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USMLE STEP 2 > Swanson - Primary Care 2 > Flashcards

Swanson - Primary Care 2 Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the most important initial treatment for DKA?

A

High volume isotonic or half normal saline fluids and regular insulin by IV pump

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2
Q

What is the benefit of tight glycemic control in T1DM?

A

Decreases micro vascular complications like retinopathy, nephropathy, and neuropathy

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3
Q

What is the appropriate rate of fluid infusion in DKA ?

A

Large volumes of NS at 5-10mL/kg/hr or 2-3 L in first few hours

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4
Q

What is alpha-Lipoic acid?

A

Potent antioxidant that enhances glucose uptake and prevents glycosylation of tissues. May improve diabetic neuropathy

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5
Q

Which medications provide general cardiovascular benefit to diabetic patients?

A

ACEI or ARB, Statins, Aspirin

Not Ca channel blockers

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6
Q

How much fat should be consumed in diabetic patients?

A

Reduce total fat content to limit caloric intake

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7
Q

When should Lantus and Lispro be given?

A

Lantus long acting give evening or before bed

Lispro (is not listless) fast acting give within 30 min of meal

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8
Q

What are the recommendations for blood glucose control in critically ill hospitalized patients?

A

Keep BG at or below 180, and avoid tight control between 81-108 as this has higher mortality

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9
Q

What is the pathophysiology of Graves’ disease?

A

Autoimmune process where antibodies stimulate thyroid receptors

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10
Q

What is the best initial test for diagnosing hyperthyroidism? What is useful to narrow down the underlying cause?

A

Serum TSH then free T4 (get T3 if T4 is normal)

Do radioactive iodine uptake to narrow (I.e. Differentiate graves from multinodular goiter from nodules etc.)

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11
Q

What is the effect of hypothyroidism on BP? What CV drugs can predispose to Hothyroid?

A

Increases systemic vascular resistance, diastolic BP goes up

Amiodarone (contains iodine) can lead to iatrogenic HoThyroid

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12
Q

How often should TSH be monitored in hypothyroid patients?

A

q4-6 weeks

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13
Q

Which groups should be screened for HIV?

A

Al people between 13-64 years, unless prevalence documented

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14
Q

What is the treatment of subacute thyroiditis?

A

Start thyroid replacement therapy to correct hypothyroidism, close monitoring of TSH

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15
Q

What is the best choice for treatment of prolactinoma?

A

Bromocriptine, because recurrence after surgery is high

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16
Q

What is the most likely cause of Cushing’s syndrome if corticosteroid use has been ruled out?

A

Pituitary adenoma

17
Q

What drugs are approved for the treatment of ankylosing spondylitis, Crohn’s, psoriatic arthritis, and Rheumatoid arthritis?

A

anti-TNF-alpha agents - Adalimumab and Infliximab

18
Q

Which infections can cause Addison’s disease?

A

African trypanosomiasis, histoplasmosis, HIV, paracoccidiomycosis, syphilis, TB

19
Q

What are the possible ophthalmological complications of SLE?

A

Keratitis, Optic Neuropathy, Sicca syndrome, uveitis

20
Q

What tests should be conducted for initial work up of HIV infection?

A

All usual basic labs, HIV genotyping cell count and CD4 count

toxo gondii IgG, Hep C Ab,CMV IgG, VDRL, TB, Pap smear

21
Q

What are examples of symptomatic HIV infection (not AIDS defining opportunistic infections)?

A

Oral thrush, aseptic meningitis, thrombocytopenia, vulvovaginal candidiasis, cervical dysplasia, fever, diarrhea, leukoplakia

22
Q

Which vaccines are safe in HIV infected individuals?

A

Most all NON-live vaccines

23
Q

What are the most common symptoms seen in acute retroviral syndrome?

A

Fever, LAD, pharyngitis, myalgias, arthralgias in >75%

Other = maculopapular rash, nausea, vomiting and diarrhea

24
Q

Which opportunistic infection associated with HIV requires continued ppx?

A

Coccidiomycosis

25
Q

What is the appropriate treatment for concurrent Hep B in someone with HIV?

A

Adefovir

26
Q

What are the AIDS-associated malignant neoplasms associated with low CD4 count?

A

Kaposi sarcoma, systemic high grade B cell lymphoma (immmunoblastic and Burkitt), primary lymphoma of brain

27
Q

What is the most important test to obtain if suspecting osteoporosis?

A

Central DXA to assess bone mineral density

28
Q

What is the current recommendation for mammograms?

A

yearly or biannual mammos starting at 40 yo

29
Q

What is the most common type of breast cancer?

A

Infiltrating ductal carcinoma

30
Q

What is the most likely cause of unilateral bloody nipple discharge?

A

Intraductal papilloma

31
Q

What is an alternative therapy for menopause symptoms?

A

SSRI or SNRI

32
Q

What is clomiphene used for?

A

Ovulation induction in patients treated for infertility

USMLE STEP 2 (21 decks)

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