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Uworld Gaby > Step3 16 > Flashcards

Step3 16 Flashcards

1
Q

Varenicline use, moa, and side effects

A

Used for smoking cessation

Partial nicotine acetylcholine agonist

Decreases withdrawal symptoms and reduces rewarding effects of nicotine

May worsen depression or other mood disorders.
Stop medication if this happens

Screen for mood symptoms before

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2
Q

Indication for plasma exchange in HELLP sd

A

Fulminant hepatitis

Aspartate aminotranferase >2000

Lactate dehydrogenase >3000

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3
Q

Treatment for Seborrheic dermatitis

A

Topical antifungals: selenium sulfide, ketoconazole

Topical dermatitis

Topical calcineurin inhibitors (pimecrolimus)

Retreatment every 1 or 2 weeks

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4
Q

Treatment for tinea

A

Griseofulvin

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5
Q

Treatment for prolactinomas

A

Dopamine agonist

Bromocriptin, carbegoline

Surgery if medical treatment fails

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6
Q

Symotoms of hypoganidsm in women

A

Vaginal dryness

Amenorrhea

Osteoporosis

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7
Q

HPV vaccine recommendation

A

Women from 11-26 (up to 45)
Men 11-21 (up to 26)
HIV 11-21

2 doses before 15, 3 doses after 15
Not indicated in pregnancy

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8
Q

Hypertrigliredemia induced pancreatitis

RISK FACTORS

A

Familial predisposition

Uncontrolled diabetes

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9
Q

Hypertrigliredemia induced pancreatitis

CLINICAL FINDINGS

A

Meets two 2 of 3 symptoms of pancreatitis

  • —– Classic abdominal pain
  • —– Lipase elevation
  • —– Radiologic findings

Triglycerides >1000

+/- Xanthomas

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10
Q

Hypertrigliredemia induced pancreatitis

Management

A

Supportive. IV fluids

Insulin if not severe

Apheresis if severe (fever, leukocytosis, acidosis, hypocalcemia)

Fibrates

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11
Q

Effect of insulin on lipids

A

Activates lipoprotein lipase which Increases movement of triglycerides out of the plasma into the tissue

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12
Q

Treatment for nausea and vomiting in pregnancy

A
  1. Small frequent meals
  2. B6 and H1 antihistamines
  3. Oral dopamine (metoclopramide) or serotonin (ondansetron) antagonist
  4. IV Fluids and antiemetics
  5. Steroids
  6. TPN or tube feedings
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13
Q

Management of acid secretions during pregnancy

A

H2 antagonist (cimetidine) safe

PPIs… not well studied

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14
Q

Laboratory findings in hyperemesis gravidarum

A

Hypokalemia
Hypochloremia
Metabolic alkalosis

Ketosis if starvation

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15
Q

Test of choice for diagnosing pneumothorax

A

Bedside ultrasound (in the acute setting and/or if the patient can not sit upright)

AP upright chest Xray (if there is no chance of decompensation)

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16
Q

Management of constipation in children

A

Increase fiber and water intake

Reduce milk consumption <24 oz/day

Osmotic laxative

Stimulant laxative for impaction (can cause abdominal pain)

Enema (eg. phosphate enema (open rectum and stimulate bowel muscle movement). Can cause abdominal pain, nausea, diarrhea, and electrolyte imbalance

17
Q

Types of cranial hematomas

A

Caput succedaneum: above the periosteum, crosses suture line. Resolve in days

Cephalohematoma: does not cross suture lines. Subperiosteal bleed. Can cause hyperbilirubinemia. Resolves in weeks

Subgleal bleeding: dangerous, manage with iv fluid, serial CBC, and ICU

18
Q

Parvo B19 presentation

A

Young children:
First: flu-like symptoms
Slapped cheek rash
Rarely arthritis

Adolescents and adults
First: flu-like symptoms
Symmetric arthralgias, Joint inflammation in PIP and metacarpal phalangeal joints

Treatment is supportive. NSAID

Remember Parvo in an adult patient with arthralgias after a cold and contact with kids

19
Q

Types of arthritis in and rash associated with each one

Parvo
SLE
Lyme
Rheumatic fever

A

Parvo: symmetrical arthralgias PIP and MCP joint after a cold (faint malar rash in adults, kids present with slapped cheek but rarely arthralgias)

SLE: polyarticular arthritis, discoid rash, malar rash, photosensitivity, systemic symptoms

Lyme: monoarthritis, erythema migrans, tick bite. Lyme endemic area

RF: 2-4 after a throat infection. Migratory polyarthritis of big joints (knee, elbow). Erythema marginatum

20
Q

Anthracyclines side effects

A

Doxorubicin and daunorubicin

Cardiotoxicity

Monitor with radionuclide ventriculography or MUGA (multigated acquisition scan)

Anthracline contraindicated i EF < 30%

21
Q

CHEMO MAN

A

Google the answers

Uworld Gaby (77 decks)

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