Things Rosh Humbled me on Flashcards
…..are the only medications that manage CHF diuresis in the presence of impaired renal function.
loop diuretics
BP and HR in neurogenic shock
hypotension and bradycardia
Asthma treatment
- mild int asthma = SABA PRN
- mild pers asthma = Low ICS
- Mod pers asthma = Low ICS + LABA or High ICS
- Severe = High ICS + LABA
Normal ABG values
- PaCO2 - 35-45
- PaO2 - 80-95
- pH 7.35-7.45
ABG in COPD exacerbation
compensatory respiratory acidosis (normal pH, borderline high/normal CO2, low pO2.)
Hypovolemic shock treatment
- NS or LR.
- dopamine if SBP <90, dobutamine if >90.
tx pericarditis
NSAIDS or colchicine
pnuemonia + verrusous skin leasion is probs what diagnosis? how do you treat it
Blastomycosis, tx with amphotercin B. (from great lakes. moist because its a fungus). HIV patients MC.
Trigger: bence jones protein
Multiple Myeloma. Causes Pathologic fractures = MC in rib, pelvis, femoral neck and vertebre.
high serum protein and Rouleaux formation on smear suggests what
multiple myeloma
blunting of the costophrenic angles or complete opacification of hemithorax on CXR suggests what
how would it present
plaural effusion.
would present with decreased chest expansion, breath sounds and tactile fremitus. also dullness to percussion.
trigger: BCR-ABL1 gene
CML
active TB tx
“RIPE” rifampin, isoniazid, pyrazinamide, ethambutol.
Latent TB tx
Isoniazid for 9 months + pyridoxine
OR
rifampin alone for 4 motnhs
MC valve abnormality in MI is …
Mitral regurg (“M” i for “mitral”)
WPW EKG presentation
short PR and slurred upstroke of QRS (delta wave)
tx w procainamide
Rheumatoid arthritic pleural effusions show what on pleural effusion testing
high protein, low glucose, low compliment level.
MC SE of CCB
constipation
Stable Ventricular Tachycardai tx
- procainamide
- amiodarone and lidocaine second line
unstable VT tx
- synchronized cardioversion.
- amiodarone.
pulseless VT tx
- defibrillation + CPR. then follow cardiac rescusitation algorithm
Acute (<48hrs) hyponatremia tx
3% hypotonic saline/10min
Chronic (>48hrs) hyponatremia tx
3% hypotonic saline over 24 hrs.
DVT w kidney failure treatment
Unfrac heparin bridged to warfarin.
if on warfarin, avoid what foods
leafy green veggies
chronic purulent sputum prod. High resolution CT scan with tram tracks.
bronchiectasis
tx w abx based on culture, chest physiotherapy and bronchodilators
Hypertensive urgency tx
clonidine or captopril
hypertensive emergency tx
nicardipine aor labetelol.
MC underlying cause for torsades de pointes.
Prolonged QT interval
MVP can cause what as a complications
MR
anti-histidyl-transfer RNA synthetase antidodies are seen when
polymyositis
greatest immediate risk reduction for abdominal aortic aneurysm.
smoking cessation
DM diagnostic criteria
- DM symptoms + random BG >200
- fasting BG >125
- BG>200 2 hours after 75g glucose load
- HbA1C>6.5
any of these 2 times
gout treatment
Indomethacin (NSAID), colchicine, glucocorticoids.
allopurinol for PREVENTION
treatment of bells palsy
glucocorticoids.
add antiviral if vesicles present in ear or if super severe.
reactive arthritis presentation
swelling, warm, painful joint several weeks after infection.
septic arthritis presentation
fever and chills with swelling/pain in joint. synovial fluid will show 50-150k WBCs and have a positive culture.
how to diagnose PE in person w renal fialure
ventilation perfusion scan
Cor pulmonale can result in what valvular disorder
tricuspid regurgitation
HFE gene =
hereditary hemachromatosis
atrophy of caudate nucleus and putamen is seen with…
huntingtons
lewy bodies in substantia nigra is seen with..
parkinsons
how do labs appear in anemia of chronic disease.
High ferritin + normal MCV + low hbg
EKG reading w 3 different P wave morhpologies is called …….. and is usually seen in COPD exacerbation and other hypoxic states
multifocal atrial tachycardia
Hypercalcemia >14 tx
IV saline FIRST, then IV bisphosphonates and calcitonins
how do you diagnose PAD
ankle brachial index
Epididymitis with bacterial growth on blue agar
E. coli
patient has CHICKENS. lives in Missouri or ohio. farming. with pneumonia now.
histoplasmosis
increased JVP, peripheral edema, ascites, hepatomegaly. AND accenuation of the pulmonic component of S2
pulmonary hypertension
dx of septic shock
sepsis + Lactate >2 despite fluid rescusitation
gross hematuria 1-2 days after upper respiratory infectin.
IgA nephropathy
acute interstitial nephritis can be caused by….
drugs, like NSAIDS!!!
MC area for acute arterial occlusion
COMMON femoral artery. becuase its most COMMON its the COMMON femoral artery
what drug is used to provoke vasospasms for prinzmetal angina in coronary angiography
argovine
what drug is used to produce bronchospasm
methacoline
Treatment of hypoglycemia
give fast acting oral carbs UNLESS unconcious or unable to ingest food! then use dextrose or glucagon
pleural criteria that is TRANSUDATIVE
LOW pleural serum protein and LDH and LOW plerual fluid LDH
caused by HF, PE, nephrotic syndrome or cirrhosis
anal fistulas, perirectal abscesses, anal ulcers all are commonly caused by….
chrons disease
opening Snap
mitral Stenosis
presents with linear erythematous induration that is palpable and tender to palpation.
superficial thrombophlebitis
dx w venous duplex, tx w NSAIDS
MC SE of metformin
GI upset (diarrhea and nuasea)
first line tx for hemroidectomy
ubber band ligation UNLESS the patient is on anticoags (sclerotherapy indicated) or if hemorroids have accutely thrombosed (excision indicated)
Acute diverticulitis dx
CT abdomen
Carcinoid syndrome
flushing
wheezing
diarrhea
sweating
hypotension
when is carotid endartectomy indicated
if patient is symptomatic OR stenosis is >70%
if TIA is suspected and CT is normal what isthe next step
get diffusion MRI
Prinzmetal Angina tx
CCB, nitrates or ACEI
DO NOT USE BB
Pulsatile liver, Large pulsatile neck veins + heart failure s/s
tricuspid regurg.
Everythings TRYing to REGURGITATE the fluids. (idk bear w me ok)
lyme disease vector
Ixodes scapularis = deer tick
PREVENTION of cluster headaches
short term steroid and CCB
(tx of current is 100% o2 on nonrebreather)
change in skin color, varicose veins, ulcers all on lower extremities
chronic venous insufficiency
tx = compression socks and elevation
CREST is the pneumonic for what diagnosis?
scleroderma!
Calcinosis Cutis
Raynauds
esophagyl dysmotility
Sclerodactyly
Telangiectasia
anticentromere antibody
scleroderma
what flu treatment is used with pregnancy
oseltamivir (tamiflu)
which hepatitis infections present with a lacey reticular rash (livedo reticularis)
Hep B and C
1st line treatment for ascites
loop diuretics (furosemide) and salt restriction
tx for hyperkalemia.
- calcium gluconate or calcium chloride
- insulin, albuterol, sodium bicarb
- loops
orthostatic hypotension definitions
fall in systolic >20 or diastolic >10 within 2-5 minutes of quiet standing after 5 minutes of supine rest.
Tx of acute myocarditis
furosemide for fluid overload
ACEI for cardiac remodeling
BB if EF<40%
harsh systolic murmur radiating to carotids
aortic stenosis
what is the MC risk factor for Aortic dissection
Hypertension
