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Internal Medicine > General IM/CTU > Flashcards

General IM/CTU Flashcards

1
Q

What is the dose for epinephrine for anaphylaxis (IM)?

A

0.3-0.5 mg for a 1 mg/mL formulation. Repeat q5-15 min as needed

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2
Q

What is the pattern of homocysteine and MMA in folate and B12 deficiency?

A

Homocysteine elevated in both

MMA only elevated in B12 deficiency

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3
Q

What is the initial treatment and doses of a 60M who presents with meningitis of unknown etiology (microbiology wise)?

A

Dexamethasone 10 mg IV q6h (0.15 mg/kg per dose q6h) for 2-4 days (first or WITH first dose of antibiotics)

Ceftriaxone 2g IV q12 h (give first)
Vancomycin 750 mg in q6h (load and maintenance according to kg)
Ampicillin 2g Iv q4h
Acyclovir 10 mg/kg IV q8h

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4
Q

What three beta blockers are used in chf?

A

Bisoprolol, carvedilol, long acting metoprolol

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5
Q

What is a paradoxically split S2 and which conditions is it seen in?

A

S2 is split in expiration (P2 then A2 closes second) and no split in inspiration.

Seen in conditions that prolong LV emptying like severe aortic stenosis and LBBB and HOCM

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6
Q

What time from last drink can someone experience alcohol withdrawal seizures?

A

6-48 hours

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7
Q

What time from last drink can alcohol hallucinosis develop?

A

12-24 hours

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8
Q

What time since the last drink can alcohol withdrawal delirium develop?

A

72-96 hours

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9
Q

GABA is an excitatory or inhibitory neurotransmitter?

A

Inhibitory

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10
Q

SPICE HAM organisms are which?

A 
Serratia
Providencia
Indolent + proteus
Citrobacter
Enterobacter
Hafnia
Acinetobacter
Morganella
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11
Q

What antibiotics should be used for SPICE HAM organisms?

A

Carbapenums
Septra
Fluroquinolones
Aminoglycosides (if sensitive)

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12
Q

ESBL E.coli or Klebsiella should be treated with what antibiotics?

A

Carbapenums
Septra
Fluoroquinolones
Aminoglycosides (if sensitive)

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13
Q

What antibiotics cover MRSA

A 
Vancomycin
Doxycycline (tetracycline)
Septra
Clindamycin 
Linezolid
Daptomycin
Ceftobiprole (5th generation cephalosporin)
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14
Q

What antibiotics cover pseudomonas?

A 
Pip tazo
Ceftazidime (3rd gen cephalosporin)
Cefepime (4th gen cephalosporin)
Meropenum
Imipenum
Cipro flows in
Aminoglycosides 
Aztreonam
Colistin
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15
Q

What covers enterococcus bacteria?

A

Vancomycin (except if it’s VRE)
Linezolid
Daptomycin

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16
Q

In general (there are exceptions), which bugs ARE NOT covered by cephalosporins?

A

Listeria
Atypicals (mycoplasma/chlamydia)
MRSA
Enterococcus

17
Q

What are the 5 minor criteria for duke’s criteria of IE?

A
  1. Predisposition such as heart condition or IVDU
  2. Fever > 38
  3. Vascular phenomena
  4. Immunologic phenomena
  5. Positive blood culture not meeting major criteria (excluded single positive cultures for cons or other organisms that don’t cause endocarditis)
18
Q

What are the 4 immunologic phenomena that count as part of duke phenomena (IE)

A
  1. Glomerulonephritis
  2. Osler node
  3. Roth spots
  4. Positive RF
19
Q

What are the major criteria from Duke Criteria (IE)?

A
  1. Persistently positive blood cultures for organisms typical for IE from 2 separate blood cultures (>12 h apart)
  2. Coxiella burnetii positive blood culture
  3. Echo showing mass/vegetation, paravalvular abscess, new or worsening valvular regurgitation, valve dehiscence
20
Q

What cardiac conditions have a positive Kussmaul’s sign?

A 
Constrictive pericarditis
Restrictive cardiomyopathy
Right ventricular myocardial infarction
Massive pulmonary embolism
Severe pulmonary hypertension
Right heart failure
Right-sides cardiac tumors 
Superior vena cava obstruction
21
Q

What is the first line treatment of hypertrophic cardiomyopathy?

A

Beta blockers

Avoid hyovolemia as well

22
Q

What CD4 count should you start prophylaxis for PJP in HIV infected individuals?
What do you use for prophylaxis?

A
  1. <200
  2. Septra 1 DS or SS Po fab daily

Alternatives:

  • septra 1 DS M/W/F
  • dapsone (not in G6PD of if SJS to septra. Okay if Sulfa allergy)
  • Atovaquone
  • aerosalized pentamidine monthly
23
Q

What level of CD4 should you start prophylaxis for toxoplasma and what do you use?

A
  1. <100
  2. Septra 1 DS Po daily or dapsone or atovaquone +/- pyrimethamine/leucovorin

Alternatives include septra 1 DS MWF or septra 1 SS daily

24
Q

What level of CD4 should you start prophylaxis for MAC and what do you use?

A
  1. <50
  2. Azithro my in 1200 mg Po weekly or clarithro my in 500 mg Po bid

Alternative is rifabutin

25
Q

What is the treatment for dystonic reactions secondary to medications (e.g. haldol)?

A

Benztropine/Cogentin 1-2 mg IV followed by 1-2 mg daily to BID po

Benadryl/Diphenhydramine 25-50 mg IV x 1 followed by 25-50 mg q 4-8 hours

26
Q

Sarcoidosis has caseating or non-caseating granulomas?

A

Non-caseating (usually)

Internal Medicine (5 decks)

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