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Medicine > step 3 15 > Flashcards

step 3 15 Flashcards

1
Q

st johns wort use

A

depression

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2
Q

saw palmetto SE’s

A

Mild stomach discomfort

Increased bleeding risk

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3
Q

black cohosh SE

A

Hepatic injury

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4
Q

kava SE’s

A

Severe liver damage

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5
Q

echinacea SE’s

A

Anaphylaxis (more likely in asthmatics)

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6
Q

lumbar spinal stenosis management

A

conservative or can include a lumbar epidural block. Surgical decompression through a laminectomy is an option when other therapies fail.

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7
Q

PMR treatment

A

low dose prednisone

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8
Q

management of pregnant woman on valproate

A

Stay on valproate. Patients are started on high-dose folic acid and screened for congenital anomalies with serum alpha-fetoprotein and an anatomy ultrasound.

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9
Q

pathophys of toxic shock syndrome

A

widespread activation of T cells by exotoxins acting as superantigens, leading to the massive release of cytokines.

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10
Q

bacteria causing dysentery

A

Salmonella, Shigella, Escherichia coli (enterohemorrhagic or enteroinvasive), Campylobacter, and Yersinia.

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11
Q

meds that can increase risk for pyloric stenosis

A

erythromycin and azithromycin

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12
Q

number needed to harm

A

reciprocal of absolute risk increase

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13
Q

NNT calculation

A

reciprocal of absolute risk reduction (ARR).

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14
Q

odds ratio calculation

A

2 × 2 contingency table, using the formula: OR = ad/bc.

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15
Q

bacterial vs viral conjunctivitis

A 
viral = watery discharge
bacterial = purulent discharge. usually presents in isolation, rather than with other symptoms
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16
Q

when is viral conjunctivitis no longer infectious

A

once eye discharge resolves (transmitted through direct contact)

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17
Q

most important single risk factor for osteoporosis and osteoporotic bone fracture.

A

age

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18
Q

pregnancy and bariatric surgery

A

need to delay pregnancy for a year to optimize weight loss and stabilize nutritional status

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19
Q

ecologic fallacy

A

Applying population-level information to an individual level.

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20
Q

effect of dose-response relationship

A

suggests causality

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21
Q

pineal tumor presentation

A

Parinaud’s syndrome, which is characterized by the loss of pupillary reaction, vertical gaze paralysis, the loss of optokinetic nystagmus, and ataxia
- headache due to increased ICP

22
Q

best study to investigate outbreak of an infectious disease

A

case-control study

- investigates relation between exposure and disease

23
Q

extraarticular manifestations of ankylosing spondylitis

A

acute anterior uveitis, aortic regurgitation, apical pulmonary fibrosis, IgA nephropathy, and restrictive lung disease

24
Q

TB meningitis presentation

A

2-3 weeks of prodromal symptoms followed by signs of meningeal irritation. Suspicion is often raised in patients with choroidal tubercles, basilar meningeal enhancement, and characteristic cerebrospinal fluid (CSF) findings.
- Choroidal tubercles (yellow-white nodules near the optic disc) are often detected via funduscopic examination.

25
Q

CSF analysis with TB

A

Elevated protein (>250 mg/dL, generally 100-500 mg/dL)
Low glucose (<10 mg/dL)
Lymphocytic pleocytosis
Elevated adenosine deaminase

  • can throw you off because lymphocyte predominance but looks bacterial.
26
Q

management of TB meningitis

A
  • should be initiated on treatment prior to bacteriologic confirmation. Treatment involves 2 months of 4-drug therapy with isoniazid, rifampin, pyrazinamide, and either a fluoroquinolone or injectable aminoglycoside, followed by 9-12 months of continuation therapy with isoniazid plus rifampin.
  • 8 weeks of adjuvant glucocorticoid therapy (dexamethasone or prednisone). This significantly reduces morbidity and mortality.
27
Q

management of drunk patient in ED who said they’d SI

A

wait until they’re sober then reassess

28
Q

management of adnexal mass during pregnancy

A

IF persistent, complex features, and/or is >10 cm in diameter then surgery during second trimester

29
Q

management of severe bipolar mania during pregnancy.

A

haldol

30
Q

drugs to stop before surgery

A
  • raloxifine (SERMS)
  • ACEi’s – hold the night before surgery (10 hours prior) unless the patient is taking them for heart failure.
  • metformin, the night before
31
Q

neoplasm associated with sjogrens

A
  • B cell lymphoma (B lymphocyte activation occurs as a component of the chronic inflammation in patients with Sjogren’s syndrome. This activation results in an increased risk of B cell lymphoma.)
32
Q

keloid treatment

A

intralesional gluocorticoids

33
Q

why we give IV lasix during HF exacerbations

A

gut wall edema secondary at anasarca can inhibit absorption

34
Q

meaning of relative risk reduction

A

proportion of risk reduction attributable to a specific intervention or exposure as compared to a control.

35
Q

RRR calculation

A

(risk in unexposed − risk in exposed) / (risk in unexposed)

36
Q

indicators of severe AS

A
  • low-intensity, single second heart (In normal physiology, inspiration pulls blood into the right side of the heart and results in delayed closure of the pulmonic valve and earlier closure of the aortic valve; a noticeable split of the aortic (A2) and pulmonic (P2) components of S2 can be appreciated. However, in severe AS, closure of the aortic valve is delayed, which results in nearly simultaneous closure of the aortic and pulmonic valves during inspiration, and is appreciated on examination as a single S2)
  • delayed and diminished carotid pulse and loud and late-peaking systolic murmur
37
Q

cutaneous cryptococcus presentation/setting

A

patients with advanced HIV (CD4 count <100/mm3) and is typically a marker of disseminated disease. Manifestations most commonly include the rapid onset of multiple papular lesions with central umbilication and central hemorrhage/necrosis

38
Q

case fatality rate vs mortality rate

A

Case fatality rate refers to the proportion of patients with a particular disease who die from the disease. It is different from the mortality rate, which describes the general population’s likelihood of dying from the disease.

39
Q

implication of negative exercise stress test

A
  • <1% risk of cardiovascular events within the next year.

- exclude the presence of nonobstructive (clinically insignificant) or microvascular CAD.

40
Q

when exercise is contraindicated in pregnancy

A
  • active vaginal bleeding
  • at risk for preterm delivery (eg *cerclage)
  • underlying medical condition that could be exacerbated by exercise
41
Q

cardiac complications of gestational diabetes for newborn

A

Increased risk for transient hypertrophic cardiomyopathy with a thickened interventricular septum due to excess glycogen deposition in the fetal myocardium. Spontaneous resolution is expected within a few weeks after birth as insulin levels normalize.

42
Q

main long term complication of IVC filters

A

The main long-term complication of IVC filter placement is recurrent DVTs. The filter can prevent clot progression to a pulmonary embolism, but it does not prevent future DVTs or treat the underlying thrombotic predisposition. As a result, patients can develop both acute and recurrent thrombosis at the insertion site. IVC thrombosis can also occur due to thrombogenicity of the filter, new local thrombus formation, or trapped embolus. IVC filters do not appear to affect overall mortality significantly.

43
Q

SE’s of breast implants

A

local complications, such as capsular contracture, implant deflation, and rupture.

44
Q

next step after high AFP in pregnancy

A

ultrasound

45
Q

causes of increased maternal AFP

A

Open neural tube defects (eg, anencephaly, open spina bifida)
Ventral wall defects (eg, omphalocele, gastroschisis)
Multiple gestation

46
Q

in general when do you need a larger sample size?

A

a higher level of power is required or when differences between groups are small.

47
Q

pylephlebitis

A
  • infective suppurative portal vein thrombosis

- rare but devastating complication of intraabdominal infections, including appendicitis.

48
Q

most common cause of nec fasc

A

Group A Streptococcus

49
Q

oculogyric crisis

A
  • form of acute dystonia resulting from antipsychotics usually
  • forced, sustained elevation of the eyes in an upward position
50
Q

androgen insensitivity presentation

A

primary amenorrhea and absent pubic/axillary hair but normal breast development

Medicine (71 decks)

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