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F-med Flashcards

1
Q

The drug of R.I.P.E Tuberculosis tx that can cause Paresthesias in fingers/toes

A

Isoniazid

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2
Q

RIPE regimen

A

Rifampin
Isoniazid
Pyrazin
Ethambutol

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3
Q

SE of Ethambutol

A

Optic Neuritis

If taking Ethambutol, should have regular eye checkups

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4
Q

Peripheral neuropath SE a/w Isoniazid are dose dependent, pts taking this should co-administer _______ to help

A

Vit B6- Pyridoxine

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5
Q

After two months of RIPE tx, what meds do you KEEP TAKING?

A

Rifampin and Isoniazid- the first two out of the regimen

ctd for the entire 6 mo

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6
Q

Pott’s dz

A

TB of the vertebrae, manifesting as:

Osteomyelitis and Arthritis

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7
Q

Vit D deficiency

A

Rickets (kids)
Osteomalacia
Tetany

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8
Q

Night vision loss, dry skin, growth delay, Bitot spots on conjunctiva of eye are a/w deficiency of WHAT vitamin?

A

Vit A

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9
Q

Vit B6

A

Pyridoxine

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10
Q

Vit B12

A

Cobalamin

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11
Q

Vit B2

A

Riboflavin

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12
Q

Vit B1

A

Thiamine

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13
Q

Vit B3

A

Niacin

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14
Q

Pts w Cholestatic Jaundice have

A

decreased total bile salt pool size

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15
Q

GGT level

A

gamma-glutamyl transferase, enzyme mostly found in liver. when liver is damaged, leaks out into blood

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16
Q

Signs of Cholestasis

A

Elevated:

Bilirubin
Alk phos
GGT

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17
Q

Charcot’s triad

A

RUQ pain
Fever
Jaundice

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18
Q

Which type of PUD ulcer is more common

A

Duodenal ulcer

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19
Q

Triple drug therapy for H. Pylori

A

Amoxicillin
Clarithromycin
PPI- Omeprazole

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20
Q

Dosing of H. Pylori tx

A

Amoxi 1000 mg
Clarithro 500 mg
Omeprazole 20 mg

everything BID x14d

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21
Q

When to do test of cure for H. Pylori?

A

at least 4 weeks after pt has completed therapy

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22
Q

What do you need to monitor if pt is on Allopurinol therapy?

A

It’s excreted by kidneys

Measure KIDNEY FX, with Cr levels

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23
Q

Kidney fx test

A

Cr

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24
Q

How often to measure Creatine level w pt on Allopurinol?

A

every 2-4 weeks

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25
Q

1st line PROPHylaxis for Gout

A

Allopurinol

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26
Q

Ideal Uric Acid level in someone with Gout

A

< 6 mg/dL

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27
Q

Needle shaped crystals with NEG birefringence

A

Gout

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28
Q

Tx of Acute Gout

A

NSAIDs
Steroids
Colchicine

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29
Q

What things can trigger/ make worse Gout?

A

Loop diuretics

Thiazide diuretics

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30
Q

Recommendations for long term f/u of pts with Hodkin’s lymphoma who have been treated to remission

A

Annual Mammogram at age 40, OR

5-7 yrs after Radiation

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31
Q

Clinical sx of Hodkin Lymphoma

A 
Painless cervical swollen lymph nodes
Itching
Fever
Night sweats
Weight loss (b sx)
Frequent infections
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32
Q

Cells pathognomic for Hodkins lymph

A

Reed- Sternberg

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33
Q

Reed Sternberg cell looks like

A

“Owl’s eye”

Hodkins lymph

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34
Q

Mediastinal mass on CXR

A

Hodkins lymph!!

Also Hepatosplenomegaly, B sx- night sweats, weight loss, fever

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35
Q

After person has received tx (chemo or radiation) for Hodgkin lymph, what secondary CA is likely to develop?

A

Lung
Breast
GI

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36
Q

Reed Sternberg

A

Hodkin Lymph

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37
Q

Tx of Acne vulgaris

A

Mild-mod: Topical retinoids or abx + peroxide

Mod: add oral Abx

Severe: Isotretinoin “Accutane”

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38
Q

Criteria for Hypotension

A

<90 sys

<60 diast

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39
Q

Most common location for Esophageal foreign body

A

Level of Cricopharyngeus muscle- C6

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40
Q

Antibodies specific for SLE (Lupus)

A

Anti-dsDNA

Anti-Smith

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41
Q

Other sx that can be a/w Lupus

A 
Fever
Low wbc
Thrombocytopenia
Hemolysis
Delirium, Psychosis
Alopecia
Oral ulcers
Pericarditis
Pleural or Pericardial effusion
Arthralgia
Proteinuria
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42
Q

Most common way that Lupus can affect your lungs

A

Pleuritis- inflammation of the pleura- the lining that covers the outside of the lungs

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43
Q

Tx of Lupus

A

Hydroxychloroquine
Steroids
Immunosuppressant
NSAIDs

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44
Q

Drug inducing lupus

HIPPS

A 
Hydralazine
Isoniazid
Phenytoin
Procainamide
Sulfa
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45
Q

Stages of Lyme Disease (Borr Burgdorf)

A

I: Erythema migrans “bullseye”, fever, fatigue, myalgia, HA

II: Myocarditis, Bells palsy

III: Chronic arthritis, chronic encephalopathy

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46
Q

Tx of Lyme dz

A

Doxy

Pregnant: Amoxicillin

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47
Q

What is diff about the Bell Palsy a/w Lyme disease?

A

It’s BILATERAL!

pathognomic for Lyme dz

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48
Q

Avoid this type of DM drug if family or personal hx of THYROID cancer

A

GLP-1 RA, “tides”

Victoza, Saxenda, Trulicity

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49
Q

Most common cause of Cushings syndrome

A

Excess steroid use

exogenous

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50
Q

Most common ENDOGENOUS cause of Cushings syndrome is

A

Cushings dz- excessive secreation of ACTH by pituitary tumor

most commonly a Benign Pituitary Tumor

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51
Q

Diagnosing Cushings Syndrome

A

Dexamethasone suppression test

52
Q

Tx of Cushing syndrome

A

Transphenoidal removal of tumor

53
Q

Helpful meds as adjunct in dealing w Cushings syndrome

A

Lower BP
Lower glucose
Lower chol

54
Q

Other signs of Cushings syndrome

A 
Amenorrhea
Depressive sx
Easy bruising
Pruple striae
Buffalo hump
55
Q

If the cause of Cushings syndrome is the pituitary tumor, then it’s called

A

Cushing’s dz

56
Q

Drugs known to cause SJS/TEN

A 
"Lamictal" (Lamotrigine)
Sulfas
Phenobarbital
Carbamazepine
Allopurinol (gout)
NSAIDs
57
Q

____ increases the risk of Fibrocystic Conditions of breast

A

Frequent alcohol consumption

58
Q

Fibrocystic breast

A

d/t fluctuating levels of Estrogen during menses

Tx: apply heat, wear supporting bras,
Pharm: Danazol

59
Q

Murmur a/w:

CP
Dyspnea
Syncope

A

Aortic Stenosis

60
Q

Aortic stenosis

A

Prominent 4th heart sound

61
Q

Why is there an audible 4th heart sound with Aortic Stenosis

A

The L Ventricle must work harder during contraction to eject its blood volume and becomes Hypertrophied

62
Q

Aortic Stenosis typical pt

A

Older
Hx of DM and HTN

c/o CP, LOC, and dyspnea

63
Q

Tx of Meneire dz

A

Restrict sodium intake

to 2-3 g daily

64
Q

Meniere dz

A
  • Episodic vertigo
  • Sensorineur HEARING LOSS
  • Tinnitus
65
Q

How long does the Vertigo last with Meniere dz?

A

up to 24 hours

66
Q

Ear fullness
Pressure
Machinery or Roaring sound in ear

A

Meniere dz

67
Q

Tx of Meniere dz

A

Avoid triggers
Antihistamine
Benzos- Diazepam (Valium)
Diuretic (HCTZ)

68
Q

What causes Meniere dz?

A

Too much pressure in the inner ear

d/t Ear Endolymph

69
Q

What causes the S4 in Aortic Stenosis?

A

LV has become hypertrophied, making it harder for LA to pump blood into it

The S4 is the result of the Atrial contraction against a noncompliant L ventricle

70
Q

S3 heart sound

A

Can be normal, OR

Dilated CM
Systolic HF

71
Q

What is S1?

A

Mitral and Tricuspid valve closing

the valves b/w Atria and Ventricles

72
Q

What is S2?

A

Aortic and Pulm valve closure

the valves leaving the ventricles

73
Q

S3 is large amt of blood striking a VERY compliant Left ventricle

This is normal in:

A

Kids

Pregnant women

74
Q

What type of Hep only exists with Hep B?

A

Hepatitis D

75
Q

Tx of Suppurative Parotitis

firm, red swelling of pre and post ear areas, extends to angle of mandible

A

Nafcillin + Metro OR Clinda

76
Q

Tx of Supp Parotitis

A

Nafcillin + Metro

OR

Nafcillin + Cinda

77
Q

If there is bilateral Parotitis in a YOUNGER pt, be thinking

78
Q

Tramdol (Ultram)

A

Mild narcotic with low abuse potential

50-100 mg up to 4x per day prn for OA

79
Q

Most common form of Arthritis

A

OA
Knees and Hips

Joint space narrowing, osteophytes

80
Q

Worry about Salmonella localizing in JOINTS or BONES in what population of ppl?

A

Sickle cell dz

81
Q

Smoking can increase risk of

A

INFERTILITY

82
Q

Tx of Gonorrhea

A

Rocephin 250 mg IM
+
Azithro 1g PO

83
Q

If you have 1 relative w Colon CA, when to start screening

A

Age 40, OR

10 yrs before fam member was diagnosed

84
Q

FAP- Familial Adenomatous Polyposis

A

Sigmoidoscopy at 12 YO

then every 1-2 yrs

85
Q

Which dz does screening start earlier for- FAP or HNPCC?

A

FAP

Sigmoidoscopy at 12 yo

86
Q

Type I Osteoporosis d/t

A

Postmenopause loss of Estrogen

87
Q

Type II Osteoporosis d/t

A

Age >75 yo

Not enough Zinc or Calcium

88
Q

Two ways someone can be dx w Osteoporosis

A

T score -2.5 or lower

Fragility fx

89
Q

What advice can you give to someone newly dx w HTN?

A

Dietary intake of K+ may lower both Systolic and Diastolic BP

90
Q

Stage 1 HTN

A

S: over 130
D: over 80

91
Q

Stage 2 HTN

A

S: over 140
D: over 90

92
Q

Tx of Vulvovaginal Candidiasis “yeast infection”

A

Topical azole

Oral Fluconazole “Diflucan”

93
Q

Diflucan is used to treat

A

Yeast infection,

brand name for Fluconazole

94
Q

Tx of SEVERE PID

in a pt w NKDA

A

Cefoxitin 2g IV q6hr
+
Doxy 100 mg q12hr

95
Q

Tx of Severe PID

A

IV Cefoxitin
+
Oral Doxy

96
Q

All pts suffering acute MI are given this at HIGH DOSES despite baseline levels

A

Statin

  • Atorvastatin (Lipitor)
  • Rosuvastatin (Crestor)
97
Q

Lateral Wall STEMI

A

Lead I, avL, 5-6

98
Q

Inferior Wall STEMI

A

II, III, avF

99
Q

Anterior Wall STEMI

100
Q

Back pain worse after sitting, better w improvement

Stiff for >30 minutes in the morning

A

Ankylosing Spondlyitis

should be tx by Rheum

“Cant see, cant pee, cant climb a tree”

101
Q

Other manifestations of Anklyosing Spondylitis

A 
Anterior Uveitis (EYE)
IBD
Psoriasis
Aortic regurg
Restrictive Pulm dz
102
Q

Someone has acute back pain, how long should they “bed rest”

A

Only 2 days, followed by progressive ambulation back to normal activity

103
Q

Common cause of Ankylosing Spong

A

presence of HLA-B27 gene

104
Q

Someone has HF, can see a ____ heart sound

A

S4, d/t noncompliant Left ventricle

105
Q

RSV Bronchiolitis

A

kid <2 YO

Fever, cough, resp distress

Tx if severe: Inhaled bronchodilator, High flow nasal cannula, CPAP, Intubation

106
Q

How to distinguish b/w CVA or Bells

A

If eye canNOT aBduct- CN 6 “Abducens” is damaged, and the cause is prob CVA-Stroke

107
Q

NSAIDs that are rec for Dysmenorrhea

A

Ibuprofen

Naproxen

108
Q

Achalasia

A

Birds beak appearance of Esophagus

bottom of esoph is too tight- regurg food

109
Q

Sialadenitis

A

inflammation and swelling of Salivary glands

RF: dehydration, chronic illness

110
Q

ASA sensitivity, polyps, Asthma

A

Samter’s triad

111
Q

RF for Frozen shoulder

A

DIABETES
Thyroid dz
stroke
Auto-immune dz

112
Q

Tx of Acute Cystitis

A

Macrobid 3-5 days

113
Q

High int Statin

A

Atorvastatin 40-80 mg

Rosuvastatin 20 mg

114
Q

Prostatitis

Tender, boggy prostate

A

Tx:
Bactrim or FluoroQ
6 weeks!!!

1.5 months

115
Q

Mammary Paget’s dz

A

Eczema like dz of nipple and Areola

a/w Underlying CA of breast

116
Q

Most common type of breast CA

A

Invasive Ductal Carcinoma

117
Q

Menopausal labs

A

Elevated FSH

Decreased Estrogen

118
Q

Tx of menopause sx

A

No uterus aka have had hysterectomy: Unopposed Estrogen is ok

intact uterus: Combo estrog and prog

119
Q

Most common type of Lung CA

A

Adenocarcinoma

+ CEA antigen

120
Q

Screen for Lung CA in

A

High risk

  • 55-80 YO
  • 30 PPY hx
  • currently smoke or quit within the past 15 yrs

Low dose Helical CT

121
Q

Itching after warm bath

JAK2 mutation

A

Polycythemia vera

elevated RBC mass
high Hgb

Fatigue, itching, burning pain and redness, engorged retinal veins, Thrombosis, Gouty arthritis

Tx: Hydroxyurea, Phlebotomy, Aspirin

122
Q

Goal hct level in pt being treated w Phlebotomy for Polycythemia Vera

123
Q

What congenital abnormality puts you at increased risk of getting Testicular CA?

A

Cryptorchidism-

1 or both of testes fail to descend into scrotum

124
Q

Janeway lesions

A

non tender red nodules on PALMS AND SOLES a/w Endocarditis

125
Q

Inferior leads on EKG: II, III, avF correlate with what Coronary Artery?

A

Right Coronary Artery

126
Q

Anterior leads V1-V4 correlate with what Coronary Artery?

A

Left Anterior Descending- LAD

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