11 Flashcards
Treatment of nongonococcal urethritis (watery discharge, dysuria, absence of bacteria)
azithromycin or doxycycline if chlamydial
if these don’t respond, then try metronidazole as it can be trichomonas
(**ceftriaxone for gonococcal urethritis)
Gold standard test for HIT, and when to start warfarin in HIT
- serotonin release assay
- after treatment with non-heparin anticoagulant and platelet counts improving upto >150,000
Treatment of HELLP (hemolytic anemia, elevated liver enzymes, low platelet count) syndrome in severe pre-eclampsia
magnesium sulfate infusion
Diagnostic test to confirm organophosphate poisoning
RBC cholinesterase activity test
Reactive arthritis (asymmetric oligoarthritis, uveitis, urethritis, keratoderma blenorrhagica), usually occurs after genitourinary/GI infection, diagnostic test?
- synovial fluid shows elevated WBC but no bacterial culture
Treatment of iodine induced thyrotoxicosis (extreme fatigue, weight loss, palpitations after imaging)
- usually self limiting
- beta blockers for mild symptoms
- antithyroid drugs for moderate to severe sx
- potassium perchlorate for refractory cases
Management of flail chest ( tachypnea, tachycardia, shallow breathing, inadequate ventilation, double rib fx in more than one site, paradoxical/segmental chest movement )
- oxygen
- pain control
- positive pressure ventilation
- surgical stabilization
Treatment of mild to moderate psoriasis? psoriatic arthritis (DIP involvement, presents a lot like RA otherwise)?
- topical glucocorticoids or vitamin D derivatives (calcipotrieine)
- if systemic, need methotrexate
when to give oral metronidazole vs oral vanc for c.diff. When do you give IV metronidazole?
- give oral vanc if WBC >15000, creatinine greater than 1.5x of baseline, or serum albumin <2.5 or temp >100.9
If there is ileus, then give IV metronidazole or rectal vanc
Centor criteria for streptococcal pharyngitis: strep testing recommended if two or more criteria met, but if one or no criteria met, then sx treatment and no test
- tonsillar exudates
- tender anterior cervical lymphadenopathy
- fever
- absence of cough
Treatment for toxic megacolon
- in presence of pneumoperitoneum: surgery
- in absence: steroids if negative for c.diff, and appropriate abx
- avoid 5 ASA and opioids
Asymmetry in a funnel plot suggests what kind of bias?
publication bias
Screening test for hemochromatosis ( central hypogonadism, liver dysfunction, DM, arthropathy, skin pigmentation, hook-like osteophytes on x-ray)? Gold standard?
- serum iron studies- transferrin saturation
- gold standard: liver biopsy
Managing sexual SE related to SSRI (decreased libido, delayed ejaculation etc)
- switch to mirtazapine or buproprion
- adjunctive therapy with sildenafil
Complications of MI
- acute pericarditis (1-4 days): pericardial friction rub, pain changes with position and deep inspiration
- chordae tendinae (2-7 days): acute hemodynamic instability, pulmonary edema
- dressler’s syndrome (weeks to months): autoimmune mediated syndrome, fever, leukocytosis, pleuritic chest pain, pericardial rub
