step 1 overlap Flashcards
dx? tick bite in northeastern US with fever and hemolytic anemia
what is the vector and treatment?
Babesiosis
Ixodes tick (the same as Borrelia burgdorferi of Lyme) treat with atovaquone + azithromycin
what drug is used for prophylaxis only for PCP?
dapsone
2 treatments for Mucor/Rhizopus?
surgical debreidement and amphotericin B
empirical treatments for meningitis? name 3 antibiotics
ceftriaxone, vancomycin and ampicilin for Listeria
what vaginal infection gives you normal vaginal infection?
Candida
name the 3 screening tests you do when you think a pt has Cushing syndrome
- inc free cortisol on 24 h urinanalysis
- inc midnight salivary cortisol
- No suppression with overnight low dose dexamethasone
for Cushing work up, you measured the ACTH for further evaluation, explain the next best step
if serum ACTH low, suspect adrenal tumor
if high ACTH, need to distinguish btw Cushing dz vs ectopic ACTH secretion
what is the stimulation test you can do to confirm adrenal insufficiency?
metyrapone stimulation test
what is the role of metyrapone? and what is the normal response?
blocks last step of cortisol synthesis
normal response is dec cortisol and inc ACTH, but in AI, ACTH remains dec after test
3 drugs that can be used for alternatives to heparin for HIT rxn
direct thrombin inhibitors
- argatroban
- bivalirudin
- dabigatran
in HIT, what activates the platelets?
antibody-heparin-PF4 complex
in prerenal azotemian, what are the 4 important lab values and what they should be?
- urine osmolality > 500
2. urine Na+ 20
2 most common reasons for intrinsic renal failure?
- acute tubular necrosis
2. ischemia/toxins
the hallmark in urine analysis for ATN?
muddy epithelial/granular cast
what are the rare side effect of PTU, methimazole?
agranulocytosis –> neutropenia with fever
