uworld Flashcards
AEDs increasing bone turnover
Carbamazepine, phenytoin, and phenobarbita and valproic acid,
envelope shaped crystals, hyperPTH, distal RTA (hypocalcitraturia)
calcium oxalate
hexagonal green/yellow crystals
cysteine
antidepressants with short half-life
paroxetine, venlafaxine
labs for autoimmune hepatitis
ANA, ASMA, LKM-1 (liver/kidney microsomal ab), LC-1 (liver cytosol ab)
tx of psoriasis in intertriginious areas
tacrolimus , mild cases with topical steroids and calcipotriene
type of statin causing intercation with amiodarone
atorvastatin
SAAG
> 1 Portal HTN
total protein >2.5 = heart failure
bugs associated with bloody diarrhea
ET Ecoli
Shigella
Campylobacter
meds causing crystal induces AKI
acyclovir, sulfonamides, MTX, Ethylene glycol , protease inhibitors, uric acid (Tumor lysis sd)
gram positive bacilli in meningitis
listeria
gram NEGATIVE bacilli with meningitis or w/ neuro devices
pseudomonas , acinetobacter
tx with cefepime
Statin with highest risk of rhabdo
simvastatin
Especially if given with amlodpipine
Med tx for tardive dyskinesia (TD is called when due to med side effect)
switch to 2nd generation antipsychotic
tx with valbenazine or deutetrabenazine
how do you monitor dabigatran (pradaxa)
check thrombin time
drugs that inreacts with SSRIs and increase chance of serotonin sd
MDMA, tramadol, selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors, ergot derivatives, linezolid, and tricyclic antidepressants
brain ring enhancing lesions in HIV patients
toxoplasmic: multiple in the basal ganglia and frontal/parietal
primary CNS lymphoma: Single, large in subcortical white matter
abscess: grey-white matter junction with vasogenic edema
causes of transudative pleural effusion
Ci Ne Constrictive Heart
Cirrhosis, Nephrotic syndrome, constrictive pericarditis and HF
tx for ITP immune thrombicytopenia purpura
for plts <30,000 high-dose oral corticosteroids due to high risk of bleeding,
IVIG is steroids are contraindication
tx for HFpEF
aldosterone, diuretic & tx of exacerbating conditions
how do calcimimetic (cinalcalcet) work?
Act on calcium sensing receptors, decreasing PTH
so less absorption of calcium. CAREFUL in hypocalcemia
common meds causing drug induced optic neuropathy
Ethambutol Sildenafil Linezolid Bevacizumab Infliximab Amiodarone
what do you monitor in patients with linnezolid
CBC for Bone marrow suppression
eye exam for optic neuropathy
Complications of P vera
thrombotic events, myelofibrosis, AML
how do you diagnose CLL
peripheral smear and flow cytometry
common drugs causing DRESS
anticonvulsants (phenytoin, carbamazepine)
allopurinol
sulfas
abx (minocycline/vancomycin)
basophilic stippling is present in
thalassemia, IDA, alcohol, lead and heavy metal poisoning
Monotherapy with an anti-pseudomonal beta-lactam
pip-tazo, cefepime or a carbapenem
which thyroid nodules need FNA? based on scintigraphy
cold nodules
CT scan shows single or multiple nodules with or without cavitations and “halo sign” (nodules surrounded by ground-glass infiltrates). In patient with pneumonia nos responding to abx and neutropenic
invasive aspergillosis
test for invasive pulmonary aspergillosis and tx
galactomanana and tx with voriconazole
meds that suppress tsh
glucocorticoids, octreotide
Drug interactions with tacrolimus
Increase drug lvl: macrolides, azoles, protease inh, CCB, grapefruit
ages to screen for lipids
male>35
female>45
microbiological indications for removal of central venous catheter infection
staph aureus
pseudomonas
fungi ie candida
mycobacteria
phenytoin side affects
dose-dependent: rash, horizontal nystagmus, ataxia, slurred speech, lethargy, coma
IV infusion: hypotension, bradyarrythmias
indications for early surgical management of IE
Valvular or conduction failure:
Acute heart failure due to valvular regurgitation
Valve leaflet fistula formation
New heart block
Uncontrollable infection:
Paravalvular abscess formation
Infection with difficult-to-treat pathogen (eg, fungi)
Persistent fever or bacteremia despite >7 days antibiotics
Embolic complications:
Systemic emboli despite appropriate antibiotics
Left-sided, mobile vegetation >10 mm & prior embolic event
Type of lung cancer in heavy smokers
SCLC: central aiway (hilar mass)
tx for TTP
plasma exchange
mononeuritis complex
painful, asymmetrical, sensory and motor peripheral neuropathy
how does acute radiation pneumonitis present?
antibiotic-nonresponsive pneumonia 4-12 weeks after neck or thoracic radiation treatment. Fever, dyspnea, cough, and pleuritic chest pain are common, as is leukocytosis.
tx with prednisone for 2 weeks
purpura, abdominal pain, arthritis, and glomerulonephritis.
henoch schoenlein
statin with highest risk of rhabdo
simvastatin especially if given with amlodipine
Antidepressants in nursing mothers
sertraline or paroxetine
pt with fever, cough and XR with b/l infiltrate sparing perihilar region
eosinophilic pneumonia
Triad of MAHA, thrombocytopenia & AKI
HUS
indications for valve replacement in AR
symptomatic
EF <50
LVSD >75mm
LVDD>75mm
urgent tx for TTP (adamts13 deficiency)
plasma exchange, glucocorticoids, and rituximab
indication for washed PRBC
IgA deficiency
h/o allergic reaction with trasfusions despite antihistamine
indication for leukoreduced PRBC
h/o lots of transfusions
pt at risk for CMV
h/o febrile nonhemolytic transfusion reaction
someone with high protein grap, with hepatosplenomegaly, lymphadenopathy and cytopenias
Waldenstrom macroglobulinemia
how do you calculate RSBI (rapid shallow breathing index)
RR/Tidal volume in liters
<105= succesful extubation
ECG findings in WPW, most common arrythmia?
Short PR interval
AVRT
Pts with WPW who gets catheter ablation
those with AVRT, Afib or asymptomatic but high risk professions
continuous cardiac murmur, HTN, diminished femoral pulses suggest
coarctation of the aorta
left interscapullary continuous murmur. its with headaches, maybe epistaxis, delayed pulses
coarctation of the aorta, associated with bicuspid aorta
most common organism in culture negative endocarditis
Coxiella Burnett (Q fever) from livestock
what age do yu start mammogram screening and how often
at age 50, q2yrs
typical EKG findings in Brugada (young male that passes out while at rest/sleeping)
ST elevation in V1-V3, TWI, RBBB
common EKG findings is ASD
RBBB (right atrial enlargement)
CHAGAS (trypanozoma cruzi) heart disease
dilated cardiomyopathy, left ventricular apical aneurysm !
Lithium and ADH
Blocks adh
Tx of lithium nephrogenic DI
Thiazides or loop
tx of methemoglobulinemia
benzocaine
HIV prep is
emtricitabine/tenofovir
Common causes of hypogonadism in males
Primary: congenital (klinefelter), drugs (ketoconazole), CKD
SECONDARY (pituitary/hypothalam): tumor, cranial trauma, hemochromatosis, apoplexy
Suppression: exogenous andogens, hyperprolacto, DM, obesity
Hypercotisolism and cirrhosis
how to test testosterone deficiency
between 7am and 10 am vaoue <300mg
causes of osteoporosis in men
Hypogonadism (primary or secondary) Hyperthyroidism Vitamin D deficiency Diabetes mellitus Hypercortisolism Hyperparathyroidism Gastrointestinal Malabsorption (eg, celiac disease) Cirrhosis Inflammatory bowel disease Oncologic Leukemia or lymphoma Multiple myeloma Medications Heparin (long-term) Corticosteroids Anticonvulsants (eg, phenytoin) Androgen-deprivation therapy(eg, GnRH agonist) Proton pump inhibitors Calcineurin inhibitors (eg, cyclosporine) Lifestyle Smoking Chronic alcohol use
young man, atopic conditions, food impaction, intermittent solid dysphagia,
eosinophilic esophagitis : furrows and concerntric rings
MAHA vs AIHA
,MAHA has hemolytic anemia, can also hace spherocytes
AIHA has spherocytes and MCV>100
SPHEROCYTOSIS and anemia
AIHA, positive coombs
meds that cause hemelysis in G6PD (bite cells)
dapsone, chloroquine,sulfonamide , rasburicase
what can cause AIHA
viral infections, pnicillin, SLE, CLL
Lupus pernio
Sarcoidosis
Racoon eyes
Amyloidosis
Level A evidence supporting the use of five medications for migraine prophylaxis (5 or 10 episodes in 1 months)
(propranolol, timolol, metoprolol) and two antiepileptic drugs (divalproex sodium and topiramate)
