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ITE High Yield Flashcards

1
Q

Pneuomcoccal vax recs

A

PPSV-23 given before age 65 for heart, liver, lung disease and smoking

PCV-13 given first; PPSV-23 given 8 weeks after with revax after 5 yrs for splenectomy and IC pts

NORMAL: PCV-13 =»1yr; give next

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2
Q

In males, who can get HPV after 21?

A

MSM

IC

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3
Q

What medication to give to someone accidentally exposed to needle stick w/ HIV?

A

Tenofovir-Emtricitabine + Raltegravir

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4
Q

Guillain-Barre CSF findings

A

WBC:0-5

Glucose: 40-70

Protein: 45-1,000 (abnormal)

*Albuminocytologic dissociation

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5
Q

MI complications

A

hours-days= Reinfarction

hrs-weeks= Ventricular septal rupture

hrs-2weeks= Free wall rupture

hrs-month= Papillary muscle rupture

1 day-3months= Pericarditis

5 days- 3 months= Ventricular aneurysm

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6
Q

Likelihood ratio

A

Sensitivity/(1-specificity)

If looking for NEGATIVE likelihood ratio, use inverse

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7
Q

Odds ratio

A

AD/BC

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8
Q

Experimental Event Rate

A

A/A+B

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9
Q

Control Event Rate

A

C/C+D

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10
Q

RR

A

(A/A+B)/(C/C+D)

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11
Q

Attributable risk

A

EER-CER

or

A/A+B-C/C+D

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12
Q

RR Reduction

A

ARR/CER

or

[(C/C+D)-(A/A+B)]-[(A/A+B)/(C/C+D)]

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13
Q

NNT

A

1/ARR

1/(A/A+B)-(C/C+D)

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14
Q

NNH

A

1/Attributable risk

1/(A/A+B)-(C/C+D)

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15
Q

Ab in PSC

A

Anti-mitochondria antibody

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16
Q

Pt w/ scleroderma who has AKI

A

GIVE ACEI

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17
Q

Ab in MCTD

A

RNP

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18
Q

Eosinophilic esophagitis

A

20 year old male who is having dysphagia

EGD show “trachealization” of esophagus; biopsy w/ >15eos/hpf

Tx: Swallowed and aerosolized steroids; PPI if needed

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19
Q

PPD positivities

A 
>5mm: 
   HIV
   Recent contact w/ TB person
   Nodule or fibrotic changes on Xray
   Organ transplant

> 10mm:
Recent arrival (<5yrs) from high prevalence country
IVDA
Resident/employee of high-risk setting
Mycobacteria lab personnel
Comorbid conditions
Children <4yrs old

> 15:
Everyone else

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20
Q

Lofgren syndrome

A

Person w/ Sarcoidosis who also develops:

Erythema nodosum

Fever

Migratory polyarthralgia

Hilar lymphadenopathy

21
Q

Methods of reducing post radiation lymphedema

A

Maintain good skin hygiene (avoid cuts, bites, scratches)

Treat anything resembling cellulitis

Elevate extremity

Wear compression sleeves

**AVOID PUNCTURING THE SKIN ON THAT SIDE; USE CONTRALATERAL ARM*

22
Q

Diagnosing Takayusu Atereritis

23
Q

Still’s Disease

A

Fever, arthritis, evanescent rash
+/- hepatosplenomegaly, serositis (pericarditis, pleuritis)

  • Is ultimately a diagnosis of exclusion
  • Suspect w/ daily spiking fever, salmon-pink maculopapular eruption, arthritis, leukocytosis, hyperferritinemia

Tx: Supportive; glucorticoids if severe; Kineret (anakinra) if chronic (DMARD)

24
Q

Tactile fremitus in consolidation and effusion

A

Increased= Consolidation

Decreased= Effusion

25
Ranson Criteria
Predicts severity of Acute Pancreatitis ``` At O hours: Age >55 WBC >16000 Glucose >200 LDH >350 AST >250 ``` ``` At 48 hrs: Hcrt decrease of 10% BUN increase by 5 Calcium <8 pO2 <60mmHg Base deficit >4meq Fluid sequestration >6L ```
26
Cogan's Syndrome
Chronic inflammatory disorder of young adults that includes interstitial kerititis and vestibuloauditory dysfnxn -Could be due to AI rxn to bones and organs of the inner ear CFss: Eye redness, photophobia, blurred vision, granular infiltrate in cornea, vertigo, ataxia, nausea, vomiting, hearing loss -Only need presence of both inner ear and eye symptoms not all of these ***May also have a large vessel vasculitis resembling Takayasu Tx: Immunosuppressants, meclizine, and eye prednisolone to start
27
Monitoring parameters for trastuzumab
Echo q3months; q6months for 2 years following cessation of therapy
28
Fanconi Syndrome
General impairment in proximal tubular function leading to urinary wasting of compounds reabsorbed in the proximal tubule Consequences include hypophosphatemia, osteomalacia, glucouria, hypouricemia, aminoaciduria, and proximal RTA due to loss of bicar -Serum calcitriol is usually low ****MOST OFTEN SEEN W/ MULTIPLE MYELOMA
29
Sutent
Sunitinib Inhibits multiple tyrosine kinasaes including PDGFR, VEGF, and CSF -Used for a lot of well-differentiated neuroendocrine tumors
30
Management of PVD
Treat like it is CAD -This means long term aspirin or clopidogrel, statin therapy, and lifestyle modification
31
Latent interferon gamma release assay
Includes quantiferon gold examination; used when an initial TST screen is positive -Can also be used as the initial test in high risk individuals
32
Treatment of vulvar SCC
IA: Surgical resection IB, II: +Sentinel Node Biopsy Palpable Nodes: Debulking procedures
33
Treatment of TRALI
Stop transfusion Hemodynamic + Ventilation support
34
Docetaxel
Microtubule depolymerization inhibition resulting in inhibition of DNA, RNA, and protein synthesis; used in breast cancer and some NSCLC, gastric adenocacrinoma, locally invasive neck cancers ADRs: Neurotoxicity (Chemotox man), alopecia, rash, fluid retention, diarrhea, neutropenia
35
Lithium monitoring parameters
Renal function (Baseline-then every 2-3months during first 6 months of treatment, then every year in pts on stable dose) Electrolytes Calcium Thyroid (same frequency as BUN/Cr)
36
Reactive gastropathy
Long term exposure to gastric damaging substances leading to inflammation, some hyperplasia, mucosal edema, proliferation of smooth muscle fibers in the lamina propria, and vascular dilation -Assoc w/ chronic bile reflux, NSAIDs, alcohol Tx: Ursodeoxycholic acid, sucralfate
37
Patient who starts HAART and then gets sick
Immune Reconstitution Inflammatory Syndrome -Symptoms will usually be associated w/ whatever opportunistic infection they have
38
Digoxin effects on EKG
Sagging ST segment; concave and upward direction Flattened T wave Shortened QT interval PR interval prolongation Possible U wave
39
Alkalotic urine can produce what stones
Calcium oxalate or calcium phosphate
40
Ab to order first for celiac
Anti-TTG
41
Microscopic colitis
Chronic, nonbloody diarrhea that is water; typically have >5 stools/day Can also have arthralgia, arthritis, uveitis suggesting AI etiology Lab: Can have positive RF, ANA, anti-mitochondrial abs, p-ANCA, anti-Saccharomyces cerevisiae antibodies Definitive dx: Biopsy Tx: NSAID avoidance; loperamide, budesonide -Can consider bismuth subsalicylate
42
Minimizing weakness after critical care
Awaken Breathing Coordination w/ daily sedative interruption and ventilator liberation practices Delirium monitoring and management Early ambulation
43
Beer potomania
Just hyponatremia in alcoholics
44
Cerebral Salt Wasting
Possibly due to impaired sympathetic reactivity causing decreased salt reabsorption or possibly due to BNP release w/ brain injuries CFs: Severe hyponatremia following neurosurgical procedure or event, hypotension, elevated hcrt Labs: Hyponatremia, Urine Na >40, increased urine osmolality, low serum uric acid
45
CK can be elevated in hypothyroidism
Yup
46
5q deletion
Myelodysplastic syndrome
47
Integrillin
Eptifibatide -Glycoprotein IIb/IIIa inhibitor
48
Asteatotic dermatitis
Common pruritic dermatitis occurring in old people in the extremities usually during cold months -Patients have severe scaling and superficial fissuring of the skin "Dry river bed" appearance Tx: Topical corticosteroids
49
Dermatitis herpetiformis
AI cutaneous eruption associated w/ gluten sensitivity; patients have intensely pruritic inflammatory papules and vesicles on forearms, knees, scalp, and butt Tx: Dapsone, gluten-free diet

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