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Boards Review Final > Board review 2 > Flashcards

Board review 2 Flashcards

1
Q

ETHICAL

A

 Examine the data
 Think about which person should be making the decision
 Humanize the options—make a decision tree
 Incorporate ethical principles, legal statutes, standards of care
 Choose an option
 Act
 Look back and evaluate

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2
Q

Insulin NPH

A

Intermediate acting

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3
Q

Insulin Lispro + Regular

A

short acting

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4
Q

Insulin glargine and detemir

A

Long acting

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5
Q

Test for macular degeneration

A

Amsler grid

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6
Q

Sx Sickle cell crisis

A

Pain, SOB, ulcers

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7
Q

2 most common SE varenicline

A

Nausea and sleep disturbance

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8
Q

Longest half life benzo

A

Diazepam–100 hours

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9
Q

Severe eye pain, halos around lights, N/V, headache, conjunctival redness

A

Acute closed-angle glaucoma

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10
Q

Sudden blurry vision, floaters, flashing lights

A

Retinal detachment

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11
Q

Cremasteric reflex in torsion

A

Absent

Assess with doppler US

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12
Q

Tx chronic open angle glaucoma

A

Miotic agents, beta blockers, alpha 2 agonists

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13
Q

Dosage of nebulized albuterol for pediatric

A

0.15mg/kg

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14
Q

Prednisolone dosage for pediatrics

A

1-2mg/kg/day divided doses once or twice a day

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15
Q

Common lab values with alcoholism

A

Low potassium, low magnesium, high triglycerides, elevated LFTs

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16
Q

Skin becomes hardened and leathery from chronic irritation

A

Lichenification

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17
Q

Leading cause of death in adolescents

A

MVA

Homicide is second; suicide is third

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18
Q

Tx cellulitis due to strep

A

Clindamycin, cephalexin, cefadroxil, Bactrim

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19
Q

Mammogram should begin at

A

Age 45 in average risk women

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20
Q

Most common sports related injury

A

Lateral ankle sprain

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21
Q

Initial tx of bacterial sinusitis

A

Amoxocillin, Doxy, Bactrim

Ceftriaxone if severe

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22
Q

If pt has had abx in past 6 weeks, tx of sinusitis

A

Levaquin

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23
Q

Tx cellulitis with fluctuance

A

Bactrim

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24
Q

Meds that can cause ED

A

Thiazide diureitcs, beta blockers, spirinolactone, metformin, digoxin, 5-a-reductase inhibitors, TCA, SSRI, benzos, antipsychotics, phenytoin, H2 blockers, opioids

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25
Q

RUQ pain + elevated LFT

A

Acute cholecystitis

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26
Q

Why are vasoconstrictors used with anesthetics

A

Hemostasis improvement, reduction o systemic absorption, prolonged duration of anesthetic

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27
Q

2 initial tx for actinic keratosis

A

5-fluorouracil and liquid nitrogen

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28
Q

Tx of choice for Graves in first trimester

A

PTU

Use methimazole in 2nd and 3rd trimesters

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29
Q

Causa Equina syndrome occurs where

A

Below L2

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30
Q

Sx opioid withdrawal

A

Muscle aches, agitation, sweating, vomiting

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31
Q

Sx dig toxicity

A

V Fib, fatigue, visual changes, bradycardia

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32
Q

Gout prevention meds

A

Allopurinol, Colchicine, Febuxostat, Probenecid

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33
Q

CN motor only

A

3, 4, 6, 11, 12

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34
Q

Where are CCBs metabolized

A

Liver

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35
Q

Common cause of catheter associated UTI in men

A

Proteus bacteria

Tx: Bactrim

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36
Q

CI to steroid use

A

Peptic ulcers

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37
Q

Initial tx of hidradenitis suppurative

A

12 weeks of oral tetracycline
if fails try clindamycin + rifampicin
If fails try Humira or Acitretin

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38
Q

Valve failure in rheumatic fever

A

Mitral Valve Stenosis

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39
Q

1st line test to diagnosis vaginal candidiasis

A

Direct visualization of vaginal discharge using wet prep

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40
Q

Morbiliform rash after giving penicillin to someone with a virus

A

Type 4 hypersensitivity reaction

Can occur up to 1 year after mono

41
Q

Penicillins

A

DOES NOT COVER STAPH

Use for strep infections

42
Q

Bactrim

A

G- and MRSA
Not strep or E Coli
Save for MRSA suspected

43
Q

Doxycyline

A

G-, atypicals, MRSA

Good choice for atypical pathogens and lower respiratory pathogens

44
Q

1st gen cephalosporins

A

Cephalexin + Cefadroxil
G+ staph and strep
NO MRSA

45
Q

2nd gen ceph

A 
Cefuroxime
Cefaclor
Cefprozil
G+ and G-
Staph, strep, H Flu, E Coli
NOT MRSA
46
Q

3rd gen ceph

A

Cefixime
Weak G+, G-
NOT staph

47
Q

Extended spectrum 3rd gen ceph

A 
Cephtriaxone 
Cefdinir
Cefpodoxime
G+ and G- and beta lactamase producers
BIG GUN ABX
48
Q

Macrolides

A

staph + atypicals

NOT STREP

49
Q

Fluoroquinolones

A

Cipro: G- and atyplicals (3rd choice after macrolide and doxy)
Levaquin: kills everything

50
Q

Flagyl

A

anaerobes
C diff or C sp
Use in the gut

51
Q

Clindamycin

A

MRSA
G+ and anaerobes
Deep tooth abscesses
BAD SE

52
Q

Screening for DM

A

Annually if BMI >25 and 1+ risk factors

Every 3 years if >45 years

53
Q

Target A1Cs

A

<7% most adults
<8% elderly
<6% type 1 or pregnant

54
Q

Meds that can cause increased risk of type 2 DM

A

Steroids, HCTZ, atypical antipsychotics, statins

55
Q

Every diabetic should be started on

A

Statin

56
Q

Recommended BP for DM

A

<130/80

57
Q

Foot exam for diabeic

A

Every 3 months

58
Q

Dilated eye exam for diabetic

A

Annually and onset of T2DM and 5 years after T1DM

59
Q

A1C check for diabetics

A

Every 3 months if not at goal; every 6 months if at goal

60
Q

Metformin

A

Reduces CV risks!!
Avoids hypoglycemia
DO not give with active liver disease or binge drinking
Reduction in all cause mortality!
Decreased A1C by 1-2%
MOA: decreases hepatic glucose production

61
Q

Sulfonylurea

A 
Glimepiride, Glipizide, Glyburide 
Increases insulin secretion
SE hypoglycemia 
Causes weight gain
Decreased A1C by 1-2%
Cheap
62
Q

DPP4-inhibitor

A

Gliptins
Reduce A1C by 0.7%
Expensive
weight neutral

63
Q

GLP-1 agonist

A 
Exanatide, liraglutide, dulaglutide 
Injectable 
Increases production of insulin in response to elevated BG levels 
Weight loss 2-6 pounds
never hypoglycemia 
Max decrease 1.5% A1C
64
Q

TZDs

A 
Glitazone
Preserves beta cell function
High dose associated with bone fractures and osteopenia 
CI in HF
Reduces A1C by 0.7%
Rarely causes hypoglycemia
65
Q

SGLT2 inhibitors

A

Flozin
Increased risk of UTI and vaginal yeast infection
Weight loss
Expensive

66
Q

Consider insulin in type 2 DM when

A

A1C >10 or FBG >300
After maxing out on orals
Pregnant

67
Q

DM prescribing consideration

A

A1C > 9: Dual therapy

A1C 10-12 or FBG>300: Injectible insulin until less glucose toxic

68
Q

3 basic questions to ask in derm

A

Where did the rash start?
How long have you had it?
Does it itch?

69
Q

 Superficial infections of the skin

A

Impetigo

Tx: topical bactroban

70
Q

Non-purulent cellulitis

A

Think staph

Tx: cephalexin

71
Q

Purulent cellulitis

A

Think MRSA
I+d first line
Bactrim, clinda, doxy

72
Q

Shingles vaccines

A

Zostavax: live vaccine; >60 years and immunocompetent
Shringrix: dead vaccine; >50 and immunocompromised

73
Q

Tx for ticks

A

Doxy

Continue for 3 days after no fever

74
Q

Azoles vs -nafines

A

Azoles stop working as soon as you stop last dose

-Nafines continue to exert activity 1 week after last dose

75
Q

Hyphae think

A

Fungal

76
Q

Most common complaint in SLE

A

Fatigue

77
Q

Palmar rash can be caused by

A

Rocky mountain spotted fever
Syphilis
Erythema multiforme

78
Q

Erythema multiforme

A

Immune mediated reaction with targetoid lesions usually due to HSV or mycoplasma pneumoniae or medication cause
Acral distribution starting on extremities

79
Q

Lesion that looks stuck on

A

Seborrheic keratosis

80
Q

Most common skin complaint in elderly

A

Itching due to dryness

xerosis

81
Q

Actinic keratosis

A

Precursor to squamous cell carcinoma

82
Q

• Papules, plaques, nodules, smooth, hyperkeratotic or ulcerative lesions; may bleed easily

A

Squamous cell carcinoma

83
Q

• Pearly domed nodule with overlying telangiectasias vessels

A

Basal cell carcinoma

84
Q

Abx for bites

A

3-5 days prophylaxis
7-10 days treatment
Augmentin usually

85
Q

Type of reaction is contact dermatitis

A

Type 4

86
Q

Vehicle potency of topical medication

A 
LEAST
Lotion
Cream
Gel
Ointment
MOST
87
Q

2 most common reasons for chronic cough

A

Asthma and GERD

88
Q

Pertussis

A

Reportable

Tx: azithromycin

89
Q

Tx CAP in elderly, co-morbids

A

Levaquin

Think DRSP

90
Q

Tx CAP in healthy younger person

A

Azithromycin or Doxy

91
Q

Tx COPD

A

Steroids + LABAs + LAACs

Can give LABA alone in COPD

92
Q

First line tx of COPD exacerbation

A

Oral Steroids

40mg prednisone per day for 5 days

93
Q

1st line tx asthma

A

Inhaled steroid

Do not use LABA alone!

94
Q

Decreasing asthma exacerbations is important to

A

Prevent progressive loss of lung function

95
Q

If suspected DRSP and pregnant

A

Azithromycin + amoxicillin

96
Q

SE of long term inhaled steroids

A

Cataracts and osteopenia

97
Q

Pulmonary fibrosis characterized by

A

Restrictive lung disease in which total lung capacity, vital capacity and diffusion of CO are all reduced
To test: perform CO diffusing capacity test

98
Q

Hemochromatosis

A

Inherited; increased iron absorption; accumulated iron in the liver causes cirrhosis; hyperpigmentation in the skin and DM in pancreas and arthralgia are sx
Tx: phlebotomy

99
Q

Primary amyloidosis

A

Nephrotic syndrome, cardiomyopathy, peripheral neuropathy, hepatomegaly

Boards Review Final (4 decks)

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