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Medicine > Step 3 7 > Flashcards

Step 3 7 Flashcards

1
Q

valvular disease workup

A

echo
left heart cath
EKG
CXR

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2
Q

AS management

A

Diuretics

Consult cardiology for valve replacement

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3
Q

dilated cardiomyopathy management

A

ACEi/ARB
Betablocker
if HR > 70 still, add ivabradine
spironolactone

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4
Q

HOCM management

A

Betablocker

Diuretics

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5
Q

kussmaul sign

A

increase in JVP on inhalation

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6
Q

tamponade presentation

A

SOB + hypotension + JVD + clear lungs

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7
Q

what echo will show with tamponade

A

diastolic collapse of RA and RV

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8
Q

long-term therapy for pericardial tamponade

A

pericardial window placement

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9
Q

treatment of constrictive pericarditis

A

surgically remove pericardium

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10
Q

thoracic dissection management

A 
EKG
CXR
CT angiography/MRA/TEE
ICU transfer
Consult surgery
Betablocker
then nitroprusside to control BP
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11
Q

PAD management

A 
Aspirin
Cilostazol
Vorapaxar
BP control with ACEi
Statins to target LDL < 100
Exercise as tolerated
IF signs of gangrene OR pain at rest → surgical bypass
Consider:
Pentoxifylline (marginally effective)
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12
Q

hemodynamic instability on CCS

A

SBP less than 90, CHF, AMS, chest pain

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13
Q

rate control meds in AFib

A

BB (metoprolol, carvedilol) or Non-DHP CCB (diltiazem) or digoxin

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14
Q

reversal drug for dabigatran

A

idarucizumab

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15
Q

VASc in CHADS-VASc

A

Vascular disease
Age 65-74
Female sex

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16
Q

NOACs

A 
Xa inhibitors (rivaroxiban, edoxaban, apixaban)
Direct thrombin inhibitor (dabigatran)
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17
Q

CHADS

A 
CHF
HTN
Age over 75
DM
Stroke/TIA
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18
Q

treatment of bleeding for patient on warfarin

A

FFP

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19
Q

reversal drug for Xa inhibitors

A

andexanet

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20
Q

benefit of NOACs over warfarin

A

NOACs prevent more strokes, cause less intracranial bleeding, and decrease mortality more, and treat DVT/PE

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21
Q

drug selection in rate control for AF

A

if hyperthyroid/ischemic heart disease/migraines/Graves/pheochromocytoma → BB
if comorbid COPD/asthma → CCB
if borderline hypotension → Digoxin

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22
Q

MAT management

A

FIRST: Oxygen
Diltiazem
Palliative care consult

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23
Q

gamma gap meaning and definition

A

difference between total serum protein and serum albumin.

4 g/dL.

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24
Q

gamma gap differential

A

blood cell dyscrasias or viral infections, e.g., multiple myeloma, monoclonal gammopathy of unknown significance, or acute HIV infection

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25
Q

antiarrhythmics for VT

A

amiodarone, lidocaine, procainamide, magnesium

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26
Q

syncope orders

A 
Chem 7
Telemetry
Oximeter
CBC
EKG
CT head
If ventricular dysrhythmia diagnosed, consult cardiology for ICD
If chest pain → CK-MB/troponin
If murmur on exam → TTE
If focal deficits on neuro exam OR seizure described → EEG
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27
Q

second set of workup for syncope if first negative

A

holter
repeat CK-MB and troponin
Urine and blood tox

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28
Q

third set of orders for syncope workup

A

tilt table testing

EP testing

29
Q

MSSA oral options

A

cephalexin, dicloxacillin

30
Q

MSSA IV options

A

oxacillin/nafcillin, cefazolin

31
Q

daptomycin SE’s

A

myopathy, rising CK

32
Q

minor MRSA infection options

A

bacrim, clindamycin, doxycyline

33
Q

MRSA infection in patient with penicillin alergy

A

RASH: cephalosporins
Anaphylaxis: clindamycin or linezolid
Severe infection: Vanc, linezolid, dapto
Minor infection: macrolides, clinda, bactrim

34
Q

meds with activity against strep

A

penicillin, ampicillin, amoxicillin

35
Q

big gun for pseudomonas coverage

A

polymyxin/colistin

36
Q

beta lactamase inhibitors

A

clavulanate

sulbactam/tazobactam/avibactam

37
Q

cephalosporins with anaerobe coverage

A

cefoxitin, cefotetan

38
Q

best long-term therapy fo CMV retinitis

A

valganciclovir

39
Q

Influenza meds

A

oseltamivir
zanamivir
peramivir

40
Q

ribavirin use

A

refractory hep C (causes anemia)

41
Q

aspergillus treatment

A

voriconazole

42
Q

best antifungal in neutropenic fever

A

Echinocandins

43
Q

OM clinical features

A

(DM + PAD) + (Ulcer or soft tissue infection)

44
Q

osteomyelitis management

A

Bone biopsy/aspiration or culture (whether under CT guidance or during surgery (to guide treatment)
Ortho consult
ID consult (dispo, vascular access, OP antibiotic coordination)
Plastics consult if skin flap may be needed
ABX → base on cultures, thus wait until biopsy or specimens from I&D obtained.
IF SIRSY → blood culture
Monitor sed rate to guide antibiotic duration

45
Q

otitis externa management

A

ofloxacin, ciprofloxacin, or polymyxin/neomycin
topical hydrocortisone
acetic acid and water solution

46
Q

malignant otitis externa management

A

surgical debridement

47
Q

treatment of refractory otitis media

A

cephalosporin or augmentin

48
Q

most accurate test for sinusitis

A

sinus aspirate for culture

49
Q

indications for influenza vaccination + approach

A
  • COPD, CHF, dialysis, steroids, health care workers, everyone over 50
  • inhaled live attenuated for anyone under 50
50
Q

impetigo treatment

A

if mild –> mupirocin or retapamulin

if severe –> oral dicloxacillin or cephalexin

51
Q

cellulitis management

A

If diabetic, venous insufficiency, or lymphedema, → consider X-ray, then possible MRI for OM.
If lower extremity → US for DVT
If persistent systemic symptoms after 48 hrs → consider X-ray, then possible MRI for OM PLUS US for abscess

52
Q

size of hair follicle infections

A

folliculitis, furuncle, carbuncle, boil

53
Q

workup of fungal infection of skin and nails

A

KOH prep

54
Q

dysuria, discharge management

A

If dysuria or discharge or both:
→ NAAT on urine sample
if positive → CTX IM + azithromycin single dose PO.

55
Q

epididymitis treatment

A

> 35 → CTX + doxycyline

<35 → fluoroquinolone

56
Q

genital herpes management

A

Treat empirically with acyclovir x 7 days
IF recurrent → daily suppressive therapy
IF refractory → foscarnet

57
Q

treatment of primary/secondary syphilis if penicillin allergic

A

doxycycline

58
Q

granuloma inguinale diagnosis

A

biopsy or touch prep

59
Q

treatment of granuloma inguinale

A

doxy, TMP/SMX, azithromycin

60
Q

pediculosis

A

mite that lives in hair-bearing areas, such as pubic hair or axilla

61
Q

UTI SYSTEM

A

if positive for symptoms (dysuria, urinary frequency or urgency, suprapubic pain, hematuria, fevers, chills, flank pain) OR a man → UA + gram stain → assess for pyuria + bacteriuria → assess complicated/uncomplicated…
uncomplicated → fosfomycin or nitrofurantoin x 3 days (if resistance to e coli low, if high, then quinolone)
complicated → culture –> TMP/SMX or ciprofloxacin x 7 days

62
Q

pyelo management

A

UA + culture
Outpatient → ciprofloxacin
Inpatient → CTX, quinolones, ampicillin, gentamicin

63
Q

perinephric abscess

A

quinolone + oxacillin/nafcillin/vancomycin

64
Q

prostatitis management

A

Cipro or TMP/SMX x 2 weeks (acute) or 6 (chronic)

65
Q

HAART combinations

A

lamivudine + abacavir + integrase inhibitor
tenofovir + emtricitabine + integrase inhibitor
tenofovir + emtricitabine + atazanavir/darunavir

66
Q

tenofovir AE’s

A

RTA, fanconi syndrome, osteopenia

67
Q

what to test for before starting abacavir

A

HLAB5701

68
Q

drugs that constitute prep

A

tenofovir + emtricitabine

Medicine (71 decks)

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