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Week 3 Flashcards

1
Q

Management of SUPRAtherapuetic INR without active bleeding

A

If <5, hold warfarin

If >5 oral vitamin K

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2
Q

Patient develops hyperthyroid after CT angio. What happened?

A

Iodine induced thyrotoxicosis

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3
Q

Tx for iodine induced thyrotoxicosis

A

Self limiting once Iodine is discontinued

Methimazole for chronic/refractory cases

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4
Q

Sx of keratitis

A

Foreign body sensation, Light sensitivity

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5
Q

First line for ACUTE reversal of warfarin

A

Prothrombin complex (FFP is second line due to large volume needed)

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6
Q

First line tx for prolactinoma

A

Dopamine agonists (cabergoline, bromocriptine)

Even if they have huge prolacinomas with compressive symptoms, still do meds before surgery

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7
Q

At what gestational age are tocolytics contraindicated?

A

34 weeks…after this, there is increaed risk of morbidity

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8
Q

2 types of tocolytics and when to use each

A

Indomethacin <32 weeks

Nifedibpine 32-34 weeks

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9
Q

Triad of Korsakoff psychosis and prognosis

A

Retrograde/Anterograde amnesia
Confabulation

DOES NOT IMPROVE. unlike werneke encephaloathy

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10
Q

Classic CT finding in korsakoff syndrome

A

Disease in the mamillary bodies

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11
Q

Equalization of right heart pressures on cath: think

A

Cardiac Tamponade

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12
Q

What is the Kleihauer-Betke test and when do you use it

A

It measurs the amount of fetal RBCs in mothers blood. Used when you have an Rh negative mother who has evidence of a hemorrhage. Based on the results, you can calculate how much Rhogam she needs

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13
Q

Frequent, low amplitude contractions after abdominal trauma or in a cocaine user. Think:

A

Placental abruption (even without evidence of bleeding…it can be concealed)

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14
Q

Age at which you can observe vs need to intervene for undescended testicle

A

If <6mo, observe

after 6mo, need to do orchiopexy because spermatogonia start dying after 6 mo

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15
Q

First step in delayed puberty if bone age is premature and no evidence of constiutional delay

A

FSH/LH….need to determine if it is central or peripheral

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16
Q

definition of pubertal delay male

A

testes <4ml by 14yo

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17
Q

First line tx for cocaine inoxication with signifcant hypertension

A

Benzos first…phentolamine only if hypertension doesn’t resolve after benzo

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18
Q

Cocaine overdose develops sharp chest pain…think:

A

Aortic Dissection

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19
Q

When is an implantable defibrillator indicated in HOCM?

A

Syncope/Hypotension/Arrhythmia during exercise
FHx of Sudden Cardiac Death

basically, if the situation souds bad, they probably need an ICD

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20
Q

Tx for salicylate toxicity

A

Bicarb infusion…alkalinize the urine

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21
Q

Tumor marker for medullary thyroid cancer

A

Calcitonin

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22
Q

Pt has meduallry thyroid cancer removed. Calcitonin still elevated. Why?

A

They ahve metastatic disease…calcitonin is being produced from somewhere else

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23
Q

Time difference for post partum blues vs depression

A

2 weeks

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24
Q

Criteria for renal US in children with UTI

A

<2yo with Febrile UTI

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25
Q

Most common complication of TURP

A

Retrograde ejaculation

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26
Q

Time/Treatment/Route for gonococcal vs chlamydial conjunctivitis in newborn

A

gonorrhea- 2-5 days, topical erythro

Chlamydial- >1week, Oral macrolide

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27
Q

3 classic lab findings in RMSF

A

Thrombocytopnenia
Hyponatremia
Transaminitis

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28
Q

Patient found to have bicuspid aortic valve with no other complications. Next step?

A

Echo in first degree relatives, bcause they may have it too and it’s important to identify

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29
Q

Dx criteria for somatic symptom disorder

A

Excessive anxiety and preoccupation over more than 1 symptom

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30
Q

Illness anxiety disorder

A

Fear of serious illness despite being totally healthy

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31
Q

Conversion disorder

A

Neurologic symptoms that are incompatible with any known disease

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32
Q

What 4 screening tests do all Turner Syndrome patients need

A

Echo
Renal Ultrasound (horseshoe kidney)
TSH
Vision/Hearing

33
Q

2 Tx for cholinergic toxicity

A

Atropine + Pralidoxime

34
Q

First lab value to correct in Fe def anemia after giving iron supplement

A

Reticulocyte count (initially, your bone marrow is depleted of iron, so you give it iron and its going to start churning out RBCs)

35
Q

Known exposure to active TB, but your PPD is negative. What do you do?

A

Repeat PPD in a couple months

If positive at that time, get CXR and sputum cx

36
Q

4 protective factors for suicide

A

Close to family
Parenthood
Pregnancy
Religious affiliation

37
Q

Who is at high risk for developing PreE?

A

Chronic HTN
CKD, DM, Autoimmune disease

Basically everyone who would be at risk for developing HTN in general

38
Q

What must be done for patients at high risk for developing pre E

A

Low dose aspirin in 2nd trimester to prevent recurrence

prior PreE, CKD, DM, Autoimmune dz

39
Q

Role of vaginal progesterone in pregnant women

A

Prevents preterm delivery if cervix is <2cm long (found incidentally)

40
Q

Role of IM hydroxyprogesterone in pregnant women

A

women with history of pre-term delivery should get this to prevent recurrence

41
Q

4 routine screening labs for all patients with dementia

A

CBC,CMP, TSH, B12

42
Q

What are the 3 “selective” dementia screening labs, and who gets them

A

Folate - alcoholics
Syphillis- Known exposure
Vit D- Risk factors for deficiency

43
Q

Best test to monitor for anthracycline induced cardiotoxicity

A

Radionucleotide ventriculography

44
Q

Treatment of cherry hemangioma

A

Observation only

45
Q

Breast lump over 35y. First test and what to do based on results

A

Mammogram

If malignant looking, do biopsy
If benign looking, do ultrasound

46
Q

Antidote for ethylene glycol and methanol poisoning

A

Fomepizole alone, do NOT co-administer with ethanol

47
Q

in patients with HIT, what is the role/duration of the direct thrombin inhibitors (dagabatron)

A

Use them as a bridge until your symptoms resolve and plt count normalizes…then switch to warfarin

48
Q

2 tx for HPV (condolma accumulata)

A

Trichloroacetic acid - Internal or external warts

Podophyllin - external only

49
Q

Tx for outpatient CAP

A

Doxy or macrolide

50
Q

2 Tx for inpatient CAP

A

CTX and macrolide

Levoquin or moxifloxacin

51
Q

Role of hydroxyurea in SSD

A

Reduces frequency of vasooclusive episodes, but aren’t used for acute management

52
Q

Treatment principle for vasooclusive episodes

A

Pain control - NSAID/Opioids

Fluids

53
Q

Most effective nonpharm way to decrease BP

A

> 10kg weight loss

54
Q

How to make the diagnosis of chronic Hep C

A

HepC IgG positive
HepC RNA elevated

Just a positive IgG tells you one of 3 things (chronic infection, prior infection that is cleared, or a false positive)

55
Q

3 meds ischemic stroke patients should get while in hospital

A

Beta Blocker/Statin

LMWH (reduce risk of developing DVT)

56
Q

Specific indication for steroids in back pain

A

Cord compression due to Metastatic disease or trauma

DO NOT GIVE FOR SPINAL EPIDURAL ABSCESS

57
Q

When to observe vs. treat ITP

A

No bleeding = observe

Active bleeding = IVIG

58
Q

Treatment for asx lead toxicity based on lead level

A

<45 - Repeat level in 1 month
45-69- DMSA, Succimer
>70- Dimercaprol + EDTA

59
Q

First line for violence and agitation

A

Benzos (haldol is second line, unless they are acutely psychotic or manic)

60
Q

Best Tx for post partum endometritis

A

Clinda and Gent (good gram Pos and Neg)

61
Q

Tx for chorio

A

Amp and Gent

62
Q

Differentiating physiologic jaundice from G6PD

A

Physiologic jaundice is not associated with anemia…G6PD is

63
Q

Rapidly progressive goiter in someone with Hashimotos…think

A

Thyroid lymphoma

All the other thyroid cancers are slow growing, or nodules….lymphhoma is very rapid

64
Q

When do you need oral meds for tinea infections?

A

Head, fingers, toes

65
Q

3 classic skin findings in HIV (usually presenting symptom)

A

Diffuse seborrheic dermatitis
Diffuse molloscum contagiosum
Sudden onset severe psoriasis

66
Q

Major side effect of st johns wort

A

Induces CYP450…makes other meds ineffective

67
Q

3 medications that reudce levothyroxine absorption

A

Bile acid binding resins (cholestyramine)
Cation supplements (Fe, Ca)
PPI

68
Q

Tx for polymyalgia rheumatica

A

Steroids

69
Q

Diagnostic test of choice for dermatomyositis

A

Antibody screening (ANA, Anti Jo 1)

70
Q

10yr fracture risk cutoff for starting bisphosphonates

A

20%

71
Q

First line tx for acute delirium

A

Halddol

72
Q

3 “buckets” that cause AMS in elderly

A

Infection
Medication
Metabolic (thyroid, glucose)

73
Q

2 pathophysiologic causes of stress incontinence

A

Uretheral hypermobility

Decreased uretheral sphincter tone

74
Q

How do you differentiate whether incontinence is due to a problem with uretheral tone or hypermobility?

A

Hypermobility - pt has chronic increased intrabaomnial pressure (prolapse, weight lifting, old people with less connective tissue)

Decreased tone = neuromuscular damage from vaginal deliveries or traumas

75
Q

Distinguishing thalassemia from Fe deficiency anemia on a smear

A

Thalassemia has Target cells

76
Q

2 most important prognostic indicators in COPD

A

FEV1&raquo_space;> Age

77
Q

DSM5 for Adjustment Disorder

A

Onset within 3 months of stressor
Marked distress/affects daily living
Doesn’t fit criteria for MDD

78
Q

First line ADHD treatment based on age

A 
<5 = behavior therapy
>5= Amphetamines
79
Q

Pt with pancreatitis develops worsening symptoms 3 days later. First step in workup

A

CT - looking for abscess, necrosis

Step 3 (4 decks)

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