IM Shelf Quick Review Flashcards
LAD EKG territory
V1-V4
RCA EKG territory
II, III, aVF
LCx/Diagonal branch of LAD EKG territory
I, aVL, V5-V6
Intermittent Asthma
ssx/SABA use
<2 days a week
Nighttime ssx
<2 times a month
Step 1 tx
Mild Persistent Asthma
ssx/SABA use
>2 days week - not daily
Nighttime ssx
3-4 a month
Step 2 tx
Moderate Persistent Asthma
ssx/SABA use
daily
Nighttime ssx
>1 time per week - not nightly
Step 3 tx
Severe Persistent Asthma
ssx/SABA use
throughout the day
Nighttime ssx
4-7 times a week
Step 4 or 5 tx
Asthma PFTs
FVC nl/decreased
FEV1 decreased
FEV1/FVC decreased
DLCO nl/increased
Reversible with bronchodilator
COPD/Obstructive PFTs
RV increased FRC increased TLC increased FVC nl/decreased FEV1 decreased FEV1/FVC decreased DLCO nl/decreased
FEV1 decreases more than FVC
Not reversible with bronchodilator
Restrictive PTFs
RV decreased FRC decreased TLC decreased FVC decreased FEV1 decreased FEV1/FVC nl/increased DLCO nl/decreased
FEV1 decreases proportional to FVC
Asthma Tx Step 1
SABA prn
Asthma Tx Step 2
low dose ICS
or
Cromolyn, LTRA, Nedocromil, theophyline
Asthma Tx Step 3
low dose ICS + LABA
or
medium dose ICS
Asthma Tx Step 4
medium dose ICS + LABA
Asthma Tx Step 5
high dose ICS + LABA
Asthma Tx Step 6
high dose ICS + LABA + oral corticosteroid
consider omalizumab if they have allergies
increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:
low ACTH
exogenous glucorticoids
adrenal adenoma
increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:
high ACTH
high dose dexamethasone suppression test:
No supression
Ectopic ACTH production
Get CT chest/abdomen/pelvis
increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:
high ACTH
high dose dexamethasone suppression test:
Adequate suppression
Cushings Disease
Get MRI of pituitary
ANA
Lupus
Anti-CCP
rheumatoid arthritis
anti-RF
rheumatoid arthritis
anti-histone
drug induced lupus
anti-dsDNA
lupus (specific) renal involvement
anti-centromere
scleroderma CREST
anti-topoisomerase
systemic scleroderma
anti-jo
polymyositis
anti ro/la
sjorgrens
anti-mitochondrial
primary biliary sclerosis
anti smooth muscle
autoimmune hepatits
MI Complications
hours -2 days
reinfarction
MI Complications
hours- 1/2 weeks
ventricular septal rupture/free wall rupture
MI Complications
1 day- 3 months
pericarditis
MI Complications
5 days - 3 months
left ventricular aneyrysm
MI Complications
2 days - 1 week
papillary muscle rupture
CAP tx
ceftriaxone + Azithromycin (IV)
Azithromycin PO
HCAP tx
Vanc and pip/tazo
Meningitis tx
ceftriaxone + Vanc + steroids +/- ampicillin (immunocompromised)
Cellulitis tx
vanc-MRSA
Clindamycin
TMP-SMX
UTI tx
amoxicillin- pregnant Nitrofurantoin- women TMP-SMX- no renal failure Ceftriaxone (IV)- septic with pyelo Ciprofloxacin- ambulatory pyelo
Anaerobe coverage
clindamycin- non GI
Metronidazole- GI/GU
Ulcerative Colitis
Ulcers Large intestine Continuous Colorectal CA Crypt abscesses Extends proximally Red diarrhea Sclerosing cholangitis
Crohns Disease
cobble stone mucosa skip lesions rectal sparing creeping fat noncaseating granulomas
AML
Auer Rods
M3: tx Vit A- trans retinoic acid
Myeloperoxidase
ALL
Kids
Ppx to cns and scrotum
CML
BCR-ABL T(9:22) Imatinib- tyrosine kinase Basophilia Assx with WBC >60k
CLL
Smudge cells
RBC Casts
Glomerulonephritis
WBC Casts
Pyelo
Muddy brown casts
ATN
Waxy casts
CKD