random babayyyy Flashcards
1
Q
acute aortic dissection meds
A
IV beta blocker
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)
3
Q
High methylmalonic acid levels can be a sign of………………
A
vitamin B12 deficiency
4
Q
Normal lipase results are………
A
0 to 160
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)
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)
7
Q
Hydroxyqloroquine treats lupus. We need to monitor patients on this drug with…….
A
eye evaluations (can cause retinal toxicity)
8
Q
- Severe atopic dermatitis
- Recurrent infections (sinopulmonary infections, noninflammatory abscesses)
- Eosinophilia w/ normal WBC count
A
Hyper IgE syndrome
9
Q
MPO deficiency leads to recurrent infections, typically with………….
A
Candida
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
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
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)
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)
14
Q
Strep mutans, mitis, oralis, and sanguinis are in what group of strep?
A
viridians streptococci
15
Q
Patiromer, zirconium, and cyclosilicate do what?
A
Cation exchange agents that bind potassium in the intestines and excrete it.
16
Q
Most common effect of tamoxifen?
A
Hot flashes (it also can increase risk of endometrial cancer, uterine sarcoma, and venous thromboembolism)
17
Q
Alcoholic neuropathy has what distribution?
A
Stocking glove
18
Q
oliguria is less than……….. ml urine output in 24 hrs
A
500
19
Q
A normal A1C level is below 5.7%, a level of…………… indicates prediabetes, and a level of…………… or more indicates diabetes.
A
- 7% to 6.4%
6. 5%
20
Q
Reactive arthritis is called……………
A
Reiter’s syndrome
21
Q
25 percent of patients on lithium will develop……..
A
hypothyroid
* Give T4 usually instead of discontinuing lithium
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)
23
Q
Pancreatic exocrine insufficiency is diagnosed with LOW fecal……..
A
elastase
24
Q
Inflamm bowel disease will have increased…….
A
fecal calprotectin and fecal leukocytes
25
Amoxicillin is first line for otitis media, but recurrent requires......
Amoxi-clav (aka augmentin)
26
Polyhysraminos is a single deepest pocket > or equal to.......... cm
8
27
tachyphylaxis
tolerance to a drug
28
On ventilator patients, adjust oxygenation by changing
FiO2 or PEEP
* If PaO2 is over 90, consider dropping FiO2 so there is not oxygen damage.
(paCO2 is by RR and TV)
29
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..........
calcium gluconate
30
What size thyroid nodules need FNA?
| If they have high risk features (Vascularity, micro calcifications) do FNA if they are greater than what size?
2cm
1cm
* Don't need to do FNA in cystic nodules because they have low risk of malignancy
31
Uremic pericarditis can occur at BUN levels >60! Treatment is.......
hemodialysis
32
Menopause therapy with a uterus......
| without a uterus.....
Estrogen + Progesterone
| Estrogen only
33
vancomycin side effects
red man syndrome
| nephrotoxicity
34
treatment for plaque psoriasis
methotrexate
| * if doesn't work, don't increase dose just move to -> TNF alpha inhibitor
35
chronic nitrous oxide use is associated with what deficiency?
B12
36
diabetes drugs that cause weight loss
GLP-1RA (tides)
| SGLT-2 inhibitors (flozin)
37
bisphosphonates side effects
```
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)
```
38
MCHC in hereditary spherocytosis.....
is increased! (cells are dehydrated and membrane gets lost so there is more hemoglobin ratio)
39
Acute fatty liver of pregnancy has profound.........
hypoglycemia
40
proteinuria is >........ mg per day
.3mg
41
pulsus parvus et tardus is seen with........
severe aortic stenosis
42
indomethacin to prevent preterm labor contractions can sometimes cause what?
oligohydraminos and premature closure of fetal ductus arteriosis
43
dilated ventricles with diffuse hypokinesis points to......
myocarditis
44
dilated ventricles with diffuse hypokinesis points to......
myocarditis
45
pyelo patients who don't improve within 48-72 hrs of antibiotics need to be evaluated for what?
Renal abscess (using an ultrasound)
46
Herpes zoster in ear, ipsilateral facial paralysis, and ear pain is........... syndrome
Ramsay hunt syndrome
47
When evaluating rapid onset hyperandrogenism, we first want to find the source of the tumor.
Elevated testosterone with normal DHEAS indicates..........
Elevated DHEAS indicates.......
Ovarian source
| Adrenal source
48
Parkland formula for burns
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
Kidney stone imagine:
- 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
Kidney stone imagine:
- 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
what kidney stones are grainy like sand?
uric acid stones
52
give burn patients...........
```
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
all fire burn/inhalation injuries get treatment for CO and cyanide
IV hydrocobalamine
54
all inhalation injuries get treatment for CO and cyanide
IV hydrocobalamine
55
suspected sepsis in neonate give.....
ampicillin gentamycin
56
suspected sepsis in child > 1 month give......
ceftriaxone vancomycin
57
tranexemic acid can prevent.....
heavy menstrual periods
58
what is miller Fischer syndrome
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
Mixed connective tissue disease presents with features of.........
lupus
systemic sclerosis
polymyositis
60
what is lofgren syndrome?
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
what is lofgren syndrome?
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
what do we do for fam members of someone with bordatella pertussis?
macrolide (azithromycin, clarithromycin) for everyone regardless of vaccination stats
63
what do we do for fam members of someone with bordatella pertussis?
macrolide for everyone regardless of vaccination stats
64
Prerenal (>20) has .......sediment
bland
| must place catheter
65
Tx of mycoplasma pneumonia
macrolide or reps fluoroquinolone (like azithromycin)
66
preeclampsia warrents delivery at > 34 weeks if there are severe features, such as creatinine >.....
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
preeclampsia warrents delivery at > 34 weeks if there are severe features, such as creatinine >.....
1.1
68
if you see thyroidectomy in hist, look for symptoms of what?
accidental parathyroidectomy (low calcium, high phos)
69
meningitis treatment
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
meningitis <1 mo
vanc, amp and cefotaxamine (because ceftriaxone causes hyperbili)
71
can't give low molecular weight heparin to people with.......
kidney problems! (look at creat)
72
change in behavior when being studied
hawthorne
73
What most likely causes dress syndrome?
allopurinol and antiepileptics
| morbiliform rash, eosinophilia, fever, malaise, diffuse lymphadenopathy
74
Know this about malarial drugs:
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
Know this about malarial drugs:
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
methimazole (which treats hyperthyroid, makes it harder to make thyroid hormone) can cause....
agranulocytosis (look for neutropenic fever)
77
number needed to treat (NNT) is what?
Inverse of the absolute risk reduction or 1/ARR.
78
ARR =
Control event rate minus experiment event rate.
79
What kills most HIV people who are compliant?
same as us! cardiovascular disease
80
Screen all adults age 18-79 for what?
hepatitis C infection
81
All men 35 and older (women 45 and older) are screened for lipid disorders, and age....... for those with increased risk of CAD.
20+
82
CXR says “interstitial infiltrates” it is code for.....
atypical infection (as opposed to consolidative pneumonia). ex: influenza
83
Neonatal sepsis empire treatment
Amp + gent until 48hr cx are negative
Cefotaxime + Amp if meningitis suspected
84
Oseltamivir can treat......
influenza
85
....................prophylaxes is indicated in all children with sickle cell younger than 5 to prevent severe pneumococcal infection.
Penicillin
86
Lisfranc (tarso-metastarsal) dislocations occur in the setting of Charcot arthropathy (diabetic neuropathic joint). Initial treatment for acute Charcot joint is........
immobilization to prevent progressive deformity.
87
Mobitz 1 (Wenkebach):
Mobitz 2:
1: Progressively lengthening PR-interval
2: The PR-interval of the conducted beats is always the same
88
hypertension + hypokalemia
Hyperaldosteronism
| * Adrenal adenomas are a common cause of primary hyperaldosteronism.
89
primary biliary sclerosis is most common in men or women?
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
what type of infiltrate is present in biopsy of microscopic colitis?
mononuclear/monocyte
risks: female sex, >50, smoking, possibly NSAIDS
91
Myelofibrosis shows pancytopenia and.............
massive splenomegaly (due to extramedulary hematopoiesis)
92
For myelodysplastic syndrome, what do we look for?
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
legionella has diarrhea and pneumonia. tx:
flouroquinolone (like levofloxacin) or newer macrolide (azithromycin)
94
how do we asses a submucosal uterine fibroid?
sonohysterography (they do transvag ultrasound and infuse saline)
95
pregnant patient wants off valproate, give them
lamotrigine
96
venlafaxine has dose dependent.....
hypertension
97
venlafaxine (and SNRIs in general) has dose dependent.....
hypertension
98
what antidepressant can treat diabetic neuropathy
duloxetine
99
among antidepressants, ...... carries a low risk of reacting with other meds, especially cardiac meds.
sertraline
100
Tartive dyskinesia tx
valbenazine or deutetrabenazine
101
all diabetic patients >....... get a statin
40
102
migraines in pregnancy
1st line: Tylenol
| 2nds: opioids (acetominiphin-coedine), antiemetics, and NSAIDS but only in second trimester.
103
severe hyponatremia is a rare side effect of......
oxytocin
104
severe hypOnatremia is a rare side effect of......
oxytocin
105
Magnesium sulfate toxicity tx
IV calcium gluconate
