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USMLE Step 1 > Rapid Review: Classic/Relevant Treatments > Flashcards

Rapid Review: Classic/Relevant Treatments Flashcards

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USMLE® Step 1 flashcards
1
Q

Absence seizures

A

Ethosuximide

- Blocks thalamic T-type Ca2+ channels

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2
Q

Acute gout attack

A

NSAIDs, colchicine

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3
Q

Acute promylocytic leukemia (M3)

A

All-trans retinoic acid
- t(15;17): fusion PML-RAR protein, prevents immature myeloid cells from differentiating into more mature cells. This block in differentiation is thought to cause leukemia. ATRA acts on PML-RAR to lift this block, causing the immature promyelocytes to differentiate to normal mature blood cells thus decreasing promyelocytes

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4
Q

ADHD

A

Methylphenidate, amphetamines

- Stimulants, increase catecholamines in synaptic cleft

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5
Q

Alcohol abuse

A

AA + disulfiram for patient
- Aldehyde dehydrogenase inhibitor
- Metronidazole can mimic effects
Al-Anon for family

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6
Q

Alcohol withdrawal

A

BZDs

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7
Q

Anorexia

A

SSRIs

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8
Q

Anticoagulation during pregnancy

A

Heparin (does not cross placenta, unlike warfarin)

  • Activates AT3, decr action of Xa and IIa (thrombin)
  • -vs. LMWH is only Xa
  • -vs. direct thrombin inh (lepirudin, bivalirudin)

Reverse OD with protamine sulfate

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9
Q

Anxiety

A

Buspirone

  • 5HT1A receptor
  • No interaction with EtOH unlike barbs, bzds
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10
Q

Arrthythmia in damaged cardiac tissue

A

Class IB antiarrythmic (lidocaine, mexiletine, tocainide)

  • Weakest of the Na channel blockers
  • Decr slope of Phase 0 depol (all Class I)
  • Decr AP duration (Ib specific)
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11
Q

B12 deficiency

A

B12

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12
Q

Benign prostate hyperplasia

A

Tamsulosin, finasteride

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13
Q

Bipolar disorder

A

Mood stabilizers

1) Li (MNOP): unk mechanism
- Movement (tremor), Nephrogenic DI (ADH antag), hypOthyroid, Pregnancy problems (Ebstein’s anomaly, malformation of the great vessels)
2) VPA: incr Na ch inactivation AND incr GABA concentration
- Liver toxicity, NTDs
- Also 1st for GTC sz with CBZ and Pheytoin
3) CBZ: incr NA ch inactivation
- Liver tox, agranulocytosis, SIADH, SJS
- Diplopia, ataxia
- 1st line for simple/complex partial and GTCs

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14
Q

Breast cancer in postmenopausal women

A

Aromatase inhibitor

- Inhibits transformation of androstenedione to estrone and testosterone to estradiol

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15
Q

Buerger’s disease

A

Smoking cessation

AKA thromboangiitis obliterans

  • small blood vessels that become inflamed and swollen. The blood vessels then narrow or become completely blocked by blood clots (thrombosis).
  • hands and feet are especially affected.
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16
Q

Bulimia

A

SSRIs

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17
Q

Candida albicans

A 
Amphotericin B (systemic)
Nystatin (oral thrush, esophagitis)
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18
Q

Carcinoid syndrome

A

Octreotide

  • somatostatin analogue
  • decreases the secretion of serotonin by the tumor and, secondarily, decreases the breakdown product of serotonin (5-HIAA)
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19
Q

Chlamydia trachomatis

A 
Doxycycline (+CFTX for GC co-infection)
Erythromycin eyedrops (ppx in infants)
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20
Q

Chronic gout

A

Probenecid (underexcretor)
- inhibit reabs of uric acid in PT
Allopurinol (overproducer)
- XO inhibitor

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21
Q

Chronic hepatitis

A

IFN-alpha

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22
Q

Chronic myelogenous leukemia

A

Imatinib

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23
Q

Clostridium botulinum

A

Anti-toxin

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24
Q

Clostridium tetani

A

PO metronidazole

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25
Q

Clostridium tetani

A

Anti-toxin + vaccine booster + diazepam

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26
Q

Crohn’s disease

A

Corticosteroids
Infliximab
- anti-TNF alpha (mostly produced by macrophages; induce fever, apoptotic cell death, sepsis [IL1 & IL6 production], cachexia, inflammation and to inhibit tumorigenesis and viral replication.)

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27
Q

Cryptococcus neoformans

A

Fluconazole (ppx in AIDS pts, CD4 <100)

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28
Q

Cystic fibrosis

A

N-acetylcysteine + antipseudomonal ppx (tobramycin/azithromycin)

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29
Q

CMV**

A

Gancyclovir

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30
Q

Depression

A

SSRIs (first line)

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31
Q

Diabetes insipidus

A

1) Central: Desmopressin
2) Nephrogenic
- HCTZ + amiloride (prevent hypoK): decrease distal convoluted tubule reabsorption of sodium and water, thereby causing diuresis. This decreases plasma volume, thus lowering GFR and enhancing the absorption of sodium and water in the proximal nephron. Less fluid reaches the distal nephron, so overall fluid conservation is obtained
- Indomethacin: reduces plasma renin activity and aldo, increases sodium and potassium retention. It also enhances the effects of vasopressin.
3) Li-induced nephrogenic: amiloride

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32
Q

T1DM

A

Dietary intervention (low sugar) + insulin replacement

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33
Q

T2DM

A

Dietary intervention (low sugar) + oral hypoglycemid + insulin (possible)

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34
Q

Diabetic ketoacidosis

A

Fluids, insulin, K+

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35
Q

Enterococci

A

Vancomycin/ampicillin + aminoglycosides

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36
Q

Erectile dysfunction

A

Sildenafil

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37
Q

ER-positive breast cancer

A

Tamoxifen

38
Q

Ethylene glycol/methanol ingestion

A

Fomepizole (alcohol dehydrogenase inhibitor)

39
Q

Folate deficiency

A

Folate

40
Q

Haemophilus influenza (B)

A

Rifampin (ppx)

41
Q

Hemorrhagic cystitis

A

Mesna

42
Q

Heparin toxicity (acute)

A

Protamine sulfate

43
Q

HER2/neu-positive breast cancer

A

Trastuzumab

44
Q

Hyperaldosteronism

A

Spirnolactone

45
Q

Hypercholesterolemia

A

Statin (first-line)

46
Q

Hypertriglyceridemia

A

Fibrate

- Upregulates LPL, incr TG clearance

47
Q

Immediate anticoagulation

A

Heparin

48
Q

Infertility

A

Leuprolide, GnRH (pulsaltile)

49
Q

Influenza A and B

A

Oseltamivir, zanamivir
- Inhibits influenza neuraminidase (needed for viral release)

vs. Amantadine/rimantadine (inh viral penetration and uncoating): Influenza A only

50
Q

Legionella pneumophilia

A

Erythromycin

51
Q

Long-term anticoagulation

A

Warfarin

52
Q

Malaria

A

Chloroquine/mefloquine (for blood schizont)

Primaquine (for liver hypnozoite)

53
Q

Malignant hyperthermia

A

Dantrolene
- muscle relaxant that acts by abolishing excitation-contraction coupling in muscle cells, likely via RyR

Also used in NMS

54
Q

Medical abortion

A

Mifepristone

  • progesterone receptor antagonist
  • endometrial decidual degeneration, cervical softening and dilatation, release of endogenous prostaglandins and an increase in the sensitivity of the myometrium to the contractile effects of prostaglandins.
55
Q

Migraine

A

Sumatriptan

56
Q

MRSA

A

Vancomycin

57
Q

MS

A

Beta-interferon

58
Q

Mycobacterium tuberculosis

A 
RIPES
Rifampin
Izoniazid
Pyrazinamide
Ethambutol
Streptomycin
59
Q

Neisseria gonorrhoeae

A

CFTX (add doxy to cover CT)

60
Q

Neisseria meningitidis

A

PCN/CFTX

Rifampin (ppx)

61
Q

NTD prevention

A

Folate

62
Q

Osteomalacia/rickets

A

Vit D supplementation

63
Q

PDA

A

Indomethacin (induces closure)

- PGD inhibitor

64
Q

Pheochromocytoma

A

alpha-antagonist

65
Q

Pneumocystic jiroveci

A

TMP-SMX (ppx in AIDS pt, CD4 <200)

  • TMP: inhibits bacterial dihydrofolate reductase, disrupts DNA synthesis
  • SMX: PABA analog, inh dihydropteroate synthetase
66
Q

Prolactinoma

A

Bromocriptine (DA agonists)

67
Q

Prostate cancer/uterine fibroids

A

Leuprolide (GnRH analog), GnRH (continuous)

  • Medical castration
  • Continuous GnRH down regulates the secretion of gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH) leading to hypogonadism and thus a dramatic reduction in estradiol and testosterone levels in both sexes
68
Q

Prostate carcinoma

A

Flutamide
- Competes with testosterone and its powerful metabolite, dihydrotestosterone (DHT) for binding to androgen receptors in the prostate gland. Prevents them from stimulating the prostate cancer cells to grow.

69
Q

Pseudomonas aeruginosa

A

Antipseudomonal PCN + aminoglycoside
- AKA extended-spectrum PCNs: Ureidopenicillins (azlocillin, mezlocillin, piperacillin); Carboxypenicillins (ticarcillin [with clavulanate], carbenicillin); Mecillinam

70
Q

Pulmonary HTN

A

Bosentan

  • Dual endothelin receptor antagonist (ET-A and ET-B)
  • Normally, endothelin-1 binding of ET-A or ET-B receptors causes pulmonary vasoconstriction
71
Q

Rickettsia rickettsii

A

Doxycycline
- a tetracycline
Chloramphenicol
- Aplastic anemia

72
Q

Ringworm infections

A

Fungal dermatophytosis

1) Terbinafine
- inhibits squaline epoxidase (ergosterol synthesis)
- LFTs
2) Griseofulvin
- Disrupts microtubule functin/mitosis
- Incr P450, tetratogenic, carcinogenic
3) Imizadoles (topical miconazole, clotrimazole)
- Gynecomastia
- Inh P450

73
Q

Schizophrenia (negative sx)

A

5-HT2A anatagonists (e.g. olanzapine)

74
Q

Schizophrenia (positive sx)

A

D2 receptor antagonists

75
Q

SIADH

A

1) Demeclocycline
- Tetracycline abx
- Decr the responsiveness of the collecting tubule cells to ADH
2) Lithium
- ADH antag

76
Q

Sickle cell anemia

A

Hydroxyurea (incr HbF via uncertain mech)

77
Q

Sporothrix schenckii

A

Oral KI (not sure why), itraconazole

78
Q

Stable angina

A

Sublingual nitroglycerin

79
Q

Staphylcoccus aureus

A

Methicillin/nafcillin

80
Q

Streptococcus bovis

A

Penicillin ppx

81
Q

Streptococcus pneumoniae

A

Penicillin/cephalosporin (systemic infection, PNA)

Vancomycin (meningitis)

82
Q

Streptococcus pyogenes

A

Penicillin ppx

83
Q

Temporal arteritis

A

High-dose steroids

84
Q

Tonic-clonic seizures

A

Phenytoin, VPA, CBZ

85
Q

Toxoplasma gondii

A

Sulfadiazine + pyrimethamine

  • Protozoa, cat feces, raw meat
  • Sulfadiazine: a sulfonamide like sulfamethoxazole, PABA analog inhibits dihydropteroate synthesis
86
Q

Treponema pallidum

A

Penicillin

Syphillis

87
Q

Ulcerative colitis

A

5-ASA, infliximab

88
Q

UTI prophylaxis

A

TMP-SMX

89
Q

Warfarin toxicity

A 
FFP (acute) - clotting factors, no plts
Vit K (chronic)
90
Q

Wegener’s granulomatosis

A

Cyclophosphamide
- Alkylating agent and immunosuppressant
Corticosteroids

USMLE Step 1 (13 decks)

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