge? very high risk patients with for example mechanical heart valve
hold DOACs: 3 days prior to surgery in normal renal fxn
126
how long delay surgery after stroke/TIA
6-12 mo
127
do all diabetics get statin?
yes if 40-75, moderate intensity - high if other RFs
128
liver mets from colon cancer?
resect
129
stop bactrim in HIV
if CD4>200x3 mo
130
stop rx in secondary progressive MS?
2 years non-ambulatory and without disease progression
131
hospitalized ACS stop smoking?
varenicline, partial nicotinic agonist
132
diabetic retinopathy rx
for proliferative or "wet" - anti VEGF injections like "bevacizumab"
133
treat superficial thrombus?
6 weeks if greater saphenous, above the knee, extensive
134
pulm htn dlco
<60%
135
RA SPARES
DIP
136
behcets ulcers
PDE4 inhibitor apremilast
137
menopause symptoms rx
estrogen and progesterone
138
PID
cefotetan/cefoxitin + doxy
139
serum sickness: complement mediated
purpura, fever, arthralgia 7-14 days after incident - rx with steroids; drug-induced hypersensitivity instead is weeks out and rash
140
rhythm control?
early AF with other cardiovascular comorbidities
