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Fitzgerald Review Book > Content > Flashcards

Content Flashcards

1
Q

Physiologic jaundice

A

Presents between days 3-5 and is due to normal breakdown of fetal hemoglobin and immature liver metabolism, causing increased unconjugated bili

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2
Q

Pathologic jaundice

A

Increased conjugated bili; or occurs in the first 24 hours of life

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3
Q

How much of the med does baby receive through breast milk

A

1%

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4
Q

How long does pumping and dumping have to occur for

A

3-5 1/2 lives of the drug

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5
Q

6 month red flag

A

no smiles

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6
Q

9 month red flag

A

No sharing of sounds or other facial expressions

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7
Q

12 months red flag

A

Lack of response to name, no babbling, no pointing or reaching or waving

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8
Q

16 months red flag

A

No spoken words

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9
Q

24 months red flag

A

No 2 word phrases

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10
Q

Screening for type 2 DM in children

A

Begins at age 10 if at risk and continues every 2 years

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11
Q

Pharmacology agents for dyslipidemia in peds

A

If >8 years and LDL >190 + >2 risk factors

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12
Q

Limit cows milk after 12 months to

A

16-24oz per day

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13
Q

BP monitoring in peds

A

> 3 years old

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14
Q

MMR and infant travelling abroad

A

1 dose can be given between 6 and 11 months

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15
Q

MMR vaccine in lactation/pregnancy

A

safe in lactation, CI in pregancy

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16
Q

When was universal Hepatitis B vaccine recommended

A

For infants in 1991, for adolescents in 1996

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17
Q

Complications of varicella

A

Bacterial skin infections, pneumonia, encephalitis, toxic shock, reyes syndrome

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18
Q

If a child >12 months has been exposed to varicella

A

Give vaccine within 3-5 days to prevent disease

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19
Q

Tx pertussis

A

Azithromycin

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20
Q

Do not give IPV if allergic to

A

Neomycin, streptomycin or polymyxin B

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21
Q

Plumbism

A

Lead poisoning

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22
Q

Lead poisoning leads to

A

Iron deficiency anemia has it inactivates heme synthesis

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23
Q

What enhances lead absorption

A

Diet low in Ca, Iron, Zn, Mg, Cu and high in fat

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24
Q

Sx of lead poisoning

A

Abdominal pain, constipation, difficulty sleeping, HA, irritable, low appetite, loss of skills

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25
Q

Bronchiolitis

A

Due to RSV
Wheezing, tachypnea, fever, conjunctivitis, pharyngitis
2-3 week course
Supportive therapy
Palivizumab can be used as prophylaxis for preemies or infants with congenital heart disease

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26
Q

Tx of hemangioma

A

Oral propanolol, systemic steroids, interferon alpha

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27
Q

Erythema toxicum neonatorum

A

Benign rash resembling flea bites; usually resolves in 5-7 days

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28
Q

AOM most common bacterial pathogens

A

Strep pneumoniae, H. Influenzae, Moraxella catarrhalis

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29
Q

Most common predisposing factor to AOM

A

Eustachian tube dysfunction due to URI

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30
Q

1st line tx AOM

A

High dose amoxicillin
Targeted at strep pneumoniae due to low rate of spontaneous resolution
if penicillin allergy: cefdinir, cefuroxime, ceftriaxone
If abx failure after 48-72 hours, try Augmentin or ceftriaxone

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31
Q

Tympanostomy tubes recommended for

A

Chronic >3 monts bilateral OME

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32
Q

Risk factors for bacterial sinusitis

A

Viral infection, allergies, second hand smoke, sinus abnormalities

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33
Q

Consider ABRS if

A

New fever at day 6/7 or persistence of cold >10 days

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34
Q

Most common causes of ABRS

A

Strep pneumoniae or H influenzae

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35
Q

Tx sinusitis

A

amoxicillin

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36
Q

UTI manifests in younger children as

A

irritability, lethargy, fever

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37
Q

Biggest cause of UTI in children

A

Vesicoureteral reflex

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38
Q

Tx of UTI in children

A

Amoxicillin, Bactrim or 2nd/3rd cephalosporin for 7-10 days

Cipro approved for >1 year old

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39
Q

Rubella

A

Fever, sore throat, malaise, nasal discharge, maculopapular rash, posterior lymph nodes 5-10 days before rash

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40
Q

Marker of effective asthma control

A

Nocturnal sx

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41
Q

Theophylline approved for

A

> 5 years old

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42
Q

Levalbuterol vs albuterol

A

Levalbuterol has greater bronchodilation and fewer SE at lower dose than albuterol

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43
Q

Most common cause of gastroenteritis in kids

A

Norovirus

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44
Q

Shigellosis

A

Fever, bloody stools

tx: bactrim

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45
Q

When do girls typically achieve adult height

A

1 year after menstruation

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46
Q

Adrenarche

A

Development of pubic hair

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47
Q

Tanner 2

A

Males: testes enlarge, scrotal reddening, long and sparse pubic hair at base of penis
Females: Breast buds and papilla elevated, downy hair along labia majora

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48
Q

Tanner 3

A

Males: Penile length increased, scrotal enlargement, dark pubic hair and coarser, growth spurt
Females: breast mound, coarser and curling pubic hair, growth spurt

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49
Q

Tanner 4

A

Males: increased penile length and width and development of glans; adult pubic hair but no spread
Females: areola and papilla elevated to form second mound, adult pubic hair with no spread, menarche

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50
Q

Tanner 5

A

male: hair spreads to thighs
Female: hair spreads to thighs

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51
Q

What should not be used if pt has varicella

A

Ibuprofen

Risk of NEC

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52
Q

Early indicator of hypoperfusion in kids

A

Cap refill <2 seconds

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53
Q

Initial tx of bacterial meningitis in children

A

Ceftriaxone with vancomycin

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54
Q

Most sensitive finding for pneumonia in children

A

Tachypnea

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55
Q

Tx pneumonia in children

A

Amoxicillin to cover strep pneumoniae

Macrolide to cover atypicals

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56
Q

Dx criteria for kawasaki disease

A

Fever >5 days
Erythema, edema and peeling of extremities
Bilateral nonexudative conjunctivitis
polymorphous rash and cervical lymphadenopathy
Strawberry tongue
-Obtain echo early as it can cause coronary artery obstruction
Tx: immunoglobulin IV and aspirin

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57
Q

Bells palsy

A

Acute paralysis of CN 7 due to inflammation

  • Can be linked to virus
  • Obtain antibody testing to lyme disease
  • Tx: steroid
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58
Q

Tx cluster HA

A

Triptans, high dose NSAIDs, high flow O2

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59
Q

Triptans

A

Serotonin receptor agonists

-Cause vasoconstriction: CI in CAD or pregnancy

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60
Q

Ergotamines

A

Act as 5-HT1A and 5-HT1B agonists; do not affect cerevrak blood flow

  • Cause vasoconstriction: CI in CAD or pregnancy
  • Not helpful for tension HA
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61
Q

HA provoking meds

A

estrogen, progesterone, vasodilators

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62
Q

Beta blockers used for HA prophylaxis

A

Metoprolol, propranolol, atenolol

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63
Q

Incubation period for bacterial meningitis

A

3-4 days

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64
Q

CSF findings in bacterial meningitis

A

Pleocytosis, increased CSF opening pressure, 90-95% neutrophils, decreased glucose, increased protein

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65
Q

Which type of meningitis causes rash

A

N. Meningitidis

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66
Q

Chemoprophylaxis bacterial meningitis

A

Single dose Cipro or IM ceftriaxone or 4 doses rifampin

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67
Q

Sx of MS

A 
Weakness/numbness of limb
Monoocular visual loss
Diplopia
Vertigo
Facial weakness
Ataxia
Nystagmus 
Heat sensitivity 
-Most common b/w 20 and 40 years 
Tx exacerbations: steroids 
Long term Tx: interferon beta 1-b
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68
Q

Dopamine agonists

A

Tx PD
Ropinirole and prampexole
-Better SE than levodopa

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69
Q

TIA

A

Stroke like sx resolve within 24 hours

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70
Q

Agents to decrease BP post stroke

A

Thiazide diuretic, CCB, ACEI/ARB

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71
Q

Temporal arteritis

A

Autoimmune vasculitis most common 50-85 years

  • Causes inflammation
  • Tender, pulseless vessels and severe unilateral HA’
  • Most serious complication: blindness
  • Tx: high dose steroids (prednisone) then low dose 6 months-2 years; give with PPI and biphosphanate + Ca.Vit D
  • Dx: arterial biopsy
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72
Q

Types of skin lesions

A

Macule: Flat <1cm (freckle)
Patch: Flat >1cm (vitiligo)
Papule: Raised <1cm (raised nevus)
Vesicle: Fluid filled <1cm (herpes)
Plaque: Raised >1cm (psoriasis)
Purpura: petrchiae, ecchymosis
Pustule: Vesicle like with purulent content (acne, impetigo)
Wheal: circumscribed area of skin edema (hive)
Nodule: raised >1cm, mobile (epidermal cyst)
Bulla: fluid filled >1cm (burn blister)

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73
Q

Lease potent topical steroid

A

Hydrocortisone

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74
Q

Absorption rates of lotion, cream, ointment

A

Lotion < cream < ointment

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75
Q

Impetigo

A

2-5 years peak
Due to GAS or staph aureus
Tx with mupirocin if small lesions
-Bacitracin and neomycin not recommended

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76
Q

Acne inducing drugs

A

lithium, dilantin

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77
Q

Tx post herpetic neuralgia

A

TCAs, gabapentin, pregabalin, topical lidocaine

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78
Q

Onychomycosis

A

Nails are dull, thickened

-Nail fungal infection

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79
Q

Basal cell carcinoma

A 
PUT ON
Pearly papule
Ulcerating 
Telangiectasis
On face, scalp, pinnae
Nodules are slow growing
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80
Q

Squamous cell carcinoma

A 
-evolves more rapidly
NO SUN
Nodular
Opaque
Sun exposed areas 
Ulcerating 
Nondistinct borders
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81
Q

Actinic keratoses can evolve into

A

Squamous cell carcinoma
Sandpaper quality
Tx: liquid nitrogen cyrotherapy

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82
Q

Tx cellulitis if no MRSA risk

A

Dicloxacillin or azithromycin

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83
Q

First line tx for cellulitis abscess <5cm with no fever

A

Incision and drainage and obtain culture

-If >5cm, add abx

84
Q

Tx cellulitis-MRSA

A

Bactrim, doxy or clinda

85
Q

Angular cheilitis

A

Caused by candida
Risk increased in advanced age, malnutrition, HIV
1st line: topical nystatin

86
Q

Burrelia burgdorfen

A

Causes Lyme disease

Infected tick on host for at least 24 hours

87
Q

Stages of lyme disease

A

1: flu like illness with target lesion (erythema migrans)
2: Months later develop a rash with multiple lesions, euthralgias, HA, fatigue, heart block, bells palsy
3: 1 year later develop joint pain and neuro issues

88
Q

Common pathogens for bacterial conjunctivitis

A

Staph aureus, strep pneumoniae, H. influenzae

Tx: fluoroquinolone ocular solution (levo, moxi, gati); 2nd line is polymyxin B + trimethoprim ocular solution

89
Q

Viral conjunctivitis

A

Usually due to adenovirus

90
Q

Common pathogen in OE

A

Pseudomonas

Tx: mild acetic acid with propylene glycol otic drops or moderate cipro otic drops with hydrocortisone

91
Q

Do not use what drop if TM ruptured

A

Neomycin

92
Q

Common pathogens in AOM

A

Strep pneumoniae, H. Influenzae, M. Catarrhalis
Tx: amoxicillin high dose
If ABX in last month: Augmentin, cefdinir, cefpodoxime, cefprozal

93
Q

Classic ophthalmological emergency

A

Red, painful eye with change in visual acuity

94
Q

Anterior uveitis

A

Pupil constricted, nonreactive and irregularly shaped; dull and painful eye

95
Q

Primary open angle glaucoma

A

Increased IOP >25, optic disc cupping, gradual loss of peripheral vision
Tx: timolol, brimonidine, dorzolamide, latanoprost

96
Q

Complication of a hordeolum

A

Cellulitis

97
Q

Meniere disease

A

Dizziness, tinnitus, low frequency hearing loss
Due to increased pressure within endolymphatic system; fluids mix causing change in vestibular nerve firing rate causing vertigo
Risk factors: aminoglycoside, salicylates, loud noises
Tx: meclizine, antiemetics, benzos/steroids

98
Q

PE in Meniere disease

A

Nystagmus, weber lateralizes to UNAFFECTED ear, Rinne AC >BC (Normal); pneumatic otoscopy in affected ear elicits symptoms of nystagmus
Romberg +
Fakuda +

99
Q

Risk factors for oral CA

A

HPV 16, male gender, increasing age, tobacco/alcohol use

100
Q

Most common oral CA

A

Squamous cell

painless, firm ulceration or raised lesion; immobile lymph nodes that are non-tender

101
Q

Risk factors for OE

A

Recent ear canal trauma, cerumen impaction, frequent swimming
Due to candida or pseudomonas

102
Q

Dx test for malignant OE

A

CT, radionucleotide bone scanning, gallium screening

103
Q

What usually precedes AOM

A

Eustachian tube dysfunction due to URI, allergic rhinitis, tobacco air pollution

104
Q

Strep pneumoniae mechanism of resistance

A

Alteration of intracellular protein binding sites

-Overcome by high doses of amoxicillin

105
Q

Strep pyogenes

A

Group A beta hemolytic strep
Causes strep throat
Incubation period of 3-5 days

106
Q

Rheumatic fever

A

Carditis + arthritis

Usually begins 19 days after onset of sore throat

107
Q

Poststrep glomerulonephritis

A

Usually self limiting

Abx use does not minimize risk

108
Q

Tx strep throat if allergic to penicillin

A

Azithromycin, clarithromycin, clindamycin

109
Q

Most common cause of perennial allergy

A

Dust mites

110
Q

Tx for acute relief of allergic rhinitis

A

Antihistamines, decongestants, oral steroids

111
Q

Controller meds for allergic rhinitis

A

Intranasal steroids, leukotriene modifiers (singulair), mast cell stabilizers (cromolyn)

112
Q

Risk factors for bacterial sinusitis

A

Virus, allergies, tobacco, abnormalities in sinus structure

113
Q

Dx for bacterial sinusitis

A

URI symptoms persistent >10 days who have maxillary/facial pain and purulent nasal discharge
-Most common cause: strep pneumoniae

114
Q

Most common cause of bacterial sinusitis

A

Strep pneumoniae

Tx with high dose amoxicillin or fluoroquinolone

115
Q

Empiric therapy for bacterial sinusitis

A

1st: augmentin
2nd: doxy
If failed therapy: increase augmentin or try levaquin or moxiflox

116
Q

Mono

A

Incubation of 30-50 days
HA, malaise, myalgias, anorexia, followed by sore throat for 5-15 days
Splenomegaly in 50% of patients
30% have concurrent strep throat
Dx test: heterophile antibody test (monospot)
Tx: prednisone for tonsillar hypertrophy

117
Q

Normal spleen

A

1X3X5 inches
Weighs 7oz
Lies between ribs 9 and 11

118
Q

Target organ damage due to htn

A

Brain ,eye, heart, kidneys

119
Q

4 1st line agents for htn

A

Thiazide diuretics, CCB, ACEI/ARB

120
Q

Most important goal of htn management

A

Avoid target organ damage

121
Q

Non-dihydropyridine CCB

A

Verapamil or diltiazem

  • Good for BP control and renal protection
  • Limit to pts with good LV fxn
  • CI in heart block
122
Q

Dihydropyridine CCB

A

More potent vasodilators

-Reserve for difficulty to treat htn

123
Q

Risk factors for endocarditis

A

Prosthetic valves, history of endocarditis, injection drug use
S/S: fatigue, aching joints, SOB, edema, cough, fever, chills, weight loss, hematuria, spleen tenderness, oslers nodes, petechiae
tx: IV abs for 4-6 weeks

124
Q

Meds indicated post MI

A

Beta blockers, nitroglycerine, statin, ACEI

125
Q

S3 and S4

A

S3: HF
S4: Myocardial ischemia

126
Q

CK-MB levels return to normal in

A

60 hours

127
Q

Leading causes of HF

A

Hypertensive heart disease and atherosclerosis

128
Q

When does peripheral edema occur

A

> 5L of extracellular fluid

129
Q

Chest X ray findings in HF

A

Cardiomegaly and alveolar edema with pleural effusions and bilateral infiltrates in butterfly pattern
Loss of sharp definition of pulm vasculature, haziness of hilar shadows, kerley B lines

130
Q

Cornerstone of HF therapy

A

ACEI/ARB

-Goal is to decrease preload, decrease afterload and inhibit renin and SANS

131
Q

Improvement of asthma sx with ICS

A

in 2-8 days

Local SE: oral candidiasis, hoarseness, sore throat

132
Q

GOLD categories for COPD

A

GOLD 1: FEV1 <80%–tx SAMA or SABA prn
GOLD 2: FEV1 between 50 and 80%–tx LAMA or LABA
GOLD 3: FEV1 between 30 and 50–Tx ICS + LABA or LAMA
GOLD 4: FEV1 < 30%–Tx ICS + LABA and/or LAMA

133
Q

COPD exacerbations tx

A

Oral prednisone

If need abx: doxy, amoxicillin, bactrim, ceph

134
Q

What percent of people exposed to TB become infected?

A

30%

135
Q

Primary TB

A

Sx free
Organisms can lie dormant within granulomas for years
Latent TB not contagious

136
Q

Active TB

A

Sx develop over 4-6 weeks

Malaise, weight loss, fever, night sweats, chronic cough

137
Q

TB propylaxis meds

A

Isoniazid for 6-9 months

-Rifampin alt

138
Q

PPD +

A

> 5mm: HIV, recent contact with TB, X ray +, organ transplants, immunocompromised
10mm: Recent immigrant from TB endemic, IV drug users, <4 years old
15mm: General pop

139
Q

pneumonia

A

Cough, dyspnea, sputum, pleuritic chest pain
X ray: interstitial infiltrates with atypical pathogens or viruses; Consolidation with strep pneumoniae
-Strep pneumoniae most common pathogen in adults
-H. influenzae most common pathogen in COPD

140
Q

CURB criteria for pneumonia

A

Confusion, BUN >19, RR>30, BP<90/60, >65 years

  • score of 1 or less = outpatient
  • > 1=hospital
141
Q

Tx of bacterial pneumonia

A

Respiratory fluoroquinolone

-Macrolides or tetracycline if atypical

142
Q

Causes of bacterial bronchitis

A

B. pertussis, Chlamydia pneumoniae, Mycoplasma pneumoniae

143
Q

Risk factors and tx for anal fissures

A

Constipation, recurrent diarrhea, childbirth, anal intercourse
Tx: increase fiber and stool softener and laxative
-If sx continue, intra-anal nitroglycerine can be tried
-Surgery and botox for more severe cases

144
Q

Internal hemorrhoids grading

A

Grade 1: no prolapse
Grade 2: prolapse upon defecation but reduce spontaneously
Grade 3: prolapse on defecation and need manual reduction
Grade 4: prolapsed and can not be reduced

145
Q

Risk factors and tx for hemorrhoids

A

Excessive alcohol, chronic diarrhea or constipation, obesity, high fat and low fiber diet, prolonged sitting, sedentary lifestyle, receptive partner in anal intercourse, loss of pelvic muscle tone
Tx: astringents and topical steroids, sitz bath, analgesics

146
Q

Peak age for appendicitis

A

10-30 years

147
Q

S/S appendicitis

A
  • Pain aggravated by coughing or walking
  • N/V late sx (differentiates from gastroenteritis)
  • WBC left side (leukocytosis, neutrophilia, bandemia)
  • Myelocytes and metamyelocytes is ominous finding
148
Q

Imaging of choice in appendicitis

A

CT

-US can be considered

149
Q

Appendiceal perforation findings

A

WBC 20-30,000
Fever >102
Peritoneal findings
Sx >48 hours

150
Q

Most common form of gallstones

A

Cholesterol

151
Q

Risk factors for gallstones

A

> 50, Female, obese, hyperlipidemia, rapid weight loss, pregnancy, high glycemic index diet

152
Q

S/S cholelithiasis

A

Intermittent discomfort within 1 hour of fatty meal; radiating pain to right scapula (Collin’s sign), vomiting provides pain relief

153
Q

Cholecystitis

A

Inflammation of gallbladder due to gall stones

  • RUQ pain and tenderness with vomiting and occasional fever
    • Murphy’s sign
  • Leukocytosis usually present
  • RUQ US test of choice
  • Complications: pancreatitis and sepsis
154
Q

Risk factors for colon CA

A

History of IBD, personal CA hx, >50 years, family history of colon CA, familial polyposis syndrome

155
Q

Risk factors for diverticulosis and sx

A

Aging, family history, connective tissue disorder
Sx: L abdominal cramping, increased gas, alternating constipation and diarrhea
Tx: high fiber diet and fiber supplements

156
Q

Diverticulitis

A

Diverticula are inflamed causing fever, leukocytosis, diarrhea, LLQ pain
-CT with contrast helpful to dx
Tx: flagyl + Cipro or Bactrim

157
Q

Physiology of gastric cells

A

Gastric parietal cells secrete HCl, mediated by H2 receptor sites
Gastric acid production increases by 30-50 after a meal
Endogenous prostaglandins stimulate and thicken the mucus layer, enhance bicarb secretion and promote blood flow
COX1: maintenance of protective gastric mucosal layer (NSAIDs block this)

158
Q

Gastric ulcer vs duodenal ulcer

A

Gastric: increased pain with eating due to increased acid
Duodenal: Increased pain 2-3 hours after eating

159
Q

Tx H Pylori ulcer

A

PPI + amoxicillin + clarithromycin
OR pepto bismol + flagyl + tetracycline + PPI

Stool antigen testing is most cost effective dx
Urea breath testing is most helpful but expensive

160
Q

H2 blockers MOA

A

Block binding of histamine, reducing the secretion of gastric acid

161
Q

PPI MOA and long term risks

A

Inhibit final step in acid secretion

Long term use can cause fractures, pneumonia, C Diff

162
Q

Misoprostol

A

Prostaglandin analog

-Gastric protection for NSAID use

163
Q

Meds that decrease lower esophageal sphincter pressure, increasing risk of GERD

A

Estrogen, progesterone, theophylline, CCB, Nicotine

164
Q

Antacid use

A

Use 1-3 hours after meals and at bedtime

-Use 2-4 hours before or 4-6 hours after fluoroquinolone

165
Q

Labs in Hep A

A

Serum aminotransferase levels increase by 20

+IgM Hep AV

166
Q

Sx in hep A

A

Onset 15-50 days after exposure

Incubation period of 28 days

167
Q

Post-exposure prophylaxis in hep A

A

immunoglobulin (within 2 weeks of exposure) and HAV vaccine

168
Q

How many people with HBV go on to develop chronic Hep B

A

50%

169
Q

Tx chronic hep B

A

Pegylated interferon + antiviral (entecavir, adefovir, lamivudine)

170
Q

Hep D can only occur with

A

Hep B

171
Q

Monitoring of hepatic tumor growth

A

Alpha feto protein

172
Q

Tx IBS

A

Loperamide + dicylomine for diarrhea
TCA to decrease gut threshold
Metoclopramide for constipation

173
Q

Labs in IBD flare

A

Increased CRP, ESR, Leukocytes

174
Q

Tx IBD

A

Aminosalicylates (sulfasalazine)

175
Q

Most common risks for pancreatitis

A

Gallstones, alcohol, increased triglycerides

Other risks: opioids, steroids, thiazide diuretics, viral infection, blunt abdominal trauma

176
Q

S/S pancreatitis

A

Abdominal pain, weight loss, anorexia, N/V

Pain improved by sitting or leaning forward

177
Q

DRE findings in BPH

A

Prostate enlarged, rubber consistency, lost the median sulcus or furrow

178
Q

Post-renal azotemia

A

Increased BUN and CR, urinary retention, outflow tract obstructions

179
Q

Tx of BPH

A

Alpha 1 blockers: Terazosin

5-alpha reductase inhibitors: Finasteride

180
Q

Chancroid

A

Vesicular form to pustular form lesion that creates a painful, soft ulcer with necrotic base
Tx: azithromycin, erythromycin, cipro, ceftriaxone

181
Q

Treponema Pallidum

A

Cause of syphilis
-Chancre: firm, round, painless, genital ulcer with clear base
Tx: IM penicillin, tetracycline, doxy

182
Q

Acute epididymitis causes

A

<35: due to chlamydia or gonorrhea
>35: due to prostatitis
Men + men: E Coli or pseudomonas

183
Q

Prehn sign

A

Decreased pain when scrotum is elevated above symphysis pubis
+ sign for epididymytis

184
Q

Gonorrhea

A

Incubation period 1-5 days
S/S: Dysuria with milky discharge
Tx: IM ceftriazone or oral cefixime + 1g azithromycin PO

185
Q

Acute bacterial prostatitis

A

Fever, tender and boggy prostate, leukocytosis and neutrophilia, urine culture +
Irritative voiding, suprapubic pain, perineal pain
Tx: IM ceftriaxone + doxy if <35, fluoroquinolone if >35

186
Q

Which testicle is most affected by torsion

A

Left

187
Q

Which testicle most often has varicocele

A

Left

188
Q

When is syphilis contagion greatest

A

2nd stage

189
Q

Condyloma acuminatum

A

Verrociform lesion seen in genital warts
Due to HPV (6+11 most common)
Tx: podofilox, imiquimod, trichloroacetic acid, cryotherapy

190
Q

Primary syphilis

A

Painless, genital ulcer with clean base, localized lymphadenopathy

191
Q

Secondary syphilis

A

Diffuse maculopapular rash involving palms and soles, generalized lymphadenopathy, low grade fever, malaise, arthralgias, myalgias

192
Q

Tertiary syphilis

A

Gumma (granulomalous lesions involving skin, mucous membranes and bone)
Aortic insufficiency, aortic aneurysms

193
Q

Herpes

A

S/S: painful ulcerated genital lesion + inguinal lymphadenopathy + fever/chills
Vital culture gold standard
+virological test with - serological test would suggest new infection

194
Q

How long does it take for person to show antibodies to HIV when infected

A

3-12 weeks

195
Q

Pre-patellar bursitis

A

Bursal aspiration considered first line due to increased pain relief

196
Q

Lateral epicondylitis

A

Forearm weakness and point tenderness over inner aspect of humerus
Hand grip weakened
ROM normal

197
Q

Medial epicondylitis

A

inside of elbow

Pain worsens with wrist flexion and pronation

198
Q

Risk factors for gout

A

obesity, DM, family history, men

199
Q

Meds that may precipitate gout

A

thiazide diuretics, niacin, aspirin, cyclosporine

200
Q

Secondary gout causes

A

Psoriasis, myeloproliferative disease, hemolytic anemia, kidney disease

201
Q

Dx for gout

A

Analysis of joint aspirate

202
Q

SE allopurinol

A

Rash, nausea, decreased liver fx

203
Q

Probenecid

A

Increase kidney’s ability to remove uric acid

-Increased risk of kidney stones

204
Q

High purine foods

A

Scallops, mussels, organ and game meats, beans, spinach, asparagus, oatmeal, brewers yeast

205
Q

How to choose long term tx of gout

A

24 hour urine for uric acid–assesses whether patient overproduces or undersecretes
Probenecid is tx for undersecretion
Allopurinol is tx for overproduction

206
Q

Pseudogout

A

Calcium pyrophosphate deposition

  • Swollen, warm, painful joints
  • Increased age, joint trauma, fam hx, hypothyroid
  • tx: NSAIDs, colchicine, oral steroids

Fitzgerald Review Book (2 decks)

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