Step 2 CK Flashcards
Alzheimer’s tx
Cholinesterase inh: donepezil, rivastigmine, galantamine
NMDA antag: memantine
Vit E
Parkinson’s dz tx
DA agonists: levodopa, carbidopa, bromocroptine, amantadine
Antichol: benztropine, trihecyphenidyl
MAO B inhibitor: selegiline
Cholinesterase inhibitors
donepezil, rivastigmine, galantamine, physostigmine
-tx Alzheimers
Anticholinergics
benztropine, trihecyphenidyl
-tx acute dystonia and Parkinsonism 2/2 antipsychotics
TCA OD
CNS dep, hypotension, hyperthermia, antichol (dilated pupils, dry flushed skin, intestinal ileus)
QRS prolongation – vent arrhythmias – PROGNOSIS
Tx = NaHCO3
NAHCO3 MOA for TCA OD
Increase extracellular Na conc to prevent inhibition of cardiac fast Na channels (QT prolong)
Alkalinity serum to decrease drug avidity for sodium channels
NaHCO3 MOA for ASA OD
Urine alkalinization
First gen H1 antihistamines
Diphenhydramine, chlorpheniramine, doxepin, hydroxyzine
Hyperacute transplant rejection
Within 24 hrs
No tx
Anti donor Abs in recipient
Antichol
Urinary retention (failure of detrusor contraction), dysuria
-tx urge incontinence
“Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone (ileus, retention), and the heart runs alone.”
Acute transplant rejection
6 d-1 yr
Antidonor T cells in recipient
Immunosuppressive and steroids
Acute hemolytic transfusion rxn
Within 1 hr
ABO mismatch
Fevers, chills, flank pain, hemoglobinuria
Positive direct Coombs
DIC, RF, shock
Tx = supportive
Anaphylactic transfusion rxn
IgA def
Sec-min
Systolic diastolic bruit with resistant HTN
RAS
Congenital rubella
Sensorineural deafness, cataracts, HSM, purpura (blueberry muffin)
Developmental delays
High PEEP vent complications
Alveolar damage, tension pneumo, hypotension
Drugs that need folic acid supp
Phenytoin, methotrexate, TMP
Other antiepileptics primidone, phenobarbital
Entamoeba histolytica tx
metronidazole
Cholinergic effects
DUMBELLS - Diarrhea, Urination, Miosis, Bradycardia, Emesis, Lacrimation, Lethargy and Salivation
- organophosphate poisoning (tx = atropine, pralidoxime)
- use cholinergic agonist (bethanechol) to tx overflow incontinence
Giardia lamblia tx
metronidazole
Salmonella tx
quinolone, TMP-SMX
Shigella tx
quinolone, TMP-SMX
Campy tx
erythro
Encapsulated organisms
S pneumo, H influ, N meningitidis, Klebsiella
Hydroxyurea MOA
increases HgF
Drugs that increase PrL levels
(psych) phenothiazines, risperidone, haldol
methyldopa
verapamil
What causes hemolysis in G6PD
fava beans sulfa drugs primquine hi-dose ASA INH nitrofurantoin dapsone
WPW tx
Class IA or IC antiarrhythmics
quinidine, procainamide
cardioversion
Trousseau’s syndrome
migratory thrombophlebitis
-MALIGNANCY: pancreatic, lung, prostate, stomach, acute leukemia, colon
-CT scan of abd
Bilirubin in urine = direct or indirect?
direct - soluble
Lidocaine - arrythmia tx
vtach
enthesitis
pain at portions of joint insertion
spondyloarthropathies (AS)
broad and waxy casts
CRF
fatty casts
nephrotic Sx
HIV ppx in needlestick
Zidovudine, lamivudine
Auer rods
AML
PAS+ and TdT+ peripheral blasts
ALL
Otitis media organisms AND sinusitis!!
- S pneumo
- H influ
- Moraxella
tx for hypovolemic hyperNa
NS
high-output HF 2/2 arteriovenous fistula
widened PP, strong peripheral arterial pulsation (brisk carotid upstroke), systolic flow murmur, tachycardia, flushed area
high-output HF conditions
Paget dz, anemia, thiamine deficiency, thyrotoxicosis, AVF
Concern for pt with DM II taking HCTZ?
HHS
Febrile neutropenia tx
Broad spectrum Abx: IV ceftazidime, cefepime (ACTIVE AGAINST PSEUDOMONAS!!!)
epiglotittis organisms
S pyogenes, H influ
airway for cervical spine injury
orotracheal intubation with RSI
DA agonists
levodopa, carbidopa, bromocroptine, amantadine
-tx Parkinson’s
tx for otitis media or sinusitis
Amox (+clavulanic acid)
lithium congenital defect
Ebstein’s anomaly
Do we use beta-blocker for acute CHF?
NOOOO
+ p-ANCA conditions (5)
- pauci-immune GN (eg crescentic)
- microscopic polyangiitis
- Churg-Strauss
- UC
- PSC
anti-mitochondrial Abs
PBC
symptomatic hypoNa tx
hypertonic saline
viral URI gets worse!
S aureus!
Vit A def
bitot’s spots, keratomalacia, xerophthalmia
vit b3/niacin def
dermatitis, diarrhea, dementia
Vit E def
increased RBC fragility
aplastic/macrocytic anemia with thumb abnormalities, abnl skin pigmentation, ear and eye abnl
Fanconi anemia
Fanconi anemia genetics
chromosomal strand breakage
MCC (congenital) aplastic anemia in children
Fanconi anemia
retinal hamartoma found in…
tuberous sclerosis
optic glioma found in…
NF-1
viral meningitis
enterovirus (echo, coxsackie)
HSV
lymphocytic choriomeningitis
mumps
Jervell-Lage-Nielson Syndrome
congenital QT prolongation (TdP) and deafness
- AR
- FHx
- syncope without disorientation
- tx = beta-blocker propranolol
Lesch-Nyhan syndrome
hypoxanthine-guanine phosphoribosyl transferase deficiency (purine met)
-self-mutilation, MR, hyperuricemia, dystonia, choreoathetosis, CP
Jervell-Lage-Nielson Syndrome
congenital QT prolongation (TdP) and deafness
- AR
- FHx
- syncope without disorientation
- tx = beta-blocker propranolol
Henoch-Schonlein purpura
- IgA mediated leukocytoclastic vasculitis
- URI, palpable purpura, abd pain, polyarticular arthritis, RF
Granulomatous dz
Takayasu’s arteritis, Wegener’s, Churg-Strauss
Pt with h/o splenectomy may have abnormality in labs:
THROMBOCYTOSIS
why are infants protected from sickle cell dz?
HgF
Pt with h/o splenectomy may have abnormality in labs:
THROMBOCYTOSIS
why are infants protected from sickle cell dz?
HgF
sudden-onset syncope without a prodrome
arrythmia!! (Torsades de pointes)
-especially on sotalol with diarrhea (hypoK, hypoMg) and CAD
torsades de pointe tx
- MgSo4!!!
2. temporary pacemaker or isoproterenol
defective mineralization of bone
osteomalacia
low bone mass with normal mineralization
osteoporosis
defective skeletal remodeling
Paget’s
Cisplatin SE
nephrotoxicity, tinnitus and hearing loss, N/V, neurotox, electrolyte abnl
drug-induced pancreatitis
- szs/bipolar - valproic acid!!!
- diuretics - furosemide, thiazides
- IBD - sulfasalazine, 5ASA
- immunosupp - azathioprine, L-asparaginase
- AIDs - didanosine, pentamidine
- Abx - metro, tetracycline
abnormal hemostasis in CRF due to…
plt dysfunction
Marfan’s + MR + thromboembolic events + downward dislocation of lens
homocystinuria 2/2 cystathionine synthase deficiency
homocystinuria tx
high doses B6
will see elevation of both homocyteine and methionine in dz
Phenylketonuria = PKU
phenylalanine hydroxylase deficiency
-MR, fair complexion, blue eyes, eczema, musty body odor
hypothyroidism vs myopathy
check reflexes!
young pt with RAS
fibromuscular dysplasia
-stent!
pt with lupus with hip pain…
think AVN 2/2 CSs!!!
pt with meningococcemia dies…
Waterhouse-Friederichsen syndrome!! –> sudden vasomotor collapse and skin rash 2/2 adrenal hemorrhage
PCWP of cardiogenic pulm edema
> 18
PCWP of ARDS
<18 mmHg
rotator cuff tendonitis
improved with lidocaine injection
Loss to follow up is a type of ___ bias
selection bias
infant who has cyanosis when feeding relieved by crying
choanal atresia
electrical alternans with sinus tachycardia
large pericardial effusion
painless jaundice
pancreatic malignancy
med to avoid in MI with acute pulm edema
Beta-blocker
Amyloidosis
RA, kidney and liver invovlement
apple-green birefringence under polarized light
Dumping syndrome
post-gastrectomy!
ARDS TV
6 ml/kg