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PANCE > Hard numbers/concepts > Flashcards

Hard numbers/concepts Flashcards

1
Q

PEN, Cephs, and Vanc (glycopeptides) inhibit what?

A

Cell wall synthesis

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2
Q

Tetracyclines and Aminoglycosides act on what?

A

30s subunit ribosome

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3
Q

Macrolides and lincosamides act on what?

A

50s subunit ribosome

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4
Q

FQ and nitromidazoles (metro) act on what?

A

DNA

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5
Q

Septra inhibits what?

A

Folate

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6
Q

Rifampin has what ADR’s?

A

Red lobster syndrome (dye) and Hepatitis

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7
Q

Isoniazid has what ADR’s?

A

Peripheral neuropathy and hepatitis

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8
Q

Isoniazid’s peripheral neuropathy is prevented with what medication?

A

B6/Pyridoxine

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9
Q

Pyrazinamide has what ADR?

A

Polyarthralgia (tx = NSAID)

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10
Q

Ethambutol has what ADR?

A

Optic neuritis and loss of red-green color vision . E for Eye.

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11
Q

What is Samter’s Triad (ASA triad) and why does it matter?

A

Atopy/asthma, Nasal polyps, Aspirin allergy

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12
Q

What scores can be used for UA/NSTEMI?

A

Heart or TIMI

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13
Q

How do you monitor heparin? What about warfarin?

A

Heparin = aPTT, Warfarin = PT/INR

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14
Q

How do you reverse heparin? Warfarin?

A

Protamine sulfate. Vitamin K or Fresh Frozen Plasma

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15
Q

What is Beck’s Triad? What other signs are seen in pericardial tamponade?

A

Becks = hypotension, muffled heart sounds, JVD

Narrow pulse pressure
Kussmaul’s sign (Increased JVP w/ inspiration)
Pulsus paradoxus (decreased BP w/ inspiration)
Electrical alternans

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16
Q

What are the 3 types of AFIB?

A

Paroxysmal <7 days
Persistant >7 days
Permanent

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17
Q

What increases the effect of warfarin?

A

fluconazole, amiodarone, septra, grapefruit juice, alcohol

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18
Q

What are the reversal agents for DOACs?

A 
Dabigatran = Idarucizumab
Xa = Andexxa
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19
Q

What are the causes of High Output HF

A

Hyperthyroid, Anemia, Beriberi (b1-thiamine def), Sepsis, Pregnancy, AV fistula

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20
Q

What is the goal BP reduction for HTN emergency?

A

Start at 180/120 w/ end organ dmg. Reduce by 25% max in 1 hour. Then to goal ~160/100 over next 23

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21
Q

What is the goal BP reduction for aortic dissection?

A

Reduce to systolic 100-120 now!

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22
Q

`RAE vs. LAE

A

RAE is tall in L2 and V1

LAE is wide/notched in L2 and biphasic in V1

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23
Q

What meds can increase statin myopathy

A

Fibrates, macrolides, amioderone, verapamil, grapefruit juice

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24
Q

What is a normal PR interval? What is a normal QRS complex?

A

PR = 0.12-0.2 seconds (3-5 boxes or 1 large box)

QRS = <0.12 or < 3 boxes

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25
Q

What things can cause prolonged QT interval?

A 
Electrolytes = Hypo Ca, K, Mg
Amioderone
Antipsychotics
ABX = FQ and Azithromycin
TCA's
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26
Q

How soon should you incise an auricular hematoma?

A

Around 48-72 hours

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27
Q

What is the definition of chronic rhinosinusitis? What about recurrent rhinosinusitis?

A

12 weeks. 4+ episodes per year.

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28
Q

Hoarseness for how long should be referred to ENT?

A

4 weeks w/ no associated URI symptoms

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29
Q

What is the mnemonic for CN innervation of EOM?

A

LR6SO4 3

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30
Q

What is the normal IOP?

A

8-21

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31
Q

What is the IV ABX of choice for orbital cellulitis?

A

Vanc and Ceftriacone or pime

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32
Q

What is the pathognomonic finding for CRAO?

A

Cherry red macula and boxcar stuff

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33
Q

Differentiate dry vs. wet ARMD

A 
dry = drusen
wet = neovascularization
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34
Q

When do you conduct optho screening for DM patients?

A

1 = five years post-diagnosis then annaully

2 = annually

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35
Q

What is the normal pr interval

A

3-5 boxes = 12-20 seconds = 1200-2000 ms

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36
Q

What is the diagnostic criteria for DM2?

A

FBGL = 126+

Random = 200 w/ symptoms or other findings

OG challenge = 200

A1C = 6.5+

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37
Q

Which DM meds are associated with weight loss and ASCVD prevention?

Hypoglycemia?

UTI?

A
  1. GLP1 and SLGT2
  2. SU
  3. SGLT2
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38
Q

Which hormones are released by the posterior pituitary?

A

ADH and oxytocin

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39
Q

What is the lab of choice for acromegaly?

A

IGF-1 (an indirect measure of GH). Oral glucose is supposed to inhibit but GH stays high.

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40
Q

How can you differentiate central vs. nephrogenic diabetes insipidus?

A

Desmopressin (DDAVP) replacement test.

DDAVP will work to decrease central. Has no effect on nephro.

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41
Q

What medications can be given for hyperthyroidism in pregnancy?

A

PTU in the first trimester

Methimazole later.

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42
Q

How do you treat thyroid storm?

A

Beta blocker (symptoms/don’t die)
PTU (block synthesis and conversion)
Iodide (inhibit release of stored hormone)
Steroids

43
Q

How do you treat myxedema coma

A

Thyroxine
Hydrocortisone
Fluids

44
Q

How do you diagnose and tx DKA?

A

BGL 250+, Arterial pH <7.3, Ketones

NS + Insulin + Potassium

NS = If sodium is high or normal –> 1/2 NS
Add D5 @ <250 bgl

If potassium is < 3.3, hold insulin till above
If potassium is >3.3-5.5, Give potassium in each L of fluid
If potassium is >5.5 check q 2 hours

45
Q

Describe EGD screening for barret’s esophagus

A

No dysplasia = q 3 years

Dysplasia = at least yearly

46
Q

Describe gastric ulcer vs duodenal ulcer pain

A

Gastric hurts with food. Duodenal = better with food.

47
Q

Name the cancer tumor markers and their associated organs

A

CEA = colon/gastro
CA 125 = ovarian
AFP = liver
CA 19-9 = Pancreatic

48
Q

Describe HEP B serology components

A

Core AB = Exposed now or at some point
Surface antigen = current infection
Surface antibody = immune

49
Q

What must be supplemented with mesalamine?

A

Folic acid

50
Q

Describe the vitamin B deficiencies

A

b1 = thiamine (beri-beri/HF/Wernicke’s)

b3 = niacin (pellagra - diarrea, dermatitis, dementia)

b12 = macrocytic anemia (neuro, glossitis, chelitis)

51
Q

List the associated cellular findings with each condition

  • Alpha thalassemia
  • Beta thalassemia
  • Sideroblastic anemia
  • B12 deficiency
  • Folate def
  • G6PD
  • Hereditary spherocytosis
A

Alpha thal = H
Beta thal = F, target cells and basophilic stippling
Sideroblastic = Basophilic stippling (lead)
B12 = Hypersegmented neutrophils
Folate = howell-jolly bodies
G6PD = Bite cells and Heinz Bodies
Hereditary spherocytosis = increased MCHC and fragile

52
Q

What are the vitamin K related factors?

A

2, 7, 9, 10

53
Q

List the dz and CD4 counts requiring prophylaxis

A

PCP = <200 = Septra

Toxoplasmosis = <100 = septra

Bird pneumonia = < 50 = azithromycin

54
Q

What is the age range for HIV screening?

A

13-64

Also TB STI PREG

55
Q

What is the lyme spirochete

A

b. bergdorferi

56
Q

What is the RMSF organism

A

R. ricketsia

57
Q

What is the dose for empiric acyclovir for Meningoencephalitis?

A

10mg/kg IV q 8HR (covers HSV until PCR result available)

58
Q

Match the diarrhea cause with appropriate ABX/Tx

Giardia
E Coli 0157:H7
C. Diff
Shigella
C. Jejuni
Salmonella
A

Giardia - METRO
E Coli 0157:H7 - PROB NOTHING (ESP KIDS –> HUS)
C. Diff - Oral VANC
Shigella - Cipro
C. Jejuni - Azithromycin
Salmonella - Cipro (Ceftriaxone for typhoid fever)

59
Q

What are the high intensity statin doses?

A

Atorvastatin 40-80mg

R- statin 20-40

60
Q

How do you treat perioral dermatitis?

A

Metro

61
Q

What drug should you never give infants due to lack of Ca in sarcoplasmic reticulum?

A

CCB

62
Q

Number one risk factor for AAA?

A

Smoking

63
Q

JNC-8 goal for people over 60 BP?

A

150/90

64
Q

H pylori triple therapy?

A

CAP or CMP

65
Q

When do we begin screening for HTN? DM?

A

18 and 35

66
Q

What CCB’s are avoided in HF?

A

Non-DHP = verapmil and diltiazem

67
Q

What electrolyte abnormality increases digitalis toxicity?

A

Hypokalemia

68
Q

Descending weakness, paralysis and n/v?

A

Botulism

69
Q

What is cobalamin?

A

b12

70
Q

What position is Mitral stenosis best heard in?

A

LLD

71
Q

Tricuspid stenosis is associated with what? Tricuspid regurg?

A

RF

Endocarditis

72
Q

ITP pt w/ >20k plt and no symptoms?

<20k?

Life threat?

A

Observe

Corticosteroids and IVIG

PLT transfusion

73
Q

1 cause of male infertility?

A

varicocele

74
Q

What blood pressure med reduces Ca in urine?

Which med increases it?

A

Thiazide

Furosimide

75
Q

Acute hemolysis test findings?

A

Increased K and LDH. Decreased haptoglobin.

76
Q

Most common cause of blindness under 65

A

DM retinopathy

77
Q

How do you calculate anion gap?

A

(Na-(Cl + HCO3))

8-16 is normal

78
Q

What electrolyte is typically low with potassium?

A

Mg

79
Q

What is CKD in terms of GFR? What is kidney failure?

A

<60 w/ albumin >30

<15 –> prob. dialysis

80
Q

What is the most common genetic dz in the US? How does it present/diagnose?

A

ADPKD

HTN and abdominal mass/enlarge

Renal US

*Aggressive tx of HTN

81
Q

What is the mnemonic for sensory vs. motor nerves

A

Some say marry money but my brother said bad bitches marry money

82
Q

Describe GCS for motor

A 
1 = none
2 = Extend
3 = Flex
4 = withdraw
5 = localize 
6 = obey commands
83
Q

GCS for verbal

A 
1 = none
2 = sounds
3 = salad 
4 = confused
5 = oriented
84
Q

GCS for eye

A 
1 = none
2 = pain
3 = verbal
4 = spont
85
Q

What is prophylaxis for cluster HA

A

Verapamil

86
Q

MCA stroke is associated with what loss of vision?

A

Homonymous hemianopsia and gaze toward infarct

87
Q

What is the main criteria for reperfusion therapy of a stroke?

A

W/in 4.5 hours and not pregnant

No improvement noted

BP < 185/110

No high bleed risk

88
Q

For the acute phase or non-reperfusion therapy, when would you treat HTN?

A

over 220/110

89
Q

What is the key factor for brain neoplasm?

A

Radiation exposure

90
Q

GBS has what pattern of travel?

A

Ground to brain

91
Q

Wernicke encephalopathy shows what s/sx and is due to what deficiency?

A

Thiamine B1

AMS
Eye dysfunction
Gait abnormality

92
Q

Describe a jefferson’s fracture.

Describe a hangman’s fracture

A

Disruption of C1 ring (need odontoid)

C2 vertebral body fx w/ anterior subluxation

93
Q

Juvenile kyphosis is known as what? What are classic radiological findings?

A

Sheurman’s dz, Shmorls nodes

94
Q

What is the delta pressure for compartment syndrome?

A

Diastolic BP - measured compartment pressure = >30

95
Q

What is the unhappy triad of knee injury?

A

ACL, MCL, medial meniscus

96
Q

What is failure to thrive?

A

Crossing 2 major lines or dropping below 5%

97
Q

Newborn weight doubles when? Triples when?

A

6 months

12 months

98
Q

What is the only vaccine at birth?

A

Hep B

99
Q

Diagnose and treat pertussis

A

Culture and PCR naso swab

Azithromycin

100
Q

When is screening for GBS? What if its positive?

A

35-37 weeks

IV pen G 4 hours before delivery

101
Q

PDA is often secondary to

A

Premature or Maternal rubella

102
Q

What would show a double bubble sign on x-ray

A

Volvulus

103
Q

PKU is what?

A

Decreased activity of phenylalanine hydroxylase (convert phenylalanine to tyrosine)

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