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MKSAP Flashcards

1
Q

FDA approved SERM for genitourinary syndrome of menopause

A

Ospemifine

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2
Q

Preferred agent for GMS

A

Vaginal moosturizer —> vaginal estrogen

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3
Q

Patient with breast CA. You want to start vaginal estrogen. Is it safe?

A

Contact oncologist first

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4
Q

Most appropriate Rx of seborrhic dermatitis

A

Zinc pyrithion shampoo. Only use low potency steroids

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5
Q

SSRI not associated with ED

A

Bupropion

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6
Q

Hormonal contraception contraindicated in migraine

A

Estrogen. Patient can still get progesterone

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7
Q

Dress syndrome also called as DIHS is an example of —- hypersensitivity

A

Type 4 or delayed—> occurs 2-4 weeks after drug exposure

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8
Q

Common drugs associated with DIHS
(Dressed AAA)

A

Allopurinol, anticonvulsants and antibiotics (sulfonamides)

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9
Q

BSA in SJS

A

<10%

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10
Q

BSA in TEN

A

> 30%

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11
Q

Rapidly growing keratotic skin lesion that developed within 4-6 weeks and appears like a volcano

A

Keratocanthoma

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12
Q

What is the skin lesion of BCC

A

Erupted volcano

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13
Q

Premature ovarian failure is diagnosed before the age of -

A

40

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14
Q

Cholesterol abnormality lost menopause

A

Elevated LDL

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15
Q

HRT for vasomotor symptoms

A

Estrogen replacement + progestin for females who have intact uterus - either continuous or cyclical to prevent Ca

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16
Q

Transdermal estrogen is preferred due to low ___ risk

A

VTE

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17
Q

How frequently should HRT be assess in menopause

A

Every year

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18
Q

Risk associated with HRT in menopause that grows every year

A

Breast CA

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19
Q

Risk factors for hidradenitis supprativa

A

Old fat female after puberty comes smoking to the clinic, reports a family history of HS and shows painful nodular lesions in the axilla, groin, and breasts.

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20
Q

Rx of hidradenitis supprativa

A

CLeaR (clindamycin and rifampin) with Adalimumab

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21
Q

Algorithm for pre-operative cardiac evaluation

A

ACS—> no—> CAD risk factors? —> yes —> MACE >1—-> METS <4 —> Will coronary revascularization change management? —> perform functional cardiac testing —> revascularize before surgery if needed

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22
Q

Score to calculate pre-operative pulmonary risk

A

ARISCAT and. STOP-BANG

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23
Q

Routine CXR and spirometer for pre-op?

A

No

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24
Q

EKG for pre-op

A

I veryone gets it

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25
Q

Define erythroderma

A

Erythema covering >80% of BSA

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26
Q

Duration of DAPT for BMS

A

1 month

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27
Q

DAPT duration after PCI for ACS and DES

A

12 months but can be stopped after 6 months

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28
Q

Duration of DAPT after PCI for stable angina with DES

A

6 months can be stopped at 3 months of needed

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29
Q

Disorder associated with SCAD

A

FMD

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30
Q

Why are steroids not used for psoriasis

A

Can pot erythrodermic paoriasis

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31
Q

Electrolyte abnormality in erythoderma

A

HypoCa

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32
Q

Do you need imaging or endoscopy for diagnosis of chronic sinusitis?

A

Yes to demonstrate mucosal involvement and rule out mechanical obstruction

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33
Q

First line treatment for premature ejaculation

A

Paroxetine + PDE-5 inhibitor

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34
Q

Which drugs (including illicit) cause ED

A
  1. BB
  2. SSRI
  3. Marijuana
  4. Opiates
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35
Q

Algorithm for evaluation of ED

A

Early morning erections absent?—> check AM testosterone for everyone.

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36
Q

Rx of ED

A
  1. First line : PDE-5 inhibitors
  2. Second line: penile alprostadil injections
  3. Testosterone if confirmed hypogonadism
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37
Q

Contraindications/caution use of PDE-5 inhibitors with these meds

A
  1. Nitrates
  2. Alpha blockers
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38
Q

Causes of painless vision loss (all posterior etiology)

A
  1. Optic neuritis
  2. CRAO
  3. CRVO
  4. RD
  5. Vit real detachment
  6. Posterior uveitis
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39
Q

Causes of painful vision loss (mostly anterior)

A
  1. Keratitis
  2. Corneal a stadium
  3. Hyphema
  4. Ant uveitis
  5. Endopthalmitis
  6. Pappiledema
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40
Q

Most common autoimmune condition a/w vitiligo

A

Autoimmune thyroid Dx

Others: type 1 DM, RA, poly glandular syndrome

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41
Q

Rx of vitiligo

A
  1. Topical steroids and calcium Erin inhibitor
  2. Phototherapy
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42
Q

Patients who are considered high risk of clotting and should be bridged with AC pre operative

A
  1. Mechanical valve
  2. Valvular A.fib
  3. Recent VTE (3 months)
  4. APS or hyper coagulability
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43
Q

When should warfarin be restarted post surgery

A

Within 12-24 hours for low bleeding risk and within 7 days for high bleeding risk

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44
Q

Which patients should be considered for AC bridging in pre op period

A
  1. Recent PE
  2. Prior stroke
  3. CHADSVASC > 7
  4. Hypercoagulable
  5. Mechanical valve
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45
Q

Two form of impetigo and causative organism

A
  1. Bullous: staph aureus
  2. Non bullous: staph aureus and step group A
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46
Q

Rx of impetigo

A
  1. Localized: topical mupirocin or ratapanulin
  2. Systemic: oral antibiotics
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47
Q

What is Ecthyma

A

Ulcerated impetigo

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48
Q

Two variants of rosacea

A
  1. Papulopustular —> diff from acne due to absence of comedone
  2. Erythrotelengectatic —> diff from SLE due to Jason Kanika fold involvement (soared in lupus)
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49
Q

Rx of papulopustular rosacea

A

Topical metronidazole and Azeliac acid and topical ivermectin; no GC

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50
Q

Rx of erythrotelebgectatic rosacea

A

Avoid exposure to triggers, sun protection, gentle cleansers

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51
Q

Second line Rx of acne

A

Antiandrogens: spirinolactone
OCP

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52
Q

Why should topical antibiotics ALWAYS be combined with benzoyl peroxide in acne?

A

Increased antibiotic resistance with antibiotics alone

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53
Q

Indications for meningococcal vaccine

A
  1. HIV
  2. Asplenia
  3. First year form students
  4. Military recruits
  5. Microbiologists
  6. Travelers to endemic regions
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54
Q

Three options for emergency contraception and preferred patients for each

A
  1. Ulipristil: delays ovulation —> preferred for BMI >26
  2. Levonorgestrel: delays ovulation —> ineffective at BMI >26
  3. Copper IUD —> best if possible
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55
Q

Name a mast cell stabilizing agent used for allergic conjunctivitis. Why not the first line?

A

Cromolyn. Not used because it requires 4 times a day use and therefore has low compliance

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56
Q

Options for colon CA screening and their timeline

A
  1. Colonoscopy: 10
  2. Flex sig + annual stool occult: 10 years
  3. Flex sig alone: 5
  4. CT colonography: 5
  5. FIT: annual
  6. FIT+DNA: every 1-3 years
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57
Q

Rx of melasma

A
  1. Sun avoidance and protection
  2. Laser
  3. Chemical peels
  4. Oral tranexamic acid
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58
Q

Most important factor determining the viability of testes in testicular torsion

A

Time to surety —> should be done within 6 hours

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59
Q

Timing of surgeries after stroke

A
  1. Urgent : after 3 months
  2. Elective: at least 6 months but ideally 9 months
60
Q

What is crusted scabies

A

1000s compared to 5-15 mites in normal scabies occurring in immunocompromised host and appears like psoriasis like lesion

61
Q

Contraindications for GLP-1

A
  1. Pancreatitis
  2. History of MEN
  3. History of MTC
62
Q

C/I of phentoramine-to pita mate

A

Nephro Litiasis

63
Q

C/T for bupropion

A

Eating disorder, seizures, current ETOH and opiate use

64
Q

Topical antibiotics associated with contact dermatitis

A

Bacitracin, polymyxin B, and neomycin

65
Q

Duration of AC in patients undergoing abdominal or pelvic surgery for oncology issues

A

4 weeks

66
Q

When should you touch the prostrate for culture - acute or chronic prostatitis?

A

Only chronic due to increased risk of bacteremia with acute proatstatis

67
Q

When should females revive MMR vaccine

A
  1. Preconception and should avoid pregnancy for 4 weeks
  2. If preferably and non immune —> after delivery and before leaving the hospital/ after termination
68
Q

Alopecia aerata typical presentation

A

Patch of non scarring hair loss

69
Q

Classic physical exam finding in Alopecia aerata

A

Exclamation point hair

70
Q

Women treated for trichomonas should be retested in ___ months

A

3

71
Q

What is Bowen disease

A

SCC of the skin in situ which presents as red papule or plaque

72
Q

What are the conditions associated with SCC

A

Immunosupression ( solid organ transplants, hematology), HIV, and HOV infection

73
Q

What is cutaneous horn in skin malignancies?

A

Seen with SCC due to accusation of keratinocytes

74
Q

FDA approved therapy for mastalgia which has failed conservative management with topical NSAID and supportive wear

A

Danazol

75
Q

Systemic drugs for Rx of onychomycosis

A

Terbenafine and fluconazole

76
Q

Older patients (>35) who are at low risk of STI have epidydymitis from uropathogens. What is the emperic Rx?

A

Levofloxacin x 10 days

77
Q

Rx is epidydimitis for patients who practice receptive anal intervourse

A

IM CTX (for STI) and oral levofloxacin (to cover for empiric pathogens)

78
Q

Common drugs cause in photo toxicity

A

Doxycycline, FQs, antimalarial, HCTZ, amiodarone

79
Q

Algorithm for GAS test based on CENTOR criteria in adults

A

Meeting <=2: no testing
Meeting >2: rapid antigen test for GAS

***HY no guidelines recommend empiric Rx without testing

80
Q

Empiric Rx of GAS pharyngitis

A

Penicillin or amoxicillin

81
Q

Rx of SJS/TEN

A

D/C offending agent. IV steroid or IVIG but none supported by strong evidence.

82
Q

When is topic therapy preferred over cryo for AK and which is the preferred agent

A

Extensive lesion (>15) and agent is 5-FU (better than imiquimod or ingenol)

83
Q

What is erythrasma

A

Superficial skin infection caused by corynebacterium that presents as thin cigarette paper like pink brown plaques that are mildly pruritic

84
Q

How is erythrasma diagnosed?

A

Wood lamp examination showing coral red patches

85
Q

How is erythrasma treated?

A

Oral or topic erythromycin

86
Q

When should biologics be held and started on the pre-operative period?

A

Withhold as close to one dosing cycle as possible and restart within 14 days if evidence of recovery

87
Q

Prostrate CA screening age

A

55-69

88
Q

55ostrate cancer screening age

A

55-69

89
Q

Weight loss promoting antidepressant

A

Bupropion

90
Q

Weight neutral antidepressants

A

Fluoxetine, venlafaxine, and nefazadone

91
Q

What is a dysplastic Nevis and how to work it up?

A

Pigmented spot which usually has more than one shade of brown - “fried egg appearance”. Clinically cannot be different EF from melanoma and therefore excision biopsy should be performed.

92
Q

Patients with dysplastic nevi are at increased risk of ___ skin cancer

A

Melanoma

93
Q

The ONLY intervention that reduced post operative pulmonary complication in patients undergoing non cardiac surgeries

A

Post op prophylactic respiratory physiotherapy.

94
Q

Does incentive spirometer reduce post-op pulmonary complications

A

NO

95
Q

Organisms causing OE

A

Psuedomonas and Staph aureus

96
Q

Treatment of uncomplicated OE

A

Ciprofloxacin + dexamethasone ear drops

97
Q

Treatment of complicated OE (otitis external)

A

Systemic antibiotic

98
Q

What is Ramsay Hunt syndrome (herpes zoster otitis)

A

Painful vescicular rash around the Travis associated with facial nerve palsy

99
Q

How many lab values do you require to make a diagnosis of androgen deficiency in a male patient

A

2 separate testosterone values <300

100
Q

You obtained two testosterone levels and conformed the diagnosis of androgen deficiency. Next step?

A

Obtain FSH and LH

101
Q

USPTF recommends —- the use of Vitaenin E and beta carotene for CVD prevention

A

Against

102
Q

VTE prophylaxis in hospitalized medical patients

A

Pharmacological only

103
Q

VTE prophylaxis in surgical patients

A

IPC + pharmacological

104
Q

Threes cores to screen for alcohol use

A
  1. AUDIT
  2. AUDIT-C
  3. SASQ (single use alcohol screening questionnaire)
105
Q

Vaginal exam is consistent with candidiasis. What is the next step - treatment or testing?

A

Confirmatory test needs to be performed before treatment because clinically cannot distinguish different kinds of vaginitis

106
Q

Rx of chronic bacterial prostatitis

A

4-6 week course of Bactrim or FQ

107
Q

Recurrent LUTI in male patients with the same organism

A

Think chronic prostatitis

108
Q

What are the 4 types of prostatitis

A
  1. Acute prostatitis
  2. Chronic prostatitis
  3. Pelvic pain syndrome: LUTS symptoms and pain with ejaculation with evidence of infection
  4. Asymptomatic unfamiliarity prostatitis: discovered on biopsy for a different reason
109
Q

Breast cancer screening age recommended by USPTF

A

50 and older

110
Q

Shared decision making regarding Brest CA screening in ages __

A

40-49

111
Q

Pigmented lesion with rolled borders

A

Pigmented BCC

112
Q

Melanoma typical appearance

A

Berry like

113
Q

Name the most common INTRAEPIDERMAL bullous skin disease

A

Pemphigus vulgaris : defective attachment between keratinocytes of the epidermis.

114
Q

How does pemphigus vulgaris present

A

Think bullae that rupture easily on the skin and one mucosal surface

115
Q

Which is the common SUBEPIDERMAL bullous skin disease

A

Bullous pemphigoid that’s occurs because of defective atfcahement between dermis and epidermis

116
Q

How does bullous pemphigoid present

A

Tense bullae that May rupture with pressure and leave a scar

117
Q

Preferred antivirals and route of administration and duration for herpes zoster

A

Valacyclovir and Famciclovir orally within 72 hours

118
Q

When can you discontinue cervical cancer screening

A

Age >65 with adequate screening I.e 2 negative pap with HPV screen or three normal pap within last 10 years, with most recent test occurring within 5 years.

119
Q

Age to start cervical cancer screening

A

25

120
Q

What is lichen plants

A

TCell medicated skin disorder commonly associated with Hep C presenting with flat topped, polygonal, purple papilla appearing on lower back, volar wrist, elbows, knees, ankle, and can involve oral mucosa.

121
Q

What is Koebner phenomenon

A

Appearance of lichen planus in areas of trauma

122
Q

When should you add low dose aspirin for primary CAD prevention

A

Age 40-75 with high ASCVD risk and low bleeding risk

123
Q

Most effective to reduce dyspnea and improve QOL in COPD patients

A

Pulmonary rehab

124
Q

Smoking cessation therapy recommended by ACC after ACS

A

During or at discharge:
1. Combination NRT: short acting no tone inhaler + nicotine patch
2. Verenecline

**bupropion or nicotine mono therapy is not preferred

125
Q

Intranasal medication approved for treatment resistant depression

A

Esketamine

126
Q

How do you define treatment resistant depression

A

Failed two appropriate drug trial in addition to aripirazole and psychotherapy

127
Q

Atypical antipsychotic used for depression

A

Aripirazole

128
Q

Causes of pain in bunion

A

Bursitis, synovitis, and mechanical weight shifting causing tarsalgia with walking

129
Q

What is the HINTS test

A

Head impulse, nystagmus, and test of skew

130
Q

Two options for treatment of suspected scaphoid fracture

A
  1. Splinting and repeat radiograph in 1-2 weeks ( not prefrred)
  2. Immidiate CT or MRI with cat or splinting after # confirmed
131
Q

Two test to be performed for all patients with syncope

A

EKG and orthostsics

132
Q

Medication that reduces frequency of binge eating

A

Lisdexamphetamine

133
Q

Define the criteria for binge eating disorder:

A

One a week for 3 months:
1. Eating rapidly than normal
2. Eating until uncomfortably full
3. Eating large amounts when not hungry
4. Eating alone due to embarrassment
5. Remorse’s or guilt after eating

134
Q

Three drug classes that reduce binge eating

A
  1. Lisdexamphetamine
  2. Topiramate
  3. SSRI
135
Q

In men with persistent lower urinary tract symptoms despite treatment with an α-blocker and no evidence of bladder outlet obstruction, the addition of an anticholinergic drug is a reasonable next step.

A
136
Q

Drug-induced acute urticaria should be treated initially with elimination of the underlying medication trigger, if possible, and with symptomatic relief with a nonsedating, long-acting second-generation H1-blocking antihistamine - fexofenadine

A
137
Q

The only contraindication to compression therapy for venous stasis ulcer

A

ABI <0.5

138
Q

Classic presentation of iliotibial band syndrome

A

A young athletes with pain the lateral knee that worsens with activity and is reproduced on noble test ( repeated extension and flexi on if supine knee with thumb on lat consuls reproduces pain)

139
Q

Rx if PTSD (3 drugs)

A
  1. Serteraline
  2. Paroxietine
  3. Venlafaxine
140
Q

First line therapy for premenopausal dysphoria

A

Serteraline

141
Q

Which unusual drug is used for Chris cough that failed conventional management

A

6 month trial of gabapentin

142
Q

Patients with unexplained chronic cough should be referred for ____

A

multimodality speech pathology intervention.

143
Q

Which opiate is contraindicated in ESRD

A

Morphine

144
Q

Which analgesic us cleared with HD

A

Hydromorphone

145
Q

Chlordiazepoxide has a very long half-life and is typically preferred in the treatment of alcohol withdrawal because it is associated with less frequent changes from agitated to sedated and a lower chance for recurrent withdrawal or seizures. However, chlordiazepoxide may accumulate in patients with severe alcoholic hepatitis and cirrhosis; benzodiazepines with a shorter half-life, such as lorazepam (Option A) and oxazepam (Option B), are preferred in these patients.

A
146
Q

Idiopathic intracranial hypertension is associated with use of tetracyclines, retinoic acid, and progesterone or estrogen supplements; discontinuation of any potential offending agent is the first step in management.

A
147
Q

Headaches, visual symptoms, and intracranial noises (pulsatile tinnitus) are the most common presenting symptoms of IIH.

A

General IM (1 decks)

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