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Pance > All The Stuff > Flashcards

All The Stuff Flashcards

1
Q

Tx for TCA OD

A

Sodium bicarbonate
Prolonged QTi

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2
Q

Opioids OD TX

A

Naloxone/naltrexone

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3
Q

BZD OD TX

A

Flumazenil

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4
Q

BB OD TX

A

glucagon

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5
Q

Theophylline OD TX

A

BB

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6
Q

Warfarin OD TX

A

vit k and FFP

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7
Q

Heparin OD TX

A

protein sulfate

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8
Q

MS is a/w with what other condition

A

Thymoma

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9
Q

Lamber Eaton vs MS

A

Related to Ach receptors
MS presynaptic
LE post synaptic

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10
Q

Which lung cancer presents with high Ca and what is that called

A

NSCLC — squamous cell carcinoma
Pancoast syndrome

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11
Q

Linear lesions on UGD
Tx

A

Candida
Fluconazole

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12
Q

What type of acidosis does metformin cause

A

Lactic acidosis
Discontinue 48hrs before iv contrast to avoid kidney damage

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13
Q

1st line tx in nephrotic syndrome

A

Prednisone

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14
Q

Signs of TCA overdose

A

Anticholinergic SE
SLUDD C opposite

Avoid TCA they have high potential for OD

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15
Q

Anti arrhythmic medications

A

Class 1 block Na — procainamide
Class 2 block adrenaline — BB
Class 3 block K — amiodarone
Class 4 block Ca — CCB

Na Lol K Ca

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16
Q

What electrolyte is low if PTH is low

A

Ca and Mg
Mg is needed to make PTH which responds to Ca

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17
Q

Anti DS DNA

A

SLE

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18
Q

Anti centromere
Anti scl

A

Scleroderma

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19
Q

Anti mi 2

A

Dermatomyositis

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20
Q

Tension pneumo management

A

Needle decompression then thoracostomy

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21
Q

PaCO2 levels

A

35-45

Lung levels same as acid levels

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22
Q

Best Tx to lower LDL, HDL, TG

A

LDL — statins
HDL — niacin
TG — fibrates

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23
Q

Alpha thalassemia peripheral smear

A

Heinz bodies

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24
Q

PE for pna

A

Dullness to percussion
Increases tactile fremitus
Egophony

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25
Q

Primary biliary cirrhosis must know

A

Antimitochondrial antibodies
Jaundice pruritis fatigue
Tx of choice is ursodiol

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26
Q

Primary sclerosing cholangitis

A

A/w ulcerative colitis
+ panca o

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27
Q

Maculopapular rash Starts at wrists and ankles and moves to trunks

A

RMSF
Ricketssia rickettsi
Tx doxy

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28
Q
  1. Erythema multiforme
  2. Erythema nodosum
  3. Erythema infectiosum
  4. Erythema marginatum
  5. Erythema migrans
A
  1. Target lesions
  2. Inflammatory nodules
  3. Slapped cheek, parvovirus
  4. Rheumatic fever
  5. Lyme disease
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29
Q

High cortisol
High cortisol 2mg
Low cortisol 8 mg

A

Cushing disease
Pituitary ACTH hypersecretion

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30
Q

High cortisol
2mg high cortisol
8 mg high cortisol

A

Cushing syndrome
Adrenal source — adrenalectomy

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31
Q

Beta thalassemia hemoglobin chains

A

Hgb A (adult)
Hgb F (fetal) — will be increased
Hgb A2 (delta chains)

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32
Q

Morning joint stiffness lasting <30 mins

A

OA
TOC Tylenol then NSAIDs

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33
Q

PPD test results

A

INDURATION not erythema
>5mm for HIV, incarcerated, homeless
>10 mm for healthcare workers
>15 mm no risk factors

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34
Q

Loop diuretics work by ___
Can lead to ___

A

Inhibiting Na/K/Cl transport to excrete water, Na, Ca, Mg, and Cl

Metabolic alkalosis

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35
Q

What electrolyte do thiazide diuretics effect

A

Increase calcium

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36
Q

Tylenol overdose tx

A

< 4 hr — activated charcoal
> 4 hr — NAC
Best to administer within 8 hrs

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37
Q

Partial molar vs complete molar pregnancy

A

Partial has fetal parts
Complete is a cluster of grapes or snow storm appearance — risk of developing gestational trophoblastic neoplasia

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38
Q

Elevated AFP level is concerning for

A

Hepatocellular carcinoma

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39
Q

What level is low if you have night blindness and dry eyes

A

Vit A

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40
Q

Bleeding gums and non healing wounds

A

Vit C

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41
Q

Diarrhea dementia and dermatitis
(Pellagra)

A

Niacin
Vit B 3 (3 Ds)

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42
Q

Vit B 2

A

Glossitis
Cheliosis
Seb derm

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43
Q

IgATTG is positive in

A

Celiac disease
+ dermatitis herpetiformis
Needs dudodenal bx by EGD

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44
Q

Vit b3 toxicity

A

Flushing of skin

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45
Q

Courvoisier sign

A

Enlarged gallbladder that is NTTP
A/w pancreatic cancer

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46
Q

Courvoisier sign

A

Enlarged gallbladder that is NTTP
A/w pancreatic cancer

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47
Q

Pencil in a cup a/w

A

Psoriatic arthritis

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48
Q

Ranson criteria is for what and what is it

A

Mortality in pancreatitis
“Ransom is against GA LAW”
Glucose >200
WBC > 16
Age > 55
LDH > 350

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49
Q

MC neoplastic colon polyp

A

Adenomatous > villous > tubular

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50
Q

MC non neoplastic colon polyp

A

Hyperplastic
Serrated has malignant potential tho

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51
Q

PCOS hormones and tx

A

LH:FSH ratio elevated
OCP
Metformin

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52
Q

What nerve is responsible for referred shoulder pain

A

Phrenic nerve

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53
Q

Cocaine induce MI tx

A

BZD

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54
Q

Cocaine induce MI tx

A

BZD

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55
Q

Foot drop is due to injury to

A

Peroneal nerve
Anterolateral leg and 1&2 toes

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56
Q

Crest syndrome is in what
What is it

A

Scleroderma
Limited, less mortality
Calcinosis
Raynauds
Esophageal dismotility
Sclerodactly

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57
Q

Abx for UTI in pregnancy

A

Complicated UTI
Amoxicillin
Augmentin
Bactrim
Keflex

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58
Q

Lisinopril is contraindicated in

A

Pregnancy
ACEI inhibitors are category D
Oligohydramnios, kidney agensis, fetal skull deformity

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59
Q

Sjorgens puts you at risk for

A

B cell NH lymphoma

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60
Q

Gram + bacteria

A

S aureus
Myco TB
Enterococci
Strep pneumonia
C botulinum

MESS-C

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61
Q

What arrhythmia is common in someone who heavily drank

A

A fib
Self resolves

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62
Q

Kaposi sarcoma is defining illness for

A

HIV

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63
Q

Pertussis presentation and tx

A

CPC — catarrhal, paroxysmal, convalescent
Can’t last a really long time

Treat with macrolides like azithromycin
MUST TREAT to prevent pna

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64
Q

Otitis externa tx

A

Topical abx
1. Ciprofloxacin/dexamethasone : abx and anti inflammatory effect
2. Ofloxacin: FQ for psuedomonal coverage
3. Neomycin/polymyxin b/hydrocortisone: both inflammation and infection but AVOID IN PERFORATED OR TUBES

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65
Q

Hypercalcemia cause and Tx

A

1° hyperparathyroidism
Parathyroidectomy

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66
Q

Tx if malignant pleural effusion

A

Indwelling pleural catheter > pleurodesis > pleurectomy if failed

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67
Q

Lights criteria

A

1 or more = exudative
Pleural fluid protein:serum protein >0.5
Pleural fluid LDH:serum LDH >0.6
Pleural fluid LDH > 2/3 ULN LDH

PROTEIN !!! Indicates infection

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68
Q

Pleural effusion vs consolidation on lung exam

A

DECREASED tactile fremitus vs increased

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69
Q

Epiglottis tx

A

IV rocephin + vanc

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70
Q

Multiple myeloma must know

A

CRAB:
HyperCa — inc osteoclast activity
Renal disease
Anemia
Bone pain — MC presenting sx

Peripheral smear: rouleaux formation
XR: many lytic lesions

MY OH MY MR CRABS

71
Q

HPV dosing guidelines

A

Initial 9-14 — 2 doses (0, 6-12mo)

Catch up
15-24 — 3 doses (0,2,6mo)
27-45 — 3 doses (0,2,6mo)

72
Q

Fundoscopic exam for
1. Acute AC glaucoma
2. Papilledema
3. CRAO
4. CRVO

A
  1. Cupping of optic nerve
  2. optic nerve cupping obscured, flame/splinter hemorrhages & cotton wool spots
  3. Cherry red macula & afferent pupillarydefect
  4. Blood & thunder retina, dilated tortuous veins
73
Q

Tx of ICH

A

BP control with nicardipine and reverse all coagulapathies

74
Q

Optic neuritis in a young woman should raise concern for

A

MS

75
Q

What is optic neuritis

A

Demyelinating inflammatory condition of the optic nerve a/w MS

Often have preceding viral illness

76
Q

Margus Gunn pupil, swollen optic disc, varying degree of vision loss is found in

A

Optic neuritis

77
Q

MC kidney stone

A

Calcium oxalate

78
Q

Radiopaque kidney stones

A

struvite — staghorn calculi
Ca oxalate — MC type
Ca PO4 — 1° hyperPTH

79
Q

Radiolucent kidney stones

A

Cystine — children
Urice — gout

80
Q

Characteristic of large VSD

A

Newborns with fatigue, sweating during feeds, poor weight gain
Loud holosystolic murmur at LLSB

81
Q

Tx for OCD

A

Seetraline (SSRI)

82
Q

Infective endocarditis causes
Native valve
IVDU
Prosthetic valve

A

IV VANCO FOR EVERYONE EMPIRICALLY

Native valve — staph aureus, strep viridans ; affects MV

IVDU — staph aureus affects TV

Prosthetic — s epidermis

83
Q

JVP elevated, gallop heart sound, DOE, fatigue, CO
RVH

A

Pulmonary HTN
Right heart cath is definitive

84
Q

Angina at rest in a young male

A

Prinzmental angina — nitrate responsive
SMOKING cessation
CCB

85
Q

Screen for ___ in pts with celiac disease

A

Bone density

86
Q

Why is early pregnancy a protective factor against breast cancer

A

Less exposure to estrogen + progesterone
Changes breast tissue

87
Q

ACh release blocked by antibodies at presynaptic ca channels

Autoantibodies bind to ACh receptors at the NMJ

A

LE

MS

88
Q

Erythema multiforme MC precipitant

A

Herpes simplex virus

89
Q

Management for sexual assault

A

Ceftriaxone 500 mg IM
doxycycline 100 mg bid
Metronidazole 2g single dose

Within 72 hrs
Levonorgestrel and HIV PEP

90
Q

Describe Tram track sign

A

Lack of tapering of the enlarged bronchi and bronchial wall thickening

91
Q

LBBB on ekg

A

Wide QRS with slurred R wave in V5 and V6 and deep S wave in V1

92
Q

MC cause of meningitis in <18 yo

A

Neiserria meningitidis
Is Pen G

93
Q

Referred right shoulder pain, aka ___, in acute chole is due to what nerve

A

Boas sign

Phrenic nerve

94
Q

Staph aureus on gram stain

A

Gram positive cocci in clusters

95
Q

Atropine is an ____ agent

A

Anticholinergic
Opposite of SLUDD-C —like miosis

96
Q

Tx for ITP in kids vs adults

A

Kids Observe vs IVIG
Adults corticosteroids

97
Q

Absence of ganglion cells in the distal colon and rectum is in

A

Hirschprungs disease
A/w trisomy 21

98
Q

WBC casts
RBC casts
Waxy cast

A

AIN — drug induced MC
GN — nephrotic syndrome
Waxy — CKD

99
Q

Gram negative diplococci

A

Gonorrhea

100
Q

Tx of
1. First idiopathic DVT
2. 1st DVT/PE with reversible factor (post op)
3. Recurrent DVT/PE or continue risk factor

A
  1. Heparin + warfarin for 6 months
  2. Heparin + warfarin for 3-6 months
  3. Heparin + warfarin for >12 months
101
Q

Alzheimer’s pathology, tx

A

Beta amyloid plaques and neurofibrilliary tangles

Donepizil memantine

102
Q

Alzheimer’s pathology, tx

A

Beta amyloid plaques and neurofibrilliary tangles

Donepizil, memantine

103
Q

Parkinson’s disease pathology and tx

A

Decrease in dopaminergic neurons in susbtantia nigra

Levodopa carbidopa (crosses BBB)

104
Q

Essential tremor tx

A

Propranolol

105
Q

Early and rapid progressive dementia with alpha synuclein aggregates inside cortex and substantia nigra

A

Lewy body

Lewy is seeing bodies

106
Q

Huntington disease pathology and sx

A

Mutation of HTT gene on ch4 with repeat CAG proteins

Middle age men

Chorea

Men dance when they hunt

107
Q

Pick disease pathology and sx

A

Fronterotemporal atrophy due to pick bodies (tangles of tau proteins)

Behavior/language impairment

108
Q

List what each part of the spinal cord is responsible for
From posterior to anterior

A
  1. Dorsal — vibration/propriocetion
  2. Cortical — motor
  3. Spinothalamic — pain/temp
109
Q

ACS presentation

A

Flexing injury
Pain, temp, and motor is affect (complete paralysis)

Bad prognosis

110
Q

Posterior cord syndrome presentation

A

Loss of vibratory sense and proprioception only

111
Q

Brown sequard PE

A

Gun shot wound
Same side vibratory, proprioception, motor deficits
Opposite side pain & temp deficits

112
Q

Central cord presentation

A

BILATERAL Upper extremity deficits > lower extremity deficits

113
Q

Neovascularization
Amsler grid “lines bent”

A

Macular degeneration

114
Q

Atropine is contraindicated in

A

Glaucoma
Worsens it

115
Q

CRVO

A

Painless
Decreased IOP ⬇️
Blood and thunder (red eye with veins)

116
Q

CRAO

A

Painless
Increased IOP ⬆️
Cherry red spot
Emergency !! Remove clot with massage, reduce IOP

117
Q

Build up of RBCs in eye
Build up of WBcs in eye

A

Vitreous hemorrhage
Anterior uveitis

118
Q

Diabetic vs hypertensive retinopathy

A

Diabetic
- non proliferative with flame shaped hemorrhage
- proliferative with neovascularization&raquo_space; VEGF

HTN
AV nicking, can progress to papilledema

119
Q

Shafers sign

A

Retinal detachment

120
Q

Abx for eye infections

A

Topical erythromycin
Pseudomonas coverage if contact lens wearer

121
Q

MC blindness

A

Cataracts
Lens opacifies
Can’t drive at night, no red reflex

122
Q

Optic nerve swelling from increased intraocular pressure

A

Glaucoma

Halos around light

123
Q

Optic neuritis tx

A

IV methylprednisolone

124
Q

Acute narrow angle closure glaucoma

A

EMERGENCY
Decreased drainage of aqueous humor
Caused by pupillary dilation
PAINFUL UNILATERAL PERIPHERAL VISION LOSS
Increased IOP
Timolol + Acetazolamide

125
Q

Open angle glaucoma

A

PAINLESS CHRONIC PERIPHERAL VISION LOSS
Tx with latanoprost

126
Q

Management of pheochromocytoma

A

Alpha blockers x2 weeks before beta blockers to prevent severe HTN

Alpha blockers — phenoxybezamine or phentolamine (AMINE)

127
Q

Gynecomastia and testricular atrophy

A

Klinefelters syndrome

128
Q

Nephrogenic DI

A

Due to kidneys not responding to ADH
Tx indomethacin

129
Q

TTP patho

A

Antibodies against ADAMTS13 —> large vWB multimers (Adam cleaves willie) cause platelet activation

large von Willebrand factor multimers accumulate and promote excessive platelet aggregation, leading to the formation of microthrombi

130
Q

TTP patho

A

Antibodies against ADAMTS13 —> large vWB multimers (Adam cleaves willie) cause platelet activation

vWB is the glue mesh that sticks to platelets. If it it’s not cleaved, continues to grow and aggregate into a bigger platelet clot

131
Q

Factor V Leiden

A

MC Bleeding disorder

Mutated factor 5 does not get broken down by protein C

132
Q

DIC

A

Activation of the coagulation system leads to many thrombi and decrease in platelets

133
Q

HUS

A

Platelet activation due to exotoxins (shiga toxin or E. coli)

The hamburger scenario

134
Q

Aplastic crisis causes

A

Parvovirus B 19 (slapped cheek)

135
Q

Virus causing kaposi sarcoma

A

HHV 8

136
Q

Red man syndrome

A

Flushing of skin with rapid infusion of vanco

137
Q

L:S < 2:1 indicates

A

Fetal lung immaturity
Give tocolytics (terbutaline or MgSo4) for 48hrs to delay delivery
Allows for steroid administration —> help with surfactant

138
Q

Fern test +

A

Rupture of membranes

139
Q

Administration of prostaglandins in labor does what

A

Increase progression of labor

140
Q

Administration of prostaglandins in labor does what

A

Increase progression of labor

141
Q

Primary adrenal insufficiency has

A

Low cortisol AND low aldosterone

Addison disease— Need to ADD more

Secondary insufficiency just low cortisol

142
Q

Central DI vs nephrogenic DI

A

Central —Not enough ADH being made
Nephrogenic — kidneys don’t respond to circulating ADH

143
Q

How to differentiate Nephrogenic from central DI

A

Water deprivation test to confirm it is not polygenic polydipsia (drank too much water)
Then DDAVP (desmopressin and ADH analog) challenge

No change = nephrogenic

144
Q

Which medication is a/w hypothyroidism

A

Amiodarone because of the iodine

145
Q

Tx of hyperthyroidism

A

PTU & methimazole
PTU in pregnancy

They cause agranulocytosis (low neutrophils <100)

146
Q

Congenital hypothyroidism

A

6 Ps
Pot belly
Protruding belly button
Pallor
Puffy face (myedema)
Protuberant tongue
Poor brain development

147
Q

Esophageal Candidiasis

A

AIDS DEFYING ILLNESS cd4<200

148
Q

MC childhood cancer

A

ALL

149
Q

Components of ALL

A

Anemia Lumpy Limping
Pancytopenia
Bone marrow bx is definitive >20% lymphoblasts
Prophylaxis with intrathecal methotrexate

150
Q

MC heme malignancy in adults

A

AML

151
Q

AML must know

A

Middle Aged adults
APL or M3 variant
Auer rods on peripheral smear
“A rod plays for NY in the big APL”
Pancytopenia
Bone marrow bx >20% myeloblasts

152
Q

CLL need to know

A

Accumulation of monoclonal B lymphocytes
Asx
Lymphocytosis >5000
Smudge cells on PS
“Crushed little lymphocytes”

If they’re old just observe, not gonna kill them
If they’re young — chemo

153
Q

CML need to know

A

Translocation between Ch9 and Ch 22 leads to PHILADELPHIA chromosome (over expression of tyrosine kinase)

Leukocytosis with neutrophilia
Tyrosine kinase inhibitors - Nib

154
Q

Hodgkin =

A

Presence of reed sternberg cells

155
Q

Patho of Hodgkin’s lymphoma

A

Mature B cells have abnormal gene and don’t die
Enlarge the lymph nodes

156
Q

Describe Reed Sternberg cells and what they’re found in

A

Hodgkin lymphoma
2 nuclei fuse together — owl eye appearance

157
Q

What has better prognosis in Hodgkin lymphoma

A

Continuous spread to local lymph nodes

158
Q

Risk factor for Hodgkins

A

EBV **

159
Q

Diagnosis of Hodgkin lymphoma

A

EXCISIONAL bx of lymph node
NOT FNA

160
Q

6 B for Hoskins lymphoma

A

All about the Bs
B cell malignancy
B sx common in advanced age
Bimodal distribution
Binucleated cells (owl eyes)
BV infection
Bound in place (local lymph nodes better)

161
Q

Most important thing to know about NHL

A

ABSENCE OF REEDN STERNBERG CELLS

162
Q

NHL need to know

A

No reed sternberg cells
Non continuous spread through blood — poor prognosis

Diffuse large B cell is MC type
Burkitt lymphoma is with EBV

R CHOP tx (rituxamab)

163
Q

Polycythemia is a

A

Blood cancer — too many RBCs
High EPO

164
Q

Types of PV and tx

A

1: mutations of jak2 gene
2: underlying condition

Phlebotomy, increase fluids, asa

165
Q

What preparation would be used for do of HSV or varicella

A

Tzanck smear

166
Q

Rapid acting insulins are used when
Name example

A

After meals
Lispro, aspart

167
Q

Regular insulin is

A

Short acting

168
Q

Regular insulin is

A

Short acting

169
Q

Intermediate acting insulin is aka

A

NPH

170
Q

Intermediate acting insulin is aka

A

NPH

171
Q

Long acting insulin name example

A

Glargine
Detemir
Degludec

24 hr duration

172
Q

Basal insulin is aka

A

Long acting insulin

173
Q

Basal bolus Math for 70kg with TDD of 0.8

A

Long acting (basal) + rapid acting (bolus)

0.8units/day X 70kg = 56 units/say
56/2 = 28 units basal
28/3 = 9 units bolus

Pance (2 decks)

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