General Medicine Flashcards
Icosapent ethyl and omega 3 fatty acid usage
Decrease triglyceride
Treatment chronic low back pain
Nonpharmacologic therapy, nsaid, duloxetine, and final is opioid but carefull
Chronic noncancer pain, which opioid
Short acting opioid
Opioid use in palliative care, manage pain from cancer or other conditions characterized by persistent pain or disabling pain with significant functional impairment
Extended release or long acting opioid
Hip osteoarthritis: FADIR positive, flexion, adduction, internal rotation
Sacroiliitis joint dysfunction: FABER positive, flexion, abduction and external rotation
Varenicline does not increase risk of cardiac event
Nicotin replacement therapy includes short acting and long acting nicotin
An abnormal result on any one of the three HINTS ( Head impulse, nystagmus, test of skew) examination component suggest a central vertigo
Window for thrombolytic therapy for stroke
3 hours
Olanzapine can cause weight gain, hyperglycemia and hyperlipidemia
Clozapine can cause agranulocytosis
Fluphenazine can increase liver enzymes
Treatment of binge eating
Cbt, ssri and lidexamfentamine
Absolute contraindication of compression therapy when abi is
0.5 or less
Acute rehab requirement
Participate 3 hours of therapy on 5 days a week
Treat nightmare related to ptsd
Prazosin
Cbt in premenstrual dysphoric disorder is very limited and variable
Risk factor for opioid overdose
More than 50 morphine mg equivalent per day and receiving opioid and benzo concurrently
Haloperidol can lower the seizure threshold in pt with withdrawal seizures
Treatment of vasovagal
Counterpressure measure, fludrocortisone, midodrine
Bupropion contrandicate in seizure and do not cause weight gain or sexual dysfucntion
Meclizine can cause fall in older adult
Time up and go test if more than 12 seconds should intervene to reduce risk of fall
Chronic cough causes step approach
Upper airway cough syndrome
Asthma
Non asthmatic eosinophilic bronchitis
Gerd with ppi
Then gerd with ph monitoring
Ct scan
Treatment of stress incontinence
First line kegel excercise
Second line vaginal estrogen
Codeine metabolized with cyp p450
Thiopurine methyltransferase metabolite azathioprine and 6 mercaptopurine
Presence of hla B 57:01 increase risk of hypersensitivity reaction when pt uses abacavir
Presence of hla B58:01 increase risk for severe cutaneous adverse reaction with allopurinol
Treatment of systemic exertion intolerance disease is
Pacing strategies
Treatment of labyrinthitis
Prednisone
Options for chronic neuropathic pain is pregabalin, gabapentin, duloxetine, capsaicin, topical lidocaine
Contrandication of methylnatrexone
Bowel obstruction
Urate lowering therapy for gout when
Stage 2 or greater ckd
Two or more acute attack per year
One or more tophi
Uric acid nephrolithiasis
Allopurinol can inhibit thiopurine methyltransferase so cant use allopurinol with azathioprine or 6 mercaptopurine
Narrow band ultraviolet B phototherapy uses for psoriasis vulgaris, mycosis fungoides, atopic dermatitis, vitiligo
Perioperation, can continue nonbiologic dmards but should stop biologic
Except lupus, biologic should stop 1 dose before surgery
Janus kinase inhibitor like tofacitinib should be held 3 days before.
Resume when the wound heal at around 14 days
Treatment of bacterial conjunctivitis
Trimethoprim polymyxin
Erythromycine
Bacitracin polymyxin
Bacterial conjunctivitis with contact lense due to pseudomonas
Ofloxacin
Bacterial vaginosis
Vaginal ph greater than 4.5
Thin gray homogeneous vaginal discharge
Positive amine whiff test, fishy odor
20% clue cells on wet mount
Treatment
Metronidazole oral or cream
Clindamycin vaginal cream
Clindamycin oral
Secnidazole oral
Tinidazile oral
Herpes zoster and involve first division on the trigeminal nerve (forehead extending over upper eyelid or nasal tip involvement
Refer to eye doc because of herpes zoster ophthalmicus and blindness
Herpes zoster and vesicle in the external ear canal
Facial paralysis and auditory vestibular symptoms can occur
Ramsay Hunt syndrome
Percutaneous balloon aortic valvulotomy uses for severe aortic stenosis and pulmonary edema or cardiogenic shock unresponsive to standard therapy
Zinc containing intranasal product can cause permanent anosmia
Lichen planus is treated by glucocorticoid and ultraviolet light
Dx scabies uses mineral oil preparation of skin scraping
Dx fungal infection uses potassium hydroxide preparation of skin scraping
Dx tinea capitis, skin fluorescence seen in erythrasma, vitiligo uses wood lamp examination
Vitiligo associate with hashimoto thyroiditis, graves disease, alopecia areata, t1dm, pernicious anemia rheumatoid arthritis, polyglandular autoimmune syndrome
Hep c related to lichen planus, porphyria cutanea tarda, leukocytoclastic vasculitis
Hiv associates with pruritus, molluscum contangiosum, seborrheic dermatitis
Indication for treating osteoporosis
Bmd t score -2.5 or less
Bmd t score -2.5 to -1 and 10 year risk of 3% or greater for hip fracture or 20% risk or greater for major osteoporosis related fracture as estimated by FRaX tool
Ct scan is more sensitive for appendicitis
We should give influenza vaccine two weeks before and one week after chemotherapy
Biotin should stop 2-5 days before testing thyroid function because it can increase t3,t4 and decrease tsh
Biotin can cause low troponin
Beta caroten can cause lung cancer on smoker
Fish oil and vitamin e can increase risk of bleeding if use anticoagulation
Treatment of rosacea is topical metronidazole cream
Copper iud prevent pregnancy by 99% if placed within 5 days of unprotected sex
For emergent conteaception levonogestrel is not effective with bmi more than 26, but ulipristal acetate is effective with bmi more than 26
Acid transnexamic inhibit melatonin synthesis can can use off label to treat refractory melasma
Anyone younger than 15 years old should receive two dose series of hpv vaccine
Older than 15 should receive three dose series of hov vaccine
Orlistat contraindication in malabsorption syndrome and cholestasis
Phentermine topiramate contraindicated in glaucoma hyperthyroidism and nephrolithiasis
Naltrexone bupropion contraindication in insomnia seizures, eating disorder opiate use or withdrawal alcohol use
Uspstf recommend aspirin in aldult 40-59 with ascvd 10 year risk of 10% or higher and no increase risk of bleeding
Treatment of seborrheic keratoses
Cryotherapy
Treatment of actinic keratosis
Topical 5 fluorauracil
Fusobacterium necrophorum causes Lemierre syndrome
Danazol is onlu fda approved drug for cyclic breast pain
Treatment of onychomycosis
Systemic terbinafine or fluconazole
Should stop clopidogrel 5 day, prasugel 7 days, ticargrelor 3-5 days before surgery
Erythrasma use wood lamp evaluation and treated by oral or topical erythromycin
Copper iud last 10 years
Levonogestrel iud last 3-5 years
To diagnose androgen deficiency, will need two test of morning serum total testosterone
Obtaining free testosterone level if alteration in sex hormone binding globulin like obesity, liver disease, diabetes, insulin resistance, glucocorticoid use
Using tacrolimus cream can cause viral skin infection hsv and vzv and skin cancer and cutaneous lymphoma
Calcipotriene cream use to treat psoriasis
Treatment of porphyria cutanea tarda
Phlebotomy or twice weekly hydroxychloroquine
Hyperacute bacterial conjunctivitis caused by neisseria gonorrhea
