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ABEM board exam > Treatments > Flashcards

Treatments Flashcards

(103 cards)

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1
Q

CRAO treatment

A 
Decrease IOP
Gentle massage
Hyperventilate (increase PaCO2)
Acetazolamide (carbonic anhydrase inhibitor --> decrease aqueous humor)
Timoptic
Ophtho consult
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2
Q

Carcinoid syndrome treatment

A

Octreotide

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3
Q

Kawasaki disease treatment

A

ASA

IVIG

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4
Q

SLE treatment

A

Steroids

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5
Q

Rocky Mountain Spotted Fever treatment

A 
Doxycycline
Or chloramphenicol (CAM) in pregnant women
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6
Q

Diptheria treatment

A

Equine diphtheria antitoxin

Erythromycin/PCN

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7
Q

Sarcoid treatment

A

Steroids

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8
Q

Dressler’s syndrome treatment

A

NSAIDs, steroids

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9
Q

ITP treatment

A

Pediatrics: none
Adults: steroids –> replace platelets to 50K, high-dose Rho-GAM (anti-D immune globulin)

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10
Q

TTP treatment

A 
Steroids
*Plasmapheresis
FFP
**AVOID PLATELETS**
(Unlike ITP give platelets, Rho-GAM; DIC give heparin and blood components)
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11
Q

HELLP treatment

A

Like pre-eclampsia
Bedrest, delivery, Mg, BP control
No diuretics or ACE inhibitors

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12
Q

Rhabdomyolysis (ATN) treatment

A

IV hydration
Treat hyperkalemia and hypocalcemia
Alkalinize urine with bicarb

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13
Q

Neuroleptic Malingnancy Syndrome treatment

A

Dantrolene or bromocriptine

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14
Q

Trichinosis treatment

A

Antihelmentics - mebendazole/albendazole

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15
Q

Erlichiosis treatment

A

Doxycyline

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16
Q

Botulism treatment

A

Antitoxin

Wound –> antitoxin, debridement, high-dose PCN

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17
Q

Tick paralysis treatment

A

Remove tick

Ascending paralysis and loss of DTRs (similar to GBS but no autonomic instability)

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18
Q

Tetanus prophylaxis

A

Minor wounds:
> 3 prior immunizations and >10 years –> Tdap
< 3 prior immunizations –> Tdap
Contaminated, puncture, crush, avulsion, burn
< 3 prior immunizations –> Tdap + TIG
> 3 prior immunizations and > 5 years –> Tdap

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19
Q

Wernicke’s treatment

A

Admission
Thiamine (Vit B1) prior to glucose
Magnesium

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20
Q

Normal pressure hydrocephalus treatment

A

Shunt

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21
Q

Multiple sclerosis treatment

A

Steroids, plasma exchange, disease modifying agents

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22
Q

Eaton-Lambert treatment

A 
Remove tumor (50%, especially lung, CA)
Plasmapheresis
Avoid neuromuscular blocking agents, aminoglycosides, IV contrast, CCBs
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23
Q

Catecholamine crisis treatment (ie pheo, MAOI crisis, cocaine overdose)

A

Labetalol + phentolamine (non-selective alpha blocker)

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24
Q

Serotonin syndrome treatment

A

Cooling

Cyproheptidine

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25
Tensilon toxicity treatment
Atropine | bradycardia and syncope
26
Myasthenia gravis treatment
Pyridostigmine or neostigmine (ACH inhibitors) Thymectomy (25% associated thymoma) Prednisone Plasmapheresis
27
Warfarin bleeding complications treatments
Stop (2.5 day half-life) IV Vit K 4-factor prothrombin complex concentrate (II, VII, IX, X) - KCentra vs FFP (10-15 ml/kg)
28
Heparin reversal
Protamine (1 mg reverses 100 U)
29
Acetaminophen overdose antidote
Acetylcysteine (NAC)
30
Arsenic poisoning treatment
Chelation: dimercaprol/BAL, DMS
31
Aspirin overdose treatment (salicylate poisoning)
Alkaline diuresis, hemodialysis Sx: tinnitus, ototoxicity, hypokalemia Metabolic acidosis due to oxidative phosphorylation uncoupling
32
Beta-blocker overdose treatment
Glucagon (hypoglycemia), intralipids | propanolol can cause seizures
33
Barbiturate overdose treatment
Alkaline diuresis, hemodialysis
34
Calcium channel blocker overdose treatment
Calcium, glucagon, glucose/insulin, intralipids
35
Carbamate overdose treatment
Atropine
36
Carbon monoxide poisoning treatment
100% O2, HBO
37
Cyanide poisoning treatment
Sodium nitrite, sodium thiosulfate, hydroxycobalamin (Vit B12) Avoid nitrites in concomitant CO poisoning
38
Digitalis poisoning treatment
Digibind (fab antibiodies), avoid transcutaneous pacer (irritability), no calcium --> "stone heart" Green-yellow vision, halos EKG: PVCs or bradydysarhythmias Indication: severe cardiac toxicity with/without hypotension, K > 5.0, digoxin level >10 (acute) or > 4 (chronic) --> 10 vials (5 vials for chronic)
39
Ethylene glycol (anti-freeze, pain, solvents)
Bicarb, ethanol, dialysis, 4-MP (fomepizole) | Binds to calcium --> calcium oxalate crystals --> renal failure
40
Iron poisoning treatment
Deferoxamine, WBI
41
Isoniazid (INH) overdose treatment
Pyridoxine (Vit B-6)
42
Lead poisoning treatment
BAL, DMS, EDTA
43
Mercury poisoning treatment
BAL, DMS
44
Methemoglobin treatment
Methylene blue
45
Methanol treatment (paint thinner, solvents, gas additive)
Bicarbonate, ethanol, dialysis, 4-MP (fomepizole) | Blindness
46
Nitrites treatment
Methylene blue
47
Opiate overdose treatment
Narcan
48
Organophosphate treatment
Atropine, 2-PAM
49
Oral hypoglycemia agent (ie sulfonylurea) overdose treatment
Glucose, glucagon, octreotide
50
TCA overdose treatment
``` Sodium bicarb, intralipids No physostigmine (may precipitate seizures or asystole) ```
51
Timing of thromboses hemorrhoid tx
Less 72 hours: I&D | > 72 hours: Sitz baths
52
Fat emboli treatment
High-dose steroids Signs/symptoms: CNS (HA, AMS, sz, coma), petechiae, dyspnea
53
Mycobactrium marinae treatment
(papules to hands/feet/elbows) Tx: clarithromycin + ethambutol/rifampin Or minocycline, clarithromycin, doxy, Bactrim Vs swimmer's itch --> supportive
54
Spigelium hernia
Absence of posterior rectus sheath --> hernia along semi-lunar line between 2 muscle layers Tx: if incarcerated --> surgery
55
Lyme disease treatment
Doxycycline (or ceferoxime/amoxicillin) x 2-3 weeks
56
Syphillis treatment
Primary and secondary: benzathine PCN 2.4 million units IM x 1 Tertiary: x 3
57
Yersinia treatment
Pneumonic (bubonic) plague | Isolation, streptomycin/gentamycin/chlorphenicol, doxy
58
ARDS treatment
Low tidal volume, permissive hypercapnia, high PEEP
59
Cryptococcal meningitis treatment
Dx: india ink stain, high opening pressure (LP) Tx: amphotericin B + flucytosine or fluconazole
60
Hydrocarbon toxicity treatment
Beta-blockers | Sniffing, huffing, bagging --> myocardial sensitization --> VF/VT
61
Hydrofluoric acid toxicity treatment
Glass etching, brick or wheel cleaners, rust removers Pain out of proportion Dysrhythmias from hypocalcemia and hyperkalemia Tx: calcium gluconate
62
Salicylate toxicity treatment
Metabolic acidosis with respiratory alkalosis | Tx: alkalization of urine, dialyze (pulm/cerebral edema, renal failure)
63
Hypercalcemia treatment
Hydration, loop diuretics (ie furosemide), calcitonin (increases renal excretion, works fastest), bisphosphonates (interferes with osteoclasts function, long term control), steroids (increases renal excretion and decreases GI absorption)
64
Thyroid storm treatment
1) anti-hormone, 2) blunt systemic effects, 3) treat precipitant, 4) prevent decompensation 1) PTU/methimazole (blocks synthesis) --> iodine (blocks release) 2) beta-blocker (propanalol), steroids (blocks conversion of T4 to T3 3) treat precipitant 4) prevent decompensation (ie, fluids, dextrose, cooling, Tylenol)
65
Peds VT/VF treatment
2-4 J/kg (max 10 J/kg)
66
Peds SVT treatment (>220 infants, >180 kids)
Vagal maneuvers Adenosine 0.1 mg/kg Cardioversion 0.5-1J/kg Avoid diltiazem --> hypotension
67
Croup treatment
Cool air Nebulized epi Dexamethasone 0.15 - 0.6 mg/kg
68
Peds hyponatremia treatment
If seizing, 3% NaCl 5 ml/kg over 20 minutes
69
Peds hypocalcemia treatment
If seizing, 10% calcium gluconate 0.3/kg.kg over 5-10 minutes
70
Glucose replacement in peds
Rule of 50 | 5 mL/kg D10W (infant) or 2 mL/kg of D25W or 1 mL/kg of D50W (adolescent)
71
Epiglottitis treatment
Humidified oxygen, IV ceftriaxone (2nd or 3rd generation cephalosporin, early intubation No role for IV steroids or racemic epi Causes: *H flu, strep, gram-neg organisms
72
Uremic bleeding treatment
IV desmopression (dDAVP) --> release vonWillibrand factor
73
Pheochromocytoma treatment
Phentolamine or phenoxybenzamine
74
Neurocysterosis (taenea solium) treatment
Pork tape worm --> ring-enhancing brain lesions --> seizure | Tx: praziquantel and steroids
75
Schisotomiasis treatment
Praziquantel
76
Vibrio vulnificans treatment
Salt water or brackish water *Hemorrhagic bull Tx: ceftriaxone + doxycycline
77
Hook worm treatment
Ivermectin or albendazole
78
Pertussis treatment
Erythromycin (azithromycin or clarithromycin or Bactrim) | Prophylaxis for adults
79
Kleihauer-Betke (KBT) test
Detects presence and quantifies volume of fetal RBCs in maternal circulation (minimum of 5mL of fetal hemorrhage) Use in significant trauma Maternal-fetal hemorrhage >30 mL --> 2nd dose of 300 umg Rhogam
80
Anticholinergic crisis treatment | Jimson weed, atropine, scopolamine
IV hydration, supportive care, benzodiazepines | Physostigmine is select cases
81
NSTEMI undergoing immediate PCI
Bivalirudin - direct thrombin inhibitor and inhibits platelet aggregation Does not cause thrombocytopenia Less incidence of major bleeding
82
Jellyfish sting treatment
Vinegar | No fresh water
83
PCP pneumonia treatment
Bactrim + steroids if PaO2 < 70 | or primaquine + clindamycin or pentamidine (IV or inhaled)
84
Cryptospyridium diarrhea in AIDS treatment
HAART (get CD4 > 100)
85
Rattlesnake (crotalid) bite treatment
Antivenom (CroFab) Pain and swelling can mimic compartment syndrome (no indication for fasciotomy unless swelling not responsive) Abnormal PT/PTT, LFTs, CBC --> treat until symptoms improve Start with 4-6 vials --> redoes 4-6 vials if necessary then 2 vials q6 hour for 18 hours
86
Mechanism of acetazolmide in acute mountain sickness treatment
Carbonic anhydrase inhibitor --> induces metabolic acidosis --> compensatory hyperventilation --> speeds of acclimation Also give dexamethasone, NSAIDs, decent Vs HACE --> higher altitude (>4k), lethargy, AMS seizures
87
Factor VIII replacement dosing
% x 0.5 units/kg Major 50 units/kg Minor 25 units/kg
88
Traveler's diarrhea
Cipro 750 mg PO x 2 or azithromycin 1g PO x 1
89
Unstable VT vs pulseless VT/VF treatment
Synchronized cardioversion vs shock
90
Swimmer's itch treatment vs mycoplasma marinum treatment
Supportive vs clarithromycin + ethambutol or rifampin
91
Toxic shock syndrome (TSS) treatment
IVF, antibiotics --> not responsive, give IVIG
92
Endocarditis treatment
Vancomycin + amino glycoside +rifampin (prosthetic valve)
93
Endocarditis prophylaxis
History of prosthetic valves, prior IE, congenital heart disease, cardiac transplant with valve disease Amoxicillin 2g PO or ampicillin 2g IV Allergic to PCN: clindamycin 600 mg PO/IV, cephalexin 2g PO or azithromycin 500 mg PO or cefazolin/ceftriaxone 1g IV
94
Toxoplasmosis treatment
Pyrimethamine, sulfadiazine + folinic acid Or IV trimethoprim-sulfamethoxazole Or dapsone + pyrimethamine
95
Psittacosis treatment
Flu-like illness, headache, exposure to bird droppings | Doxycycline or tetracycline
96
Transfusion Related Acute Lung Injury (TRALI) treatment
Sudden onset non-cardiogenic pulmonary edema Respiratory support, supportive care, IVF, pressors No role for nitroglycerine or furosemide
97
Chilblains treatment
Rewarming and drying --> nifedipine (also use in high altitude pulmonary edema, Raynauds) No debridement
98
Stingray treatment
Remove barb, irrigate wound, no wound closure, hot water immersion (toxin is heat labile), tetanus, Keflex and doxy No antitoxin
99
Meningitis prophylaxis
Rifampin, cipro or ceftriaxone
100
Lidocaine toxicity
Bicarb, IV fat emulsion (intralipids)
101
Adverse effect of malaria treatment
Quinine IV --> hypoglycemia
102
Giardia treatment
Hiker's diarrhea Metronidazole TID Dx: stool antigen or O&P
103
Yersinia treatment
Mimics acute appendicitis | Ciprofloxacin

ABEM board exam (3 decks)

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