Rosh Review highlights Flashcards
Nephrogenic Diabetes insipidus can be caused by the medication?
Lithium
Myxedema is a life threatening condition of _______
with a classic presentation of these 3 s/sx?
Hypothyroidism
Hypotension, hypothermia, and bradycardia
Medication most appropriate to treat Myofascial pain syndrome
Cyclobenzaprine
Medication most appropriate indicated for fibromyalgia
Pregabalin
Tinea corporis is also known as ?
Ring worm
Opiate withdrawal symptoms may be achieved with what medication?
Clonidine and antiemetics
What class drug is the most frequent cause of poisoning leading to a variety of anticholinergic symptoms?
TCA (Amitriptyline)
Cholinergic Toxicity acronym for symptoms
SLUDGE
Salivation, lacrimation, urination, defecation, GI cramps, emesis
Urge incontinence is classified as urinary urgency with inability to delay urination.
If behavioral approaches are not helpful, what is the next anticholinergic therapy ?
Oxybutinin or Tolterodine
A patient with salicylate toxicity from aspirin will present with what symptoms? what is the treatment?
Fever, tachypnea, diaphoresis, tinnitus and vertigo.
Tx- Sodium Bicarb (traps S-Acid in urine)
Meniere’s disease tetrad of symptoms?
Vertigo, tinnitus, and hearing loss.
What is the treatment for peritonsillar abscess?
ABX (Augmentin + Septra) and Needle Aspiration or I and D
which antibiotic is most appropriate fir otitis media on a child that has a history of rash with amoxicillin?
Cefdinir
Most common type of prostate cancer?
Adenocarcinoma
Oral Leukoplakia is associated with_____
Oral Hairy Leukoplakia is associated with_____
Oral Leukoplakia- 50%–> dysplasia of malignancy 2t Tobacco.
Oral Hairy Leukoplakia (tongue)- EBV or HIV
Pseudomonas Aeruginosa is susceptible to what cephalosporin?
Cefepime
Maintenance treatment of COPD patient group C (FEV<45%)?
Tiotropium (Lon acting anticholinergic)
Most common cardiac rhythm abnormality in Anorexia Nervosa?
Bradycardia
A patient US shows an empty gestational sac, and no fetal pole. HcG is at 1,000. What is the next treatment?
Repeat HcG after 48-72 hours
HcG < 1500 without IUP require conservative management.
Diabetic agent with increased risk of MI?
Thiozilidinediones (Rosiglitazone)
“Increases insulin sensitivity in fat and muscles”
medication that is indicated in patients with an acute coronary syndrome or hx of MI for anticoagulation therpay?
Ticagrelor (Not for Stroke)
medication considered in patients with non-valvular atrial fibrillation at low risk for stroke?
Aspirin
Common oral anticoagulant that specifically inhibits factor Xa, resulting in predictable anticoagulation
therefore requires no routine monitoring?
Apixaban
Cluster B patients are distinguished by what characteristics?
Dramatic, emotional, self destructive, and erratic
Cluster A patients are distinguished by what characteristics?
odd and eccentric
Cluster C patients are distinguished by what characteristics?
anxious and fearful
Nephrotic syndrome associated with Hodgkin’s and NHL?
Minimal change Nephrotic Syndrome
MC is associated with Good Pasture syndrome?
Rapid Progressive Glomerulonephritis
which medication is used in the long-term treatment of schistosomes infection?
Praziquantel
Which virus is Roseola Infantum associated with?
HHSV 6
Roseola Infantum is characterized by ?
High fever lasting 3-4 days that effervesces with the appearance of a rash.
Diabetes medication that cause hypoglycemia, pancreatitis, and is contraindicated in gastroparesis?
Glucagon Like Peptide 1 (GLP-1)
classic signs of malignant hyperthermia include muscle rigidity 2T increased Ca2+ accumulation (Succinylcholine) what is the treatment?
Dantrolene
A poorly HTN controlled patient with a throbbing headache and vision changes should not be treated with?
Triptan or Ergotamine (Adrenergic agonists)
includes ACS, PAD, cerebrovascular, or angina
Most common malignancy in men age 15-35?
Testicular cancer
MC pathogen in cat or dog bite?
Pasteurella Multocida
Pathogen responsible for cat scratch fever?
Bartonella Henselae
Other than aspirin, what medication should be avoided in children recovering from flu or chicken pox?
Bismuth subsalicylate
a rash that includes oral mucosa, lips, conjunctivae and genitals. Cause by ______ and ________
Sulfonamides, allopurinol and Mycoplasma pneumoniae
Steven-Johnson syndrome
Abruptio Placentae risk factors include?
HTN, trauma, and cocaine use
painful vaginal bleeding
Gold standard testing for herpes virus?
Viral culture and PCR
A patient with chronic ethanol usage should be admitted if presents the following what 3 symptoms?
Fever, tachycardia, and hyperextension.
carcinoid tumors triad?
diarrhea, rash, and flushing
MC use post partum depression medication with fewest side effects? (undetectable in infant serum)
Sertraline
Lead poisoning >____ requires chelation. Lead poison oral and IV treatment include ?
Chelation= >45
Succimer PO (IV EDTA)
Dupuytren contracture is associated with what disease?
Diabetes Mellitus
Treatment for acetaminophen toxicity
N-Acetylcysteine
hypertension treatment for cocaine toxicity
Benzodiazepines and Phentolamine
Alpha Thalassemia is more common in what race?
SE Asian descent
Thrombocytopenia, hyponatremia, rash, and arthralgias/myalgias think?
Rocky mountain Spotted fever
Antibiotics preferred to treat Bordetella Pertussis?
Macrolides
St John’s Wort is notoriously known for decreasing effects of ______ medication, causing_____?
Warfarin’ Ischemic Strokes
Rabies exposure requires Immunoglobulin treatment and ___ doses of inactivated rabies vaccine over ___
4 doses of vaccine over 14 days
Antidote for methanol?
Fomepizole
Oil of wintergreen contains what?
5G of salicylates
Antibiotics for AOM can be deferred if child is?
> /= 2 yoa or has mild-moderate symptoms
Gottron’s papules (knuckle violaceous papules, proximal muscle weakness, periorbital heliotrope rash
Think what disorder?
Polymyositis Dermatomyositis
MC pathogen of AOM in children?
H. Influenza
Staccato cough, afebrile, and hyperinflated or expanded lungs in a neonate 19 weeks or less think?
Chlamydial pneumoniae
Physical complaints from various organ systems that cause impairment.
Symptoms change, disorder is persistent.
Somatic Symptom Disorder
Purposely feigning illness using deception to attain goals.
Factitious Disorder
hyponatremia, hyperkalemia, hyperpigmentation, abdominal pain w NV think what disorder?
Adrenal Insufficiency (Addison’s)
DTaP is given_____ age_____
TDaP is given______ age____
Both vaccines are acellular.
Before the age of 7
After the age of 7 (D comes before T)
2T sun exposure pearly papule lesion with rolled borders and telangiectasias?
MC type of skin cancer and Dx with shave biopsy
Basal Cell Carcinoma
Lesion is also 2T sun exposure presents as a non-healing indurated and ulcerated papule
“Central erosion or ulceration”
Squamous cell Carcinoma
Hyperextendable joints, long protruding ears, long face, prominent jaw, micro penis and large testicles
Fragile X syndrome
Why is peptic ulcer disease a RF for Nephrolithiasis ?
Increased use of acid antacids
Anterior uveitis, IBD, restrictive pulmonary disease, and back pain you think what?
Ankylosing spondylitis (HLA-B27)
Benign murmur low and short tone that reduces in intensity with inspiration, sitting or standing?
Still’s Murmur (Venous Hum increases with maneuvers)
- Anemia - Fever -Thrombocytopenia -Renal failure
- Neurologic findings
Thrombotic Thrombocytopenic Purpura
How many weeks in between should there be for live vaccines?
4 weeks
Hyperpigmentation, hyperkalemia, hyponatremia think what disorder?
Primary Adrenal insufficiency (Addison’s Disease)
When testing for acromegaly, what blood test should you order?
Insulin Like Growth Hormone (IGH-1) “Not HG”
Treatment for Histoplasmosis?
Itraconazole (Amphotericin B)
succinylcholine is contraindicated in spinal cord injuries within 3-6months why?
Sux causes hyperkalemia as Spinal cord injuries–> denervation syndromes (same with MS and ALS)
Diaphoresis, lacrimation, and piloerection are symptoms of withdrawal to what substance?
Opioids
How many café Au let spots are required for Neurofibromatosis 1
6
Delayed tendon reflex relaxation is associated with what disorder?
Hypothyroidism
True or false Carpal Tunnel is a common complication of what disorder ?
Hypothyroidism
TIA risk anticoagulant recommendations?
Low or moderate risk TIA = Aspirin alone
High Risk TIA= Aspirin plus clopidogrel
Abnormal facies, cleft palate, hypercalcemia, and seizures (Jitteriness) think of what newborn genetic disorder?
DiGeorge Syndrome (Chromosome 22 deletion)
What is the treatment for Dry socket?
Iodoform gauze saturated with Eugenol (Oil of cloves).
What is the MC incontinence in elderly?
Urge (Detrusor overactivity Tx= anticholinergics)
MC manifestation of abusive head trauma in infants?
Retinal hemorrhage
WBC counts >100K, Decreased leukocyte alkaline phosphate, and Philadelphia chromosome thin what D/O?
Chronic myelogenous Leukemia (CML)
Pancytopenia, gingival hyperplasia, WBC > 100K, and Auer rods?
Acute Myelogenous Leukemia (AML)
MC childhood malignancy (Esp. Down syndrome), CNS Sx (fever MC), hepatosplenomegaly, LAD think ?
Acute Lymphocytic Leukemia (ALL)
MC leukemia in adults, B Cell Clonal Malignancy, “Smudge Cell” think ?
Chronic Lymphocytic Leukemia (CLL)
What differentiates foot and mouth disease versus Herpangina ?
Herpangina- Lesions @ palate, uvula, tonsils
F and M disease- lesions@ tongue, anterior oral cavity, and hands and feet.
Bulimia Nervosa SSRI of choice for treatment?
Fluoxetine
Girl with normal development of breasts but no menstruation or has no axillary or pubic hair think ?
Complete Androgen insensitivity syndrome?
Which IV sedative –> metabolic acidosis with high doses and prolonged use?
Propofol
What is the alternate treatment for Pasteurella Multocida for PNC allergy ?
Cefuroxime and Clindamycin
When you see Wickham’s Striae yo think what D/O?
Lichen Planus (Pruritic, Polygonal, purple, papule)
Treatment of OCD in children or adolescents?
Sertraline or Fluoxetine
Contraindication of Methotrexate in ectopic pregnancy?
Renal Insufficiency
Tick borne illness with skin ulcers and LAD
Tularemia (Streptomycin)
Which of the following causes secondary osteoporosis in women?
Corticosteroid use
what is the step process in treatment of pheochromocytoma?
Alpha Blockade prior to Beta blockade
Phentolamine followed by Labetalol
Cholesterol medication that can exacerbate Gout
Niacin
Decreased PTH, hypocalcemia, and hyperphosphatemia you think?
Hypoparathyroidism 2T Parathyroid removal/ radiation
N acetylcysteine is administered within_____ of Tylenol ingestion for reduced risk of hepatotoxicity.
8 hours (If over 8 hours–> loading dose of 140 mg kg needed)
which serum biomarker would be elevated in a patient with epithelial ovarian carcinoma?
Cancer Antigen 125
Neonatal bacterial conjunctivitis prevention and treatment?
Gonorrhea= Topical Erythromycin
Chlamydia= Oral Erythromycin
Etomidate a non barbiturate used in rapid sequence intubation is known for what common side effect?
Myoclonic Jerks
Hyperkalemia can cause
Wide QRS, Prolonged PRI, Peaked T waves
Hyper magnesia can cause
hyporeflexia, prolonged PR and QT interval, and wide QRS
Chvostek sign can be seen in what biochemical lab abnormality ?
Calcium (Hypocalcemia)
Chlordiazepoxide is what kind of medication and when is it used?
Benzodiazepine often used as anti-seizure medication
Can phenytoin be used for anti-seizure medication?
No, it does not treat alcohol withdrawal syndrome seizures.
Most common medications for ADHD
Methylphenidate and Atomoxetine (Non-stimulant)
xanthomas on the extensors and abdominal pain that radiates to back think hyper_____ –> __________
Hyper triglyceride levels: –> Pancreatitis
Retinopathy is caused by DM or HTN, what is MC to be seen under fundoscopic exam if Retinopathy is present?
Micro aneurysms or hypervascularization
1st Metatarsal fractures with _____ or more displacement require?
1mm or more: Immediate Ortho referral
Biggest difference between erysipelas and Cellulitis?
Cellulitis has poorly demarcated borders.
Erysipelas has clear demarcated borders and lymphatic streaking is present (Lymphatic involvement).
Pyelonephritis in a pregnant patient (in/out patient)?
1st- Cipro or Septra inpatient (outpatient= cipro)
2nd- Ampicillin/Gentamycin or 3rd Generation cephalosporin
In an AIDS patient pyrimethamine and sulfadiazine medication is the treatment of choice for what?
Toxoplasma Gondii
Pathognomonic finding for Cerebral toxoplasmosis Gondii?
Multiple ring enhancing lesions on CT
Which is the most concerning in malignant melanoma ABCDEs?
Border irregularity of lesion
Major cause of perinatal infections to include sepsis and meningitis?
Group B Strep (Strep Agalactiae).
NSAID contraindicated in Gastric Bypass patients due to black box warning?
Meloxicam
Most appropriate initial pharmacologic agent to treat prostate cancer?
Leuprolide
Drugs that are used for iron chelation in overdose cases?
Deferoxamine- Parenteral only
Deferasirox- Preferred 2T ease of use (PO)
Study of choice to diagnose epiglottitis ?
Indirect Laryngoscopy (Nasopharyngeal scope)
Clozapine 2nd Generation anti-psychotic requires monitoring of _______ due to causing ______.
WBC/ Absolute Neutrophil count: Severe nuetropenia
A 5 year old patient presents wit positive Rapid strep but has anaphylaxis with PCNs what is the TOC?
“Cefdinir is a great alternate for non-immediate hypersensitivity but not for anaphylaxis”
Clindamycin
Which can be a potential benign cause of hiccups ?
Hyponatremia
Treatment of leiomyoma for patients that wish to retain fertility?
Myomectomy
Frequent ear infections and persistent ear drainage despite appropriate antibiotic use think?
Cholesteatoma
MCC of cholesteatoma?
Prolonged Eustachian Tube Dysfunction
Symptoms of Lidocaine overdose include?
Metallic taste, tremor, and bradycardia
Uncomplicated treatment of UTI for pregnant patient?
Amoxicillin - cephalexin- Nitrofurantoin
Complicated/Pylonephritis treatment of UTI for pregnant patient?
3rd Generation cephalosporin or Amp/Gentamycin
Treatment of Malaria Falciparum?
Chloroquine
Complicated Quinidine + Doxycycline
Anemia of chronic disease treatment in CKD due to decreased erythropoietin?
Darbepoetin
Medications that cause gingival hyperplasia?
CCBs, cyclosporin, and phenytoin
Difference between Bacterial tracheitis and Croup?
Bacterial tracheitis are toxic appearing, respiratory failure, and mucopurulent secretion
(+) pseudo membrane @ epiglottis
Multiple central joint pain that improves with exercise in a young <30 yo adult think of what disorder?
Ankylosing Spondylitis (Rheumatoid A. = peripheral joints)
Thrombosis, splenomegaly and proliferation of all 3 myeloid cell lines thin what?
Polycythemia Vera
Serum Ferritin levels of < ___ mcg/L is diagnostic.
15 mcg/L
Hypokalemia is also associated with what other electrolyte disorder?
Hypomagnesemia
Shistocytes on blood smear you think what disorder?
Thombotic Thrombocytopenic Purpura
Child that has thrombocytopenia post viral illness think?
Idiopathic Thrombocytopenic Purpura
Myxedema Coma is associated with?
Severe Hypothyroidism (Hyponatremia MC)
What thyroid drug blocks release of stored thyroid hormone?
Iodine
Methimazole and PTU MOA?
Block Thyroid hormone synthesis
In differentiating BB or CCB overdose what differences do you see?
BBs –> AMS and hypoglycemia
CCBs –> Hyperglycemia
Fetal Heart Rate Mnemonic
Variable- Cord Compression
Early- Head compression
Accelerations- OK
Late- Placental insufficiency (VEAL CHOP)
Antiarrhythmic that leads to Torsades de pointes
Procainamide
Prolonged bleeding time with normal INR, PT, and PTT?
Von Willebrand disease
Multiple spontaneous abortions think what?
Antiphospholipid Ab Syndrome
MC Pneumonia treatment for children < 5?
High dose amoxicillin
Where should the umbilical crod be cut after delivery?
3 cm from the Umbilicus
Treatment of vertigo with stress reduction, low salt diet, no tobacco or alcohol and physiotherapy mainly ____
Vestibular rehabilitation (Meniere’s)
MC cardiac rhythm abnormality in Anorexia Nervosa
Bradycardia
A cherry red spot on fundoscopic exam what test is appropriate?
ECG
MC location for oral cancer
Tongue
Visual evoked potential testing is the study of choice for what disorder?
Optic neuritis
drug that induces Pseudotumor cebri?
Doxycycline (Tetracyclines)
Aortic enteric fistula is most common at?
Duodenum
Akathisia is defined as ?
Restlessness
Droplet precautions are for ?
Influenza and other mild virus.
Airborne precautions are for
TB, Measles, varicella,
Parkinsonian features with dementia think/
Lewy Bodies dementi
Flu vaccine may begin at what age?
2 months
Abdominal complication common with Nenoch-Schonlein Purpura?
Intussusception
Highest greatest effect against high triglycerides
Fibrate Gemfibrozil (Niacin if fibrate CI)
Bacterial Peritonitis treatment abx of choice?
3rd Generation Cephalosporin
Suggestion of congestive Heart failure?
3rd HS S3 Gallop
MCC of infectious lymphadenitis?
Staph Aureus
Henselae (Cervical or Axillae Lymphadenitis)
When in doubt, which is the best Anticoagulant ?
Dabigatran