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

Rapid Review: Classic/Relevant Treatments 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
Clostridium tetani
Anti-toxin + vaccine booster + diazepam
26
Crohn's disease
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.)
27
Cryptococcus neoformans
Fluconazole (ppx in AIDS pts, CD4 <100)
28
Cystic fibrosis
N-acetylcysteine + antipseudomonal ppx (tobramycin/azithromycin)
29
CMV**
Gancyclovir
30
Depression
SSRIs (first line)
31
Diabetes insipidus
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
32
T1DM
Dietary intervention (low sugar) + insulin replacement
33
T2DM
Dietary intervention (low sugar) + oral hypoglycemid + insulin (possible)
34
Diabetic ketoacidosis
Fluids, insulin, K+
35
Enterococci
Vancomycin/ampicillin + aminoglycosides
36
Erectile dysfunction
Sildenafil
37
ER-positive breast cancer
Tamoxifen
38
Ethylene glycol/methanol ingestion
Fomepizole (alcohol dehydrogenase inhibitor)
39
Folate deficiency
Folate
40
Haemophilus influenza (B)
Rifampin (ppx)
41
Hemorrhagic cystitis
Mesna
42
Heparin toxicity (acute)
Protamine sulfate
43
HER2/neu-positive breast cancer
Trastuzumab
44
Hyperaldosteronism
Spirnolactone
45
Hypercholesterolemia
Statin (first-line)
46
Hypertriglyceridemia
Fibrate | - Upregulates LPL, incr TG clearance
47
Immediate anticoagulation
Heparin
48
Infertility
Leuprolide, GnRH (pulsaltile)
49
Influenza A and B
Oseltamivir, zanamivir - Inhibits influenza neuraminidase (needed for viral release) vs. Amantadine/rimantadine (inh viral penetration and uncoating): Influenza A only
50
Legionella pneumophilia
Erythromycin
51
Long-term anticoagulation
Warfarin
52
Malaria
Chloroquine/mefloquine (for blood schizont) | Primaquine (for liver hypnozoite)
53
Malignant hyperthermia
Dantrolene - muscle relaxant that acts by abolishing excitation-contraction coupling in muscle cells, likely via RyR Also used in NMS
54
Medical abortion
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
Migraine
Sumatriptan
56
MRSA
Vancomycin
57
MS
Beta-interferon
58
Mycobacterium tuberculosis
``` RIPES Rifampin Izoniazid Pyrazinamide Ethambutol Streptomycin ```
59
Neisseria gonorrhoeae
CFTX (add doxy to cover CT)
60
Neisseria meningitidis
PCN/CFTX | Rifampin (ppx)
61
NTD prevention
Folate
62
Osteomalacia/rickets
Vit D supplementation
63
PDA
Indomethacin (induces closure) | - PGD inhibitor
64
Pheochromocytoma
alpha-antagonist
65
Pneumocystic jiroveci
TMP-SMX (ppx in AIDS pt, CD4 <200) - TMP: inhibits bacterial dihydrofolate reductase, disrupts DNA synthesis - SMX: PABA analog, inh dihydropteroate synthetase
66
Prolactinoma
Bromocriptine (DA agonists)
67
Prostate cancer/uterine fibroids
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
Prostate carcinoma
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
Pseudomonas aeruginosa
Antipseudomonal PCN + aminoglycoside - AKA extended-spectrum PCNs: Ureidopenicillins (azlocillin, mezlocillin, piperacillin); Carboxypenicillins (ticarcillin [with clavulanate], carbenicillin); Mecillinam
70
Pulmonary HTN
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
Rickettsia rickettsii
Doxycycline - a tetracycline Chloramphenicol - Aplastic anemia
72
Ringworm infections
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
Schizophrenia (negative sx)
5-HT2A anatagonists (e.g. olanzapine)
74
Schizophrenia (positive sx)
D2 receptor antagonists
75
SIADH
1) Demeclocycline - Tetracycline abx - Decr the responsiveness of the collecting tubule cells to ADH 2) Lithium - ADH antag
76
Sickle cell anemia
Hydroxyurea (incr HbF via uncertain mech)
77
Sporothrix schenckii
Oral KI (not sure why), itraconazole
78
Stable angina
Sublingual nitroglycerin
79
Staphylcoccus aureus
Methicillin/nafcillin
80
Streptococcus bovis
Penicillin ppx
81
Streptococcus pneumoniae
Penicillin/cephalosporin (systemic infection, PNA) | Vancomycin (meningitis)
82
Streptococcus pyogenes
Penicillin ppx
83
Temporal arteritis
High-dose steroids
84
Tonic-clonic seizures
Phenytoin, VPA, CBZ
85
Toxoplasma gondii
Sulfadiazine + pyrimethamine - Protozoa, cat feces, raw meat - Sulfadiazine: a sulfonamide like sulfamethoxazole, PABA analog inhibits dihydropteroate synthesis
86
Treponema pallidum
Penicillin | Syphillis
87
Ulcerative colitis
5-ASA, infliximab
88
UTI prophylaxis
TMP-SMX
89
Warfarin toxicity
``` FFP (acute) - clotting factors, no plts Vit K (chronic) ```
90
Wegener's granulomatosis
Cyclophosphamide - Alkylating agent and immunosuppressant Corticosteroids

USMLE Step 1 (13 decks)

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