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Internal Medicine > Family Medicine Techniques, Tips and Treatment Options > Flashcards

Family Medicine Techniques, Tips and Treatment Options Flashcards

1
Q

Drug addiction and withdrawal

A

Suboxone (Buprenorphine)

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2
Q

How to treat anxiety

A

Initiate an SSRI as baseline and use a benzodiazepines for break through.

Zoloft (Sertraline) or
Xanax (Alprazolam)

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3
Q

Withdrawal symptoms

A

Vistaril (hydroxyzine)

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4
Q

How to treat depression

A

Celexa (Citalopram)

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5
Q

What is the benefit of Welchol

A

Lowers LDL-C and improves glycemic control. Good for dyslipidemia and diabetes

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6
Q

Dannitol

A

Phenobarbital +Atropine + scopolamine

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6
Q

Blepharitis

A

Inflammation of the eye follicles

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7
Q

High blood pressure

A

The list is far too long.

According the ATP-3; consider starting with HCT and then adding an ACE or beta blocker for Heart failure

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8
Q

Treatment options for hyperthyroidism

A

Methimazole,
PropylThioUracil,
Tapazole

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9
Q

Treatment for pre-diabetes

A
  1. Diet and exercise
  2. Metformin
  3. Janumet
  4. Glyburide
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10
Q

Treatment for neuropathic pain

A

Neurontin (Gabipentin)

Lyrica (Pregabalin)

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11
Q

Neuropathic Pain management

A

Neurontin (gabapentin)

Lyrica (Pregabalin)

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12
Q

Treatment of Migraines

A

Imitrex (Sumatriptin)

Amerge (Naratriptin)

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13
Q

What is used as an anti convulsant and for neuropathic pain and is more potent than gabapentin

A

pregabalin

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14
Q

prevention of migraines

A

Topamax (Topiramate)

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15
Q

What are some options for pain control

A

NSAIDS Percocet Exalgo Opana Norco Lortabs Nucyntra (tapentadol) Ultram (tramadol)

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16
Q

Diagnostic protocol for gall bladder issues

A
  1. Ultrasound
  2. Hidascan
  3. Endoscopy
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17
Q

What are the first generation anti depressants

A

Tricyclics

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18
Q

Scoring system of AFIB

A

CHAD S2 Score: Congestive Heart Failure, Hypertension, Age > 75, Diabetes Mellitus, Stroke (Prior)

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19
Q

What are the 2nd generation heterocyclic Anti depressants

A

Trazodone (Desyrel)

Buproprion (Wellbutrin)

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20
Q

What is the determination of a liver transplant

A

MELD Score:

MELD = 3.78[Ln serum bilirubin (mg/dL)] + 11.2[Ln INR] + 9.57[Ln serum creatinine (mg/dL)] + 6.43

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21
Q

What are the 3rd generation heterocyclic Anti depressants

A

Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)
Vilazodone (Viibryd)

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22
Q

What is the Common bacteria associated with hospital acquired pneumonia

A

Pseudomonas

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23
Q

What is the mechanism of action of the 3rd generation heterocyclic anti depressants

A

Block serotonin and Nor epinephrine

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24
Q

What is the treatment for HAP

A
  1. Flouroquine
  2. Zosyn
  3. Vancomycin
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25
Q

name the SSRI’s

A 
Fluoxetine (prozac) 
Sertraline (zoloft) 
Paroxetine (paxil) 
Fluvoxamine (luvox) 
Citalopram (Celexa) 
Escitalopram (Lexapro)
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26
Q

What are the bugs associated with community acquired pneumonia

A
  1. Strep Pneumo 2. Mycoplasma
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27
Q

Name the short acting benzodiazepines

A

Triazolam (Halcion)
Oxazepam (serax)
Midazolam (Versed)
Alprozolam (xanax)

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28
Q

What is the treatment for CAP

A

Option A.

  1. Rocefin
  2. zithromax

Option B.
Levoquin

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29
Q

What is the duration of short acting benzo’s

A

2-8 hours

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30
Q

Can Amiodarone lead to a complete loss of thyroid function

A

Oh yea

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31
Q

Name the intermediate acting benzodiazepines

A

Temazepam (Reston)

Lorazepam (Ativan)

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32
Q

What labs are needed when admitting a new patient

A 
CMP, 
CBC, 
Chest Xray, 
EKG, 
Sed Rate
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33
Q

What is the duration action of intermediate acting benzo’s

A

10-20 hours

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34
Q

What is the cutoff value for determination of COPD vs CHF?

A

BNP of 100

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35
Q

Name the long acting benzodiazepines

A

Chlordiazepoxide (librium)
Diazepam (Valium)
Fluorazepam (Dalmane)
clonazepam (Klonipin)

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36
Q

What is the lab short hand for electrolytes

A

NA/K,
Cl/CO2,
BUN/Cr,
Ca/Glucose

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37
Q

What is the first line treatment for depression

A

SSRI’s

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38
Q

What is the lab shorthand for blood

A

WBC>HG/HCT<pH

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39
Q

What class of drugs will lower LDL the most

A

Statins (18-55% reduction)

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40
Q

What are the 2nd generation heterolytic antidepressants

A

Trazodone (desyrel)

Buproprion (wellbutrin)

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41
Q

Name the statins

A 
Lovastatin 
Pravastatin 
Simvastatin 
Fluvostatin 
Atorvastatin 
Cerivastatin
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42
Q

Name the 3rd generation heterolytic anti depressants

A

Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)

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43
Q

What is the effect of the statins

A

LDL (reduced 18-55%)
HDL (reduced 5-15%)
TG (Reduced 7-30%)

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44
Q

What is the mechanism of the 3rd generation heterolytic anti depressants

A

Block serotonin and nor epinephrine

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45
Q

Name the bile acid sequestrants

A

Cholestyramine
Colestipol
Colesevalam

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46
Q

Name the SSRI’s

A 
Fluoxetine (prozac) 
Sertraline (Zoloft) 
Paroxetine (paxil) 
Fluvoxamine (luvox) 
Citalopram (celexa) 
Excitalopram (lexapro)
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47
Q

What are the effects of the bile acid sequestrants

A

LDL (reduced 15-30%)
HDL (reduced 3-5%)
TG (no change or increased)

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48
Q

Name the short acting benzo’s (2-8 hours)

A

Triazolam (halcion) oxcizepam (serax) midazolam (Versed) Clonazepam (klonipin)

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49
Q

What are the effects of nicotinic acid

A

LDL (reduced 5-25%)
HDL (reduced 15-35%)
TG (reduced 20-50%)

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50
Q

Name the intermediate acting benzo’s (10-20 hours)

A

Temazepam (Restron)

Lorazepam (Ativan)

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51
Q

Name the fibric acids

A

Gemofibrozil
Fenofibrate
Clofibrate

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52
Q

Name the long acting benzo’s (1-3 days)

A

Chlordiazepoxide (librium) Diazepam (Valium) Fluorazepam (Dalmane)

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53
Q

What are the effects of fibric acids

A

LDL (reduced 5-20%)
HDL (reduce 10-20%)
TG (Reduced 20-50%)

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54
Q

What is natural penicillin used to treat

A 
Streptococci 
Meningococci 
Clostridium 
Listeria 
Enterococci 
Diptheria 
Anthrax 
Syphilis 
Spirochetes 
Actinomycosis 
Bacteroides
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55
Q

What can be used for nausea

A

Zofran (Ondansetron)

Reglam (metoclopromide)

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56
Q

Name the antipseudomonal penicillins

A

piperacillin (zosyn)

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57
Q

What can be used to improve memory

A

Nomanda (memantine)

Exelon (Rivastigmine)

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58
Q

Name the extended spectrum penicillins

A

Amoxicillin

Ampicillin

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59
Q

What can be used to prevent coagulation

A

Pradaxa (Dabigatran)
Plavax (Clopidogrel)
Warfrin (Coumadin)
Heparin Enoxaparin

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60
Q

Name three examples of B-lactamase inhibitors

A

clavulonic acid Sulbactam Tazobactam

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61
Q

What is an FDA approved prescription weight loss drug

A

Bellviq (locaserine hydrocholoride)

Qsymia (Phentermine + topiramate)

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62
Q

1st gen cephalosporins treat what organisms

A 
GRAM + and PECK: 
Gram positive (Pneumococci, streptococcus and staphylococcus),

Gram Negative bacilli (PEcK)
Proteus,
E. Coli,
Klebsiella

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63
Q

What drug is used to tx narcolepsy

A

provigil (modafinil)

64
Q

What organisms can be treated by 2nd Generation cephalosporins

A 
HEN PECK:
H. Influenzae, 
Enterobacter, 
Neisseria 
PECK from the first generation
65
Q

What is used to clean ears

A

Debrox (carbamide peroxide)

66
Q

What organisms can be treated by 3rd generation cephalosporins

A

HEN PECK + Pseudomonas, Enterobacter, citerobacter and providencia

67
Q

What can be used to increase WBC counts

A

neurogen (Filgastim)

68
Q

Name the first generation cephalosporins

A

cefadroxil (duricef)- Oral,
cephalexin (keflex) - Oral,
Cephradine (Velosef) - Oral,
Cefazolin (Ancef) - IV

69
Q

What can be used to relax muscles associated with tension head aches

A

Dolgic (Acetamenaphen + butabital)

70
Q

Name the second generation cephalosporin

A

Cefaclor (ceclor) - PO, Cefuroxime (Ceftin) - PO, Loracarbef (Lorabid) - PO, Cefprozil, Cefotetan (Cefotan) - IV, Cefoxitin (Mefoxin) - IV, Cefuroxime (Zinacef) - IV

71
Q

What can be used to treat against C-diff in addition to parasites and other bacteria.

A

Flagyl (Metronidazole)

72
Q

Name the 3rd generation cephalosporin

A 
Cefoperazone (cefobid) - IV, 
Cefotaxime (Claforan) - IV, 
Ceftazidime (Fortaz) - IV, 
Ceftizoximine (Cefizox) - IV, 
Ceftriaxone (Rocephin) - IV, 
Cefpodoxime (Vantin) - PO, 
Cefdinir (Omnicef) - PO, 
Ceftibuten (Cedax) - PO
73
Q

What can be used for BPH

A

Proscar (finasteride)

74
Q

Name the 4th generation cephalosporin

A

Cefepine (maxipine) - IV Only

75
Q

What can be used for cough suppression

A

Tessalon (benzonate)

76
Q

What are the clinical indications of aztreonam (azactam)

A

Aerobic gram negative rods (pseudomonas, klebsiella, serratia)

77
Q

What can be used to treat ADHD

A

Vyvanse (lisdexamphetamine)

78
Q

name a central acting muscle relaxant

A

Zanaflex (tizanidine)

79
Q

Name the carbapenems

A

Imipenem (Primaxin)
Meropenem (merrem)
ertapenem

80
Q

How are all carbapenems administered

81
Q

Name the aminoglycoside

A 
Amikacin 
Netilmicin 
Neomycin 
Tobramycin 
Gentamycin
82
Q

What organisms with Carbapenems treat agains

A

All gram positive, gram negative, anaerobic organism.

Exceptions include MRSA, VRE, C. Difficile

83
Q

Name the tetracyclines

A

Tetracycline
Doxycycline
Demeclocycline
Minocycline

84
Q

When should you use Vancomycin

A

MRSA and Severe infections. IV Only

85
Q

Name the macrolides

A

Erythromycin
Clarithromycin
Azithromycin

86
Q

When should you use bacitracin

A

topical against gram +

87
Q

What’s the difference between CMP and BMP

A

A CMP is a BMP (kidney, electrolytes) PLUS liver function

88
Q

Cycloserine is used against what

A

Mycobacterium Tuberculosis that are resistant to first line drugs.

89
Q

Problems with welchol and diabetes

A
  1. Not to be taken with glyburide

2. Can improve glycemic control in NIDDM

90
Q

Name the aminoglycosides

A

Amikacin (amikin) Netilmicin (netromycin) Neomycin (mycifradin) Tobramycin (Nebcin) Gentamycin (Garamycin)

91
Q

What needs to be considered when treating a patient long term with lasics

A

Electrolyte level.

Consider using 10 mg of oral potassium for every 20 mg of lasics

92
Q

What is the therapeutic use for aminoglycosides

A 
(KEEP)
Klebsiella
E. Coli, 
Enterobacter, 
pseudomonas; 
DO NOT COVER ANAEROBES
93
Q

What are some causes of pitting edema

A

Venous insufficiency/ stasis.
Poor Kidney function.
Right Heart Failure Pulmonary HTN

94
Q

What are the toxicity associated with aminoglycosides

A

Nephrotoxicity, Ototoxicity, NMB

95
Q

What are anticoagulation treatment options

A

Coumadin
Pradaxa (dabigatran)
Rivaroxaban
Apixaban

96
Q

Name the tetracyclines

A

Tetracycline (Symycin)
Doxycycline (Vibramycin)
Demeclocycline (declomycin)
Minocycline (minocin)

97
Q

What is Pradaxa

A

Dabigatran:

A direct thrombin inhibitor used to anti-coagulate

98
Q

What is the antibiotic spectrum of tetracycline

A 
bacteriostatic against: 
Gram positive, 
Gram negative, 
Anaerobes, 
chlamydiae, 
Mycoplasma, 
Rickettsiae
99
Q

What drug can be used to cardiovert AF of short duration

A

Flecanide.

Not to be used with LV insufficiency

100
Q

What are the adverse affects of tetracyclines

A

GI Upset, Boney structures and teeth, LIver tox, Photo sensitivity, Vestibular resactions, Renal tox

101
Q

What drug can be used for cardioversion with structural heart disease

A

Ibutilide (IV Only).

It prolongs repolarization and the QT interval

102
Q

name the macrolides

A

Erythromycin (E-mycin),
Clarithromycin (Biaxin),
Azithromycin (Zithromax)

103
Q

What is the max creatinine clearance level for metformin

104
Q

What is azithromycin used for

A

Alternative for penicillin allergic patients: gram positives (less than erythromycin), H INfluenza, M. Catarrhalis, Mycobacterium avium, mycoplasma, legionella, C. trachomatis, Corynebacterium diptheria, B. Pertusis.

105
Q

What is a severe side effect of metformin

A

Rhabdomyolysis which can lead to Renal failure with Creatinine clearance greater than 1.5

106
Q

What are the averse effects of macrolides

A

GI Upset,
Cholestatic hepatitis,
allergic reaction,
prolonged qt

107
Q

If a patient is on metformin and about to undergo contrast imaging, what must be done.

A

STOP THE METFORMIN

108
Q

what is the clinical use of clindamycin

A 
severe infections by anaerobic bacteria:
bacteroides fragilis, 
streptococci, 
staphylococci, 
pneumococci, 
Clostridium perfringens
109
Q

Pediatric Hepatitis vaccinations should be given when?

A
  1. Birth
  2. 1-2 Months
  3. Not before 24 Weeks and not after 16 weeks after initial dose
110
Q

Can an atypical antipsychotic be used for anxiety

A

OH YEA; Seraquel (quetiapine)

111
Q

What are the 2 month pediatric vaccines

A
  1. RV
  2. DTaP
  3. Hib
  4. PCV
  5. IP
112
Q

What is the mechanism for using cranberry juice for a UTI

A

Laboratory studies have demonstrated that cranberry juice inhibits adherence of uropathogens to uroepithelial cells. The mediators of this anti-adherence effect may be fructose, which could interfere with adhesion of type 1 fimbriated E. coli to uroepithelium, and proanthocyanidins, which can inhibit adherence of P-fimbriated E. coli.

Efficacy is yet to be determined.

113
Q

What are the 4 month pediatric vaccines

A
  1. RV
  2. DTaP
  3. Hib
  4. PCV
  5. IP
114
Q

When should you begin treating a UTI

A

Symptomatic and when the colony count is greater than 100,000

115
Q

What are the 6 month pediatric vaccines

A
  1. DTaP

2. PCV

116
Q

At what interval is the QT considered prolonged

A

great than 500

117
Q

What ages are the Rotavirus vaccine given

A

2 months 4 months

118
Q

How do you treat hyponatremia in the elderly

A
  1. Hydration
  2. Increase salts
  3. Steroids
  4. Alpha agonist (midodrine)
119
Q

What ages the are the DTaP vaccine given

A
  1. 2 months
  2. 4 months
  3. 6 months
  4. 15-18 months
  5. 4-6 years
120
Q

What are treatment options for menopause

A
  1. soy products

2. SSRI

121
Q

What ages are the Hep B vaccine given

A
  1. Birth
  2. 1-2 months
  3. 6-18 months
122
Q

What is a good cocktail for a steroid injection?

A
  1. 0.5 cc Lidocaine 2. 0.5 cc Marcaine 3. 2.0 cc Depot-medrol; Check up to date for a better mixture
123
Q

What are the ages for the Hib vaccine

A
  1. 2 months
  2. 4 months
  3. 12-15 months
124
Q

What is a good chemotherapy treatment option for pancreatic cancer

A

gemcitabine

either alone or in combination with erlotinib

125
Q

What are the ages for the pneumococcal vaccine

A
  1. 2 months
  2. 4 months
  3. 6 months
  4. 12-15 months
126
Q

What is the glucose to A1C conversion estimates

A

A1C of 7 = Glucose of 150;
A1C of 6 = Glucose of 120;
A1C of 5 = Glucose of 90

127
Q

What are the ages for the inactivated poliovirus

A
  1. 2 months
  2. 4 months
  3. 6-18 months
  4. 4-6 years
128
Q

What are the major causes of microhematuria

A

TIGHTS: Trauma, Infection, Glomerulonephritis, HTN, Tumor, Stones

129
Q

What are the ages that the measles mumps and rubella vaccine administered

A
  1. 12-15 months

2. 4-6 years

130
Q

What requires more energy: Diastole or Systole

A

Diastole requires more energy.
Systole (contraction) is a downhill gradient while diastole requires ATP - ST Segment changes on an EKG is due to diastolic changes - 1st symptoms of an MI is due to diastolic dysfunction

131
Q

When should the varicella virus vaccine be administered

A
  1. 12-15 months

2. 4-6 years

132
Q

What is the bruce protocol?

A

Protocol used for an echo stress test.

Treadmill is increased 2 degrees. Max heart rate is 220-age. The target on a stress test is 85% of max

133
Q

When should the HEP A vaccine be administered

A
  1. 12-24 months

2. 6-18 months after initial dose

134
Q

Where do the majority of blood clots in the heart form

A

Atrial septal Appendage

135
Q

How do you treat low magnesium and low potassium in the hospital setting

A

2 grams magnessium sulfate over 4 hours and 20 mEq q4hrs X 4 doses

136
Q

What large group of people is blood thinners relatively contra-indicated

A

All patients with a fall hazard potential.

137
Q

Erythematous Nodosum

A

A delayed Hypersensitivity reaction to antigens producing nodules that are typically located in the pretibial region.

138
Q

What is Beyes theorem

A

Pretest probability = post test probability; With low pretest probability you will do nothing, while with high pretest probability you will do everything

139
Q

What may dig toxicity induce

A

PAT (Paroxysmal Atrial Tachycardia)

140
Q

What are the key drugs excreted by the kidneys

A

NSAIDs

add others here

141
Q

What is the treatment options for reducing prostate size

A

1st line is Alpha blockers,

2nd line 5-a-reductase inhibitors

142
Q

What additional benefit my statins serve to the male population

A

prostate protective (finnish study)

143
Q

How does testosterone correlate to CAD

A

Low testosterone may increase risk

145
Q

Why is BUN elevated in GI bleeds

A

blood is digested in the GI tract forming Urea

146
Q

Name the gram negative rods

A 
E. Coli
Enterobacter
Citrobacter
Morganella
Pseudomonas
Serratia
147
Q

What is the only carbapenem that does not cover pseudomonas

148
Q

What is the best medication for abdominal anaerobes

A

metronidazole

149
Q

What is the best medication for anaerobic strep

A

clindamycin

150
Q

What antibiotic medications have no anaerobic coverage

A

aminoglycosides
aztreonam
fluoroquinolone

151
Q

What is the treatment for HCV

A

ribavarin and interferon

152
Q

What is the treatment for Chronic Hepatitis B

A 
lamivudine
interferon
adefovir
tenofovir
entecavir
telbivudine
153
Q

What is the treatment for candida infection

A

fluconazole

154
Q

What is voriconazole used to treat against

A

candida

aspergillus

155
Q

What is an adverse effect of voriconazole

A

visual disturbance

156
Q

Name the echinocandins

A

caspofungin
micafungin
anidulafungin

157
Q

What are the echinocandins used to treat

A

neutropenic fever

  • DOES not cover cryptococcus *
158
Q

What are the adverse effects of amphotericin

A

Renal toxicity
hypokalemia
metabolic acidosis
fever, shakes, and chills

159
Q

How is the duration of treatments determined for osteomyelitis

A

sedimentation rate

90% of patients will not have fever or an elevated WBC.

Treatment for osteomyelitis requires IV antibiotics

Internal Medicine (9 decks)

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