Term
|
Definition
100-200...TMP/SMX or Dapsone (PCP)
50-100...TMP/SMX or dapsone (PCP)
...TMP/SMX or dapsone (TOXO)
<50
... TMP/SMX or dapsone (PCP)
...TMP/SMX or dapsone (TOXO)
...Azithromycin or Clarithromycin(MAC) |
|
|
Term
| what is the major effect of Selenium deficiency |
|
Definition
|
|
Term
| Why do pregnant women often develope mild respiratory alkalosis |
|
Definition
| because they have an increased Progesterone level and the leads to tachypnea |
|
|
Term
| When you see a patient who might have multiple myeloma what accronym can help? |
|
Definition
C - Calcium is high
R - Renal failure
A - Anemia
B - Bones - fractures and lytic lesions |
|
|
Term
| What is the major triad of symptoms associated with McCune Albright syndrome |
|
Definition
This is a child who:
1. develops precocious puberty
2. has cafe au-lait spots
3. has some sort of bone problems
It is kinda like a NF-1 patient with precocious puberty |
|
|
Term
| what is another term for measles |
|
Definition
|
|
Term
| what is a pathopneumonic sign of measles |
|
Definition
| Koplik spots... bluish dot on erythematous background |
|
|
Term
| When would you see atypical measels? |
|
Definition
In vaccinated individuals.
there are no koplik spots or rash
It is potentially fatal |
|
|
Term
| What is a simple way to resolve a uric acid kidney stone? |
|
Definition
| give potassium citrate... this will alkalinize the urine and dissolve the stone |
|
|
Term
| What is a pathogneumonic sign of pertussis and how do you treat it |
|
Definition
whooping cough
use a macrolide like azithromycin |
|
|
Term
| What is pellagra and what are the symptoms? |
|
Definition
Vitamin B3 (niacin) deficiency.
think - 4D's
Diarrhea
Dementia
Dermatitis
Death(possibly) |
|
|
Term
| what does esophagitis look like (SXS) and what drugs can cause it? |
|
Definition
retrosternal chest pain and epigastric pain and swallowing pain.
Iron/KCl/bisphosphonates/NSAIDS/ASA/tetracyclines/quinidine |
|
|
Term
| What is bartter syndrome? how does it present? |
|
Definition
it is a defect of KCl absorption in the Thick ascending limb.
It causes hypokalemic alkalosis.
It also has polyuria/polydipsia/mental retardation/growth retardation. |
|
|
Term
| So you have an HIV patient with PCP. How do you treat it and when should you add prednisolone? |
|
Definition
Treat with TMP/SMX
add prednisolone when PaO2 <70 |
|
|
Term
| If you have a confirmed cirrhotic what should you screen for? |
|
Definition
|
|
Term
| how do we prophylactically treat esophageal varicies |
|
Definition
|
|
Term
| What is the first presentation of Lyme disease? |
|
Definition
| fever and rash (erythema migrans - pathoneumonic) |
|
|
Term
| What are the later manifestations of lyme disease? |
|
Definition
Joints - oligoarthralgia
Neuro - Bell's palsy is the most common
Cardio - Transient AV block (most) |
|
|
Term
| What si the treatment for lyme disease and when should it be initiated? |
|
Definition
The treatment for lyme disease is Doxycycline unless you are <8yo then you get amoxicillin. BUT if you have cardiac or neurologic manifestations you get IV Ceftriaxone.
The only time you can initiate treatment without confirmatory serology is if Erythema migrans is present. |
|
|
Term
| Is there prophylaxis for tick bites? |
|
Definition
| yes. treat with a dose of doxycycline if the tick was attached for greater than 24hrs. |
|
|
Term
| What are some other things that might mimic lyme disease? Why doesn't this matter to the patient? |
|
Definition
Rocky mt. spotted fvr - different rash
ehrlichiosis - No rash (not in NE US)
But that is ok you treat all of them with doxycycline |
|
|
Term
| Quickly differentiate neimann pick/Tay-sacks/gaucher/krabbe dz? |
|
Definition
NP - cherry red spot and HSM
TS - cherry red spot no HSM
Gaucher - HSM no cherry red spot
krabbe - hyperacusis and seizures |
|
|
Term
| what are the enzyme deficiencies for neimann pick/Tay-sacks/gaucher/krabbe dz? |
|
Definition
NP - sphingomyelinase
TS - hexosaminidase
gaucher - glucocerebrosidase
krabbe - galactocerebrosidase |
|
|
Term
| Please give treatment for gonnorrhea and chlamydia? |
|
Definition
GC - ceftriaxone (levofloxacin and flagyl for those allergic)
Chlamydia - doxycycline Or azithromycin |
|
|
Term
| describe Edwards disease and its cause |
|
Definition
| Edwards is trisomy 18. It manifests with rockerbottom feet and micrognathia and microcephaly and overlapping fingers. |
|
|
Term
| please describe patau disease and its cause |
|
Definition
| patau is trisomy 13 and it presents with cleft palate and polydactyly and heart malformations |
|
|
Term
| What are admissions criteria for pneumonia? |
|
Definition
C - confusion
U - Uremia
R - respiratory distress(RR>30, pO2<60, pH<7.35)
B - low BP (systolic below 90)
65 - 65yrs or older
ALSO -fvr>104, pulse>125, other comorbidities |
|
|
Term
| How is CAP pneumonia treated outpatient? |
|
Definition
simple - macrolide
complex - quinolone |
|
|
Term
| how is CAP pneumonia treated inpatient |
|
Definition
Quinolone
OR
ceftriaxone + azithromycin |
|
|
Term
| What is the MOST common cause of CAP pneumonia? |
|
Definition
|
|
Term
| what should you think of with PNA with foul-smelling sputum? associations?treatment? |
|
Definition
you should think of anaerobic infection.
Some associations: bad teeth/aspiration/EtOH
treat with clindamycin. |
|
|
Term
| how do you know if a pleural effusion is a transudate/exudate/empyema? what do you do with them? |
|
Definition
empyema - pH<7.2 -drain and treat antibiotics
Exudates - LDH>60% of serum, protein>50% serum. these are caused by infection or cancer (find it or treat it) |
|
|
Term
| what are some common causes of pneumonia and their associations? |
|
Definition
H. influenzae - COPD/asthma
Staph. aureus - recent viral infection
klebsiella - alcohol/diabetes, blood streaked sputum
anaerobes - bad teeth/aspiration/foul smell
Mycoplasm pneumoniae - young healthy, dry cough, bullous myringitis
Legionella - AC, GI sxs, CNS sxs |
|
|
Term
| If I have lobar pneumonia I can rule out these bugs |
|
Definition
myclplasma
viruses
coxiella
PCP
chlamydia |
|
|
Term
| How do you test for legionella |
|
Definition
|
|
Term
| how do you test for mycoplasma? |
|
Definition
|
|
Term
| patient develops PNA more than 48hrs after being hospitalized what is it? how do you treat it? |
|
Definition
it is most likely gram negative bacilli such as pseudomonas.
be sure to use anti-psuedomonals: pipercillin/tazobactam, cefepime/ceftazidime, penems |
|
|
Term
| Ventilator associated pneumonia... treat it |
|
Definition
combine 3 drugs:
1. anti-pseudomonal beta-lactam
-ceftazidime/cefepime
-pipercillin/tazobactam
-carbapenem
2. second anti-pseudomonal
-gentamicin/tobramycin/amikacin
-ciprofloxacin/levofloxacin
3. MRSA drug
-vancomycin
-linezolid |
|
|
Term
| what is the clinical pentad of henoch-sholein purpura? |
|
Definition
1. GI sxs
2. purpura
3. arthralgias
4. hematuria |
|
|
Term
| on colonoscopy a patient has greater than 100 polyps... what do they have? how should you monitor? what are some other conditions that require increased screening? |
|
Definition
this pt has FAP - start screening yearly at 12.
HNPCC (a bunch of +family with 1 premature) - start at 25 then 1-2yrs. |
|
|
Term
| what is normal screening protocol for colon cancer? |
|
Definition
start at 50 then every 10yrs
if family has it start 10yrs before that.
if you had it - 1,3, then every 5. |
|
|
Term
|
Definition
It is a deficiency of collagen IV.
they present with deafness and hematuria. they have a family history of renal failure. |
|
|
Term
| how do you treat neurocystercosis? |
|
Definition
| albendazole or praziquantel |
|
|
Term
| what causes HUS and how does it present? |
|
Definition
HUS is cause by E. coli and it presents with a triad.
1. thrombocytopenia
2. microangiopathic hemolytic anemia
3. acute renal failure |
|
|
Term
| patient with marfanoid sxs + thrombotic event +/- Mental retardation... what is it? cause? test? inheritance pattern? |
|
Definition
they have homocysteinuria
caused by cystathione synthase deficiency.
they have increased homocysteine and methionine.
autosomal recessive. |
|
|
Term
| how do you treat CHF caused by aortic regurg? |
|
Definition
| the goal is to decrease afterload... use ACEi or nifedipine |
|
|
Term
| If you have a kidney stone and the urine is alkaline what is it? cause? |
|
Definition
| struvite stone caused by proteus |
|
|
Term
| what does zinc deficiency cause? |
|
Definition
|
|
Term
| which glycogen storage diseases have increased LFT? |
|
Definition
glycogen debracher deficiency
glycogen branching enzyme deficiency |
|
|
Term
| which glycogen storage disease has "floppy baby" with big tongue? |
|
Definition
|
|
Term
| progressive proximal muscle weakness that starts in the LE and goes to the UE? |
|
Definition
|
|
Term
| you have a patient with parkinsonism/orthostasis/neuro sxs... what is it? If I said it were a jewish child? |
|
Definition
Shy-Drager (multi system atrophy.
Riley-day syndrome |
|
|
Term
| Exanthem thing with occipital/post cervical nodes + arthritis |
|
Definition
|
|
Term
| how do you treat pin worms? |
|
Definition
|
|
Term
which bugs cause endocarditis with:
1. IV drug abuse
2. prosthetic valve
3. colon cancer
4. valve dz |
|
Definition
1. s. aureus
2. s. epidermidis
3. s. bovis
4. s. viridans (subacute Bacterial endocarditis) |
|
|
Term
| how do you treat bartter syndrome? |
|
Definition
|
|
Term
| what is the most common complication in Very Low Birth Weight babies? |
|
Definition
|
|
Term
| so a patient presents with rickets but their VitD is normal? |
|
Definition
| this is hereditary hypophosphatemic rickets. it is X-linked |
|
|
Term
|
Definition
| treat with cefepime... if it doesn't resolve in 3d add vancomycin |
|
|
Term
| kid with a brain tumor in the cerebellar vermis |
|
Definition
|
|
Term
| kid with a ventricular brain tumor |
|
Definition
|
|
Term
| kid with an extradural tumor |
|
Definition
|
|
Term
| adult with a cerebral white matter tumor |
|
Definition
|
|
Term
| cerebellar hemisphere tumor |
|
Definition
|
|
Term
|
Definition
usually:
-ceftriaxone for nisseria and H flu
-Vancomycin for strep pneumoniae
ADD:
Ampicillin for listeria (<1yr or >50)
Dexamethasone to decrease M&M |
|
|
Term
| kid with fever for 5d, erythematous rash, conjunctivitis, cervical nodes, oral thing. he also has increased ESR/CRP/WBC/platelets |
|
Definition
| Kawasaki - treat with ASA and IVIG |
|
|
Term
| what conditions result in microcytic polycythemia? |
|
Definition
there are 3
1. Polycythemia Vera
2. Hypoxia
3. Thallassemia |
|
|
Term
| patient has low platelets, high LDH, anemia, Creatinine 2.8, fvr, and some neuro sxs... what is it? |
|
Definition
|
|
Term
| which form of hepatitis is never acute and often has arthralgias? |
|
Definition
|
|
Term
| so you got a patient with chronic pain for which he takes NSAIDs and he has all these other problems and he developes hematuria and proteinuria with unchanged RBC's and WBC in the urine... what is it? what happened? what else could have happened? |
|
Definition
he has analgesic nephropathy which caused papillary necrosis.
NSAID overuse can also have tubulointerstiial nephritis |
|
|
Term
| Male patient develops a UTI and it remits with treatment but comes right back... what is it? cause? how to treat? |
|
Definition
he has prostatitis caused by E. coli or Chamydia.
Treat with 4-6weeks of flouroquinolones |
|
|
Term
| You have a kid with hearing problems, proteinuria, and recurrent hematuria... what is it? what will you see with microscopy? |
|
Definition
| thick/thin glomerular capillary and a split GBM |
|
|
Term
| what 3 major cancers metastesize to the brain |
|
Definition
|
|
Term
what causes meningitis in:
1. 1-3 mo old
2. 3m - 3yr old
3. 3-10yrs
4. >10yrs
5. patient with a VP shunt
6. Sickle cell disease
7. brain abcess |
|
Definition
1. GBS >>> listeria or E.coli
2. strep pneumo v nisseria
3. strep pneumo v nisseria
4. nisseria
5. staph epidermidis
6. pneumococcal
7. citrobacter |
|
|
Term
| what is prophylaxis for meningitis in close contacts |
|
Definition
|
|
Term
| what are the two murmurs that increase with valsalva? treatment? |
|
Definition
mitral regurg and HOCM
treat: BB, CCB, surgery |
|
|
Term
| what are the two congenital conjugated hyperbilirubinemias? differentiate. |
|
Definition
Dubin-Johnson - has black pigmentation in liver
Rotor - |
|
|
Term
| what are the two congenital unconjugated hyperbilirubinemias? differentiate. |
|
Definition
gilbert -
crigler-najjar - presents in infancy (profound) |
|
|
Term
| patient walks in with fvr 103.4, sclera icterus, severe RUQ pain, hypotention, tachycardia, they develop altered mental status... US shows no stones, dilated ducts... what is it? treatment? |
|
Definition
| ascending cholangitis... a stone is partially obstructing the common bile duct... It needs to be treated with emergent decompression. |
|
|
Term
| What is the key difference between bipolar 1 and 2? |
|
Definition
| bipolar two has two parts... hypo mania |
|
|
Term
| baby is born and has RR:28, HR:49, pO2:63... nothing else... what is wrong? treatment? |
|
Definition
| this is apnea of prematurity it is caused by an immaturity of the respiratory centers. treat with theophylline |
|
|
Term
| tell me about measles. what is another name? cause? presentation? testing? treatment? |
|
Definition
it is also known as rubeola. presents with 3C's (cough, coryza, conjunctivitis, koplik spots if lucky), and rash that starts on face.
use IgM serology to diagnose. treatment is supportive |
|
|
Term
| tell me about fifth disease. cause? presentation? and treatment? |
|
Definition
| it is caused by parvo B19. presents with fever, URI, and a slapped cheek rash. treatment is supportive |
|
|
Term
| Tell me about roseola. cause? presentation? treatment? |
|
Definition
| caused by HHV6/7. presents with fever and URI, and a rash that starts on the trunk. treatment is supportive. |
|
|
Term
| Tell me about Mumps. cause? presentation? treatment? |
|
Definition
| caused by paramyxovirus. parotid gland swelling possible orchitis. treatment is supportive. |
|
|
Term
| what are the TORCH infections? |
|
Definition
T - toxoplasm - chorioretinitis, hydrocephalas. check IgM. Pyrimethamine-sulfadiazine.
O- Syphillis- palm/sole rash, snuffles, bossing, hutch teeth, saddle nose. VDRL->FTABS. treat- PCN.
R- Rubella- PDA, cataract, deaf, HSM, blueberry muffin rash. treat supportive.
C- CMV- periventricular Calcification, microcephaly, chorioretinitis, deaf, petechiae. get viral titer/PCR. treat: gancyclovir.
H- Herpes- wk1(shock DIC), wk2(vesicles), wk3(encephalitis). tzanck smear. acyclovir. |
|
|
Term
| When do you need dental prophylaxis? |
|
Definition
there are 5 cases:
1. cyanotic heart disease
2. prosthetic valves
3. previous endocarditis
4. repaired congeital heart disease with left over defect.
5. valvulopathy in a transplant. |
|
|
Term
| Whats the deal with the lady on OCP's and her liver? how do you treat it? what are potential complications? |
|
Definition
| well, she is usually 20-40 and she develops a hepatic adenoma. these are pretty benign so long as they don't rupture in which case they bleed alot and require surgery. Usually simply discontinuing the OCP will result in regression. |
|
|
Term
|
Definition
|
|
Term
| What is Diamond blackfan anemia? When does it present? |
|
Definition
| it is a pure red cell aplasia. it presents in the first three months of life. |
|
|
Term
| What is procainamide used for? |
|
Definition
|
|
Term
| What diseases is Erythema nodosum associated with? |
|
Definition
| Sarcoidosis/TB/histoplasmosis/IBD |
|
|
Term
| what is the glomerulonephroppathy most associated with cancer? what about Hodgkins lymphoma? |
|
Definition
| Memebranous is the most common with cancer. Min change with Hodgkins. |
|
|
Term
| which vaccines are the live ones? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is the most common electrolyte abnormality associated with Sub Arachnoid Hemorrhage? |
|
Definition
| hyponatremia secondary to SIADH |
|
|
Term
| What is the major side effect of Amiodarone? |
|
Definition
|
|
Term
| what is the empiric treatment for meningitis? |
|
Definition
ceftriaxone, ampicillin (>50/<1)
Give rifampin for prophylaxis |
|
|
Term
| So you got an AIDS patient with a bunch of neuro signs... MRI shows patchy, focal, non-enhancing lesions... what is it? cause? |
|
Definition
| he has progressive multifocal leukoencephalopathy. caused by JC virus which causes a demylination of the CNS. |
|
|
Term
| what is the treatment of alzheimers? |
|
Definition
Donepezil (AChEi) for mild dz
memantine (NMDA antag) for svr/mod |
|
|
Term
| what titer profile do you see in a person vaccinated against HBV? |
|
Definition
|
|
Term
| what is the most common cause of Septic arthritis in ALL patients? |
|
Definition
|
|
Term
| What must you do to a stable ACS patient after observing them before they can be discharged? |
|
Definition
| they must undergo some sort of stress test. |
|
|
Term
| What are the discharge meds for an ACS patient? which has the biggest mortality benefit? |
|
Definition
ASA, BB, statin. ACEi.
Asprin as been shown to have the greatest mortality benefit. |
|
|
Term
you have a patient with a pulmonary renal type disease, BUT there is >10
% eosinophils and they have this weird neuropathy thing... What is it? what lab will they be positive for? |
|
Definition
| this is Churg Strauss dz. they will be positive for C-ANCA. |
|
|
Term
| patient with pulm renal type dz... They also have this weird sinusitis, and they might have granulatous rash... what is it? What might they be positive for? |
|
Definition
| Wegeners granulomatosis. they will be positive for P-ANCA. |
|
|
Term
|
Definition
|
|
Term
| what the problem in osteomalacia? |
|
Definition
| they have poor mineralization of the bone. the matrix is good. |
|
|
Term
| So you have an AIDS patient who develops bloody diarrhea and tenesmus... they are negative for C. diff... what is it? what should you do to prove it? treatment? |
|
Definition
| probably CMV colitis. confirm with colonoscopy with biopsy. treat with ganciclovir. |
|
|
Term
|
Definition
| FENa is a way to determine the cause of renal impairment. if it is <1% it is pre-renal (hypoperfusion). >2% it is either intra-renal or post-renal. |
|
|
Term
If you see a patient with the triad of
1. bradycardia
2.HTN
3. Irregular respiration
What is it? |
|
Definition
| This is Cushings triad and it indicates increased ICP |
|
|
Term
| Older patient with Dementia, incontinence, and gait abnormality... What is it? what to do? |
|
Definition
Normal pressure Hydrocephalus...
Place a VP-shunt or something to reduce ICP they will magically get better if you caught it early enough. |
|
|
Term
| What do I have if my EKG shows U waves? |
|
Definition
|
|
Term
| patient develops osteomalacia and they are found to have a non-gap metabolic alkalosis... what is it? |
|
Definition
|
|
Term
| What is the T-score that defines osteoporosis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| anti-mitochondrial antibodies |
|
Definition
| primary biliary cirrhosis |
|
|
Term
| what is the only treatment for ALS? |
|
Definition
|
|
Term
| what is the big side effect of all anti-thyroid drugs? |
|
Definition
|
|
Term
| Anterior shoulder dislocation |
|
Definition
| aBducted and externally rotated |
|
|
Term
| why do you get hypocalcemia from massive blood transfusions? |
|
Definition
| the transfused blood has citrate in it and that binds the Ca in the blood. |
|
|
Term
| what are the two weirdo things that hypothyroidism can be responsible for? |
|
Definition
| hoarseness and memory changes |
|
|
Term
| What is the progression of ECG changes in MI? |
|
Definition
| hyperacute T waves -> STE MI -> inverted T waves -> normalize T waves -> Q wave |
|
|
Term
| what does the protein electrophoresis show in Multiple Myeloma? |
|
Definition
| Spikes in the IgM and IgA |
|
|
Term
what is the treatment for PMDD?
PMS? Dysmenorrhea? |
|
Definition
|
|
Term
| what are the side effects of Thiazides? |
|
Definition
hyperGLUC
G - glucose
L - lipids
U - Uric acid
C - Calcium |
|
|
Term
| What are the major signs of Right hear Failure/inarct? |
|
Definition
CP/hypotension/JVD/clear lungs
STE in leads II/III/aVF |
|
|
Term
| What are the only 3 holosystolic murmurs? |
|
Definition
1. mitral regurg
2. tricuspid regurg
3. VSD |
|
|
Term
| What is the most common cyanotic heart defect in children? when does it present? |
|
Definition
| Tetrology of Fallot. It present after the neonatal period. |
|
|
Term
| What is the most common cyanotic heart defect in the neonatal period? What is a clue on the heart sound? what do you treat with? |
|
Definition
| Transposition of the Great Vessels. It should have a single S2. treat wth thing to keep the PDA open like prostaglandins. |
|
|
Term
| gray baby, absent pulses, single S2, increased RV impulse... what is it? |
|
Definition
| hypoplastic left heart syndrome. |
|
|
Term
| baby born 1d ago, severe dyspnea, single S2, systolic ejection murmur, and bounding pulses. CXR shows cardiomegaly and increased pulmonary vascular markings... what is it? |
|
Definition
|
|
Term
| male 60yo patient present with incontinence caused by things that increase intraabdominal pressure(caugh laugh sneeze) and frequency... PE reveals a smooth enlarged prostate and urinary retention of 900mL(after foley is placed... what is the first line treatment for this guy? long term management? |
|
Definition
| this guy has overflow incontinence caused by BPH. The first ling agent is going to be an Alpha-blocker(doxazosin, terazosin, tamsulosin). long term management will be focused on the BPH with drugs like finastride(5alpha-reductase inhibitor) |
|
|
Term
| Patient presents with a DKA/HHS type symptomology... Glucose is 280. there is an anion gap metabolic acidosis. Cr is 2.4. they are on metoprolol, metformin, atorvastatin, lisinopril, and ASA. Urine shows 4+ glucose. What is it? |
|
Definition
| This is a case of lactic acidosis caused by metformin. It is not DKA/HHS because the glucose is not high enough and there are no ketones. This is also not RTA because there is an anion gap |
|
|
Term
| so you have a kid who presents with polyuria/dypsia/weight loss. blood glucose is 325. What is the most likely diagnosis? What should you screen this kid for and how would you do that? |
|
Definition
| this kid most likely has type1 DM. There is an increased incidence of celiac disease in this patient population so you should screen for celiac with an IgA level and an anti-transglutaminase antibody. |
|
|
Term
|
Definition
| suspect congenital rubella syndrome or galactosemia. These are the most common causes. There are alot of things that can do this including syphillis, CMV, toxo, herpes, and a ton of other things. |
|
|
Term
| What does the Serum Ascities Albumin Gradient tell you? |
|
Definition
It is the ratio of serum-albumin:ascitic-albumin.
<1.1 - point toward NON-portal HTN casuses |
|
|
Term
| what is the common name for osteitis deformans? |
|
Definition
| pagets disease of the bone. |
|
|
Term
|
Definition
It is a measure of a tests ability to pick up people with the disease.
It is the TP/(all diseased) |
|
|
Term
|
Definition
| It is the measure of a tests ability to say that a person does not have the dz. It is TN/(all healthy) |
|
|
Term
| what is the positive predictive value? |
|
Definition
| this is only applicable after receiving a positive test. It is the probability that a positive is positive. TP/(all positve) |
|
|
Term
| what is the negative predictive value? |
|
Definition
| this is only applicable after receiving a negative test. It is the probability that a negative is negative. TN/(all negative) |
|
|
Term
what is the major side effect of
1. Ziprasidone?
2. olanzapine?
3. quetiapine?
4. clozapine?
5. Risperidone? |
|
Definition
1. QT prolongation
2. Diabetes and weight gain
3. Less incidence of mvmt disorder (tricky)
4. agranulocytosis
5. increased movement disorder. |
|
|
Term
If a kid has acne...
how do you differentiate mild/mod/severe? treatment? |
|
Definition
if you have anything other than comedones it is not mild. Use topical benzoyl-peroxide/macrolide.
If you have Cysts and nodules it is severe. Use oral vit A and oral doxy/minocycline.
Anything else is moderate and should be treated with topical Vit A(tretinoin, adapalene, tazarotene. If no response add oral doxy/minocycline |
|
|
Term
| what 3 antituberculous drugs cause sideroblastic anemia? |
|
Definition
| Isoniazid, pyrazinamide, and cycloserine |
|
|
Term
| What is the classic chromosomal anomaly with CML? |
|
Definition
| 9:22 translocation that results in the BCR-ABL fusion tyrosine kinase protein |
|
|
Term
| how do we treat urge incontinance? |
|
Definition
| start conservatively with kegel and bladder training. when that doesn't work move on to things lik oxybutinin(anti-cholinergic) |
|
|
Term
Malaria prophylaxis...
What drugs are working with?
When to use which? |
|
Definition
the main drugs we are using are:
chloroquin, doxycycline, atovaquone/proguanil
OR
mefloquine or doxycycline for resistant areas
The only areas that are not resistant: central america, paraguay, Dominican, argentina and carribean. |
|
|
Term
stress tests for the heart...
1. when should you NOT use exercise?
2. when is adenosine/dipyrimadole the answer? When is it NOT?
3. when is stress echo the answer? |
|
Definition
1. there are 3 main reasons:
-they can't exercise
-there is baseline ECG abnormality
-they are on digoxin
2. It is the answer when they have one of the above. Don't use it in COPD/Asthma (bronchospasm)
3. Stress echo is done when there is "significant" baseline ECG abnormality. |
|
|
Term
| So you have a rheumatoid patient who presents with some sort of infection and a big liver... What is it? what are the 3 big signs? what do you treat it with? |
|
Definition
| this is Felty Syndrome. It is characterized by RA, Splenomegaly, and Neutropenia. Treat with MTX/penicillamine/sulfasalazine/gold salts. |
|
|
Term
| what is the medical management of acromegally? |
|
Definition
|
|
Term
| what is Osler-Weber-Rendu syndrome? hint it often presents with iron def. anemia, epistaxis, and telangectasias. |
|
Definition
| It is also known as Hereditary Hemorrhagic Telangectasia. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| gram negative diplococcus |
|
|
Term
|
Definition
| gram-negative pleomorphic rods |
|
|
Term
|
Definition
addisons disease
diabetic nephropathy
renal insufficiency
Drug: spirnolactone, amiloride, NSAID, ACEi
Sickle cell |
|
|
Term
| If you see a kid with grossly bloody bowel movement and the workup has been negative so far and the question is asking next steps... |
|
Definition
| You better damn well have meckles diverticulum on the brain and remember that the technitium scan is also know as the "meckle scan"... damn it! |
|
|
Term
| E. coli, proteus, klebsiella, enterobacter... what do they have in common? |
|
Definition
| They are all gram negative rods that can cause pyelonephritis. |
|
|
Term
| what is ogilvie syndrome? |
|
Definition
| It is a "pseudoobstruction" of the colon. Think of it as illeus of the colon. |
|
|
Term
| How do you treat panic disorder? |
|
Definition
| benzodiazepines OR SSRI/other antidepressant |
|
|
Term
Shortness of Breath What is the most likely diagnosis
1. sudden onset, clear lungs?
2.sudden onset, wheeze, increased exp. phase?
3. decreased breath sounds unilat, trach dev.?
4. pallor and gradual onset (d-wks)
5. pulsus paradoxus, JVD, tachycard, decreased heart sounds?
6. dullness to percussion?
What will all of these lack since they are not CHF |
|
Definition
1. pulmonary embolus
2. asthma
3. pneumothorax
4.anemia
5. tamponade
6. pleural effusion
They will all lack orthopnea/S3 |
|
|
Term
| which drugs lower mortality in CHF? |
|
Definition
ACEi/ARB
metoprolol/carvedilol/bisoprolol
Spirnolactone - B/c anti-aldo effect |
|
|
Term
| What drugs are clearly beneficial in diastolic heart failure? |
|
Definition
| Beta-blockers and diuretics |
|
|
Term
acute onset SOB. pt has rales, JVD, S3. lower extremity edema, and orthopnea... CXR shows cephalization of flow and pleural effusions... What is it?
What do you do if an arrhythmia is present?
What is the initial therapy? |
|
Definition
Pulmonary edema - flash flooding in the lungs.
with arrhythmia cardiovert (synch)
intial - O2/morphine/nitrate/loops |
|
|
Term
| Patient presents with jaundice, history of thyroiditis and ITP, labs show hypergammagloulinemia, +ANA, +anti-smooth-muscle-antibody... What is it? treatment? |
|
Definition
| this is autoimmune hepatitis. treat with low-dose prednisone. |
|
|
Term
| 50's with behavior changes that are socially inappropriate? what is it? CT findings? |
|
Definition
| this is picks disease. fronto-temporal cortical atrophy |
|
|
Term
| Kid with recurrent meningitis secondary to nisseria... What is the defect? |
|
Definition
|
|
Term
| most common cardiac abnormality in babies of diabetic mothers? |
|
Definition
| asymmetric septal hypertrophy |
|
|
Term
| what are 4 big things you must know about what a 1 month old can do? |
|
Definition
| lift head, coo, track with eyes, recognize parents. |
|
|
Term
| What are 4 big things that a 12 month old can do? |
|
Definition
| WALK, 2 finger pincer grasp, mama/dada, imitate parents. |
|
|
Term
| What 4 big things can a 6 month old do? |
|
Definition
| sit up, racking grasp, babble, stranger anxiety. |
|
|
Term
| What things to know about a 9 month old? |
|
Definition
| walk with assistance, 3 finger grasp, wave bye-bye/pat-a-cake |
|
|
Term
|
Definition
| 2 steps, 2-word phrases, 2 step commands, stack 6 blocks. |
|
|
Term
| What can a 3 year old do? |
|
Definition
| TRI-cycle, 3 word sentence, brush teeth, draw circle |
|
|
Term
| What can a 4 year old do? |
|
Definition
| hop, copy a cross, play with kids. |
|
|
Term
| please explain the ABCD's of hypersensitivity reactions. |
|
Definition
A)type 1: Allergy(IgE)-think bee sting
B)type 2: Blood group reaction-think antibody mediated cell destruction.
C)type 3: Clumps (IC)-depostis in joints and kidney
D)type 4: Delayed(cell mediated)- think graft verses host Tcell mediated. |
|
|
Term
| What is asherman syndrome? |
|
Definition
| lack of a period secondary to obliteration of the uterine cavity. |
|
|
Term
| Causes of secondary amenorrhea? |
|
Definition
1. pregnancy
2. hyperprolactinemia
3. thyroid dysfunction
4. annovulation |
|
|
Term
| patient has secondary amenorrhea... normal TSH and PRL... has withdrawal bleeding after progeterone... what is wrong? most likely secondary to what? |
|
Definition
| annovulatory cycles... PCOS/ovarian failure |
|
|
Term
| what other comorbid conditions is tourettes associated with? |
|
Definition
|
|
Term
| young AAF with SOB... rales no wheezes... cervical lymphadenpathy... CXR show hilar adenopathy... What is it? how to diagnose? what is the characteristic skin finding? |
|
Definition
Sarcoidosis.
do a lymph node biopsy
skin shows Erythema nodosum
treat with prednisone |
|
|
Term
| At what age should you begin to screen for diabetes Mellitus? what do you initially screen with? what is diagnostic? |
|
Definition
start at 45. screen with fasting glucose.
two fasting readings higher than 125 or any one above 200. also elevations on GTT. |
|
|
Term
| What are the three most common causes of night-time cough? |
|
Definition
| Asthma, GERD, post-nasal drip |
|
|
Term
| What are the diagnostic criteria for PCOS? |
|
Definition
must have 2 or more:
1. oligo/amenorrhea
2. signs of hyperandrogenism
3. cycts in the ovaries |
|
|
Term
| What kind of infections do you get when your T-cells are down/out? |
|
Definition
Think of things that AIDS patients get:
PCP, varicella, candida... |
|
|
Term
| Adult presents with lots of sinopulmonary inections (bronchitis/PNA/sinusitis/otitis media)... they also have diarrhea... labs show that all antibodies are decreased, normal WBC... imaging reveals normal tonsils, spleen...What is it? What is the treatment? What are they at increased risk of developing? |
|
Definition
| This is Common Variable Immunodeficiency. treat with abo's and IVIG. They are at increased risk of lymphoma. |
|
|
Term
| little punk boy child comes in with his 16th bout of snotty nose pneumonia... no lymphnodes are palpated, no spleen, his tonsils are not visible... labs show decreased immune globumlins... What is it? treatment? |
|
Definition
| This is X-linked agammaglobulinemia. treat infections with abo's. and treat long'term with IVIG. |
|
|
Term
| So another little boy comes in with his 18000th case of sinupulmonary whatever... This kid also has diffuse petechiae, and he get nose bleeds, and he also has eczema... What is it? treatment? |
|
Definition
| This is Wiskott-aldrich syndrome. treat with bone marrow transplant. |
|
|
Term
| You suspect someone has celiac sprue... what is the initial screening work up? What do you need to order along side it? what is the diagnostic test? When do you tell them to lay off the gluten? |
|
Definition
| The best initial test is serology for anti-endomesial antibodies or anti-tissue transglutaminase antibodies (the gliadin one is not as good). You should order an IgA level along side it. You should follow up positive results with a tissue biopsy. Only after confirming your suspicions should you tell them to lay off the gluten (otherwise it messes up the tests) |
|
|
Term
| Older patient comes in losing weight, stools becoming thinner, occult blood in stool, anemic... What is it most likely? what is the initial test? what should you follow a positive test with? |
|
Definition
| most likely colon cancer. start with colonoscopy. follow up with CT abdomen to evaluate for mets. |
|
|
Term
| Mexican comes in with a fever, cough productive of sputum and blood, and drenching night sweats, and he has lost some weight... What is it? What is the best initial test? How would you exclude disease? You have a positive test... Treatment? |
|
Definition
The patient likely has TB... Start with CXR. you can exclude disease with three acid fast sputum stain.
Treatment: think RIPE
R- rifampin
I- Isoniazid
P- Pyrazinamide
E- Ethambutol (until sensitivity known)
treat for 6mo (drop P and E after 2)
extend to 9 mo for miliary/bone/brain |
|
|
Term
| What are the Side effects of TB therabpy? |
|
Definition
Think RIPE:
R-Rifampin: red color
I-Isoniazid: peripheral neuropathy (give B6 pyridoxine)
P-pyrazinamide: hyperuricemia
E-Ethambutol: optic neuritis/color
(decrease dose in Renal failure)
*all these med cause hepatotoxicity BUT do not stop unless LFT>3-5Xupper limit. |
|
|
Term
| PPD... ready go! What do you do with a negative result? a positive result? Treatment? |
|
Definition
PPD is positive if induration is >:
A) 15mm in people with no risk
B) 10mm in:
-immigrant, healthcare, prisoners...
-alcoholics, Diabetes
C) 5mm in:
-immunocompromised
-contact with active TB
-abnormal CXR
*negative result should be retested in 1-2wks if first test.
*postive result should be followed up with a CXR to exclude active disease.
*Treatment for latent TB is Isoniazide with pyridoxine for 9 months. |
|
|
Term
| What is Dressler syndrome? |
|
Definition
| post-heart-surgery pericarditis |
|
|
Term
Tell me about Polyarteritis nodosa...
1. General presentation?
2. what will labs show?
3. what kind of testing should you do?
4. What do you treat with? |
|
Definition
1.PAN presents with glomerulonephritis on a background of nonspecific sxs (fvr/malaise/myalgia/arthralgia/weight)
AND things involving systems like:
GI: crampy abdominal pain worse w/ food
Neuro: mono-neuritis multiplex, stroke in ayoung person.
Skin: digital gangrene, blothy skin
Some form of cardiac disease.
2. increased ESR/CRP, anemia, leukocytosis
3. Angiography is good in abscence of biopsy.
4. Prednisone AND cyclophosphamide |
|
|
Term
| 4-day old present with unconjugated bilirubinemia... has been breast feeding... 3 wets a day and 1 bowel movement since birth... what is it? How does it work? |
|
Definition
This is breast feeding jaundice (it should be called lack of breastfeeding)
Mom is not producing enough milk and the baby gets insufficient calories and becomes dehydrated and decreased BM causes increased enterohepatic circulation... Jaundice! |
|
|
Term
| little kid with mental retardation and self-mutilative bevahior... What is it? what is the deficit? What is the inheritance? |
|
Definition
| lesch-nyhan syndrome. deficiency of hypoxanthine phosphoribosyl transferase. it is X-linked |
|
|
Term
| patient with HIV comes in with watery diarrhea... CD4 is 88... all attempts at diangosing the etiology are negative... what is it? treatment? |
|
Definition
| Cryptosporidia. treat the HIV |
|
|
Term
| please differentiate the clinical presentation of gulliane-barre syndrome/tetanus/botulism |
|
Definition
GBS: typically follows diarrheal illness and presents as an ascending flaccid paralysis.
Botulism: may have diarrheal thing (or something about co-workers being affected). It is a descending flaccid paralysis.
Tetanus: presents with spastic paralysis. |
|
|
Term
| older woman comes in complaining of short episodes of vertigo brought on by turning her head to the left... No ringing in her ears... What is it? |
|
Definition
| Benign paroxsymal positional vertigo |
|
|
Term
| ARDS... What is it? what is the cause? How is it defined? treatment? |
|
Definition
it is massive insult to the alveoli that causes build up of fluid in the alveoli.
The etiologies are:
-spesis/aspiration
-trauma
-drowning
-burns/pancreatitis
Defined as pO2/FiO2<300
Treat with low tidal volume ventilation. |
|
|
Term
| anxious patient is brought in by friend...hallucinations, tremors, nausea, vomiting... has a seizure... What is it? |
|
Definition
|
|
Term
| what are the two drugs that cause hallucinations and seizure on withdrawal? |
|
Definition
| benzodiazepines and alcohol |
|
|
Term
| drug with diarrhea on withdrawal? |
|
Definition
|
|
Term
| pupillary constriction on intoxication? |
|
Definition
|
|
Term
| pupillary dilation on intoxication? |
|
Definition
|
|
Term
| two drugs with belligerence with intoxication? |
|
Definition
|
|
Term
| what is the treatment for inflamed cat bite on kids arm? what two bugs are you trying to cover? |
|
Definition
| amoxicillin/clavulinate to cover for pasturella and staph aureus. |
|
|
Term
| Coccidiomycosis... presentation? associated skin finding? Distribution? treatment? |
|
Definition
| mild PNA can disseminate and lead to granulomas/meningitis. associated with Erythema nodosum. Found in arid areas (SW US/latin america). Amph B or itraconazole |
|
|
Term
| What is an acronym that will help you remember DiGeorge syndrome and how do you test for it? |
|
Definition
C-Cardiac anomoly
A-abnormal facies
T-Thymic hypoplasia
C-Cleft palate
H-hypocalcemia
22 - deletion of 22q11
Test for it with PCR based genotyping. |
|
|
Term
| What is an easy way to differentiate between ehlers-Danlos and Maran |
|
Definition
| Marfans is a tall patient with long fingers. Ehlers-Danlos is not. |
|
|
Term
| Which nephrotic syndrome is associated with HIV/HBV/HCV and IV drug users? |
|
Definition
| Focal segmental Glomerular Sclerosis |
|
|
Term
| What is a missed abortion? |
|
Definition
| Retention of POC for several menstrual cycles. |
|
|
Term
| What is a threatened abortion? |
|
Definition
| This is vaginal bleeding during pregnancy with a closed cervical os and viable fetus(assume so until told otherwise). |
|
|
Term
| What is an inevitable abortion? |
|
Definition
| This is vaginal bleeding, rupture of membranes, cervical dilation during the first half of pregnancy. |
|
|
Term
| What is the normal BUN:Cr ratio? what does an increase mean? |
|
Definition
no more than 15:1.
If it is increased that is an indication of prerenal disease. |
|
|
Term
| what cancer is DES exposure associated with? |
|
Definition
| Adenocarcinoma of the Vagina |
|
|
Term
| flaccid bullae, IgG found in skin, Skin and mucosa involvemant |
|
Definition
|
|
Term
| tense bullae, IgG and C3 found in skin. |
|
Definition
|
|
Term
| what is the big lab difference between CML and leukamoid reaction |
|
Definition
| leukamoid has increased LAP |
|
|
Term
| So you have a patient with abdominal pain, tenesmus, bloody diarrhea that has been going on for weeks... he acutely worsens and becomes unstable... what is it? what to confirm? |
|
Definition
| Toxic mega colon. do an X-ray |
|
|
Term
| If HTN is due to hardening of the arteries what should you see? |
|
Definition
|
|
Term
| What patient will probably benefit from a side effect of metformin? |
|
Definition
| the obese patient because it causes weight loss. |
|
|
Term
| What lobe is affected in aptient with hemi-neglect? |
|
Definition
| the contra-lateral parietal lobe |
|
|
Term
| long term diabetic with a swollen foot (red, indurated, edema, pain)... difficulty walking on it... last A1c 9.1%... What are the two groups of diagnosis that you need to differentiate between and what are some simple ways of accomplishing this task? |
|
Definition
| The two big things in this patient to differentiate between are infectious and neuropathic arthropathy (AKA charcot joint)... Some easy things that will help to differentiate are WBC and presence of fvr. |
|
|
Term
| Pt presents with PNA please walk me through the approach to this patient. |
|
Definition
| first you must determine inpatient or outpatient (use CURB65 criteria). If out patient you should determine is there comorbidities/recent antibiotic use(if so use Quinolone) If not use macrolide... If the patient is to be inpatient you should either use a respiratory flouroquinolone OR Cephtriaxone plus azithromycin. |
|
|
Term
| What is the formal name of skin tags? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| So you have a male patient... short, broad chest, has coarctation of the Aorta, webbed neck... What is it? |
|
Definition
| This is noonan syndrome... Think of it as the male Turner syndrome. |
|
|
Term
| leukemias... rules of thumb. |
|
Definition
ALL ( Acute little life .........children usually affected)
AML ( Adult most risky Leukaemia)
CML ( Country music lover.........young adult , less severe , Philidelphia Chromosome, Philidelphia is where you play country music)
CLL ( Chronic Long life............usually elderly people, mild course, Increase lymphocyte counts ) |
|
|
Term
| what is the number one type of Ovarian cancer? |
|
Definition
|
|
Term
| What lab values do you see in embryonal cancer? |
|
Definition
|
|
Term
| Validity/accuracy/specificity/sensitivity all require what? |
|
Definition
| comparison to a gold standard |
|
|
Term
| case control gives you what statistic? When is this statistic a close approximation of it's cousin? |
|
Definition
| it gives you the odds ratio and the odds ratio is approximately equal to relative risk when the disease is rare. |
|
|
Term
| how to calculate attributable risk? |
|
Definition
|
|
Term
| normal distribution requires what to be true and what is the distribution? |
|
Definition
the mean=median.
68% in 1stdev
95% in 2
99.7 in 3 |
|
|
Term
| what is the difference between a t-score and a z-score. |
|
Definition
| both compare means between two groups but the Z score is used for populations. |
|
|
Term
| what is an ANOVA used for? |
|
Definition
| to compare 3 or more means |
|
|
Term
| what is observer/ascertainment bias? |
|
Definition
| this is misclassifaction of diseased as non-diseased or vice versa. |
|
|
Term
| How do we control for confounding |
|
Definition
by reducing variability before using matching, restriction, or randomization.
This can also be done by stratification of the results. |
|
|
Term
|
Definition
|
|
Term
| which two anti-psychotics cause weight gain? don't? |
|
Definition
olanzapine and quetiapine - Gain
ziprasidone and aripiprazole - no gain |
|
|
Term
| chi square is used to compare what? |
|
Definition
| proportions of categorized outcomes |
|
|
Term
| So you have a pregnant lady with decreased fetal movement... ready go |
|
Definition
| start with NST if that is non-reactive add vibroacoustic stim if that doesn't work move on to a Biophysical profile. If at any point you get a reactive reading move on to repeated monitoring |
|
|
Term
| When is a LEEP/CONE the answer for sure? |
|
Definition
|
|
Term
| So you have a gardener and he has this reddish nodule that progresses to ulceration on his finger and he develops subQ nodules along the arm... What the hell is it? |
|
Definition
|
|
Term
| RTA 1... mechanism, associations, treatment |
|
Definition
| This is a defect in the distal tubule(can be caused by amphB, autoimmune Dz)where it cannot excrete H and thus cannot generate new HCO3... There is alkaline urine (>5.5), increased kidney stones... treat with NaHCO3 |
|
|
Term
| RTA 2... mechanism, associations, treatment. |
|
Definition
| This is a problem with the proximal tubule(can be caused by amyloidosis, mult. myeloma, fanconi, or heavy metals) where the tubule can't reabsorb filtered HCO3... The urine is variable, it causes osteomalacia... Treat with thiazides. |
|
|
Term
| RTA 4... mechanism, associations, treatment. |
|
Definition
| This is a collecting duct/aldosterone resistance problem(can be caused by Diabetes... it has HYPERkalemia...treat with fludrocortisone |
|
|
Term
| How can you differentiate between diarrhea and RTA? |
|
Definition
One comes out of your butt... DUH!!
Or you can use the Urine Anion Gap...
UAG=Na-Cl
Diarrhea will have a negative UAG |
|
|
Term
| patient has ST-elevation in leads I, aVL, V2, and V4... treated and survives now has Q waves in same leads... echo shows low Ejection fraction... He is on ACE,BB,Spirnolactone... What drug is particularly indicated in this patient? |
|
Definition
| Warfarin... Early anticoagulation in aterior wall MI patients has been shown to significantly reduce Mortality. |
|
|
Term
| When does lipid screening in women begin? |
|
Definition
|
|
Term
| When do Ulcerative Colitis patients need colonoscopy? |
|
Definition
| after 8-10yrs of known disease. |
|
|
Term
| What are the time constraints on adjustment disorder? |
|
Definition
| must start within 3 months of the stressor and sxs must lessen by 6 months. |
|
|
Term
| I had chlamydia and was treated how long do I have to wait until getting an IUD? |
|
Definition
|
|
Term
| Which type of COPD has a decreased DLCO and why? |
|
Definition
| Emphysematous (pink-puffer) due to loss of alveolar capilaries |
|
|
Term
| When do you not perform balloon valvulotomy in patients with mitral valve stenosis? |
|
Definition
if the valve has an area >1.5cm you should do yearly follow up.
If the pulmonary artery pressure is less than 50 don't do it either. |
|
|
Term
| bleeding from mucosal surfaces... normal platelet number and morphology... pltlts don't aggregate with ADP the DO aggregate to ristocetin... what is it? how do you confirm diagnosis? |
|
Definition
| glanzman's thrmbasthenia... confirm with flow cytometry demonstrating deficient GPIIb-IIIa |
|
|
Term
| patient has a TIA and as part of the symptomology he has dizziness with vertigo... Which artery is he having issues with? |
|
Definition
| The vertebrobasilar artery. |
|
|
Term
| How do you treat legionaires Dz? |
|
Definition
| treat with a macrolide like erythromycin. |
|
|
Term
| conjunctivitis in the neonatal period and treatment... ready go... |
|
Definition
before 2d -chemical (supportive)
2-5d - gonococcal (ceftriaxone)
>5d - Chlamydia (oral erythromycin to prevent pneumonia) |
|
|
Term
| main drugs that cause reactions? |
|
Definition
There are 6:
1. Penicillins
2. sulfa drugs(includ thiazides,lasix)
3. allopurinol
4. phenytoin
5. lamotrigine
6. NSAIDS |
|
|
Term
| what is the difference between morbilliform rash, erythema multiforme stephens joshon, and toxic epidermal necrolysis? |
|
Definition
| neither morbilliform nor Erythema multiform have mucosal involvement, But EM has target lesions and you can treat it with prednisone. The other two SJ and TEN both involve mucosa but ten involves a larger portion of the body and it has nikolsky you treat both with IVIG |
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|
Term
| what are the groups included in beta lactam antibiotics? |
|
Definition
| penicillins, cephalosporins, carbapenems, aztreonam. |
|
|
Term
| What does amoxicillin treat? |
|
Definition
Remember amoxicillin HELPS
H-H. influenzae
E-E.coli
L-Listeria
P-Proteus
S-Salmonella |
|
|
Term
| Listeria, MRSA, and Enterococcus are resistant to this class of antibiotics? |
|
Definition
|
|
Term
| Anaeropbes are treated with what? |
|
Definition
above the diaphragm: clindamycin, PCN
abdominal/GI: Flagyl, beta-lactam/lactamase combinations. |
|
|
Term
| Where do you find gram negative bacilli? name some? antibiotics? |
|
Definition
they are found in the gallbladder,diverticula,kidney,gut wall
KEPPEC(Klebsiella,E.coli,Proteus,Pseudo,Enterobacter,Citrobacter)
cover with
beta-lactams, quinolones, and aminoglycosides. |
|
|
Term
| causes of bloody diarrhea... |
|
Definition
CESSY V
Campylobacter
E. coli
Salmonella
Shigella
Yersinia
Vibrio |
|
|
Term
| how do you treat crabs and scabies |
|
Definition
|
|
Term
|
Definition
IP: treat with ceftriaxone first. treat with amp/gent until cultures..
OP: Ciprofloxacin |
|
|
Term
| what do you treat prostatitis with? |
|
Definition
|
|
Term
HIV drug side effects:
1. Zidovudine
2. Stavudine/didanosine
3. abacavir
4. protease inhibitor (end W/ navir)
5. indinavir
6. tenofovir |
|
Definition
1. anemia
2. peripheral neuropathy
3. stephens johnson
4. hyperGL
5. nephrolithiasis
6. renal insufficiency |
|
|
Term
patient presents with chest pain...
1. what can be given to rule out vasospasm?
2. after ruling out vasospams and obtaining an EKG you discover that it is an NSTEMI... do you give thrombolytics?
3. what is the time frame to recieve thrombolytics?
4. what are some situations where thrombolytics should be avoided? |
|
Definition
1. nitro
2. NO... thrombolytics do not benefit NSTEMI
3. 12 hours for thrombolytics
4. systolic BP above 180 |
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|
Term
| you suspect a pt has an esophageal tear... ready go! |
|
Definition
| Esophagram with water-soluble contrast is 90% accurate... if negative go with clinical suspicion (you can still order a barium swallow to rule out... but remember barium will further exacerbate mediastinitis) |
|
|
Term
| what are the main causes of Multi-Atrial Tachycardia? What is the preferred CCB to treat? what other class can be used? when should the second class be avoided? |
|
Definition
1. hypoxia
2. COPD
3. HypoK
4. hypoMg
5. CAD/HTN/valve dz
6. drugs (theophylline/isoproterenol)
Verapamil is the preferred CCB... can use BB but don't give to reactive airway. |
|
|
Term
| What is the ranson criteria? What is it used for? What pneumonic helps remember the criteria? |
|
Definition
It is a clinical tool to help predict both the likelihood and the mortality of acute pancreatitis.
W - WBC >16 for non stone 18 otherwise
A - age > 55/70
L - LDH >350/400
L - liver enzyme (AST)>250
S - sugar >200/220
(after 48hrs)
F - fluid >4/6L
O - pAO2<60
C - calcium < 8
H - hematocrit fall > 10%
U - Urea(BUN)increased by 1.8 s/p fluid
B - base def > 4/5 |
|
|
Term
| what is a typical presentation of ASA toxicity? waht is the acid base derangement? how do you manage? |
|
Definition
typically tachypnea, tachycardia, hyperthermia BUT they are NOT SOB. They may also have tinnitus (kinda a giveaway).
PATH:
1. stim resp center - resp alk
2. uncouples OXPHOS - met lactic acid.
MGMT: Dont forget ABC's
1. give glucose for AMS - ASA impairs gluc utilization
2. gastric lavage/charcoal - if in time
3. alkalinize urine - load HCO3, fluids
4. check ASA, ABG, clinical assess Q2
5. if ASA > 100 consider HD |
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