Family Medicine Techniques, Tips and Treatment Options Flashcards
1
Q
Drug addiction and withdrawal
A
Suboxone (Buprenorphine)
2
Q
How to treat anxiety
A
Initiate an SSRI as baseline and use a benzodiazepines for break through.
Zoloft (Sertraline) or
Xanax (Alprazolam)
3
Q
Withdrawal symptoms
A
Vistaril (hydroxyzine)
4
Q
How to treat depression
A
Celexa (Citalopram)
5
Q
What is the benefit of Welchol
A
Lowers LDL-C and improves glycemic control. Good for dyslipidemia and diabetes
6
Q
Blepharitis
A
Inflammation of the eye follicles
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
8
Q
Treatment options for hyperthyroidism
A
Methimazole,
PropylThioUracil,
Tapazole
9
Q
Treatment for pre-diabetes
A
- Diet and exercise
- Metformin
- Janumet
- Glyburide
10
Q
Treatment for neuropathic pain
A
Neurontin (Gabipentin)
Lyrica (Pregabalin)
11
Q
Neuropathic Pain management
A
Neurontin (gabapentin)
Lyrica (Pregabalin)
12
Q
Treatment of Migraines
A
Imitrex (Sumatriptin)
Amerge (Naratriptin)
13
Q
What is used as an anti convulsant and for neuropathic pain and is more potent than gabapentin
A
pregabalin
14
Q
prevention of migraines
A
Topamax (Topiramate)
15
Q
What are some options for pain control
A
NSAIDS Percocet Exalgo Opana Norco Lortabs Nucyntra (tapentadol) Ultram (tramadol)
16
Q
Diagnostic protocol for gall bladder issues
A
- Ultrasound
- Hidascan
- Endoscopy
17
Q
What are the first generation anti depressants
A
Tricyclics
18
Q
Scoring system of AFIB
A
CHAD S2 Score: Congestive Heart Failure, Hypertension, Age > 75, Diabetes Mellitus, Stroke (Prior)
19
Q
What are the 2nd generation heterocyclic Anti depressants
A
Trazodone (Desyrel)
Buproprion (Wellbutrin)
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
21
Q
What are the 3rd generation heterocyclic Anti depressants
A
Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)
Vilazodone (Viibryd)
22
Q
What is the Common bacteria associated with hospital acquired pneumonia
A
Pseudomonas
23
Q
What is the mechanism of action of the 3rd generation heterocyclic anti depressants
A
Block serotonin and Nor epinephrine
24
Q
What is the treatment for HAP
A
- Flouroquine
- Zosyn
- Vancomycin
25
name the SSRI's
```
Fluoxetine (prozac)
Sertraline (zoloft)
Paroxetine (paxil)
Fluvoxamine (luvox)
Citalopram (Celexa)
Escitalopram (Lexapro)
```
26
What are the bugs associated with community acquired pneumonia
1. Strep Pneumo 2. Mycoplasma
27
Name the short acting benzodiazepines
Triazolam (Halcion)
Oxazepam (serax)
Midazolam (Versed)
Alprozolam (xanax)
28
What is the treatment for CAP
Option A.
1. Rocefin
2. zithromax
Option B.
Levoquin
29
What is the duration of short acting benzo's
2-8 hours
30
Can Amiodarone lead to a complete loss of thyroid function
Oh yea
31
Name the intermediate acting benzodiazepines
Temazepam (Reston)
| Lorazepam (Ativan)
32
What labs are needed when admitting a new patient
```
CMP,
CBC,
Chest Xray,
EKG,
Sed Rate
```
33
What is the duration action of intermediate acting benzo's
10-20 hours
34
What is the cutoff value for determination of COPD vs CHF?
BNP of 100
35
Name the long acting benzodiazepines
Chlordiazepoxide (librium)
Diazepam (Valium)
Fluorazepam (Dalmane)
clonazepam (Klonipin)
36
What is the lab short hand for electrolytes
NA/K,
Cl/CO2,
BUN/Cr,
Ca/Glucose
37
What is the first line treatment for depression
SSRI's
38
What is the lab shorthand for blood
WBC>HG/HCT
39
What class of drugs will lower LDL the most
Statins (18-55% reduction)
40
What are the 2nd generation heterolytic antidepressants
Trazodone (desyrel)
| Buproprion (wellbutrin)
41
Name the statins
```
Lovastatin
Pravastatin
Simvastatin
Fluvostatin
Atorvastatin
Cerivastatin
```
42
Name the 3rd generation heterolytic anti depressants
Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)
43
What is the effect of the statins
LDL (reduced 18-55%)
HDL (reduced 5-15%)
TG (Reduced 7-30%)
44
What is the mechanism of the 3rd generation heterolytic anti depressants
Block serotonin and nor epinephrine
45
Name the bile acid sequestrants
Cholestyramine
Colestipol
Colesevalam
46
Name the SSRI's
```
Fluoxetine (prozac)
Sertraline (Zoloft)
Paroxetine (paxil)
Fluvoxamine (luvox)
Citalopram (celexa)
Excitalopram (lexapro)
```
47
What are the effects of the bile acid sequestrants
LDL (reduced 15-30%)
HDL (reduced 3-5%)
TG (no change or increased)
48
Name the short acting benzo's (2-8 hours)
Triazolam (halcion) oxcizepam (serax) midazolam (Versed) Clonazepam (klonipin)
49
What are the effects of nicotinic acid
LDL (reduced 5-25%)
HDL (reduced 15-35%)
TG (reduced 20-50%)
50
Name the intermediate acting benzo's (10-20 hours)
Temazepam (Restron)
| Lorazepam (Ativan)
51
Name the fibric acids
Gemofibrozil
Fenofibrate
Clofibrate
52
Name the long acting benzo's (1-3 days)
Chlordiazepoxide (librium) Diazepam (Valium) Fluorazepam (Dalmane)
53
What are the effects of fibric acids
LDL (reduced 5-20%)
HDL (reduce 10-20%)
TG (Reduced 20-50%)
54
What is natural penicillin used to treat
```
Streptococci
Meningococci
Clostridium
Listeria
Enterococci
Diptheria
Anthrax
Syphilis
Spirochetes
Actinomycosis
Bacteroides
```
55
What can be used for nausea
Zofran (Ondansetron)
| Reglam (metoclopromide)
56
Name the antipseudomonal penicillins
piperacillin (zosyn)
57
What can be used to improve memory
Nomanda (memantine)
| Exelon (Rivastigmine)
58
Name the extended spectrum penicillins
Amoxicillin
| Ampicillin
59
What can be used to prevent coagulation
Pradaxa (Dabigatran)
Plavax (Clopidogrel)
Warfrin (Coumadin)
Heparin Enoxaparin
60
Name three examples of B-lactamase inhibitors
clavulonic acid Sulbactam Tazobactam
61
What is an FDA approved prescription weight loss drug
Bellviq (locaserine hydrocholoride)
| Qsymia (Phentermine + topiramate)
62
1st gen cephalosporins treat what organisms
```
GRAM + and PECK:
Gram positive (Pneumococci, streptococcus and staphylococcus),
```
Gram Negative bacilli (PEcK)
Proteus,
E. Coli,
Klebsiella
63
What drug is used to tx narcolepsy
provigil (modafinil)
64
What organisms can be treated by 2nd Generation cephalosporins
```
HEN PECK:
H. Influenzae,
Enterobacter,
Neisseria
PECK from the first generation
```
65
What is used to clean ears
Debrox (carbamide peroxide)
66
What organisms can be treated by 3rd generation cephalosporins
HEN PECK + Pseudomonas, Enterobacter, citerobacter and providencia
67
What can be used to increase WBC counts
neurogen (Filgastim)
68
Name the first generation cephalosporins
cefadroxil (duricef)- Oral,
cephalexin (keflex) - Oral,
Cephradine (Velosef) - Oral,
Cefazolin (Ancef) - IV
69
What can be used to relax muscles associated with tension head aches
Dolgic (Acetamenaphen + butabital)
70
Name the second generation cephalosporin
Cefaclor (ceclor) - PO, Cefuroxime (Ceftin) - PO, Loracarbef (Lorabid) - PO, Cefprozil, Cefotetan (Cefotan) - IV, Cefoxitin (Mefoxin) - IV, Cefuroxime (Zinacef) - IV
71
What can be used to treat against C-diff in addition to parasites and other bacteria.
Flagyl (Metronidazole)
72
Name the 3rd generation cephalosporin
```
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
What can be used for BPH
Proscar (finasteride)
74
Name the 4th generation cephalosporin
Cefepine (maxipine) - IV Only
75
What can be used for cough suppression
Tessalon (benzonate)
76
What are the clinical indications of aztreonam (azactam)
Aerobic gram negative rods (pseudomonas, klebsiella, serratia)
77
What can be used to treat ADHD
Vyvanse (lisdexamphetamine)
78
name a central acting muscle relaxant
Zanaflex (tizanidine)
79
Name the carbapenems
Imipenem (Primaxin)
Meropenem (merrem)
ertapenem
80
How are all carbapenems administered
IV only
81
Name the aminoglycoside
```
Amikacin
Netilmicin
Neomycin
Tobramycin
Gentamycin
```
82
What organisms with Carbapenems treat agains
All gram positive, gram negative, anaerobic organism.
| Exceptions include MRSA, VRE, C. Difficile
83
Name the tetracyclines
Tetracycline
Doxycycline
Demeclocycline
Minocycline
84
When should you use Vancomycin
MRSA and Severe infections. IV Only
85
Name the macrolides
Erythromycin
Clarithromycin
Azithromycin
86
When should you use bacitracin
topical against gram +
87
What's the difference between CMP and BMP
A CMP is a BMP (kidney, electrolytes) PLUS liver function
88
Cycloserine is used against what
Mycobacterium Tuberculosis that are resistant to first line drugs.
89
Problems with welchol and diabetes
1. Not to be taken with glyburide
| 2. Can improve glycemic control in NIDDM
90
Name the aminoglycosides
Amikacin (amikin) Netilmicin (netromycin) Neomycin (mycifradin) Tobramycin (Nebcin) Gentamycin (Garamycin)
91
What needs to be considered when treating a patient long term with lasics
Electrolyte level.
| Consider using 10 mg of oral potassium for every 20 mg of lasics
92
What is the therapeutic use for aminoglycosides
```
(KEEP)
Klebsiella
E. Coli,
Enterobacter,
pseudomonas;
DO NOT COVER ANAEROBES
```
93
What are some causes of pitting edema
Venous insufficiency/ stasis.
Poor Kidney function.
Right Heart Failure Pulmonary HTN
94
What are the toxicity associated with aminoglycosides
Nephrotoxicity, Ototoxicity, NMB
95
What are anticoagulation treatment options
Coumadin
Pradaxa (dabigatran)
Rivaroxaban
Apixaban
96
Name the tetracyclines
Tetracycline (Symycin)
Doxycycline (Vibramycin)
Demeclocycline (declomycin)
Minocycline (minocin)
97
What is Pradaxa
Dabigatran:
| A direct thrombin inhibitor used to anti-coagulate
98
What is the antibiotic spectrum of tetracycline
```
bacteriostatic against:
Gram positive,
Gram negative,
Anaerobes,
chlamydiae,
Mycoplasma,
Rickettsiae
```
99
What drug can be used to cardiovert AF of short duration
Flecanide.
| Not to be used with LV insufficiency
100
What are the adverse affects of tetracyclines
GI Upset, Boney structures and teeth, LIver tox, Photo sensitivity, Vestibular resactions, Renal tox
101
What drug can be used for cardioversion with structural heart disease
Ibutilide (IV Only).
| It prolongs repolarization and the QT interval
102
name the macrolides
Erythromycin (E-mycin),
Clarithromycin (Biaxin),
Azithromycin (Zithromax)
103
What is the max creatinine clearance level for metformin
1.5
104
What is azithromycin used for
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
What is a severe side effect of metformin
Rhabdomyolysis which can lead to Renal failure with Creatinine clearance greater than 1.5
106
What are the averse effects of macrolides
GI Upset,
Cholestatic hepatitis,
allergic reaction,
prolonged qt
107
If a patient is on metformin and about to undergo contrast imaging, what must be done.
STOP THE METFORMIN
108
what is the clinical use of clindamycin
```
severe infections by anaerobic bacteria:
bacteroides fragilis,
streptococci,
staphylococci,
pneumococci,
Clostridium perfringens
```
109
Pediatric Hepatitis vaccinations should be given when?
1. Birth
2. 1-2 Months
3. Not before 24 Weeks and not after 16 weeks after initial dose
110
Can an atypical antipsychotic be used for anxiety
OH YEA; Seraquel (quetiapine)
111
What are the 2 month pediatric vaccines
1. RV
2. DTaP
3. Hib
4. PCV
5. IP
112
What is the mechanism for using cranberry juice for a UTI
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
What are the 4 month pediatric vaccines
1. RV
2. DTaP
3. Hib
4. PCV
5. IP
114
When should you begin treating a UTI
Symptomatic and when the colony count is greater than 100,000
115
What are the 6 month pediatric vaccines
1. DTaP
| 2. PCV
116
At what interval is the QT considered prolonged
great than 500
117
What ages are the Rotavirus vaccine given
2 months 4 months
118
How do you treat hyponatremia in the elderly
1. Hydration
2. Increase salts
3. Steroids
4. Alpha agonist (midodrine)
119
What ages the are the DTaP vaccine given
1. 2 months
2. 4 months
3. 6 months
4. 15-18 months
5. 4-6 years
120
What are treatment options for menopause
1. soy products
| 2. SSRI
121
What ages are the Hep B vaccine given
1. Birth
2. 1-2 months
3. 6-18 months
122
What is a good cocktail for a steroid injection?
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
What are the ages for the Hib vaccine
1. 2 months
2. 4 months
3. 12-15 months
124
What is a good chemotherapy treatment option for pancreatic cancer
gemcitabine
| either alone or in combination with erlotinib
125
What are the ages for the pneumococcal vaccine
1. 2 months
2. 4 months
3. 6 months
4. 12-15 months
126
What is the glucose to A1C conversion estimates
A1C of 7 = Glucose of 150;
A1C of 6 = Glucose of 120;
A1C of 5 = Glucose of 90
127
What are the ages for the inactivated poliovirus
1. 2 months
2. 4 months
3. 6-18 months
4. 4-6 years
128
What are the major causes of microhematuria
TIGHTS: Trauma, Infection, Glomerulonephritis, HTN, Tumor, Stones
129
What are the ages that the measles mumps and rubella vaccine administered
1. 12-15 months
| 2. 4-6 years
130
What requires more energy: Diastole or Systole
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
When should the varicella virus vaccine be administered
1. 12-15 months
| 2. 4-6 years
132
What is the bruce protocol?
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
When should the HEP A vaccine be administered
1. 12-24 months
| 2. 6-18 months after initial dose
134
Where do the majority of blood clots in the heart form
Atrial septal Appendage
135
How do you treat low magnesium and low potassium in the hospital setting
2 grams magnessium sulfate over 4 hours and 20 mEq q4hrs X 4 doses
136
What large group of people is blood thinners relatively contra-indicated
All patients with a fall hazard potential.
137
Erythematous Nodosum
A delayed Hypersensitivity reaction to antigens producing nodules that are typically located in the pretibial region.
138
What is Beyes theorem
Pretest probability = post test probability; With low pretest probability you will do nothing, while with high pretest probability you will do everything
139
What may dig toxicity induce
PAT (Paroxysmal Atrial Tachycardia)
140
What are the key drugs excreted by the kidneys
NSAIDs
| add others here
141
What is the treatment options for reducing prostate size
1st line is Alpha blockers,
| 2nd line 5-a-reductase inhibitors
142
What additional benefit my statins serve to the male population
prostate protective (finnish study)
143
How does testosterone correlate to CAD
Low testosterone may increase risk
144
Dannitol
Phenobarbital +Atropine + scopolamine
145
Why is BUN elevated in GI bleeds
blood is digested in the GI tract forming Urea
146
Name the gram negative rods
```
E. Coli
Enterobacter
Citrobacter
Morganella
Pseudomonas
Serratia
```
147
What is the only carbapenem that does not cover pseudomonas
ertapenem
148
What is the best medication for abdominal anaerobes
metronidazole
149
What is the best medication for anaerobic strep
clindamycin
150
What antibiotic medications have no anaerobic coverage
aminoglycosides
aztreonam
fluoroquinolone
151
What is the treatment for HCV
ribavarin and interferon
152
What is the treatment for Chronic Hepatitis B
```
lamivudine
interferon
adefovir
tenofovir
entecavir
telbivudine
```
153
What is the treatment for candida infection
fluconazole
154
What is voriconazole used to treat against
candida
| aspergillus
155
What is an adverse effect of voriconazole
visual disturbance
156
Name the echinocandins
caspofungin
micafungin
anidulafungin
157
What are the echinocandins used to treat
neutropenic fever
* DOES not cover cryptococcus *
158
What are the adverse effects of amphotericin
Renal toxicity
hypokalemia
metabolic acidosis
fever, shakes, and chills
159
How is the duration of treatments determined for osteomyelitis
sedimentation rate
90% of patients will not have fever or an elevated WBC.
Treatment for osteomyelitis requires IV antibiotics
