Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > Online med ed misc > Flashcards

Online med ed misc Flashcards

1
Q

Unstable angina vs NSTEMI vs STEMI

A

UA: no trops, no ST #
NSTEMI: trops, no ST #
STEMI: trops, ST #

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If heart failure and EF < 35% but not class IV, give___

A

AICD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Progression of heart failure management

A

class I beta-blockers + ACE-i/ARB –> class II Loop diuretics –> class III Isosorbide dinitrate-hydralazine + spironolactone –> AICDif not class IV and EF <35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of CHF exacerbation

A 
Lasix
Morphine
Nitrates
O2
Position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Potential causes of CHF exacerbation

A

MI

med/diet non-compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pathologic murmurs (2)

A

systolic grade 3 or murmur
any diastolic murmur

Always get an ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mitral stenosis: auscultation findings

A

left atrial stretch and fluid in the lungs –> afib and or CHF sxs

Findings: rumbling diastolic murmur with an opening snap heard best at Apex

NOTE: often from rheumatic heart disease and occurs in younger people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mitral stenosis: TX

A

Initial: balloon valvuloplasty (through left heart cath) as valve is not calcified as in other valvular d/os

late: replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aortic regurgitation: auscultation findings

A

Aortic valve insufficiency –> left venticular dilation

Findings: rumbling diastolic murmur heard at base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of aortic insuffiency

A

acute: aortic dissection, infection, and infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presentation of aortic insufficiency

A

acute: cardiogenic shock, flash pulmonary edema, CP
chronic: CHF, CP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aortic insufficiency: TX

A

replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aortic stenosis: auscultation findings

A

left ventricular dilation –> CHF as seen also in aortic insufficiency

Findings: systolic murmur heard best at base in crescendo-decrescendo quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of AS

A

ATHEROSCLEROSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mitral insufficiency: auscultation findings

A

left atrial dilation –> afib and CHF sxs

Findings: holosystolic murmur heard best at apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypertrophic obstructive cardiomyopathy: auscultation findings

A

systolic murmur like AS, but more blood with physical exam maneuvers in heart makes better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SOB or syncope with exertion in a young athlete

A

HCOM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HOCM: TX

A

beta-blockade (want heart to be slow enough for long enough diastole)

AVOID decreases in pre-lod (dehydration, exercise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mitral valve prolapse: auscultation findings

A

Findings: systolic murmur heard at apex, better with physical exam maneuvers that increase preload (leg left and squatting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MVP: TX

A

beta-blockade

avoid dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Systolic vs diastolic HF

A

systolic: Echo shows dilated LV, caused by viruses, alcohol, pregnancy, ischemia, TX with beta-bloackade, ACE-is, and diuretics

Diastolic: Echo shows concentric LVH, caused by hypertension or material restriction from amyloid/sarcoid/hemochromatosis, TX with beta-blockade or CCBs (verapimil or dilt), avoidance of HTN and dyhydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diastolic HF with neuropathy =

A

amyloidosis

Dx: fat pad/gingiva bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diastolic HF with pulmonary disease =

A

sarcoid

Dx: cardiac MRI and endomyocardial bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diastolic HF with cirrhosis and bronze DM =

A

hemachromatosis

Dx: ferritin and genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Types of causes of pericardial disease (4)

A

(1) infection (remember TB)
(2) autoimmune (RA, dresslers, uremia)
(3) trauma (penetrating and blunt, dissection)
(4) cancer (breast, lung, lymphoma, esophageal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Best TX for pericarditis

A

NSAIDs and colchicine

NOTE: can use steroids, but this makes recurrence more likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Best imaging modality for pericarditis

A

MRI

NOTE: EKG used though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Findings on EKG for pericaditis

A

PRsegment depression and diffuse ST segment elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

indications for statin therapy

A

vascular disease (MI, PVD, CAS)

LDL > 190

LDL btw 70-189 + 40-75yo + DM

LDL btw 70-189 + 40-75yo + high ASCVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

syncope considerations

A 
W vasovagal 
Orthostatic hypotension
Mechanical cardiac (can cause SCD)
Arrythmogenic cardiac (can cause SCD)
Neurologic
Psych
Electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

High-intensity statins

A

atrovastatin 40 or 80
ruvastatin 20 or 40

DO NOT use with fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Moderate-intensity statins

A

atorvastatin 10 or 20
ruvastatin 5 or 10

NOTE: also for people who need statins but contraindicated against high-intensity (GI upset, age > 75yo, liver or renal dysfxn, past myositis or hepatitis with high dose statin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Causes of secondary HTN

A

Consider in pts < 35yo with HTN or those with refractory HTN

Hypercalcemia 
Hyperthyroid
Hyperaldosteronism
Aortic coarctation
Renovascular
Pheo
Cushings
OSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Initial basic testing for patient diagnosed with HTN (4)

A

UA, CMP (need initial LFTs), lipid profile, baseline ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Aspirin + ____ improves survival in pts following NSTEMI

A

P2y12 receptor blocer (clopidogrel, prasugrel, or ticagrelor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Aspirin + _____ for >12 months following drug-elating stent placement

A

P2y12 receptor blocer (clopidogrel, prasugrel, or ticagrelor)

37
Q

Lytes criteria

A

LDH fluid > 2/3 ULN
LDH fluid/serum >0.6
Total protein fluid/serum >0.5

Need any one to be exudate
If all positve = transudate

38
Q

Causes of exudate vs transudate

A

exudate: malignancy, PNA, TB
transudate: CHF, nephrosis, gastrosis, cirrhosis

39
Q

Cell count finds in thoracentesis

A

PMNS: PNA
Lymphs: TB/malignancy
RBCs: cancer (automatically stage IV)

40
Q

Virchows triad

A

(1) venous stasis
(2) endothelial injury
(3) Hypercoaguability

41
Q

EKG finding in PE

A

s1q3T3

42
Q

What to get to reassure self that pt does not have pe

A

d-dimer (only get with low pre-test probablity)

43
Q

If PE suspected but pt allergic to contrast or has CKD, give ____

A

V/Q scan (not Cta) if CXR normal

44
Q

If massive PE, give ____

A

tPa

45
Q

Management in ARDs

A

CO2: low tidal volume, higher respiratory rate

O2: choose PEEP over FIO2
recruit alveoli!

46
Q

Pt coming in with chronic insidious progression of hypoxemia, with dry cough and crackles heard on auscultation

A

Suspect ILD

47
Q

Imaging for suspected ILD

A

high res CT (shows ground glass opacities)

48
Q

Tx of ILD

A

steroids, sometimes DMARDs

49
Q

Causes of ILD

A

rheumatologic disease (RA, SLE, DCSS)
primary (sarcoid)
exposures (asbestos, hypersensitivity pneumonitis, pneumoconiosis)
Idiopathic (acute is < 6wks, chronic >6months)
Drug-induced (amio, bleomycin, radiation)

50
Q

AA female with hypoxemia, heart block, bells palsy, and erythema nodosum

A

SARCOID

51
Q

W/U of ILD

A

Hi res CT (ground glass opacity)
PFTs (restrictive pattern)
biopsy

52
Q

Silicosis associations

A

rock quarry and sand blasting

NOTE: rule out TB

53
Q

Arthralgias and ILD

A

coal miners pneumoconiosis

54
Q

Visualization/biopsy of different locations of lung nodules

A

if in bronchiole or around: EGUS

if in periphery: CTguided percutaneous

if in middle: VATS

55
Q

Work up of lung cancer before TX

A

CT chest
staging
PET
PFTs

56
Q

Determination of risk with lung nodule

A 
(low-risk qualities)
Size (small <2cm)
Surface (smooth)
smoking
Self (age < 45)
NOTE: if calcified, less likely cancer
57
Q

Types of secondary DM

A

Endocrine diseases (cushing, acromegaly, glucogonoma)

pancreatic conditions

pancreatic cancer

drug-induced

genetic syndromes

58
Q

Initial testing in an acute asthma exacerbation vs nonacute asthma

A

acute asthma: ABG and peak expiratory flow

nonacute asthma: methacholine/histamine challenge

NOTE: methacholine is an artifical form of acetylcholine used in diagnostic testing

59
Q

Asthma in which IgE is eleveated: associations

A

Atopy, asthma, and allergy triad

allergic bronchopulmonary asperigillosis

60
Q

Asthma in which IgE is elevated: TX

A

omalizumab

61
Q

Asthma that is part of atopy and allergy triad: long-term control agent

A

leukotriene modifiers (montelukast, zafirleukast, or zileuton)

62
Q

Acute asthma exacerbation: TX

A

O2
albuterol
steroids (NOTE: takes a while to kick in)
duonebs (albuterol and iprtropium)
Magnesium will relieve bronchospasm while steroid still kicking in

63
Q

Possible EKG findings in pt with COPD

A

RAH and RVH

Afib or MAT

64
Q

TX progression in COPD not controlled with albuterol

A

anti-cholinergic (tiotropium), then ICS

65
Q

Findings of bronchiectasis on CXR

A

dilated, thickened bronchi, sometimes with tram tracks

NOTE: most accurate imaging is high res CT

66
Q

An asthmatic patient with recurrent episodes of brown-flecked sputum and transient infiltrates on CXR

A

Allergic bronchopulmonary aspergillosis

NOTE: can also present with cough, wheezing, hemoptysis, and bronchiectasis

67
Q

Allergic bronchopulmonary aspergillosis: TX

A

Oral steroids and

oral itraconazole for severe cases

68
Q

A young pt with chronic lung disease (cough, sputum, hemoptysis, wheezing, and dyspnea) and recurrent episodes of infection/sinusitis who is infertile

A

cystic fibrosis

69
Q

Cystic fibrosis

A

antibiotics
inhaled recombinant human deoxynuclease
albuterol
pneumococcal and influenza vaccines

lung transplant if tx refractory advanced disease

Ivacaftor increases the activity of CFTR in some patients

70
Q

3 most common pathogens in COPD exacerbation

A

strep pneumo
H influenzae
moraxella catarrhalis

71
Q

Atypical pna =

A

organisms (mycoplasma, chlamydophila, legionella, Coxiella, and viruses) that are not visible on gram stain and not culturable on standard blood agar

72
Q

Ventilator-associated pneumonia

A

3 different agents

(1) anti-pseudomonal beta-lactam (cephalosporin or pip-tazo, or carbapenem)
(2) 2nd anti-pseudomonal agent (aminoglycoside or fluoroquinolone)
(3) MSSA agent (vanc or linezolid)

73
Q

Aminoglycosides

A

gentamicin
tobramicin
amikacin

74
Q

fluoroquinolones

A

ciprofloxacin

levofloxacin

75
Q

CAP: TX outpatient vs inpatient

A

Outpatient:
If previosuly healthy–macrolide or doxycycline

If comorbidities or recent antibx–levofloxacin or moxifloxican (respiratory fluoroquinolones)

Inpatient:
respiratory fluoroquinolone or ceftriaxone+azithro

76
Q

Macrolides

A

azithromycin

clarithromycin

77
Q

Type of vision loss with open angle glaucoma

A

gradual bilateral loss of peripheral vision over a period of years –> tunnel vision

Central vision spared

78
Q

Euthyroid sick syndrome =

A

low T3 syndrome

a fall in total and free T3 levels with normal T4 and TSH levels

79
Q

Warm vs cold agglutinin disease: TX

A

Warm: Steroids initially, IVIG with acute episode does not respond to steroid, splenectomy if recurrence, rituximab if all else fails

Cold: warming of limbs, rituximab, sometimes plasmapharesis

80
Q

G6PD deficiency: Dx

A

PBS showing heinz bodies ad bite cells

Most accurate test is G6PD level 1-2months after an acute episode of hemolysis

81
Q

TTP or HUS: TX

A

severe episodes treated with plasmapheresis or plasma exchange

82
Q

Paroxysmal nocturnal hemoglobinuria: clinical presentation

A

episodic dark urine, pancytopenia, clots in unusual places (mesenteric and hepatic veins)

83
Q

Paroxysmal noctrunal hemoglobinuria: TX

A

Prednisone, BMT for cure

Eculizumab for episodes of hemolysis and thrombosis

84
Q

Chronic aplastic anemia: TX

A

BMT for cure

antithymocyte globulin (ATG) and cyclosporine

85
Q

Essential thrombocytosis: TX

A

hydroxyurea

86
Q

Non-hodgkin lymphoma: diagnostic testing and tx

A

Dx: excisional biopsy

TX: stage 1&2–local radiation and small course of chemi

stage 3,4, or any B sxs–CHOP (cyclophosphamide, hyrdoxyaunorubicin/adriamycin, vincristine/oncovin, prednisone)

87
Q

Hodgkin lymphoma: DX and TX

A

DX: Reed-sternberg cells on patholgy

TX: stages 1&2–chemo and radiation

stages3,4, or B sxs–ABVD (adriamycin, bleomycin, vinblastine, dacarbazine)

88
Q

Multiple Myeloma: TX

A

HSCT for cure
Chemo otherwise
Meds: steroids + lenalidomide OR melphalen (in older pts)

89
Q

Waldentrom macroblobulinemia: TX

A

rituximab

Step 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions