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step 3 9 Flashcards

1
Q

CREST vs scleroderma

A

CREST is limited, no join, heart, lung, or kidney involvement

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2
Q

PM/DM orders

A

LFT’s

ANA

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3
Q

clinical significance of anti-Jo-I in PM/DM

A

increased risk of ILD

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4
Q

most common serious threat to life from DM/PM

A

cancer

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5
Q

special features of Takayasu’s arteritis

A

loss or decrease of pulse + TIA/stroke

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6
Q

behcet’s presentation

A

Oral and genital ulcers
ocular involvement
skin lesions
CNS disease

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7
Q

cutoff for synovial fluid cell count in septic arthritis

A

over 50,000 suggests infectious

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8
Q

CCS gout orders

A

joint fluid examination for cell count, culture, protein
serum uric acid
x-ray showing punched-out lesions
Extremity exam for tophi

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9
Q

gout management

A 
Treat flare with NSAIDs
IF refractory → steroids
If single joint → intraarticular
If multiple joints → oral steroids
IF renal insufficiency + within 24 hours of attack --> colchicine
PPX → allopurinol
IF not tolerating → febuxostat
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10
Q

pseudogout clinical presentation differentiators

A
  • knee and wrist involved, no toes
  • slower in onset
  • less severe
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11
Q

gout management

A 
Treat flare with NSAIDs
IF refractory → steroids
If single joint → intraarticular
If multiple joints → oral steroids
IF renal insufficiency + within 24 hours of attack --> colchicine
PPX → allopurinol
IF not tolerating → febuxostat
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12
Q

septic arthritis management

A

ortho consult
tap the joint (arthrocentesis)
Empiric abx → CTX + vancomycin IV

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13
Q

plantar fasciits vs. tarsal tunnel syndrome

A

tarsal tunnel is more painful with use + may need steroids/surgery

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14
Q

CCS sickle cell workup

A

blood cultrues
UA
retics + CBC
CXR

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15
Q

sickle cell management

A 
Pain:
oxygen
IVF with NS
IF fever → *****CTX
L-glutamin
Folate replacement
Tight BP control
Pneumovax
Hydroxyurea (titrate up until fetal Hg is 15%, pain stops, or WBC starts to drop)
Enoxaparin
IF 
drop in Hgb/HCT → consider parvovirus B19 or folate deficiency
severe hyperbilirubinemia OR visual disturbance OR pulmonary infarction OR priapism OR stroke → exchange transfusion
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16
Q

hemoglobin sickle cell disease

A

milder version, only renal problems (hematuria, isosthenuria, UTI’s)

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17
Q

treatment of cold-induced hemolysis

A

rituximab

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18
Q

transfusion reactions

A

Shortness of breath → TRALI → no treatment, resolves spontaneoulsy
Anaphylaxis → IgA deficiency. Confirm + use blood donations in future from IgA deficient donor.
Hemolysis → ABO incompatability
Delayed jaundice → minor blood group incompatability
Bump in temperature → Febrile nonhemolytic reactions .

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19
Q

AML treatment

A

idarubicin (daunorubicin) and cytosine arabinoside

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20
Q

APML treatment

A

ATRA

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21
Q

ALL treatment

A

intrathecal methotrexate

22
Q

agent that extends survival most in CLL

A

fludarabine

23
Q

erythrocytosis system

A

Order ABG to exclude hypoxia → if normal get epo level + hematology consult + nuclear red cell mass test for JAK2 (PV)

24
Q

PV treatment

A 
Phlebotomy
Hydroxyurea
Aspirin daily
IF thrombocythemia → anagrelide
B12 + LAP
25
myeloma treatment
``` melphalan steroids Possibly thalidomide/lenalidomide/bortezomib Serial BMP’s to monitor for renal failure IF hypercalcemia → hydration/diuresis IF bone fractures → bisphosphonates IF renal failure → hydration IF anemia → epo Flu, pneumovax, tetanus ppx IF young with advanced disease → BMT ```
26
B symptoms of lymphoma
fever, weight loss, night sweats
27
APA syndrome treatment
heparin followed by warfarin
28
thrombophilia differential
APA syndrome, protein C deficiency, factor V leiden, antithrombin deficiency
29
HIT diagnosis and management
diagnostic: Platelet factor 4 antibodies or heparin-induced antiplatelet antibodies treatment: Stop heparin → switch to NOAC
30
reversal drug for warfarin toxicity
Prothrombin comple concentrate (PCC) (works faster than vitamin K or FFP)
31
Uremia induced platelet bleeding treatment
desmopression
32
ITP management
If severe bleeding → IVIG OR RHOGAM FIRST If platelet count > 50,000 → no treatment If platelet count <50,000 with minor bleeding → prednisone If CHRONIC and no response to splenectomy → ROMIPLOSTIM AND ELTROMBOPAG
33
thrombocytopenia management
Check to see if on heparin or cirrhotic → If no and generally healthy prob ITP: start prednisone → then Peripheral smear + US of LUQ + test antibodies to glycoprotein IIb/IIIa receptor
34
folliculitis treatment
topical mupirocin
35
genital herpes management
Treat empirically with acyclovir x 7 days If diagnosis unclear → tzanck smear IF recurrent → daily suppressive therapy IF refractory → foscarnet
36
herpes zoster management
diagnose clinically watch out for complications → pneumonia, hepatitis, dissemination acyclovir ASAP Pain management options → *gabapentin, TCA’s, topical capsaicin IF severe pain + elderly → steroids IF nonimmune → give zoster immune globulin within 96 hours of exposure
37
genital warts management
Clinical diagnosis IF person concerned about damage to surrounding tissue or pain → imiquimod (takes several weeks though) IF not concerned and just want to get rid of them → cryotherapy or trichloracetic acid
38
scabies treatment
permethrin
39
treatment of pediculosis
OTC pyrethrins
40
toxic shock syndrome management
ICU transfer High volume IVF Pressors → dopamine ABX targeting MSSA + MRSA → vancomycin + oxacillin/nafcillin/cefazolin
41
staphylococcal scalded skin syndrome treatment
Transfer to burn unit | Oxacillin/nafcillin
42
anthrax treatment
ciprofloxacin or doxycycline
43
SK management
Remove only if cosmetically bothersome to patient with liquid nitrogen or curettage
44
melanoma management
BRAF inhibitor + surgery and possible radiation | IF unresectable → talimogene (genetically modified herpes virus)
45
BCC management
Shave or punch biopsy | Mohs microsurgery
46
kaposi management
HAART, raise CD4 count | If no rise, give liposomal adriamycin and vinblastine
47
koebner phemonenon
development of psoriasis at site of skin injury
48
normal anion gap
below 16
49
seborrheic dermatitis management
hydrocortisone (or other low potency topical steroid on F) ketoconazole (or selenium sulfide) zinc pyrithione shampoo
50
contact dermatitis diagnosis and management
``` Diagnostic: patch testing Treatment: Antihistamines topical steroids ```

Medicine (71 decks)

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