FM1 Flashcards
PSVT - Heart rate 176 - tx?
iv adenosine / ablation
Aortic Regurgitation - Dx
diastolic mumur, high-pitched blowing murmur over LSB with wide pulse pressure
Pleural Effusion? Lung sounds
+ egophany, decreased resonance and TF
Erythema Multiforme - cause
HSVd
DM1 - Tx
Long acting insulin (GDD)
- Glargine
- Determir
- Degludec
Short acting insulin (LAG)
-Lispro
-Aspart
-Glulisine
Regular: Humulin
DM2 - Tx
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
kid blood sugar 550 and parents state AMS –>
DKA –> GIVE FLUIDS 1st then O2
Anterior Uveitis - Dx
Often seen in sarcoidosis - reddness of the eye + blurred vision, photophobia, tearing
Sudden loss of unilateral vision and has afib, painless
Retinal Vacular Occlusion - blood and thunder retina
Achalasia - tx - can only swallow foods with liquids
Esophageal dilation (heller myotomy)
Cholangiocarcinoma - epigastric pain that radiates to the back
Bile duct cancer –> itchy, light colored stools,
apthous ulcers often seen in >
Chrons
UC vs Chrons - Dx
Chrons: skip lesions, transmural, mouth to anus + ASCA – tx: Melassamine
UC: Curable, BLOODY DIARRHEA, rectum (NO COLONOSCOPY) + PANCA - tx: resection
Hepatocellular carcinoma - Etiology?
hep b & hep c
Intussuception- sc -
torsion with mesenteric artery - telescoping of the bowel
Sickle Cell Anemia - HM ?
Anti-inflammatories and Fluids
IF fever –> (ceftriaxone, ampicillin)
PREVENTATIVE: PCN Prophylaxis
Polycythemia Vera - SC - long term phlebotomy risk
All cell lines increased (JAK2 Mutations)
vitamin def
Salmonellosis - from eggs - “pea soup” tx
ciprofloxacin (FQs)
Mono - H/P
HHP4
Transmission = saliva
no sports 3-4 weeks
OA: Tx
Lose weight, Tylenol, NSAIDs , Capsaicin, duloxetie, intraarticular steroids, compromised fusion = joint replacement
RA: DxS
Symmetrical joint pain, DIP, MCP, knees, feet, hands, ulnar deviation
RF +
Anti-CCP (MOST SPECIFIC)
Anti-cyclic citrullinated peptide
MDD - tx
ssri
Lung cancer locations :
Peripheral:
- “S”
Central:
-
solitary pulmonary nodule - 7mm / 23mm
<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
TB - DxS
CXR = Cavitary lesions in upper lungs
Sputum Culture (GOLD) = acid/fast stain bacillis rods - NAAT
Skin test
Quant gold
Orbital Cellulitis - Dx Imaging - red, hot swollen eye,
CT of orbits
Prostatitis - H/P - enlarged, boggy prostate - complications?
UTIs, dysfunction, etc.
CKD - S/C - Long term cause
DM
WPW syndrome/DELTA WAVE - Clinical Tx
Stable: IV procainimide
Unstable: Cardiovert
**Catheter Ablation **if needed
Dilated Cardiomyopathy - all ventricles are enlarged, tx
ACE, ARB, BB, Entresto (Sacubitril/Valsartan)
HTN - tx
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
Giardiasis Tx (camping and drink stream water - diarrhea)
Metrodinazole
Reactive Arthritis - dx
conjunctivitis, uveitis, joint pain
COPD - tx
LABA
tiotropium
aclidinium
umeclidiniun
/
LAMA
salmeterol
formoterol
arformoterol
COPD - risk factor
smoking
TB - h/p
immunosuppression, close quarters, drug use, fever/weight loss/night sweats/bloody sputum
Renal Calculi (nephrolithiasis) - size / tx
<5mm = fluids, pain meds
5-10mm = shock wave lithotripsy/uretoscopy/stent
>10mm = percu nephrolithomy
Heart Sounds
- Systolic:
- Diastolic:
S3
S4
Prostatitis tx - boggy, tender prostate, fever
> 35 ciprofloxacin/bactrim
<35 ceftriaxone/doxy (std)
Tactile fremitus and egophany meaning
TF - pneumonia
egophany - consolidation/fluid
hyperresonance meaning
air in lungs
Hilar lymphadopathy
Sarcoidosis - granulomas + predisone +/-DMARDS
or TB
AMD (eye)
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
Cotton Wool/Flame Hemorrhages
diabetic & HTN retinopathy
DM screenings, yearly exams
annual eye exam, lipids
microalbumin once yearly
a1c every 3 months
4-6 months = foot exam
Cystocele, Rectocele - tx
anterior
posterior
tx- pessary
STD - males - tx
Uretritis = sudden onset of yellow, white, discharge
Epididmysis = testicle pain +Prehn sign, unilateral
Prostatitis = boggy, tender prostate, fever, urinary symptoms
Chylamdyia: Doxy
Gonorrhea: Ceftriaxone
<35 = treat for C/G
STD - females - tx
Chylamdyia: Doxy
Gonorrhea: Ceftriaxone
BV: Metrodinazole (FISHY + whiff test - clue cells)
Trich: Metrodinazole (GREEN/Yellow + Strawberry Cervix)
Cand: Fluconazole
What increased HIV transmission risk
Genital herpes
OCP moa
prevents ovulation
BP medications
ACE (lisinopril)
ARB (losartan)
BB
CCB
Thiazide Diuretics (HCTZ)
resistance htn causes, Dx, tx
from the kidneys (renal artery stenosis, renal parechyema disease)
Thyroid disorders
Graves
Hosimotos
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
adrenal disorders
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
anorexia/bulimia
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
GAD tx
SSRI
Pterygium
triangle shape tissue on medial corner of the eye to the corena
Mumps
Orchitis - testicular pain with cervical lymphadopathy
Mass in upper lobe of lungs + Cough
TB
30 pack year smoker – now coughing up blood -
cancer
Hordelum? tx
Bump on nose beneath eye that exudates pus - self limiting with warm compress
Cephalexin if needed
PID tx
Ceftriaxone + Doxy
Tamsulosin used for
- MOA
BPH
Alpha blocker, reduces symptoms
Finesteride reduces SIZE (5-alpha reductase)
Initial med for high A1C =
Metformin
C/I with seizures
Wellbutrin/Buproprion
Male with gynecomastia, fatigue, etc - cause
high prolactin? (Spironolactone)
Adenocarcinoma (lung cancer)
Cirrhosis (hypogonadism)
H2 blockers
Risperidone