Brainscape's Knowledge GenomeTM

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


See full index

Boards Step 3 > DIT notes / Step 3 Secrets Notes > Flashcards

DIT notes / Step 3 Secrets Notes Flashcards

1
Q

Syncope: what do you ALWAYS order?

A

ECG (then treadmill stress or echo if cardiogenic, EEG/CT /MRI if neurologic, etc)

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

Patient started on a new medication and got first-dose orthostatic hypotension, which is likely?

A

alpha-1-antagonist, i.e. terazosin

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

First thing you order for management in shock + what 3 things should you reassess after you give it?

A

IV fluid BOLUS (10/20mL/kg)

1) Blood pressure
2) Urine output (preferably after inserting Foley catheter)
3) Lungs (listen for crackles in case you caused CHF)

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

If fluids fail to increase BP in septic and cardiogenic shock, what should you give next?

A

IV norepinephrine

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

If fluids fail to increase BP in hemorrhagic shock, what should you give next?

A

Blood transfusions, source control

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

Besides IV access, what other “tubes” should you be considering in a shock case?

A

Central venous catheter (for pressors!) or swan-ganz catheter

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

What 4 unique elements of management should you consider for anaphylactic shock as opposed to other shock?

A

1) administer O2 / intubation / trach/ cricothyroidotomy if laryngeal edema
2) epinephrine
3) corticosteroids
4) monitor for at least 6 hours after initial reaction

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

What is dopamine used for in acute setting?

A

Symptomatic bradycardia or cardiogenic shock from HF

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

First line medications for hypertension treatment in general population, and in non-CKD blacks?

A

Gen: ACE/ARB/CCB/diuretic
Blacks: CCB/thiazide diuretic

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

What populations do you avoid using CCBs in?

A

Heart failure, heart block, sick sinus syndrome

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

What hypertension drugs are safe to use in pregnancy?

A 
“Hypertensive Moms Love Nifedipine”:
Hydralazine
Methyldopa
Labetalol
Nifedipine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment for hypertensive emergency?

A

IV nitroprusside, labetalol, or nicardipine

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

How is renal artery stenosis diagnosed and treated?

A

Dx: MRI or angiography
Tx: Balloon angioplasty

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

Screening test for patient with secondary hypertension for cause as 1) Cushing syndrome 2) conn syndrome

A

1) 24 hour urine for free cortisol OR dexamethasone suppression test
2) plasma aldosterone : renin

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

5 tests that should be ordered in every patient with HTN

A

1) ECG
2) H&H
3) BMP
4) lipid panel
5) urinalysis

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

What two BP meds cause hypercholesterolemia?

A

Thiazides

Beta blockers

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

Treatment for achalasia

A

Pneumatic dilation or botulism toxic administration

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

Treatment for nutcracker esophagus / esophageal spasm, first and second line?

A

1st: CCBs

2nd line: Myotomy

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

What are the timing-critical treatments to consider for patients being admitted for STEMI?

A

PCI (balloon angioplasty/stent) within 2 hours;

if not possible, do fibrinolytics (tPa) within 12 hours

20
Q

ACS medication to avoid in 1) right sided MI and 2) inferior MIs

A

1) beta blockers

2) Nitroglycerin (bc RV, hypotension)

21
Q

Treatment for prinzmetal angina

A

CCBs and nitroglycerin

22
Q

Dx and treatment of chronic mesenteric ischemia?

A

Definitive dx: selective angiography of SMA

Tx: surgical revascularization

23
Q

Outpatient treatment of chronic CHF(5)?

A

1) Sodium restriction
2) ACE-I
3) BB
4) diuretics (furosemide, spironolactone, etc)
5) Vasodilators
+/- digoxin if severe systolic HF/ decreased EF

24
Q

Treatment of cor pulmonale(5)?

A

1) parenteral epoprostenol
2) bosentant
3) PDE5 inhibitor
4) CCB
5) heart-lung transplant

25
Q

What degree heart block do you treat and how?

A

Second degree Mobitz type I: atropine or pacemaker only if symptomatic
Second degree Mobitz type II and third degree: pacemaker

26
Q

Treatment for WPW with a fib/tachy + eventual

A

Procainamide or quinidine

Eventual: radiofrequency catheter ablation of pathway

27
Q

How do you treat v tach differently when patient is stable vs unstable, considering pulse is present in both?

A

Stable v tach: procainamide, amiodarone, or synchronized CV

Unstable v tach: synchronized CV

28
Q

What size of AAA to do serial ultrasound vs management, and what is the management

A

<5 cm: serial U/S
>5 cm, symptomatic, or rapidly enlarging: decrease HR with esmolol, decrease BP with nitroprusside or nicardipine, and then surgical correction
Pulsatile AAA + hypotension: emergent laparotomy (bc ruptured)

29
Q

What heart murmur radiates to axilla and what radiates to carotid?

A

Axilla: mitral regurgitation
Carotid: aortic stenosis

30
Q

Antibiotic prophylaxis used for dental procedures (patients with prosthetic valve/IE he/congenital heart dz)?

A

Amoxicillin (cephalexin or clinda if PCN allergy)

31
Q

Empiric treatment for native valve endocarditis?

For prosthetic valve endocarditis?

A

NATIVE: Cephalosporin or PCN (oxacillin for MSSA, or vanco for MRSA) + aminoglycoside (gentamicin)
PROSTHETIC: vanco + gentamicin + cefepime or carbapenem

32
Q

Criteria for rheumatic fever?

A 
JONES:(2 of 5)
Joints: migratory poly arthritis
O- heart - carditis
Nodules, subQ
Erythema marginatum 
Sydenham chorea

Or minor: prolonged PR , ESR, WBC, ETC

33
Q

Definitive treatment for thoracic outlet syndrome?

A

Surgical ie cervical rib resection

34
Q

Treatment for Leriche syndrome?

A

(Claudication in butt, butt atrophy, impotence in men)

Aortoiliac bypass graft

35
Q

Management of claudication?

A

1) Conservative bc it is “angina of the extremities”: exercise, smoking cessation, cholesterol/BP/glucose control
2) aspirin > clopidogrel
3) cilostazol

36
Q

DVT Ppx for low, medium, and high risk patients , and patients with high bleed risk

A

Low: early ambulation
Medium: LMW heparin, low dose unfractionated heparin, or fondaparinux
High: “,”, or oral vitamin K antagonist
High risk of bleeding: pneumatic compression stockings

37
Q

Treatment for superficial thrombophlebitis

A

NSAIDs, warm compresses, thrombectomy if nonresolving

38
Q

Difference between restrictive cardiomyopathy and constrictive pericarditis?

A

Restrictive CM: ventricular biopsy ABNORMAL

constrictive pericarditis: ventricular biopsy NORMAL

39
Q

Treatment of HOCM

A 
Beta blockers or disopyramide 
Avoid competitive sports
AVOID inotropes (digoxin, diuretics, vasodilators)
40
Q

Treatment of cardiac camponade

A

If stable: first confirm dx with echo

If unstable: pericardiocentesis

41
Q

Thing to remember electrolyte changes with diuretic drugs

A

LOOPS LOSE Ca+2
Thiazides Keep Ca+2 (and glucose, lipids, Uric acid), lose Na+
Potassium sparing diuretics (spironolactone), bc of their name, are the only diuretics which KEEP K+

42
Q

Anesthesia to give during labor?

A

Epidural (NOT spinal - this is different!)

43
Q

Pre-eclampsia and eclampsia lead to what two fetal issues to remember?

A

IUGR, uteroplacental insufficiency

44
Q

How is hemolytic disease of the newborn monitored and treated

A

1) Amniotic fluid spectrophotometry
2) Ultrasound
3) delivery if mature, with lecithin-to-sphingomyelin ratio
4) intrauterine transfusion
5) phenobarbital

45
Q

How frequently should b-HCG increase in first trimester?

A

double every 2 days
(if slower/stays same, may be threatened abortion/ectopic preg;
if faster, may be mole/chorio)

46
Q

when to give RhoGAM?

A

if mom Rh- and dad Rh+:

1) at 28 wks
3) after (~72 h) delivery OR after anything that causes transplacental bleeding: abortion, stillbirth, ectopic pregnancy, amniocentesis, CVS

47
Q

What disorders are associated with prolonged gestation?

A

1) Anencephaly

2) Placental sulfatase deficiency

Boards Step 3 (4 decks)

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