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ABEM board exam > Treatments > Flashcards

Treatments Flashcards

1
Q

CRAO treatment

A 
Decrease IOP
Gentle massage
Hyperventilate (increase PaCO2)
Acetazolamide (carbonic anhydrase inhibitor --> decrease aqueous humor)
Timoptic
Ophtho consult
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2
Q

Carcinoid syndrome treatment

A

Octreotide

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3
Q

Kawasaki disease treatment

A

ASA

IVIG

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4
Q

SLE treatment

A

Steroids

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5
Q

Rocky Mountain Spotted Fever treatment

A 
Doxycycline
Or chloramphenicol (CAM) in pregnant women
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6
Q

Diptheria treatment

A

Equine diphtheria antitoxin

Erythromycin/PCN

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7
Q

Sarcoid treatment

A

Steroids

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8
Q

Dressler’s syndrome treatment

A

NSAIDs, steroids

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9
Q

ITP treatment

A

Pediatrics: none
Adults: steroids –> replace platelets to 50K, high-dose Rho-GAM (anti-D immune globulin)

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10
Q

TTP treatment

A 
Steroids
*Plasmapheresis
FFP
**AVOID PLATELETS**
(Unlike ITP give platelets, Rho-GAM; DIC give heparin and blood components)
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11
Q

HELLP treatment

A

Like pre-eclampsia
Bedrest, delivery, Mg, BP control
No diuretics or ACE inhibitors

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12
Q

Rhabdomyolysis (ATN) treatment

A

IV hydration
Treat hyperkalemia and hypocalcemia
Alkalinize urine with bicarb

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13
Q

Neuroleptic Malingnancy Syndrome treatment

A

Dantrolene or bromocriptine

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14
Q

Trichinosis treatment

A

Antihelmentics - mebendazole/albendazole

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15
Q

Erlichiosis treatment

A

Doxycyline

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16
Q

Botulism treatment

A

Antitoxin

Wound –> antitoxin, debridement, high-dose PCN

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17
Q

Tick paralysis treatment

A

Remove tick

Ascending paralysis and loss of DTRs (similar to GBS but no autonomic instability)

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18
Q

Tetanus prophylaxis

A

Minor wounds:
> 3 prior immunizations and >10 years –> Tdap
< 3 prior immunizations –> Tdap
Contaminated, puncture, crush, avulsion, burn
< 3 prior immunizations –> Tdap + TIG
> 3 prior immunizations and > 5 years –> Tdap

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19
Q

Wernicke’s treatment

A

Admission
Thiamine (Vit B1) prior to glucose
Magnesium

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20
Q

Normal pressure hydrocephalus treatment

A

Shunt

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21
Q

Multiple sclerosis treatment

A

Steroids, plasma exchange, disease modifying agents

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22
Q

Eaton-Lambert treatment

A 
Remove tumor (50%, especially lung, CA)
Plasmapheresis
Avoid neuromuscular blocking agents, aminoglycosides, IV contrast, CCBs
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23
Q

Catecholamine crisis treatment (ie pheo, MAOI crisis, cocaine overdose)

A

Labetalol + phentolamine (non-selective alpha blocker)

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24
Q

Serotonin syndrome treatment

A

Cooling

Cyproheptidine

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25
Q

Tensilon toxicity treatment

A

Atropine

bradycardia and syncope

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26
Q

Myasthenia gravis treatment

A

Pyridostigmine or neostigmine (ACH inhibitors)
Thymectomy (25% associated thymoma)
Prednisone
Plasmapheresis

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27
Q

Warfarin bleeding complications treatments

A

Stop (2.5 day half-life)
IV Vit K
4-factor prothrombin complex concentrate (II, VII, IX, X) - KCentra vs FFP (10-15 ml/kg)

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28
Q

Heparin reversal

A

Protamine (1 mg reverses 100 U)

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29
Q

Acetaminophen overdose antidote

A

Acetylcysteine (NAC)

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30
Q

Arsenic poisoning treatment

A

Chelation: dimercaprol/BAL, DMS

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31
Q

Aspirin overdose treatment (salicylate poisoning)

A

Alkaline diuresis, hemodialysis
Sx: tinnitus, ototoxicity, hypokalemia
Metabolic acidosis due to oxidative phosphorylation uncoupling

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32
Q

Beta-blocker overdose treatment

A

Glucagon (hypoglycemia), intralipids

propanolol can cause seizures

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33
Q

Barbiturate overdose treatment

A

Alkaline diuresis, hemodialysis

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34
Q

Calcium channel blocker overdose treatment

A

Calcium, glucagon, glucose/insulin, intralipids

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35
Q

Carbamate overdose treatment

A

Atropine

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36
Q

Carbon monoxide poisoning treatment

A

100% O2, HBO

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37
Q

Cyanide poisoning treatment

A

Sodium nitrite, sodium thiosulfate, hydroxycobalamin (Vit B12)
Avoid nitrites in concomitant CO poisoning

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38
Q

Digitalis poisoning treatment

A

Digibind (fab antibiodies), avoid transcutaneous pacer (irritability), no calcium –> “stone heart”
Green-yellow vision, halos
EKG: PVCs or bradydysarhythmias
Indication: severe cardiac toxicity with/without hypotension, K > 5.0, digoxin level >10 (acute) or > 4 (chronic) –> 10 vials (5 vials for chronic)

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39
Q

Ethylene glycol (anti-freeze, pain, solvents)

A

Bicarb, ethanol, dialysis, 4-MP (fomepizole)

Binds to calcium –> calcium oxalate crystals –> renal failure

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40
Q

Iron poisoning treatment

A

Deferoxamine, WBI

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41
Q

Isoniazid (INH) overdose treatment

A

Pyridoxine (Vit B-6)

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42
Q

Lead poisoning treatment

A

BAL, DMS, EDTA

43
Q

Mercury poisoning treatment

A

BAL, DMS

44
Q

Methemoglobin treatment

A

Methylene blue

45
Q

Methanol treatment (paint thinner, solvents, gas additive)

A

Bicarbonate, ethanol, dialysis, 4-MP (fomepizole)

Blindness

46
Q

Nitrites treatment

A

Methylene blue

47
Q

Opiate overdose treatment

A

Narcan

48
Q

Organophosphate treatment

A

Atropine, 2-PAM

49
Q

Oral hypoglycemia agent (ie sulfonylurea) overdose treatment

A

Glucose, glucagon, octreotide

50
Q

TCA overdose treatment

A 
Sodium bicarb, intralipids
No physostigmine (may precipitate seizures or asystole)
51
Q

Timing of thromboses hemorrhoid tx

A

Less 72 hours: I&D

> 72 hours: Sitz baths

52
Q

Fat emboli treatment

A

High-dose steroids

Signs/symptoms: CNS (HA, AMS, sz, coma), petechiae, dyspnea

53
Q

Mycobactrium marinae treatment

A

(papules to hands/feet/elbows)
Tx: clarithromycin + ethambutol/rifampin
Or minocycline, clarithromycin, doxy, Bactrim
Vs swimmer’s itch –> supportive

54
Q

Spigelium hernia

A

Absence of posterior rectus sheath –> hernia along semi-lunar line between 2 muscle layers
Tx: if incarcerated –> surgery

55
Q

Lyme disease treatment

A

Doxycycline (or ceferoxime/amoxicillin) x 2-3 weeks

56
Q

Syphillis treatment

A

Primary and secondary: benzathine PCN 2.4 million units IM x 1
Tertiary: x 3

57
Q

Yersinia treatment

A

Pneumonic (bubonic) plague

Isolation, streptomycin/gentamycin/chlorphenicol, doxy

58
Q

ARDS treatment

A

Low tidal volume, permissive hypercapnia, high PEEP

59
Q

Cryptococcal meningitis treatment

A

Dx: india ink stain, high opening pressure (LP)
Tx: amphotericin B + flucytosine or fluconazole

60
Q

Hydrocarbon toxicity treatment

A

Beta-blockers

Sniffing, huffing, bagging –> myocardial sensitization –> VF/VT

61
Q

Hydrofluoric acid toxicity treatment

A

Glass etching, brick or wheel cleaners, rust removers
Pain out of proportion
Dysrhythmias from hypocalcemia and hyperkalemia
Tx: calcium gluconate

62
Q

Salicylate toxicity treatment

A

Metabolic acidosis with respiratory alkalosis

Tx: alkalization of urine, dialyze (pulm/cerebral edema, renal failure)

63
Q

Hypercalcemia treatment

A

Hydration, loop diuretics (ie furosemide), calcitonin (increases renal excretion, works fastest), bisphosphonates (interferes with osteoclasts function, long term control), steroids (increases renal excretion and decreases GI absorption)

64
Q

Thyroid storm treatment

A

1) anti-hormone, 2) blunt systemic effects, 3) treat precipitant, 4) prevent decompensation
1) PTU/methimazole (blocks synthesis) –> iodine (blocks release)
2) beta-blocker (propanalol), steroids (blocks conversion of T4 to T3
3) treat precipitant
4) prevent decompensation (ie, fluids, dextrose, cooling, Tylenol)

65
Q

Peds VT/VF treatment

A

2-4 J/kg (max 10 J/kg)

66
Q

Peds SVT treatment (>220 infants, >180 kids)

A

Vagal maneuvers
Adenosine 0.1 mg/kg
Cardioversion 0.5-1J/kg
Avoid diltiazem –> hypotension

67
Q

Croup treatment

A

Cool air
Nebulized epi
Dexamethasone 0.15 - 0.6 mg/kg

68
Q

Peds hyponatremia treatment

A

If seizing, 3% NaCl 5 ml/kg over 20 minutes

69
Q

Peds hypocalcemia treatment

A

If seizing, 10% calcium gluconate 0.3/kg.kg over 5-10 minutes

70
Q

Glucose replacement in peds

A

Rule of 50

5 mL/kg D10W (infant) or 2 mL/kg of D25W or 1 mL/kg of D50W (adolescent)

71
Q

Epiglottitis treatment

A

Humidified oxygen, IV ceftriaxone (2nd or 3rd generation cephalosporin, early intubation
No role for IV steroids or racemic epi
Causes: *H flu, strep, gram-neg organisms

72
Q

Uremic bleeding treatment

A

IV desmopression (dDAVP) –> release vonWillibrand factor

73
Q

Pheochromocytoma treatment

A

Phentolamine or phenoxybenzamine

74
Q

Neurocysterosis (taenea solium) treatment

A

Pork tape worm –> ring-enhancing brain lesions –> seizure

Tx: praziquantel and steroids

75
Q

Schisotomiasis treatment

A

Praziquantel

76
Q

Vibrio vulnificans treatment

A

Salt water or brackish water
*Hemorrhagic bull
Tx: ceftriaxone + doxycycline

77
Q

Hook worm treatment

A

Ivermectin or albendazole

78
Q

Pertussis treatment

A

Erythromycin (azithromycin or clarithromycin or Bactrim)

Prophylaxis for adults

79
Q

Kleihauer-Betke (KBT) test

A

Detects presence and quantifies volume of fetal RBCs in maternal circulation (minimum of 5mL of fetal hemorrhage)
Use in significant trauma
Maternal-fetal hemorrhage >30 mL –> 2nd dose of 300 umg Rhogam

80
Q

Anticholinergic crisis treatment

Jimson weed, atropine, scopolamine

A

IV hydration, supportive care, benzodiazepines

Physostigmine is select cases

81
Q

NSTEMI undergoing immediate PCI

A

Bivalirudin - direct thrombin inhibitor and inhibits platelet aggregation
Does not cause thrombocytopenia
Less incidence of major bleeding

82
Q

Jellyfish sting treatment

A

Vinegar

No fresh water

83
Q

PCP pneumonia treatment

A

Bactrim + steroids if PaO2 < 70

or primaquine + clindamycin or pentamidine (IV or inhaled)

84
Q

Cryptospyridium diarrhea in AIDS treatment

A

HAART (get CD4 > 100)

85
Q

Rattlesnake (crotalid) bite treatment

A

Antivenom (CroFab)
Pain and swelling can mimic compartment syndrome (no indication for fasciotomy unless swelling not responsive)
Abnormal PT/PTT, LFTs, CBC –> treat until symptoms improve
Start with 4-6 vials –> redoes 4-6 vials if necessary then 2 vials q6 hour for 18 hours

86
Q

Mechanism of acetazolmide in acute mountain sickness treatment

A

Carbonic anhydrase inhibitor –> induces metabolic acidosis –> compensatory hyperventilation –> speeds of acclimation
Also give dexamethasone, NSAIDs, decent
Vs HACE –> higher altitude (>4k), lethargy, AMS seizures

87
Q

Factor VIII replacement dosing

A

% x 0.5 units/kg
Major 50 units/kg
Minor 25 units/kg

88
Q

Traveler’s diarrhea

A

Cipro 750 mg PO x 2 or azithromycin 1g PO x 1

89
Q

Unstable VT vs pulseless VT/VF treatment

A

Synchronized cardioversion vs shock

90
Q

Swimmer’s itch treatment vs mycoplasma marinum treatment

A

Supportive vs clarithromycin + ethambutol or rifampin

91
Q

Toxic shock syndrome (TSS) treatment

A

IVF, antibiotics –> not responsive, give IVIG

92
Q

Endocarditis treatment

A

Vancomycin + amino glycoside +rifampin (prosthetic valve)

93
Q

Endocarditis prophylaxis

A

History of prosthetic valves, prior IE, congenital heart disease, cardiac transplant with valve disease
Amoxicillin 2g PO or ampicillin 2g IV
Allergic to PCN: clindamycin 600 mg PO/IV, cephalexin 2g PO or azithromycin 500 mg PO or cefazolin/ceftriaxone 1g IV

94
Q

Toxoplasmosis treatment

A

Pyrimethamine, sulfadiazine + folinic acid
Or IV trimethoprim-sulfamethoxazole
Or dapsone + pyrimethamine

95
Q

Psittacosis treatment

A

Flu-like illness, headache, exposure to bird droppings

Doxycycline or tetracycline

96
Q

Transfusion Related Acute Lung Injury (TRALI) treatment

A

Sudden onset non-cardiogenic pulmonary edema
Respiratory support, supportive care, IVF, pressors
No role for nitroglycerine or furosemide

97
Q

Chilblains treatment

A

Rewarming and drying –> nifedipine (also use in high altitude pulmonary edema, Raynauds)
No debridement

98
Q

Stingray treatment

A

Remove barb, irrigate wound, no wound closure, hot water immersion (toxin is heat labile), tetanus, Keflex and doxy
No antitoxin

99
Q

Meningitis prophylaxis

A

Rifampin, cipro or ceftriaxone

100
Q

Lidocaine toxicity

A

Bicarb, IV fat emulsion (intralipids)

101
Q

Adverse effect of malaria treatment

A

Quinine IV –> hypoglycemia

102
Q

Giardia treatment

A

Hiker’s diarrhea
Metronidazole TID
Dx: stool antigen or O&P

103
Q

Yersinia treatment

A

Mimics acute appendicitis

Ciprofloxacin

ABEM board exam (3 decks)

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