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Parkinson's dz tx

DA agonists: levodopa, carbidopa, bromocroptine, amantadine

Antichol: benztropine, trihecyphenidyl

MAO B inhibitor: selegiline

1

Alzheimer's tx

Cholinesterase inh: donepezil, rivastigmine, galantamine

NMDA antag: memantine

Vit E

3

Cholinesterase inhibitors

donepezil, rivastigmine, galantamine, physostigmine

-tx Alzheimers

4

Anticholinergics

benztropine, trihecyphenidyl

-tx acute dystonia and Parkinsonism 2/2 antipsychotics

5

TCA OD

CNS dep, hypotension, hyperthermia, antichol (dilated pupils, dry flushed skin, intestinal ileus)

QRS prolongation -- vent arrhythmias -- PROGNOSIS

Tx = NaHCO3

6

NAHCO3 MOA for TCA OD

Increase extracellular Na conc to prevent inhibition of cardiac fast Na channels (QT prolong)

Alkalinity serum to decrease drug avidity for sodium channels

7

NaHCO3 MOA for ASA OD

Urine alkalinization

8

First gen H1 antihistamines

Diphenhydramine, chlorpheniramine, doxepin, hydroxyzine

9

Hyperacute transplant rejection

Within 24 hrs

No tx

Anti donor Abs in recipient

10

Antichol

Urinary retention (failure of detrusor contraction), dysuria

-tx urge incontinence

"Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone (ileus, retention), and the heart runs alone."

11

Acute transplant rejection

6 d-1 yr

Antidonor T cells in recipient

Immunosuppressive and steroids

12

Acute hemolytic transfusion rxn

Within 1 hr

ABO mismatch

Fevers, chills, flank pain, hemoglobinuria

Positive direct Coombs

DIC, RF, shock

Tx = supportive

13

Anaphylactic transfusion rxn

IgA def

Sec-min

14

Systolic diastolic bruit with resistant HTN

RAS

15

Congenital rubella

Sensorineural deafness, cataracts, HSM, purpura (blueberry muffin)

Developmental delays

16

High PEEP vent complications

Alveolar damage, tension pneumo, hypotension

17

Drugs that need folic acid supp

Phenytoin, methotrexate, TMP

Other antiepileptics primidone, phenobarbital

18

Entamoeba histolytica tx

metronidazole

19

Cholinergic effects

DUMBELLS - Diarrhea, Urination, Miosis, Bradycardia, Emesis, Lacrimation, Lethargy and Salivation

-organophosphate poisoning (tx = atropine, pralidoxime)

-use cholinergic agonist (bethanechol) to tx overflow incontinence

20

Giardia lamblia tx

metronidazole

21

Salmonella tx

quinolone, TMP-SMX

22

Shigella tx

quinolone, TMP-SMX

23

Campy tx

erythro

24

Encapsulated organisms

S pneumo, H influ, N meningitidis, Klebsiella

25

Hydroxyurea MOA

increases HgF

26

Drugs that increase PrL levels

(psych) phenothiazines, risperidone, haldol

methyldopa
verapamil

27

What causes hemolysis in G6PD

fava beans
sulfa drugs
primquine
hi-dose ASA
INH
nitrofurantoin
dapsone

28

WPW tx

Class IA or IC antiarrhythmics

quinidine, procainamide

cardioversion

29

Trousseau's syndrome

migratory thrombophlebitis
-MALIGNANCY: pancreatic, lung, prostate, stomach, acute leukemia, colon

-CT scan of abd

30

Bilirubin in urine = direct or indirect?

direct - soluble

31

Lidocaine - arrythmia tx

vtach

32

enthesitis

pain at portions of joint insertion

spondyloarthropathies (AS)

33

broad and waxy casts

CRF

34

fatty casts

nephrotic Sx

35

HIV ppx in needlestick

Zidovudine, lamivudine

36

Auer rods

AML

37

PAS+ and TdT+ peripheral blasts

ALL

38

Otitis media organisms AND sinusitis!!

1. S pneumo
2. H influ
3. Moraxella

39

tx for hypovolemic hyperNa

NS

40

high-output HF 2/2 arteriovenous fistula

widened PP, strong peripheral arterial pulsation (brisk carotid upstroke), systolic flow murmur, tachycardia, flushed area

41

high-output HF conditions

Paget dz, anemia, thiamine deficiency, thyrotoxicosis, AVF

42

Concern for pt with DM II taking HCTZ?

HHS

43

Febrile neutropenia tx

Broad spectrum Abx: IV ceftazidime, cefepime (ACTIVE AGAINST PSEUDOMONAS!!!)

44

epiglotittis organisms

S pyogenes, H influ

45

airway for cervical spine injury

orotracheal intubation with RSI

46

DA agonists

levodopa, carbidopa, bromocroptine, amantadine

-tx Parkinson's

46

tx for otitis media or sinusitis

Amox (+clavulanic acid)

47

lithium congenital defect

Ebstein's anomaly

48

Do we use beta-blocker for acute CHF?

NOOOO

49

+ p-ANCA conditions (5)

-pauci-immune GN (eg crescentic)
-microscopic polyangiitis
-Churg-Strauss
-UC
-PSC

50

anti-mitochondrial Abs

PBC

51

symptomatic hypoNa tx

hypertonic saline

52

viral URI gets worse!

S aureus!

53

Vit A def

bitot's spots, keratomalacia, xerophthalmia

54

vit b3/niacin def

dermatitis, diarrhea, dementia

55

Vit E def

increased RBC fragility

56

aplastic/macrocytic anemia with thumb abnormalities, abnl skin pigmentation, ear and eye abnl

Fanconi anemia

57

Fanconi anemia genetics

chromosomal strand breakage

58

MCC (congenital) aplastic anemia in children

Fanconi anemia

59

retinal hamartoma found in...

tuberous sclerosis

60

optic glioma found in...

NF-1

61

viral meningitis

enterovirus (echo, coxsackie)

HSV

lymphocytic choriomeningitis

mumps

62

Jervell-Lage-Nielson Syndrome

congenital QT prolongation (TdP) and deafness
- AR
-FHx
-syncope without disorientation
-tx = beta-blocker propranolol

63

Lesch-Nyhan syndrome

hypoxanthine-guanine phosphoribosyl transferase deficiency (purine met)

-self-mutilation, MR, hyperuricemia, dystonia, choreoathetosis, CP

64

Jervell-Lage-Nielson Syndrome

congenital QT prolongation (TdP) and deafness
- AR
-FHx
-syncope without disorientation
-tx = beta-blocker propranolol

65

Henoch-Schonlein purpura

-IgA mediated leukocytoclastic vasculitis

-URI, palpable purpura, abd pain, polyarticular arthritis, RF

66

Granulomatous dz

Takayasu's arteritis, Wegener's, Churg-Strauss

67

Pt with h/o splenectomy may have abnormality in labs:

THROMBOCYTOSIS

68

why are infants protected from sickle cell dz?

HgF

69

Pt with h/o splenectomy may have abnormality in labs:

THROMBOCYTOSIS

70

why are infants protected from sickle cell dz?

HgF

71

sudden-onset syncope without a prodrome

arrythmia!! (Torsades de pointes)

-especially on sotalol with diarrhea (hypoK, hypoMg) and CAD

72

torsades de pointe tx

1. MgSo4!!!
2. temporary pacemaker or isoproterenol

73

defective mineralization of bone

osteomalacia

74

low bone mass with normal mineralization

osteoporosis

75

defective skeletal remodeling

Paget's

76

Cisplatin SE

nephrotoxicity, tinnitus and hearing loss, N/V, neurotox, electrolyte abnl

77

drug-induced pancreatitis

1. szs/bipolar - valproic acid!!!
2. diuretics - furosemide, thiazides
3. IBD - sulfasalazine, 5ASA
4. immunosupp - azathioprine, L-asparaginase
6. AIDs - didanosine, pentamidine
7. Abx - metro, tetracycline

78

abnormal hemostasis in CRF due to...

plt dysfunction

79

Marfan's + MR + thromboembolic events + downward dislocation of lens

homocystinuria 2/2 cystathionine synthase deficiency

80

homocystinuria tx

high doses B6

(will see elevation of both homocyteine and methionine in dz)

81

Phenylketonuria = PKU

phenylalanine hydroxylase deficiency

-MR, fair complexion, blue eyes, eczema, musty body odor

82

hypothyroidism vs myopathy

check reflexes!

83

young pt with RAS

fibromuscular dysplasia

-stent!

84

pt with lupus with hip pain...

think AVN 2/2 CSs!!!

85

pt with meningococcemia dies...

Waterhouse-Friederichsen syndrome!! --> sudden vasomotor collapse and skin rash 2/2 adrenal hemorrhage

86

PCWP of cardiogenic pulm edema

>18

87

PCWP of ARDS

<18 mmHg

88

rotator cuff tendonitis

improved with lidocaine injection

89

Loss to follow up is a type of ___ bias

selection bias

90

infant who has cyanosis when feeding relieved by crying

choanal atresia

91

electrical alternans with sinus tachycardia

large pericardial effusion

92

painless jaundice

pancreatic malignancy

93

med to avoid in MI with acute pulm edema

Beta-blocker

94

Amyloidosis

RA, kidney and liver invovlement

apple-green birefringence under polarized light

95

Dumping syndrome

post-gastrectomy!

96

ARDS TV

6 ml/kg