LAST REVIEWS! Flashcards
How can you tell the difference between HOCM murmur and Aortic Stenosis Murmur
HOCM gets louder with valsalva, decreases preload, therefore increased left ventricular outflow obstruction
AS gets softer with valsalva decreased preload, less blood to go through stenosis.
What is the treatment for acute decompensated CHF presenting with pulmonary edema?
NOLIP Nitrates Oxygen Loop diuretics Ionotropic Drugs Positioning
**on test – loop diuretics!
What specific beta blockers reduce mortality in CHF patients?
Bisoprolol
Carvedilol
Extended-release metoprolol
Which two types of medications are most likely used to treat Prinzmetal angina?
CCB
Nitrates
What happens to HR in neurogenic shock?
Decreased
What are the two most common sites to place a pulmonary artery catheter?
Right IJ
Left Subclavian
How many criteria do you need for diagnosis of rheumatic fever? What are the criteria?
2 major or 1 major and 2 minors.
Major = Jones Minor = Peace Previous rheumatic fever ECG with PR prolongation Arthralgias CRP and ESR elevation Elevated Temperature
What 4 conditions need endocarditis prophylaxis prior to surgery/dental procedure?
Prosthetic cardiac valve
Previous infective endocarditis
Congenital heart disease
Cardiac transplantation with cardiac valvulopathy
Meds: amoxicillin – 2 g given 30-60 minutes prior to procedure
What is the criteria for diagnosis of endocarditis?
2 major, 1 major 3 minor, 5 minor
Major = BE Minor = FIVE PM
U waves are indicative of what abnormalities?
Hypokalemia
Hypercalcemia
Hyperthyroid
Top 5 treatments for PSVT?
- carotid massage
- Valsalva maneuver
- IV adenosine
- CCB
- BB
MAT treatment
CCB
BB blockers
Correct electrolyte abnormalities
AF Management:
Evaluate for thrombus with TEE
Anticoagulate
Rhythm control w/ sotalol / amiodarone
Rate control w/ BB
A FLUTTER management:
Rate control/rhythm control
Cardioversion if hemodynamically unstable
V TACH treatment:
Electrocardioversion if hemodynamically unstable
Antiarrhythmic medication of hemodynamically stable
V FIB TX
CPR, immediate electrical cardioversion
What should be the goal BP initially when treating hypertensive urgency?
BP to 160/100
Reduce MAP no more than 25% in first 2-3 hours
What is cilostazol used for?
Improves blood flow to LE and decreases claudication.
What is the treatment for Henoch-Schonlein Purpura?
Supportive Care
What is tx for hiatal hernia?
PPI/ Dietary Modification
Nissen Fundoplication if refractory to tx
What type of gastric cancer involves all layers of the stomach?
Linitis Plastica
All patients who present with likely acute upper GI hemmorhage need what diagnostic study?
EGD esophagogastroduodenoscopy
Tropical Sprue or Celiac disease?
- Megaloblastic anemia
- Iron deficiency
- TS
2. CD
TX for Tropical Sprue?
Tetracycline
Folic acid
possibly B12
Stool osmotic gap calculation and results meaning:
Stool osmotic gap = 290 - 2(Na +K in stool)
> 125 = osmotic diarrhea
Where is the most common site for a carcinoid tumor?
Ileum
What is the best radiological test for Acute cholangitis?
ERCP (on gallbladder issue where US is not best diagnostic radiological test)
What viral infection is likely to more likely to cause fulminant hepatic failure in pregnant women?
Hepatitis E
in Hepatitis B, what is indicated when HEP B DNA level is high?
Active viral replication, treatment is indicated when high.
What medication is used to kill enteric bacteria that generate ammonia in patients with cirrhosis?
Rifaximin
What is the treatment for SBP?
Cefotaxime or other third generation cephalosporin for at least 5 days.
Which vasopressor:
- Theoretically causes renal vasodilation
- High doses optimize the a1 vasoconstriction?
- Dopamine
2. Epinephrine/ Dopamine
How many symptoms do you need to diagnose SLE?
4 out of 11
What antibodies are Diffuse Scleroderma associated with?
What about Limited cutaneous systemic sclerosis?
Anti-DNA topoisomerase 1 antibodies (Anti-SCL 70)
Anti-centromere antibodies
What antibodies are associated with Mixed connective tissue disease?
Anti-U1-RNP antibodies
When is the ulnar claw apparent?
When asked to extend fingers, inability to extend 3rd and 4th digit
When is the hand of benediction apparent?
When median nerve injury farther up the arm, apparent when asked to flex the fingers
What is a more common injury at the knee?
ACL tear with a lateral meniscus injury
What is the cause of back pain that is accompanied by abnormal gait where knees are flexed and hips remain flexed?
Spondylolisthesis
What is the treatment of Warm agglutinin hemolytic anemia?
Glucocorticoids
Rituximab
Splenectomy
What is the treatment for Hereditary Spherocytosis?
Folic acid 1 mg daily
RBC transfusions in cases of extreme anemia
Splenectomy for moderate/severe disease.
What test do you use to monitor for Heparin?
PTT
What test is used to monitor LMWH?
Antifactor XA activity, but normally this is not monitored
What is the abx tx for patients with meningitis > 1 month old?
Ceftriaxone and Vancomycin
add Ampicillin when > 50
What is the treatment for renal amyloidosis?
Melphalan - suppress bone marrow, Hematopoietic cell transplant
Which disease?
Hyaline Casts
Normal patients with concentrated urine
Which disease?
RBC Casts
Glomerular bleeding
Which disease?
WBC Casts
Tubularinterstitial disease, acute pyelonephritis
Which disease?
Epithelial Cell casts
Acute Tubular necrosis
AIN
Which disease?
Granular Casts
ATN
What are 4 causes of Normal Anion Gap Metabolic Acidosis?
Hypoaldosternoism Artificial feeding (TPN) Renal Tubular Acidosis Diarrhea
What happens to potassium level in Fanconi Syndrome?
Low Potassium
What is the mechanism cause by which HELLP results in low platelets?
Systemic inflammation and platelet consumption
What happens to lung compliance in ARDS?
it significantly decreases
What is the most common cause of abnormal hemostasis in patients with CRF?
Platelet dysfunction.
MLD and cause of patient with painful vesicles, punched out erosions, hemorrhagic crusting along with fever and lymphadenopathy in young child on cheeks.
Eczema herpeticum caused by HSV
Management of:
LSIL
21-24: Repeat Pap in 1 year
> 25: Colposcopy and repeat pap in 1 year
Management of HSIL
21-24: Colposcopy
> 25: Colposcopy and LEEP
Management of ASCUS
21-24: Repeat Pap in 1 year
> 25: Colposcopy and HPV test
Management of ASC-H
21-24: Colposcopy
> 25: Colposcopy
Management of AGC
21-24: Colposcopy + endocervical sampling
> 25: Colposcopy, Endocervical sampling, Endometrial biopsy > 35 years or risk factors
MLD: 2-3 mm yellow pustule with red base arising in the first 24-72 hours, microscopic examination of the pustular contents reveals numerous eosinophils, usually gone by 3 weeks
Erythema Toxicum Neonatorum
MLD: Spider-webbing/marbling of the skin
Cutis marimorata
