Step 2 Flashcards pt. 2
(182 cards)
1
Q
role of hCG during pregnancy
A
preserves corpus luteum during early pregnancy to maintain progesterone secretion until the placenta is able to produce progesterone on its own
2
Q
salvage therapy
A
Treatment for disease when the standard therapy fails
3
Q
schizophrenia CT findings
A
increased ventricular size on CT
4
Q
screening for 0-5 year olds
A
strabismus, amblyopia, and refractive errors
5
Q
sepsis ppx for splenectomy
A
anti-pneumococcal, H flu, and menin vaccines before operation, daily PO PCN 3-5 years s/p
6
Q
serum sickness-like reaction
A
hypersensitivity reaction 1-2 weeks after administration of certain drugs (PCN, amox, TMP-SMX)
7
Q
severe pre-eclampsia
A
BP>160/110, protein excretion >5g/24hrs
8
Q
SGA complications
A
hypoxia, polycythemia, hypoglycemia, hypothermia, and hypocalcemia
9
Q
shizoaffective disorder
A
presence of mood symptoms during the course of schizophrenia like symptoms
10
Q
shown to reduce the morbidity and mortality of measles
A
vitamin A
11
Q
sickle cell aplastic crisis
A
acute severe anemia with low/absent retics
12
Q
side effect: dihydropyridine Ca channel antagonists
A
peripheral edema
13
Q
single most preventable cause of fetal growth restriction in the US
A
smoking
14
Q
steps in suspected meningitis in children
A
blood cx, lumbar puncture then abx
15
Q
Stepwise treatment for ascites
A
1) sodium and water restriction, 2) spironolactone, 3) loop diuretic, 4) frequent abdominal paracentesis
16
Q
steroid induced folliculitis
A
monomorphous pink papules and absence of comedones
17
Q
susceptibility bias
A
type of selection bias where treatment regimen is selected based on severity of their condition; negates the benefits of randomization
18
Q
tacrolimus toxicity
A
same as cyclosporin but no hirsutism or gum hypertrophy
19
Q
tamoxifen MOA
A
selective estrogen receptor modulator (antagonist in breast, partial-agonist in endometrium and osteoclasts)
20
Q
TB chemoppx for positive PPD
A
isoniazid for 9 months
21
Q
test for macular degeneration
A
grid test, lines appear curved
22
Q
tetanus ppx: minor/clean wound who has >3 toxoid doses
A
none
23
Q
tetanus ppx: minor/clean wound who is unimmunized, uncertain or <3 toxoid doses
A
tetanus toxoid only
24
Q
tetanus ppx: severe/dirty wound who has >3 toxoid doses
A
toxoid if latest booster given >5 years ago
25
tetnus ppx: severe/dirty wound who is unimmunized, uncertain or <3 toxoid doses
toxoid and Ig
26
thalassemia trait labs
microcytic anemia with mild reticulocyte elevation; RDW, MCHC, TIBC and ferritin levels normal
27
The rest of descent
Lack of changing two hours for primigravid patients or one hour from multigravida patients
28
thyroid hormone changes during pregnancy
increased total T3/T4 (normal free) from HCG stim of TSH receptors and increased TGB concentration
29
timing for gestational diabetes
24-28 weeks
30
to differentiate saline responsive/resistant metabolic alkalosis
saline responsive has a chloride <20
31
To familial disorders of conjugated hyperbilirubinemia
Dubin-Johnson and rotor syndrome
32
torus palatinus
congenital, benign bony growth of midline suture of the hard palate
33
toxicity: cyclophosphamide
hemorrhagic cystitis, bladder carcinoma, sterility, and myelosuppression
34
toxoplasmosis dx
multiple ring enhancing lesions, serology NOT specific
35
triad of congential rubella
sensorineural deafness, cardiac malformation, and cataracts; usually only occurs if infected first 4 weeks)
36
trimethoprim electrolyte disturbance
hyperkalemia, blocks epithelial sodium channel in the collecting tubes
37
Turcot's syndrome
association between brain tumors and FAP or HNPCC
38
tx: absence seizures
ethosuxamide or valproic acid
39
tx: Actinomyces
Penicillin, high-dose for 6 to 12 weeks
40
TX: acute aortic dissection
Beta blockade
41
tx: acute limb ischemia
IV heparin then definitive tx (surgical, finbrinolysis, embolectomy)
42
tx: acute MS flare
IV corticosteroids
43
tx: amebic liver abscess
PO metronidazole
44
tx: asymptomatic bacteriuria in pregnancy
7 days nitrofurantoin, amoxicillin, or first generation cephalosporin
45
tx: benign intracranial HTN
acetazolamide
46
tx: bipolar maintainence
moderate: atypical antipsychotics or monotherapy lithium or valproate
47
severe: combo lithium or valproate plus atpyical antipsychotic
...
48
tx: blastomycosis
itraconazole or amphotericin B
49
tx: candida vulvovaginitis
azole anti-fungal
50
TX: cat scratch disease
usually resolves but can use 5 days of azithromycin
51
tx: central precocious puberty
r/o CNS lesion, GnRH agonist to prevent premature fusion of the epiphyseal plates
52
tx: chalmydia
1 dose azithromycin or 7 day course of doxycycline
53
TX: chronic hep B
Persistently elevated ALT levels, detectable serum HBS AG, HBE AG, and HPV DNA; treatment with interferon or the lamivudine
54
TX: clubfoot
Stretching and manipulation of the foot followed by plaster cast, knowledgeable splints, we're taping
55
TX: cradle cap
moisturizers, antifungals and topical steroids
56
tx: dermatitis herpetiformis
gluten free diet and dapsone
57
tx: DUB moderate, no active bleeding
progestin
58
tx: DUB, mild
iron supplementation
59
tx: DUB, moderate with uncontrolled bleeding or severe
estrogen
60
TX: dumping syndrome
Dietary changes, octreotide in resistant cases
61
tx: empiric neutropenia with fever
ceftazidime or cefepime
62
tx: endometrial hyperplasia without atypia
cyclic progestins
63
TX: esophageal coins
Observed for 24 hours, if symptomatic remove with flexible endoscopy
64
tx: ethylene glycol poisoning
fomeipzole or ethanol
65
tx: excessive feto-maternal hemorrhage in the setting of Rh - mother
need to adjust and correct the dose of rho-gam
66
tx: fibromusclular dysplasia of renal artery
stent placement
67
tx: first line asymptomatic bacteruria during pregnancy
amoxicillin, nitrofurantoin, and cephalexin
68
tx: gastric mucosa-assocaited MALT
antibiotic therapy for the eradiction of H pylori
69
tx: GERD in infants
thickened feeds, positioning to decreased intraabdominal pressure
70
tx: hairy cell leukemia
cladribine
71
tx: HELLP syndrome
delivery if after 34 weeks, steroids/lung development if stable and under 34 weeks
72
tx: histoplasmosis
itraconazole
73
tx: HIV dysphagia
empiric fluconazole
74
tx: HIV dysphagia non-responsive to fluconazole
IV gancyclovir
75
tx: hypercalcemia of immobilization
hydration, bisphosphinates
76
tx: immune thrombocytopenia
corticosteroids for plt <30,0000
77
tx: induce ovulation in PCOS
clomiphene citrate (estrogen analog)
78
tx: inevitable abortion
suction curretage and rho-gam if Rh-negative
79
tx: infant VSD
is small, observation (will sound much harsher)
80
TX: inflamed, fluctuant lymph nodes
dicloxacillin, cephalexin or clindamycin
81
tx: inpatient opiod withdrawal
oral or IM methadone
82
tx: intrauterine fetal demise, coagulation abnormalities
induction of labor, low fibrinogen and platelets can indicate DIC
83
TX: isolated duodenal hematoma
Conservatively with nasogastric suction and parenteral nutrition
84
tx: kawasaki's
ASA and IVIG w/in 10 days to prevent cardiac complications
85
tx: lichen sclerosis
high-potency topical steroids
86
TX: local impetigo
Topical mupirocin or oral erythromycin
87
TX: Lyme Disease in children
Amoxicillin <8 years old
88
tx: malignant otitis externa
ciprofloxacin
89
TX: mastitis
Dicloxacillin or cephalosporins, continue breast-feeding from the affected breast
90
tx: meniere's disease
environmental and dietary modifications; low sodium diet
91
tx: minimal change disease
empiric steroid therapy in any child with suggestive presentation
92
tx: minor cat bites
amoxicillin/clavulanate for 5 days
93
tx: morton neuroma
bilateral inserts
94
tx: mucormycosis
aggressive surgical debridement plus early systemic chemotherapy
95
tx: multiple brain mets
palliative whole brain radiation
96
tx: narcolepsy
psychostimulants, scheduled daytime naps, combination antidepressants and psychostimulants
97
tx: neonatal chalmydial conjunctivitis
PO erythromycin
98
tx: neonatal gonococcal conjunctivitis
IV/IM ceftriaxone/cefotaxime
99
tx: nocardia
TMP-SMX
100
TX: overflow incontinence from epidural anesthesia
Intermittent catheterization
101
tx: pertussis
macrolide antibiotics
102
tx: polymyalgia rheumatica
low dose prednisone
103
tx: post partum endometritis
IV clindamycin and gentamicin
104
tx: pseudomonas
cefepime or pip/tazo
105
tx: pulmonary edema from MI
diuretics necessary adjunct
106
tx: RA
DMARD should begin ASAP, in active disease MTX the drug of choice
107
tx: relapsing-remitting MS
Beta-interferon or glatiramer acetate
108
TX: RV infarct
Fluid resuscitation, nitrates should be avoided
109
tx: SCC of vagina in poor surigcal canditate
radiation, highly effective
110
tx: SCFE
immediate surgical screw fixation
111
tx: second line treatment depression
different SSRI (same class)
112
tx: septic abortion
abx and gentle suction curettage (vigorous curettage associated with perforation)
113
tx: severe SIADH
hypertonic saline
114
tx: SIADH asymptomatic
fluid restriction and/or salt tablets
115
TX: Sickle cell stroke
Exchange transfusion acutely
116
TX: sinus braducardia
atropine-->pacing-->permanent pacemaker
117
tx: symptomatic gallstones but no surgery
ursodeoxycholic acid; dissolves small radiolucent stones
118
TX: symptomatic moderate or severe hypercalcemia
saline, calcitonin, and bisphosphonate
119
TX: symptomatic Paget's disease of the bone
Oral or IV amino bisphosphonates
120
tx: syphilis in those allergic to PCN
2 weeks doxycycline or one dose azithromycin
121
tx: tinea versicolor
selenium sulfide
122
TX: Tourette's syndrome
Typical antipsychotics such as haloperidol pimozide
123
tx: trigeminal neuralgia
carbamazepine
124
tx: uric acid stones
alkalinization of urine >6.5 with oral potassium bicarb or citrate
125
tx: vaginismus
relaxation, Kegel exercises, insertion of objects to encourage desensitization
126
TX: WPW
cardioversion or anti-arrhythmics like procainamide
127
tx: X-linked agammaglobulinemia
IVIG
128
tx:diabetic gastroparesis
prokinetic agents (metoclopramide, erythromycin, cisapride)
129
tx:severe manic episode while being treated with mood stabilizer
aggressive combination of anti-psychotics and mood stabilizers in the hospital setting
130
type 4 RTA pathophysiology
aldosterone deficiency or insensitivity, usually in the setting of diabetic nephropathy
131
type of antibiotic: amikacin
aminoglycoside: nephrotoxic and drug levels must be monitored
132
type of bilirubin that appears on urine dipstick
conjugated
133
type of crystals in cystinuria
hexagonal crystals
134
underlying malignancy of padget's disease of the breast
adenocarcinoma
135
vaccinations for HIV patients
influenza, TDAP, S. pneumo, hep A and hep B
136
vaccinations for patients with chronic liver disease
hep A/B, influenza, pneumovax
137
Valkmann's ischemic contracture
final dequel of compartment syndrome in which dead muscle has been replaced with fibrous tissue
138
vessels that bleeding during Mallory-Weiss tears
submucosal arteries of the distal esophagus and proximal stomach from increased intragastric pressure during vomiting
139
VSD murmur
pansystolic murmur loud is that the left lower sternal border plus diastolic flow murmurs at the apex
140
vulvar lesions that respond to trichloroacetic acid or podophyllin
HPV
141
Waterhouse-Friderichsen syndrome
meningococcemia with sudden vasomotor collapse and skin rash due to adrenal hemorrhage
142
weber test
tuning fork on middle of forehead; look where it localizes
143
weight goal by 1st brithday
triple birth weight
144
well known complication of giant cells/temporal arteritis
aortic aneurysms
145
what composes the cauda equina
spinal nerves before they exit the spinal canal
146
what primidone can precipitate when treating essential tremor
AIP, manifests as abdominal pain, neurologic and psychiatric symptoms
147
when not to treat for GC/chlamydia simultaneously
when only one is confirmed by NAAT
148
When to include prednisone to PCP treatment
When PaO2 is < 70
149
when to suspect hemochromatosis
new onset diabetes, arthropathy, and hepatomegaly
150
when to suspect trophoblastic disease
pregnant patients with severe vomiting
151
when to tx HCV
elevated ALT, detectable HCV RNA, and histologic evidence of chronic hepatitis
152
when to tx parkinson's with trihexyphenidyl
younger patients where tremor is the primary symptom
153
why CXR in children <2 look abnormal
thymic shadow
154
why infants born to mothers with Graves are at risk of thyrotoxicosis
passage of thyroid stimulating Igs across the placenta
155
why normal pregnancy has compensated respiratory alkalosis
Stimulatory effect of progesterone on the medullary respiratory center
156
why there is malabsorption in Zollinger-Ellison syndrome
inactivation of pancreatic enzymes from increased stomach acid production
157
winter's formula
PaCO2 = 1.5(HCO3-) + 8
158
Wiskott-Aldrich pathophysiology of thrombocytopenia
decreased platelet production
159
injury associated with anterior shoulder dislocation
axillary nerve/artery
160
HA, binocular palsies, periorbital edema, hypo/hyper-esthesia; can become bilateral; can be precipitated by uncontrolled infection of the skin
PR: venous sinus thrombosis
161
hematologic complication of EBV infection
hemolytic anemia 2-3 weeks s/p symptom onset
162
tx: BCC
Mohs surgery; 1-2mm of clear margins
163
accumulated molecule in 21-hydroxylase deficiency
17-hydroxyprogesterone, presents with virilization and salt wasting
164
dx: PKU
Guthrie test, qualitative coloration test
165
subperiosteal hemorrhage; hours after birth; limited to one cranial bone
PR: cephalohematoma
166
abnormal thyroid function test in acute, severe illness
PR: sick euthyroid syndrome
167
tx: infections caused by a human bite
amox-clav; covers gram +, gram -, and anaerobes
168
sx <2 night time awakenings, normal FEV1, no limitations to activity
PR: mild intermittent asthma
169
how to remove a tick
tweezers as close to the skin ASAP
170
> 40, indolent progressive anterior hip pain, worsened by activity, relieved by rest; non-tender, no systemic sx
PR: DJD
171
RQ for carbohydrate metabolism
1
172
RQ for lipid metabolism
0.7
173
RQ for protein metabolism
0.8
174
2-5 y/o; localized abdominal mass, hematuria
PR: Wilm's tumor
175
1 year old; abdominal mass, fever, hepatomegaly, HTN; crosses the midline
PR: neuroblastoma
176
G6PD deficiency levels
during hemolytic episode, may be normal
177
toxicity: didanosine
pancreatitis
178
toxicity: abacavir
hypersensitivity
179
toxicity: NRTIs
lactic acidosis
180
toxicity: NNRTIs
Stephen's Johnson syndrome
181
toxicity: nevirapine
nephropathy
182
toxicity: indinavir
crystal induced nephropathy
