FM Shelf Flashcards by Scott nellis

Initial monotherapy for HTN in diabetics/CKD?

ACE inhibitor or an ARB

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Initial monotherapy for HTN in blacks?

Thiazide or long acting CCB

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Innocent murmur that is described as vibratory or musical?

Still’s murmur

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Osteoporosis is defined by T score below ??? on a DEXA scan

-2.5

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Metformin cannot be used in patients with a GFR less than ??

30 mL/min

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Most common cause of secondary HTN?

Renal artery stenosis

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??? are contraindicated in tx of HTN 2/2 bilateral renal artery stenosis

ACE inhibitors (but preferred if unilateral)

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??? diuretics aggravate gout by inhibiting secretion of uric acid

Thiazides (HCTZ)

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??? are routinely followed for anyone on a statin

LFTs

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What BP med has shown to reduce mortality in post MI pts?

ACE Inhibitors and Beta blockers (also used in CHF pts)

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HCOM presents as a systolic murmur that ??? in intensity with a Valsalva maneuver

Increases

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To decrease intensity of HCOM murmur, must ??? preload

Increase. (Via beta blockers)

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Likely dx: increased TIBC and RDW, decreased serum iron and ferritin

Fe deficiency anemia

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Lateral epicondylitis pain can be reproduced with resisted wrist ???

Extension

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Compartment syndrome is a surgical emergency, often presenting after trauma and associated with the 6 P’s:

Pain, paresthesia, pallor, paralysis, pulselessness, poikilothermia

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Sequence of ligamentous injury during inversion ankle sprains:

ATF, CF, PTF

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Electrolyte abnormality after severe diarrhea? After sever vomiting?

Diarrhea: hypokalemia and metabolic ACIDOSIS. Vomiting: hypokalemia and metabolic ALKALOSIS

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To decrease ammonia levels in hepatic encephalopathy, pts are started on:

Lactulose, neomycin, and a LOW protein diet

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ABX for Lyme disease?

Doxycycline

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Symptomatic bradycardia tx?

Atropine

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??? is characterized by ipsilateral loss of vibration/paralysis, and contralateral loss of pain and temperature

Brown-Sequard syndrome

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Gout: acute tx? Prophylaxis?

NSAIDs (Indomethacin), colchicine, steroids; Allopurinol

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Aspiration pneumonia is most often caused by ???

Anaerobic bacteria

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Elderly pts with pneumonia, likely cause?

Strep pneumoniae

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Hot tub folliculitis is caused by ???

Pseudomonas aeruginosa

Best initial Dx test for suspected valvular dz?

ECHO

Most accurate diagnostic test for Zollinger-Ellison Syndrome?

Secretin stimulation test

Cirrhosis symptoms spider telangiectasias and gynecomastia are due to increased circulating???

Estrogen

ABX that can exacerbate MG symptoms?

Clindamycin and Aminoglycosides (avoid in MG pts)

Aphasia is a ??? lobe problem

Temporal

This Gram negative organism is a common cause of cellulitis in burn victims and patients with DM?

Pseudomonas aeruginosa

HepC tx: must perform psych eval before begging tx because ???, a component of the tx, has been shown to exacerbate psych disorders

Pegylated interferon

Tx of choice for HepC?

Pegylated interferon and Ribavirin

Screening test to detect diabetic nephropathy?

UA (*Microalbuminuria)

T or F: medial meniscal tears are more common than lateral meniscal tears

TRUE

Diagnostic study of choice to evaluate meniscal tears?

MRI

In alcoholics, thiamine deficiency (wernicke-Korsakoff syndrome) preferentially affects what brain structure?

Mamillary bodies

Blowing holosystolic murmur that radiates to axilla?

Mitral regurgitation

When the ACLS is torn, the ??? meniscus more commonly torn too

Lateral (otherwise MM is most common)

Potassium replenishment doses: oral? Central line? IV?

40. 20. 10.

For each 10 mEq of potassium given, the serum potassium level should rise by ??? mmol/L

0.1

Primary TB affects ??? lobes and is asymptomatic; secondary affects ??? lobes and presents with fevers, night sweats, weight loss

Lower; Upper

Painless glaucoma? Painful glaucoma?

Open-angle. Closed-angle.

Tendons affected in DeQuervains tenosynovitis?

Abductor policis longus & extensor pollicis brevis

Dx of obstructive sleep apnea via polysomnography:

At least 5 episodes of apnea with hypoxia per hour of sleep

Primary aldosteronism is a cause of secondary HTN that will present with:

Hypokalemia, metabolic alkalosis, low renin levels

T or F: NSAIDs are contraindicated in pregnancy

True

External hemorrhoids are ???, whereas internal hemorrhoids are ???

Painful; Painless

Type of dementia with characteristic visual hallucinations?

Lewy body dementia

Type of dementia with characteristic change in personality and inappropriate social conduct?

FTD or Picks dz

??? should be expected in a young, sexually active pt with arthritis, tenosynovitis, and a rash

Disseminated gonococcal arthritis

Four causes of microcytic anemia:

Thalassemia, Iron deficiency, Chronic dz, Sideroblastosis (TICS)

ABX for prophylaxis for pts with cardiac dz at risk of IE when undergoing invasive procedures?

Amoxicillin

Pain with climbing stairs, likely dx?

Patellofemoral syndrome

CKD leads to ???, and thereby elevated ???. Placing the pt at increased risk form osteoporosis and osteopenia

Hypocalcemia; PTH

Breath Hydrogen test: a hydrogen level > ?? is Dx of lactose intolerance

20 ppm

Psoriatic arthritis has classic ??? deformity of DIP and PIP joints

"Pencil in cup"

??? is commonly localized to the 2nd/3rd interdigital space, and commonly presents in pts wearing narrow shoes

Morton neuroma

Bisphosphonate MOA for osteoporosis tx?

Binds hydroxyapatite and inhibits osteoclasts

Most common tear in lateral epicondylitis?

Extensor Capri radialis brevis

Theater sign

Knee Pain after prolonged sitting (PFS)

Triad of reactive arthritis?

Urethritis, conjunctivitis, arthritis

Initial step in evaluation of pt with dementia?

MMSE

Most reliable way to improve HDL?

Exercise

Test of choice in establishing GERD?

24 hour pH monitoring

Surgery is indicated in AAA that are > ??? in diameter

5.5 cm

US surveillance of AAA's, how often for: AAA's 3-4 cm? AAA's 4-5.5 cm?

Every year. Every 6 mos

Tx pheochromocytomas with ???, followed by ???

Alpha blocker (phenoxybenzamine); Beta blockers

Prehns sign?

Epididymitis: relief of pain with testicular elevation

Watson test helps confirm a ??? fracture

Scaphoid

CHF breathing pattern characterized by cycles of apnea followed by hyperapnea

Cheyne-Stokes respirations

PFS is 2/2 weakness of ???

VMO (vastus medialis obliquus)

Popliteal cyst assoc. with chronic arthritis?

Bakers cyst

Best initial imaging for bakers cyst?

US; MRI too but more $$

First line treatments for CAP?

Macrolides, doxycycline, or fluoroquinolones

Tx of H. Pylori?

Omeprazole, metronidazole, tetracycline, bismuth subsalicylate

HgbA1C goal for diabetics?

Austin-Flint murmur?

Mid-diastolic rumble of aortic regurgitation

To prevent glucocorticoid-induced osteoporosis, thx pt with:

Vit D, calcium, bisphosphonates