Miscellaneous 2 Flashcards
when to get preop Hb/Hct
expected major blood loss
when to get preop electrolytes
incr risk of it being abnormal (diuretics)
when to get preop serum creatinine
major surgery
expect hypotension
will use nephrotoxic drug
patient > 50 yo
ages that need preop EKG
men > 45
women > 55
differential for bilateral LE edema
CHF
liver
ATN or nephritic syndrome
decr vision
boring eye pain
headache
associated w/ autoimmune diseases
scleritis
most sensitive test for alcohol
most specific test for alcohol
sensitive: GGT
specific: MCV
ADR of niacin
increases insulin resistance
ADR of thiazolidinediones (pioglitazone, rosiglitazone)
edema
MOA sitagliptin (Januvia)
suppresses glucagon elaboration and delayed gastric emptying
how to dose NPH and regular insulin in type 1 diabetics
2/3 total AM, 1/3 total PM
75% should be NPH, 25% regular insulin
so 50% NPH AM, 17% regular insulin AM
25% NPH PM, 8.5% regular insulin PM
how to dose Lantus and Lispro in type 1 diabetics
40-50% Lantus, 50-60% Lispro
how does stress affect cholesterol
raises LDL
smoking affects what part of cholesterol
decreases HDL
what statins aren’t metabolized by CYP
pravastatin (Pravachol)
rosuvastatin (Crestor)
fluvastatin (Lescol)
use what in pt with low HDL and high TG
gemfibrozil
gemfibrozil MOA
changes hepatic metabolism of lipoproteins
MOA ezetemibe (Zetia)
interferes w/ cholesterol absorption in gut
med that increases HDL most
niacin (then fenofibrate)
med that decreases TG a lot
fenofibrate
bariatric surgery for obese person BMI > 35 needs to also have one of the following
Pickwickian syndrome
obesity related cardiomyopathy
severe DM
severe sleep apnea
echinacea used for
prophylaxis URI
herbal used for prophylaxis of URIs
echinacea
medical and medicine causes of SIADH
infections (meningitis, pneumonia) CNS tumors amiodarone carbamazepine SSRIs chlorpromazine
things that cause false positive UDS
poppyseed muffin NSAIDs selegiline Vicks inhalers dextromethorphan fluoroquinolones rifampin venlafaxine
most common complication of gastric bypass surgery
iron and B12 deficiency
sxs of DRESS and next step
eosinophilia
erythroderma
fever, lymphadenopathy
elevated liver enzymes
DC offending medication (allopurinol is worst)
start corticosteroids
why are combined OCPs CI in migraine with aura
increases risk of ischemic strokes
low dose ASA guidelines for men and women
- age
- purpose
men age 45-79 for MI
women age 55-79 for ischemic stroke
2 meds that can be used for both prevention and treatment of acute mountain sickness
acetazolamide
dexamethasone
management of hypercalcemic crisis
normal saline
then loop diuretic if still high ca
indication for stress ulcer prophylaxis
mechanical ventilation for 48 hours
tx of uveitis associated w/ ankylosing spondylitis
ocular corticosteroids
pt on beta blocker, and unresponsive to epinephrine, next step?
IM glucagon (person on beta blocker will most likely not be responsive to epinephrine)
anti-GAD antibodies
T1DM
CI of tramadol
seizures
analgesic of choice when stage 3-5 CKD
APAP
safest NSAID for pt with h/o acute MI
naproxen
first line therapy for keloid
corticosteroid injection
which form of calcium should you use in patients on PPIs
calcium citrate (doesn’t require acidic environment)
tx chronic fatigue syndrome
CBT and/or graded exercise therapy
