Part 2 Video series Flashcards
Mechanism of action of aztreonam?
inhibit cell wall synthesis by inhibiting cross linking
Mechanism of action of azithromycin?
inhibit 50S subunit
Mechanism of action of doxycyline?
inhibit 30S subunit
Mechanism of action of dicloxacillin
blocks peptoglycan cross-linking
Mechanism of action of moxifloxacin
block topo II/IV
Mechanism of action of TMP?
inhibit DHF reductase
Mechanism of action of amiodarone?
class 3 K channel
Mechanism of action of atenolol
class 2 beta blocker
Mechanism of action of disopyramide
class 1A Na channel
Mechanism of action of diltiazem
class 4 Ca channel
Mechanism of action of procainamide
Class 1A Na channel
Mechanism of action of propafenone
Class 1C Na channel
Mechanism of action of aspirin
COX1 and COX2 inhibitor
Mechanism of action of clopidogrel
ADP receptor blocker
Mechanism of action of heparin
antithrombin activation
Mechanism of action of rivaroxaban
direct xa inhibitor
Mechanism of action of tirofiban
G2b/3a
Mechanism of action of warfarin
vit K factor inhibitor
Child at well child. Anxious, able to stand unassisted, walk with assistance, say “mama” and “dada” and stack two blocks. Development of child?
12 months
Causes of macrocephaly?
ICH, acromegaly, Tay Sachs
Most common treatment for amblyopia?
eye patching good eye
APGAR score, stands for?
Appearance pulse grimace activity respirations
Infant has pink trunk but blue extremities. Breathing infrequently and has a weak cry. FLexion of his limbs, no resistance. Pulse is 105. Baby grimaces, does not move away. APGAR score?
6
Infant is breathing 62 breaths/min, displaying nasal flaring, and grunting. CXR shows hazy interstitial infiltrates. Next steps in management?
CPAP, intubation
2 year old girl has low grade fever, runny nose and a bark-like cough for the past 3 days. Tired but has been playing regularly during the day and cough worsens at nighttime. On exam, patient has coarse breath sounds but no wheezing or stridor. Oxygen is 99%. Next step?
decadron
8 year old boy with asthma goes to well child visit. Uses albuterol inhaler 3-4 times per month. PEx is normal. Next step?
add low dose inhaled steroid
Empiric abx management for patient with epiglottitis?
clinda/vanc and cefepime/ceftriaxone
9 year old boy is seen for tachy and lightheadedness. PMH of severe asthma on multiple meds. Asthma good control. Lungs clear, oxygen sat 99%. Pulse is 150 beats/min, BP is 72/40. What med is causing sx?
theophylline
4 day old has 101.2 fever with witnessed seizure. What anti-infective tx is most appropriate?
amp, cefotaxime/gent, acyclovir
2 year old has 2 day fever 103. Parents report no other ill-like sx. Normal PEx and vital signs stable. WBC is 22,000. UA is normal. Blood and urine cx obtained. Next most appropriate step?
CXR, maybe admission, iv abx
3 week old is brought in for frequent projectile vomiting. Patient formula fed and vomits right after all meals. Patient losing weight. What metabolic abnormalities might be present?
hypochloremic, hypokalemic metabolic alkalosis
2 day old 30 week gestational age newborn has bilious vomiting and lethargy. An abd xray reveals air in the wall of intestines. Appropriate next step?
stop feeds, amp/cefotaxime/metronidazole
Primary risk factors for NEC?
preterm birth
enteral feeding
2 month old intant boy is having frequent spitting up of milk based formula. Infant gaining normal weight. Appropriate next step?
reassurance, lactose free formula, upright feedings, thicken feeds
mechanism of action of antidiabetic drug that increases insulin release?
sulfonylureas
mechanism of action of antidiabetic drug that agonist at PPAR gamma receptors?
TZDs
mechanism of action of antidiabetic drug decreases heaptic gluconeogenesis?
metformin
mechanism of action of antidiabetic drug increases insulin sensitivity?
TZDs
antidiabetic drug that recommended first line tx for type 2 diabetes?
metformin
class of oral antibiabetic drugs that commonly causes hypoglycemia
sulfonylureas
antidiabetic drug that causes lactic acidosis?
metformin
antidiabetic drug that is not safe in patients with advance CHF
TZDs
antidiabetic drug that should not be used in patients with elevated serum creatinine
metformin
antidiabetic drug that is metabolized bny liverkl so can be used in patients with renal disease
TZDs
antidiabetic drug that should be stopped following administration of IV contrast
metformin
drug class that helps slow progression of diabetic nephropathy?
ARB/ACEI
greatest risk for sudden cardiac death in a patient who has just suffered an acute MI in the last few hours?
VT/VFib
meds that reduce mortality in patients with CHF
ACEI, beta blockers, aldosterone inhibitors
tx of HOCM?
beta blocker, restrict phys activity, avoid volume depletion
immediate tx for flash pulm edema from CHF
nitrates, PPV
most likely cause of LOC when high school athlete loses consciousness during a football game
HOCM
most likely cause of elderly man loses consciousness only when wearing a tie and a tight fitting collar
hypersensitivity carotid sinus
most likely cause of LOC and loss of bladder control and delayed return to baseline
seizure
most likely cause of LOC during venipuncture and diaphoresis pallor bradycardia
neurocardiogenic syncope
most likely cause of gradual LOC with diaphoresis and tachycardia in a type 1 diabetic
decreased BSG
most likely cause of gradual LOC with hyperglycemia and abd pain in a type 2 diabetic
HHS
Murmur of opening snap and rumbling late diastolic murmur at the apex
mitral stenosis
Murmur of bounding radial pulses and early diastolic murmur along the left sternal border
aortic regurg
Murmur of mid systolic click followed by a late systolic murmur
MVP
Murmur of weak radial pulses and crescendo/decrescendo systolic murmur at the RUSB radiating to the carotids
aortic stenosis
Murmur of holosystolic murmur at the apex radiating to the left axilla
mitral regurg
Which endocrine disorder is most likely to cause a fib?
TSH, hyperthyroidism
Drugs used to control heart rate in patient in a flutter?
dilt or metop
First line pharmacotherapy for a patient with paroxysmal SVT?
IV adenosine
First line tx for a patient with vtach without a pulse?
CPR/defib
Microorganism associated with travel in the desert southwest?
coccidiodes
Microorganism associated with rust colored sputum?
strep pneumo
Microorganism associated with cave exploring?
histoplasma
Microorganism associated with PNA in HIV patient with CD4 less than 200
PCP
antiretroviral avoided during pregnancy?
efavirenz
antiretroviral class known to cause lactic acidosis?
NRTI - zidovudine, didanosine, stavudine, lamivudine, emtricitabine, abacavir, tenofovir
antiretroviral class known to cause elevated glucose and lipids
protease inhibitors - darunavir, ritonavir, indinavir, atazanavir, saquinavir, nelfinavir, fosamprenavir, tipranavir
antiretroviral class known to cause rash
NNRTI - efavirenz, nevirapine, rilpivirine, etravirineq
antiretroviral class known to cause diarrhea
protease inhibitors - darunavir, ritonavir, indinavir, atazanavir
antiretroviral agent causing fatal hypersens reaction?
abacavir
antiretroviral agent causing hyperbili
atazanavir
antiretrotival agent boosting levels of other protease inhibitor
ritonavir
65 year old man presents with hematuria and vague back pain. WBC is 5500 and hgb is 21. Dx?
Renal cell carcinoma
38 year old man presents with hemoptysis and recurrent sinusitis. Urine shows microscopic hematuria. Type of glomerulonephritis? tx?
grandulomatosis with polyangiitis
cyclophosphamide and steroids
most common cause of upper GI bleeding?
PUD, esophagitis, esophagel varices
Most likely cause of anemia with restless legs syndrome
iron defn
most likely cause of anemia in a patient who east ice
iron defn
most likely cause of anemia that develops after taking sulfa drug
G6PD
most likely cause of microcytic anemia in an alcoholic
sideroblastic
most likely cause of microcytic anemia in a patient with RA
AOCD
most likely cause of microcytic anemia with neuro sx
lead poisoning
most likely cause of megaloblastic anemia with neuro sx
b12 defn
most likely cause of megaloblastic anemia without neuro sx
folate
malignancy which is always positive for t(9;22)
CML
philadelphia chromosome
malignancy of 10 year old boy with trisomy 21
ALL
malignancy treated with bortezomib plus melphalan
MM
malignancy treated with ATRA
AML, M3
malignancy treated with thalidomide
MM
malignancy treated with rituximab
non-hodgkin CD20
malignancy treated with imatinib
CML
Cause of amenorrhea for ballet dancer with eating disorder
functional hypothalamic
Cause of amenorrhea for short stature, low set ears and webbed neck
turner syndrome
Cause of amenorrhea following dilation and curettage after spontaneous abortion
ashermann syndrome
Cause of amenorrhea with cyclic pelvic pain and blue bulge at introitus on exam
imperforate hymen
Cause of amenorrhea with elevated testosterone level and no axillary or pubic hair on exam
androgen insens
Cause of amenorrhea with overweight female with acne and hirsutism
PCOS
Cause of amenorrhea with postpartum patient with inability to breastfeed
sheehan syndrome
Cause of amenorrhea with patient with anosmia
kallmann syndrome
Cause of amenorrhea with patient with galactorrhea
pituitary adenoma
Cause of amenorrhea, most common cause
pregnancy
antidepressant choice for depressed patient with insomnia
atypicals
antidepressant first line for most cases of unipolar depression
SSRI
antidepressant good choice for patient who cannot tolerate SSRI sexual dysfunction
bupropion
antidepressant good choice for patient with appetite suppression and weight loss
mirtazapine
antidepressant that may helpo with smoking cessation
bupoprion
antidepressant in overdose may cause sedation and life threatening arrhythmias
TCAs
medication used to prevent vasospasm after a subarachnoid hemorrhage
nimodipine
HA made worse by foods containing tyramine
migraine
HA obese woman with papilledema
IIH
HA jaw muscle pain when chewing
temporal arteritis
HA periorbital pain with ptosis and miosis
cluster HA
HA photophobia and or phonophobia
migraine
HA most common cause of HA
tension
HA lacrimation and or rhinorrhea
cluster
HA elevated ESR
temporal arteritis
HA worse headache of my life
SAH
HA scintillating scotomas prior to HA
migraine
HA responsive to 100% oxygen supplementation
cluster
tx of dig tox
dig immune FAB
tx of warfarin tox
vit K, FFP
tx of heparin tox
protamine sulfate
tx of tPA tox
aminocaproic acid
tx of anticholinergic tox
physostigmine
tx of organophosphates tox
atropine, pralidoxime
tx of carbon monoxide
100% oxygen
tx of lead poisoning
EDTA, succimer, dimercaprol
tx of mercury poisoning
dimercaprol, penicillamine
tx of copper poisoning
penicillamine
tx of iron poisoning
defuroxamine, deferasirox, deferiprone