FM Shelf Flashcards
Initial monotherapy for HTN in diabetics/CKD?
ACE inhibitor or an ARB
Initial monotherapy for HTN in blacks?
Thiazide or long acting CCB
Innocent murmur that is described as vibratory or musical?
Still’s murmur
Osteoporosis is defined by T score below ??? on a DEXA scan
-2.5
Metformin cannot be used in patients with a GFR less than ??
30 mL/min
Most common cause of secondary HTN?
Renal artery stenosis
??? are contraindicated in tx of HTN 2/2 bilateral renal artery stenosis
ACE inhibitors (but preferred if unilateral)
??? diuretics aggravate gout by inhibiting secretion of uric acid
Thiazides (HCTZ)
??? are routinely followed for anyone on a statin
LFTs
What BP med has shown to reduce mortality in post MI pts?
ACE Inhibitors and Beta blockers (also used in CHF pts)
HCOM presents as a systolic murmur that ??? in intensity with a Valsalva maneuver
Increases
To decrease intensity of HCOM murmur, must ??? preload
Increase. (Via beta blockers)
Likely dx: increased TIBC and RDW, decreased serum iron and ferritin
Fe deficiency anemia
Lateral epicondylitis pain can be reproduced with resisted wrist ???
Extension
Compartment syndrome is a surgical emergency, often presenting after trauma and associated with the 6 P’s:
Pain, paresthesia, pallor, paralysis, pulselessness, poikilothermia
Sequence of ligamentous injury during inversion ankle sprains:
ATF, CF, PTF
Electrolyte abnormality after severe diarrhea? After sever vomiting?
Diarrhea: hypokalemia and metabolic ACIDOSIS. Vomiting: hypokalemia and metabolic ALKALOSIS
To decrease ammonia levels in hepatic encephalopathy, pts are started on:
Lactulose, neomycin, and a LOW protein diet
ABX for Lyme disease?
Doxycycline
Symptomatic bradycardia tx?
Atropine
??? is characterized by ipsilateral loss of vibration/paralysis, and contralateral loss of pain and temperature
Brown-Sequard syndrome
Gout: acute tx? Prophylaxis?
NSAIDs (Indomethacin), colchicine, steroids; Allopurinol
Aspiration pneumonia is most often caused by ???
Anaerobic bacteria
Elderly pts with pneumonia, likely cause?
Strep pneumoniae
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?
- 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