Vitals Flashcards
(146 cards)
1
Q
What are the adverse affects of Daptomycin, linezolid and imipenem
A
dapto myopathy linezolid low platelets and imipennem is sezures
2
Q
Where is the erysipelas found
A
Face
3
Q
Can ericipules cause rheumatic fever
A
No. It causes glomerulonephritis similar to pharyngitis but only pharyngitis causes emetic fever.
4
Q
What are the three signs of disseminated gonorrhea
A
Joint inflammation rash and Tendonitis
5
Q
Is acyclovir safe in pregnancyis💉🌡👶🏻
A
Yes. Give at 36 weeks and if there are lesions
6
Q
What does WBC, leuk esterase and nitrates mean?
A
WBC and leuk esterase means bacteria is present. Nitrate means it’s gram negative
7
Q
What mess can be used as acute and prophylaxis for malaria
A
Mefloquine
Atovaquone/proguanil
8
Q
What is the initial therapy for angioedema?
A
Ecallantide which blocks bradykinin and kallikrein
9
Q
What is the single most effective treatment for allergic rhinitis?
A
Intranasal steroids
10
Q
What are the risk factors for ischemic heart disease?
A
DM, HTN, cigarette, HTL, PAD, obesity, inactivity, family history
11
Q
Which meds are given before angioplasty.
A
Prasugrel, clopidogrel and ticagrelor
12
Q
What do you do when there is contraindication to thrombolytics to lower mortality?
A
Angioplasty or PCI
13
Q
What do you give if patient is allergic to aspirin or undergoes angioplasty and stenting or is having an acute MI?
A
Clopidogrel or ticagrelor
14
Q
Why is prasugrel not used?
A
Because it increases bleeding for age >75 or wt <60kg
15
Q
When is thrombolytics used?
A
ST elevation or LBBB w/in 12 hrs of CP
16
Q
What lab abnormality will be caused by ACE and ARBs
A
Hyperkalemia
17
Q
Which meds lower mortality in CHF?
A
Ace/arb, Beta blocker and spironolactone
18
Q
When is biventricular pacemaker is the answer?
A
EF < 35 with QRS > 120
19
Q
When is implantable cardioverter the answer?
A
Persisting EF of < 35
20
Q
What is abnormal aortic gradient?
A
Anything greater than zero
21
Q
When is S3 gallop pathological ?
A
When it’s older patient with CHF or mitral regurgitation.
22
Q
How is Amyloid diagnosed on ekg and echo?
A
It shows low voltage ekg and echo will show speckled pattern
23
Q
Symptoms of spinal stenosis?
A
Worse walking down hill or stairs
Relieved by walking uphill, sitting and cycling
24
Q
What history is associated with arterial thrombosis?
A
AS and A Fib
25
What's CHADS
CHF, HTN, age > 75, DM, CVA or TIA
Used for Afib life long anticoagulant
26
What's the treatment for CHADS?
Score 0-1 needs aspirin
Score 2 or more needs warfarin
CVA/TIA equals 2
27
When do you give oxygen for a patient coming in with atrial arrhymia?
When a patient has COPD.
28
What do you give for torsade de pointes?
Magnesium
29
Which anti glycemic med is contraindicated in CHF?
Rosiglitazone
30
Which hyperglycemic meds increase insulin and block glucagon?
Gliptins
31
Which hyperglycemic meds promote slow gastric emptying and promote weight loss?
Exenatide and liraglutide
32
How does PTU work?
It blocks T4 to T3
33
What is the best initial test for Cushing's syndrome?
24 hr urine cortisol
34
What do you do to figure out where is source of cushings?
Give high dose dexamethasone. If it lowers the ACTH then the origin is pituitary. If it does not suppress the ACTH then it's ectopic. Scan chest for lung or carcinoid.
35
What is the treatment for addison disease?
Hydrocortisone which gives both gluco and minerocorticoids
36
When you have a patient with HTN + low renin and low Potassium think..
Hyperaldosteronism
37
Pheochromocytoma
Episodic hypertension and MEN 2
38
How do you tell patient is having severe asthma?
When no wheeze is heard
39
What test to order for SOB?
Oxygen, pulse ox, CXR and ABG
40
How to manage acute COPD
ABG. CPAP or bipap and then intubation
41
Pregnant lady with recent uti and lung fibrosis
Think nitrofuratoin
42
What does EKG show in ILD
Pulm HTN, right atrial and right ventricular hypertrophy
43
Risk factor for PPI
HCAP and c-diff
44
VAP
Fever, hypoxia, new infiltrate and increasing secretions
45
Treatment for positive PPD with no active infection.
Isoniazid for 9 months
46
What is characteristic of RA?
Anemia with normal MCV
47
What the difference between RA and alkylosing spondylitis?
Sacroiliac joins are spared in RA. Methotrexate is initial therapy.
Sacroiliac joints are involved. Methotrexate does not work. Give infliximab
48
Scleroderma
Tight skin + heartburn + Raynauds
49
How do you treat ILD?
Cyclophosphamide
50
Crest lung finding
Only pulmonary hypertension
51
Test for crest
Anti centromere antibody
52
What is the single most accurate test for PM/DM?
Biopsy
53
How do you differentiate between PM/DM and polymyalgia rheumatica?
PM/DM: weakness + CPK + Aldolase
Polymyalgia rheumatica : > 50 + proximal muscle pain (more than weakness) + ESR
54
Side effects of methotrexate
Lung and liver fibrosis
55
Wegners marker
C-Anca
56
Churg strauss
Vasculitis + eosinophilia + asthma
57
Takayasu
Young Asian female with diminished pulses
Don't do biopsy
Do aortic arteriography or MRA
58
Treatment for acute gout
NSAID then steroid then colchicine
59
What are the risk factors for septic arthritis
Any arthritic joint or prosthetic joint
60
Bone difference between paget and prostate
Paget is osteoclasts
| Prostate is osteoblastic
61
Lab for hgH
Microcytic anemia with high reticulocyte count
62
Risk factor for metformin
B12 absorption
63
Result of B12 replacement
Reticulocyte is first, neuron is last
64
What is deleted with b12 therapy
Potassium
65
How do you know that splenectomy will work for autoimmune hemolysis?
Response to IVIg means it will respond to splenectomy
66
What test do you do for TTP/hUS
Adamts-13
67
Treatment for paroxymal nocturnal hemoglobinuria
Eculizumab which inhibits C5 and prevents complement activation
68
What is auer rods associated with
AML
69
What is the risk factor for M3 acute polymyelocytic leukemia
DIC
70
What happens to untreated CML?
It turns into ALL
71
Jak 2 mutation is found in which diseases
PVera and ET
72
What are elevated in PVera?
B12 and LAP
73
What are the B symptoms?
Fever weight loss and night sweat
74
What is eosinophilic esophagitis?
Dysphasia with history of allergies
Do scope and biopsy and treat with PPT and budesonide
75
What is a common complain in GERD?
Cough
76
What are the characteristics of peptic ulcer?
Single
<1 cm
Proximal near pylorus
Resolves with treatment
77
Which acute hepatitis can be treated
Hep C
78
Which hep c med does not need addition of interferon?
Sofosbuvir
79
What are the meds for hep c treatment?
Boceprevir, telaprevir and simeprevir
80
Which hepatitis does not have a vaccine or ppx ?
Hep c
81
How do you determine portal HTN ?
If saag is > 1.1 then it's portal due to cirrhosis or CHF
82
What is the most common cause of death from hemochromatosis?
Cirrhosis
83
What's is the time limit for thrombolytics for stroke?
3 hrs
84
What causes stroke in young people ?
Vasculitis or hypercoagulable state
85
What is a common problem with anti epileptic drugs ?
Osteoporosis
86
Why can't we give anticholinergic drugs for PD to people under 60?
Benztropine and hydroxyzine cause memory loss
87
Width cytotoxic drug causes PML?
Natalizumab
88
What are the symptoms of pseudomotor ?
```
Headache
Sixth nerve palsy
Visual field loss
Transient obscure vision
Pulsutile tinnitus
```
89
What is the single most important criterion for meningitis ?
CSF cell count. Thousands polys equals bacteria
90
How do you classify encephalitis?
Fever + confusion
91
What is the normal WBC count for CSF
1:500 RBC
92
What is one of the causes of RLS?
Iron deficiency
93
How do you figure out if it's ATN is due to contrast?
It's very rapid
94
How do you know the Renal failure is not due to cyclophosphamide ?
Cyclophosphamide causes hemorrhage not renal failure
95
What are the phosphate binder?
Calcium acetate
| Calcium carbonate
96
Treatment for extreme hyponatremia
Conivaptan and tolvaptan. They raise sodium by blocking ADH
97
When do you use tamoxifen ?
When you have 2 or more first degree relatives with breast cancer
98
What is the survival rate of testicular cancer?
90-95%
99
Testing for cervical cancer
Ascus positive, do HPV test, if positive do colposcopy
100
What is the best initial test for a patient coming with pain + crepitus + high fever + portal of entry ?
Surgery
101
What is the standard for IV access for children without peripheral access ?
Interosseous proximal tibia for children less than 6. Give 20 ml/kg
102
What is the standard for open skull fracture?
Tetanus toxoid and ppx antibiotics
103
When do you give steroid for cerebral edema?
Tumors and abscesses. They don't work for head trauma
104
What is the classification of primary peritonitis ?
Spontaneous inflammation in children with nephrosis or adults with ascites with mild pain
105
What is a GI medical emergency?
Cholangitis. ERCP is the treatment of choice
106
What are the risk factors of pancreatitis ?
```
Alcohol
Gallstones
Medications: didanosine, pentamidine, flagyl, tetracycline, thiazides, furosemide
Hyperglycemia
Trauma
Post ERCP
```
107
What are the signs of hemorrhagic pancreatitis?
Lower hmatocrit
Very high WBC > 18, glucose and bun
Very Low calcium
108
What is reynold's Pentad?
Jaundice fever abd pain Altered mental status and shock
109
When do you worry about gas gangrene?
If it's a penetrating or dirty wounds. Give large doses of IV penicillin and hyperbaric oxygen
110
What are the blastic lesion ?
Prostate and breast
111
What cause lyric lesions ?
Lung, renal, breast , thyroid and MM
112
How do you differentiate plantar fasciitis?
Pain resolves quickly after walking
113
What organisms are the most common in central line associated infections ?
A. Aureus, coagulase negative staph, candida
114
What is the treatment for neonatal RDS?
Lucinactant
115
What is VACTERL
```
Vertebral
Anal
Cardiac
Teachea esophagus
Radial renal
Limb
```
116
What's the differential diagnosis of double-bubble?
Duodenal atresia
Annular pancreas
Malrotation
Volvulus
117
What is the risk of formula feed?
Necrotizing enterocolitis. Pneumatosis intestinalis is pathognomonic.
118
What is the most feared complication of kernicterus?
Indirect bilirubin is the cause. Give immediate exchange transfusion
119
What are test for suspected child abuse?
PT/PTT CBC
Skeletal survey
Head CT
Ophthalmic exam
120
How do you differentiate epiglottis from croup?
Epiglottis does not have cough. Croup has barking cough
121
What is the best prevention against bronchiolitis?
Breastfeeding
122
What is the mutation in CF?
G551D. All CF patients should go through genotyping
123
When is a murmur innocent?
Fever, infection and anxiety
When it's systolic
Grade < 2
124
Which infection causes chronic malabsorption?
Giardia. Get duodenal aspirate
125
What are the risk for celiac disease?
Osteoporosis and T cell lymphoma
126
When do you give rhogam?
```
At 28 weeks
Within 72 hrs
After miscarriage or abortion
During amniocentesis
With heavy vaginal bleed
```
127
When is GBS related meningitis is not a vertices transmission?
When it's after 1st week of birth
128
What is the classic triad of congenital toxo?
Chorioretinitis
Intracranial calcification
Hydrocephalus
129
What is the hep B vertical transmission rate?
80-90%
130
What is the indication for methotrexate in pregnancy?
Pregnancy mass < 3.5 cm
Absence of fetal heart
BHCG < 6000
No history of folic supplement
131
When is cerclage placed ?
At 14-16 wks
132
How do you differentiate between leimyoma and adenomyosis?
Leiomyoma is asymmetric and non tenter
| Adenomyosis is symmetric and tender
133
What are the initial workup for ovarian mass?
B hcg
Ultrasound
Laparoscopy
Laparotomy if complex or greater than 7 cm
134
What are the conditions where CA 125 is elevated
```
Ovarian cancer
Cirrhosis
Endometriosis
Peritonitis
Pancreatitis
```
135
What are the possible cause of amenorrhea?
```
PCOS
Hypothyroidism
Pituitary adenoma
Elevated prolactin
Meds like antidepressants and antipsychotic
```
136
What is Denosumab?
It's a RANKLe inhibitor that inhibits osteoclasts
137
What are the contraindications to CT?
Creatinine > 1.5
MM
Metformin. Stop and restart are 48 hrs
138
What are poor prognosis for a schizoprenia ?
```
Early age
Negative symptoms
Poor premorbid function
Family history
Disorganized or deficit type
```
139
What's the risk for clozapine ?
Agranulocytosis
140
What's the side effect of olanzapine ?
Weight gain
141
How do you treat tardive dyskinesia?
Benztropine
142
What are the adverse effects of lithium?
Einstein anomaly
| Diabetes insipidus
143
SSRI treats which disease?
Depression
GAD
Panic, OCD, social phobia,
Bulimia
144
Passive aggressive personality disorder
Self aggression and self mutilation
145
How do you identify an aspirin overdose?
Tinnitus
146
What are the signs of methoglobinemia?
Cyanosis with normal pO2
