DUMBELLS - Diarrhea, Urination, Miosis, Bradycardia, Emesis, Lacrimation, Lethargy and Salivation - organophosphate poisoning (tx = atropine, pralidoxime) - use cholinergic agonist (bethanechol) to tx overflow incontinence

Step 2 CK Flashcards by wendy Ma

Alzheimer’s tx

Cholinesterase inh: donepezil, rivastigmine, galantamine

NMDA antag: memantine

Vit E

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Parkinson’s dz tx

DA agonists: levodopa, carbidopa, bromocroptine, amantadine

Antichol: benztropine, trihecyphenidyl

MAO B inhibitor: selegiline

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Cholinesterase inhibitors

donepezil, rivastigmine, galantamine, physostigmine

-tx Alzheimers

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Anticholinergics

benztropine, trihecyphenidyl

-tx acute dystonia and Parkinsonism 2/2 antipsychotics

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TCA OD

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

QRS prolongation – vent arrhythmias – PROGNOSIS

Tx = NaHCO3

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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

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NaHCO3 MOA for ASA OD

Urine alkalinization

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First gen H1 antihistamines

Diphenhydramine, chlorpheniramine, doxepin, hydroxyzine

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Hyperacute transplant rejection

Within 24 hrs

No tx

Anti donor Abs in recipient

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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.”

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Acute transplant rejection

6 d-1 yr

Antidonor T cells in recipient

Immunosuppressive and steroids

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Acute hemolytic transfusion rxn

Within 1 hr

ABO mismatch

Fevers, chills, flank pain, hemoglobinuria

Positive direct Coombs

DIC, RF, shock

Tx = supportive

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Anaphylactic transfusion rxn

IgA def

Sec-min

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Systolic diastolic bruit with resistant HTN

RAS

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Congenital rubella

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

Developmental delays

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High PEEP vent complications

Alveolar damage, tension pneumo, hypotension

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Drugs that need folic acid supp

Phenytoin, methotrexate, TMP

Other antiepileptics primidone, phenobarbital

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Entamoeba histolytica tx

metronidazole

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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

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Giardia lamblia tx

metronidazole

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Salmonella tx

quinolone, TMP-SMX

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Shigella tx

quinolone, TMP-SMX

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Campy tx

erythro

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Encapsulated organisms

S pneumo, H influ, N meningitidis, Klebsiella

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Hydroxyurea MOA

increases HgF

Drugs that increase PrL levels

(psych) phenothiazines, risperidone, haldol methyldopa verapamil

What causes hemolysis in G6PD

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

WPW tx

Class IA or IC antiarrhythmics quinidine, procainamide cardioversion

Trousseau's syndrome

migratory thrombophlebitis -MALIGNANCY: pancreatic, lung, prostate, stomach, acute leukemia, colon -CT scan of abd

Bilirubin in urine = direct or indirect?

direct - soluble

Lidocaine - arrythmia tx

vtach

enthesitis

pain at portions of joint insertion spondyloarthropathies (AS)

broad and waxy casts

CRF

fatty casts

nephrotic Sx

HIV ppx in needlestick

Zidovudine, lamivudine

Auer rods

AML

PAS+ and TdT+ peripheral blasts

ALL

Otitis media organisms AND sinusitis!!

1. S pneumo 2. H influ 3. Moraxella

tx for hypovolemic hyperNa

high-output HF 2/2 arteriovenous fistula

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

high-output HF conditions

Paget dz, anemia, thiamine deficiency, thyrotoxicosis, AVF

Concern for pt with DM II taking HCTZ?

HHS

Febrile neutropenia tx

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

epiglotittis organisms

S pyogenes, H influ

airway for cervical spine injury

orotracheal intubation with RSI

DA agonists

levodopa, carbidopa, bromocroptine, amantadine -tx Parkinson's

tx for otitis media or sinusitis

Amox (+clavulanic acid)

lithium congenital defect

Ebstein's anomaly

Do we use beta-blocker for acute CHF?

NOOOO

+ p-ANCA conditions (5)

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

anti-mitochondrial Abs

PBC

symptomatic hypoNa tx

hypertonic saline

viral URI gets worse!

S aureus!

Vit A def

bitot's spots, keratomalacia, xerophthalmia

vit b3/niacin def

dermatitis, diarrhea, dementia

Vit E def

increased RBC fragility

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

Fanconi anemia

Fanconi anemia genetics

chromosomal strand breakage

MCC (congenital) aplastic anemia in children

Fanconi anemia

retinal hamartoma found in...

tuberous sclerosis

optic glioma found in...

NF-1

viral meningitis

enterovirus (echo, coxsackie) HSV lymphocytic choriomeningitis mumps

Jervell-Lage-Nielson Syndrome

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

Lesch-Nyhan syndrome

hypoxanthine-guanine phosphoribosyl transferase deficiency (purine met) -self-mutilation, MR, hyperuricemia, dystonia, choreoathetosis, CP

Jervell-Lage-Nielson Syndrome

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

Henoch-Schonlein purpura

- IgA mediated leukocytoclastic vasculitis | - URI, palpable purpura, abd pain, polyarticular arthritis, RF

Granulomatous dz

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

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

THROMBOCYTOSIS

why are infants protected from sickle cell dz?

HgF

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

THROMBOCYTOSIS

why are infants protected from sickle cell dz?

HgF

sudden-onset syncope without a prodrome

arrythmia!! (Torsades de pointes) -especially on sotalol with diarrhea (hypoK, hypoMg) and CAD

torsades de pointe tx

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

defective mineralization of bone

osteomalacia

low bone mass with normal mineralization

osteoporosis

defective skeletal remodeling

Paget's

Cisplatin SE

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

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

abnormal hemostasis in CRF due to...

plt dysfunction

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

homocystinuria 2/2 cystathionine synthase deficiency

homocystinuria tx

high doses B6 | will see elevation of both homocyteine and methionine in dz

Phenylketonuria = PKU

phenylalanine hydroxylase deficiency -MR, fair complexion, blue eyes, eczema, musty body odor

hypothyroidism vs myopathy

check reflexes!

young pt with RAS

fibromuscular dysplasia -stent!

pt with lupus with hip pain...

think AVN 2/2 CSs!!!

pt with meningococcemia dies...

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

PCWP of cardiogenic pulm edema

>18

PCWP of ARDS

<18 mmHg

rotator cuff tendonitis

improved with lidocaine injection

Loss to follow up is a type of ___ bias

selection bias

infant who has cyanosis when feeding relieved by crying

choanal atresia

electrical alternans with sinus tachycardia

large pericardial effusion

painless jaundice

pancreatic malignancy

med to avoid in MI with acute pulm edema

Beta-blocker

Amyloidosis

RA, kidney and liver invovlement apple-green birefringence under polarized light

Dumping syndrome

post-gastrectomy!

ARDS TV

6 ml/kg

Step 2 CK Flashcards

(97 cards)