Brainscape's Knowledge GenomeTM

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


See full index

Step 3 > February Deck > Flashcards

February Deck Flashcards

1
Q

Electrolyte disturbances w/ tumor lysis syndrome

A

Hyperkalemia
Hyperuremia
Hyperphosphatejmia (& hypocalcemia)

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

TLS treatment of hyperuremia

A

rasburicase (urate oxidase analogue)

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

locally aggressive benign tumor, may recur

A

Desmoid Tumor

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

AVM bleeding more likely if pt also has…

A

ESRD
Aortic stenosis
vonWilabrand

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

Daily Adult nutrition goal

A

30 kcal/kg per day
1 g/kg protein per day

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

Precursor to skin cancer is called ______
Treatment

A

actinic keratosis

Liquid nitrogen (cryosurgery)
Surgery
5-fluoruricil cream, diclofinac cream, etc.

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

Management of Stage 3 pressure ulcer is….

A

debridement of necrotic tissue

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

How do IVC Filters effect PE risk and DVT risk?

A

1/2 PE risk
Double DVT risk

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

Extrapyramidal Effects

A

Acute Dystonia
Akathesia (restlessness)
Parkinsonism
Tardive Dyskinesia

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

Management acute dystonia

A

Benadryl or benztropine

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

Management of akathesia

A

Beta blocker
Benzodiazapine
Benztropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management parkinsonism

A

benztropine, amantadine

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

Management tardive dyskinesia

A

Valbenazine, deutrabenzine

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

Use defibrilation for which cardiac rhythms?

A

V fib
pulseless V tach

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

Management of PEA?

A

CPR!!
(Pulseless electrical activity)

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

Evaluation of carpal tunnel syndrome

A
  1. nothing, trial splinting
  2. nerve conduction studies and electromyography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Normal physiologic changes of 3rd trimester pregnancy

(that can be confused for infection)

A

hypotension
mild resp alkalosis (2/2 progesterone)
Low bicarb (compensatory renal excretion)
Mild leukocytosis (15000)

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

Lung complication of polymyositis?

A

Interstitial lung disease

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

Polymyositis sx
vs.
polymyalgia rheumatica

A

Proximal muscle weakness, no/mild pain

Proximal muscle STIFFNESS
Gaint cell arteritis association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What further infectious testing is usually done after new dx of HIV?

A

Hep B (b/c some anti-HIV meds target both)

Hep C
TB
STIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is prognosis of Minimal Change disease?

A

Usually remission w/ steroids, but high risk relapse
usually achieve ultimate remission after age 5
usually no longterm kidney issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is most irreversible SE of systemic steroids?

A

Cataracts
(therefore pts on longterm steroids require frequent optho monitoring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bells palsey vs stroke

A

Bells Palsy effects eyebrow (CANNOT raise eyebrow)
Stroke does not effect eyebrow (can raise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

2 most common causes of dilated cardiomyopathy is:

A

Idiopathic
CAD (ischemic cardiomyopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

All pts with unexplained new-onset CHF should undergo:

A

Echo
Stress testing or cardiac angiography (assess CAD as cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Endometriosis vs. genitopelvic pain/penetration disorder

A

Endometriosis is DEEP pelvic pain

penetration disorder is more superficial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What happens to TSH and Free T3/T4 in pregnancy?

A

TSH stays about the same but TOTAL T3 and T4 increase

hCG mimics TSH to produce more TH
AND estrogen causes increase T4-binding globulin
Therefore, total TH goes up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When is metformin NOT first line for DM?

A

Renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Medication management for Hot flashes?

A

1 Menopausal hormone therapy
2 SSRI (ex: if develop clot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Sx parvovirus?

A

children: Slapped cheek

teens & adults: flu-like + rash, then 1 wk later symmetric joint pain +/- rash (lacy, reticular rash)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sx of neuroleptic malignant syndrome

A

Fever
Rigidity
AMS
Autonomic Instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Sx of Serotonin syndrome

A

Fever/hyperthermia
Myoclonus
Hyperreflexia
Tachycardia
AMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Sx Lithium Toxicity

A

N/V, Diarrhea
Tremor
Slurred Speech
AMS
ATAXIA

RENAL excretion: sensitive to diuretics and vol depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Management of lower back pain is:

A

acutely: maintain normal levels of moderate activity
After recovery: exercise regimen to avoid recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When and why does breast milk Jaundice develop?

A

starts 3-5 days, peaks 3 WOL

High beta-glucuronidase in BM deconjugates bilirubin, reabsorbed by gut

KERNICTEROUS IS RARE, KEEP EM FEEDING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What type of bilirubin causes jaundice in:
Biliary atresia
Breast milk jaundice

A

direct/conjugated

Indirect/Unconjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Typical anginal sx in older folks

A

not pain
dyspnea, lightheaded, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Patients w/ suspected stable CAD should undergo what test for confirmation?

A

Noninvasive stess testing
(then echo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which MI is most likely accompanied by bradycardia?

A

Inferior wall
II, III, aVF

(dec blood supply from RCA to SA node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Management of distal esophageal spasm?

A

CCB
Tricyclic antidepressants

41
Q

Meniere Disease sx

A

Vertigo 20min - 24hr
+/- N/V
Hearing loss/tinnitus

2/2 increased endolymph pressure

42
Q

Benign Paroxysmal Positional Vertigo Sx

A

<1 min episodes vertigo
Trigger head movement
No HA

2/2 calcium debris in ear cannals

43
Q

Vestibular Neuritis

A

Dizziness (?)
N/V, gait impairment
Sudden onset, self-limited (few days)

2/2 inflammation CN IIX after viral infx

44
Q

Hyphema management

A

<50% - discharge home w/ close ophtho follow up

> 50% - admit, bedrest, raise head of bed, serial IOP checks

45
Q

What is unique about RV MI?

A

Inferior wall II, III, aVF

Failing RV relies on hydrostatic pressure from body to push blood through to lungs
If give nitrates, diuretics, opaites, decrease RV pre-load, worsen hypotension

–> give bolus

46
Q

Sjogren’s syndrome is associated with what cancer?

A

B cell lymphoma (non-hodgkins)

Bc chronic inflammation results in activation of polyclonal B cells

47
Q

Who should get CT chest screening for lung cancer?

A

50 - 80 yo
>20 pack year hx
& currently smoking or quit <15 years ago

48
Q

In gallstone pancreatitis, when should cholecystectomy occur?

A

Mild: “urgently” w/in 7 days

Severe: Wait for inflammation to go down/complications resolve

49
Q

Pts w/ HIV and PCP often have increased inflammatory response as treatment starts. What do you do?

A

corticosteroids if ABG w/:
alveolar-arterial oxygen gradient >35
PaO2 <70

50
Q

____ is one of most common causes acute aortic dissection in YA

A

HTN 2/2 cocain

Suspect if CP but normal HR and BP, normal ECG, and NEUROLOGIC findings (carotid involvement)

51
Q

Sx Sarcoidosis

A

SOB, hilar lymphadenopathy

FATIGUE
Peripheral lymphadenopathy
Hepatomegaly
Facial nerve palsy
Arthritis
Skin plaques or erythema nodosum

52
Q

Management of pts with acute decompensated HF

A

Decreased cardiac preload (diuretics)

Therefore decreases pulmonary capillary wedge pressure, reduces pulm edema

53
Q

SE of Varenicline?

A

disrupted sleep, abnormal dreams

may use w/ nicotine replacement therapy with no added SE

54
Q

Management of inhalation injury?

A

Signs of blistering/MM injry –> intubation

If nonspecific signs, may use flexible laryngoscopy first to assess for risk of airway obstruction

55
Q

PICC complications vs. Centrally inserted central line complications?

A

PICCs - higher thrombotic risk

CICCs - higher infection risk
Higher procedural complications
Decreased pt comfort

56
Q

What is the mechanism of sarcoidosis?

A

Infiltrative Noncaseating granulomas

Hypercalcemia 2/2 macrophage activation?

57
Q

Liver labs in infiltrative liver disease

A

Alk phos and GGT > AST or ALT

Ex: Hepatic sarcoidosis

(vs hepatic steatosis in which AST/ALT > alk phos)

58
Q

Salvating, sweaty, N/V, diarrhea, miosis —> Sz, resp failure

What did he take?

A

Organophosphates
(acetylcholinesterase inhibitor –> increase ACh)

Result: Cholinergic toxicity

59
Q

Treatment of cholinergic toxicity?

A

Atropine (competitive inhibitor of ACh)
Pralidoxime (reactivates ACh-E)

(Dumbells or wet wet wet)

60
Q

Signs of cardiac chest pain?

A
  1. Subcostal ??
  2. Increases with exertion
  3. Stops with rest/nitroglycerin
61
Q

Dry Mucus membranes, heart block, midryasis, urinary retension.

what did she take?

A

Atropine

(Anticholinergic antagonist or anti-muscarinic)
Anticholinergic toxicity

62
Q

Pruritis followed by bullae, erosions and erythema.

What is this?

A

Bullous pemphigoid

Skin biopsy, then steroids

Bullae w/ skin sloughing and mucosal involvement and pain (not itchy) is bullous vulgaris

63
Q

Definition of pre-eclampsia?
management?

A

htn
protein in urine

  1. Magnesium (sz)
  2. Antihypertensives
  3. w/o severe features deliver >37 weeks
    w severe features deliver >34 weeks
64
Q

when to discontinue aspirin prior to proceedures?

A

7 days prior IF bleeding risk

no need if low bleeding risk (cardiac cath)

65
Q

when to discontinue metformin prior to proceedure?

A

if large iodine contrast (cardiac cath)

2 days prior?

66
Q

Electrolyte disturbances by lots of vomiting?

A

Hypokalemic hypochaloric metabolic alkalosis

hyponatremia 2/2 water retension from hypovolemia

67
Q

Management of post-MI pericarditis?

A

High dose aspirin

(as opposed to NSAID + colchicine as used for idiopathic or viral pericarditis)

68
Q

During DKA, what is the goal BG while awaiting anion gap correction?

A

BG >200

Therefore, decrease the rate of IV insulin and add dextrose to fluids as needed to maintain BG and avoid hypoglycemia

69
Q

How do you transition pt with now-resolved DKA off insulin drip?

A

Give SQ long-acting insulin, continue (bridge) IV insulin ~1-2 hrs (b/c delay uptake of SQ insulin)

Start short-acting insulin with meals
Start sliding-scale

70
Q

what abx increase risk of c diff?

A

fluoroquinalones, cephalasporins, clindamycin

If C. diff dx, ideally stop instigating abx or change to a lower-risk one
(and start PO vanc or fidamoxacin for c diff)

71
Q

ANY patient with syphilis w/ ____ sx requires LP

A

ANY patient with syphilis w/ NEURO sx requires LP

Blurry vision, HA, etc.

b/c early dissemination often seeds CSF. may be cleared on its own, but have to check esp if HIV+

72
Q

Syphilis Tx by stage:
Primary, Secondary, Early latent

Late Latent or UNKNOWN duration

Neurosyphilis

Congenital syphilis

A

Benzathine Penicillin G

Primary, Secondary, Early latent: 1x IM dose

Late Latent or UKNOWN duration: IM for 3 weeks

Neurosyphilis: IV q4h 10-14 days

Congenital syphilis: IV q8-12h for 10 d

73
Q

What lab work does ARNI (angiotensin-receptor-neprysilin-inhibitor ex: sacubitril-valsartan) effect?

A

Elevate BNP!
(don’t trust it)

neprysilin usually breaks down BNP

74
Q

<2 yo w/ unexplained fever but otherwise well appearing.
Work up?

A

UA for suspected UTI

If appears ILL, also BCx, LP, etc as needed

75
Q

Nonmedication Management of OCD?

A

CBT (exposure and response prevention)

76
Q

Management of borderline personality disorder?

A

Dialectical Behavior Therapy

77
Q

How is viral conjunctivitis spread?

A

by eye discharge
ok to go to school after discharge resolves

78
Q

Management of plantar wart?

A

Salicyclic acid (1-3 wks)
cryotherapy (liquid nitrogen)

look for thrombosed arteries

2/2 HPV

79
Q

anticoagulation for patients with mechanical prosthetic valves?

A

WARFARIN only
(no doac)

80
Q

Classification of PE and tx
(massive, submassive, low risk)

A

Massive: RV failure w/ obstructive shock (hypotension)
- TPA (if safe)

Submassive: RV dysfunction (echo findings or trop/BNP elevation) w/o shock (no hypotension)
- anticoag +/- catheter based stratagies

low risk: No RV dysfunction
- only anticoag

81
Q

Repeat asthma exacerbations, brown mucus w/ cough, hemoptysis, transient consolidations on imaging.
Dx?

A

Allergic broncopulmonary aspergilosis
Exaggerated IgE response
Mangement: steroids and itraconazol

think for asthma or CF!!

82
Q

management of acute hep B?

A

unlikely to become full liver failure, therefore, SUPPORTIVE care

If prolonged or does develop, admit and anti-virals

83
Q

Meds to hold prior to surgery?

A

Metformin (lactic acidosis)
Raloxifine (clotting risk)

ACE/ARB (hypotension - hold night before unless for HF)
Diuretics (hypotension, hold day of)

84
Q

Suspected slow gastric emptying work up?

A
  1. EGD - assess for obstruction to gastric outlet
  2. gastric emptying study (ex: gastroparesis)
85
Q

acute interstitial nephritis sx and management

A

AKI +
Eosinophils
Rash
Pyuria
WBC casts

Cause: abx, NSAIDS, PPIs, rheum disease, infxns

Tx:
Stop offending agent
Serial kidney function studies
If no abrupt improvement, systemic glucocorticoids

86
Q

ECG signs of R heart strain

A

R axis deviation
pre-cordial T wave inversion
S1Q3T3

87
Q

Work up in suspected massive PE

A
  1. Bedside Echo - looking for R heart strain
  2. CT angiogram but only if hemodynamically stable
88
Q

Management of LVOT obstruction?

A

Beta Blockers (increase filling time)

If not option: Verapamil (CBB)
Alcohol Septal ablation (only after pharm options exhausted)

89
Q

Sx Salicylate toxicity

A

Aspirin

MIXED acid-base disorder
tachypnea (resp alkalosis)
Lactic acidosis
tachycardia
hyperthermia
N/V
AMS

90
Q

Salicylate toxicity MANAGEMENT

A
  1. SODIUM BICARB to alkalize urine and plasma to neutralize uncharged ASA molecules that can go through BBB and cell walls –> toxicity
  2. glucose for neuroglycopenia
  3. activated charcoal
  4. HD
91
Q

Rubeola

A

Measles disease

Cough
Coryza
Conjunctivitis
Koplik Spots
Cephelocaudal macular rash

92
Q

Roseola

A

“sixth disease”

High fever
rash as fever breaks

93
Q

Revised cardiac risk index
(Cardiovascular risk during non-cardiac surgery)

A

High risk surgery (vascular, intrathoracic)
Hx CHF
Ischemic heart disease
Hx Stroke/TIA
DM w/ insulin
Creatinine >2 pre-op

0-1: low risk
>2: elevated risk

94
Q

Single-screening for risky alcohol use

A

How many times in past year have you had 5 or more drinks in one day? (men)

(4 for women)

95
Q

management of scrotal injury?

A

If mild pain and normal PE, pain meds and outpt f/u

if abnormal PE (bruising, no cremasteric reflex) –> scrotal US and UA

96
Q

Precipitators of hepatic encephalopathy

A

Drugs (sedatives, narcotics)
Hypovolemia
Electrolyte changes (hypoK)
Inc nitrogen load (GI bleed)
Infection
Portosystemic shunting (TIPS)

97
Q

What is cardiac index?

A

Cardiac output (corrected per body SA)

98
Q

management of cocaine MI

A

benzodiazepine (dec systematic outflow, tachycardia, htn)
nitroglycerine

if continues: PCI
(cocaine can stimulate thrombus formation)

99
Q
A

Step 3 (6 decks)

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