UWOrld Facts 4 Flashcards
What are contraindications to the MMR vaccine?
1) anaphylaxis to neomycin
2) anaphylaxis to gelatin (eg marshmallows)
3) pregnancy
4) immunodeficient state (congenital immunodeficiencies, long-term immunosuppressive therapy, hematologic or solid tumors, severe HIV infection)
* *in patients with personal or family history of epilepsy, MMR and varicella vaccines should be given separately
If a TG level is >500 mg/dL, what should be used to treat?
fibrate = gemfibrozil (if
How do you calculate MELD?
bilirubin, INR, creatinine. 95% survival rate among patients with score
TIPS is avoided in patients with a score greater than __
24
How is a relapse of C diff treated?
first = metronidazole for non-severe (WBC
What is the post-exposure prophylaxis for HIV exposure?
2 NRTIs for 4 weeks; if high viral load in source patient, PI should be added
What type of squamous cell skin cancer is treated by 5-FU?
squamous cell in situ; NOT invasive
What are the treatments for invasive squamous cell skin cancer?
surgery, cryotherapy, electrosurgery, and radiation therapy
Surgical removal during pregnancy is indicated for adnexal cysts that are larger than ___ cm
5 cm
Surgery should be delayed to the 2nd trimester
Hypertension up to a BP of _____ mm Hg is permitted in patietns who did NOT receive thrombolytic therapy.
In those who did, ____ must be maintained.
NO tpa: 220/120
TPA: 185/105
How should you treat septic abortion?
zosyn; imipenem; or triple therapy with clinda + gent + ampicillin
Patients with ocular melanoma can be monitored every 3-6 months as long as its dimensions remain
diameter
Choroidal melanomas can be treated with radiotherapy, as long as the tumors aren’t too large and/or __________
don’t extend past the sclera
Pseudomonas is the most common cause of CF-related pneumonia in adults, but ________ is the most common cause in CF children
Staph aureus
Median nerve entrapment between teh two heads of pronator teres manifests as
pain in the volar forearm along with pain/numbness in right wrist and palmar surface of the first three fingers
T/F: Lobular carcinoma in situ (LCIS) has no malignant potential.
TRUE. But it does increase the risk of developing invasive lobular ductal carcinoma in EITHER breast
What is the treatment of LCIS?
Excisional biopsy. Follow up with surveillance (yearly mammogram); chemoprevention with tamoxifen or raloxifene; or prophylactic bilateral mastectomy
What other tests should be performed in a patient with central hypothyroidism?
MRI to assess pituitary
Also prompt assessment of other pituitary hormones (ACTH). Levothyroxine treatment in patients with uncorrected adrenal insufficiency may trigger adrenal crisis
The tick that transmits Lyme disease is _________, while the one that transmits RMSF is _________
Lyme = brown (Ixodes scapularis’ deer tick). Also transmits Anaplasma, Babesia
RMSF = black (Dermacentor)
T/F: If a tick is found on a person and not engorged with blood, there is no risk of contracting Lyme disease.
True! Ticks take at least 24 hours to firmly attach to their victims; transmission takes place at least 36-48 hours after the tick has started suctioning the patient’s blood
A history of preeclampsia in the first pregnancy increases the possibility of a second episode in the following pregnancy, especially if the preeclampsia presented before ___ weeks of pregnancy.
33
IF
How do you calculate ATTRIBUTABLE RISK PERCENT?
ARP = (risk in exposed - risk in unexposed) / risk in exposed
How do you calculate population attributable risk percent?
(risk in total population - risk in unexposed) / risk in total population
**also (prevalence) (RR - 1) / [(prevalence) (RR - 1) + 1]
Which medications should be discontinued before surgery?
1) Raloxifene and tamoxifen (discontinue 4 weeks prior to surgical procedures with moderate to high risk of VTE)
2) ACE/ARBs night before (unless patient has heart failure)
3) metformin
Target-specific oral anticoagualnts (like dabigatran, rivaroxaban, apixaban, edoxaban) are renally excreted and are approved for patients with
NON VALVULAR atrial fibrillation (mild AS is ok)
What is Bezold abscess?
A neck abscess resulting from an erosion thorugh the medial aspect of the mastoid tip
What happens to PaCO2 during pregnancy?
Increase in respiratory drive cause a resting alkalosis with PaCO2 from 27-32
What is the firstline treatment for juvenile myoclonic epilepsy?
valproic acid
What are the firstline treatments for complex partial seizures?
valproate, lamotrigrine, levetiracetam
What are the first line treatmetns for absence seizure?
ethosuximide, valproate
What is the first line treatmetn for tonic clonic seizure?
valproate, lamotrigine, levetiracetam
What is the first line agent for treatmetn of simple partial seizure?
carbamazepine, lamotrigine, oxcarbazepine, and levetiracetam
Which seizure meds do not affect OCP?
lamotrigine, levetiracetam
T/F: Gabapentin is contraindicated in patients with JME
True! IT can exacerbate seizures
What is the difference between Type 1 and Type 2 HIT?
Type 1 = nonimmune direct effect of heparin on platelet activation; plt count normalized with continued hep tx
Type 2: antibodies to PF4; occurs 5-10 days after initiation of hep tx with >50% drop in plt count
How can you confirm HIT?
1) serotonin release assay (should be high)
2) heparin-inudced platelet aggregation assay
3) heparing pf4 antibody elisa
What are direct thrombin inhibitors?
argatroban, lepirudin, etc