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MKSAP > Mksap 2 > Flashcards

Mksap 2 Flashcards

1
Q

Inflammatory breast cancer Rx

A

Chemo, surgery, radiation

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2
Q

IBS RX?

A

Rifaximin, tca, antispasmodic

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3
Q

Condition associated with vitiligo

A

Thyroid disorder

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4
Q

Treatment insomnia after CBT

A

doxepin or non-benzo Benz agonist like zolpidem

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5
Q

RA meds during surgery

A

hold biologics (adalimumab), continue MTX

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6
Q

Dementia LB vs. Parki

A

Park: dementia “well after” motor sx. Dementia/LB: Motor/dementia within 1-2 years

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7
Q

Rx dementia with LB

A

Rivastigmine and donepezil, melatonin for sleep

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8
Q

chronic tension headache rx?

A

amitriptyline

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9
Q

isofosfamide fanconi syndrome

A

prox renal tubular dysfunction, phos wasting <5%

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10
Q

osteoporosis refractory to bisphos

A

denosumab

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11
Q

raloxifene contra-indications

A

cardiac disease

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12
Q

HCV rash association

A

lichen Plans

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13
Q

botulism

A

diplopia, dysphonia, dysarthria, dysphagia

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14
Q

BCC appearance

A

nodular, pink, central defect, telangiectasia, ulceration, crusting

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15
Q

Surveillance on trastuzumab

A

TTE

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16
Q

IgG related disease rx

A

RTX

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17
Q

PMR rx

A

12-20 mg prednisone daily

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18
Q

Slowly rising PSA after prostatectomy - rx?

A

Androgen receptor blocker

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19
Q

COPD with persistent sx add?

A

LABA or LAMA (tiotropium)

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20
Q

Dermatomyositis rx

A

start with prednisone, then after response add ritux or azathioprine

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21
Q

TLS prevention

A

IVF and rasburicase>allopurinol

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22
Q

AI pancreatitis

A

pancreas appears sausage shaped, IgG 4 elevated, responds to steroids

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23
Q

normal abdominal aortic diameter

A

<3

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24
Q

periop warfarin

A

hold 5 days before, start 12 hrs after

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25
Q

timing of TDAP pregnancy

A

27-36

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26
Q

Primary hypogonadism labs/most common cause

A

low T, high LH and FSH. Klinfelter most common: tall, small testes, infertility, signs of androgen deficiency

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27
Q

rx laryngeal ca

A

radiation, chemo prn

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28
Q

latent tb rx

A

rif/isoniazid x3 mo, alt iso x6-9mo

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29
Q

primary hyperaldo

A

suspect if low K

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30
Q

target BP?

A

<130/80

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31
Q

lupus flare preg

A

rising anti-ds Dan, falling comp, proteinuria, swelling, HTN - rx steroids

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32
Q

regions ok to band

A

esophagus, cardia, not fundus

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33
Q

resp compensation for metabolic acidosis

A

acute: 1 inc bicarb for every 10; chronic 3.5 for every 10

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34
Q

incidental aneurysm

A

anterior <12 mm and posterior <7 mm ok to monitor

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35
Q

folate dose preg

A

0.4 to 0.8 mg folic acid (even if lamotrigine)

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36
Q

Sens for and US for NASH

A

80%!

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37
Q

BMD screening?

A

65 OR younger if high frax score

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38
Q

age related macular degeneration

A

yellow/white mottling

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39
Q

Most common hereditary nephrotic syndrome

A

FSGS - especially in African descent, APOL1 gene

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40
Q

anticoagulant for mechanical valve in pregnancy

A

warfarin in 2nd and 3rd trimesters. warfarin in first in f<5, otherwise IV heparin

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41
Q

dx prion disease

A

“real time quaking induced conversion assay”

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42
Q

ecthyma

A

saucer shaped ulcers, legs or feet, caused by strep

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43
Q

rx primary adrenal insufficiency

A

high acth, low cort with BID hydrocortisone and daily fludrocort

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44
Q

rx cap in healthy hosts

A

doxy or amoxicillin; if comorbidities think about fluoroquinolones but not cipro which doesn’t cover S.pneumo

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45
Q

Sweet syndrome

A

reactive febrile skin eruption, “juicy” lesions -

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46
Q

rx severe malaria

A

artesunate

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47
Q

precautions shingles immunocompromised

A

1 dermatome is enough to call it disseminated, put on contact and airborne

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48
Q

pregnancy BP goal

A

<140/<90

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49
Q

gallbladder polyp management

A

> 1cm ccy given cancer risk; 5 mm or les can be monitored

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50
Q

sepsis if tunneled HD line management

A

remove! sometimes can rx with lock therapy for staph epi; sometimes can exchange over guide wire if clear cultures in 48h

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51
Q

genetic association prostate cancer?

A

BRCA

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52
Q

CAD and DM meds to add?

A

GLP-1 OR SGLT2

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53
Q

PSA arthritis improves or worsens with movement

A

improves! can have axial and enthesitis

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54
Q

CSF bacterial meningitis

A

white count>1000, NF 90%, high protein 100-500, glucose <40. IF HSV is highly suspected, repeat LP in 3-7 d

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55
Q

CTEPH management

A

a/c+surgery

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56
Q

“response” in MDD management

A

PHQ9<5 or decrease by 50%, continue therapy for 6 months at least

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57
Q

ESKD and cystic changes managemnt

A

yearly US

58
Q

crytoposporidium is leading pool related diarrhea.

A

rx with nitazoxanide if HIV awaiting immune reconstitution

59
Q

diverticulitis on immunosuppression?

A

admit. surgery for peritonitis or sepsis

60
Q

Enterovirus meningitis

A

causes sx but not encephalitis, often get rash; lymphocytic predominance, HSV1/2 confusion and often lesions. West nile can cause meningitis or encephalitis

61
Q

asthma med associated with depression?

A

montelukast

62
Q

central hypothyroidism how to titrate?

A

go for mid to upper level for free T4

63
Q

AIP CT findings

A

diffusely enlarged pancreas with indistinct borders, rx with steroids

64
Q

rx for fibromyalgia, depression, anxiety?

A

duloxetine

65
Q

alpha thal trait

A

anemia but normal electrophoresis

66
Q

beta thal trait

A

reduced Hgb A, increased F and A2

67
Q

NNT

A

1/ARR (ex, if 30% in one group and 25% in another, it is 1/.05)

68
Q

subdural vs epidural

A

subdural crescent, epidural bulges more

69
Q

post tia mgmt

A

asp/plavix x 21days, then asp monotherapy

70
Q

3 year colo if

A

tubular >10, or 5-10 tubulars <10, or villous/tubulovillous histology

71
Q

gynecomastia workp

A

AM testosterone, HCG, LH, estradiol

72
Q

test of cure for h pylori

A

4 weeks after finishing therapy, 2 weeks after d/c PPI, stool Ag

73
Q

tolerable ACE’s with breast feeding

A

enalapril, captopril, benzalapril, quinapril

74
Q

a/c duration DVT

A

3-6 months (short if) provoked, high risk bleeding, or unprovoked distal leg

75
Q

absence sz:

A

<15 seconds, the adult, prolonged version is “focal impaired awareness sz” - lasts minutes, has post-octal period

76
Q

treat anal fissures

A

topical calcium channel blockers

77
Q

retinal arteriosclerosis

A

associated with HTN, copper wiring, AV knicking

78
Q

when EGD after PPI?

A

2 months

79
Q

Repeat IGRA after what CD4 count

A

> 200

80
Q

D dimer first if?

A

low or moderate likelihood, if high likelihood just go to US

81
Q

rx for irritate SKs?

A

cryo

82
Q

PML appearance compared to toxo or CNS lymphoma

A

not enhancing, when compared with toxo and lymphoma

83
Q

when to treat PSA in CAP?

A

if PSA grown in 1 year, or IV abx in the last 3 mo

84
Q

pulmonary nodule eval

A

if low risk and 6-8, repeat in 6-12 mo; if <6 nothing needed

85
Q

eye drops for allergies

A

antihistamine/mast cell stabilitzing

86
Q

Recurrent neisseria infections (meningococc+gonorrhea)

A

screen for C50 deficiency

87
Q

rx JAK mutation

A

hydroxyurea=aspirin; if >60 yo, rx with those regardless of mutation status if ET

88
Q

microscopic colitis - what causes and how to rx?

A

NSAIDs, PPIs, SSRIs, intraepithelial lymphocytosis, start by withrdrawing, then budesonide PRN

89
Q

adjunct rx in PAD and conditions that are contraindication?

A

cilostazol PDE5 inhibitor, contraindicated in CHF

90
Q

chronic cutaneous lupus

A

discoid, often not systemic

91
Q

cardiac angiosarcoma

A

usually arise in the R atrium, associated with sanginous pericardial effusion, can met to lung vs. myxoma usually LA, don’t met, don’t cause effusion

92
Q

drugs that cause lupus?

A

minocycline

93
Q

Hodgkins appearance vs ebb

A

owl eye

94
Q

cutoff btw moderate and high statin

A

20%; 7.5-20 Is intermediate

95
Q

plan B+alternative for elevated BMI

A

use in BMI<26, works x 3 days, for higher BMI, ulipristal

96
Q

dx allergic asthma

A

absolute eos

97
Q

ABPA - when to suspect?

A

difficult to control asthma, productive cough, mucous plugs,

98
Q

inclusion body myositis - how to rx?

A

prednisone, PT, MTX only if idiopathic

99
Q

external validity=

A

generalizability

100
Q

rx serotonin syndrome?

A

benzos

101
Q

internal rewarming?

A

T<28 or failure with external

102
Q

indications for polysome not at home testing

A

mission critical workers, cardiac or pulm comorbidities

103
Q

subclinical hyperthyroidism rx -

A

methimazole

104
Q

rx hydradenitiis

A

doxy, topical Glinda, adalimumab (TNF alpha inhibitor)

105
Q

abx ppx PJI?

A

no!

106
Q

rx chemo induced early menopause?

A

hormone replacement therapy

107
Q

ash leaf spots

A

tuberous sclerosis, intellectual disability, seizure

108
Q

enteric fever

A

salmonella enterica or salmonella typhi: fever, arthralgia, myalgia, rash

109
Q

PAN

A

medium vessel vasculitis - that affects renal vasculature (Dx by MRA, doesn’t cause glomerulonephritis), nodular rash, abdominal pain, nononeuritis multiplex.

110
Q

erythasma

A

superficial skin infection corynebacterium, rx erythromycin - thin, atrophic, pink/brown plaques

111
Q

premenstrual dysphoric disorder

A
  1. ssri 2.ocp
112
Q

opioid use and hyponatremia

A

secondary adrenal insufficiency

113
Q

bullous pemphigoid vs. pemphigus vulgarius

A

bullous: widespread and not mucosal; vulgaris is mucosal

114
Q

nodules that don’t need follow up

A

<6 mm in low risk host

115
Q

severe AS

A

dobutamine stress to tell low flow low gradient AS and pseudo severe AS

116
Q

fibromyalgia rx?

A

duloxetine or pregabalin, milnacipran

117
Q

junctional

A

P wave inverted in II, before or after QRS

118
Q

saliva substitute

A

pilocarpine or cevimeline

119
Q

slow risk of progression in PCKD?

A

tolvaptan

120
Q

predictor mortality panc

A

bun

121
Q

adenosine stress c/I?

A

asthma

122
Q

primary ppx CAD

A

low dose asa in 50-70 and high risk and low risk bleeding. ?>10%

123
Q

digital ulceration and Raynaud/s?

A

systemic sclerosis

124
Q

predict steroid responsiveness of asthma?

A

fractional exhaled nitrous oxide ; predicts if it’s eosinophilic and will respond to steorids

125
Q

when to bridge? very high risk patients with for example mechanical heart valve

A

hold DOACs: 3 days prior to surgery in normal renal fxn

126
Q

how long delay surgery after stroke/TIA

A

6-12 mo

127
Q

do all diabetics get statin?

A

yes if 40-75, moderate intensity - high if other RFs

128
Q

liver mets from colon cancer?

A

resect

129
Q

stop bactrim in HIV

A

if CD4>200x3 mo

130
Q

stop rx in secondary progressive MS?

A

2 years non-ambulatory and without disease progression

131
Q

hospitalized ACS stop smoking?

A

varenicline, partial nicotinic agonist

132
Q

diabetic retinopathy rx

A

for proliferative or “wet” - anti VEGF injections like “bevacizumab”

133
Q

treat superficial thrombus?

A

6 weeks if greater saphenous, above the knee, extensive

134
Q

pulm htn dlco

A

<60%

135
Q

RA SPARES

A

DIP

136
Q

behcets ulcers

A

PDE4 inhibitor apremilast

137
Q

menopause symptoms rx

A

estrogen and progesterone

138
Q

PID

A

cefotetan/cefoxitin + doxy

139
Q

serum sickness: complement mediated

A

purpura, fever, arthralgia 7-14 days after incident - rx with steroids; drug-induced hypersensitivity instead is weeks out and rash

140
Q

rhythm control?

A

early AF with other cardiovascular comorbidities

MKSAP (5 decks)

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