Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal > NBME/ General Things to remember for shelf > Flashcards

NBME/ General Things to remember for shelf Flashcards

1
Q

paroxysmal v tach may present as

A

syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

clubbing should always raise red flag for?

A

lung cancer, order CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

High pitched bowel sounds+ air fluid levels=

A

obstruction of bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

direct current countershock =

A

SCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

U/A finding specific for rhabdo….

A

+ for blood, - for RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pre-renal azotemia definition

A

BUN:Cr greater than 20

FeNa less than 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

FeNa & BUN: Cr for intrarenal azotemia

A

BUNCr lower than 20

FeNa higher than 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

isolated systolic hypertension cause

A

decreased compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Phases of ATN

A

oliguric –> diuretic –> recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Four stages pressure ulcers

A

1- skin intact
2- skin gone
3- crater like
4- involves bone/muscle/tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management pressure ulcer by stage

A

1- prevent
2- wet to dry dressing
3 & 4- debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Location mycoplasma PNA on CXR

A

can be segmental or nonsegmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of HyperPTH in squamous cell

A

bisphosphonates (–dronate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prevention of anemia in CKD

A

EPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cold/nonfunctioning nodule thyroid management

A

FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Knee pain and swelling that self resolves?

A

gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Common predisposing feature to gout

A

alcoholism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most sensitive test for osteo

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lung hyperressonance=

A

pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Increased tactile fremitus on lung exam=

A

consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

lung conditions that cause mediastinal shift

A

Peff (away), TPTX (away), lobar collapse (towards)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Best osteoarthritis prevention

A

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pain over delt with abduction

A

supraspinatus tendon tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

(noncardiac) Cancer causing heart murmur

A

gastric carcinoma

carcinoid tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cause of AMS in respiratory failure

A

Hypercarbia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

methimazole serious ADR

A

neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Sudden onset severe hypertension, normal labs

A

renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Imaging for unexplained pancreatitis

A

ERCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Adult with recurrent pna/ diarrhea/ sinusitis….screen for?

A

CVID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Urgent Dialysis indications

A 
AEIOU
acidosis
electrolye change 
ingestion toxin
overload 
uremia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

K^ drugs

A

ACE/ARBs
spiro/amiloride
BBer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Acute UTI empiric treatment

A

Bactrim
nitrofurantoin
fosfomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Met alkalosis –> next step

A

Cl measurement
low= vomiting/prior diuretic

high= endo (aldo/ACTH/cushings); diuretic or barter/gitleman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Metabolic alkalosis with low Cl is _____ _____

A

saline responsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Three steps in evaluating Hyponatremia?

A

Serum osm above 290?
Urine osm below 100?
Urine Na greater/less than 25?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Hyponatremia 2/2 CHF/Cirrhosis presents how?

A

serum osm below 290; urine osm above 100; urine sodium LES THAN 25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How does SIADH present?

A

serum osm below 290; urine osm above 100; urine sodium ABOVE 25 (not peeing out any water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Causes of hyponatremia that present similar to SIADH

A

hypothyroid

adrenal def

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Causes of hyponatremia with high serum osm

A

very high hyperglycemia

advance renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cause of hyponatremia with low urine osm

A

primary polydipsia/beer potomania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Drug preventing calcium stones? Uric acid stones?

A

Calcium- thiazides (avoid loops)

Uric acid- give K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Hexagonal stones are?

Envelope stones are?

A

hexagonal- uric acid

envelope- Ca Ox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

AGAP equation

A

sodium -cl - bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

winters formula

A

paco2= 1.5xbicarb + 8 +/- 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Bicarb changes in respiratory alkalosis/acidosis?

A

acidosis ^10 CO2= ^1 bicarb

alkalosis ^10 CO2= ^2 bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

CO2 change assc with met alkalosis

A

^bicarb 1= ^CO2 0.75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the add back method?

A

Calculate actual AGAP - calculated. Add difference back to bicarb.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

FeNa/FeUrea in pre renal disease

A

FeNA is LESS THAN 1

Fe Urea is less than 35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Intra/post renal AKI test of choice

A

noncontrast CT/US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

GFR and staging of CKD

A 
I- above 90
II- 60-89
III- 30-59
IV-15-29
V- under 15

**HD at stage 5, start preparing at stage IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

DM goals in CKD

A

A1C under 7; glucs 80-120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Cinacalcet- role in CKD?

A

Give to prevent ^^PTH due to low Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hb goal in CKD

A

above 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Causes of low K

A

vomiting/diarrhea

high aldo, loops, thiazides, barters, gittlemans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

K+ EKG changes

A

classic= T waves but can be anything!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Hypernatremia treatment

A

mild- oral water
moderate- D5
severe- NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How are Na and gluc related in low Na/hyperosmolarity

A

for every ^100 glucose= ^1.6 Na
(ie 500 gluc= 400^ gluc= ^4.6 Na)
measured Na= 130; actual = 136
just give insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

UNa ~

Uosm ~

A

UNa~aldo

Uosm~ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Treatment of hypercalcemia

A

FLUIDS –> calcitonin –> bispohs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cause of ^^ vitamin D?

A

granulomas- sarcoid, TB

=^^Ca and PO4; low PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

How to evaluate low Ca?

A

check albumin, check ionized Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Contrast hyperCa in mets vs Squamous Cell

A

Squamous Cell- ^^Ca; low PO4
Mets to Bone- ^^ Ca & PO4
Order vitamin D to r/o granulomatous disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Which kidney stones are radiolucent

A

uric acid and cysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

When do stones require surg?

A

greater than 1.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

RCC produces

A

EPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

MUDPILES

A 
methanol
uremia 
dka 
propylene glycol
iron/inh 
lactic acidosis
ethylene glycol
salicylates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Causes of respiratory acidosis

A

hypoventilations- opiates, asthma, copd, OSA, poor muscle strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

When to use stress echo?

A

baseline EKG changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Wide complex tachy –> next step

A

SCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

MMSE suggestive of dementia

A

25 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Subchondral cysts=

A

OA, first line = NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Acute MI blood gas finding

A

lactic acidosis= MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Management of esophageal perforation=

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Gram stain -; papules on palms; arthritis=

A

gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

STE =

A

MI

**Tamponade = alternans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Midshaft fracture of the humerus=

A

radial nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

High platelets + pain in finger tips: dx and tx?

A

tx: polycythemia, therapeutic phlebotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Options for pyelo treatment

A

Oral FQs, IV ceftriaxone, amp + aminoglycoside

7-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Labrynthitis findings

A

dull TMs
distorted light reflex
dizziness

**tx= antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

+ Fecal Occult… Next step

A

colonoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

alopecia + rash= what mineral deficiency

A

Zinc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

PPD considered positive in HIV

A

5+ mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Scleroderma pathogenesis & MC antibody & population

A

excess collagen
MC antibody = ANA
middle aged women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Two most common complications of scleroderma

A

pulm fibrosis

esophageal dysmotiliy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

CREST syndrome findings

A 
C-calcinosis of digits 
R- raynauds 
E- esophageal dysmotility
S- sclerodactyly 
T- telangiectasias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Cheilosis and corneal vascularization = deficiency of what mineral/ vitamin

A

B2/ riboflavin

“the 2 C’s of B2”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Describe “dermatitis” assc with B3/niacin deficiency

A

broad collar rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

dermatitis, alopecia, adrenal insufficiency cause

A

B5/ pantothenic acid deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

B6/ pyridoxine anemia type

A

siderblastic anemia + neuro findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q 
Folate is vitamin B \_\_\_\_\_\_
Niacin is vitamin B \_\_\_\_\_\_\_\_\_
Pyridoxine is vitamin B \_\_\_\_\_\_\_
Pantothenic acid is vitamin B \_\_\_\_\_
Riboflavin?
A 
Folate= 9
niacin = 3 
pyridoxine= 6 
pantothenic acid = 5 
riboflavin = 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Scurvy findings

A

corkscrew hair
swollen gums
bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Vitamin E deficiency findings?

How different from vitamin B6?

A 
E= hemolytic anemia, acanthocytosis, neuro findings 
B6= sideroblastic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Cause of vitamin K deficiency in adults

A

prolonged use abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q 
Delayed wound healing 
Alopecia 
Rash 
Dysgeusia 
Cause
A 
Zn def 
(assc with IBD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Hypervolemic hypenatremia cause

A 
cushings 
hyperaldo 
bicarb 
TPN 
saltwater drowning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Euvolemic hypernatremia causes

A

DI

insensible respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Hypovolemic hypernatremia causes

A

diuretics, glycosuria, renal failure

sweating, diarrhea, respiratory sensible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

In true hyponatremia serum osmolality is

A

low; under 280

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Cause of “pseudohyponatremia” (serum osmolality above 280)

A

mannitol
glycerol
high protein
high triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Causes of hyponatremia with urine sodium under 25

A

CHF
cirrhosis
depleted volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Causes of hyponatremia with urine sodium above 25

A

SIADH
adrenal
hypothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Hep B antibody assc with vaccination

A

Hep B surface; core = true infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

How to screen for CKD in HTN

A

creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Pilonidal cyst first approach to treatment

A

surgical drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Typical blood product given in GI bleed

A

packed RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

diuretic induced hypernatremia pattern

A

hypovolemic

normal response to water deprivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Cause of respiratory distress in sepsis

A

increased vascular permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

New onset PKD inheritance pattern

A

still assume AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Treatment SIADH

A

fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Cause of hypotension in MI

A

decreased contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

harsh systolic ejection murmur, peaking in late systole, with slow rising carotid pulse =

A

aortic sten- bicuspid esp if young

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Calcium levels in pancreatitis

A

low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Murmur assc with bicuspid aortic valve

A

can be AR or AS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

AR murmur

A

decrescendo diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Subauricular bruit is a clue for

A

FMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Cause of differential BP in upper extremities

A

supravalvular aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

V1-2 STE =

A

LAD infarct- anteroseptal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

V3-4 STE=

A

distal LAD infarct- anteroapical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

V5-6 STE =

A

anterolateral infarct- LAD or LCX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

I, AVL STE=

A

lateral infarct - LCX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

II, III, aVF STE=

A

inferior infarct- RCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

V7-9 STE + V1-3 depression=

A

Posterior MI - PDA (usually originates from RCS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

How does myocardial infarction lead to pulmonary edema?

A

acute mitral regurg = increased LA/LV filling pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Treatment of afib in wolff Parkinson white syndrome

A

SCD

procainamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Drugs that are contraindicated in WPW

A

CCB adenosine dig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Severe AS =

A

soft s2

delayed carotid pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

AAA rupture risks

A

large diameter
rapid expansion
cigarette smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Afib origin

Aflutter origin

A 
fib= pulm veins 
flutter= tricuspid annulus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

ISH cause

A

thickened arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

For purposes of boards… latent TB therapy?

A

isoniazid + B6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

+ CXR, - AFB=

A

latent TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Interpretation of PPD

A

+ if induration greater than:
5mm in immunocompromised
10 with risk factors
15 for anyone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Pyrazinimide ADRs

A

gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

SIRS criteria

A

temp above 38, below 36
WBC above 12, below 4
HR above 90
RR above 20

2/4 = +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Therapy sepsis

A

2-3 L fluid
empiric abx
pressors if pressure doesn’t stay above 90 with IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

fever, headache, focal deficit=

A

abscess or cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Criteria for safety of LP

A 
FAILS 
focal neurologic deficit 
AMS 
immunosuppressed 
lesion 
seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

If LP is not safe, what is next best step?

A

CT scan to rule out mass lesion

if +… check for toxo/biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

LP appearance in encephalitis

A

mostly leukocytes

check for HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

bacterial meningitis appearance on LP + empiric abx

A 
lots of polys (more than 1000)
ceftriaxone 
vanc 
steroids 
\+amp only if immunosuppressed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Treatment of cryptococcal meningitis

A

amphotericin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Treatment of Lyme/ RMSF meningitis

A

ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Treatment of neurosyphillis

A

IV penicillin q4 x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Crytpococcal meningitis LP findings

A

high opening pressure

++Cryptococcal antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Toxo: management

A

TMP-SMX; rescan in 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Cellulitis
layer
most common bugs
clue

A

subQ
well demarcated
staph strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Treatment for cellulitis if toxic

A

strep: zosyn/ ampclauv
staph: vanc/ linezolid/ clinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Treatment for cellulitis if nontoxic

A

strep: 1st gen ceph
staph: TMP-SMX/Bactrim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Osteo presentation

A

refractory cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

osteo treatment

A

debridement; 4-6 weeks IV antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Gas gangrene
presentation
bug
treatment

A

infected wound
c perfiringes
PCN + clinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Nec Fac
presentation
bugs
xray

A

weird cellulitis (blue and black, rapid, crepitus)
staph, strep
xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Treatment Nec Fac

A

1st gen ceph
clinda
amp
& debride

THREE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Diabetic foot treatment

A

vanc and zosyn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Oster + cirrhosis + osteo=

A

vibrio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

PrEP drugs

A

emcitbrabine

tenofovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

PEP drugs

A

emcitrabine
tenofovir
+/- raltegravir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Highest risk method of HIV transmission

A

vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Opportunistic bugs at 200, 100, 50 CD4 count

A

200- PCP
100- Toxo
50- MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What are the NRTIS to remember? (5)

A 
ziDOVEudine 
ABBAcavir 
DIDanOsine 
LAMBivudine 
Tenofovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Protease inhibitors suffix

A

-cavir except ABBAcavir= NRTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

NNRTI drugs (2)

A
  • Nevirapine

- Efavirenz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

HIV testing in anti-retroviral syndrome

A

PCR load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

CAP empiric therapy

A

1) FQ (sickly)
2) 3rd gen ceph + macrolide (hosp)
3) macrolide alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

HCAP empiric therapy

A

vanc and zosyn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

Meningitis empiric therapy

A

vanc
ceftriaxone
steroids
+/- amp if immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

UTI in pregnant pt empiric therapy

A

amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

TMP-SMX should be avoided as empiric therapy for UTI in what patients?

A

renal failure

warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

Treatment for pyelo

A

inpatient: IV ceftriaxone
outpt: oral Cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

pseudomonas coverage

A

zosyn
carbapenems
cefepime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

anaerobe coverage

A

clinda most places

metro if vaginal/abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

FQ for gram-; gram +?

A

gram- Cipro

gram+ moxi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Treatment for lung abscess

A

3rd gen ceph + clinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

When is asx bacteruria treated?

A

pregnancy, procedure

amoxicillin –> repeat screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q 
duration of treatment for 
simple cystitis 
complex cystitis 
pyelo
perinephric abscess
A

3,7,10,14 respectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

What makes cystitis complicated?

A 
pregnant 
penis 
plastic 
procedure 
pyelo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Empiric treatment options for cystitis

A

Bactrim
nitro
fosfomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Empiric treatment options for prostatitis

A

Bactrim
FQ
doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Perinephric abscess treatment

A

I&D

14 days IV ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

When to get CT scan in pyelo

A

no improvement x72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

Best diagnosis method for primary, secondary, tertiary syphilis

A

1- dark field
2- RPR –> TP abs
3- LP PRP and TP abs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Treatment of primary syphilis, early latent, late latent, tertiary.

A

primary- 1x IM pen
early latent- 1x IM pen
late latent- weekly x 3 weeks
tertiary- IV q4 x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Interpretation RPR results…

A

:

not a fraction
second # should drop with treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

Treatment LGV, how distinguished from primary syphilis?

A

syphilis: chancre and LN are Nontender
LGV: chancre Nontender, LN tender +/- drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Treatment LGV

A

doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

Chancroid dx and tx

A

gram stain and cx

azithro or Cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

dx HSV

A

PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

OM vs OE on exam

A

OM- pain relieved with tugging of pinna

OE- painful if pinna moved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

OM treatment

A

amox or cefdininr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

OE treatment

A

supportive or cipo + steroid drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Mastoiditis signs

A

bulging behind ear
anteriorly rotated ear
tx is surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

Sinusitis treatment

A

augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

Phayngitis scoring of symptoms

A 
CENTOR 
c-cough +1 
e- exudate +1 
n- nodes +1 
temp above 38 + 1 
OR under 14 +1 (-1 if over 44)

1- do nothing
2-3 do rapid strep
4 empiric treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

Treatment of strep pharyngitis

A

augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

Treatment anterior/ posterior epistaxis

A

cauterization with silver nitrate

posterior = packing + px abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

Treatment of acute endocarditis with a native valve?

A

vanc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Treatment of acute endocarditis with a prosthetic valve

A

young (less than 65 days) = vanc, gent, cefepime

old (greater than 65) = vanc, gent, ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

subacute endocarditis treatment

A

gent and ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

Alternative to vanc in treatment of endocarditis

A

dapto

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

Acute endocarditis culture guidelines

A

culture until negative

treat with abx until cx is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

Subacute endocarditis culture guidelines

A

culture until +

don’t treat until +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

Who gets surgery for endocarditis?

A 
vegetation above 15 mm
above 10 + emboli
florid CHF 
abscess
fungus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

What are the three major criteria for endocarditis

A

bacteremia
new murmur
+echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

Two pansystolic murmurs

A

VSD

MR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

systolic murmur- early ejection

A

AS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

Drugs that decrease morality in [CHF] ? 3

A

ACEi
BBer
Spiro

+/- hydral with nitro (AA, FMT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

Location of VSD? MR?

A

VSD- everywhere

MR- axilla, apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

Maneuvers that increase MVP and HCOM

A

standing

valsalva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

Post prandial pain- ddx

A

mesenteric ischemia

DPU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

S4 cause

A

atrial contraction against stiff ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

Becks Triad

A

distant heart sounds
low BP
JVD/ Hypotension

= Tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

Cardiac conditions that require fluid (3)

A

RHF
shock
tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

When to give IV metoprolol

A

severe HTN

afib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

Dobutamine use

A

pressor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

MI type that causes hypotension

A

posterior/inferior= RHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

BP that is absolute/ relative CI to thrombolytics

A 
220= absolute 
180= relative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

Time window for thrombolytics in MI

A

12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

MI type that most commonly causes arrhythmias

A

RCA; supplies SA node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

Aside from congenital VSD, what may cause VSD?

A

post MI ventricular free wall rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

Persistent STE post MI=

A

aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

Head nodding/ fingernail pulsations is a clue for

A

AR (hyperdynamic)

AS= hypodynamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

When to give px before oral procedures

A
  • prosthetic
  • congenital cyanotic disease
  • history of IE
  • cardiac transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

Which murmurs need echo?

A

diastolic
3/6
thrill
symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

How does valsalva cause increased HCOM murmur

A

decreased blood= increased contact of leaflets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

Exhalation increases what murmurs?

A

exhalation- L sided

inspiration- R sided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

Bicuspid aortic valve management?

A

annual echo

screen first degree relative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

Which valve is normally bicuspid?

A

mitral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

Bicuspid aortic valve causes what complications?

A

AS
AR
aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

Drugs that decrease mortality in [MI]? (3)

A

ASA
BBer
statin

230
Q

most common risk factor for IHD

A

HLP

231
Q

Family history of MI at what age is worrisome?

A

women earlier than 55

men earlier than 45

232
Q

Time limit for PCI

A

must be able to transfer within 2 hours otherwise do thrombolytics

233
Q

Best troponin for ACS

A

troponin I

234
Q

When can adenosine not be used for chemical stress test?

A

COPD/ asthma

235
Q

When can CABG be done?

A

left main
3 vessels
2 vessels + DM
1 vessel that FMT

236
Q

Stenting always gets what medical therapy?

A

double antiplatelet (ASA, plavix)

237
Q

Who gets statins (4)

A

risk above 7.5
LDL above 190
ACS/stroke
diabetics age 45-75

238
Q

Who gets aspirin? (2)

A

older than 50
risk above 10
no contraindications

239
Q

Drugs for everyone with MI

A 
MONA 
ACE 
BBer
clopidogrel 
statin
240
Q

Paracentesis: Polys under 250 + SAAG above 1.1 causes (2)

A

cirrhosis

CHF

241
Q

Paracentesis: Polys under 250 SAAG below 1.1 causes (1)

A

nephrotic

242
Q

Paracentesis: High white count- more than half polys: ddx? (3 things)

A

SBP (above 1.1)
secondary infection (SAAG varies)
pancreatitis (high amylase, above 100, SAAG under 1.1)

243
Q

Paracentesis: High white count- mostly lymphocytes- ddx? (two things)

A

malignancy

TB

244
Q

Normal FEV1 FVC ratio

A

0.7

245
Q

Normal DLCO

A

0.8

246
Q

PFT clue to NMJ d/o

A

low max inspiratory/expiratory pressures

247
Q

Platypnea is a clue to?

A

hepatopulmonary syndrome

248
Q

Lights criteria

A

Pp/Sp above 0.5
Pldh/Sldh above 0.6
LDH more than 2/3 ULN

249
Q

Criteria for draining

A

below 7.2

below 60 gluc

250
Q

Treatment for effusion with loculation

A

VATS (surgery)

251
Q

loud P2
fixed split S2
TR
=

A

Pulmonary hypertension

252
Q

PAH PFT pattern

A

restrictive

253
Q

TB effusion clue

A

risk factors for TB

bloody effusion

254
Q

What causes increased fremitus?

A

consolidation

effusion decreases

255
Q

How to confirm TB effusion

A

pleural biopsy

256
Q

Chylothorax dx

A

high triglycerides in effusion fluid

257
Q

When does anemia lead to MI/CVA etc?

A

Hgb 4-5

258
Q

DcO2=

A

CO x Hgb x %sat

259
Q

Retic levels in destructive anemia

A

More than 2%

260
Q

Macro, micro, normocytic anemia are destructive or productive, most commonly?

A

Macro/ Micro = production failure

Normocytic= destruction

261
Q

Microcytic anemia –> next step in narrowing diagnosis?

A

Iron panel (TIBC, Fe, ferritin, %sat)

262
Q

Normocytic anemia –> next step in dx

A

LDH, billi, haptoglobin

263
Q

Causes of normocytic anemia

A

Hemolytic
Bleeding
Ca
CKD

264
Q

Causes of microcytic anemia

A

IDA
Thal
Sideroblastic
ACID

265
Q

B12, folate def are what kind of microcytic anemia?

A

Megalocytic (hypersegmented neutrophils)

266
Q

Aside from B12/ folate def, what causes macrocytic anemia?

A

Liver
Alcohol
Drugs
Metabolism

267
Q

B12/folate:

Which has high MMA? Homocysteine?

A 
MMA = B12 
Homocysteine = both
268
Q

Test that narrows causes of B12 def?

A

Schillings rules out pernicious anemia

Give IM/oral B12 —> check urine for B12, none = PA

269
Q

Drugs that cause megaloblastic anemia (3)?

A

5FU
AZT
Ara-C

270
Q

2 metabolic disorders that cause megaloblastic anemia

A

Leach nyhan

Hereditary orotic aciduria

271
Q

How does chrons cause B12 def?

A

Terminal ileum destruction = site of IF+B12 absorption

272
Q

How long must B12 be deficient from diet before becoming symptomatic?

A

Years!

273
Q

Neuro symptoms assc with B12 def? How treated?

A

DCML destruction
Tabes dorsalis
Loss of propioception etc

Irreversible

274
Q

Who is generally folate deficient

A

Alcoholics

Depressed widows not eating

275
Q

Iron studies suggestive of IDA

Fe Ferritin TIBC

A

Low Fe
Low ferritin
High TIBC

276
Q

Two common causes IDA

A

Colon Cx

Menorrhagia

277
Q

Iron studies suggestive of anemia of chronic disease

A

Low Fe
High Ferritin
Low TIBC

278
Q

Give causes sideroblastic anemia

A 
Drugs 
Alcohol 
Lead 
B6 def 
MDS
279
Q

HgF is elevated in which Thal type?

A

Beta

280
Q

Treatment of major Thal

A

Transfuse

Deferoxamine in case of iron overload

281
Q

Normocytic anemia that is not hemolytic- causes

A

CKD
Ca
MDS
Leukemia

282
Q

PNH cause

A

PIG-A def
Lack of CD55 cells
Increased complement/attack complex formation

283
Q

Treatment of PNH

A

Eculizumab

284
Q

Two diseases with spherocytes on smear

A

HP

AIHA

285
Q

Bite Cells + Heinz Bodies =

A

G6PD def

286
Q

Three Meds that cause crisis in G6PD Def

A

Bactrim nitrofurantoin dapsone

287
Q

How to dx G6PD def

A

Check level 6-8 weeks after attack

288
Q

Hereditary sphrocytosis
Dx
Tx

A

Osmotic fragility

Splenectomy

289
Q

AIHA

Cold/IgM are assc with what infections

A

Mono

Mycoplasma

290
Q

Warm AIHA/IgG is assc with what disease, Dx? tx?

A

AI, cancer
Dx Coombs +++
Tx steroids –> rituxumab –> splenectomy

291
Q

Sickle cell stroke treatment

A

Exchange transfusion

292
Q

Appearance of chronic vs acute leukemia cells

A 
chronic= large nucleus
acute= small nucleus
293
Q

WBC count suggestive of leukemia? acute?

A

greater than 60

acute if more than 20% blasts

294
Q

Acute leukemia, next steps in diagnosis

A

analyze smear –> BMBx

295
Q

Treatment AML? Treatment ALL?

A

AML- vitamin A for M3/ auer rods; other= chemo

ALL- chemo, +++CNS px

296
Q

CML, CLL, ALL, AML:
Which is seen in kids?
Which is seen in middle age people?
(other= old)

A 
CML= middle age
ALL= kids
297
Q

Chronic leukemia, next steps in dx?

A

Diff —> BMBx

298
Q

Treatment CML? CLL?

A

CML- imantinib

CLL- HSCT is young, chemo if old with sx, nothing if old and asx

299
Q

AML cell markers?

ALL cell markers?

A

AML- myeloperoxidase

ALL- tdt, cALLa

300
Q

AML assc exposures

A

benzene, radiation

301
Q

CML- genetic assc?

A

t(9,22)..philidelphia chromosome; BCR-ABL; treat with TKi (imantinib)

302
Q

Nontender lymphadenopathy- next step in dx?

A

excisional biopsy

303
Q

How to stage lymphoma

A

CXR, CT CAP/Pet, BMBx

304
Q

How to stage hodgkins

A

1-1 node
2- 2+ nodes, same side of diaphragm
3- 2+ nodes, opposite sides
4- mets

305
Q

Cyclophosphamide ADR
Cisplatin ADRs (2)
Vincristine/blastine ADR

A

cyclophosphamide hemorrhagic cystitis
cisplastin- ear and kidney toxic
vin- neuropathy

306
Q

Which is more severe- Hodgkins or nonhodgkins?

A

non

307
Q

Two types of non hodgkins

A

Burkitts

Extranodal

308
Q

ETOH LNs /Pel Epstein are assc with?

A

Hodgkins

309
Q

Hodgkins chemo regimen

A

ABVD

310
Q

Non-Hodgkins chemo regimen

A

R-CHOP

311
Q

Multiple Myeloma three serum/urine findings

A

high Ig
osteoclast stim factor
Bence Jones Proteins

312
Q

How do MM patients become immunocompromised

A

^^Ig but its dysfxnal

313
Q

Four tests to evaluate plasma cell d/o

A

spep
upep
skeletal survey (not nuc med)
BMBx

314
Q

Treatment waldenstroms

A

(lymph predominates)
rituximab
+/- plasmapheresis

315
Q 
spep
upep
skeletal survey 
BMBx 
results in MM
A

MM-
+spep, upep
+/- skeletal survey
BMBx more than 10% plasmas

316
Q 
spep
upep
skeletal survey 
BMBx 
results in MGUS
A 
spep+ 
protein gap +
upep ----
skeletal survery ---- 
BMBx les than 10% plasmas
317
Q 
spep
upep
skeletal survey 
BMBx 
results in Waldenstroms
A

+spep
-upep, skeletal survey
BMBx more than 10% lymphocytes

318
Q

Contrast platelet vs factor bleeding

A

platelet- gingiva, skin, vagina

factor- hemarthrosis, hematoma

319
Q

Test of choice for platelet bleeding

A

platelet count

320
Q

Test of choice for factor bleeding

A

PT/PTT and mixing studies

321
Q

Three general causes of thrombocytopenia

A

1) sequestration
2) destruction
3) poor production

322
Q

Four diseases that cause platelet destruction

A 
ITP
TTP
HIT
DIC 
(alphabet soup)
323
Q

Two processes that cause sequestration

A

splenic crisis

cirrhosis

324
Q

Platelet bleeding, platelets within normal limits…

what are causes of platelet dysfunction?

A

drugs (ASA, NSAIDs)
uremia
VWD (which causes VIII instability), BS, Glanzmans

325
Q

VWD
dx
tx

A

platelet bleeding –> normal counts –> vwf assay

tx: DDAVP, VIII supplementation in case of bleeding

326
Q

Bernard Souiler deficiency

A

GP1B

327
Q

Glanzmanns deficiency

A

GP2b3A

328
Q

How to diagnose inhibitors as a cause of factor bleeding

A

PT/PTT increases –> mixing study negative= inhibitor

329
Q

Factor I is? II is?

A

II prothrombin

I fibrin

330
Q

Four causes of thrombophilia directly related to factors

A

prothrombin 20210A mutation
factor 5 leiden mutation
protein C,S def
antithrombin def

331
Q

Antiphospholipid syndrome:
path
dx

A

lupus anticoag

Russell viper venom assay

332
Q

When to anticoagulate in thrombophilias

A

most- after second clot

APl- after first clot

333
Q

Clot types in TTP vs DIC

A

TTP- hyaline

DIC- fibrin

334
Q

TTP- cause & sx

A 
ADAMST 13 def 
FAT RN 
fever 
anemia 
thrombocytopenia

renal failure
neuro sx

335
Q

lab findings in TTP

A

low platelets + shistocytes

normal PT/PTT/fibrinogen/ddimer

336
Q

Treatment TTP

A

exchange transfusion

337
Q

DIC lab findings (platelets, smear, PT/PTT, finbrinogen, d-dimer)

A

low platelets
schistocytes
high PT/PTT, d-dimer
low fibrinogen

338
Q

Timeline HIT

A

heparin –> 7-14 days –> low platetlets

339
Q

Management HIT

A

stop heparin
start argatroban
bridge to heparin

340
Q

ITP:
cause
dx

A

ab to platelets

diagnosis of exclusion, low platelets, AI d/o pt

341
Q

Treatment ITP

A

steroids
IVIG
splenectomy/rituximab if FMT

342
Q

Cause of pigmented gallstones

A

hemolysis

343
Q

IV abx for gallbladder disease

A

amp&gent + metro

cipro + metro

344
Q

Cholelithiasis- 2 tx options

A

chole

ursodeoxycholic acid if not candidate

345
Q

Define cholelithiasis, cholecystitis, cholangitis, choledocolithiasis

A

cholelithiasis- stones in gall bladder, colicky

cholecystitis- stones at cystic duct + inflammation, constant

cholangitis- ascending infection, dilated ducts

choledocolithiasis- obstruction at common duct by stone, “painful jaundice”

346
Q

Cholecystitis findings on US

A

pericholecystic fluid

thickened gallbladder wall

347
Q

Workup for

  • cholelithiasis
  • cholecystitis
  • choledocolithiasis
  • cholangitis
A
  • cholelithiasis: U/S
  • cholecystitis: U/S then HIDA
  • choledocolithiasis: U/S then MRCP then urgent ERCP
  • cholangitis: U/S then EMERGENT ERCP

chole always an option later, only emergent ERCP= cholangitis

348
Q

Medical therapy for all gallbladder disease

A

IVF
IV abx (metro +ampgent or cipro)
NPO

349
Q

Triad/Pentad of cholangitis

A
  • RUQ pain
  • jaundice
  • fever
  • +AMS/ hypotension
  • (see dilated ducts on US)

-note choledocolithiasis also = painful jaundice but not SAS

350
Q

Common bugs in cholangitis

A

gram - anaerobes

351
Q

Workup for dysphagia

A

barium swallow –> EGD +Bx –> manometry if mechanical

352
Q

Achalasia-
absence of ____ plexus
best treatment

A

myenteric

myotomy

353
Q

Treatment of diffuse esophageal spasm

A

CCB; NG PRN

354
Q

Esophageal webs are assc with?

Strictures are assc with?

A

Webs- Plummer Vinson

Strictures- severe longstanding GERD

355
Q

Appearance of stricture vs cancer on barium swallow

A 
stricture= SYMMETRIC loss 
cancer= assymetric
356
Q

Describe plummer vinson syndrome

A

IDA
dysphagia
webs
female

357
Q

Dx of esophagitis

A

EGD with biopsy

If infectious screen for HIV

358
Q

Drugs that cause esophagitis

A

tetracyclines
NSAIDs
bisphosphonates
HAART

359
Q

Clues to eosinophilic esophagitis

A

atopy
asthma
allergies

(trial of PPi–> FMT may do aerosolized steroids)

360
Q

What treatments should never be done for caustic esophagitis

A

neutralization of ph

induced emesis

361
Q

Alarm symptoms that warrant immediate EGD in GERD

A

anemia

weight loss

362
Q 
Treatment of 
GERD
metaplasia 
dysplasia 
cancer
A

GERD- PPI
metaplasia- high dose PPI BID, surveillance
dysplasia- location ablation + surveillance
cancer- stage and resect

363
Q

PUD which location is worse with food? better with food?

A

worse- stomach

better- duodenum

364
Q

Cause of cushings ulcers

A

^^ICP
steroids
ventilators

365
Q

Endoscopy findings below suggest what ulcer types:

  • many and shallow
  • heaped margin, necrotic center
  • single
A
  • many = NSAIDs
  • heaped margins w/ necrotic centers
  • single= H pyolori
366
Q

Triple therapy for h pylori

A

clarithromycin
amoxicillin
PPI

367
Q

Dx for Zollinger Ellison

A

If ^^^ gastrin (normal 25)… check secretin stim test

decreased pH should decrease gastrin

368
Q

ZE- benign or malignant

A

benign but induces malignancy

369
Q

Gastric adenocarcinoma bx findings

A

signet rink cells

assc = asia and nitrites

370
Q

Treatment for gastroparesis

A

metaclopromide PO daily

erythromycin IV for acute

371
Q

BG level- Clue to gastroparesis

A

low glucs after meals

give insulin but no food gets absorbed

372
Q

What is considered a +++ emptying study in gastroparesis

A

more than 60% of contents at 2 hrs or 10% at 4 hrs

373
Q

Diabetics with gastroparesis will also have?

A

neuropathy!!

374
Q

5 types of invasive (bloody diarrhea, +WBCs, + lactoferrin):

A

1) Salmonella
2) Shigella
3) EHec
4) E Histolytica
5) campy

375
Q

6 types of enterotoxic (watery) diarrhea

A

1) c diff
2) vibrio
3) ETEC
4) SA
5) B cereus
6) giardia

376
Q

When can loperamide be used in gastroenteritis

A

viral

377
Q

Triad HUS

A

bloody diarrhea
ARF
anemia

(supportive or plasma exchange therapy)

378
Q

Secretory diarrhea: clue + labs

A

occurs at day + night

no gap, WBC, RBC, mucous, fat etc in stool

379
Q

Infalammatory diarrhea lab findings

A

+WBC, RBC, mucous

380
Q

Osmotic/malabsorption diarrhea lab findings

A

high osm gap in both

fecal fat + if malabsorption

381
Q

Stool osm gap equation

A

measured osms - calculated osms (2xNa+K)

382
Q

Stool osm gap interpretation

A

below 50 = secretory

above 100= osmotic/malabsorption

383
Q

Secretory diarrhea types

A

1) hormone secreting tumor
2) celiac sprue
3) c diff

384
Q

Three tumors that cause diarrhea

A

VIPoma
Zollinger Ellison
Carcinoid

385
Q

ZE dx

A

high gastrin above 250; secretin stim fails to decrease gastrin; SRS to localize

386
Q

Carcinoid causes symptoms when?

A

lung/ mets; not intestinal

387
Q

What is absorbed from terminal ileum

A

B12, fats, bile salts

388
Q

How to dx malabsorption

A

100g fat diet–> more than 14 g fat in stool –> give pre-digested xylose –> absorbed = pancreas; unabsorbed = intestinal border

389
Q

tropical Sprue- clue

A

carribean farmer

390
Q

Whipples disease:

  • bx clue
  • meds
A

PAS+ organism

Bactrim or doxy

391
Q

Presentation of:
Diverticular spasm
D hemorrhage
Diverticulitis/perforation

A

spasm: post prandial LLQ pain relieved with BM
hemorrhage: large volume painless BRBPR
perforation/ diverticulitis: “left sided appendicitis”

392
Q

Abx for diverticulitis

A

cipro+metro
or ampgent + metro

same as gallbladder path

393
Q

Cirrhosis causes

A 
VW HAPPENS Very Weird (stuff) Happens 
Viral 
Wilsons 
Hemochromatosis 
A1AT 
PSC 
PBC 
Ethanol
NASH/ NAFLD 
Something else
394
Q

Treatment Hep C

A

INF + ribavirin

395
Q

Wilsons treatment

A

penicillamine

396
Q

Hemochromatosis tx

A

phlebotomy

deferoxamine

397
Q

A1At treatment

A

transfer

398
Q

PSC/PBC treatment

A

transplant

399
Q

NASH/NAFLD/alcoholic liver treatment

A

transplant

400
Q

Treatment of hepatic encephalopathy

A

lactulose

rifamixin

401
Q

SAAG in portal HTN/ CHF

A

above 1.1

402
Q

Marker for HCC

A

AFP; triple phase CT washout

403
Q

Treatment SBP

A

rocephin

404
Q

Management GIB

A

stabilize (fluids, PPI, type and cross, call GI..octreotide if cirrhotic)
endoscopy

405
Q

Four causes of LGIB

A
  • Hemorrhoids
  • Diverticular Hemorrhage
  • Mesenteric Ischemia
  • Ischemic Colitis
406
Q

Mesenteric ischemia vs ischemic colitis

A

mesenteric ischemia- s/sx of vasculopathy
CAD of gut

ischemic colitis- death at watershed, heavy painful bleeding

407
Q

Diagnosis pancreatitis

A

CT with fluid around pancreas

408
Q

Medical mangagement of pancreatitis

A

IVF
NPO
pain control
ERCP if gallstones

409
Q

Complications of early pancreatitis

A

ARDS (leaky caps)
low Ca (saponification)
pleural effusion/ ascites

410
Q

Prognosis measurement for pancreatitis

A

BUN

411
Q

When to drain pancreatic cyst

A

greater than 6 wks old

412
Q

p-ANCA is assc with what IBD?

A

UC

413
Q

Direct jaundice- painless causes

A

cancer
stricture
PBC
PSC

414
Q

Two enzymatic causes of indirect jaundice

A

Crigler Najar

Gilbert (mild)

415
Q

Two enzymatic causes of direct jaundice

A 
Dubin Johnson (black liver)
Rotors
416
Q

Urine is dark in what type of jaundice

A

direct

417
Q

HBSAB IgG vs IGM

A 
IGM = early infection
IGG= immune, vaccine
418
Q

Two markers for active Hep B infection

A

HSBAG

HBEAG

419
Q

Sand blasting, rock quarries=

A

silicosis

420
Q

aeronautics, electrical work=

A

berylliosis

421
Q

Hypersensitivity Pneumonitis tx

A

remove source

no steroids

422
Q

DPLD CXR and CT findings

A 
reticulonodular infiltrates 
ground glass (CT)
423
Q

Best test for DPLD

A

bx

424
Q

Treatment DPLD

A

steroids –> biologics

425
Q

Two drugs that cause DPLD

A

bleo

amio

426
Q

Define acute interstitial pneumonitis vs IPF

A 
IPF = longer than 6 mo's
acute= under 6 weeks
427
Q

Rheum diseases that cause fibrosis

A

SLE
RA
SS

428
Q

Three extra pulm clues to sarcoidosis

A

heart block
bells palsy
EN

429
Q

Tx sarcoid

A

steroids

430
Q

Asbestosis:
Ca effect
CXR findings
bx findings

A

high Ca
pleural plaques, mesothelioma
barbell bodies

431
Q

O2 is _________limited

CO2 is ______

A 
O2= diffusion
CO2= perfusion
432
Q

Result of ARDS leaky caps on O2/CO2 movement

A

CO2 moves but O2 does not so low CO2= alkalosis

433
Q

Three causes ARDS

A

drowning
transfusion injury
septic shock

434
Q

PCWP and LVF in ARDS

A

low PCWP

normal LV filling

435
Q

PCWP and LVF in CHF

A

high PCWP

low LV filling

436
Q

Ventilator settings in ARDS

A

low TV
high RR
high PEEP

437
Q

COPD treatment order

A
  1. SABA
  2. LAMA
  3. LABA
    (what dingess is on)

if above does not work:

  1. ICS
  2. PDE4i
  3. OCS
438
Q

Goal O2 sat in COPD

A

88-92

439
Q

COPDE antibiotics

A

doxy

azithro

440
Q

PE ABG findings are same as

A 
ARDS 
low CO2 (perfusion limited)-- moves out 
O2 low (cant get in--diffusion limited)
441
Q

Treatment PE

A

heparin then bridge to wardarin

442
Q

Massive PE is accompanied by _____ and need ____

A

hypotension

TPA

443
Q

Wells Criteria

A 
DDTTT2CC 
Don't Die Tell The Team 2 Calculate Criteria 
(3)
-DVT symptoms 
-Dx most likely 
(1.5)
-Tachy
-TE in past 
-Three days immobile 
(1) 
-Cancer
-Coughing up blood
444
Q

Wells score 2 and under –> F/U
Score above 4?
Score above 6?

A

2: D-Dimer –> CTA
4+: CTA
6+: VQ

445
Q

How to bx mass in periphery, middle lung, small airways, large airways

A

periphery: perc biopsy w/ CT guiding
middle: surg
small airways: EBUS (endobronchial w/ US)
large: bronchoscopy

446
Q

When to bx lung mass

A

more than 2 cm + risks

age above 70, smoking, spiculations

447
Q

When to get serial CTs for lung mass

A

under 2 cm

low risk

448
Q

First thing to do in case of lung mass

A

get old films

449
Q

Two paraneoplastic syndromes assc with small cell

A

Cushings

SIADH

450
Q

Exudative effusion causes

A

malignancy
pneumonia
TB

451
Q

Transudative effusion causes

A

1 CHF
2 nephrosis
3 cirrhosis
4 gastrosis

452
Q

When LABA is given in Asthma what must also be given?

A

ICS or ^ mortality

453
Q

Stage 1-4 asthma daily symptoms

A

I- 2x/week
II less than 1x/daily
III daily
IV all day

454
Q

Stage 1-4 asthma nightly symptoms

A

I less than 2x/mo
II less than 1x/ week
III more than 1x/ week
IV nightly

455
Q

CCP ab is + in what rheum disease

A

RA

456
Q

Smooth muscle AB is + in what rheum disease

A

AI hepatitis

457
Q

Ro, la are + in what rheum disease

A

sjogrens

458
Q

jo is + in what rheum disease

A

PM

DM

459
Q

AMA is + in what rheum disease?

A

PBC

460
Q

Non inflammatory chronic joint pain =

A

OA

no fever, ESR, CRP

461
Q

Seropositive rheum diseases causing joint pain? negative?

A

sero+: lupus, RA

sero-: CT d/o

462
Q 
WBC in joint that is 
normal 
OA 
inflammatory 
septic
A

normal under 200
OA under 2k
inflammatory 2k-50k
septic more than 50k

463
Q

Spetic arthritis gram stain negative =

A

gonorrhea

464
Q

Drugs that cause SLE (3)

A

hydral
procainamide
methyl dopa

465
Q

Lupus nephritis tx

A

cyclophosphamide

466
Q

General lupus tx

RA tx

A

lupus: HF
RA: MTX

steroids for flare, cyclophosphamide/myco for nephritis

467
Q

Lupus nephritis ab

A

dsDNA

468
Q

Complement changes in lupus

A

low C3,4

469
Q

Cause of miscarriage in lupus

A

APL disease

470
Q

1st line RA tx is

A

MTX

471
Q

Xray finding specific to lupus

A

C1-2 spine disease/ periarticular osteopenia

472
Q

RA spares what joint

A

DIP spared

473
Q 
Scleroderma:
sclerodactyly tx 
raynauds tx 
GERD tx 
renal crisis tx
A

scleor- penicillamine
raynauds- CCB
GERD- PPI
renal- ACEi, no steroids

474
Q

Clue for nephrogenic systemic sclerosis

A

gadolinium/ MRI

475
Q

Sjogrens ab + 3 findings

A 
dry shit (eyes, mouth, parotid swells)
ro, la
476
Q

Tests for IIM

A

mi, jo abs
high CK
best is bx
can do EMG to r/o neuropathic cause

477
Q

Gout vs pseudogot

A

gout- negative birefringent, needles

pseudo- positive birefringent, rhomboid

478
Q

Diuretic that causes gout

A

thiazide

but protects from osteoporosis

479
Q

gonorrhea arthritis tx method

A

IV

480
Q

4 seronegative arthritis types
MC sex?
tx?

A 
PAIR 
psoriatic 
ank spon
IBD assc 
reactive

males
NSAID and local steroids

481
Q

Takayasu & GCA: age, dx, tx

A

GCA-elderly, bx, steroids

Takayasu- aortic, young adult, CTA, steroids

482
Q

Clue to takayasu

A

pulselessness

483
Q 
PAN- medium vasculitis 
assc with what infection
3 symptom clues 
dx
tx
A

Hep B
mesenteric ischemia, purpura, sensory loss
angiogram
steroids + cyclo

484
Q

Small vasculitis:
c-ANCA?
p-ANCA?

A 
Wegners/GPA= c-anca
eosinophilis/MPA= p-anca
485
Q

Two small vessel vasculitis caused by immune complexes

A

cryoglobulinemia

HSP

486
Q

Cryoglobulinemia
assc
clue
tx

A

Hep C
purpura
plasmapheresis

487
Q

AKI, not pre-renal…. next best step

A

CT non con or US

488
Q

Pre-renal AKI types

A

leak (nephrosis, gastrosis, cirrhosis)
pump failure
hole (bleed, diarrhea)
clog (RAS, FMD)

489
Q 
Goals for:
BP 
a1c
BG 
in CKD patients
A

130/80
less than 7
80-120

490
Q

How to prevent PTH ^^ in CKD

A

cincalcet

491
Q

How to stabilize in ^^K

A

Ca for EKG

492
Q

how to temporize in ^^K

A

insulin & D50
bicarb
b agonists

493
Q

How to decrease total body K

A

loop
kayexelate
dialysis

494
Q

Diruetics that lower K

A

loops

thiazides

495
Q

Refractory low K =

A

low mag!

496
Q

When to give hypertonic saline in low Na?

A

seizures (3%)

497
Q

UNa ~

Uosm ~

A 
aldo= Na 
osm= ADH
498
Q

Euvolemic hyponatremia causes

A 
RATS 
Thyroid low 
Addisions 
RTA 
SIADH
499
Q

Serum Osm calculation n

A

2xNa +gluc/1.8 + BUN/2.8

normal ~280

500
Q

How are ca and albumin related

A

change 1 in albumin = change 0.8 Ca opposite direction

501
Q

Simple renal cyst treatment

A

no treatment if asx

502
Q

ADPKD = screen for

A

aneurysm, MRI

503
Q

How to diagnose exogenous insulin use

A

low C-peptide

or + secretalogue score

504
Q

C-peptide in insulinoma

A

high

505
Q

How to monitor DKA severity

A

gap

506
Q

DM dx
a1c
Fasting
GTT

A

a1c- 5.7, 6.5
fasting- 100, 125
GTT- 140, 200

507
Q

When is a1c not helpful?

A

early DM

gestational DM

508
Q

Ab type in DM1

A

GAD

IA2

509
Q

Oral hypoglycemic that cause weight gain?

weight loss?

A 
gain = TZD, --glitazone 
loss= GLP1i,  --glutides
510
Q

Three rapid acting insulins

A
  • lispro
  • aspart
  • glulisine
511
Q

Two long acting insulisn

A
  • glargine

- detemir

512
Q

MEN1 tumors

A

hard P’s

  • pituitary
  • pancreatic
  • parathyroid
513
Q

MEN2a tumors

A

parathyroid
pheo
medullary thyroid

514
Q

MEN2b tumors

A

pheo
medullary
neuronal

515
Q

Pancreatic tumors

A

ZE

insulinoma

516
Q

Gene assc with MEN2a,b

A

RET

517
Q

How does thyroid hormone affect prolactin?

A

TRH —-I prolactin

T4 —–I TRH

518
Q

How does dopamine effect prolactin?

A

inhibits

so dopa antagonists increase

519
Q

How are GH and BG related?

A

GH increases glucose
glucose should decrease growth hormone
insulin shoud increase GH

520
Q

Dx for high growth hormone

A

IGF1

glucose suppression test

521
Q

How to dx hypopituitarism

A

insulin/ vasopressin stim test (should ^ GH in healthy pt)

LH FSH also low

522
Q

SIADH treatment

A

fluid restriction

demeclocycline

523
Q

Treatment thyroid storm

A

BB
methimazole
steroids

524
Q

Tx for follicular thyroid cancer

A

radioactive iodine

525
Q

Which thyroid cancer has highest mortality rate

A

anaplastic

526
Q

Cushing dx

A

low then high

low dose dexa suppression
ACTH levels
high dose dexa suppression

(responds to low dose, normal ACTH= adrenal tumor// no response to low dose, high ACTH, no response to high dose= ectopic// no response to low dose, high ACTH, response to high dose = pituitary tumor)

527
Q

Addisons lab values + dx

A

low cushings AND aldo

early AM cortisol –> cosyntropin test

528
Q

Medical treatment pheo

A

a blocker –> b blocker –> resect

529
Q

Incidentaloma management

A

R/O conns pheo cushings

if above 4 cm resect, or if functioning resect

530
Q

SVT drug

A

adenosine

531
Q

brady drug

A

atropine, only sinus, first degree, 2nd degree

532
Q

Old person no disease BP goal

A

150/90

533
Q

Person under 60 or with disease BP goal

A

140/90

534
Q

3 first line drugs BP control

A

CCB Thiazide ACE

535
Q

Who doesn’t get ACE

A

Above 75
black
no CKD

536
Q

Stage 1 HTN drug

A

1 drug (CCB Thiaizde ACE)

537
Q

Stage 2 HTN drug

A

2 drugs (CCB, Thiazide, ACE)

538
Q

Old (more than 48 hours) afib needs….

A

echo

539
Q

Vtach appearance

A

monomorphic

540
Q

Normal PR length

A

one big box

541
Q

Shockable rhythms

A

pulseless vtach

vfib

542
Q

Shockable rhythm drugs

A

epi amio

543
Q

Pulseless person drugs

A

epi absent epi absent

544
Q

Who can get aspirin in afib

A 
no CHADSS 2 risks 
CHF
HTN 
age above 75
DM 
stroke 
stroke
545
Q

How to count rate on EKG

A

300 150 100 75 60 50 43 37

546
Q

What type of heart failure cannot get nitro

A

RHF

547
Q

Three symptoms for determining chest pain type

A

substernal or l
increased with exercise
decreased with NG
3= typical 2= atypical 1= noncardiac

548
Q

CHF treatment cascade

A 
ACE and BBer all classes 
diuretic class 2 
spiro/iso class 3
ionotrope class 4
549
Q

Opening snap=

A

mitral stenosis

550
Q

MVP murmur is same as ____ except ___

A

MR except increased with Valsalva

551
Q

HCOM is caused by what mutation

A

sarcomere

552
Q

4 murmurs that decrease with Valsalva

A

MS
MR
AS
AR

553
Q

What murmur gets balloon valvulopasty

A

MS

554
Q

Treatment HCOM and MVP

A

BBer

555
Q

Three diseases causing restrictive heart failure

A

amyloid
sarcoid
hemochromatosis

556
Q

Amyloid dx

A

fat pad bx

557
Q

Clues to sarcoid amyloid hemo restrictive CHF

A

amyloid- neuropathy
sarcoid- lung disease
hemo- cirrhosis

558
Q

Sarcoid restrictive heart disease dx

A

endomyocardial bx

559
Q

Two common causes of pericarditis

A

viral

uremia

560
Q

NSAIDs treat pericarditis except when?

A

PUD
low platelets
CKD

561
Q

Pericardial knock=

A

constrictive pericarditis –> need pericardectomy

562
Q

1st line tx pericarditis

A

NSAIDs and colchicine

563
Q

3 causes of + orthostatics

A

elderly
parkinsons
DM

564
Q

MAP=

A

CO x SVR

565
Q

CO=

A

HR x SV

566
Q

SV=

A

contractility x preload

567
Q

Neurogenic syncope clue

A

FND

568
Q

+ orthostatics

A

20 change SBP
10 change DBP
pulse change 15

569
Q

What are high dose statins

A

atorva 40-80

rosuva 20-40

570
Q

ezetimibe causes

A

diarrhea

571
Q

niacin causes

A

flushing, give aspirin

Internal (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions