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Medicine > step 3 18 > Flashcards

step 3 18 Flashcards

1
Q

mangement of angioedema with ACEi

A

switch to arb (low risk of angioedema because do not affect kinin system)

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2
Q

caveat about synovial fluid analysis with hereditary hemochromatosis

A

calcium pyrophosphate dihydrate rhomboid shape crystals found in 50% of patients

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3
Q

other SE of SGLT2 inhibitors

A

euglycemic diabetic ketoacidosis (euDKA), a recognized complication of sodium-glucose cotransporter-2 (SGLT2) inhibitor (eg, canagliflozin) therapy.

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4
Q

RFs for spontaneous abortion

A

prior spontaneous abortion, advanced maternal age, extremes in BMI, and maternal substance abuse.

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5
Q

when child abuse is right answer

A
  • sudden behavioral problems
  • risky sexual behavior
  • moving into new home
  • impaired concentration with declining academic performance
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6
Q

management of cervical insufficiency

A

cerclage placement

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7
Q

positive likelihood ratio formula

A

sensitivity / (1 - specificity)

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8
Q

negative likelihood ratio formula

A

(1 - sensitivity) / specificity

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9
Q

what qualifies patients as homebound?

A

use a supportive device (eg, walker, wheelchair) for mobility, are unable to leave home without another person’s assistance, or cannot leave home due to a medical contraindication.

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10
Q

skilled home health insurances

A

physical and occupational therapy, medication compliance monitoring, and wound care.

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11
Q

sulfonylurea overdose management

A

octreotide (decreases insulin secretion)

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12
Q

most effective contraceptive

A

progestin subdermal implant

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13
Q

management of amputated body part

A
  • wrap in gauze, moisten with saline, place in sealed sterile plastic bag
  • place in container with ice mixed with saline (don’t want it directly on ice which can cause frostbite and severely damage it)
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14
Q

shin splints (medial tibial stress syndrome) vs. compression fracture

A

no tenderness to palpation with shin splints

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15
Q

management of tibial stress fractures

A

pneumatic splinting, reduced weightbearing, and a graduated exercise program. Most patients may resume full-intensity exercise within 12 weeks,

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16
Q

treatment of bile-salt induced diarrhea after CCK

A

bile salt-binding resins such as cholestyramine (binds and sequesters bile salts)

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17
Q

what are bile salts

A

conjugated bile acids

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18
Q

calcification type suggesting benign with lung cancer

A 
Eccentric, reticular, or punctate calcification --=malignant
Popcorn calcification (hamartoma) or concentric, central, or diffuse homogeneous calcification  = bening
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19
Q

seborrheic dermatitis treatment

A

Seborrheic dermatitis is a chronic, relapsing condition. Initial treatment can provide significant improvement in symptoms, but patients usually benefit from intermittent re-treatment.

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20
Q

affect of OCPs on thyroid hormone

A

increase the serum concentration of thyroid binding globulin (TBG)

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21
Q

management of patient who takes alternative medication AMA

A

document in chart and follow patient

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22
Q

when patients with unknown GBS status get prophylaxis

A

if the pregnancy is preterm (<37 weeks gestation), if they develop an intrapartum fever, or if they have rupture of membranes >18 hour

23
Q

abx of choice for intrapartum GBS prophylaxis

A

penicillin

24
Q

presentation of autosomal dominant polycystic kidney disease

A

hypertension, hematuria, proteinuria, renal insufficiency, and/or flank pain

25
Q

Autosomal dominant polycystic kidney disease management

A
  • rigorous control of BP with ACEi’s

- statin

26
Q

presentation of candidal endopthalmitis

A

neutropenic patient or patient with central line + fever, eye pain, decreased visual acuity, and funduscopic evidence of focal, glistening, white, mound-like lesions that may extend into the vitreous and cause vitreous haze.

27
Q

fundoscopic exam with candida

A

focal, glistening, white, mound-like lesions on the retina that may extend into the vitreous, with resultant vitreous haze.

28
Q

management of candidal endopthalmitis with vitreous involvement

A

systemic antifungal medication (eg, amphotericin B), intravitreal antifungal injection, and vitrectomy.

29
Q

metformin contraindications

A

renal insufficiency, hepatic dysfunction, alcohol abuse, sepsis, or congestive heart failure (especially with creatinine >1.5 mg/dL)

30
Q

metformin SE’s

A

gastrointestinal upset (eg, nausea, abdominal pain, diarrhea), decreased intestinal vitamin B12 absorption, and lactic acidosis

31
Q

management of optic neuritis

A

IV methylprednisonolone

32
Q

management of MS exacerbations during pregnancy

A

steroids

33
Q

pregnancy complications of MS

A

modest increase in cesarean section and assisted delivery (eg, vacuum, forceps) rates compared to those without MS

34
Q

genetics of MS?

A

3%-23% of MS cases are familial)

35
Q

how to reduce risk of peripheral edema with CCBs

A

combination of CCBs with ACE inhibitors is associated with a significant reduction in CCB-associated peripheral edema

36
Q

management of febrile UTI in infant

A

If younger than 24 months should undergo renal and bladder ultrasound to evaluate for anatomic abnormalities. Those with recurrent infections or abnormal ultrasound findings should also undergo a voiding cystourethrogram

37
Q

types of severe malnutrition

A

Marasmus (wasting)

Kwashiorkor (edematous malnutrition)

38
Q

management of severe malnutrition

A 
Rewarming for hypothermia
Antibiotics for presumed systemic infection
Rehydration
Oral rehydration solution preferred
Intravenous fluids if in shock
Refeed cautiously
39
Q

severe malnutrition management complications

A

Heart failure

Refeeding syndrome

40
Q

complications of donating kidney for donor

A

Patients have an increased risk of gestational complications after donor nephrectomy compared to pregnancies before the procedure. However, the rate is similar to that of the general population. Thus, should recommend completing childbearing before donating kidney.

41
Q

workup of hyperthyroidism in pregnancy

A

just order TSH

42
Q

Anterior uveitis (iritis) presentation

A

pain, redness, variable visual loss, and a constricted and irregular pupil. Visualization of leukocytes in the anterior segment confirms the diagnosis.

43
Q

infectious keratitis presentation

A

severe photophobia and difficulty in keeping the affected eye open. Penlight examination reveals a corneal opacity or infiltrate.

44
Q

deal with disclosing HIV status

A

Physicians are not universally required to disclose the HIV status of patients to involved third parties, although all new cases of HIV must be reported to the local Department of Public Health.

45
Q

toxo treatment

A

Pyrimethamine, sulfadiazine, folate

46
Q

treatment of chronic prostatitis

A

6 weeks of a fluoroquinolone (eg, ciprofloxacin) or trimethoprim-sulfamethoxazole.

47
Q

dengue hemorrhagic fever presentation

A

hemoconcentration, marked thrombocytopenia, prolonged fever, and respiratory/circulatory failure

  • positive tourniquet test (petechiae after cuff inflation)
  • spontaneous bleeding
48
Q

unique features of classic dengue fever

A
  • retro-orbital pain

- rash

49
Q

normal distribution standard deviation values

A

“68-95-99.7 rule.”

68% of all values are within 1 standard deviation (SD) from the mean; 95% of all values are within 2 SDs from the mean; and 99.7% of all values are within 3 SDs from the mean.

50
Q

most impt protective factors for suicide

A

Connection to family, pregnancy, and responsibility for children

51
Q

use of MELD

A

determine 90-day mortality in patients with advanced liver disease

52
Q

MELD components (thus variables associated with mortality)

A

serum bilirubin, INR, serum creatinine, and serum sodium levels

53
Q

effects of prolactinomas

A

galactorrhea in women, gynecomastia in men, and symptoms of hypogonadism in both sexes. Long-term suppression of sex hormone production by prolactinoma in women can lead to osteoporosis.

Medicine (71 decks)

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