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STEP2CK > Treatments > Flashcards

Treatments Flashcards

1
Q

Grave’s Disease- Best definitive tx?

A

Radioiodine Therapy

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2
Q

Cat Bite- Pasteurella tx?

A

Augmentin 5 days

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3
Q

Entamoeba Histolytica- liver abscess tx?

A

Metronidazole

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4
Q

Pediatric Viral Myocarditis tx

A

Diuretics + Inotropes

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5
Q

Nocardia tx

A

Bactrim 6-12 mos

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6
Q

Chagas Tx

A

Benznidazole

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7
Q

Bacillary Angiomatosis from Bartonella tx

A

Erythromycin

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8
Q

PCP PNA in HIV

A

Bactrim + Steroids (add steroids if PaO2 35

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9
Q

Prophy MAC in HIV (CD4

A

Azithromycin

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10
Q

Prophy PCP in HIV (CD4

A

Bactrim or Dapsone

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11
Q

Myasthenic Crisis tx

A

IVIG or Plasmapheresis, not both

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12
Q

Poor appetite in cancer tx?

A

Megesterol acetate

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13
Q

Pertussis tx

A

Azithromycin

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14
Q

Giant Cell Arteritis Tx

A

High-Dose Steroids

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15
Q

ADPCKD: Tx

New onset HTN with bilateral palpable masses

A

ACEi/ARBs

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16
Q

C. Dif Tx

A

PO metronidazole
PO vancomycin (for more severe or refractory)
WBC >15K , elevated creatinine
(Can use rectal vanc for Ileus)

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17
Q

Neuroleptic Malignant Syndrome

A
  1. ) Dantrolene
  2. ) Bromocriptine
  3. ) Amantadine
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18
Q

Parkinson’s

A

Mild: ACh antagonists: Benztropine, Trihexylphenidyl
DA releasers: Amantadine
Severe: Levodopa/carbidopa
COMT inhibitors, MAOi
DA agonistis: Pramipexole, Ropinirole

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19
Q

Restless Leg Syndrome

A

Pramipexole

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20
Q

Multiple Sclerosis

A

Glatiramir Acetate, Interferon B

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21
Q

Mild Hyponatremia
Moderate Hyponatremia
Severe Hyponatremia

A
  • Restrict fluids
  • Saline + Diuretic
  • 3% Saline (hypertonic) + conivaptan/tolvaptan (ADH receptor blockers): for symptomatic SIADH
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22
Q

Chronic SIADH

A

Demeclocycline

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23
Q

VSD tx

A

Conservative: Digoxin + Diuretics

Surgical : close the VSD

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24
Q

HACEK Endocarditis

A

Ceftriaxone

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25
Q

Hib Epiglottitis

A

Ceftriaxone

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26
Q

Endometritis

A

Clindamycin/Gentamin

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27
Q

HIV : best initial regimen

A
  1. emtricitabine
  2. tenofovir
  3. efavirenz
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28
Q

Infant of HIV + mother

A

Zidovudine for 6 weeks

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29
Q

Hereditary Angioedema

A
  • Ecallantide or FFP : acutely
  • Androgens : danazol/ stanazol : chronic

*ALWAYS PROTECT THE AIRWAY FIRST!

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30
Q

CVID

A

Treat infxns as they come

Chronic use of IVIG infusions

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31
Q

SCID

A

Bone marrow transplant is curative

*otherwise just treat infxns

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32
Q

What txs lower mortality in chronic angina?

A

BBs, Aspirin, Nitroglycerin (BAN)

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33
Q

What tx lowers mortality in HLD?

A

Statins

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34
Q

Unstable Ectopic Pregnancy

A

IVF, blood products, dopamine–> Surgery when stable

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35
Q

Septic Abortion

A

D&C + IV antibiotics (Levofloxacin + metronidazole)

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36
Q

Preterm Labor (without chorioamnionitis)

A
  1. Betamethasone
  2. Tocolytics (mag, terbutaline, ccb)
  3. Amp + azithro as chorio prophy
    (swap amp for cefazolin or clinda if PCN allergic)
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37
Q

Gestational HTN

A

Methyldopa, Nifedipine, Labetalol,

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38
Q

Preeclampsia

A

Stabilize mom and deliver deliver deliver
Prophy seizure: Mag sulfate
HTN control: Hydralazine

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39
Q

Gestational DM

A

Insulin (NPH and aspart), Metformin and Glyburide

oral agents are NOT safe in pregnancy

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40
Q

Adenomyosis (globular, boggy uterus)

A

Hysterectomy

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41
Q

Endometriosis

A

NSAIDS, OCPs : mild
Danazole, Leuprolide : moderate (suppress LH/FSH)
Surgery: severe
Done childbearing? TAH-BSO

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42
Q

Uveitis

A

topical steroids

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43
Q

Acute angle closure glaucoma

A

Acetazolamide
Pilocarpine
Mannitol
Trabeculoplasty

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44
Q

Open Angle Glaucoma

A

**Prostaglandin Analogues- prosts
**Topical BB
Topical carbonic anhydrase inhibitors -amides
pilocarpine
Trabeculoplasty

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45
Q

CRVO

A

Ranibizumab (Lucentis- also used for wet mac degen)

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46
Q

CRAO

A

100% Oxygen, Ocular massage

Acetazolamide, ant. chamber paracentesis

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47
Q

Panic Disorder

A

Acute Management: Benzodiaz.

Chronic Tx: SSRIs

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48
Q

Adjustment disorder

A

Psychotherapy, Not meds.

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49
Q

ADHD

A

First Line: methylphenidate (Concerta) or dextroamphetamine
Second Line: atomoxetine- Strattera (NE reuptake inhib)
*Strattera has better side-effect profile

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50
Q

Bipolar Depression

A

Lithium or Lamotrigine

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51
Q

Cyclothymia

A

Carbemazepine, Lithium, Valproate, psychotherapy

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52
Q

Atypical Depression (Wt gain, inc appetite, more sleep, worse mood in the evenings)

A

SSRIs or MAOis (SSRIs are safer)

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53
Q

Seasonal Affective Disorder

A

Phototherapy + Buproprion

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54
Q

Postpartum Psychosis

A

Antipsychotic, lithium, antidepressants

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55
Q

Acute Dystonic Reaction (hrs to days of antipsych)

-includes oculogyric crisis/torticollis

A

Benztropine or Diphenhydramine

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56
Q

OCD

A

SSRI’s : First Line (including fluvoxamine)
Clomipramine : Second Line
Behavioral Therapy: exposure and response prevention

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57
Q

PTSD

A

Paroxetine
Sertraline
Prazosin for nightmares

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58
Q

GAD

A

SSRIs, buspirone, and venlafaxine

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59
Q

Alcohol withdrawal Benzos

A

Chlordiazepoxide, Lorazepam, Oxazepam

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60
Q

Anabolic Steroid Withdrawal

A

SSRIs (presents with HA/depression/anxiety)

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61
Q

Opiate WIthdrawal

A

Clonidine
Methadone
Buprenorphine (partial mu agonist)

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62
Q

Narcolepsy

A

Modafinil
Forced naps
Methylphenidate/dextroamphetamine

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63
Q

Insomnia

A

Good Sleep Hygiene

Zolpidem, Eszopiclone, Zaleplon

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64
Q

Tinea Versicolor

A

Selenium Sulfide Shampoo

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65
Q

Methemoglobinemia

A

100% oxygen and methylene blue*

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66
Q

Tropical Sprue

A

Folate + Doxycycline

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67
Q

Organophosphate Toxicity

A

Pralidoxime (acetylcholine esterase activator)

Atropine (works quicker)

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68
Q

Brown Recluse Spider Bite

A

Debride necrosis
Steroids
Dapsone

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69
Q

Black Widow Spider Bite

A

Calcium (for repletion)

Antivenin

70
Q

Head Trauma, to lower ICP

A

HOB elevated
Intubate–>Hyperventilate
Mannitol
Drain blood/fluid

71
Q

Wolff-Parkinson-White Syndrome (delta wave +short PR)

DEFINITIVE DX WITH EP STUDIES

A

Acute: Procainamide, amiodarone
Chronic: Ablation (curative) of abnormal conduction tract around AV node

*Don’t use blockers of AV node (dig/ccbs), as these will force conduction through the abnormal WPW pathway

72
Q

Third Degree AV block or Second Degree type II AV block (EVEN if asymptomatic)

A

Pacemaker

73
Q

SVT

A

Vagal Maneuvers

Adenosine

74
Q

Symptomatic sinus bradycardia

A

Atropine

75
Q

Penile Fracture

A

Retrograde Urethrogram followed by surgery

76
Q

Scaphoid Fracture (even with negative initial xray)

A

Wrist immobilization

77
Q

Intrahepatic Cholestasis of Pregnancy

A

Ursodeoxycholic Acid

78
Q

N. Meningitis

A

Ceftriaxone AND rifampin/cipro/ceftriazone to close contacts

79
Q

H. Ducreyi (Chancroid)

A

Azithromycin (1 dose)

80
Q

Lymphogranuloma venereum (tender/suppurative inguinal LAD)

A

Doxycycline

81
Q

Syphillis

A

Primary/secondary: IM Penicillin or Doxy if allergic

Tertiary: IV penicillin or desensitize if allergic for tertiary

82
Q

Scabies

A

Permethrin cream for everyone, all over

Really bad- crusted? Ivermectin

83
Q

Pediculosis (crabs)

A

Permethrin

84
Q

Pyelonephritis

A

Outpatient: Cipro
Inpatient: Ceftriaxone, or amp/gent until cultures are back

85
Q

Chronic prostatitis

A

Bactrim for 6-8 weeks

86
Q

Achalasia

A

Pneumatic Dilation

Botulinum toxin injection

87
Q

Nutracker esophagus/ Esophageal Spasm

A

CCB

88
Q

Unstable Angina

A

BB, heparin,
GIIbIIIa receptor BLOCKER
CLOPIDOGREL
ACEinhibitor/ARB

89
Q

Prinzmetal angina (coronary spasm)

A

Nitro- acutely

CCB- chronically

90
Q

DVT

A

IV/subQ hep bridged to warfarin for 3-6 mos

INR: 2-3

91
Q

Primary pulmonary hypertension

A 
Prostacyclin
Antiendothelin (bosentan)
PDE-5 inhibitors
CCB
Heart/lung transplant
92
Q

HOCM

A

BB and disopyramide

93
Q

WPW syndrome

A

Pocainamide/quinidine

94
Q

Vfib

A

Defib, epi, vasopressin, amio/lidocaine

95
Q

Wilson’s Disease

A

Pennicillamine (Cu chelator)

Oral zinc is recommended- prevents Cu absorption

96
Q

Uncomplicated Cystitis

A

Trimeth-Sulf (3-days)
Nitrofurantoin (5-days)
Fosfomycin (one dose)
… if resistant .. Fluoroquinoloes

97
Q

Hx of Rheumatic Fever: prophy

A

RF w.o carditis: PCN for 5 years or until 21
RF w. carditis but no residual valve problem: PCN for 10 years or until 21
RF with carditis + valve problems: PCN for 10 years or until 40

98
Q

Uric Acid Kidney Stones

A

Alkalinize urine with potassium citrate

Limit dietary purines

99
Q

Neutropenic Fever (ANC

A

Broad spectrum pseudomonal monotherapy

  1. ) Zosyn
  2. ) Meropenem
  3. ) Cefepime
100
Q

Asymptomatic Bacteruria in pregnancy

A

Nitrofurantion x7 days

101
Q

Meniere’s Disease

A

Short term tx: Antihistamines, Anticholinergics, Benzos

Long-term: diuretics

102
Q

Uterine Atony

A

Uterine Massage
Fluid resuscitation
Oxytocin, methylergonovine, carboprost

103
Q

Esophageal Varices Ppx

A

Propranalol, nadolol (Nonselective BB)

104
Q

Hoarding Disorder

A

SSRIs, CBT

105
Q

Ascites

A

Fluid restriction
Spironolactone
Loops
Frequent taps

106
Q

Low EF/systolic dysfxn OR valvular incompetence

A

ACEi/ARBs

107
Q

ST-segment depression ACS

A

Give heparin right away!

108
Q

Everyone with systolic dysfunction (low EF) needs..

A

ACEi, BB, spironolactone, diuretics, digoxin

Approved BB: metoprolol, bisoprolol, carvedilol
Spironolactone for CHF stage III, IV

109
Q

Mortality benefit in systolic dysfunction…

A

BASH’D

BB, ACEi, Spironolactone, Hydralazine, Defibrillator

110
Q

Chemical Eye Burns

A 
Copious Irrigation
(Alkali worse than Acid- don't play chemist)
111
Q

Chalazion (painless)

A

Warm compresses first..

Inject steroids

112
Q

Herpes simplex keratitis

A 
Topical antiviral (idoxiuridine, trifluridine)
NO STEROIDS
113
Q

Kleptomania

A

Psychotherapy

114
Q

Flail Chest

A

Intercostal nerve block

115
Q

Hepatic Encephalopathy

A

Fluids, electrolyte replacement (POTASSIUM)
Lactulose
Rifaximin

116
Q

Disk herniation (+SLR) WITHOUT FND

A

Return to normal activities
NSAIDs and muscle relaxants
If 4-6weeks no improvement- MRI/CT

117
Q

Toxic Megacolon

A 
Bowel rest (NPO), NG-tube, IV steroids
If no improvement- emergency sx (subtotal colectomy + end-ileostomy)
118
Q

VIPoma

A

Octreotide

119
Q

PNH (CD55, CD59 defic)

A

Predisone, Eculizumab (blocks C5 in complement pathway)

120
Q

Guillain Barre Syndrome

A

IVIG/Plasmapheresis

121
Q

Fibromuscular Dysplasia

A

Angioplasty + stenting (definitive)

Med manage HTN

122
Q

Emphysematous cholecystitis

A

IV fluids, electrolytes
Cholecystectomy
IV abx for gram - and anaerobes (unasyn, zosyn, etc)

123
Q

Carcinoid Tumor

A

Surgery, radiation, chemotherapy, hormonal supp (Octreotide)

124
Q

Legionella/Legionaire’s Disease

A

Floroquinolones or newer macrolides

125
Q

UTI in Pregnancy

A

Amoxicillin

126
Q

Lyme Disease

A

Early: amoxicillin or Doxy
Late: ceftriaxone (carditis or CNS)

127
Q

Community acquired PNA

A

Fluoroquinolones = best therapy

128
Q

Diverticulitis

A

FQs + metronidazole (except moxiflox can be used alone)

129
Q

H. Ducreyi

A

Single dose of azithromycin

130
Q

Torsades dePointes

A

Magnesium sulfate

*if 2/2 quinidine use- Na Bicarb

131
Q

Empiric pyelonephritis tx (cx pending)

A

Amp-Gent

132
Q

Staph IE in prosthetic valves

A

Nafcillin or Vanco + Rifampin

133
Q

Bronchitis

A

Supportive tx, abx don’t typically help

134
Q

Neonatal meningitis

A

Amp-Gent

135
Q

Child/adult meningitis

A

3rd gen ceph/vanc

136
Q

Chlamydia pneumonia

A

8 yo: doxycyclin/azithromycin

137
Q

CMV PNA

A

Valganciclovir

138
Q

Sporothrix (thorn bush)

A

Itraconazole

139
Q

Aspergillosis

A

Voriconazole

140
Q

Neurocysticercosis

A

Albendazole, praziquantel

141
Q

Diptheria

A

Antitoxin plus penicillin OR erythromycin

142
Q

Impetigo

A

Non-bullous - Mupirocen

Bullous- Dicloxacillin

143
Q

Kid

A

INH for 3 mos and re-test PPD

144
Q

CAD in a severe asthmatics

A

CCB : verapamil/diltiazem

145
Q

Prinzmetal angina

A

CCB

146
Q

HTN crisis from MAO

A

IV Phentolamine

147
Q

Bipolar in pregnancy

A

Benzos

148
Q

Panic disorder with agoraphobia

A

(Check EKG first, cardiac enzymes, echo, T4, etc)
Benzo- short term
SSRI- chronic (4-6 weeks for efficacy)

149
Q

Insomnia

A

Sleep hygiene, Zolpidem, eszopiclone, zaleplon

150
Q

Paranoid Personality Disorder

A

Low dose antipsychotic

151
Q

Alzheimers

A

Rivastigmine, Donepozil, Memantine

152
Q

AIHI - warm agglutinin

A

High dose glucocorticoids
Rituximab
Splenectomy

153
Q

Epidural Hematoma

A

Craniotomy

154
Q

Chronic Subdural Hematoma

A

Craniotomy (can reverse dementia)

155
Q

Myocardial Contusion

A

MONA- BASH (just like MI)

156
Q

Pelvic trauma

A

Give Blood and track H&H, it will tamponade off

157
Q

Fecal incontinent (>3 yo, more than 1 month)

A

Fiber, biofeedback, dextranomer/hyaluronic acid, CR surgery

158
Q

ABPA

A

Oral steroids (inhaled NOT effective), Itraconazole if recurrent

159
Q

Ventilator-Associated PNA

A

Two pseudomonal coverage

One MRSA coverage

160
Q

HIV positive with PCP PNA + G6PD deficiency

A

Pentamidine

161
Q

SBP

A

3rd gen cephalosporin

If 2+ organisms or PMNS >250 - add metronidazole

162
Q

Hyperkalemia

A 
Stabilize membranes -ca gluconate
IV insulin/glucose - quickest
Albuterol
Kayexalate
Diuretics (furosemide, tzd)
163
Q

Hemodynamically unstable with PE

A

Thrombolytics

164
Q

Stable PE -obvious

A

Heparin- bridge to warfarin

165
Q

Dupuytrens contracture

A

TLC!
Triamcinolone
Lidocaine
Collagenase injections

166
Q

First like rheumatoid arthritis and psoriatic arthritis

A

MTX (take folate!)

167
Q

Pityriasis Rosea

A

Steroids or UV light

168
Q

Seborrheic dermatitis

A

Topical antifungals and steroids because this is a HYPERsensitivity to dermal infxn
-like ABPA is a HYPERsensitivity to fungal lung infxn (treated with oral steroids + itraconazole if nec)

169
Q

Pemphigus vulgaris

A

Systemic steroids
Azathioprine or mycophenolate to get off steroids
Rituximab

170
Q

Nonallergic Rhinitis (onset of stuffiness >20yo without sneezing/eye symptoms)

A

Intranasal antihistamines + Intranasal anticholinergics

171
Q

Bipolar manic episode (Chronic)

A

Lithium at LEAST one year after one episode

172
Q

Toxoplasmosis

A

Pyramethamine, Sulfadiazine

STEP2CK (12 decks)

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