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Medicine > step 3 6 > Flashcards

step 3 6 Flashcards

1
Q

new name for hypochondriasis

A

illness anxiety disorder

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2
Q

anorexia mgmt

A

olanzapine

SSRIs + psychotherapy

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3
Q

intermittent explosive disorder vs disruptive mood dysregulation disorder

A

with intermittent they return to normal mood, in disruptive, patients do not

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4
Q

treatment of pathologic gambling

A

group psychotherapy (gambling anonymous)

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5
Q

workup for any signs of drug use

A

HIV
Hep B and C
PPD

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6
Q

answer to question describing a patient with alcohol abuse

A

UDS

Check LDH, GGTP, AST/ALT

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7
Q

wernicke-korsakoff management

A

Thiamine IV
B12
Folate
magnesium

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8
Q

alcohol withdrawal management

A

CIWA protocol for benzos PO or IV
diazepam 5-10 mg IV repeat q5-10 minutes until symptoms controlled, goal to sedate until patient is calm but alert.
If cirrhotic or alcoholic hepatitis —> use ativan or oxazepam (serax)
when benzodiazepine doses reach 15-20 mg lorazepam IV per hour –> consider adjunctive therapy with clonidine 0.3 mg po q6h or haldol 0.5 – 1.0 mg IV q4h if delirium and psychotic features are present
qAM BMP
mag
phos
Ativan 2 mg PRN for seizure lasting longer than 5 minutes
IV access
IVF
Thiamine 100 mg daily IV
Folate 1 mg daily
MVI 1 tab/day either PO or IV starting immediately on admission and continuing for the length of their stay
Put in quiet, protective environment
IF severe liver disease → use short acting benzo, lorazepam or oxazepam

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9
Q

alcohol dependency management

A

Refer to inpatient rehabilitation or outpatient group therapy (AA)
If receiving psychotherapy, give Naloxone or acamprosate .

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10
Q

delirium tremens window

A

48-96 hours after last drink

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11
Q

cannabis withdrawal presentation

A

irritability, difficulty sleeping, depression, fevers, nausea, vomiting

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12
Q

paraphilia treatment

A

psychotherapy + aversive conditioning

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13
Q

voyeurism

A

watching UNSUSPECTING person having sex or naked

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14
Q

frotteurism

A

recurrent urge or behavior involving touching or rubbing against a nonconsenting partner

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15
Q

PMS treatment

A

CBT + SSRI

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16
Q

AMS in ED orders

A

Standard lab orders below → naloxone + thiamine + dextrose + O2/NS → UDS

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17
Q

benzo management

A

verify but don’t give flumazenil, may precipitate a seizure

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18
Q

management of digoxin OD

A

digoxin-binding antibodies

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19
Q

organophosphate antidote

A

atropine, pralidoxime

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20
Q

ASA overdose labs

A 
CBC
chemistry panel
ABG
PT/INR/PTT
Salicylate level
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21
Q

ASA overdose treatment

A

sodium bicarbonate

charcoal

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22
Q

diagnostic labs for generic overdose

A 
UDS
CBC, chem-7, UA
ASA level
Acetaminophen level
ETOH level
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23
Q

digoxin toxicity

A

halos around objects and blurred vision
GI disturbance
encephalopathy

24
Q

causes of methemoglobinemia

A

nitroglycerin, anesthetics, dapsone, drugs ending in caine (lidocaine, benzocaine, bupivicaine)

25
Q

cause of NMS

A

Any medications within the family of neuroleptics can cause the condition, though typical antipsychotics appear to have a higher risk than atypicals

26
Q

settings of organophosphate poisoning

A

crop duster/insecticides

nerve-gas

27
Q

organophosphate poisoning treatment

A

atropine
pralidoxime
remove clothes and wash rest off the patient

28
Q

first step in TCA overdose

A

EKG

29
Q

black widow spider bite presentation

A

severe abdominal pain, rigidity, hypocalcemia, no tenderness

30
Q

brown recluse bite

A

necrotic, bullae, dark lesions

31
Q

brown recluse bite treatment

A

debride the wound

32
Q

rabies treatment

A

immune globulin + vaccine

33
Q

signs of respiratory injury in burns

A

hoarseness
wheezing
stridor

34
Q

burn management

A

assess for respiratory compromise → intubate → if no respiratory compromise give fluids at 4 mL of LR or NS for each kg

35
Q

first step in hypothermia mgmt

A

EKG

36
Q

first step in acute angle closure glaucoma mgmt

A

pilocarpine drops

37
Q

retinal detachment management

A

consult opthalmology, dilated retinal exam

38
Q

uveitis treatment

A

steroids

39
Q

uveitis presentation

A

photophobia

40
Q

first step in managing mentally intact patient refusing treatment

A

try to discuss it with patient

41
Q

emancipated minor

A

living independently, self-supporting, married, in the military

42
Q

partial emancipation

A

sex
reproductive health
substance abuse

43
Q

cases in which minors can make decisions

A

sex, reproductive health, HIV, prenatal care, STDs

44
Q

requirements of informed consent

A

benefits, risks, alternatives, intelligible language, specific to procedure

45
Q

consent in emergencies?

A

assumed unless prior wishes are known

46
Q

when you can break patient confidentiality

A

someone else is at risk (transmissible disease (TB, HIV, syphilis, gonorrhea)
- psych patient trying to hurt someone

47
Q

health care proxy meaning

A

both an appointed agent AND a document

48
Q

living will utility

A

useless unless it specifically states interventions patient does not want

49
Q

when to consult ethics committee

A

1) no capacity and no clearly stated wishes on the part of the patient
2) family is split on nature of care

50
Q

response to patient requesting futile care

A

you can deny it, you are under no obligation to provide futile care

51
Q

abortion minutiae

A

unrestricted in first trimester, grey area in second, illegal in third

52
Q

gifts are fine when

A

small and not tied to specific treatments and tests

53
Q

sexual contact

A

illegal between psychiatrists and patients, must end doctor-patient relationship for others

54
Q

who to report impaired faculty to

A

department chair or dean of medical school

55
Q

who to report impaired physicians too

A

state medical board of office of professional medical conduct

56
Q

when to report physicians

A

only when patients are at risk of harm

57
Q

GERD management

A

Start with H2/RA
If uncontrolled → PPI lowest effective dose, try to wean back to H2/RA, with goal to wean entirely off PPI
IF RF’s (men, smoker, obesity, age greater than 50)
Symptoms >5-10 years = surveillance endoscopy for barrett esophagus

Medicine (71 decks)

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