Step3 20 Flashcards
Medications that can cause urinary retention
Sympathomimetics
if the patient is using decongestants
Anticholinergics
if the patient is taking TCAs
Anesthetics, antipsychotics
Acquired Long QT
Low Ca, Mg, K
Medications:
Arrythmics: amiodarone, sotalol, flecainide
Anginal:
Analgesics: methadone, oxycodone
Biotics: fluoroquinolones, macrolides, aminoglucosides
Cychotis: Haloperidol, quetiapine, risperidone
Depresants: SSRI, TCAs
Diuretics
Emetics: ondasetron
Criteria for implantable cardioverter/defibrillator placement
THIS IMPROVES SURVIVAL
Primary
Patients with previous MI and EF < 30%
Patients with NYHA II, III and EF <35%
Secondary
Prior VF or unstable VT without reversible cause
Prior sustained VT with underlying cardiomyopathy
Indications for cardiac resynchronization therapy
Think… Heart block
A) LVEF <35% and sinus rhythm + one of the following
- QRS >150, NYHA III, IV on optimal therapy
- QRS 120-150 with NYHA III, IV with optimal therapy (optional)
- NYHA I or II undergoing pacemaker
B) LVEF <30% with LBBB, NYHA I, or II on optimal therapy
Dxx of conjunctivitis according to the type of discharge
Viral:
Watery, mucus
Bacterial:
Purulent
Allergic:
Watery
The cholestatic pattern on labs
Elevated bilirubin
Elevated ALP
Extraintestinal manifestations of Inflammatory Bowel Disease (7)
Aphthous stomatitis Episcleritis/uveitis Arthritis Pyoderma gangrenosum Erythema nodoso Primary sclerosing cholangitis P-anca
Chrones:
Fistulas
Treatment for cardio symptoms in TCAs toxicity
Sodium bicarbonate
Decreases affinity of TCA for Na channels, reducing the risk of arrhythmias
Give to anyone with QRS >100 or evidence of arrhythmia
When do you use Magnesium sulfate for arrhythmias
When Mg is low
Torsades
What imaging study do you do in a patient with Staphylococcal bacteremia
Echocardiogram
Difference between Delusional disorder (somatic type) and Illness anxiety disorder
Delusionals are convinced they have something
Illness anxiety fear they have a serious undiagnosed condition but can acknowledge the possibility that they don’t have anything
Thrombophilias
Activated protein C resistance / factor V Leiden;
Most common, young white patient
Heparin-induced thrombocytopenia:
Hospitalized patient on heparin with a sudden drop in platelet count
Antiphospholipid antibody sd.
Woman with multiple miscarrages
Preferred imaging for brain lesions
MRI
CT if the patient is on status epilepticus or you suspect a hemorrhage
Microcytic anemia with normal RDW
Thalassemia or anemia of chronic disease
Dxx of microcytic anemia
Iron TIBC or transferrin Ferritin RDW Peripheral smear
Iron deficiency anemia vs. thalassemia vs. anemia of chronic disease
IRON DEFICIENCY Iron: low TIBC or transferrin: elevated Ferritin: low RDW: elevated Peripheral smear: microcytosis, hypochromic
THALASSEMIA Iron: normal, elevated TIBC or transferrin: normal, low Ferritin: normal, elevated RDW: normal Peripheral smear: target cells
ANEMIA OF CHRONIC DISEASE Iron: low TIBC or transferrin: low Ferritin: elevated RDW: normal Peripheral smear
