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5 Flashcards

1
Q

Treatment of syphilis in:

  1. primary, secondary, early latent stage (<12 months)
  2. late latent stage (>12 months), or unknown, cardiosyphillis
  3. neurosyphillis
  4. congenital syphillis
A
  1. benzathine penicillin G IM in single dose
  2. benzathine penicillin G IM weekly in 3 doses
  3. aqeuous penicillin G IV 10-14 days
  4. aqeuous penicillin G IV 10 days
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2
Q

What is Jarisch-Herxheimer reaction?

A

acute febrile reaction within 24 hours of spirochetes treatment – chills, headaches, myalgia.
innate immunologic reaction to lysis of spirochetes

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3
Q

3 thyroid effects of amoidarone, and treatments related to conditions

A
  • decreased peripheral T4-T3 conversion, clinically euthyroid, no treatment needed. normal to slightly elevated TSH.
  • inhibits thyroid hormone synthesis–> hypothyroidism. Give levothyroxine. Increased TSH
  • amiodarone induced thyrotoxicosis (AIT)– depending on type 1 vs 2, antithyroid drugs vs steroids. Low TSH.
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4
Q

Treatment of painful vertebral metastasis in metastatic prostate cancer

A
  • 1 week of antiandrogen (flutamide) followed by LH releasing hormone agonist (leuprolide) to reduce initial symptom flare
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5
Q

Treatment of tinea capitis, diagnosis test?

A

oral griseofulvin and terbinafine

KOH prep

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6
Q

Pt with HIV presents with fever, blurry vision, headaches, and signs of meningitis. What bug is it? Treatment?

A

Cryptococcus neoformans (yeast)

  • amphotericin B and flucytosine. If improvement occurs, then consolidation and maintenance with fluconazole.
  • if meds don’t improve, then repeat lumbar puncture to decrease intracranial pressure
  • ** don’t start HAART until 4-10 weeks later for paradoxical worsening of infection
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7
Q

Cryptococcus neoformans meningitis findings in CSF

A
  • elevated opening pressure
  • elevated protein, low glucose
  • positive india ink presentation/cryptococcal antigen test
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8
Q

What screening tests are needed in patients with Turner’s syndrome?

A
  • Echo
  • renal ultrasound
  • TSH levels
  • visual and hearing test
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9
Q

lead poisoning test, management based on levels of lead- mild, moderate, severe

A
  • mild (5-44mcg): no meds, repeat level in 1 month
  • moderate (45-69): DMSA
  • severe (>70): DMSA+EDTA
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10
Q

Definition of pre-eclampsia

A
  • new onset hypertension >140/90 after 20 weeks gestation AND
  • proteinuria OR
  • signs of organ damage
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11
Q

Severe features of pre-eclampsia

A
  • creatinine >1.1 or doubling
  • thrombocytopenia <100,000
  • > 160/110
  • elevated transaminases
  • pulmonary edema
  • new onset visual/ cerebral symptoms
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12
Q

Management of pre-eclampsia

A
  • IV mag for seizure ppx
  • delivery for term patients
  • if bp >160/110, then give IV labetalol, hydralazine or nifedipine PO
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13
Q

HPV indications

A
  • female 9-26
  • male 9-21 (upto 26 in MSM)
  • immunocompromised individuals 9-26
  • NOT indicated in pregnant women
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14
Q

Clinical manifestations of Henoch Schonlein purpura (IgA mediated leukocytoclastic vasculitis)

A
  • palpable purpura, esp in legs and buttocks
  • arthritis/ arthralgia
  • abdominal pain/intussusceptions
  • renal disease similar to IgA nephropathy
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15
Q

Lab findings and treatment of HSP

A
  • normal to increased creatinine
  • normal platelet count and coag studies
  • hematuria +/- RBC casts +/- proteinuria
  • supportive (hydration & NSAIDs) treatment, hospitalization and systemic glucocorticoids for severe sx
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16
Q

How long should varicella zoster virus patients be isolated?

A

isolate till lesions are crusted

17
Q

Clinical features of lateral medullary syndrome (wallenburg syndrome)

A
  • vestibulocerebellar: horizontal and vertical nystagmus, vertigo
  • sensory: loss of pain and temperature in ipsilateral face and contralateral body
  • ipsilateral bulbar muscle weakness
  • ipsilateral horner’s syndrome, hiccups
18
Q

Best test to diagnose infantile hypertrophic pyloric stenosis, and what med usage is linked with this disease

A

ultrasound

erythromycin

19
Q

Contraindications of MMR

A
  • anaphylaxis to neomycin, gelatin
  • severe immunodeficiency
  • pregnancy
  • ** presence of fever after vaccine is ok
20
Q

Diagnosing acute mesenteric ischemia

A
  • metabolic acidosis
  • marked leukocytosis
  • hemoconcentration (high hematocrit)
  • CT angiogram
21
Q

harsh holosystolic murmur in 4th intercostal space, palpable thrill. Which cardiac defect causes this?

A

VSD

22
Q

Which electrolyte imbalance can lead to rhabdomyolysis?

A

hypophosphatemia

23
Q

Gold standard for diagnosing nephrolithiasis

A
  • non contrast helical CT scan

- in pregnant patients, u/s is good alternative

24
Q

When is lung cancer screening recommended? Which test?

A
  • pt age 55-80
  • more than 30 years smoking history AND is current smoker or quit smoking in last 15 years
  • CT scan of lung
25
Q

latent TB infection treatment

A

isoniazid with B6 for 6-12 months

26
Q

Clinical features of juvenile myoclonic epilepsy and treatment

A
  • myoclonic jerks of upper extremity within first hour of waking
  • generalized tonic clonic seizures usually occur in all patients, sometimes concomitant anxiety disorder
  • EEG: bilateral polyspike and slow discharge
  • tx: valproic acid
27
Q

Actinic keratosis (usually from sun exposure) treatment, risk of progression to which cancer?

A
  • cryosurgery or by surgical excision
  • field therapy if area is large, like 5-fluorouracil cream, topical diclofenac, photodynamic therapy
  • SCC
28
Q

Screening for gestational diabetes, and target glucose levels

A
  • 2 step oral glucose test:
    if 1 hour glucose test of oral glucose challenge of 50g is >140, then 3 hour glucose challenge of 100g
  • target: fasting– <95, 1 hour post prandial <140, 2 hour postprandial <120
29
Q

what are heberden’s nodules?

A

DIP joint nodules present in OA

30
Q

Signs of progressive multifocal leukoencephalopathy (PML)? Treatment?

A
  • rapidly progressive focal neurologic deficits (cognitive impairment, hemiparesis, aphasia, ataxia, visual defects)
  • JC virus, in late AIDs
  • HAART seems to help as treatment
31
Q

In women from age 21-24, if ACS-US or LSIL is found on pap smear, then what? what if age >25?

A
  • repeat pap smear in 1 year, colposcopy only if ACS-US on 3 consequetive pap smear, or atypical squamous cells, atypical glandular cells-H, or HSIL.
  • if above 25, then HPV DNA test

step3 (16 decks)

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