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Step 3 > STEP3_First > Flashcards

STEP3_First Flashcards

1
Q

GDMT

A

ACE or entresto, BB, loop, aldosterone antagonist

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2
Q

Who should get biventricular pacing? (Criteria 3)

A

LVEF <35%, NYHA >=II, LBBB + QRS >150 (ALL need to be met)

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3
Q

Why HFeEF patients get biventricular pacing?

A

Resynchronization therapy has shown to iprove exercise tolerance and reduce rate of recurrent hospitalizations

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4
Q

Treatment of peri-infarction pericarditis

A

Usually self-resolving, but if too much discomfort High dose aspirin, avoid other NSAIDs

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5
Q

Dressler syndrome

A

Immune-mediated pericarditis occurring WEEKS after an MI

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6
Q

Peri-infarction pericarditis

A

Pericarditis within 4 days of an acute MI (Dressler is weeks after)

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7
Q

When to give nitro to patients in ADHF?

A

Those with inadequate response to diuretics; initial management of flash pulmonary edema

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8
Q

Murmur associated with ASD

A

Wide and fixed splitting of second heart sound

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9
Q

BP medication that can cause rash

A

HCTZ (because they are sulfa)

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10
Q

What anti-hypertensive med is good to use in gout patients?

A

Losartan since it has uricosuric effects

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11
Q

UWORLD definition of low EF

A

<60%

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12
Q

Who gets statins?

A

LDL<190, >40 and DM, or ASCVD rirsk >7.5-10%

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13
Q

Severe AS characteristics

A

Soft single S2, delayed carotid pulse (parvus et tardus) and lou late-peaking systolic murmur

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14
Q

Supplies of the LAD

A

Anterior wall of the L ventricle and anterolateral wall with its branches

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15
Q

Supplies of the RCA

A

Right ventricle and inferoposterior walls of the L ventricle

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16
Q

How to decrease edema caused by CCB

A

Add ACE inhibitor

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17
Q

WPW ECG

A

short PR interval, delta wave and wide QRS complex

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18
Q

INR for patients with mechanical valves

A

2-3 or 2.5-3.5 if risk factors (Afib, rEF, risk of clot, hypercoag)

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19
Q

PCP intoxication symtpoms

A

Agitation, combative, bizarre, HTN, traumatic injuries, ataxia, nystagmus

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20
Q

PCP intoxication timing

A

Usually lasts 7-8 hours

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21
Q

Treatment of PCP intoxication

A

If violent: Benzos; If mild (dissociative and withdrawal): low stimulation environment

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22
Q

How long to try antidepressant before switching

A

6 weeks

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23
Q

Treatment for acute and prevention of cluster headache

A

Oxygen, sumtriptan, verapamil (prevention)

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24
Q

Difference between schizophrenia and schizoaffective

A

Mood symptoms only brief in schizophernia while prominent in schizoaffective

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25
Q

Possible lethal side effect of stimulants

A

Sudden cardiac death

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26
Q

What drugs can interact with lithium?

A

Thiazides, ACE, NSAIDs

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27
Q

Side effects of valproic acid

A

Thrombocytopenia and hepatotoxicity

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28
Q

Treatment of acute dystonia

A

Benztropine and diphenhyddramine

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29
Q

Treatmend of tardive dyskinesia

A

bvalbenazine and deutrabenazine

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30
Q

MRI lesions seen in MS?

A

Periventricular, juxtacortical, infratentorial or in the spinal cord

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31
Q

Treatment of MS in patient with cutaneous sympoms vs organ involvement

A

Prednisone in both, HXQN if cutaneous/ methotrexate if organ involvement

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32
Q

What type of med is riluzole?

A

A glutamate inhibitor for ALS

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33
Q

Treatment of akathisia

A

Reduction of antipsychotic or propanolol

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34
Q

Common side effect of lithium therapy

A

hypothyroidism

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35
Q

Factitious disorder

A

Purposfully falsifying sympotms to assume the sick role

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36
Q

How to manage sexual dysfuntion in patients taking SSRIs?

A

Switching to non-SSRI buproprion or mirtazapine, augmentation with sildenafil or bupropion and dose reduction if possible

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37
Q

When can people with mild concussions return to cotact sports

A

Rest for >24hours and slowly up. Fully back in 1 week

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38
Q

First step if concern for increased ICP

A

MRI to rule out mass… starting with LP can lead to herniation

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39
Q

Erbs Palsy

A

Adduction and internal rotation waiters tip, nerves C5-C7

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40
Q

Who gets urine culture repeat/ test of cure?

A

Pregnant patients with UTI

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41
Q

Nitrofurantoin and pregnancy

A

Avoided in first trimester due to risk of orofacial clefts and late thrid trimester due to asscoiattion with neonatal hemolytic anemia

42
Q

UTI antibiotics that are safe in pregnancy

A

Cephalexin, fosfomycin, Augmentin

43
Q

bactrim and pregnancy

A

Associated with Neural, cardiac and cleft palate defects if used in first trimester and with kernicterus if late third trimester

44
Q

Antibitocis contraindicated in pregnancy

A

Tetracyclines, FQN, bactrim

45
Q

Dx criteria of acute bronchitis

A

Cough >5 days - 3w w/o systemic findings and wheezing/rhonchi or chest wall tenderness

46
Q

Treatment of acute bronchitis

A

Symtpom management only, no abx recommended and CXR only if pneumnia is suspected

47
Q

Treatment of latent TB

A

Rifampin based therapy for 3-4 months, Iso for 6-9months or iso+ rifam;in weekly for 3 moths (not if HIV)

48
Q

Initial treatment of C. diff

A

PO vanc or fidaxomicin

49
Q

When to use flagyl for C. diff

A

If fulminant (hypotension, shock, ileus) and use with PO vanc

50
Q

Characteristics of sulcus tumor/Pancoast

A

Shoulder pain, Horner syndrome, neuro symptoms, weight loss, supraclavicular lymphadenopathy

51
Q

Urgent intervention if this symptom is present in someone with pancoast tumor

A

Any signs of spinal cord compression since it happens in 25% of patients with this tumor

52
Q

Most common Nec fasc bug

A

GAStrep, Staph,, Clostridium

53
Q

Treatment of PAD

A

Antiplatelet and high statin therapy for 2ary prevention; exercise program, cilostazol only if lifestyle modifications failed, revascularization

54
Q

Skin papules with umbilication in HIV

A

Cutaneous cryptococcosis

55
Q

Charact of MAC

A

Fever, night sweats, abdominal pain, diarrhea and weight loss

56
Q

Diagnosis of cutaneous cryptococcosis

A

Lesion biopsy with histopathological examination

57
Q

Labs in Rocky Mountain (Rickettsia)

A

Low platelets and sodium, High AST/ALT

58
Q

When to give steroids in PCP pneumonia?

A

If A-a gradient >35 or arterialoxygen tension is <70

59
Q

Post exposure HIV treatment

A

Antiretroviral therapy (triple drug) for 28days started within 72 hours

60
Q

Ratio of WBC/RBC that has almost 100% NPP for meningitis

A

<0.01

61
Q

How to confirm active TB

A

Sputum smears and culutre (although low sensitivity) confirmed by NAA

62
Q

Treatment of allergic bronchopulmonary aspergillosis

A

Glucocorticoids +/- itra or voriconazole

63
Q

When is oseltamivir used for influenza?

A

If patients require hospitalization, severe progressive illness or unerlying high-risk medical conditions. Or mild within 48hours

64
Q

Treatment of Tabes dorsalis

A

10-14days of IV penicillin G

65
Q

Treatment of aspiration pneumonia

A

Clinday or B-lactam + Blactamase inhibitor

66
Q

Meds for close contacts of meningococal meningitis

A

rifampin, cipro, CTX

67
Q

Charact of 1,2 and 3rd syhilis

A

1) cahncre, 2)rash, condyloma lata, 3) neurosyphilis, aortitis

68
Q

After how many hours of tick attachment is someone at risk for Lyme?

A

> 36hours, otherwise little risk

69
Q

When to give antibiotics for COPD exacerbation

A

If increased sputum purulence, volume or increased dyspnea

70
Q

Charact of early neurosyphilis

A

meningitis, ocular and otosyphilis

71
Q

What is the most important predictor of COPD?

A

FEV1 especially if <40

72
Q

Signs of keratitis

A

Photophobia, impaired vision and foreign body sensation (can cause blindness)

73
Q

Common complication of conjunctivitis

A

keratitis (cornea infxn)

74
Q

Common bugs in conjuctivitis

A

Staph, Strep, Haemophilus and Moraxella

75
Q

How to treat bacterial conjunctivitis

A

Topical macrolide, IF CONTACTS: then topical FQN (for PsA)

76
Q

Potential side effect of ginkgo biloba and gingseng

A

bleeding risk

77
Q

Side effect of kava kava

A

Liver damage

78
Q

How to evaluate PTX in the acute setting

A

US

79
Q

Common bug in eripsyelas

A

GAS

80
Q

Sensitivity of Xrays in stress fractures

A

<50 % sensitive especially in the first 2-3 weeks after symptom onset

81
Q

Varicella isolation

A

If localized (standard) if disseminated (contact/airborne)

82
Q

Stimulat toxicity findings

A

Anxiety, agitation, insomnia, loss of appetite

83
Q

Treatment of priapism >4 hrs

A

Aspiration of corpora cavernosa and intracavernosal injection of alpha ahonist

84
Q

Drug of choice for awake intubation

A

Ketamine (awake done if difficult airway)

85
Q

Which one is done first if intubation is not possible?

A

Cricothyroidotomy

86
Q

Higher electrolyte that gets affecged with TPN?

A

Hypophosphatemia

87
Q

Treatment of candida endophathalmitis

A

vitrectomy, systemic amphotericin B and intravitreal antifungal injection

88
Q

Signs of Down syndrome

A

Upslanting palpebral fissure, epicanthal folds, transvrese palmar creases

89
Q

treatment of AK

A

cryosurgery, excision, 5-FU (mostly when multiple)

90
Q

ACL ligament injury features

A

Popping, effusion/hemarthrosis, joint instability

91
Q

Catching sensation of the knee

A

Meniscal tear (sually more insidious)

92
Q

Treatmetn of salicylate toxicity

A

Alkalinization of blood and urine with sodium bicarb drip, glucose, activated charcoal if early

93
Q

Treatment of narcolepsy

A

Stimulants like modafinil or methylphenydate; if cataplexy is present SNRI, SSRI, TCA and sodium oxybate should be added

94
Q

Type of hypersensitivity reactions

A

Type 1) IgE-mediated, 2) Autoantibodies 3) immune complex mediated, 4) T-cell mediated

95
Q

Metabolic disarray that can happen right after surgery especially with transfuisions

A

Hypocalcemia

96
Q

Tendon reflexes in hypocalcemia vs hypoagnesemia

A

Hyperreflexic in hypoCa vs hyporeflexic in HypoMag

97
Q

When to leave bite wounds open

A

On extremities if >12hours or in face if >24hours

98
Q

Calcium decrease in relationship to albumin

A

0.8 decrease per every 1 pt albumin down

99
Q

Charact of bullous pemphygoid biopsy

A

Subepidermal cleavage and deposition of IgG and/or C3 along the basement membrane

100
Q

Another name for acute uveitis

A

irititis

101
Q

Association with Lichen Planus

A

HepC

Step 3 (4 decks)

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