1.IM Flashcards
Old pat post surgery developed DVT in recovery room next step is …
IVC ( inferior vena cava filter )
N.B: According to Aladelegan : developed DVT immediate “ in recovery room “ after surgery , initial ttt is IVC , while anti-coagulant is contraindication
UpToDate ** below
1.Name of sign ?
2. Abnormalities on this ECG ?
3. Indicate what ?
4. First line treatment for this condition?
1.Tick sign
2. Downsloping ST depression with a characteristic “reverse tick” or “Salvador Dali sagging” appearance
Flattened, inverted, or biphasic T waves
Shortened QT interval
3. Digoxin effect !! Not toxicity!
4. Digoxin immune Fab (DigiFab, Digibind) is an immunoglobulin fragment that binds with digoxin. It is currently considered first-line treatment for significant dysrhythmias
About 11 years with red eye and yellow discharge on examination bilateral red conjunctiva and wet discharge
1. What is the most appropriate management:
2. Most likely diagnosis ?
- Topical broad spectrum antibiotics for 4 days if not respond referal to ophthalmology
- Bacterial conjunctivitis
What is the findings on this ECG ?
What is the most likely diagnosis ?
What is first drug to give ?
- Prolonged PR interval.
Broad, bizarre QRS complexes — these merge with both the preceding P wave and subsequent T wave.
Peaked T waves. - Hyperkalemia
- Calcium gluconate (1st drug, to stabilize membrane)
Pt comes with fatigue,pallor & pica what is the most likely diagnosis ?
Look at picture for peripheral blood smear
IDA
Plasmodium species causes relapse malaria?
P.Vivax
Middle aged male complaining of fever and bony back pain of 4 months duration , blood culture result gram negative coccobacilli , dx ?
A. Brucellosis
B. Tuberculosis
C. Staph aureus
A
Q.Hiv pt admitted in icu then develop sob fever ,, symptoms of pneumonia, asking about the causative organism ?
A. Pneumocystis Jirovici j
B. Pseudomonas aregenosa
HIV + Pneumonia»_space; common organism according to CD4
If CD4 >200»_space; Streptococcus pneumoniae
If CD4 < 200 à Pneumocystis Jirovici or carinii
UQU notes
What is most effective for secondary prevention of CVD ;
A-rosuvastatin
B-niacin
C- fibrate
D-no treatment is needed
A
Man presents palpitation and dizziness these symptoms have occurred several times but typically resolved after a few minutes. and ECG consistent w/ wolff-Parkinson-white syndrome, while in the emergency department he notes worsening palpitations, diaphoresis. His BP is 108/77. Reapted is shown. Pharmacotherapy w/ which of the following agents is indicated at this time?
A. Procainamide
B. Diltiazem
C. Amiodarone
D. Adenosine
A is the safest treatment
Note ; For unstable patients, electrical cardioversion is the treatment of choice regardless of the presence of WPW syndrome.
Which is consistent with rheumatic heart disease ?
Mitral stenosis
Mean Arterial Pressure is 55 , intracranial pressure 15. What’s the cerebral perfusion pressure?
CPP=MAP-ICP
(55_15)=40
Elderly with a lot of comorbidities her A1C is currently 7 but she was between 8-9 in the previous years so we had to add insulin above metformin that she was taking. She is presenting with distal symmetrical neuropathy. She is taking glargine, aspart, and lisinopril. What should be done/given? (No labs were given)
A- tighter A1C control
B- vitamin B12
C- amitriptyline
C . amitriptyline
Is anti depressant drug used as pain reliever in Diabeatic neuropathy
Note by Dr,Rayan ;
No labs = you can’t diagnose B12 deficiency (because of metformin) On the other hand = Diabetic neuropathy is very common and can be diagnosed clinically → amitriptyline is needed since a tight glycemic control (A1c 7) didn’t improve the pain
Hepatitis B serology ** very important
Old pat started treated by vancomycin due to MARSA & immediately he develop rash , itching in his trunk , what is the best next step ?
Decrease infusion rate ( red man syndrome )
Stop infusion if he had SOB & hypotension ) = anaphylactic reaction .
