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STEP3_First Flashcards

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1
Q

GDMT

A

ACE or entresto, BB, loop, aldosterone antagonist

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2
Q

Who should get biventricular pacing? (Criteria 3)

A

LVEF <35%, NYHA >=II, LBBB + QRS >150 (ALL need to be met)

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3
Q

Why HFeEF patients get biventricular pacing?

A

Resynchronization therapy has shown to iprove exercise tolerance and reduce rate of recurrent hospitalizations

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4
Q

Treatment of peri-infarction pericarditis

A

Usually self-resolving, but if too much discomfort High dose aspirin, avoid other NSAIDs

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5
Q

Dressler syndrome

A

Immune-mediated pericarditis occurring WEEKS after an MI

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6
Q

Peri-infarction pericarditis

A

Pericarditis within 4 days of an acute MI (Dressler is weeks after)

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7
Q

When to give nitro to patients in ADHF?

A

Those with inadequate response to diuretics; initial management of flash pulmonary edema

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8
Q

Murmur associated with ASD

A

Wide and fixed splitting of second heart sound

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9
Q

BP medication that can cause rash

A

HCTZ (because they are sulfa)

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10
Q

What anti-hypertensive med is good to use in gout patients?

A

Losartan since it has uricosuric effects

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11
Q

UWORLD definition of low EF

A

<60%

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12
Q

Who gets statins?

A

LDL<190, >40 and DM, or ASCVD rirsk >7.5-10%

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13
Q

Severe AS characteristics

A

Soft single S2, delayed carotid pulse (parvus et tardus) and lou late-peaking systolic murmur

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14
Q

Supplies of the LAD

A

Anterior wall of the L ventricle and anterolateral wall with its branches

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15
Q

Supplies of the RCA

A

Right ventricle and inferoposterior walls of the L ventricle

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16
Q

How to decrease edema caused by CCB

A

Add ACE inhibitor

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17
Q

WPW ECG

A

short PR interval, delta wave and wide QRS complex

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18
Q

INR for patients with mechanical valves

A

2-3 or 2.5-3.5 if risk factors (Afib, rEF, risk of clot, hypercoag)

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19
Q

PCP intoxication symtpoms

A

Agitation, combative, bizarre, HTN, traumatic injuries, ataxia, nystagmus

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20
Q

PCP intoxication timing

A

Usually lasts 7-8 hours

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21
Q

Treatment of PCP intoxication

A

If violent: Benzos; If mild (dissociative and withdrawal): low stimulation environment

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22
Q

How long to try antidepressant before switching

A

6 weeks

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23
Q

Treatment for acute and prevention of cluster headache

A

Oxygen, sumtriptan, verapamil (prevention)

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24
Q

Difference between schizophrenia and schizoaffective

A

Mood symptoms only brief in schizophernia while prominent in schizoaffective

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25
Possible lethal side effect of stimulants
Sudden cardiac death
26
What drugs can interact with lithium?
Thiazides, ACE, NSAIDs
27
Side effects of valproic acid
Thrombocytopenia and hepatotoxicity
28
Treatment of acute dystonia
Benztropine and diphenhyddramine
29
Treatmend of tardive dyskinesia
bvalbenazine and deutrabenazine
30
MRI lesions seen in MS?
Periventricular, juxtacortical, infratentorial or in the spinal cord
31
Treatment of MS in patient with cutaneous sympoms vs organ involvement
Prednisone in both, HXQN if cutaneous/ methotrexate if organ involvement
32
What type of med is riluzole?
A glutamate inhibitor for ALS
33
Treatment of akathisia
Reduction of antipsychotic or propanolol
34
Common side effect of lithium therapy
hypothyroidism
35
Factitious disorder
Purposfully falsifying sympotms to assume the sick role
36
How to manage sexual dysfuntion in patients taking SSRIs?
Switching to non-SSRI buproprion or mirtazapine, augmentation with sildenafil or bupropion and dose reduction if possible
37
When can people with mild concussions return to cotact sports
Rest for >24hours and slowly up. Fully back in 1 week
38
First step if concern for increased ICP
MRI to rule out mass… starting with LP can lead to herniation
39
Erbs Palsy
Adduction and internal rotation waiters tip, nerves C5-C7
40
Who gets urine culture repeat/ test of cure?
Pregnant patients with UTI
41
Nitrofurantoin and pregnancy
Avoided in first trimester due to risk of orofacial clefts and late thrid trimester due to asscoiattion with neonatal hemolytic anemia
42
UTI antibiotics that are safe in pregnancy
Cephalexin, fosfomycin, Augmentin
43
bactrim and pregnancy
Associated with Neural, cardiac and cleft palate defects if used in first trimester and with kernicterus if late third trimester
44
Antibitocis contraindicated in pregnancy
Tetracyclines, FQN, bactrim
45
Dx criteria of acute bronchitis
Cough >5 days - 3w w/o systemic findings and wheezing/rhonchi or chest wall tenderness
46
Treatment of acute bronchitis
Symtpom management only, no abx recommended and CXR only if pneumnia is suspected
47
Treatment of latent TB
Rifampin based therapy for 3-4 months, Iso for 6-9months or iso+ rifam;in weekly for 3 moths (not if HIV)
48
Initial treatment of C. diff
PO vanc or fidaxomicin
49
When to use flagyl for C. diff
If fulminant (hypotension, shock, ileus) and use with PO vanc
50
Characteristics of sulcus tumor/Pancoast
Shoulder pain, Horner syndrome, neuro symptoms, weight loss, supraclavicular lymphadenopathy
51
Urgent intervention if this symptom is present in someone with pancoast tumor
Any signs of spinal cord compression since it happens in 25% of patients with this tumor
52
Most common Nec fasc bug
GAStrep, Staph,, Clostridium
53
Treatment of PAD
Antiplatelet and high statin therapy for 2ary prevention; exercise program, cilostazol only if lifestyle modifications failed, revascularization
54
Skin papules with umbilication in HIV
Cutaneous cryptococcosis
55
Charact of MAC
Fever, night sweats, abdominal pain, diarrhea and weight loss
56
Diagnosis of cutaneous cryptococcosis
Lesion biopsy with histopathological examination
57
Labs in Rocky Mountain (Rickettsia)
Low platelets and sodium, High AST/ALT
58
When to give steroids in PCP pneumonia?
If A-a gradient >35 or arterialoxygen tension is <70
59
Post exposure HIV treatment
Antiretroviral therapy (triple drug) for 28days started within 72 hours
60
Ratio of WBC/RBC that has almost 100% NPP for meningitis
<0.01
61
How to confirm active TB
Sputum smears and culutre (although low sensitivity) confirmed by NAA
62
Treatment of allergic bronchopulmonary aspergillosis
Glucocorticoids +/- itra or voriconazole
63
When is oseltamivir used for influenza?
If patients require hospitalization, severe progressive illness or unerlying high-risk medical conditions. Or mild within 48hours
64
Treatment of Tabes dorsalis
10-14days of IV penicillin G
65
Treatment of aspiration pneumonia
Clinday or B-lactam + Blactamase inhibitor
66
Meds for close contacts of meningococal meningitis
rifampin, cipro, CTX
67
Charact of 1,2 and 3rd syhilis
1) cahncre, 2)rash, condyloma lata, 3) neurosyphilis, aortitis
68
After how many hours of tick attachment is someone at risk for Lyme?
>36hours, otherwise little risk
69
When to give antibiotics for COPD exacerbation
If increased sputum purulence, volume or increased dyspnea
70
Charact of early neurosyphilis
meningitis, ocular and otosyphilis
71
What is the most important predictor of COPD?
FEV1 especially if <40
72
Signs of keratitis
Photophobia, impaired vision and foreign body sensation (can cause blindness)
73
Common complication of conjunctivitis
keratitis (cornea infxn)
74
Common bugs in conjuctivitis
Staph, Strep, Haemophilus and Moraxella
75
How to treat bacterial conjunctivitis
Topical macrolide, IF CONTACTS: then topical FQN (for PsA)
76
Potential side effect of ginkgo biloba and gingseng
bleeding risk
77
Side effect of kava kava
Liver damage
78
How to evaluate PTX in the acute setting
US
79
Common bug in eripsyelas
GAS
80
Sensitivity of Xrays in stress fractures
<50 % sensitive especially in the first 2-3 weeks after symptom onset
81
Varicella isolation
If localized (standard) if disseminated (contact/airborne)
82
Stimulat toxicity findings
Anxiety, agitation, insomnia, loss of appetite
83
Treatment of priapism >4 hrs
Aspiration of corpora cavernosa and intracavernosal injection of alpha ahonist
84
Drug of choice for awake intubation
Ketamine (awake done if difficult airway)
85
Which one is done first if intubation is not possible?
Cricothyroidotomy
86
Higher electrolyte that gets affecged with TPN?
Hypophosphatemia
87
Treatment of candida endophathalmitis
vitrectomy, systemic amphotericin B and intravitreal antifungal injection
88
Signs of Down syndrome
Upslanting palpebral fissure, epicanthal folds, transvrese palmar creases
89
treatment of AK
cryosurgery, excision, 5-FU (mostly when multiple)
90
ACL ligament injury features
Popping, effusion/hemarthrosis, joint instability
91
Catching sensation of the knee
Meniscal tear (sually more insidious)
92
Treatmetn of salicylate toxicity
Alkalinization of blood and urine with sodium bicarb drip, glucose, activated charcoal if early
93
Treatment of narcolepsy
Stimulants like modafinil or methylphenydate; if cataplexy is present SNRI, SSRI, TCA and sodium oxybate should be added
94
Type of hypersensitivity reactions
Type 1) IgE-mediated, 2) Autoantibodies 3) immune complex mediated, 4) T-cell mediated
95
Metabolic disarray that can happen right after surgery especially with transfuisions
Hypocalcemia
96
Tendon reflexes in hypocalcemia vs hypoagnesemia
Hyperreflexic in hypoCa vs hyporeflexic in HypoMag
97
When to leave bite wounds open
On extremities if >12hours or in face if >24hours
98
Calcium decrease in relationship to albumin
0.8 decrease per every 1 pt albumin down
99
Charact of bullous pemphygoid biopsy
Subepidermal cleavage and deposition of IgG and/or C3 along the basement membrane
100
Another name for acute uveitis
irititis
101
Association with Lichen Planus
HepC

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