medicine bread and buttah

Question 1

DKA management

Answer 1

• start normal saline
• test potassium, replete if <3.3
• start with IV insulin then move to subQ
• replete bicarb if pH <6.9
• replete phosphorous if needed (esp if cardiac dysfunction, respiratory suppression)

Question 2

ACS meds

Answer 2

Morphine
Oxygen
Nitroglycerin
Aspirin
Beta blockers (metoprolol tartrate)
AceI
Statin (high intensitivty, atorvastatin or ruvostatin)
Heparin

Question 3

PCP treatment

Answer 3

pneumocystis jirovechii pneumonia

-TMP-SMX + prednisone

Question 4

lab sign of upper gi bleed

Answer 4

elevated BUN (but not creatinine)

Question 5

most common cause of peptic ulcers

Answer 5

h pylori, nsaids

Question 6

mallory weiss tears

Answer 6

from retching, at GE junction

Question 7

H pylori testing

Answer 7

1. stool antigen is first test (but not if they’ve been on a PPI before)
2. serum antigen
3. breath ammonium (to test for eradication, remove PPI first)

Question 8

H pylori tx

Answer 8

2 weeks amoxicillin and macrolide (clarithromycin); 4+ weeks PPI (omeprazole)
(may add bismuth)

Question 9

treatment for esophageal varicies

Answer 9

• octreotide (vasoconstriction)
• antibiotics: ceftriaxone for SBP
• long term: beta blockers (but not active bleeding) or TIPS (shunts blood away from liver) (TIPS has risk of hepatic encephalopathy)

Question 10

plummer vison

Answer 10

iron deficient anemia + esophageal webs + increased risk of squamous cell carcinoma

Question 11

pain out of proportion on abdominal exam, hypotension, diarrhea, h/o cardiac or valvular disease

Answer 11

ischemic colitis
get CT
need surgery

Question 12

outpt tx for CAP

Answer 12

azithromycin

Question 13

inpt tx for CAP

Answer 13

azithromycin + ceftriaxone