3/8 Reading Flashcards
initial rx of hiatal hernia?
PPI and wt loss
what is first line rx for achalasia?
dilation of esophagus
treatment of eosinophilic esophagitis?
PPI and no allergenic foods…can also swallow steroids
what is best course of action to take with AIDs patient who has pain with swallowing and low CD4 count?
can go ahead and trial fluconazole
what is rx of zenker diverticulum?
surgical repair
what is test to confirm zenker diverticulum?
barium study
three esophageal disorders you use manometry for?
achalasia
scleroderma
spasms
what are sx of diabetic gastroparesis?
stomach distension, bloating and constipation
what are two rx options for diabetic gastroparesis/
erythromycin and metoclopramide
if patient has c diff and is successfully treated but then recurs, what is rx?
vanc
what is CT finding in chronic pancreatitis?
calcifications of the pancreas
sx of carcinoid syndrome?
intermittent diarrhea, wheezing, flushing and cardiac abnormalities
what is best test to identify carcinoid syndrome?
urinary 5HIAA
what is rx of carcinoid syndrome?
octreotide
what is stool test for lactose intolerance?
increased stool osmolality
sx of SIBO
flatulence, bloating, diarrhea, steatorrhea
rx of SIBO
rifaximin
what is colonoscopy plan after CRC resection?
1, 3 then 5 years
peutz jehgers syndrome cancer risk
colon
breast
pancreatic
gonads
gardner syndrome cancers
osteomas and CRC
what hep B antigen means likely to pass to fetus?
E-antigen
side effects of interferon
arthralgia
thrombocytopenia
depression
leukopenia
rx for wilson disease
penicillamine
what are some other findings in wilson disease?
RTA
psychotic features
kayser fleischer in eyes
anemia
if patient has NASH and diabetes, what med?
pioglitazone
what is empty sella syndrome?
basically undersized pituitary
what should you do for empty sella syndrome?
check adrenal andthyroid function
what is first line rx for acromegaly?
transphenoidal pituitary removal
what meds can be used for acromegaly if surgery not an option?
cabergoline
octreotide
pegvisomant
what are medication options for prolactinoma/
cabergoline or bromocriptine (dopaine agonist)
what are tsh t3, t4 and reverse t3 levels in euthyroid sick syndrome?
t3 and 4 are low, reverse t3 is high, TSH is normal
best therapy for graves opthalmopathy
steroids
do thiazide diuretics cause hyper or hypocalcemia?
hypercalcemia
what is best test for Vit d levels?
25 vit D
rx for paget disease?
bisphosphonates then calcitonin
what is test to confirm paget disease?
nuclear bone scan
what is test to confirm adrenal insufficiency?
cosynotropin stimulation test
what is odd lab finding in hypocortisolism?
eosinophilia
if patient cant have an aldosterone secreting adenoma removed, what meds?
spironolactone or eplerenone
what is rx of glucagonoma?
octreotide and surgical removal
what fasting glucose is diagnostic for DM>
125
what non fasting glucose level is diagnostic for DM?
200
when do mammograms start and stop?
50 and 74
guidelines for lung cancer screening
CT yearly if greater than 20 year history
what is post exposure prophylaxis for Hep A?
vaccine in adults, vaccine and immuneglobulin in infants
post exposure prophylaxis for hep B?
vaccine and immuneglobulin
name first line rx for BPH
tamsulosin and terazosin
what are common nutritional deficiencies in vegandiet?
B12, Vit D and calcium
treatment for avascular necrosis of femoral head?
hip replacement
what is unhappy triad of knee
mcl, acl and meniscus
tarsal tunnel syndrome is entrapment of what nerve?
tibial
when is a family member with CAD a risk factor?
if male less than 55 and female less than 55
correction of what risk factor will help most with CAD?
smoking cessation
what two meds should patient with stable angina be on?
aspirin and beta blocker
what is goal LDL in patient with CAD?
70 or lower
whats most common adverse effect of statins?
liver enzyme elevation
what med when combined with statin increases risk of statin myopathy?
fibrates
fibrates are best at doing what?
lowering triglycerides
what are worst leads to have MI in?
V2-V4
what lab should be checked in patient you are worried about re infarction soon after an MI?
CK MB
what med in addition to spirin and clopidogrel for NSTEMI?
LMWH
what is usual cause of ED after an MI? what med can cause it?
anxiety…beta blockers
what four meds increase mortality in HF
Ace/arbs
spironolactone
beta block
sacubitril/valsartan
two murmurs that do not increase with exhalation?
MVP and HOCM
patient with HOCM with syncope should have what put in?
defibrillatory
what med should patients with HOCM be on?
metoprolol
PFTs in CF?
mixed restrictive and obstructive, low DLCO
3 abx options for HAP
cefepime
zosyn
penems
what is rx of VAP
two anti pseudomonal abx then vanc
what abx can cause seizures?
impipenem
if patient gets pneumococcal vaccine before 65, what should be done?
get it again 5 years later
abx for lung abscess?
clinda or penicillin
what lab is elevated in PJP?
LDH always up
patient with PJP cannot have bactrim, what should you give?
pentamidine or clinda/primaquine
what is best test for symptomatic patient with Tquestionable TB?
cxr and sputum stain and culture
what is rx for active tb
RIPE for 6 mobnths then isoniazid/rifampin for 4 months
sand blasting lung
silicosis
electronic manufacturer lung
berylliosis
what is of BOOP?
bronchiolitis obliterans organizig pneumonia
what are sx of BOOP?
cough dyspnea fever weight loss
what reverses rivaroxaban, epixaban?
andexanet alfa
rx of hypersensitivity pneumonitis?
steroids
3 drug classes for pulm htn
prostacyclin analogues endothelin agonists (bosentan) phosphodiesterase inhibitors (sildenafil)
