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ABR > General Medicine > Flashcards

General Medicine Flashcards

1
Q

ABI (LE SBP/UE SBP) < 0.9
1.0
> 1.3

A

< 0.9: Diagnostic for PAD
1.0: normal
> 1.3: arteriosclerosis

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2
Q

Next step after inconclusive ABI

A

Exercise ABI

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3
Q

Management for PVD with intermittent clarification

A

Supervised exercise program

Cilostazol + statin

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4
Q

Post gastric bypass surgery
Nystagmus
Ophthalmoplegia

A

Thiamine deficiency

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5
Q

Bariatric surgery
Microcytic anemia
Blast cells and ring sideroblasts

A

Copper deficiency

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6
Q

Bariatric surgery

Macrocytic anemia

A

B12 deficiency

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7
Q

Bariatric surgery

Cardiomyopathy

A

Selenium deficiency

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8
Q

Flashes/streaks of light
Black dots, wavy curtains
Cobwebs

A

Retinal detachment

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9
Q

Sudden onset of painless vision loss

Cherry red spot in macula

A

Retinal artery occlusion

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10
Q

Sudden painless vision loss

Multiple hemorrhages on fundoscopy

A

Retinal vein occlusion

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11
Q

Edge of phone or door is blurry

Yellowish spots on fundoscopy

A

Macular degeneration

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12
Q

Management for a-v nicking on fundoscopy

A

Anti-hypertensive

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13
Q

DM
Mild vision loss
Fundoscopy with Aneurysms, hemorrhages and exudates

Management

A

Dx: non-proliferation or background retinopathy with macular edema

Tx: tighter glycemic control (A1c < 6.5)

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14
Q

DM
Blurry vision
Fundoscopy with neovascularization

Management

A

Dx: proliferative DM retinopathy

Tx: Laser therapy

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15
Q

Headache. Blurry vision
Mid-dilated pupil. Sluggishly reactive
Ciliary flush. Hazy cornea

A

Glaucoma

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16
Q

crystals in retinal artery on fundoscopy

Next diagnostic step

A

Infective endocarditis

Carotid duplex US

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17
Q

Difficulty driving at night
Glare from oncoming traffic
Difficulty reading road signs

A

Cataract

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18
Q

Layering of WBCs (“white deposits”) in anterior chamber

Intraocular WBCs on slit-lamp

A

Endophthalmitis

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19
Q

Conjunctivitis

Thick discharge

A

Bacterial

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20
Q

Conjunctivitis

Gritty/sandy or burning eye

A

Viral

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21
Q

Conjunctivitis
Watery discharge
Itching

A

Allergic

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22
Q

Uveitis

Redness, pain, photophobia, +/- miosis, blurry vision

A

Anterior uveitis

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23
Q

Uveitis

Only blurry vision

A

Posterior uveitis

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24
Q

Dendritic ulcer (branching pattern) with fluorescein stain positive on corneal exam

A

HSV 1 keratitis

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25
Q

Redness in eye on mechanical ventilation Also with contact lenses

A

Pseudomonas keratitis

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26
Q

Increased intraocular pressure
Progressive visual loss due to optic nerve damage
Gradual loss of peripheral vision

A

Glaucoma

Open-angle: cup to disc ratio > 50%

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27
Q

Management for acute glaucoma

A

Pilocarpine drops

Emergent transfer to ophthalmologist

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28
Q

Woods lamp after fluoroscein reveals pattern of parallel lines of vertical abrasion

A

Foreign body

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29
Q

Small nodule under tarsus

A

Chalazion

Obstruction of meibomian glands

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30
Q

Pustule on lid margin

A

Hordeolum

Inflammation of gland of Zeis or moll

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31
Q

Vascular structure in conjuntiva
Can spread to cornea and impair vision

Management

A

Dx: Pterygium

Tx: surgery

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32
Q

AIDS

fundoscopy with cheese, ketchup appearance

A

CMV retinitis

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33
Q

Chronic ear infection
Discharge and mass protruding through the tympanic membrane
Hearing loss

A

Cholesteatoma

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34
Q

Otitis externa + DM

Management

A

Dx: malignant otitis externa

Tx: systemic antipseudomonal coverage

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35
Q

Pre-op management when on anti-TNF meds

A

Hold meds 2 weeks before surgery and restart 2-4 weeks after

(Would otherwise cause wound dehiscence)

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36
Q

Alcohol
Delirious
Normal VS

A

Alcoholic hallucinations

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37
Q

Alcohol
Delusional
Seizure
Tachycardic, hypertensive

A

Delirium tremors

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38
Q

Alcohol

Confusion, ataxia, nystagmus, Diplopia

A

Wernicke’s encephalopathy

Thiamine deficiency

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39
Q

Alcohol

Anterograde and partial retrograde amnesia

A

Korsakoff’s psychosis

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40
Q

Lab that will identify chronic heavy alcohol use

A

Increased carbohydrate deficient transferrin

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41
Q

Alcohol
Leg pain
Weakness of foot and decreased ankle jerk

A

Alcoholic neuropathy

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42
Q

White/gray spots on conjunctiva

A

Vitamin A deficiency

43
Q

Blurring of disk margin
Elevated liver enzymes
Hypercalcemia

A

Vitamin A toxicity

44
Q

Tea and toast diet
Bleeding gums
Perifollicular hemorrhages
Normal CoAgs

A

Vitamin C deficiency (scurvy)

45
Q

TB patient on INH
Neuropathy
MCV low

A

Pyridoxine/vit B6 deficiency

46
Q 
Alcohol
Sensory ataxia
Rhomberg +
Dementia, Decreased proprioception
Spasticity, optic neuropathy
Normal pink-prick sensation
A

Subacute degeneration of cord

Vitamin B12 deficiency

47
Q

Constipstion
Dry mucous membranes
Hypercalcemia

A

Vitamin D toxicity

48
Q

Dementia
Dermatitis
Diarrhea

A

Niacin deficiency (Pellagra)

49
Q

Diarrhea

Transverse vertical white lines on nails

A

Arsenic poisoning

50
Q

TPN
Alopecia
Hyperkeratotic rash
Anemia, loss of taste

A

Zinc deficiency

51
Q

Anxiety
Chest pain
SoB
Click on cardiac exam

A

MVP

More common with panic disorders

52
Q

Duration of treatment with anti-depressant for 1st episode of depression

A

4-9 months

53
Q

Appropriate time to switch antidepressants if no response

A

After 6-8 weeks

54
Q

SSRI

Cloudy urine

A

Retrograde ejaculation

55
Q

Indications for electroconvulsive therapy

A 
Refractory depression
Psychotic features
Suicidality
Catatonic stupor 
Pregnancy
56
Q

Treatment for manic depressive bipolar disorder

A

Lamotrigine

57
Q

Treatment for manic bipolar disorder

A

Lithium or valproic acid/atypical antipsychotic

58
Q

Side effects of lithium

A

DI
Hypothyroid
Hypercalcemia
Hand tremors

59
Q

Side effect of clozapine

A

Agranulocytosis

60
Q

Side effect of olanzapine

A

Metabolic syndrome

Increased BG and weight

61
Q

Side effects of typical antipsychotics

A 
Acute dystonic reaction (Tx: benadryl/benztropine)
Akathisia
Tardive Dyskinesia
NMS (hyporeflexia)
Prolonged QT interval
62
Q

Hyperthermia
AMS, tremor, autonomic instability
Hyperreflexia

A

Serotonin syndrome

63
Q 
Hyperthermia
AMS
autonomic dysfunction
Lead pipe rigidity. Rhabdomyolysis
Hyporeflexia
A

Neuroleptic malignant syndrome

64
Q 
OR
Hyperthermia
HTN, sustained muscle contraction 
Difficulty ventilating
Hyporeflexia
A

Malignant hyperthermia

65
Q

Hyperthermia
AMS
Tachycardia
Decreased BMs and urinary retention

A

Anticholinergic delirium

66
Q

Management for Bulimia

A

Fluoxetine and psychotherapy

67
Q 
Increased secretion 
Profuse sweating
N/V, sob
Tremors, fasciculations
Miosis, bradycardia

Management

A

Organophosphorous poisoning

Remove clothing
Activated charcoal
Atropine/pralidoxime

68
Q

Management for Metoprolol toxicity refractory to atropine

A

Glucagon

Epinephrine gtt

69
Q

Management for urge incontinence

A

Lifestyle changes

  • weight loss
  • bladder training

Kegel
Anticholinergics (oxybutynin)

70
Q

Management for Stress incontinence

A

Weight loss

-kegel

71
Q

Management for overflow incontinence

A 
Urethral obstruction (PSA < 1.8)
-alpha blockers (Terazosin, tamsulosin)
Prostrate hyperplasia (PSA > 1.8) 
-alpha block + 5a reductase inhibitor (finasteride)

Detrusor underactivity
DM neuropathy, MS, anticholinergics
-Bethanacol

72
Q

Management for BPH

1) with normal BP and PSA
2) HTN
3) hematuria

A

1) tamsulosin
2) terazosin
3) finasteride

73
Q

Management for pressure ulcers

A

Stage 1: skin intact
-static foam or gel mattress

Stage 2: shallow ulcer
-occlusive or semipermeable dressing

Stage 3: visible fat
-debridement + prn Abx

Stage 4: visible bone, tendon, muscle
-debridement + prn Abx

74
Q

Pregnancy screening

  • UTI
  • OGTT
  • GBS
75
Q

Postpartum

Fever. Chills

A 
Postpartum endometreitis 
(GBS)
76
Q 
Pregnant
Postexposure ppx
-Hep A
-Hep B
-measles
-varicella
A
  • Immunoglobulin
  • HBIG
  • Immunoglobulin within 1 week
  • Varicella immunoglobulin within 10 days
77
Q

Vaccines contraindicated in pregnancy

A

Live vaccines

  • MMR
  • varicella
  • oral polio
  • yellow fever
  • HPV
78
Q

PCV 13 administration

A

1x only

Immunocompromised

79
Q

PPSV 23 Administration

A

Give every 5-10 years

80
Q

Mild mitral stenosis and management

A

1.5 sq cm

No treatment

81
Q

Moderate mitral stenosis and management

A

1-1.5 sq cm

Beta blocker

82
Q

Severe mitral stenosis and management

A

<1.0 sq cm

Valvuloplasty

83
Q

Cardiac contraindications to pregnancy

A 
pHTN
Eisenmenger syndrome
Marian syndrome w/ dilated aortic root
Dilated CM with CHF
Severe aortic stenosis
84
Q

Murmur in ASD

A

Mid-diastolic (RA&raquo_space; RV)

Mid-systolic (RV&raquo_space; PA)

85
Q

Postpartum
Fatigue, SOB, + JVD
Dilated CM with LVEF 30%

A

Postpartum cardiomyopathy

Can occur ins 3rd trimester

86
Q

Pregnant

+S3, II/VI systolic murmur at apex

A

Normal volume overload of pregnancy

87
Q

Pregnant
HTN, pedal edema
Thrombocytopenia/coagulopathy
proteinuria ,AKI

Management

A

DIC due to pre-eclampsia

Deliver baby

88
Q

Etiology of DIC in pregnancy

A 
Dead fetus
Abruptly placentae
Amniotic fluid embolism
Acute fatty liver of pregnancy 
Pre-eclampsia
89
Q

Pre-eclampsia + seizure

Management

A

Eclampsia

Mg Sulfate

90
Q

Management for postpartum lactating with prolactin > 200

A

MRI to r/o prolactinoma

Bromocriptine

91
Q

Management for patient on OCP or tamoxifen going for elective surgery

A

Stop meds 1 month prior

92
Q

2-3rd trimester
Itching
Elevated transaminases and ALP
No vomiting

Management

A

Intrahepatic cholestasis if pregnancy

Cholestyramine
Ursodeoxylate
Early delivery at sign of fetal distress

93
Q

1st trimester
No itching
Elevated transaminases
Vomiting

A

Hyperemesis gravidarum

94
Q

2-3rd trimester
Itching
Normal transaminases
No vomiting

A

Pruritus gravidarum

95
Q

Carinitine or choline deficiency or tetracycline use

Management

A

AFLP

Delivery of fetus

96
Q

Management for dysfunctional uterine bleeding

A

Levonorgestrel IUD

97
Q

Dysmenorrhea, dyspareunia
Enlarged ovaries and palpable bands on ligaments
No pelvic motion tenderness

A

Laparoscopy to r/o endometriosis

98
Q

Postcoital contraception

A

Levonorgestrel within 72 hours

Inhibits ovulation and zygote implantation

99
Q

Adverse effects of OCP

A

HTN, DVT/PE, stroke
Peliosis hepatis, budd-chiari
Elevates theophylline level and causes toxicity (MAT on EKG)
Euthyroid thyroxinemia (total T3 inc but normal TSH)
Mood swings, erythema nodusum, PCT

100
Q

Contraindications to OCP

A 
H/o DVT, stroke
Pregnancy, CAD, HTN (>160/100)
Migraines with aura
Breast cancer (currently or < 5 yrs)
Smoker > 35 y/o & > 15 cigg per day (progesterone only)
Chronic hepatitis
101
Q 
Trying to conceive
Infertility treatment 
SOB, abd distention/pain
Ascites, enlarged ovaries, Inc number of ovarian follicles
Hemoconcentrated
A

Hyperstimulation syndrome

102
Q

Pelvic pressure
Constipation
Sensation of incomplete evacuation

103
Q

Medicare A
Medicare B
Medicare D

A

Hospitals/care facilities
Physicians/providers
Prescriptions

104
Q

Fiduciary relationship between physician and patient

A

Justice
Autonomy
Non-maleficence
Beneficence

ABR (12 decks)

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