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Step 2 High Yield > Treatments And Tests > Flashcards

Treatments And Tests Flashcards

0
Q

What is the treatment for nonexertional heat stroke?

A

Evaporative cooling

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1
Q

What is the treatment of exertional heat stroke?

A

Rapid cooling with ice water immersion
Fluid resuscitation
Electrolyte correction

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2
Q

What is the treatment for cocaine abuse resulting in chest pain?

A

IV BZDs + oxygen
Aspirin ( to retard thrombus formation because cocaine promotes platelet aggregation and activation)
Nitroglycerin & CCBs for pain
May do cardiac cath if have ST elevation with maximal medical therapy

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3
Q

What is the tx for SVC syndrome?

A

Radiation therapy

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4
Q

What is the tx for poly arteritis nodosa?

A

Corticosteroids

Cyclophosphamide

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5
Q

What is the tx for Kawasaki disease?

A

IVIG and ASA

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6
Q

What is the tx for urge incontinence?

A

Frequent voluntary voiding

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7
Q

How do you diagnose HSP?

A

Skin biopsy

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8
Q

What is the best next step when you suspect an aortic rupture in stable patient ?

A

TEE or CT chest

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9
Q

How do you diagnose cataracts?

A

Ophthalmic exam

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10
Q

How do you diagnose duodenal hematoma?

A

Ab CT with oral contrast

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11
Q

How do you treat a duodenal hematoma?

A

NG tube decompression

Parenteral nutrition

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12
Q

How do you diagnose pelvic fracture?

A

Pelvic XR

Pelvic CT

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13
Q

What is the tx of a pelvic fracture?

A

External binder and surgical eval
Emergent external fixation.
Angiography with embolization of bleeding vessels
Retrograde urethrogram

Internal fixation for stable patients

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14
Q

What is the tx for warm autoimmune hemolytic anemia?

A

Prednisone

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15
Q

What is the tx for autoimmune hemolytic anemia that is not responsive to prednisone?

A

Splenectomy

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16
Q

What is the diagnostic test for retained products of conception?

A

Pelvic US: shows increased vascularity, increased echogenicity, thick endometrial stripe

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17
Q

What is the tx for retained products of conception/septic abortion?

A

Blood and endometrial cultures
IV antibiotics
Surgical evacuation of the uterus (suction curettage)
Close obs

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18
Q

What is the management for caustic ingestion?

A
  1. ABC
  2. Decontamination: remove clothing, irrigate exposed skin
  3. CXR for respiratory sx
  4. Endoscopy within 24 hours
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19
Q

What should you do if there are esophageal burns on endoscopy?

A

Order barium swallow 2-3 weeks after to look for strictures

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20
Q

What is the tx for septic arthritis with greater than 100K WBC, >90% neutrophils and purulent drainage?

A

Emergent surgical drainage to prevent joint destruction. And lifelong consequences

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21
Q

What is the best next step for someone with predominantly elevated alk phos and slightly elevated LFTs?

A

Ab US or CT

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22
Q

What is the first step in the evaluation of primary amenorrhea?

A

Pelvic exam and US

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23
Q

What is the best next step after a pelvic US reveals an absent uterus in the eval or primary amenorrhea?

A

Karytotyping and serum testosterone

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24
Q

What is the best next step after pelvic US revealing the presence of a uterus in the eval of primary amenorrhea?

A

Serum FSH

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25
Q

If serum FSH is decreased, what is the next step?

A

Cranial MRI

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26
Q

If serum FSH is increased, what do you do next?

A

Karytotyping

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27
Q

What should be done before starting Clozapine?

A

A CBC

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28
Q

What is the tx of akithisia?

A

Bb

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29
Q

What is the tx of drug induced Parkinsonism?

A

Benztropine (anticholinergic)

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30
Q

What should you supplement with chronic hemolysis

A

Folate

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31
Q

What is the tx for theophylline toxicity?

A

Charcoal

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32
Q

What is the tx for postnasal drip?

A

Antihistamine
Nasal steroid
Or nasal antihistamine

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33
Q

What is the tx for exercise induced asthma?

A

Beta adrenergic agonist before exercise?

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34
Q

What is the tx for neuroleptic malignant syndrome?

A

Dantrolene then bromocriptine and amantadine

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35
Q

What is the tx for GBS prophylaxis?

A

Penicillin or ampicillin

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36
Q

What antibiotic is given for GBS prophylaxis if the patient is allergic to penicillin?

A

Cefazolin

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37
Q

When is GBS prophylaxis given?

A

When patient has baby with GBS infection

Patient had GBS bacteriuria

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38
Q

What is a more appropriate tx for depression in a patient with a shorter life expectancy?

A

Stimulants like modafinil or methylphenidate

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39
Q

What is the most appropriate initial test in a non-African American patient with a possible family hx of thalassemias?

A

A CBC

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40
Q

What is the tx for esodeviation (strabismus)?

A

Covering the normal eye

Contact lenses

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41
Q

What can riluzole do?

A

Prolong survival and time to tracheostomy in ALS

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42
Q

What does a pleural ph of less than 7.2 mean?

A

Empyema –> chest tube!

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43
Q

What are the two criteria for chest tube placement for pleural fluid ?

A

Ph less than 7.2

Glucose less than 60

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44
Q

What is the tx for os good schlatter?

A

Rest
NSAIDs
Stretching

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45
Q

How do you diagnose Bruton’s agammaglobulinemia?

A

Quantitative immunoglobulin levels

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46
Q

What is the tx of Bruton’s?

A

Prophylactic antibiotics

IVIG

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47
Q

How do you diagnose CVID?

A

Quantitative immunoglobulin levels

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48
Q

How do you confirm CVID?

A

Confirm with B and T cell subsets

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49
Q

What is the tx of CVID?

A

IVIG

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50
Q

What is the tx for IgA deficiency?

A

Treat infections

Do NOT give IVIG

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51
Q

How do you diagnose digeorge syndrome?

A

Absolute lymphocyte count
Mitogen stimulatin response
Delayed hypersensitivity skin testing

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52
Q

What is the tx for DiGeorge?

A

Bone marrow transplant
Thymus transplant
IVIG
PCP prophylaxis

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53
Q

How do you treat SCID?

A

Bone marrow transplant
IVIG
PCP prophylaxis

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54
Q

How do you treat Wiskott Aldrich?

A

IVIG and antibiotics

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55
Q

What is the treatment for CGD?

A

Daily TMP-SMX
IFN-gamma
BM transplant

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56
Q

What is the diagnostic test for CGD?

A

Nitroblue tetrazolium test

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57
Q

What is curative for leukocyte adhesion deficiency?

A

Bone marrow transplant

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58
Q

What is the tx of choice in Chediak Higashi?

A

Bone marrow transplant

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59
Q

What is the tx if choice for Lyme disease in a 7 year old?

A

Oral amoxicillin or cefuroxime

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60
Q

What is the INR range goal for patients with prosthetic heart valves?

A

2.5-3.5

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61
Q

What is the best way to prevent contrast induced nephropathy?

A

IV hydration

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62
Q

What is the tx of congenital hypothyroidism?

A

10 mcg of levothyroxine and then titrated from there

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63
Q

What is the tx for crystal induced nephropathy from acyclovir?

A

Discontinue the drug

IVF

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64
Q

What is the tx for a threatened abortion?

A

Reassurance and follow up US in one week

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65
Q

What is first line nonpharmcologic tx for social anxiety disorder?

A

Cognitive behavior therapy

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66
Q

What is first line nonpharmalogical tx of Tourette’s?

A

Habit reversal training

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67
Q

What is the tx for anemia of chronic disease due to CKD?

A

IV iron dextran and EPO

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68
Q

What is the tx of metabolic alkalosis?

A

NS and potassium to increase renal perfusion stopping the secretion of H and K to retain water

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69
Q

What is the first step in the work up of delirium?

A

UA and serum electrolytes, CBC, review med list, H&P

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70
Q

What are the indications for a cystoscopy?

A 
Gross hematuria with no evidence of glomerular disease
Microscopic hematuria
Recurrent UTIs 
Obstructive sx 
Abnormal bladder imaging 
Abnormal urine cytology
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71
Q

What is the treatment for cachexia/anorexia?

A

Progesterone analogs - megestrol acetate or medroxyprogesterone

Steroids and mirtazapine have been used too

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72
Q

What is the tx for chediak higashi?

A

Daily vit C and TMP-SMX

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73
Q

What is the dihydrorhodamine test for?

A

CGD

It is more sensitive and can quantify the severity of disease

74
Q

What is the gold standard for diagnosis of partial adrenal deficiency?

A

Cosyntropin stimulation

75
Q

What would acclimation of 17-hydroxy pregnenolone signify?

A

3-beta hydroxy steroid dehydrogenase deficiency causing deficiency in all steroid hormones

76
Q

What would the accumulation of corticosterone mean?

A

Deficiency of 17-alpha hydroxylase - no androgen or cortisol synthesis, overproduction of mineralocorticoid

Hypokalemia, hypogonadism, HTN

77
Q

What are the steps in eval of a kidney stone?

A

CT without contrast

  1. Pain control (NSAIDs if normal renal function)
  2. If stone is small enough to pass (less than 5 mm) –> increase fluid intake to greater than 2 L per day
78
Q

How do you treat infertility in premature ovarian failure?

A

IVF with donor oocyte

79
Q

What is the tx for flail chest?

A

Oxygen
Pain control
Surgery

80
Q

What are the immunosuppressive agents used in the tx of myasthenia gravis?

A

Prednisone, azathioprine, cyclosporine

81
Q

What is the tx for body dysmorphic disorder?

A

Establish rapport with patient, regular visits to discuss their concerns
SSRI
Referral to psych

82
Q

What drug do you start when a child with CF comes in with the flu?

A

Vanc for s.aureus

83
Q

What is the drug of choice for outpatient tx of S. pneumo?

A

High dose amoxicillin

84
Q

What is the most appropriate first step in treating DKA?

A
  1. NS and regular insulin
  2. Potassium replacement
  3. Antibiotics
85
Q

What is the fluid infusion in DKA once the blood glucose reaches 200-250?

A

D5W with half NS + K

86
Q

When is sodium bicarbonate given in DKA?

A

Ph less than 7.1
Bicarb less than 5
Severe hyperkalemia

87
Q

How do you tx INR over 5 with no bleeding?

A

Skip next warfarin dose

88
Q

How do you tx INR 5-9 with no bleeding?

A

Stop warfarin temporarily

89
Q

How do you tx an INR greater than 9?

A

Stop warfarin and start oral vit K

90
Q

What is the tx of choice for acute cystitis and pyelo in no pregnant women?

A

Nitrofurantoin for 5 days (only if GFR over 60 and no pyelo)
TMP-SMX for 3 days
Fosfomycin in a single dose

91
Q

What is the tx of choice for complicated cystitis?

A

Fluoroquinolones for 5-14 days

Urine culture

92
Q

What is the tx for outpatient pyelonephritis?

A

Fluoroquinolones

93
Q

What is the tx for inpatient pyelo?

A

Urine culture

IV fluoroquinolones, ceftriaxone

94
Q

What is the first thing that should be done to evaluate a blunt abdominal trauma?

A

FAST or DPL to assess for intra peritoneal fluid

95
Q

What should be done if a FAST is positive?

A

Exploratory laparotomy

96
Q

What should be done if patient is stable and FAST is negative?

A

CT

97
Q

What is the tx for endometritis?

A

IV clindamycin and gentamicin

98
Q

What is cordocentesis or percutaneous umbilical cord sampling used for?

A

Rapid karytotyping
Detection of fetal anemia or Rhesus isoimmunization
Or to detect mosaicism after CVS or amino suggestive of such

99
Q

What is the tx for homocysturia?

A

Vit B6
Restrict methionine
Supplement cysteine

100
Q

How do you diagnose homocystinuria?

A

Increased homocysteine and methionine

101
Q

How do you diagnose appendicitis?

A

Clinically

102
Q

What are the imaging tests used for acute appendicitis?

A

CT with PO and IV contrast

US

103
Q

What is the tx for appendicitis?

A

NPO
IVF
antibiotics for gram negs and anaerobic bac

104
Q

What is the tx for perforation of the appendix?

A

Antibiotics until patient is afebrile and normal WBC

Close by delayed primary closure

105
Q

What is the tx for appendiceal abscess?

A

Antibiotics
Percutaneous drainage
Elective appendectomy 6-8 weeks later

106
Q

What is the tx for cervical adenitis

A

Clindamycin

107
Q

How do you confirm diagnosis of esophageal perforation?

A

Contrast esophagogram

108
Q

What is the tx for bacterial rhinosinusitis?

A

Augmentin

109
Q

How do you diagnose a bladder injury?

A

Retrograde cystogram with postvoid films

110
Q

How do you diagnose choanal atresia?

A

CT with intranasal IV contrast

111
Q

How do you diagnose a retro pharyngeal abscess?

A

CT with contrast

112
Q

What is the dx test for primary ciliary dyskinesia?

A

Exhaled nitric oxide

113
Q

What is another name for the dx test for CF?

A

Pilocarpine iontophoresis

114
Q

What is the immediate tx for hypercalcemia over 14?

A

Normal saline hydration plus calcitonin

Avoid loops

115
Q

What is the long term tx for hypercalcemia?

A

Bisphosphonates (zoledronic acid)

116
Q

What is considered severe hypercalcemia?

A

Over 14

117
Q

How do you diagnose atlantoaxial subluxation?

A

Lateral XR of c-spine in flexion

118
Q

What is the tx of atlantoaxial subluxation?

A

Surgical fusion of C1-C2

119
Q

How do you treat Ricketts?

A

Vit D 1000-2000 IU daily

120
Q

How do you tx diabetic retinopathy?

A

Argon laser photo coagulation

121
Q

What is the first step in the management of gastroschisis?

A

Sterile wrap the bowel

122
Q

What are the steps in management of gastroschisis and omphalocele?

A 
NG tube to decompress
IV access
Broad spectrum antibiotics
Wrap bowel 
Maintain neonate in thermoneutra environment
123
Q

What is the tx for suspected variceal hemorrhage?

A

IVF
IV octreotide
Antibiotics

124
Q

What is the tx for recurrent variceal bleeding after endoscopic therapy?

A

TIPS or shunt surgery

125
Q

What screening do you do for Beckwith- Weidemann syndrome?

A

Ab US q 3 months from until 8
AFP - Every 3 months until 4 years old
Renal US from 8 to adolescence

126
Q

What is the tx for mild SIADH (forgetfulness, ataxia)?

A

Fluid restriction
Oral salt tablets
Loop diuretic is urine osmolality is 2 X the serum osmolality

127
Q

What is the tx for moderate SIADH (confusion, lethargy?

A

Hypertonic saline for 3-4 hours then fluid restriction

128
Q

What is the tx for severe SIADH?

A 
Bolus of hypertonic saline
Vasopressin antagonist (conivaptan)
129
Q

What is the first step in evaluating post op oliguria?

A

Bladder scan

130
Q

What is the tx for bleeding in liver failure?

A

FFP

131
Q

How do you diagnose Patellofemoral syndrome?

A

Extension of the knee while compressing the patella

132
Q

What is the antibiotic of choice for treating a human bite?

A

Amoxicillin-clavulanate

133
Q

How do you treat acetaminophen toxicity?

A

Charcoal if ingested within the last 4 hours
Obtain acetaminophen level at 4 hours
Give N-acetylcysteine within 8 hours depending on results of acetaminophen level

134
Q

What is the tx for asx bacteriuria of pregnancy?

A

Nitrofurantoin
Amoxicillin
Or cefazolin/cephalexin for 7 days

135
Q

What is the preferred tx for Paget’s disease?

A

Bisphosphonates

136
Q

What is the tx for anorexia?

A

CBT
Nutritional rehab
Olanzapine (if no response)

137
Q

What is the tx for bulimia?

A

CBT
Nutritional rehab
SSRI

138
Q

What are the indications for hospitalization of a bulimic or anorexic patient?

A

Electrolyte imbalance
Dehydration
Bradycardia
Severe weight loss

139
Q

What is first line tx for acute mania?

A

Antipsychotics and mood stabilizers

140
Q

What are the indications for GBS prophylaxis when GBS status is unknown?

A

Less than 37 weeks gestation
GBS cultured from urine at any time during the pregnancy
ROM more than 18 hours
Prior hx of delivery to a infant with GBS sepsis

141
Q

What test can be used to confirm a ruptured fetal umbilical vessel?

A

The Apt test

142
Q

What is the tx of choice for foreign body ingestion?

A

Flexible endoscopy

143
Q

What is the tx of choice for foreign body aspiration?

A

Rigid bronchoscope

144
Q

What is the tx for anemia of chronic disease?

A

Treat the underlying disease

145
Q

What is the tx for anemia of prematurity?

A

Iron supplements and serial Hb checks

Possible transfusion

146
Q

What is the tx for diamond Blackman anemia?

A

Corticosteroids

147
Q

What is the tx for carotid stenosis of less than 50% and sx?

A

Statins and aspirin

148
Q

What are the recommended meds for prophylaxis of cluster headaches?

A

Verapamil
Lithium
Ergotamine

149
Q

What is the tx for autoimmune hemolytic anemia?

A

Prednisone

Splenectomy

150
Q

What is the management of a UTI in a child less than 24 months?

A

Treat with antibiotics for 7-14 days with follow up

Renal US and bladder US

151
Q

Who should get a renal and bladder US ?

A

Children under 24 months with first febrile UTI
Children with recurrent febrile UTIs
UTI in a child if any age with a family hx of renal or urological disease, HTN, or poor growth
If don’t respond to tx

152
Q

What is the prevention med for bronciolitis in infants with bronchopulmonary dysplasia, severe congenital heart defects and prematurity?

A

Palivizumab = monoclonal antibody against RSV

153
Q

What is the tx for bronchiolitis?

A

Contact isolation
Hydration
Oxygen

154
Q

What is the tx for diagnosing diaphragmatic rupture?

A

Ct scan

155
Q

How do you diagnose urethral hypermobility?

A

Stick a cotton swab in the urethra and demonstrate an angle greater than 30 degrees upon valsalva (increase in abdominal pressure)

156
Q

What is the tx for meconium aspiration?

A

Suction nose and upper airway
Oxygen
Empiric antibiotics for pneumonia
Intubation

157
Q

What is the tx for neonatal RDS?

A

CPAP
Or intubation/mechanical ventilation
Surfactant

158
Q

What should be done in the case of tendinopathy caused by fluoroquinolones?

A

Stop the quinolone

Do not exercise or use the affected area

159
Q

What should all transplant patients receive prophylaxis for?

A

Opportunistic infections like PCP

Use TMP-SMX

160
Q

What is the tx for narcolepsy?

A

Modafinil
Maintain proper sleep habits
Minimize alcohol
Avoid meds that make you sleepy

161
Q

What medicine treats cataplexy in narcolepsy?

A

Sodium oxybate

162
Q

What is used to tx restless leg syndrome?

A

Pramipexole

163
Q

How do you diagnose a psoas abscess?

A

CT scan of abdomen

164
Q

What is the tx for adjustment disorder?

A

Psychodynamic psychotherapy

165
Q

What is the tx for endometrial hyperplasia without atypia?

A

Progestin therapy

Repeat endometrial bx at 3 months

166
Q

What is the tx for endometrial hyperplasia with atypia if the patient still desires children?

A

Progestin therapy

167
Q

What is the tx for endometrial hyperplasia with atypia?

A

Hysterectomy

168
Q

How do you evaluate for a spinal abscess?

A

MRI with gad or CT with contrast
ESR/CRP
CBC
Blood cultures

169
Q

What is the tx for an epidural abscess?

A

CT guided aspiration and culture

Immediate surgical decompression

170
Q

What is the tx for mild bipolar disorder?

A

Monotherapy with an atypical antipsychotic or lithium/valproate

171
Q

What is the tx for severe bipolar?

A

Lithium/valproate + atypical antipsychotic

172
Q

What is empiric tx for intoxication/psychotic/withdrawal sx?

A

Glucose, thiamine, oxygen, naloxone

173
Q

What is the tx for peripheral neuropathy related to INH?

A

100mg/day of pyridoxine

174
Q

What is the best next step in evaluating for a primary cancer after finding brain mets?

A

chest CT

175
Q

What is the gold standard for diagnosing myocarditis?

A

Endomyocardial bx

176
Q

What is the tx for myocarditis?

A

Diuretics and inotropic

177
Q

What is the tx for kleptomania?

A

CBT

178
Q

What is the immediate tx for panic attack?

A

Lorazepam

179
Q

What is the tx for rhabdo from NMS?

A

Alkalinization of the urine

IVF

180
Q

What is the first line tx for specific phobia?

A

CBT

181
Q

How can tracheobronchial rupture be confirmed?

A

CT
Bronchoscope
Surgical exploration

182
Q

What is the diagnostic test for myocardial rupture

A

US

183
Q

How do you diagnose a splenic rupture?

A

CT with contrast

Step 2 High Yield (20 decks)

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