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Medicine > step 3 29 > Flashcards

step 3 29 Flashcards

1
Q

treatment resistant depression management

A

augment antidepressants with second generation antipsychotics (olanzapine)

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2
Q

SE’s of second-generation antipsychotics as a class

A

weight gain, dyslipidemia, hyperglycemia, new diabetes (all are associated but olanzapine associated with greatest risk)

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3
Q

hypoplastic left heart syndrome presentation

A
  • neonate with mild cyanosis at birth who develops progressive respiratory distress and shock after closure of ductus arteriosus
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4
Q

TOF presentation

A
  • tet spell (episodes of severe cyanosis due to RV outflow obstruction) + systolic ejection murmur (due to RV outflow obstruction)
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5
Q

truncus arteriosus presentation

A
  • heart failure due to excessive pulmonary blood flow + systolic ejection murmur
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6
Q

Management of mother with positive titer for anti-Rh(D) antibodies

A

Can’t do anything (only effective if given before alloimmunization has occurred)

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7
Q

umbilical hernia in newborn management

A
  • if reducible, asymptomatic, defer surgery until age 5 (usually closes spontaneously during first few years of life)
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8
Q

Gaucher disease presentation

A

anemia, thrombocytopenia, splenomegaly, bony pain, fractures (glucocerebrosidase deficiency)
- can present in late adulthood

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9
Q

common complication of severe MR

A

AF due to LA dilation

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10
Q

severe mitral valve regurg management

A

If primary – surgery

If secondary – medical management

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11
Q

artificial tears medical erm

A

methylcellulose drops

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12
Q

white counts in synovial fluid analysis

A

less than 2,000 = OA
2,000-75,000 = inflammatory (RA and gout)
100,000 = infectious arthritis

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13
Q

when infertility workup is indicated

A

women younger than 35 = after 1 year

women older than 35 = after 6 months

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14
Q

other features of GBS

A
  • paresthesias
  • autonomic dysfunction (palpitations, orthostasis)
  • respiratory muscle weakness/SOB
  • weakness in hands too
  • dysphagia, facial muscle weakness
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15
Q

sequela of cortisol-producing adrenal adenoma

A

adrenal crisis (remaining cortex becomes atrophied due to negative feedback inhbition)

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16
Q

sick sinus syndrome presentation

A

Rapidly alternating SVT + bradycardia (also called bradycardia-tachycardia syndrome)

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17
Q

other important feature of parkinson’s

A
  • unilateral onset + persistent asymmetry (eg asymmetric hand rigidity)
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18
Q

difference between parkinson’s and parkinson-plus syndromes

A

parkinson-plus = rapid progression, early postural instability (falls) (which doesn’t happen until late in PD), dysautonomia, symmetric motor signs, lack of tremor, poor response to dopaminergic therapy

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19
Q

lab findings in nephropathy from aortic atheroembolism

A

elevated serum + urine eosinophils

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20
Q

RCC presentation

A
  • flank or abdominal mass that is firm, nontender, and moves with respiration
  • hematuria, resulting in anemia
  • flank pain
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21
Q

gout prophylaxis

A

allopurinol + colchicine or NSAID during initiation and titration of allopurinol (changes in uric acid level from allopurinol can trigger an acute flare)

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22
Q

management of patellofemoral pain syndrome in young women

A

NSAIDS, stretching and strengthening

23
Q

biggest RF for development of a recurrent stroke

A

prior stroke or TIA

24
Q

sequeal of tension pneumos

A

can rapidly lead to CODES

25
Q

acute blood pressure drop while putting in central line?

A

prob caused a pneumo

26
Q

other findings on CXR that suggest tension pneumo

A

widened rib spacing

depressed hemidiaphragm

27
Q

where to insert needle for tension pneumo

A

midclavicular line, second intercostal space

28
Q

human bite wound management

A
  • irrigate as quickly as possible

- augmentin

29
Q

management of vulvovaginal atrophy

A

first – vaginal lubricant

second – topical estrogen

30
Q

postpartum thyroiditis management

A

betablockers (can’t use methimizole because it’s from the release of preformed thyroid molecules. Antithyroid drugs inhibit thyroid hormone synthesis.)

31
Q

prognosis of postpartum thyroiditis

A

Increased risk of persistent goiter + chronic thyroid dysfunction

32
Q

benefit of meta-analysis

A

with greater statistical power, you can detect a small effect size. This may lead to a significant effect but may be small clinical relevance.

33
Q

signs of sexual abuse

A
  • recurrent UTI with no medical cause

- knowledge of detailed sexual acts

34
Q

caput succedaneum vs. cephalohematoma

A

cephalohematoma = does not cross suture lines. well-demarcated. Usually from vacuum or forceps-assisted deliveries., and happen within first few hours or days of life.
caput succedenaum = crosses suture lines, resolves within days of birth

35
Q

other indication for ECT

A
  • not eating or drinking with VS instability
36
Q

treatment of depression with psychotic features

A

SSRI + antipsychotic

37
Q

common side effect of nasal glucocorticoids

A

epistaxis

38
Q

croup features

A

stridor + barking cough (loud, forceful coughing)

39
Q

confidence interval caveat

A

if it’s 1-1.6, still insignificant since it includes 1

40
Q

ecological study design

A

disease rates (eg prevalence) and exposure are measured at the population or community level and their association examined

41
Q

interstitial cystitis treatment

A

NSAIDs

amitriptyline

42
Q

cardiac glycosides

A

digoxin

43
Q

management of acute decompensation of peripartum cardiomyopathy

A

hydralazine (arterial dilator to reduce afterload) + long acting nitrate (isosorbide mononitrate) (reduced preload)

44
Q

isosorbide mononitrate as a med

A

long acting nitrate, used for preload reduction

45
Q

ascertainment bias

A
  • results are distorted by knowledge of which intervention the participants are assigned to (reason for blinding)
46
Q

bloody diarrhea vs. watery suggests..

A

bloody suggests bacterial

47
Q

first-line therapy in sexually active patients with primary dysmenorrhea

A

combination oral contraceptives

48
Q

SLE and pregnancy

A
  • increased risk to fetus. Should avoid pregnancy until disease in remission for 6 months.
  • happens through transplacental passage of maternal anti-SSA and anti-SSB antibodies, that can lead to complete heart block
49
Q

spontaneous pneumomediastinum pathophys

A
  • young males with lung disease or persistent cough or using inhalants
  • air escapes the alveoli through small tears in bronchovascular sheath
50
Q

spontaneous pneumomediastinum management

A
  • usually resolves sponatenously

- NSAIDs and O2 (speeds up resorption)

51
Q

ADHD presentation

A
  • restlessness, impulsivity, distractibility, irritability
  • procrastination
  • in adulthood rash decisions, emotional dysregulation, executive dysfunction
52
Q

side effects of long term stimulants

A
  • small but persistent elevation in blood pressure and heart rate (you can develop tolerance to meds but not heart rate)
53
Q

lifestyle modification of stress urinary incontinence

A

weight loss, smoking cessation, decreasing caffeine and alcohol intake

Medicine (71 decks)

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