Brainscape's Knowledge GenomeTM

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


See full index

BCPS 2020 > Random 1 > Flashcards

Random 1 Flashcards

1
Q

DM1/DM2 Diagnosis

A 
Requires 2 abnormals tests (can be from same sample):
Fasting > 126
Random > 200 + sx
A1C > 6.5%
OGTT with 75g glucose > 200
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gestational DM diagnosis

A

Two-step OGTT:

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

DM BP goal

A

< 130/80

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

Weight based insulin dosing

A

0.03 - 0.06 u/kg/day

For NPH/R –> 2/3 qAM and 1/3 qPM. Give 2/3 NPH and 1/3 R

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

DKA

A

Give fluid replacement, and insulin 0.01 unit/kg bolus + 0.1 unit/kg/hour

goal to lower BG by 10% within first hour

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

Diagnosis criteria of DM nephropathy

A

urine albumin/creatinine ration > 30 mg/dl (requires 2 of 3 over 3-6 months for diagnosis)

treat with ARB/ACE-i

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

DM insipidous

A

desmopressin

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

How many carbs for 1 unit of rapid acting insulin

A

rule of 500 - divide 500 by total daily insulin requirements

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

How much BG reduction with 1 unit of rapid acting insulin

A

Divide 1800/TDI

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

SLGT-2’s and associated ADE’s

A

Canagliflozin, dapagliflozin, empagliflozin

Increased risk of UTI’s, must dose adjust based on GFR
Increased bone fracture risk
Euglycemic DKA - hold 3 days prior to surgery

Can reduce CV mortality and can improve renal outcomes. Used as first line in patients with CHF/CKD (caution if eGFR> 30-45, may consider GLP1)

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

Causes hyperthyroidism

A

Graves disease
Goiter’s, Plummer dx
Drug induced (amio)

High levels of T4, low TSH

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

Causes hypothyroidism

A

Hashimoto dx, drug-induced (lithium, amio)

Low T4, High TSH (>10)

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

Hyperthyroid tx

A

Methimazole 10-30mg qd (first line, 10x more potent than PTU). 4-6 months to see effects, risk of hepatotoxicity
Use PTU if 1st trimester of pregnancy (PTU prevents conversion of T4 to T3)

Both methimazole/PTU = ADE agranulocytosis

Use iodine to reduce size of goiter (7-10 days before procedure)
Use non-selective BB (nadalol, propranolol) for sx relief if HR > 90

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

Thyroid storm tx

A

PTU 500-1G load, then 250mg q4h + iodine 1 hour after PTU.

Give prednisone 300 mg IV load +/- APAP, BB (propranolol, can also prevent T4 to T3 conversion)

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

Hypothyroid tx

A

Levothyroxine 1.6 mcg/kg/day (synthetic T4)
Levothyroxine 25 mcg (CVD risk) or 50 mcg starting
adjust in increments of 12.5mcg-25 mcg

Higher req in preg, monitor q4-8 weeks

Dessicated thyroid 60 mg = 100 mcg levothyroxine

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

Myxedema Coma

A

severe hypothyroidism, given IV t4 (levothyroxine) 200-400 mcg load + 1.6 mcg/kg daily

IV dose ~ 75% of PO dose
+/- abx, IV HCT 100 mg q8h

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

Pseudo abx

A 
pip/tazo
cefepime
ceftazidime
aminoglycosides
mero, dori
cipro, levo
aztreonam
polymixin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MRSA abx

A 
Linezolid, vanco, dapto
Bactrim
Doxycycline
Clinda
Tigecycline
Ceftaroline
Oritavancin, telavancin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

VAP - risk factors for MDR

A

IV abx within 90 days
Hospitalization > 5 days
Septic shock, ARRRT

*Give 2 antipseudo + MRSA for empiric tx

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

Sepsis

A

Infection + 2 or more:
AMS
RR >= 22
SBP <= 100

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

Septic shock

A

Sepsis + need for vasopressors to maintain MAP >= 65 AND lactate > 2 mmol despite adequate fL resus

22
Q

BLS

A

ABC = airway, breathing, compressions
30 chest compressions, 2 inch recoil, 2 breathes per round
100-120 compressions/min

23
Q

Post-ROSC

Target temp management (hypothermia)

A

Goal 32-36C
Tx shivering with meperidine, fentanyl, tramadol, or sedatives
Monitor glucose q1-2 hours
Hyperkalemia risk during rewarming

24
Q 
Equivalent Doses Diuretics:
Furosemide IV
Furosemide PO
Bumex IV
Torsemide IV or PO
A

Furosemide IV - 20mg
Furosemide PO - 40 mg
Bumex IV - 1 mg
Torsemide IV or PO - 20 mg

25
Q

Drugs of choice for N&V in pregnancy

A

Phosphorylated carbohydrate solution
pyridoxine
antihistamines
ginger

26
Q

Drugs that induced pancreatitis

A 
Amiodarone
Azathiopurine/mercaptopurine
Estrogens
Exenatidine, sitagliptin
Tetracycline
Bactrim
Valproic Acid
27
Q

H. pylori triple tx

A

PPI BID + amoxicillin 1,000 mg BID or metronidazole 500 mg TID + clarithromycin 500 mg BID for 14 days

Don’t use if PCN allergy or previous macrolide exposure

28
Q

H. pylori quad tx

A

PPI BID + bismuth 300 mg QID + metronidazole 500 mg TID + tetracycline 500 mg QID (or doxy) for 10-14 days

29
Q

Child Pugh score components

A 
ascites
encephalopathy
bilirubin
albumin
PT

Class A 5-6
Class B 7-9
Class C >= 10

30
Q

MELD

A

6-40
SCr, bili, INR
MELD-Na adds sodium
UNOS updated to put limits on lab values (dialysis limit –> 4)

31
Q

Management of ascites

A

Furosemide 40 mg + spironolactone 100 mg
Add albumin if > 5L fluid is removed.

For refractory ascites > add midodrine 7.5 mg TID

32
Q

Management of hepatic encephalopathy

A

Lactulose 15-45 mL q2h until bowel movement, titrate to 2-3 bowels per day.

Add rifaximin to prevent reoccurence. Can also consider neomycin.

33
Q

Management of GI varices (acute)

A

Goal to maintain Hgb > 8

  • Octreotide 50 mcg bolus, 50 mcg/hr IV 3-5 days with endoscopic intervention.
  • +/- vasopression + NTG, but higher risk of ADE
  • Give abx such as ceftriaxone 1 g x 7 days
34
Q

GI varices prophylaxis

A

Small varices, no bL risk - no proph
Medium/large varices, no bL risk - yes
Secondary prophylaxis - yes

Non-selective BB (propranolol, carvedilol, nadolol) titrate to goal HR of 55-60

35
Q

Management of SPB

A

Diagnosis if > 250 polymorphs
Give 3rd generation cephalosporin - cefotaxime, ceftriaxone - treat 5-10 days

Add albumin on day 1 and 3 if meet the following: SCr > 1, BUN > 30, and total bili > 4

36
Q

Latent TB treatment

A

Isoniazid 300 mg daily
Isoniazid 900 mg 2x week (DOT)
X 9 months

Non HIV: rifampin 600 mg daily 4 months

37
Q

Active TB treatment

+ resistance to isoniazid and rifampin

A

RIPE x 2 months

RI x 4 months

Both daily or 5 days per week

Resistance to isoniazid - use levo or moxi
Resistance to rifampin - use “IPE” for 9-12 months of continuation phase

38
Q

BP goal in stroke/tPa cut-off

A

Goal BP < 185/110

39
Q

tPa for stroke and PE

A

Stroke: 0.9 mg/kg (max 90 mg) 10% given bolus, rest over 1 hour

PE: 100 mg with 10% given bolus, rest over 2 hours. Resume UFH without bolus (18 mg/kg/hr max 2K) if aPTT < 80. May use 50 mg IV bolus if life-threatening cardiac arrest due to PE.

40
Q

Surgery hold dates for:
Clopidogrel
Prasugrel
Ticagrelor

A 
Clopidogrel 5d
Prasugrel 7d (prodrug)
Ticagrelor 5d (reversible, rest are not)
41
Q

Heparin dose for STEMI vs. VTE

A

STEMI: 60 u/kg bolus (max 4K) + 12 u/kg/hr infusion (max 1K/hr)

PE: 80 u/kg bolus (max 10K) + 18 u/kg/hr (max 2k)

42
Q

Surgery hold dates for:
Clopidogrel
Prasugrel
Ticagrelor

A

Clopidogrel 5d
Prasugrel 7d
Ticagrelor 5d

43
Q

DM2 tx if ASCVD

A

GLP-1 agonists
Liraglutide or semiglutide
No renal dose adjust in Liraglutide

Could also use SLGT2 inhibitor

44
Q

Plavix - PPI drug interaction

A

CYP2C19

45
Q

DM2 tx if ASCVD

A

GLP-1 agonists
Liraglutide or semiglutide
No renal dose adjust in Liraglutide

46
Q

Febrile Neutropenia

A

Temp > 101F (or 100.4F > 1 hour) and ANC < 500

47
Q

Stage 1 HTN
Stage 2 HTN
Resistant HTN

A

Stage 1: 130-139/80-98 (initiate 1 HTN med if ASCVD risk >10%)
Stage 2: >140/>90 (initiate 2 HTN meds)

Resistant HTN: > 130/80 on 3 or more HTN meds. Want to maximize diuretics, may add spironolactone.

Do not add hydralazine or minoxidil without BB + diuretic.

48
Q

HTN meds if AA

A

non-DHP CCB

Thiazides

49
Q

CHADS2VASC cut offs

A

Women > 3

Men > 2

50
Q

Edoxaban dosing

A

60 mg qd
CrCl 15-50 or wt < 60kg –> 30 mg qd

Avoid if CrCl > 95 or < 15

51
Q

Tx if NVAF + PCI

A

clopidogrel + Xarelto 15 mg daily
apixaban 5 mg BID + clopidogrel
Pradaxa 150 mg BID + clopidogrel

52
Q

A.Fib
Paroxysmal
Permanent
Persistent

A

Paroxysmal: Random episodes, terminate spontaneously
Perm: Despite attempts to cardiovert
Persistent: > 7 days in a.fib

If in a.fib for > 48 hours, give AC and antiarrythmic before cardioversion.

BCPS 2020 (9 decks)

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