Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Comprehensive STEP 3 > Comprehensive step 3 > Flashcards

Comprehensive step 3 Flashcards

1
Q

Infectious Disease

A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MSSA Abx (IV)

A

nafcillin/oxacillin or cefazolin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MSSA Abx (PO)

A

Dicloxacillin or cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MRSA (IV)

A

Vanc, tigecycline,linezolid, daptomycin, ceftaroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MRSA (minor infection)

A

Clindamycin, TMP/SMX, doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Strep Abx (that don’t cover staph)

A

PCN, amox, amp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SE of (A) linezolid (B) Daptomycin (C) imipenem

A

(A) low plt (B) myopathy (C) sz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anaerobic Strep Abx

A

Clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antiviral for longterm therapy for CMV retinitis

A

Valganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antivirals for CMV

A

valganciclovir, ganciclovir, foscarnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antivirals for herpes simplex, varicella zoster

A

acyclovir, valacyclovir, famiclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SE (A) Valganciclovir and ganciclovir (B) Foscarnet)

A

(A) neutropenia and bone marrow suppression (B) renal toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antiviral for Hep C

A

ribavarin in combo with interferon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ribavarin uses

A

Hep C, RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chronic Hep B

A

lamiduvane, interferon, adefovir, tenofovir, entecavir, tebivudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fluconazole uses

A

candida, cryptococcus, candidiasis as an alternative to topical agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for aspergillus

A

Voriconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Voriconazole SE

A

visual disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Best antifungal for neutropenic fever

A

echinocandins (caspofungin, micafungin, anidulafungin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SE Amphotericin

A

renal toxicity, hypokalemia, metabolic acidosis, fever/shakes/chills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Osteomyelitis (A) first line test (B) second line (C) most accurate

A

(A) XR (B) MR (C) bone bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Earliest XR finding in osteomyelitis

A

Periosteal elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Osteomyelitis: How do you monitor response to therapy?

A

trend ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Most common cause of osteo?

A

Staphylococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MSSA osteo tx

A

IV oxacillin of nafcillin 4-6wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

MRSA osteo tx

A

IV vanc, linezolid, daptomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Otitis Externa: presentation

A

itching and drainage from the external auditory canal, difficult to visualize the tympanic membrane bc of swelling, manipulation of tragus is painful; associated w swimming, foreign bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Otits Externa: treatment

A

Topical abx (ofloxacin or polymyxin/neomicin)+hydrocortisone +acetic acid and water solution to reacidify the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Malignant Otitis Externa: presentation

A

osteo of the skull from pseudomonas in patient w diabetes, can lead to brain abcess and skull destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Malignant Otitis Externa: diagnostics and tx

A

Skull XR or MRI, most accurate test is bx; tx with surg debridement and abx effective against pseudomonas cipro, piperacillin, cefepime, carbapenem, aztreonam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Otitis Media: presentation

A

redness, bulging, decreased hearing, loss of light reflex, immobility of tympanic membrane (most sensitive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Otitis Media: therapy

A

Amox (7-10 days), Next step is tympanocentesis and aspirate of the tympanic membrane for cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Otitis Media: abx if initial therapy fails

A

Amox-clavulanate, cefdinir, ceftibuten, cefuroxime, cefprozil, cefpodoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sinusitis: (A) initial test (B) most accurate test

A

(A) XR (B) sinus aspirate for cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Sinusitis: treatment

A

amox if fever and pain, persistence after 7day trial of decongestants, purulunt discharge; +inhaled steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Centor Criteria for strep pharygitis

A

Pain/Sore throat, exudate, adenopathy, NO cough/hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Strep Pharyngitis: diagnosis and tx

A

initial test- rapid strep most accurate-cx; PCN or Amox if allergic use azithro or clarithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Flu: treatment in first 48hrs

A

Oseltamivir or zanamivir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Impetigo: presentation + infectious agent

A

weeping, crusting, oozing, honey-colored lesions; strep pyogenes or S aureus infecting epidermal layer of skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Impetigo: therapy

A

Topical mupirocin or retapamulin; Severe: oral dicloxacillin of cephalexin; MRSA: TMP-SMZ, clinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Erysipelas: presentation

A

GAS (step pyogenes) infection of skin; bright red and hot skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Eryspelas: diagnosis and tx

A

Blood cx on CCS, treatment in MC; oral dicloxacillin or cephalexin; if cx confirms group A beta hemolytic strep switch to PCN VK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Cellulitis: next step if suspected in leg

A

Lower extremity doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cellulitis: treatment

A

Minor: dicloxacillin or cephalexin PO; Severe: IV oxacillin, nafcillin, or cefazolin; If allergic use cefazolin of vanc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Fungal Infection of skin/nails: diagnostic testing

A

Initial: KOH prep of scraping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Fungal infection of skin/nails: treatment in no hair/nail involvement

A

topicals like clotrimazole, miconazole, ketoconazole, econazole, terconazole, nistatin, ciclopirox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Fungal infection of skin/nails: treatment if scalp/nail involvement

A

terbinafine, itraconazole, griseofulvin (for tinea capitus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Disseminated gonorrhea presentation

A

polyarticular disease, petechial rash, tenosynovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

PID treatment

A

Ceftriaxon (IM) and doxy (PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Epididymo-Orchitis (painful tender testicle) treatment (A) <35 (B) >35

A

(A) ceftriaxone and doxy (B) fluoroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Chancroid: dx and tx

A

swab for Gm stain (Gm- coccobacilli) and culture (nairobi medium or Mueller-Hinton agar) tx IM ceftriaxone or 1 dose of azithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

LGV: presentation

A

large tender nodes and ulcer, nodes called buboes may develop suppurting, draining sinus tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

LGV: dx and tx

A

serology for C trachomatis, aspirate bubo and tx with doxy and azithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

HSV2:dx and tx

A

if clear presentation, just treat; acyclovir, valacyclovir, or famciclovir for 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Syphilis: most accurate test

A

Darkfield microscopic exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Syphilis (1*): tx

A

Single IM shot of PCN, doxy if allergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Jarisch-Herxheimer reaction:

A

fever, HA, myalgia developing 24hrs after tx for early stage syphilis; self-limited tx with ASA and continue tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Syphilis (2*): symptoms and diagnostic

A

Rash, mucous patch, alopecia areata, condyomata lata; RPR and FTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Syphilis (2*): treatment

A

IM PCN, doxy if allergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Syphilis (3*): presentation and diagnostics

A

Tabes dorsalis, argyl-robertson pupil, general paresis; RPR and FTA; LP for neurosyphilis (VDRL and FTA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Syphilis (3*) treatment

A

IV PCN, if allergic sensitize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

When do you densensitize to PCN to treat syphilis?

A

3* syphillis, pregnant women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Granuloma Inguinale: presentation

A

beefy red genital lesion that ulcerates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Granuloma Inguinale: dx and tx

A

biopsy or touch prep, klebsiella granulomatis; doxy, TMP/SMX or azithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Uncomplicated UTI: tx

A

TMP-SMX x3days, if E coli resistance is >20% use cipro or levofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Complicated UTI: (A) define (B) tx

A

(A) anatomic abnormality present (B) TMP-SMX or cipro x7days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Asymptomatic Bacteriuria: treat?

A

Only if pregnant or urologic procedure planned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Pyelo: tx

A

Cipro if outpatient; Amp/Gen for inpatient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Perinephric abcess: dx

A

no response to pyelo tx after 5-7days; sono will show collection; biopsy will guide therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Perinephric abcess: tx

A

quinolone +staph coverage (oxacillin or nafcillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Prostitis: tests

A

UA, Urine WBCs after prostate massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Prostitis: tx

A

extended course of cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Infective Endocarditis: at risk patients

A

prosthetic heart valve, IV drug user, dental procedures that cause bleeding, h/o cyanotic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Infective Endocarditis: fever and new murmur (next step?)

A

Blood Cx, if positive do echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Infective Endocarditis: other findings

A

Roth spots (retina), Janeway lesions (flat, painless in hands and feet), Osler’s nodes (raised and painful), splinter hemorrhages under nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Infective Endocarditis: if TTE is negative…

A

proceed to TEE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Infective Endocarditis: therapy

A

Vanc and gent 4-6wks, surgery if anatomic defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Infective Endocarditis: next step if S bovis is culprit

A

Colonoscopy to r/o GI CA (assoc w/ Grp D strep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Endocarditis: when to ppx

A

prosthetic valves, unrepaired cyanotic heart disease, prev endocarditis, transplant recipients who develop valve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Endocarditis: which procedures need ppx

A

dental that cause bleeding(amox), resp tract surgery, surgery of infected skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Which class are these meds: zidovudine, didansodine, stavudine, lamivudine, abacavir, emtricitabine, tenofovir

A

NRTIs (Nucleoside reverse-transcriptase inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

NRTIs: Class wide SFX & Individual SFX

A

Class SFX = Lactic Acidosis; zidovudane-anemia; didanosine+stavudine: pancreatitis and neuropathy; abacavir- rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Which class are these meds: indinavir, ritonavir, lopinavir, -avir?

A

Protease Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Adverse effects of Protease Inhibitors - Class SFX & Individula SFX?

A

Class SFX = Hyperglycemia and hyperlipidemia; indinavir- kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Which class are these meds? Efavirenz, nevirapine, atravirine, rilpivirine

A

NNRTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

NNRTI: adverse effects

A

drowsiness (efavirenz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Needlestick ppx (if HIV+ blood)

A

HAART x 1mos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

CD4<50: ppx?

A

for MAC, azithro weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

CD4<200 ppx?

A

PCP ppx with TMP-SMX (if allergic atovaquone or dapsone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

PCP: when to give steroids?

A

pO2<70 or A-a gradient>35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Toxoplasmosis: presentation and initial test

A

HA, N/V, focal neuro findings, head CT w/ contrast shows “ring” or contrast enhancing lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Toxoplasmosis: treatment:

A

pyrimethamine and sulfadiazine x2weeks, repeat CT to confirm lesions are smaller thus confirming toxo, if they don’t improve brain bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

CMV in HIV

A

CD4<50, blurry vision; perform dilated ophtho exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

CMV: tx

A

ganciclovir or foscarnet; lifelong maintenace w oral valganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Cryptococcus:

A

CD4 <50 with fever, HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Cryptococcus: dx

A

LP: >lymphocytes, India Ink Stain, cryptococcal antigen test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Cryptococcus: tx

A

Amphotericin followed by fluconazole; fluconazole is continued until CD4 rises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

PML (Progressive Multifocal Leukoencephalopathy)

A

CD4 <50, focal neuro findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

PML: dx and tx

A

head CT or MRI, lesions DO NOT show ring enhancement, no mass effect; treat with HAART

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

MAC in setting of HIV:

A

CD4 <50, wasting with fever and fatigue, anemia if invasion of bone marrow, inc AlkP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

MAC: dx and tx

A

Bone marrow or liver Bx, incr LFT & GGTP; tx with clarithro and ethambutol, ppx w azithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Lyme: (A) most common late manifestation (B) Cardiac (C) neuro

A

(A) Joint involvement (B) AV conduction block (C) Bell’s palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Lyme tx (A) rash, joint, palsy (B) CNS or cardiac

A

(A) oral doxy or amox (B) IV ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Nocardia: presentation

A

resp disease in immunocompromised, branching Gm+ filaments that are weakly acid-fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Nocardia: dx and tx

A

1) CXR & Cx 2) TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Actinomyces: Pathophys; Dx; Tx

A

hx of facial or dental trauma –> innoculation of commensal actinomyces. dx with Gm stain and cx; Tx PCN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Histoplasmosis: endemic in…

A

Ohio and Mississippi River Valleys, associated with bat droppings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Histoplasmosis: Presentation, test, tx

A

Palate and oral ulcers, splenomegaly, pancytopenia; Histo Urine Antigen, bx w culture, only treat if disseminated (amphotericin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Coccidoidomycosis: endemic in….presents…treat with..

A

Arizona, joint pain and erythema nodosum, itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Blastomycosis: endemic in….look for….treat with…

A

rural SE, broad budding yeast causing acute pulm disease also bone lesions, amphotericin or itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Allergy and Immunology

A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Anaphylaxis Treatment

A

SQ epi (1:1000), steroids, antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Heriditary Angioedema occurs from deficiency of…

A

C1 esterase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Agioedema: (A) diagnostics (B) tx

A

(a) low C2 and C4 (B) infusion of FFP, chronic therapy includes ecallantide (inhibits kallikrein), androgens like danazol and stanazol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Common Variable Immunodeficiency (CVID)

A

men and women; recurrent sinopulmonary infections, spruelike abdominal disporder, malabsoprtion, steatorrhea, diarrhea, lymph nodes, adenoids and spleen are present may be enlarged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

CVID: diagnosis and tx

A

low total IgG, IVIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

X-Linked Agammaglobulinemia (Bruton’s)

A

male children w recurrent sinopulmonary infections; lymph nodes, adenoids, spleen are diminished in size or absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Bruton’s: diagnosis and tx

A

B-cells and Immunoglobulins missing; IVIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

IgA deficiency

A

many are asymptomatic; some w recurrent sinopulm infections, spruelike malabsorption, increased atopy, anaphalyxis when get blood from donors who are not IgA deficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

IgA deficiency: tx

A

treat infections as they arise, IVIG wont work since it has little IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Hyper IgE Syndrome: presentation and tx

A

recurrent skin infections caused by Staph, tx infections as they arise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Oncology

A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Which screening test lowers mortality rate the most?

A

Mammography >50yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

When is screening mammography done?

A

Age 50-75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Abnormal Mammogram, next step?

A

Biopsy, if cancer is present test for ER/PR receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Sentinal node biopsy: when is it done, what is it

A

follows abnormal mammo; dye placed into operative field and the first node it goes into gets biopsied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

When should the sentinal node be dissected?

A

no dissection if node is free of cancer; axillary lymph node dissection if +cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

BRCA is associated with:

A

increased risk of familial breast ca, increased risk of ovarian ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

(+)Breat Ca, treatment?

A

initial: lumpectomy w radiation of the site is equal to modified radical mastectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Preventive therapy for breast ca?

A

Tamoxifen if 2+ first-degree relatives w breast ca, start at age 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Axillary nodes + or the cancer is >1cm in size, additional tx?

A

Adjuvant chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Which drugs are used if breast ca is Estrogen and/or progesterone +?

A

Tamoxifen or raloxifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Adverse effects of Tamoxifen?

A

DVT, hot flashes, endometrial ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Hormonal inhibition in breast ca, drugs?

A

tamoxifen, raloxifene, aromatase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Name the aromatase inhibitors (which are pure estrogen anatagonists):

A

anastrazole, letrozole, exemestane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

SE of aromatase inhibitors

A

can lead to osteoporosis (no DVTs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

When is adjuvant chemo used in breast ca? (A)(B)(C)

A

(A) Cancer in axilla (B) >1cm (C) more efficacious in menstruating women since tamoxifen and aromatase inhibitors will not work in these women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What is trastuzumab and when is it used?

A

Monoclonal antibody against the breast ca gene HER-2/NEU, useful in metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

How is colon ca treated?

A

Resection of colon and chemo (5-FU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Pt refuses colonscopy, other screening option?

A

occult blood testing starting age 50 then yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Screening if family member with colon ca

A

colonscopy at age 40 or 10yrs before age relative contracted ca, then q 10yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Screening for colon ca if: HNPCC, 3 family members, family <50

A

colonoscopy at age 25 then q 1-2yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Screening if familial Adenomatous polyposis?

A

sigmoidoscopy at age 12 then q1-2 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Screening if juvenile polyposis, peurtz-jeghers, turgot’s syndrome, garner’s?

A

no additional screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

When should you do an excisional bx on a solitary lung nodule?

A

>1cm in patients who are smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Name instances where surgery cannot be performed for Lung Ca.

A

b/l disease, meastases, malignant pleural effusion, involvement of aorta vena cava or heart, lesions within 1-2cm of carina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Is small cell ca resectable?

A

No, almost always present with a contraindication to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Next Step: abnormal pap w low-grade or high grade dysplasia.

A

colposcopy and bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Next Step: atypical squamous cells of undetermined significance

A

HPV testive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Next Step: ASCUS, +HPV

A

colposcopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Next Step: ASCUS, -HPV

A

repeat Pap in 6-12 mos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Pap smear: start at age (a) and do every (b) and stop at age (c)

A

(a) 21 (b) 2-3 yrs (c) 65 unless there has been no previous screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Treatment of localized prostate cancer

A

surgery and either external radiation or implanted radioactive pellets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Treatment of metastatic prostate ca

A

Androgen blockage (flutamide and leuprolide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What does finastride treat?

A

BPH and male pattern hair loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Cord compression 2/2 prostate cancer, what do you do?

A

Start flutamide (testosterone receptor blocker), do not start leuprolide (GnRH agonist) since it can worsen compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Ovarian Ca: marker of progression?

A

CA125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Ovarian Ca: treatment?

A

surgical debulking followed by chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Man <35 with painless scrotal lump

A

testicular ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

Testicular Ca: diagnostics

A

NO NEEDLE Biopsy! Inguinal orchiectomy of affected testicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Testicular Ca: labs?

A

AFP, LDH, beta-hCG, CT abdomen and pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Testicular Ca: treatment

A

local disease: radiation, widespread: chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Preventative Medicine

A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Pnumococcal vaccine is indicated in all patients >–

A

>65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

Meningococcal Vaccine: routine at age (a); who should get it earlers (b)

A

(a) 11 (b) functional asplenia, complement deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

HPV vaccine given to women ages:

A

13-26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What age group gets varicella-zoster vaccine?

A

>60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Most effective method of achieving smoking cessation?

A

Oral meds like bupropion and varencline; nicotine patches and gum are less effective but can be tried first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

What age should women get bone density screen?

A

65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

AAA screening

A

men >65 who were ever smokers should be screened with ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

When is diabetes screening routine?

A

in pt with HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

HTN screening

A

all >18 should have BP checked at every office visit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Hyperlipidemia screening

A

men>35 women >45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

Endocrinology

A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

Diagnosis of Diabetes may be made with one of the following: Two fasting glucose >(a); One random glucose >(b) w symptoms; Abnormal GTT; HgA1c > (c)

A

(a) 126 (b) 200 (c) 6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

Best initial therapy for T2DM

A

diet, exercise, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Best initial medical therapy for T2DM

A

Metformen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Which class of diabetes meds can lead to weight gain?

A

Sulfonureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Mechanism of metformin

A

blocks gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

Metformin contraindications

A

Renal insufficiency (->lactic acidosis); use of contrast agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

Name some sulfonureas

A

glyburide, glimepiride, glipizide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Mechanism of sulfonureas

A

increase release of insulin from the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Adverse effects of sulfonureas

A

Hypoglycemia, SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

DPP-IV inhibitors (stigaliptin, saxagliptin): mechanism

A

block metabolism or incretins like glucagon-like peptide; i.e. increase insulin release and block glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Thiazolidinediones (rosiglitazone, pioglitazone): mechanism and contraindication

A

increase peripheral insulin sensitivity, CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

Alpha-glucosidase inhibitors (acarbose, miglitol): mechanism and SE

A

block absorption of glucose at the intestinal lining; diarrha, abdominal pain, bloating, flatulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

Insulin secretagogues (nateglinide and repaglinide): mechanism and SE

A

cause increased release of insulin (short-acting), hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

Insulin: Long-Acting or Short? Glargine

A

Long (aka Lantis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

Insulin: Long-Acting or Short? Aspart

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

Insulin: Long-Acting or Short? Lispro

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Insulin: Long-Acting or Short? NPH

A

long (2x/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

Insulin: Long-Acting or Short? Glulisine

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

Insulin: Long-Acting or Short? Detemir

A

long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

How long does short-acting insulin last? When is it given?

A

2 hours, given at mealtime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

GLP analongs (exenitide) mechanism?

A

slow gastric emptying and promote weight-loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

DKA presentation

A

hyperventilation to compensate for metabolic acidosis (low bicarb), fruity breath and confusion 2/2 hyperosmolar state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

DKA: diagnosis

A

Initial test: serum bicarb if low implies an elevated anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

Why is sodium level low in DKA?

A

high glucose artificially drops sodium level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

DKA Labs: (a) glucose (b) K (c) bicarb (d) pH (e) anion gap (beta hydroxybutyrate

A

(a) >250 (b) hyperkalemia (c) low (d) low with low pCO2 as resp compensation (e) elevated, high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

DKA: treatment

A

bolus while getting labs, then IV insulin…K level will drop so add potassium to IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

Diabetes: BP goal

A

<130/80

202
Q

Diabetes: LDL goal , goal if CAD+diabetes

A

<100, < 70

203
Q

Diabetes: urine microalbumin abnormal, next step?

A

ACEinhibitor even if BP is normal

204
Q

Diabetes: +neuropathy, next step?

A

gabapentin or pregabalin

205
Q

Diabetes: gastroparesis tx

A

metoclopramide or erythromycin

206
Q

Hypothyroid: initial tests

A

T4 (decreased), TSH (increased)

207
Q

Hypothyroid: tx

A

T4 or thyroxine replacement

208
Q

Hyperthyroid: labs?

A

T4 (increased) TSH (low)

209
Q

Disease? Eye, skin, nail findings with elevated RAIU

A

Graves

210
Q

Disease? Low RAIU, no PE findings

A

Silent hyperthyroidism

211
Q

Disease? Tender thyroid, low RAIU

A

Subacute hyperthyroidism

212
Q

Disease? No PE findings, high RAIU

A

pituitary adenoma

213
Q

Graves’ Disease: tx

A

PTU or methimazole acutely, then radioactive iodine to ablate gland; propranolol to tx sympathetic sx

214
Q

Subacute thyroiditis: tx?

A

ASA for pain relief

215
Q

Disease? High t4, high tsh

A

pituitary adenoma

216
Q

Pituitary Adenoma: tx?

A

MRI of brain, surgical resection

217
Q

Thyroid Storm

A

acute, severe life threatening hyperthyroidism

218
Q

Thyroid Storm: tx?

A

iodine, PTU or methimazole, dexamethasone (to block peripheral conversion of T4->T3), propranolol

219
Q

Can you determine the etiology of a goiter?

A

Nope, it can be 2/2 hyperT, hypoT or normal function

220
Q

Solitary thyroid nodule: next step?

A

FNA, if its cancer needs to be surgically removed

221
Q

Most common cause of hypercalcemia? How can we test for this?

A

Primary hyperparathyroidism, increased parathyroid hormone levels

222
Q

Name other causes of hypercalcemia.

A

Malignancy, granulomatous disease (sarcoid makes vitD), Vit D intocixation, thiazide diuretics (increase reabsorption of Ca), TB, histoplasmosis, berylliosis

223
Q

Hyperparathyroidism: which organs damaged?

A

Kidney (stones), osteoporosis/osteomalacia/fx, confusion, constipation and abd pain

224
Q

Hyperparathyroidism: treatment?

A

Surgical removal (remember it may be part of multiple endocrine neoplasia aka MEN)

225
Q

Issue? Confusion, constipation, polyuria/polydipsia, short QT, renal insufficiency, ATN, renal stones

A

Hypercalcemia (stones, bones, psychic moans, GI groans)

226
Q

Acute Hypercalcemia: tx

A

IVF, furosemida after hydration (loop diuretics increase Ca excretion), bisphosphonate (potent but slow); calcitonin if above don’t work; +steroids if etiology is granulomatous disease

227
Q

Issue? Sz, neural twitching, arrhythmia-prolonged QT

A

Hypocalcemia

228
Q

Chvostek’s Sign? Trousseau’s sign?

A

area of facial nerve tapped, muscles on that side of the face will contract; inflate BP cuff and after a few min patient’s hand will contract

229
Q

HypoC: caused by hypo/hyper Mg? Hypo/hyper Phos?

A

hypoMag, hyperPhos

230
Q

HypoC: treatment

A

replace Ca; if VitD def or hypoparathyroid give VitD + Ca

231
Q

Cushing Syndrome: describe

A

fat redistribution, easy bruising and striae (loss of collegen from cortisol), HTN, muscle wasting, hirsutism (2/2 increased adrenal androgen levels)

232
Q

Cushing Syndrome Cause: High ACTH, suppression of highdose dexamethasone

A

Pituitary tumor –>remove

233
Q

Cushing Syndrome Cause: High ACTH, NO suppression of highdose dexamethasone

A

ectopic ACTH Production, or CA (cxr)

234
Q

Cushing Syndrome Cause: low ACTH, NO suppression of highdose dexamethasone

A

adrenal adenoma –> remove

235
Q

Cushing Syndrome: initial test

A

1mg overnight dexamethasone suppression test , positive if 8am level is not suppressed after taking 11pm dose; 24-hour urine cortisol (do if abnormal dexamethasone suppression)

236
Q

Overnight Dexamethasone Suppression Test: what gives false positives?

A

depression, alcoholism, emotional or physical stress

237
Q

Cushings: low ACTH level, next step?

A

CT or MRI of Adrenals

238
Q

Cushings: high ACTH level, next step?

A

High-dose dexaM suppression test; if high scan chest, if low scan brain

239
Q

Cushings: if you suspect pituitary cause but MRI is negative, next step?

A

petrosal venous sinus sampling used to localize the lesion and see which part of pituitary should be removed

240
Q

Disease? Hyperpigmented skin with fatigue, anorexia, weight loss, weakness, hypotension

A

Addison’s Disease

241
Q

Addison’s: Lab values K? Na? Glu?

A

HyperK, HyoNa, Hypoglycemia, neutropenia (glucocorticoids increase glucose and WBCs)

242
Q

Addison’s: most accurate diagnostic tests?

A

Cosyntropin stimulation test: no rise in cortisol level after administration of this synthetic ACTH; CT scan adrenal

243
Q

Addison’s: tx?

A

steroid replacement; prednisone, fludocortisone in refractory patients

244
Q

Disease? HTN, low renin, low K

A

HyperAldosteronism

245
Q

Hyperaldosteronism: confirm dx with?

A

CT of adrenals

246
Q

HyperAldosteronism: Tx?

A

surgical resection if solitary adenoma; if hyperplasia use spironolactone

247
Q

Pheochromocytoma:best initial tests?

A

High plasma and urinary catecholamine levels, plasma-free metanephrine and VMA levels

248
Q

Pheochromocytoma: most accurate tests?

A

CT or MRI of adrenals, metastatic disease is detected with an MIBG scan

249
Q

Pheochromocytoma: tx?

A

*Phenoxybenzamine for alpha blockate, then propranolol, then resection

250
Q

CAH: ACTH? Aldo? Cortisol? Tx?

A

high ACTH, low aldo, low cortisol; Tx with prednisone (inhibits pituitary)

251
Q

21, 17, or 11? HTN with low adrenal androgen levels

A

17-hydroxylase deficiency (no virilization)

252
Q

21, 17, or 11? Hirsutism, hypotension

A

21-hydroxylase deficiency *elevated 17-hydroxyprogesterone level

253
Q

21, 17, or 11? Hirsutism, HTN

A

11-hydroxylase deficiency

254
Q

Prolactinoma: presentation in men

A

impotence, decreased libido, gynecomastia, headache and visual disturbance

255
Q

Prolactinoma: presentation in women

A

amenorrhea and galactorrhea in absence of pregnancy; prolactin inhibits GNRH so if no GNRH no LH/FSH release!

256
Q

Other causes of high prolactin levels: drugs and other

A

metoclopramide, phonthiazines, TCAs, hypothyroid (high TRH stimulate prolactin release), stress, exercise

257
Q

Prolactinoma: diagnostic testing

A

MRI brain

258
Q

Prolactinoma: tx?

A

dopamine agonist (bromocriptine or cabergoline), if this doesn’t work then surgical removal

259
Q

Acromegaly: diagnostic testing

A

Initial Test: Insulin-like growth factor (IGF), not GH! Most Accurate: suppression of GH by glucose rules-out acrogmegaly then MRI

260
Q

Acromegaly: tx?

A

surgical resection w transphenoidal removal, octreotide (somatostatin prevents GH release), cargoline or bromocriptine (also prevent release), pegvisomant (GH receptor antagonist)

261
Q

Testicular Feminization

A

girl who does not menstruate, +breasts no cervix ovaries and missing top 1/3 of vagina; no penis prostate or scrotum

262
Q

Klinefelter’s Syndrome: describe

A

Tall men, XXY, high FSH/LH but no testosterone is produced from testicles since there are no receptors! Tx with testosterone

263
Q

Kallman’s Syndrome: describe

A

anosmia with hypogonadism 2/2 problem at hypothalmus; low GnRH, FSH, LH

264
Q

Nephrology

A

…

265
Q

3 effects of chronic renal failure

A

smaller kidneys, Hct will drop 2/2 loss of EPO production, Ca levels drop 2/2 loss of VitD hydroxylation

266
Q

Prerenal azotemia: BUN/Cr? Ur Sodium? Fractional Excretion of Na? UrOsm?

A

BUN/Cr>15:1; low urine Na (<20); Fractional Excretion <1%; UrOsm >500

267
Q

Which tests should you order if you suspect renal problem?

A

UA, chemistries, Renal U/S

268
Q

Can unilateral obstruction cause renal failure?

A

Nope

269
Q

Post-renal Azotema: BUN/Cr?

A

>15:1 (like in prerenal)

270
Q

Intrarenal Renal Failure: BUN/Cr? UrNa? UrOsm?

A

BUN/Cr 10:1, Urine Na >40, UrOsm <350

271
Q

Which test should you order if you suspect contrast-induced renal failure?

A

Magnesium level

272
Q

Aminoglycosides (gen, tobra, amikacin) can cause renal insufficiency. What lab supports this?

A

Hypomagnesemia

273
Q

Toxin-induced Renal Insufficiency: UA reveals

A

muddy brown or granular casts

274
Q

Cyclophosphamide effect on kidney?

A

Hemorrhagic cystitis NOT renal failure

275
Q

Rhabdo: best initial test?

A

UA showing + dipstick for blood with no cells seen on micropscopic evaluation

276
Q

Rhabdo: most accurate test

A

urine myoglobin

277
Q

Rhabdo: labs

A

UA, CPK, Chemistry (hyperK, hypoC, low bicarb)

278
Q

Rhabdo: tx

A

NS bolus, mannitol and diuresis to decrease contact time of myoglobin with tubule, alkalinize the urine

279
Q

HyperK with peaked T-waves: tx?

A

Calcium gluconate, insulin, glucose

280
Q

Antifreeze ingestion (ethylene glycol): best initial test, tx

A

UA shows envelope-shaped oxalate crystals, ethanol or fomepizole with immediate dialysis

281
Q

Tumor Lysis Syndrome effect on kidney, tx

A

uric acid crystals, tx with hydration and allopurinol

282
Q

If renal disease but patient NEEDS contrast

A

hydration with NS, +bicarb NAC or both

283
Q

RBCs, RBC casts, proteinuria (mild, <2g/24hrs), edema

A

Glomerulonephritis

284
Q

Goodpasture Syndrome: presentation

A

cough, hemoptysis, SOB, lung findings

285
Q

Goodpasture Syndrome: dx

A

Initial: anti-basement membrane antibodies Most accurate: Renal bx shows “linear deposits”

286
Q

Goodpasture Syndrome: tx

A

plasmapheresis and steroids

287
Q

Churg-Strauss Syndrome: presentation

A

asthma, cough, eosinophilia in addition to renal abnormalities

288
Q

Churg-Strauss Syndrome: dx

A

Initial: CBC for eos Accurate: Biopsy

289
Q

Churg-Strauss Syndrome: tx

A

Glucocorticoids, if no response add cyclophosphamide

290
Q

Wegener’s Granulomatosis: presentation

A

upper respiratory problems like sinusitis and otitis, lung issues (cough, hemoptysis, abnormal CXR), also systemic vasculitis (join, skin, eye, brain, GI)

291
Q

Wegener’s Granulomatosis: diagnosis

A

Initial: c-ANCA Accurate: renal biopsy

292
Q

Wegener’s Granulomatosis: tx

A

steroids and cyclophosphamide

293
Q

Polyarteritis Nodosa (PAN): describe

A

systemic vasculitis involving every organ EXCEPT lung, +fever, weight loss, multiple motor and sensory neuropathy with pain

294
Q

Polyarteritis Nodosa (PAN): dx

A

initial: ESR and inflammatory markers accurate: bc of sural nerve or kidney ALSO tst for HepB and Hep C , angiography showing “beading” can spare need for bx

295
Q

Polyarteritis Nodosa (PAN): tx

A

cyclophosphamide and steroids

296
Q

IgA Nephropathy (Berger’s Disease): presentation

A

painless recurrent hematuria, usually Asian pt after recent viral resp tract infection; proteinuria and red cells (as will all glomerular disease)

297
Q

IgA Nephropathy (Berger’s Disease): diagnosis

A

Intial: no specific blood test, most accurate is Renal Biopsy esp as complement levels are normal

298
Q

IgA Nephropathy (Berger’s Disease): treatment

A

Steroids used in boluses when sudden worsening of proteinuria; ACEi used in all patients with proteinuria, Fish oil may have some effect in delaying progression

299
Q

HSP: presentation

A

adolescent or child with purpuric lesions, abdom pain, joint pain, renal involvement

300
Q

HSP: diagnostics

A

Initial: clinical Accurate: renal bx shows IgA deposition but it is not necessary

301
Q

HSP: treatment

A

supportive

302
Q

Post-Strep Glomerulonephritis: presentation

A

cola colored urine, periorbital edema, HTN; both throat and skin infections can lead to this

303
Q

Post-strep Glomerulonephritis: diagnostics

A

Initial: ASLO, anti-Dnase, antihyaluronidase in blood, low complement; Accurate: Biopsy shows subepithelial deposits of IgG and C3 (but don’t do!)

304
Q

Post-strep Glomerulonephritis: tx

A

PCN and other abx for infection, although they don’t reverse disease; control HTN and fluid overload w diuretics

305
Q

Cryoglobulinemia: presentation

A

Hep C with renal involvement; joint pain and purpuric skin lesions

306
Q

Cryoglobulinemia: diagnosis

A

Initial: serum cryoglobulin component levels (immunoglobulins, light chains, IgM), low C4; Accurate: Bx

307
Q

Cryoglobulinemia: tx

A

treat Hep C with interferon, ribavarin, boceprevir or telaprevir

308
Q

Lupus Nephritis: diagnostics

A

ANA and anti-dsDNA Accurate: Renal Bx can determine extent of disease and guide therapy

309
Q

Lupus Nephritis: tx

A

Sclerosis only: none; Mild disease: steroids; Severed: Mycophenolate mofetil and steroids

310
Q

Kidney, Eye+Ear problems (+deafness)

A

Alport’s, no specific therapy

311
Q

Hemolytic Uremic Syndrome triad, also look for

A

Intravascular hemolysis, elevated Cr, thrombocytopenia; history of E. coli 0157:H7

312
Q

Thrombotic Thrombocytopenic Purpura (TTP): 5 findings

A

fever, neuro symptoms, intravascular hemolysis, elevated Cr, thrombocytopenia

313
Q

HUS and TTP: tx

A

plasmapheresis in severe case; NO platelets, no abx

314
Q

Nephrotic Syndrome: (a) grams of protein in urine (b) other findings

A

>3.5g/day; edema, low albumin in blood, hyperlipidemia, thrombosis (bc of loss of antithrombin III, protein C, and Protein S in urine)

315
Q

Define Nephrotic Syndrome

A

Hyperproteinuria, hypoproteinemia, hyperlipidemia, edema

316
Q

Nephrotic Syndrome: diagnostics

A

Initia: UA with elevated protein; next: spot urine for prot:cr ratio >3.5:1, 24-hr urine >3.5g protein; Accurate: renal bx

317
Q

Nephrotic syndrome in kids:

A

Minimal Change Disease

318
Q

Nephrotic syndrome in adults w cancer

A

membranous

319
Q

Nephrotic syndrome in Hep C patients

A

membranoproliferative

320
Q

Nephrotic syndrome in HIV, heroin use

A

focal segmental

321
Q

Treatment of nephrotic syndrome:

A

steroids, if no response add cyclophosphamide

322
Q

When is dialysis indicated?

A

HyperK, metabolic acidosis, uremia w/ encephalopathy, fluid overload, uremia w/ pericarditis, no renal failure but toxicity with drug (lithium, ethylene glycol, ASA)

323
Q

Causes of DI

A

Central (failure to produce ADH in brain), Nephrogenic (insensitivity of the kidney)

324
Q

Causes of Nephrogenic DI

A

hypoK, hyperCa, lithium toxicity

325
Q

DI: urine Osm? Urine Na? Urine Volume? Change in UrOsm with water deprivation?

A

urine Osm? LOW Urine Na? LOW Urine Volume? HighChange in UrOsm with water deprivation? NO

326
Q

Central or Nephrogenic DI? Decrease in urine volume w DDAVP (vasopressin)

A

Central

327
Q

Central or Nephrogenic DI? Increase in urine osmolality with DDAVP

A

Central

328
Q

Central DI: tx

A

vasopressin/DDAVP

329
Q

Nephrogenic DI: tx

A

correct underlying cause, thiazide diuretics

330
Q

Hypervolemic Hyponatremia: causes

A

CHF, nephrotic syndrome, cirrhosis

331
Q

Hypovolemic Hyponatremia: causes

A

diuretics, GI loss of fluids, skin loss of fluids (burns, sweating)

332
Q

Which endocrine disease causes hyponatremia with hyperK and mild metabolic acidosis? Tx?

A

Addison’s Disease, aldosterone replacement like fludrocortisone

333
Q

Euvolemic Hyponatremia: causes

A

SIADH, hypothyroid, psychogenic polydipsia, hyperglycemia

334
Q

Which medications can cause SIADH?

A

sulfonureas, SSRIs

335
Q

SIADH: urine sodium? Urine Osm? Serum Osm? BUN/Cr? Bicarb?

A

Urine sodium: >20mEq/L; UrOsm >100mOsm/kg; Low serum Osm <290; normal BUN/Cr, bicarb

336
Q

How do you treat mild hyponatremia?

A

fluid restriction

337
Q

Severe Hyponatremia: tx?

A

saline infusion with loop diuretics, hypertonic saline, ADH blockers (conivaptan, tolvaptan)

338
Q

Central pontine myelinosis occurs when sodium is corrected more than:

A

10-12mEq/L in first 24 hours; or more than 18 in first 48hrs

339
Q

Which meds can be used for chronic SIADH 2/2 malignancy?

A

Demeclocycline, conivaptan, tolvaptan

340
Q

Severe HyperK on EKG shows? Tx

A

peaked T waves; calcium gluconate IV to protect heart then insulin and glucose

341
Q

Moderate HyperK (no EKG findings): tx

A

insulin+glucose; bicarb to shift K into cells if acidosis is the cause or if there is rhabdo/hemolysis/or other reason you need to alkalinize urine; kayexalate takes several hours

342
Q

Hypokalemia: EKG findings

A

U-waves (extra wave after T-wave showing purkinje fiber repolarization); also muscular weakness from its ability to inhibit contraction

343
Q

metabolic acidosis w anion gap–>Aspirin overdose: type of metabolic disturbance, tx?

A

resp alkalosis from hyperventilation, over a short period metabolic acidosis develops–> lactic acidosis; bicarb

344
Q

Metabolic Acidosis w Anion Gap–>Methanol intoxication: diagnostic, tx

A

methanol level, +fomepizole or ethanol to block formic acid production until patient can be dialyzed

345
Q

Metabolic Acidosis w Anion Gap–>Isoniazid toxicity: tx

A

stop meds, move clock forward on CCS

346
Q

Metabolic Acidoses w/o Gap: distal RTA (Type I) urine pH? Serum K? stones? Test?

A

high pH, low K, +stones, give acid and urine pH continues to be basic

347
Q

distal RTA (type 1): tx

A

bicarb

348
Q

Metabolic Acidoses w/o Gap: proximal RTA (Type II): urine pH? Serum K? stones? Test? Tx?

A

low pH, low K, -stones, bicarb since pt cant absorb it pH rises, thiazide diuretics or high dose bicarb

349
Q

Metabolic Acidoses w/o Gap: hyporeninemic hypoaldosteronism (Type IV): diabetic patients; urine pH? Serum K? stones? Test? Tx?

A

low pH, high K, no stones, urine sodium loss, aldosterone in form of fludrocortisone

350
Q

Metabolic Alkalosis: Conn Syndrome

A

hyperaldo from primary causes urianry acid loss, usually with hypoK

351
Q

How to diagnose HTN?

A

Repeat abnormal measurement in 1-2weeks, may take 3-6 measurements to get an accurate assessment of BP

352
Q

Most effective lifestyle modification for HTN?

A

weight loss

353
Q

First line treatment for htn?

A

lifestyle modifications, 3-6mos

354
Q

Second line treatment for HTN? In Diabetics?

A

thiazides (hydrochlorothiazide or chlothalidone); ACEi/ARB

355
Q

If BP not controlled with diuretic add:

A

beta blocker (atenolol, metorprolol), ACEi, ARB, CCB

356
Q

Gastroenterology

A

…

357
Q

Young nonsmoker who has dysphagia to both solids and liquids, may be regurgitation of food particles and aspiration of previously eaten material

A

Achalasia

358
Q

Achalasia: best initial test? Most accurate test?

A

Initial: Barium Swallow Accurate: Esophageal Manometer

359
Q

Achalasia: tx?

A

Initial: pneumatic dilation or surgical myotomoy; if pt refuses above, try botulinum toxin injection

360
Q

Esophageal Cancer: dysphagia to solids or liquids first?

A

Solids first, liquids later

361
Q

Esophageal Cancer: treatment?

A

surgical resection if there are no local or distant mets; follow with chemo based on 5-FU

362
Q

Peptic Strictures: diagnostic testing

A

intial: barium study

363
Q

Plummer-Vinson Syndrome

A

proximal stricture found in association with iron deficiency anemia, more common in middle-aged women; tx: iron replacement

364
Q

Schatzki’s Ring: describe, best therapy?

A

distal ring of the esophagus which presents w intermittent dysphagia; pneumatic dilation

365
Q

Zenker’s Diverticulum: describe, initial test? Initial therapy?

A

dysphagia w horrible bad breath; barium study; surgical resection

366
Q

Diffuse Esophageal Spasm: presentation

A

severe chest pain, often without risk factors for ischemic heart disease, can occur after drinking a cold beverage +/-dysphagia

367
Q

Diffuse Esophageal Spasm: dx? Tx?

A

Manometry, barium studies may show corkscrew pattern during episode of spasm; Ca-channel blocker, nitrates

368
Q

Scleroderma presenting w symptoms of reflux: tx?

A

PPIs

369
Q

Barret’s Esophagus: tx?

A

PPI and repeat endoscopy q2-3yrs

370
Q

Low-grade dysplasia: tx?

A

PPI and repeat endoscopy in 3-6mos

371
Q

High-grade dysplasia: tx?

A

Endoscopic mucosal resection, ablative removal or distal esophagectomy

372
Q

Most common cause of peptic ulcer disease?

A

Helicobacter, NSAIDs, head trauma, burns, intubation, Crohn’s, Zollinger-Ellison Syndrome

373
Q

Gastric cancer occurs in __% of patients with gastric ulcer.

A

4%

374
Q

Patient >45 with epigastric pain, next step?

A

Scope to exclude gastric cancer

375
Q

Atrophic gastritis cause:

A

pernicious anemia and associated with vitB12 deficiency

376
Q

Gastritis: diagnostics

A

Most accurate: Endoscopy w biopsy; Serology: sensitive not specific; breath testing and stool antigen can distinguish between old and new disease

377
Q

H. Pylori: tx

A

PPI+ clarithromycin and amoxicillin

378
Q

Zollinger-Ellison Syndrome: findings

A

elevated gastrin level and elevated gastric acid output

379
Q

ZES: diagnostics

A

Endoscopic Ultrasound, nuclear somatostatin scan, secretin stimulation (no change of gastrin secretion or gastric acid output when secretin is transfused)

380
Q

ZES: tx?

A

local disease: surgical resection metastatic disease: lifelong PPIs

381
Q

ZES+hypercalcemia

A

think MEN syndrome

382
Q

Crohn’s Disease: ASCA? ANCA?

A

ASCA+, ANCA-

383
Q

Ulcerative Colitis: ASCA? ANCA?

A

ASCA-ANCA+

384
Q

IBD: intial therapy

A

Mesalamine

385
Q

IBD: acute exacerbation tx

A

Budesonide (steroid that has extensive first-pass metabolism in liver)

386
Q

IBD: severe disease therapy

A

Azathioprine, 6MP, Infliximab (remember to plant PPD)

387
Q

IBD: colonoscopy

A

q1-2yrs after 8-10yrs of colonic involvement

388
Q

Severe Infectious Diarrhea: Tx

A

fluoroquinolones, like cipro

389
Q

Nonbloody Diarrhea: MSM, hikers, bloating, flatus, steatorrhea

A

Giardia, tx with flagyl

390
Q

Nonbloody Diarrhea: refried chinese rice, vomiting

A

B. cereus, self-resolves

391
Q

Carcinoid Syndrome

A

diarrhea, flushing, episodes of hypotension

392
Q

Carcinoid Syndrome: diagnoses, treatment

A

urinary 5-HIAAl octreotide (somatostatin analog)

393
Q

Skin lesion associated with celiac disease

A

dermatitis herpetiformis: vesicular skin lesion not present on mucosal surfaces

394
Q

Tropical Sprue treatment

A

tetracycline or TMP/SMX for 3-6mos

395
Q

Whipple’s Disease: malabsorption plus….

A

arthralgia, neuro abnormalities, ocular findings

396
Q

Whipple’s Disease: Diagnosis? Treatment?

A

Accurate: Small bowel bx shows PAS+ organisms, PCR stool for T whippelii;Tx: tetracycline or TMP/SMX for 12 mos

397
Q

Chronic Pancreatitis: intial test? Most accurate?

A

Initial: Abd XR to detect pancreatic calcification, Abd CT w/o contrast (better) Accurate: Secretin stimulation test (normal person should release a large volume of bicarb-rich pancreatic fluid in response to IV secretin

398
Q

Chronic Pacreatitis: Tx?

A

Replace enzymes PO (amylase, lipase, trypsin)

399
Q

Gardner’s Syndrome

A

benign bone tumors (osteomas)+other soft tissue tumors

400
Q

Peutz-Jeghers Syndrome

A

melanotic spots on the lips, hamartomatous polyps through small bowel and colon; no extra colon ca screening

401
Q

Juvenile Polyposis

A

multiple hamartomas in bowel, no extra screening

402
Q

Dysplastic Polyp Found: next step?

A

repeat colonoscopy 3-5yrs after the polyp was found

403
Q

Diverticulosis: presentation

A

older individual, LLQ abdominal pain, lower GI bleeding

404
Q

Diverticulosis: diagnostics

A

Accurate: Colonoscopy Best: Abd CT

405
Q

Diverticulitis: presentation

A

complication of diverticulosis, LLQ pain, tenderness, fever, elev WBCs

406
Q

Diverticulitis: diagnostics

A

Abdominal CT..colonoscopy is contraindicated!

407
Q

Diverticulitis: treatment

A

Abx: cipro and flagyl

408
Q

Define orthostatic HTN

A

drop in systolic >20mmHg or rise in pulse >10bpm

409
Q

When to transfuse pRBCs?

A

Hct <30 in old pt; Hct<20-25 in younger pt

410
Q

When to tranfuse FFP?

A

elevated PTT/INR and vit K is too slow

411
Q

When to transfuse plts?

A

<50k if pt is bleeding or surgery

412
Q

What is the most common cause of death in GI bleeding?

A

myocardial ischemia

413
Q

When is NG tube the answer?

A

if unsure if bleeding is upper or lower, iced saline lavage is always the wrong answer

414
Q

Most common complication of transjugular intrahepatic portosystemic shunt (TIPS) procedure?

A

hepatic encephalopathy

415
Q

Acute Mesenteric Ischemia: most accurate test

A

Angiography

416
Q

Acute Mesenteric Ischemia: treatment

A

surgical resection of the bowel, SURGICAL EMERGENCY

417
Q

Diabetic Gastroparesis: treatment

A

Erythromycin (increases motilin in the gut) or metoclopramide

418
Q

Acute pancreatitis: Initial Test? Most Accurate?

A

Amylase/Lipase; Abd CT, MRCP detects causes of biliary and pancreatic duct obstruction not found on CT scan

419
Q

If there is dilation of the common bile duct without a pancreatic head mass, cosider this test:

A

ERCP which can detect the presence of stones or strictures, can also remove stones and dilate strictures

420
Q

Hep B or C: polyarteritis nodosa

A

Hep B

421
Q

Hep B or C: cryoglobulinemia

A

Hep C

422
Q

ALT or AST: viral Hepatitis

A

ALT elevated

423
Q

ALT or AST: drug-induced hepatitis

A

AST elevated

424
Q

Hep B: first test to become abnormal?

A

surface antigen

425
Q

Hep B: vaccinated patients labs show positive….

A

surface Ab

426
Q

Hep B: acute disease labs show…

A

surface Ag, e-Ag, core Ab

427
Q

Hep B: healed/recovering patient labs show…

A

core Ab, surface Ab

428
Q

Hep C: initial test? Most accurate?

A

Hep C Ab; Hep C pcr for RNA, liver bx

429
Q

Ascities: serum to ascitis albumin gradient (SAAG): <1.1

A

portal HTN is NOT present

430
Q

SBP diagnosed with cell count > __ neutrophils

A

250

431
Q

SBP: treatment

A

cefotaxime

432
Q

Primary Biliary Cirrhosis: findings

A

middle-aged woman c/o itching; xanthelasmas (cholesterol deposits) on exam, usually with history of other autoimmune disorders

433
Q

Primary Biliary Cirrhosis: best initial test? Most accurate?

A

Initial: Elevated AlkP with nl bilirubin, IgM elevated Accurate: Antimitochondrial Ab, liver bx

434
Q

Primary Biliary Cirrhosis: tx

A

ursodeoxycholic acid

435
Q

Primary Sclerosis Cholangitis (PSC): presentation

A

IBD, itching, elevated bili, elevated AlkP

436
Q

Primary Sclerosis Cholangitis (PSC): diagnostics? Tx?

A

ERCP shows beading of biliary system, Antismooth muscle Ab, ANCA+; ursodeoxycholic acid

437
Q

Wilson’s Disease

A

cirrhosis, liver disease, choreiform movement disorder, neuropsych issues, hemolysis

438
Q

Wilson’s Disease: diagnosis

A

Initial: slit lamp for Kayser Fleischer rings, ceruloplasmin levels (low) Most Accurate: Liver Bx

439
Q

Wilson’s Disease: tx

A

pencillamine

440
Q

Most common cause of death from hemochromatosis?

A

cirrhosis

441
Q

Hemochromatosis: diagnosis

A

Initial: elevated serum iron and ferritin with low iron-binding capacity Most Accurate: liver bx, can alternatively do MRI and genetic test for Hfe mutation

442
Q

Hemochromatosis: tx

A

phlebotomy

443
Q

Autoimmune Hepatitis: labs

A

ANA, Anti-smooth muscle Ab, SPEP shows hypergammaglobulinemia, liver/kidney microsomal Ab; Most accurate: liver bx

444
Q

Autoimmune Hepatitis: tx

A

prednisode, can use other immunosuppressants (azathioprine) if you want to wean off of steroids

445
Q

NASH: AST vs ALT?

A

ALT>AST

446
Q

Pulmonary

A

…

447
Q

Asthma and reactive airway disease are confirmed with an increase in the FEV1 of ___% during pulmonary function testing after inhaled bronchodilators

A

>12%

448
Q

Methacholine stimulation testing

A

decreased FEV1 if patient has asthma

449
Q

Asthma Exacerbation: therapies to order

A

Inhaled bronchodilators, bolus of steroids, inhaled ipatropium, O2, Magnesium

450
Q

How long do steroids take to be effective in asthma exacerbation? (PO/IV)

A

4-6hours

451
Q

Best initial therapy for asthma

A

Inhaled Bronchodilator (albuterol)

452
Q

If pt not controlled on albuterol, add a chronic controller such as…

A

inhaled steroid

453
Q

If inhaled steroid and albuterol don’t control asthma add:

A

LABA (sameterol or formeterol)

454
Q

Long term controller for asthma: Hay Fever

A

Cromolyn or nedocromil

455
Q

Long term controller for asthma: Atopic disease

A

Montelukast

456
Q

Long term controller for asthma: COPD

A

tiotropim, ipratropium

457
Q

High IgE levels, no control w cromolyn

A

Omalizumab (anti-IgE antibody)

458
Q

COPD: acute SOB management (tests and tx)

A

ABG, CXR, Albuterol, ipratropium, bolus steroids, CV, Resp, neuro exams

459
Q

COPD: fever, sputum, or infilitrate with exacerbation. Management?

A

Ceftriaxone and Azithro for community acquired pneumonia

460
Q

COPD: EKG findings

A

R-axis deviation, RVH, R atrial hypertrophy

461
Q

COPD: (a) FEV1 (b) FVC (c) FEV1/FVC ration (d) DLCO

A

(a) down (b) down (c) down (d) decrease in diffusion capacity lung carbon monoxide

462
Q

COPD: when do you give long-term home oxygen?

A

pO2<55 or O2 sat <88%

463
Q

COPD: chronic therapy

A

ipratropium inhaler, albuterol inhaler, pneumococcal vaccine, influenza vaccine, smoking cessation

464
Q

COPD age<40 in a nonsmoker who has bullae at the lung bases

A

Alpha-1-antitrypsin deficiency

465
Q

Alpha-1-antitrypsin deficiency: diagnostics

A

CXR, Labs (low albumin, elevated PT), alpha-1-antitrypsin

466
Q

Alpha-1-antitrypsin deficiency: treatment

A

infusion of alpha-1-antitrypsin

467
Q

Bronchiectasis: anatomic defect and presentation

A

profound dilation of bronchi; chronic resolving and recurring episodes of lung infections that give a very high volume of sputum that can be measured by the cupful! +hemoptysis +fever

468
Q

Bronchiectasis: testing

A

CXR with “tram tracking”, most accurate is chest CT

469
Q

Bronchiectasis: treatment

A

no curative therapy, treat infections as they occur; chest physiotherapy, rotate abx to avoid the development of resistence

470
Q

Interstitial Lung Disease: glass workers, mining, sandblasting, brickyards

A

Silicosis

471
Q

Interstitial Lung Disease: coal workers

A

coal worker’s pneumoconiosos

472
Q

Intersitial Lung Disease: cotton

A

byssinosis

473
Q

Interstitial Lung Disease: electronics, ceramics, fluorescent light bulbs

A

beryliosis

474
Q

Interstitial Lung Disease: mercury

A

pulmonary fibrosis

475
Q

Interstial Lung disease: fever? Clubbing?

A

NOPE

476
Q

Interstitial Lung Disease: diagnostics

A

CXR (interstitial fibrosis), CT, Lung Bx, PFTs

477
Q

Interstitial Lung Disease: FEV1? FVC? FEV1/FVC? Total Lung Capacity? DLCO?

A

low FEV1, low FVC, nl-high FEV1/FVC, low total lung capacity, low DLCO

478
Q

Interstitial Lung Disease: which type respnds to steroids?

A

berylliosis because it’s a granulomatuc disease

479
Q

What is BOOP?

A

Bronchiolitis obliterans organizing pneumonia. Bronchiolitis/inflammation of small airways with chronic alveolitis of unknow origin

480
Q

BOOP: presentation

A

Cough, rales, SOB, fever, malaise, myalgias

481
Q

BOOP: diagnosis

A

CXR (patchy bilateral infiltrates), chest CT Most accurate: open lung bx

482
Q

BOOP: treatment

A

steroids! No response to abx

483
Q

Loud P2, Tricuspid Regurg, R ventricular heave, Reynaud’s. Diagnosis?

A

Pulmonary HTN

484
Q

Pulmonary HTN: tx

A

bosentan (endothelin inhibitor), epoprostenol and treprostinil (pulm vasodilators), Ca-channel blockers, sildenifil

485
Q

PE: when is D-dimer testing helpful

A

if its negative; use in patient with a low probability of PE in whom you want a single test to exclude PE

486
Q

PE: how long should warfarin be used after the use of heparin?

A

6 mos

487
Q

Pleural Effusion: initial test? Most accurate?

A

CXR with decubitus films; most accurate is thoracentesis

488
Q

Pleural Effusion: exudate or transudate? Pleural protein > 50% of serum

A

exudate

489
Q

Pleural Effusion: exudate or transudate? Pleural LDH > 60% of serum

A

exudate

490
Q

What is pleurodesis and when is it performed?

A

large effusion and recurrent from a cause that cant be corrected; infusion of an irritative agen like bleomycin or talcum into pleural space which inflames pleura and causes fibrosis so lung will stick to wall and pleural space will be eliminated

491
Q

Asthmatic with worseing asthma symptoms, coughs up brownish mucous plugs with recurrent infiltrates, peripheral eosinophilia

A

Allergic Bronchopulmonary Aspergillosis

492
Q

Allergic Bronchopulmonary Aspergillosis: diagnostics

A

Aspergillus skin testing, IgE levels, circulating precipitins, A. fumigatus-specific antibodies

493
Q

Aspergillosis treatment

A

Steroids, itraconazole if refractory

494
Q

Hypovolema: CO? Wedge pressure? SVR?

A

low, low, high

495
Q

Cardogenic Shock: CO? Wedge pressure? SVR?

A

low, high, high

496
Q

Septic Shock: CO? Wedge pressure? SVR?

A

high, low, low

497
Q

Pathogen in Community-Acquired Pneumonia

A

Pneumococcus

498
Q

Pathogen in Hospital-Acquired Pneumonia

A

Gm- Bacilli

499
Q

Outpatient PNA: treatment?

A

macrolides (azithro, doxy, clarithro) or respiratory fluoroquinolone (levo, moxi)

500
Q

Inpatient PNA: treatment?

A

Ceftriaxone and azithro, or fluroquinolone

Comprehensive STEP 3 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions