FM1 Flashcards

1
Q

PSVT - Heart rate 176 - tx?

A

iv adenosine / ablation

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2
Q

Aortic Regurgitation - Dx

A

diastolic mumur, high-pitched blowing murmur over LSB with wide pulse pressure

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3
Q

Pleural Effusion? Lung sounds

A

+ egophany, decreased resonance and TF

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4
Q

Erythema Multiforme - cause

A

HSVd

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5
Q

DM1 - Tx

A

Long acting insulin (GDD)
- Glargine
- Determir
- Degludec

Short acting insulin (LAG)
-Lispro
-Aspart
-Glulisine

Regular: Humulin

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6
Q

DM2 - Tx

A

1st - Metformin (Biguanides - liver production)
Sulfonureas - Glipizides - squeezes insulin out of pancreas
TZD: Pioglitazone, rosiglitazone - increased sensitivity in periphery (cant use in preg)
Alpha glucosidae inhibitors (acarbose- delays absorption)
GLP1 - suma”glutide”- increases glucose secretion
SGLP2 - “glaniflozin”s- pees out glucose
DPP4 - works as GLP1

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7
Q

kid blood sugar 550 and parents state AMS –>

A

DKA –> GIVE FLUIDS 1st then O2

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8
Q

Anterior Uveitis - Dx

A

Often seen in sarcoidosis - reddness of the eye + blurred vision, photophobia, tearing

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9
Q

Sudden loss of unilateral vision and has afib, painless

A

Retinal Vacular Occlusion - blood and thunder retina

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10
Q

Achalasia - tx - can only swallow foods with liquids

A

Esophageal dilation (heller myotomy)

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11
Q

Cholangiocarcinoma - epigastric pain that radiates to the back

A

Bile duct cancer –> itchy, light colored stools,

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12
Q

apthous ulcers often seen in >

A

Chrons

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13
Q

UC vs Chrons - Dx

A

Chrons: skip lesions, transmural, mouth to anus + ASCA – tx: Melassamine

UC: Curable, BLOODY DIARRHEA, rectum (NO COLONOSCOPY) + PANCA - tx: resection

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14
Q

Hepatocellular carcinoma - Etiology?

A

hep b & hep c

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15
Q

Intussuception- sc -

A

torsion with mesenteric artery - telescoping of the bowel

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16
Q

Sickle Cell Anemia - HM ?

A

Anti-inflammatories and Fluids
IF fever –> (ceftriaxone, ampicillin)

PREVENTATIVE: PCN Prophylaxis

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17
Q

Polycythemia Vera - SC - long term phlebotomy risk

A

All cell lines increased (JAK2 Mutations)
vitamin def

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18
Q

Salmonellosis - from eggs - “pea soup” tx

A

ciprofloxacin (FQs)

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19
Q

Mono - H/P

A

HHP4
Transmission = saliva
no sports 3-4 weeks

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20
Q

OA: Tx

A

Lose weight, Tylenol, NSAIDs , Capsaicin, duloxetie, intraarticular steroids, compromised fusion = joint replacement

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21
Q

RA: DxS
Symmetrical joint pain, DIP, MCP, knees, feet, hands, ulnar deviation

A

RF +
Anti-CCP (MOST SPECIFIC)
Anti-cyclic citrullinated peptide

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22
Q

MDD - tx

A

ssri

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23
Q

Lung cancer locations :

A

Peripheral:
- “S”
Central:
-

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24
Q

solitary pulmonary nodule - 7mm / 23mm

A

<6 = no F/U
6-8 = F/U 6=12 months
>8 = F/U every 3, 8, 18 months = PET scan

Any growth needs a BIOPSY
No growth = CT every 2 yrs

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25
Q

TB - DxS

A

CXR = Cavitary lesions in upper lungs
Sputum Culture (GOLD) = acid/fast stain bacillis rods - NAAT

Skin test
Quant gold

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26
Q

Orbital Cellulitis - Dx Imaging - red, hot swollen eye,

A

CT of orbits

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27
Q

Prostatitis - H/P - enlarged, boggy prostate - complications?

A

UTIs, dysfunction, etc.

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28
Q

CKD - S/C - Long term cause

A

DM

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29
Q

WPW syndrome/DELTA WAVE - Clinical Tx

A

Stable: IV procainimide
Unstable: Cardiovert
**Catheter Ablation **if needed

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30
Q

Dilated Cardiomyopathy - all ventricles are enlarged, tx

A

ACE, ARB, BB, Entresto (Sacubitril/Valsartan)

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31
Q

HTN - tx

A

Wt loss, DASH diet, stop smoking, decrease salt intake

ACE, ARB, BB, thiazide diuretics (HCTZ, chlorthalidone, indapamide)

CAD - ACE + BB
Gout - no thiazide diuretics
CKD/T2DM - ACE
AA - HCTZ
Post MI - ACE, BB

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32
Q

Giardiasis Tx (camping and drink stream water - diarrhea)

A

Metrodinazole

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33
Q

Reactive Arthritis - dx

A

conjunctivitis, uveitis, joint pain

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34
Q

COPD - tx

A

LABA
tiotropium
aclidinium
umeclidiniun
/
LAMA
salmeterol
formoterol
arformoterol

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35
Q

COPD - risk factor

A

smoking

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36
Q

TB - h/p

A

immunosuppression, close quarters, drug use, fever/weight loss/night sweats/bloody sputum

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37
Q

Renal Calculi (nephrolithiasis) - size / tx

A

<5mm = fluids, pain meds
5-10mm = shock wave lithotripsy/uretoscopy/stent
>10mm = percu nephrolithomy

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38
Q

Heart Sounds
- Systolic:
- Diastolic:

A

S3
S4

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39
Q

Prostatitis tx - boggy, tender prostate, fever

A

> 35 ciprofloxacin/bactrim
<35 ceftriaxone/doxy (std)

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40
Q

Tactile fremitus and egophany meaning

A

TF - pneumonia
egophany - consolidation/fluid

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41
Q

hyperresonance meaning

A

air in lungs

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42
Q

Hilar lymphadopathy

A

Sarcoidosis - granulomas + predisone +/-DMARDS

or TB

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43
Q

AMD (eye)

A

loss of central vision
DRY: gradual, age-related - drusen bodies
WET: sudden, new vessels form

Fluorescent stain/Amsler grid

DRY tx: VITAMIN E, C + ZINC
WET tx: VEGF inhibitors - BEVACIZUMAB) - inhibits blood cell formation

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44
Q

Cotton Wool/Flame Hemorrhages

A

diabetic & HTN retinopathy

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45
Q

DM screenings, yearly exams

A

annual eye exam, lipids
microalbumin once yearly
a1c every 3 months
4-6 months = foot exam

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46
Q

Cystocele, Rectocele - tx

A

anterior
posterior
tx- pessary

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47
Q

STD - males - tx
Uretritis = sudden onset of yellow, white, discharge

Epididmysis = testicle pain +Prehn sign, unilateral

Prostatitis = boggy, tender prostate, fever, urinary symptoms

A

Chylamdyia: Doxy
Gonorrhea: Ceftriaxone

<35 = treat for C/G

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48
Q

STD - females - tx

A

Chylamdyia: Doxy
Gonorrhea: Ceftriaxone
BV: Metrodinazole (FISHY + whiff test - clue cells)
Trich: Metrodinazole (GREEN/Yellow + Strawberry Cervix)
Cand: Fluconazole

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49
Q

What increased HIV transmission risk

A

Genital herpes

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50
Q

OCP moa

A

prevents ovulation

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51
Q

BP medications

A

ACE (lisinopril)
ARB (losartan)
BB
CCB
Thiazide Diuretics (HCTZ)

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52
Q

resistance htn causes, Dx, tx

A

from the kidneys (renal artery stenosis, renal parechyema disease)

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53
Q

Thyroid disorders
Graves
Hosimotos

A

hyper: TSH low, T3/T4 high
+ TSH receptor antibody
tx: PTU (1st trimester -12 weeks). Methimazole
- Radioactive iodine

hypo: TSH high, T3/T4 low
+ Anti-Thyroid Peroxidase + Anti Thyroid globulin Ab
tx: levothyroidine

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54
Q

adrenal disorders

A

Addisons “adrenal insufficiency”: Low cortisol
- Low Cortisol and Aldosterone
–> AM cortisol
–> Cosyntropin stim test (artifical acth)
- Prim: Addisons - gland problem = will not elevate
- Sec = pituitary problem = will elevate
TX: Hydrocortisone + Fludrocorisone

Cushings: High cortisol (from steroid use)
–> 24 hr urine free cortisol
–> LOW Dose Dex Suppression test
- Cushings SYN = will elevate
- Cushingd Dz = will not rise
–> High dose Dex Suppression
- Cushings dz = Will rise

Tx: Transphenoid surgery

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55
Q

anorexia/bulimia

A

anorexia: wants to be smaller
- under weight, high cholesterol
tx: fix weight

bulimia: does not like they are like this - normal/over weight
- binge purge cycles = tx: fluoxetine

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56
Q

GAD tx

A

SSRI

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57
Q

Pterygium

A

triangle shape tissue on medial corner of the eye to the corena

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58
Q

Mumps

A

Orchitis - testicular pain with cervical lymphadopathy

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59
Q

Mass in upper lobe of lungs + Cough

A

TB

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60
Q

30 pack year smoker – now coughing up blood -

A

cancer

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61
Q

Hordelum? tx

A

Bump on nose beneath eye that exudates pus - self limiting with warm compress

Cephalexin if needed

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62
Q

PID tx

A

Ceftriaxone + Doxy

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63
Q

Tamsulosin used for
- MOA

A

BPH
Alpha blocker, reduces symptoms
Finesteride reduces SIZE (5-alpha reductase)

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64
Q

Initial med for high A1C =

A

Metformin

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65
Q

C/I with seizures

A

Wellbutrin/Buproprion

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66
Q

Male with gynecomastia, fatigue, etc - cause

A

high prolactin? (Spironolactone)
Adenocarcinoma (lung cancer)
Cirrhosis (hypogonadism)
H2 blockers
Risperidone

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67
Q

Cause of otitis externa

A

Pseudomonas

68
Q

Otitis media tx

A

Amoxicillin

69
Q

tx resistance otitis media

A

Augmentin –> Azithro

70
Q

Schizophrenia symp

A

auditory hallucinations

71
Q

Foreign body aspiration

A

Rt main bronchi

72
Q

If BP if 220/120 - first initial tx

A

If no EOD = Clondine
If EOD = Nitroprusside

73
Q

Delta wave on EKG - tx

A

WPW = ablation

74
Q

Bloody diarrhea

A

shigella

75
Q

lymes disease presentation

A

bulls eye rash

76
Q

MC cause of cdiff

A

Levo/Ciprofloxacin

77
Q

VonWillie prolongs/decreases the half life of which factor?

bleeding, petechiae, etc.

A

Prolongs PT/PTT
Tx: Desmopressin

78
Q

Polycythemia vera tx

A

phyelbotomy

79
Q

Male with bilateral hydronephrosis tx

A

catheter, stent?

80
Q

Penis discharge cause/treatment

A

Ceftriaxone/Doxy

81
Q

Unilateral CVA tenderness + UA with blood –> kidney stone ? next step ? image

A

ct non- contrast
UA

82
Q

Yellow spots on retinas from ?

Xanthomas are on the SKIN from

A

Drusen Spots from macular degeneration
High cholesterol

83
Q

Avoid what drug in 3rd trimester of pregnancy?

A

Nitro

84
Q

DEXA screening starts at age

A

65

85
Q

First line tx for IBS

A

fiber, low fodmap

86
Q

pain, multiple trigger points

A

fibromyalgia

87
Q

definitive tx for heart block

A

pacemaker

88
Q

reducing alcohol cravings

A

Naltrexone

89
Q

Hebreden nodes vs Brouchard nodes with OA

A

He, Bo, He (DIP, PIP, MCP)

90
Q

tx for retropharyngeal abscess

A

surgical I&D + abx (clinda or amp/sulba)

91
Q

tx lymes

A

doxy

92
Q

Abortion types:
- Closed os + intact POC + bleeding
- open os + poc intact
- open os + poc expelled
- Closed os + poc expelled
- closed os + intact POC (no bleeding)

A
  • threatened
  • inevitable
    -incomplete
    -complete
    -missed
93
Q

Gastritis

A

gerd like symtoms
H.Pylori and NSAIDS
Endoscopy WITH BIOPSY

94
Q

What meds are C/I in ulcers

A

NSAIDs

95
Q

MCC of community acquired pneumonia

A

strep pneumo

96
Q

Indirect Hernia

A

bowel protrudes into inguinal canal

97
Q

Direct Hernia

A

does not enter the inguinal canal
Hesselbach triad

98
Q

Rash over kids body

A

viral exanthem

99
Q

folate deficiency in

A

alcoholics

100
Q

tx for fibromyalgia

A

duloxetine or amitriptyline

101
Q

elderly with broken fx from fall needs a ?

A

DEXA scan

102
Q

When will lateral epicondlytis hurt

A

wrist extension

103
Q

Lithotripsy complication (breaks up kidney stones)

A

UTI

104
Q

What diagnostic test needed for stable angina

A

stress test

105
Q

heart failure s/s

A

dyspnea, orthopnea, sob, cough

106
Q

coronary stents need what other meds -

A

Aspirin,Clopidogrel,BB, statins ?

107
Q

ITP symps

A

autoimmune reaction against the platelets
KIDS
bleeding gums brushing teeth, petechiae, bruising, etc.
TX: Observe

108
Q

Cushings dx

A

abdominal strae, buffalo hump,

109
Q

Ataxia, vomitting, headaches -

A

papilledema??
acustic neuroma

110
Q

Ptgerium

A

tissue growth on median portion of eye

111
Q

Long term Macular degeneration

A

hard exudates, drusen, nicking

112
Q

1st line tx for allergies

A

Fexofenadine

113
Q

bph 1st line -

A

alpha blockers - tamsulosin

114
Q

coarctation of the aorta

A

femoral pulses are weaker than brachial
systolic murmur radiates to the back

115
Q

mitral stenosis

A

mid-diastolic rumbling murmur with opening snap - at apex
rheumatic heart ds

116
Q

What murmurs increase with valsalva? the others decrease

A

MVP, Hypertrophic Cardiomyopathy

117
Q

PVD tx

A

compression socks

118
Q

PAD need dx

A

ABI

119
Q

HLAB27 is seen in

A

Reactive Arthritis

tx: nsaids

120
Q

Treatment for bacterial sinusitis over 10 days + worse + purulent d/c

A

amoxi, augmentin, azithromycin

121
Q

Labyrinthitis

A

Continuous tinnitus and hearing loss after a URI

122
Q

Bells Palsy Tx

A

Prednisone

123
Q

Umbilicated Papules cause

A

molluscum contagiosum

124
Q

tension ha

A

band around head

125
Q

lichen planus tx

A

inflammatory dermatitis after (hep C)
itchy rash on extremitits, volar wrist and ankles
6 p’s: purple puritic polygonal, planar, plaques/papules
tx: STEROIDS

126
Q

Erysipelas dx

A

like cellulitis (red, hot, raised), but well-defined borders
often on face
Tx: PCN, Amoxi, Cephalexin

127
Q

Macular degeneration h/p

A

central vision loss

128
Q

CML DxS

A

phil chromosome

129
Q

Vitamin K def

A

easy bleeding, bruising
malabsorption: chrons, UC, gastric bypass

130
Q

Giant Cell Arterits tx

A

jaw pain, temporal pain, loss of vision in one eye
polymyalgia rheumatica (narrowed blood flow)

prednisone

131
Q

Threatened abortion h/p

A

closed os, bleeding, POC in womb

132
Q

Neprolithiasis tx

A

<5 = observe and fluids
>5 = stent

133
Q

Psoriasis tx/hm

A

topical steroids
Calcipotriene (vit d)
phototherapy

134
Q

Graves S/C

A

autoimmune - tsh receptor antibodies cause increased thyroid hormone synthesis, release, increased thyroid growth

135
Q

Vitreous hemorrhage - hm

A

diabetic retinopathy - neovascular - tx Bevacizumab (VEGF inhibitors), control glucose

136
Q

peritonsillar abcess - h/p

A

hot potato voice, deviated uvela

137
Q

diabetic proliferative retinopathy - s/c

A

growth of new abnormal vessles that can lead to viterous hemorrhage = neovascularization

138
Q

bowel obstruction c/i

A

SMALL = adhesions = ng tube suction, NPO, bowel rest
LARGE = cancer = Surgery

139
Q

PUD - tx

A

H.Pylori = CAP
Cipro, Amoxi, PPI

neg HP = H2 blocker, PPI

140
Q

Cirrhosis - dx

A

scarring of the liver
cramps, bruising, itching, hypogonadism (gynecomastia), fatigue, JAUNDRICE, telangiectasia, Hepatomegaly

Increased Bilirubin, increased AST, Alk Phos, decreased Albumin, increased GGT

141
Q

Pancreatitis - dx

A

elevated lipase
LUQ pain, radiates to back, worse laying down, better sitting forward - umbilical bruising, flank bruising

142
Q

Hemophilia a - dx

A

kid, bruises on knees = Factor 8 = prolonged PTT

143
Q

hodgkins lymphoma - h/m

A

lymph tumors in the upper portion of the body, weight loss, fatigue
Reed Stenburg (owl eyes)

tx: CHEMO and radiation
stem cell transplant

144
Q

partial seizure - dxs

A

Head CT
EEG
Prolactin/Lactic acid

145
Q

temporal arteritis - dxs

A

temporal biopsy

146
Q

RA tx

A

DMARDs (Methotrexate)

147
Q

Dementia - h/m

A

exercise, vitamin E
Cholinesterase Inhibitors: Donepezil, Rivastgmine, Galatamine

148
Q

Primary TB tx

A

asymptomatic pt with no xray findings

Rifampin
isonizide

149
Q

compartment syndrome - dx

A

The “5 P’s”: pain, pallor (pale skin tone), paresthesia (numbness feeling), pulselessness (faint pulse) and paralysis (weakness with movements).

150
Q

appendicitis - dx s

A

ct abdomen

151
Q

BPH - cI and tx

A

alpha blockers - tamsulosin
5alpha reductase inhibitors - finesteride

152
Q

erythema multiform - dx

A

after HSV or drug - red, target shaped lesions all over the body

153
Q

IBD - ctx

A

UC = Mesalamine
C = steroids - TNF (mab)

154
Q

polycythemia vera - s/c

A

chronic leukemia (blood cancer) that causes your bone marrow to produce too many red blood cells (all cell lines increased)

155
Q

spontaneous abortion - h/m

A

<16 wks = D&C
>16 wks = Dilate and evacuate

156
Q

mallot finger - s/c

A

DIP ligament tear

157
Q

radial head sublux - c/i

A

supination-flexion technique

158
Q

molluscus contagiosum - dx - s/c

A

pox virus
waxy, pearly white papules with central umbilication

159
Q

allergic rhinitis tx

A

hype I hypersensitivity reaction
intranasal steroid (Flonase/ fluticonisone)
H2 blockers (loratidine/ claritin)

160
Q

placenta abruption - dx

A

3rd trimester bleeding PAINFUL + abdominal pain

premature placenta seperation

161
Q

PTSD - tx

A

Sertraline, Paxil

162
Q

prostatitis - h/p

A

boggy, tender prostate, fever

163
Q

myasthenia gravis - dx

A

Ach depletion, muscle weakness, eye drooping throughout the day
hard to speak, swallow, fatigue, weakness

164
Q

familial hypercholesterolemia s/c

A

hereditary - defect in chromosome 19 - cannot remove LDL from body, LDL builds up

164
Q

alzeihmer h/p

A

gradual loss on memory -
short term loss 1st
may have strokes