step 3 8 Flashcards

1
Q

toxo management

A

pyrimethamine + sulfadiazine x 2 weeks

if no decreased lesion size at 2 weeks repeat CT, brain biopsy for lymphoma.

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2
Q

cryptococcus CD4 cutoff

A

less than 50

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3
Q

PML CD4 count

A

50

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4
Q

M avium CD4 count

A

50

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5
Q

endocarditis diagnosis

A

duke’s criteria, 2 major, 1 major and 3 minor, or 5 minor criteria

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6
Q

endocarditis RF’s

A

Prosthetic heart valve, IVDU, dental procedure causing bleeding, previous endocarditis, cardiac surgery

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7
Q

most common bugs in endocarditis

A

staph and strep

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8
Q

cardiac defects that need prophylaxis

A

prosthetic valves
unrepaired cyanotic heart disease
previous endocarditis

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9
Q

procedures that need prophylaxis

A

dental procedures that cause bleeding
respiratory tract surgery
surgery of infected skin

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10
Q

drugs to use for procedural prophylaxis

A

amoxicillin for oral procedures, cephalexin for skin procedures

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11
Q

leptospirosis presentation

A

fever, abdominal pain, muscle aches

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12
Q

leptospirosis treatment

A

CTX, penicillin

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13
Q

tularemia presentation

A

ulcer at site of contact + lymphadenopathy + conjunctivitis

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14
Q

where cysticercosis lives

A

mexico, SA, Eastern Europe, India

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15
Q

DM diagnosis

A

2 fasting glucose greater than 126
1 random glucose greater than 200 with symptoms
Abnormal OGTT
HgbA1c greater than 6.5%

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16
Q

long-acting insuline

A

glargine (lantus)
detemir
NPH

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17
Q

short acting insulin drugs

A

aspart
lispro
glulisine

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18
Q

treatment of diabetic retinopathy

A

laser photocoagulation

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19
Q

thyroid storm treatment

A

Iodine
methimazole
Dexamethasone
Propranolol

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20
Q

solitary thyroid nodule management

A

TSH/T4 → if normal then FNA (could be cancer)→

21
Q

hypercalcemia presentation

A

stones, fractures from osteoporosis, confusion, constipation and abdominal pain
(“stones, bones, psychic moans, and GI groans”)

22
Q

hypocalcemia causes

A

surgery, hypomagnesemia, vitamin D deficiency, acute hyperphosphatemia, fat malabsorption, PTH resistance (rare)

23
Q

affect of dexamethasone suppression test on ACTH production etiologies

A

will suppress pituitary tumors but not others

24
Q

cushing syndrome is just

A

hypercortisolism

25
hypercortisolism management
Confirm hypercortisolism: 1 mg overnight dexamethasone suppression given overnight If abnormal, rule out false positives with 24-hour urine cortisol. Identify source: 1) ACTH If low → origin is adrenal gland → scan with CT or MRI → if found consult surgery If high → origin is pituitary gland or ectopic production 2) High-dose dexamethasone test: if suppressed → pituitary source → MRI or CT → if negative need inferior petrosal sinus sampling if not suppressed → ectopic (cancer making ACTH) → scan chest for lung cancer or carcinoid → if found, consult surgery
26
hyperaldosteronism clinical feature
hypokalemia + metaboic alkalosis (high bicarb)
27
pheochromocytoma diagnosis system
urine and plasma metanephrine and catecholamines → CT/MRI of adrenals to confirm → may need MIBG scan to detect metastatic disease (which can’t be treated with surgery)
28
treatment of klinefelter's
testosterone
29
FEV1 cut-off for diagnosis of asthma and RAD
greater than 12 percent
30
any shortness of breath on CCS orders
oxygen continuous oximeter CXR ABG
31
acute asthma exacerbation treatment
``` Albuterol treatment Methylprednisolone bolus Inhaled ipratropium Oxygen Magnesium ABG if acidotic transfer to ICU and repeat if persistent on repeat, intubate and put on ventilator ```
32
sarcoidosis workup
CXR → biopsy (looking for noncaseating granulomas)
33
most common CXR finding in PE
atelectasis (tissue not being perfused)
34
most common findings in PE on ECG
sinus tachycardia | nonspecific ST-T wave changes
35
tests to order on pleural fluid
``` gram stain and culture acid-fast stain total protein LDH glucose cell count w/ differential pH ```
36
central respiratory stimulants
acetazolamide | medroxyprogesterone
37
ARDS diagnostic criteria
pO2/FiO2 less than 200
38
most common bugs in healthcare associated pneumonia
gram-negative bacilli
39
TB workup
check for previous PPD → if none, PPD --> CXR → if findings suggestive of latent infection → check for previous TB treatment, then INH x 9 months if findings suggestive of active infection → confirm with sputum culture + acid-fast stain *on step 3 go straight to CXR
40
NHL treatment
CHOP, cyclophosphamide, hudroxyadriamycin, oncovin, prednisone
41
HOdgkins treatment
ABVD, adriamycin, bleomycin, vinbkastine, dacarbazine
42
Chemo nausea treatment if qt prolonged
Aprepitant, rolapitant, netupitant
43
RA pleural effusion characteristic
very low glucose level
44
rheumatoid arthritis management
``` NSAIDs Steroid bridge to DMARD DMARD ASAP (Methotrexate) If failed add anti-TNF + make sure they’ve been tested for hepatitis B and TB Exacerbation → steroids ```
45
ankylosing spondylitis management
NSAIDs Infliximab/adalimumab Sulfasalazine Secukinumab
46
reactive arthritis clinical features
history of urethritis or GI infection + conjunctivitis + arthritis
47
anti-Ro + anti-SSA in pregnancy confer increased risk for..
heart block
48
most common drugs causing drug-induced SLE
hydralazine, procainamide, isoniazid
49
sideroblastic anemia treatment
pyridoxine