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COMLEX stuffssss > random babayyyy > Flashcards

random babayyyy Flashcards

1
Q

acute aortic dissection meds

A

IV beta blocker

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2
Q

Hypokalemia may be caused by increased intracellular entry of potassium following what?

A 
insulin 
Beta agonists (albuterol)
Hematapoeisis 
GI losses
Renal potassium wasting (hyperaldo vs diuretics)
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3
Q

High methylmalonic acid levels can be a sign of………………

A

vitamin B12 deficiency

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4
Q

Normal lipase results are………

A

0 to 160

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5
Q

Always check cerivical spine if any of the following are present:

  • neuro defecit
  • tenderness
  • altered mental status
  • intoxication
  • …………………….
A

Distracting injury (ex: broken femur)

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6
Q

Always check cerivical spine if any of the following are present:

  • neuro defecit
  • tenderness
  • altered mental status
  • intoxication
  • …………………….
A

Distracting injury (ex: broken femur)

  • also note: if we do the CT and find cervical fracture, image the rest of the spine too! (CT thoracic and lumbar spine)
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7
Q

Hydroxyqloroquine treats lupus. We need to monitor patients on this drug with…….

A

eye evaluations (can cause retinal toxicity)

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8
Q
  • Severe atopic dermatitis
  • Recurrent infections (sinopulmonary infections, noninflammatory abscesses)
  • Eosinophilia w/ normal WBC count
A

Hyper IgE syndrome

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9
Q

MPO deficiency leads to recurrent infections, typically with………….

A

Candida

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10
Q

Main difference between primary adrenal insufficiency and central is………
What is the main cause of primary adrenal insufficiency?

A

primary has hyperpigmentation and hyperkalemia.

Autoimmune adrenalitis

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11
Q

…………………… act on the distal ureter, lowering muscle tone and reducing ureteral spasm secondary to stone impaction. They facilitate stone passage and reduce the need for analgesics.

A

Alpha 1 receptor blockers

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12
Q

How do you differentiate hyperemesis gravidum from normal pregnancy nausea?

A

Lab values (hypochloremia, hypokalemia, met alk, elevated liver enzymes, and KETONES IN URINE)

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13
Q

recurrent sinopulmonary and GI infections (ex Giardia) in a young child (starts when maternal antibodies wane), and small/absent lymphoid tissue (ex small tonsils) is……..

A

X-linked agammaglobulinemia (Brutons)

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14
Q

Strep mutans, mitis, oralis, and sanguinis are in what group of strep?

A

viridians streptococci

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15
Q

Patiromer, zirconium, and cyclosilicate do what?

A

Cation exchange agents that bind potassium in the intestines and excrete it.

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16
Q

Most common effect of tamoxifen?

A 
Hot flashes 
(it also can increase risk of endometrial cancer, uterine sarcoma, and venous thromboembolism)
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17
Q

Alcoholic neuropathy has what distribution?

A

Stocking glove

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18
Q

oliguria is less than……….. ml urine output in 24 hrs

A

500

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19
Q

A normal A1C level is below 5.7%, a level of…………… indicates prediabetes, and a level of…………… or more indicates diabetes.

A
  1. 7% to 6.4%

6. 5%

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20
Q

Reactive arthritis is called……………

A

Reiter’s syndrome

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21
Q

25 percent of patients on lithium will develop……..

A

hypothyroid

* Give T4 usually instead of discontinuing lithium

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22
Q

gold standard dx for malrotation with midgut volvulus in a neonate

A

Upper GI series (will show a right sided ligament of Trietz and a corkscrew duodenum)

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23
Q

Pancreatic exocrine insufficiency is diagnosed with LOW fecal……..

A

elastase

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24
Q

Inflamm bowel disease will have increased…….

A

fecal calprotectin and fecal leukocytes

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25
Q

Amoxicillin is first line for otitis media, but recurrent requires……

A

Amoxi-clav (aka augmentin)

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26
Q

Polyhysraminos is a single deepest pocket > or equal to………. cm

A

8

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27
Q

tachyphylaxis

A

tolerance to a drug

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28
Q

On ventilator patients, adjust oxygenation by changing

A

FiO2 or PEEP
* If PaO2 is over 90, consider dropping FiO2 so there is not oxygen damage.

(paCO2 is by RR and TV)

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29
Q

Magnesium sulfate acts as a calcium channel blocker in the CNS, therefore raising seizure threshold. If someone has magnesium toxicity (first sign is hyporeflexia), give them……….

A

calcium gluconate

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30
Q

What size thyroid nodules need FNA?

If they have high risk features (Vascularity, micro calcifications) do FNA if they are greater than what size?

A

2cm
1cm

  • Don’t need to do FNA in cystic nodules because they have low risk of malignancy
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31
Q

Uremic pericarditis can occur at BUN levels >60! Treatment is…….

A

hemodialysis

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32
Q

Menopause therapy with a uterus……

without a uterus…..

A

Estrogen + Progesterone

Estrogen only

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33
Q

vancomycin side effects

A

red man syndrome

nephrotoxicity

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34
Q

treatment for plaque psoriasis

A

methotrexate

* if doesn’t work, don’t increase dose just move to -> TNF alpha inhibitor

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35
Q

chronic nitrous oxide use is associated with what deficiency?

A

B12

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36
Q

diabetes drugs that cause weight loss

A

GLP-1RA (tides)

SGLT-2 inhibitors (flozin)

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37
Q

bisphosphonates side effects

A 
osteonecrosis of jaw 
esophageal ulceration (take alone, first thing in morning with 8 ounces of water, must sit up after taking, no other meds or food for at least 30 min)
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38
Q

MCHC in hereditary spherocytosis…..

A

is increased! (cells are dehydrated and membrane gets lost so there is more hemoglobin ratio)

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39
Q

Acute fatty liver of pregnancy has profound………

A

hypoglycemia

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40
Q

proteinuria is >…….. mg per day

A

.3mg

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41
Q

pulsus parvus et tardus is seen with……..

A

severe aortic stenosis

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42
Q

indomethacin to prevent preterm labor contractions can sometimes cause what?

A

oligohydraminos and premature closure of fetal ductus arteriosis

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43
Q

dilated ventricles with diffuse hypokinesis points to……

A

myocarditis

44
Q

dilated ventricles with diffuse hypokinesis points to……

A

myocarditis

45
Q

pyelo patients who don’t improve within 48-72 hrs of antibiotics need to be evaluated for what?

A

Renal abscess (using an ultrasound)

46
Q

Herpes zoster in ear, ipsilateral facial paralysis, and ear pain is……….. syndrome

A

Ramsay hunt syndrome

47
Q

When evaluating rapid onset hyperandrogenism, we first want to find the source of the tumor.
Elevated testosterone with normal DHEAS indicates……….
Elevated DHEAS indicates…….

A

Ovarian source

Adrenal source

48
Q

Parkland formula for burns

A

The Parkland formula for the total fluid requirement in 24 hours is as follows:
4ml x TBSA that was burned (%) x body weight (kg); 50% given in first eight hours, then 50% given in next 16 hours.

49
Q

Kidney stone imagine:

A
  • US if not likely other problem, if preg, or children
  • also can use NON CONTRAST CT

(Only do X ray to monitor progression, and only works if stone contains calcium -> radiopaque)

<5 mm -> monitor them to pass
< 10 -> conservative management (alpha blockers and ccb)
>10 or complicated consult urology and can do shock wave lithotripsy
>20 percutaneous nephrolithotomy

50
Q

Kidney stone imagine:

A
  • US if not likely other problem, if preg, or children
  • also can use NON CONTRAST CT

(Only do X ray to monitor progression, and only works if stone contains calcium -> radiopaque)

51
Q

what kidney stones are grainy like sand?

A

uric acid stones

52
Q

give burn patients………..

A 
fluids 
beta blocker 
insulin and nutrition
anabolic steroids 
PPi to prevent curling ulcer (dehydrated mucous membranes in stomach will be at risk of ulcer)
53
Q

all fire burn/inhalation injuries get treatment for CO and cyanide

A

IV hydrocobalamine

54
Q

all inhalation injuries get treatment for CO and cyanide

A

IV hydrocobalamine

55
Q

suspected sepsis in neonate give…..

A

ampicillin gentamycin

56
Q

suspected sepsis in child > 1 month give……

A

ceftriaxone vancomycin

57
Q

tranexemic acid can prevent…..

A

heavy menstrual periods

58
Q

what is miller Fischer syndrome

A

A type of guillone barre. Features include weakness of the eye muscles causing difficulty moving the eyes; impaired limb coordination and unsteadiness; and absent tendon reflexes. Other symptoms may include facial, swallowing and limb weakness, as well as respiratory failure

59
Q

Mixed connective tissue disease presents with features of………

A

lupus
systemic sclerosis
polymyositis

60
Q

what is lofgren syndrome?

A

A type of sarcoidosis!
Löfgren syndrome is a type of acute sarcoidosis, an inflammatory disorder characterized by swollen lymph nodes in the chest, tender red nodules on the shins, fever and arthritis.

61
Q

what is lofgren syndrome?

A

A type of sarcoidosis!
Löfgren syndrome is a type of acute sarcoidosis, an inflammatory disorder characterized by swollen lymph nodes in the chest, tender red nodules on the shins, fever and arthritis.

62
Q

what do we do for fam members of someone with bordatella pertussis?

A

macrolide (azithromycin, clarithromycin) for everyone regardless of vaccination stats

63
Q

what do we do for fam members of someone with bordatella pertussis?

A

macrolide for everyone regardless of vaccination stats

64
Q

Prerenal (>20) has …….sediment

A

bland

must place catheter

65
Q

Tx of mycoplasma pneumonia

A

macrolide or reps fluoroquinolone (like azithromycin)

66
Q

preeclampsia warrents delivery at > 34 weeks if there are severe features, such as creatinine >…..

A

1.1
(or elevated transaminases, scotoma, HA, thrombocytopenia)
Or if urine protein > 3.4, but just got straight to delivery if they have other organ damage like elevated creatinine. don’t check urine protein.

67
Q

preeclampsia warrents delivery at > 34 weeks if there are severe features, such as creatinine >…..

A

1.1

68
Q

if you see thyroidectomy in hist, look for symptoms of what?

A

accidental parathyroidectomy (low calcium, high phos)

69
Q

meningitis treatment

A

Vanco plus 3rd gen cepholosporin
add ampicillin in old people greater than 50 or immune compromised to protect from listeria

also do Vanc plus 3rd gen cepholosporin for neurosurg or pen skull trauma.

70
Q

meningitis <1 mo

A

vanc, amp and cefotaxamine (because ceftriaxone causes hyperbili)

71
Q

can’t give low molecular weight heparin to people with…….

A

kidney problems! (look at creat)

72
Q

change in behavior when being studied

A

hawthorne

73
Q

What most likely causes dress syndrome?

A

allopurinol and antiepileptics

morbiliform rash, eosinophilia, fever, malaise, diffuse lymphadenopathy

74
Q

Know this about malarial drugs:

A

P vivax is in central and South America. chloroquine clears but primaquine needs to be taken longer to get rid of dormant malaria which is a possibility with p vivax.

P falcifarum (africa, east Asia) only needs chloroquine

75
Q

Know this about malarial drugs:

A

P vivax is in central and South America. chloroquine clears but primaquine needs to be taken longer to get rid of dormant malaria which is a possibility with p vivax.

76
Q

methimazole (which treats hyperthyroid, makes it harder to make thyroid hormone) can cause….

A

agranulocytosis (look for neutropenic fever)

77
Q

number needed to treat (NNT) is what?

A

Inverse of the absolute risk reduction or 1/ARR.

78
Q

ARR =

A

Control event rate minus experiment event rate.

79
Q

What kills most HIV people who are compliant?

A

same as us! cardiovascular disease

80
Q

Screen all adults age 18-79 for what?

A

hepatitis C infection

81
Q

All men 35 and older (women 45 and older) are screened for lipid disorders, and age……. for those with increased risk of CAD.

A

20+

82
Q

CXR says “interstitial infiltrates” it is code for…..

A

atypical infection (as opposed to consolidative pneumonia). ex: influenza

83
Q

Neonatal sepsis empire treatment

A

Amp + gent until 48hr cx are negative

Cefotaxime + Amp if meningitis suspected

84
Q

Oseltamivir can treat……

A

influenza

85
Q

………………..prophylaxes is indicated in all children with sickle cell younger than 5 to prevent severe pneumococcal infection.

A

Penicillin

86
Q

Lisfranc (tarso-metastarsal) dislocations occur in the setting of Charcot arthropathy (diabetic neuropathic joint). Initial treatment for acute Charcot joint is……..

A

immobilization to prevent progressive deformity.

87
Q

Mobitz 1 (Wenkebach):

Mobitz 2:

A

1: Progressively lengthening PR-interval
2: The PR-interval of the conducted beats is always the same

88
Q

hypertension + hypokalemia

A

Hyperaldosteronism

* Adrenal adenomas are a common cause of primary hyperaldosteronism.

89
Q

primary biliary sclerosis is most common in men or women?

A

men!
Often associated with inflammatory bowel disease, usually asymptomatic but can see pruritus, jaundice, fatigue. Has intra and extra hepatic strictures with segmental dilations.

90
Q

what type of infiltrate is present in biopsy of microscopic colitis?

A

mononuclear/monocyte

risks: female sex, >50, smoking, possibly NSAIDS

91
Q

Myelofibrosis shows pancytopenia and………….

A

massive splenomegaly (due to extramedulary hematopoiesis)

92
Q

For myelodysplastic syndrome, what do we look for?

A

anemia with low reticulocytes!

  • Blood lines will be low but we need to see there is low reticulocytes.
  • Spleen is normal sized.
  • Common in patients who had chemo/rad
93
Q

legionella has diarrhea and pneumonia. tx:

A

flouroquinolone (like levofloxacin) or newer macrolide (azithromycin)

94
Q

how do we asses a submucosal uterine fibroid?

A

sonohysterography (they do transvag ultrasound and infuse saline)

95
Q

pregnant patient wants off valproate, give them

A

lamotrigine

96
Q

venlafaxine has dose dependent…..

A

hypertension

97
Q

venlafaxine (and SNRIs in general) has dose dependent…..

A

hypertension

98
Q

what antidepressant can treat diabetic neuropathy

A

duloxetine

99
Q

among antidepressants, …… carries a low risk of reacting with other meds, especially cardiac meds.

A

sertraline

100
Q

Tartive dyskinesia tx

A

valbenazine or deutetrabenazine

101
Q

all diabetic patients >……. get a statin

A

40

102
Q

migraines in pregnancy

A

1st line: Tylenol

2nds: opioids (acetominiphin-coedine), antiemetics, and NSAIDS but only in second trimester.

103
Q

severe hyponatremia is a rare side effect of……

A

oxytocin

104
Q

severe hypOnatremia is a rare side effect of……

A

oxytocin

105
Q

Magnesium sulfate toxicity tx

A

IV calcium gluconate

COMLEX stuffssss (2 decks)

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