Test 40 - Created Aug 6 Flashcards

1
Q

what is considered threatened limb in acute limb ischemia and what to do about it

A

severe pain, delayed cap refill, no arterial Doppler signals, sensory/motor deficits

tx = heparin and emergency surgical revascularization

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2
Q

net clinical benefit

A

clinical usefulness of a med; measure of its possible benefit minus its possible harm.

If a question asks this, look for the answer that has both a benefit and a harm of the med. Also, make sure they’re statistically significant!

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3
Q

what’s the purpose of “intention-to-treat” approach

A

preserve randomization and to avoid the effects of crossover and dropout

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4
Q

apathetic thyrotoxicosis in elderly patient

A

lethargy, confusion, depression

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5
Q

next step in newly discovered hypercalcemia

A

PTH level

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6
Q

cancers with hypercalcemia

A

Squamous cell, renal, bladder, breast, ovarian, multiple myeloma, lymphoma

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7
Q

when fibrates prescribed

A

triglycerides > 1000

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8
Q

when statins are indicated

A

established ASCVD, LDL >190, age >40 with DM + high 10 yr ASCVD risk, 7.5-10% 10 yr ASCVD risk

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9
Q

when looking at lipid profile, which numbers do you pay attention to when thinking about statin therapy?

A

LDL

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10
Q

what causes a diverticular bleed

A

arterial erosion due to colonic mucosal outcropping

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11
Q

ways to diagnose diverticular bleed

A

colonoscopy or tagged RBC scan

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12
Q

ways to treat diverticular bleed

A

IV volume replacement, endoscopic therapy, angiographic embolization, colonic resection

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13
Q

what to do if patient in pain, having dyspnea, and already been giving morphine

A

if patient is dying and “comfort care” only, give more morphine to make patient more comfortable

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14
Q

labs done at initial prenatal visit

A

Rh(D) type and Ab, CBC, STDs, rubella, varicella, pap, urine Cx, urine protein

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15
Q

labs done at 24-28 wks GA

A

CBC, Ab screen if Rh(D) neg, GTT

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16
Q

labs done at 36-38 wks GA

A

GBS culture

17
Q

reasons why pt with h/o cholecystectomy may have acute cholangitis

A

biliary stricture, malignant biliary obstruction, or post-cholecystectomy migration of a biliary clip; GB is removed but biliary duct remains, hence why cholangitis can happen!

18
Q

tx of pediatric sepsis in < 1 month old

A

amp + gent
or
amp + cefotaxime

19
Q

why is ceftriaxone bad in a hyperbili baby

A

it can displace albumin-bound bilirubin and worsen hyperbili

20
Q

what 2 drugs can cause hyperbilirubinemia

A

ceftriaxone and sulfonamides

21
Q

when is tx needed for salmonella

A

kid < 1 yo and immunocompromised people

22
Q

what to do when a pt declines a recommended service based on inaccurate or incomplete info

A

provide a balanced assessment of the intervention including benefits, risks, and limitations; improves the decision-making

23
Q

what uterine anomaly is most commonly associated with recurrent pregnancy loss and how do you fix it?

A

uterine septum; hysteroscopic resection (surgery)

24
Q

next step if maternal serum AFP elevated

A

repeat AFP to double-check value and then do obstetric U/S for detailed anatomic survey

25
Q

positive antibodies for antiphospholipid-antibody syndrome

A

lupus anticoagulant, anticardiolipin Ab, and anti-beta-2 glycoprotein Ab

26
Q

tx of hepatic adenoma

A

Asx and < 5 cm: stop OCPs

SXS or > 5 cm: surgery with serial imaging and AFP levels

27
Q

best choice of anti-HTN drug for pt on Lithium

A

CCB (-dipine) or loop diuretic

28
Q

what do to if statin was discontinued due to CK level >10x normal after extensive exercise

A

repeat CK level and restart statin if level has normalized (statin can make muscle injury worse)

29
Q

who has worse prognosis with PSGN

A

adults with h/o CKD, metabolic syndrome, or DM

30
Q

tx of hyperthyroidism in pregnancy

A

maintain a mild hyperthyroid state with PTU in 1st tri and methimazole in 2nd/3rd tri; overtreatment can cause fetal hypothyroid and goiter