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GEN IM Flashcards

1
Q

Treatment of PAD

A

Supervised exercise > Cilostazol > pentoxyfylline

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2
Q

In PAD, which med has decreased coronary events?

A

ACE-I

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3
Q

Criteria for PAD

A

ABI

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4
Q

Metabolic syndrome

Criteria for waist circumference

A

Men > 40 asian > 35

Women > 35 asian > 31

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5
Q

Metabolic syndrome

Criteria for TGAs

A

> 150

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6
Q

Metabolic syndrome

Criteria for low hdl

A

Men

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7
Q

Metabolic syndrome

Criteria for BP

A

BP > 130/85

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8
Q

Metabolic syndrome

Criteria for FBS

A

> 100

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9
Q

Treatment for obese stage 1

A

BMI > 30

Reduce diet by 500-1000 kcal/day then exercise

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10
Q

Treatment for obese stage 2

A

BMI > 35, If with risk factor (HTN, DM, Dyslipidemia, CHF, OSA)

BARIATRIC SURGERY

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11
Q

Treatment for morbid obesity

A

Bariatric surgery

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12
Q

vit deficiencies associated w/ bariatric surgery

A

Vit D (supplement w/ 5000 u/day), vit B12, copper, iron

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13
Q

T/F obesity increases risk of CA

A

Endometrial > breast, prostate, colon

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14
Q

Post bariatric px develops fever?

A

Consider anastomotic suture/staple leak

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15
Q

Post bariatric px starts gaining weight?

A

Consider gastrogastric fistula

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16
Q

How to feed bariatric px

A

ABW
1.2 g/kg of protein
11-14 g/kg of carbohydrates

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17
Q

Streaks/showers of floaters

A

Retinal detachment

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18
Q

Cherry red spot

A

CRAO

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19
Q

Multiple hemorrhages on fundoscopy in a hypercoagulable px

A

CRVO

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20
Q

Central vision blurry, peripheral vision spared

A

Macular degeneration

Tx:
Quit smoking
Antioxidant vitamins
magnefying glass

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21
Q

Mid dilated fixed pupil

A

Glaucoma

Tx: urgent referral; put pilocarpine before transfer

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22
Q

Hypopyon

A

Endophthalmitis

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23
Q

HSV 1 keratitis tx?

A

Trifluridine

Dendritic ulcer on fundoscopy

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24
Q

Pathology of chalazion

A

Obstruction of meibomian glands

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25
Q

Dxtic for cavernous sinus thrombosis

A

CT. If negative do MRV if suspicion high

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26
Q

AIDS px with cheese & ketchup appearance on fundoscopy

A

CMV retinitis

TX: ganciclovir

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27
Q

Tx of otitis externa

A

Polymyxin drops

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28
Q

Tx for malignant otitis externa

A

Cefepime + amikacin/tobramycin

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29
Q

Most common cause of viral conjunctivitis

A

Adenovirus

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30
Q

Tx for otitis media

A

Amoxicillin

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31
Q

Which med can cause delirium in elderly postop

A

Meperidine (demerol)

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32
Q

What to give for postop delirium?

A

Haldol

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33
Q

In alcoholics, + ataxia, nystagmus, confusion, diplopia

A

Wernicke’s syndrome

TX: Thiamine before glucose

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34
Q

In alcoholics, + confabulation, amnesia

A

Korsakoff’s syndrome

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35
Q

Tx for delirium tremens

A

Lorazepam - haldol - phenobarbital - propofol

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36
Q

At risk for alcoholism

A

Men: 4 drinks in one occasion
Women: 3 drinks

CAGE and AUDIT questionnaire

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37
Q

Best strategy for alcohol abuse

A

SBIRT

Screen, brief intervention, referral gor treatment

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38
Q

Best screening for chronic alcoholism

A

Carbohydrate free transferrin

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39
Q

Best tx for alcohol addiction in support group

A

Naltrexone

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40
Q

Whitish/grayish spots in conjunctiva

A

Vit A def

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41
Q

Nausea, vomiting, blurring of vision, hyperCa, blurring of disc margins on fundoscopy

A

Vit A toxicity

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42
Q

Constipation, dry mucous membranes, hyperCa

A

Vit D toxicity

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43
Q

Dementia, dermatitis, diarrhea

A

Pellagra

Niacin def

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44
Q

Diarrhea w/ Vertical lines on nails

A

Arsenic poisoning

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45
Q

Alopecia, hyperkeratotic rash, anemia

A

Zinc def

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46
Q

Cheilosis, glossitis, dermatitis

A

B2 def

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47
Q

Goiter/hypothyroidism

A

Iodine

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48
Q

Tea & toast diet, bleeding gums

A

Scurvy

Vit c def

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49
Q

Vit Deficiency causing cardiomyopathy, CHF

A

Hypophosphatemia, thiamine, selenium

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50
Q

MVP shows increased incidence in what psych d/o?

A

Panic disorder

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51
Q

Tx for generalized anxiety disorder

A

Buspirone

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52
Q

Tx for panic disorder

A

SSRI

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53
Q

Tx for OCD

A

SSRI: fluoxetine, fluvoxamine
TCA: clomipiramine

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54
Q

Tx for PTSD

A

SSRI, psychotherapy

55
Q

Tx of conversion d/o

A

Suggestible therapeutic modality

56
Q

Deliberate production of signs and symptoms

A

Factitious d/o

57
Q

Pathologic lying

A

Munchaussen’s syndrome

58
Q

Reproduction of symptoms for secondary gain

A

Malingering

59
Q

PE does not match multiple complaints

A

Somatization d/o

60
Q

SSRI with low lethal potential

A

Citalopram

61
Q

Duration of sx of depression to be classified as depression

A

> 2 weeks

If > 2 yrs, dysthmic d/o

62
Q

Most common cause of suicide

A

Depression

63
Q

First episode depression, duration of tx?

64
Q

When to expect effect of antidepressants

65
Q

When to shift antidepressants

66
Q

If depression recurrent

A

2 or more years

67
Q

Depression + enuresis tx

A

Imipramine

68
Q

Tx for panic disorder

A

Alprazoloma then SSRI

69
Q

OC disorder

A

Fluoxetine, fluvoxamine, chlomipramine

70
Q

Depression + chronic pain

A

Amitripryline

71
Q

Depression at insomnia

A

Amitriptyline

72
Q

Side effect of TCAs

A

Antichoinergic sx

Orthostatic hypotension

73
Q

Side effect of MAOis

A

HTNsive crisis

74
Q

Antidepressant to avoid in bulimia

75
Q

Depression + insomnia tx

A

Amitriptyline

76
Q

T/F SSRI can cause suicidal ideation

A

T

d/c drug

77
Q

Tx of hypothermia

A

Passive rewarming

78
Q

Tx of heat stroke

A

Evaporative cooling

79
Q

Px wants to quit but no quit date?

A

Begin varenecline

80
Q

Side effect of varenicline

A

Depression, suicidal ideation, psychosis

81
Q

Px has tried nicotine patches?

A

Try 2 methods; if ineffective– bupropion

82
Q

Side effect of bupropion

A

Seizures

*also never drug for bulimia

83
Q

T/F px with parhologic psych condition can be treated against their will

84
Q

Re Syphilis:

RPR +, manual FTA neg

85
Q

3 cardinal signs of brain death

A

Coma
Apnea
Absence of reflexes

86
Q

Palliative px w/ coarse rales

A

Give Glycopyrolate

87
Q

When not to use OCP

A 
Hx of DVT
CAD
HTN
Migraines
Smoker > 35 (use progestin only)
Breast CA
Chronic hepatitis
88
Q

Peliosis hepatis

A

Complication of OCP; blood filled cavities may rupture causing shock

Dx: CT
Tx: surgery

89
Q

OCP failure may occur w/ use of other drugs like

A

St John’s wort
Rifampicin
Tocilizumab

90
Q

Mild midcycle spotting w/ OCP

91
Q

Mod to severe midcycle bleeding w/ OCP

A

D/C and try IUD; or use higher dose of estrogen

92
Q

Classification of MS

A

Valve area
Mild > 1.5 cm
Mod 1-1.5 cm
Severe

93
Q

Px w/ ASD wants to get pregnant

A

If shunt > 2:1 – surgery first

94
Q

Contraindications to pregnancy

A 
Eisenmenger syndrome
Pulmonary HTN
Severe AS
Dilated CMP with CHF 
marfan's w/ dilated aortic root
95
Q

T/F can hocm and MVP get pregnant

96
Q

Anti-HTN drugs for pregnancy

A

Labetalol
Hydralazine
Methyldopa

97
Q

Anti-seizure medicine NOT to use in pregnancy

A

Valproic acid

98
Q

Drug for Grave’s dse in pregnancy

99
Q

Which drugs to use for itching in pregnancy

A

Hydroxyzine

Chlorpheniramine

100
Q

Best time to fly when pregnant

A

2nd trimester

101
Q

Tx for intrahepatic cholestasis of pregnancy

A

Cholestyramine

Ursodeoxycholic acid

102
Q

Tx for acute fattly liver of pregnancy

A

Delivery will resolve ab(N)

*inc LFTs, Bili, ammonia

103
Q

Antiseizure med safe in pregnancy

A

Carbamazepine, MgSO4

104
Q

What dose of warfarin is safe in pregnancy?

105
Q

Most aminoglycosides are unsafe in preg except

A

Gentamicin

106
Q

Most common cause of mortality in pregnancy

A

Postpartum endometritis

107
Q

Agent in postpartum endometritis?

A

Grp b strep

108
Q

When to give Ig in measles/varicella

A

W/in 1 week in measles

W/in 10 days in varicella

109
Q

Can an HIV mother breastfeed her baby

110
Q

Who should not receive live vaccines

A 
Immunocompromised pxs like
HIV
CLL/nonHodgkins lymphoma
CKD
Asplenia
Those on TNF alfa agents
111
Q

T/F if px is allergic to eggs can you give flu vaccine?

A

Yes as long as in hospital or MDs clinic

If w/ anaphylaxis, non-egg flublok

112
Q

Pressure ulcer st 2?

A

Shallow ulcer w/ pink bed

Tx: occlusive or semi-permeable dressing

113
Q

Tx for st 3-4 ulcers

A

Debridement & Antibiotics

114
Q

BPH + hematuria med

A

Finasteride

115
Q

Pathology of urge incontinence

A

Detrussor overactivity

Tx:
Weight loss
Timed bathroom breaks
Kegels
Anticholinergics (oxybutinin, tolterodine)
116
Q

Pathology of stress incontinence

A

Poor sphincter tone

Tx:
Weight loss
Kegel’s

117
Q

Pathology of overflow incontinence

A

Urethral obstruction/BPH
Detrussor underactivity

Tx:
Prostate vol 1.8 – finasteride + alfa blocker

Bethanechol

118
Q

Tx of vertebral compression fracture

A

Rehab + Analgesia

If no improvement in 1month, vertebroplasty

119
Q

Fall w/ nondisplaced femoral neck fracture

A

Surgery with pinning

120
Q

Fall w/ displaced femoral neck fracture

A

Total hip arthroplasty

121
Q

Fall w/ intertrichanteric fracture

A

Hip compression screws

122
Q

Major predictor of fracture fr fall

A

Osteoporosis

123
Q

Best test to predict mobility & falls

A

Timed get up and go test

– > 14 sec high risk of falls

124
Q

Normal MMSE score

125
Q

Tx for beta blocker poisoning

A

Glucagon

Epinephrine

126
Q

Tx for Ca channel poisoning

127
Q

Dxtic for organoPO4 poisoning

A

RBC cholinesterase level

128
Q

Tx for organoPO4 poisoning

A

Atropine

Pralidoxime

129
Q

Diff bet methamphetamine & ecstasy

A

Meth agitated but alert, ecstasy has mental status changes

Ecstasy has hypoNa

130
Q

Indications for electroconvulsive tx

A

Refractory depression
Suicidality
Catatonic state
Psychotic features

131
Q

Relative CI for ECT

A

MI
CHF
Aneurysm
COPD

132
Q

Tx of manic depressive

A

Lamotrigine

133
Q

Tx of bipolar

A

Lithium, valproic acid, atypical

Antipsychotic

134
Q

Side effect of lithium

A

Diabetes insipidus
Hypothyroidism
Hypercalcemia
Tremors

CARDIO (4 decks)

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