Treatments

Question 1

Miscarriage

Answer 1

Tranexamic acid
Misoprostol
D+C if incomplete and add ppx azithromycin or doxycycline

Question 2

Abortion

Answer 2

Mifepristone of misoprostol vaginal or buccal (up to 10wks)

Rh Ig as needed

D+C up to 14 wks

Question 3

Intrahepatic cholestasis of pregnancy

Answer 3

Ursodeoxycholic acid

Question 4

HELLP

Answer 4

If plt<50 give steroids
-if falling below this or coagulate consider transfusion

If plt <20 transfuse, then deliver immediately

Question 5

PPH

Answer 5

Oxytocin
Tranexamic acid
Carboprost
Misoprostol
Ergotamine

Question 6

Infertility

Answer 6

Clomiphene citrate, tamoxifen (SERM for anovatory cause)
Metformin (PCOS)
Gonadotropin
Bromocriptine (lower prolactin)

Tuboplasty or lysis or adhesion for women

IVF or ICSI or IUI

Sperm or ova donation

Adoption

Question 7

PCOS

Answer 7

Metformin
Combined OCP
Spironolactone
Weight loss BMI<35 or 10%
Metropolis for infertility (nonsteroidal aromatics inhibitor)

Question 8

Intrahepatic cholestasis of pregnancy

Answer 8

Ursodeoxycholic acid
Early delivery 36wks
Follow LFT 6wks postpartum

Question 9

DM in pregnancy

Answer 9

Metformin
Glyburide
Insulin

Question 10

Empiric treatment for tuberculosis

Answer 10

Rifampin
INH
Pyrazinamide
Ethambutol

Plus vitamin B6

Question 11

Thoracic outlet syndrome

Answer 11

PT
NSAID
Surgery if tumor

Question 12

Vertigo symptomatic management

Answer 12

Antihistamines
Benzodiazepines
Antiemetics

Question 13

BPPV

Answer 13

Epley maneuver
Sermons maneuver

Question 14

Ménière’s disease

Answer 14

Betahistine
Diuretic
Limit Na, caffeine, ETOH, smoking

Question 15

Vestibular neuritis and labyrinthitis

Answer 15

Methylprednisone

Question 16

Pemphigus vulgaris

Answer 16

Systemic steroids
Cover erosions with antibiotic ointment

Question 17

Actinic keratosis

Answer 17

5 fluorouracil
Imoquimod
Diclofenac
Cryo

Question 18

Cutaneous T cell lymphoma

Answer 18

In Africa population, probiotic plaques and lymphadenopathy

UVA/UVB, high potency steroids, retinoids, chemo

Question 19

A Fib rate control

Answer 19

BB
CCB
Digoxin (adjunct)
DCCV
Procainamide

Question 20

A Fib rhythm control

Answer 20

Flecainide
Sotalol
Dronedarone
Amiodarone

Question 21

Epistaxis

Answer 21

Nasal ribbon packing
Silver nitrate
Balloon tamponade
Lidocaine soaked gauze
Nasal tampon or sponge
Thrombogenic foams/gels

Electrocautery for ENT

DC ASA/antiplatelet 5-7d, NSAIDS 3-4 days, continue warfarin

Antistaph if double packing and remove in 3 days

Question 22

Dupytren’s contractures

Answer 22

Corticosteroid injection
Collagenase injection
Open fasciotomy 

Question 23

Mallet finger/extensor tendon rupture

Answer 23

Finger splints in DIP extension for six weeks, restart treatment if flexion at any points

Question 24

Raynaud’s phenomenon

Answer 24

Warmth
Exercise
CCB

Question 25

Bacterial tracheitis

Answer 25

1-3 days URTI symptoms before worsening strider, dyspnea, high, fever, toxic, poor response to nebulize epinephrin steroids Lateral neck, x-ray to look for steeple sign Airway, oxygen IV antibiotics to covers staph aureus GAS Spnemo HIB (CTX) ICU

Question 26

Retropharyngeal/per toner abscess

Answer 26

Torticollis, drooling, high, fever, neck pain Neck x-ray to look for bulging posterior pharynx CT Intubation I&D IV antibiotics

Question 27

Epiglottitis

Answer 27

Drooling, sniffing position, toxic, fever, hot potato voice, no barky cough Neck x-ray for thumb sign Intubate IV. Cortical steroids. IV antibiotics I see you

Question 28

COPD first line

Answer 28

LAMA LABA SABA

Question 29

NMS

Answer 29

Symptoms include high temp, rigidity, aLOC, autonomic dysfunction From dopamine withdrawal - discontinue neuroleptic (antipsychotic) - dantrolene - benzos - bromocriptine - follow CK - supportive care and treat high temp

Question 30

Child car seat

Answer 30

- <2 year rear facing - <18kg front facing 5 point harness - <9yr booster seat - <13 backseat only

Question 31

HTN in CKD patient

Answer 31

edema: thiazide and loop diuretics No edema: thiazide diuretics, CCB Universal: ACEi and SGLT2i

Question 32

NV in T1

Answer 32

Diclectin first line (sedating) Gravel Zofran Maxran IV steroids in T2 OTC: antacids, pepcid, ginger, vitamin B6, acupressure bands

Question 33

Alcohol use disorder

Answer 33

Naltrexone (safe when drinking) Acampeosate, disulfiram (not safe while drinking) Topirimate and gabapentin as second line

Question 34

Rosacea

Answer 34

PO: doxycycline, metronidazole, azithromycin, tretinoin Topical: metrogel, azelaic acid, retinol, sulphur, ivermectin, retinol

Question 35

Recurrent vasovagal events

Answer 35

Fludrocortisone Midodrine

Question 36

Preeclampsia prevention

Answer 36

ASA and calcium

Question 37

Interstitial cystitis

Answer 37

Bladder training, avoid causative foods Heat and ice on bladder Stress management PT TCA, antihistamine

Question 38

Cannabis hyperemesis syndrome

Answer 38

Haldol Ativan Capsaicin IVF