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Tx for AV nodal reentrant tachycardia (SVT)
- Stable: Vagal (valsalva, cough, gag, ice, carotid massage). If unsuccessful, Adenosine or CCB.
- Unstable: cardiovert
Nitrates are CI with what heart murmur? Why?
- Aortic Stenosis
- AS is preload-dependent
In Non-obstructive Hypertrophic Cardiomyopathy, what is the only viable Tx?
Cardiac transplant
MCC syncope in non-specific Hx, normal PE and ECG
Idiopathic
Pt. presents to ED with a finger lac. She is 8 wks pregnant and has had 2 days of vaginal spotting and lower abdominal cramping. She has a closed os and no tenderness or masses on palpation (~possible threatened abortion or ectopic pregnancy). What is the mgmt?
Treat her laceration, perform hCG quantitative level and pelvic US
Dx for Intussusception
Ultrasound (target-sign)
Multiple sclerosis is associated with what eye condition? What is the finding?
- Optic neuritis
- Afferent pupillary defect
What is the mgmt for Molar Pregnancy?
Ob/Gyn consult for dilation and curettage. X-ray to R/O METS.
Alcoholic. Oculomotor dysfunction (MC nystagmus**), cerebellar dysfunction (ataxia), AMS. Dx?
Wernicke Encephalopathy
What mandates antibiotic treatment for Neutropenic Fever?
- Single oral temp. of 101F (38.3C)
- 100.4 for >1 hr + ANC < 500
Tx for Primary Immune Thrombocytopenia
- Kids: observe ± IVIG (severe w/bleed)
- Adults: Steroids > IVIG; Platelets <20K - transfusion, splenectomy
Tx for Acute Chest Syndrome in SCD
Broad-spectrum antibiotics + ICU
Tx for Chronic Urticaria
Nortriptyline (tricyclic antidepressants)
Tx for Tumor Lysis Syndrome
IVF + ER dialysis (with multiple electrolyte abnormalities)
Mgmt of Red Man Syndrome
IV diphenhydramine and stop infusion. If no more Sxs, can restart slower.
What is the Rx of choice for Myofascial Pain?
Cyclobenzaprine (muscle relaxant)
Tx for Traveler’s Diarrhea besides rehydration
- Ciprofloxacin
- Azithromycin (pregnant and kids)
CI air-contrast enema in reducing pediatric intussusception?
- Free air under diaphragm
- Peritonitis
What labs are seen in Appendicitis?
Leukocytosis
Electrolyte abnormalities seen in refeeding syndrome
HypoK
HypoPhos
What is the appearance on imaging for Sigmoid Volvulus (colon twist) and what is the Tx?
- Bent inner tube
- Sigmoidoscopy
Viral infection MC associated with pediatric intussusception
Adenovirus
Dx for Pancreatic Cancer
CT
Workup for ped obesity
- Lipid panel
- CMP
Dx for Epiglottitis
Laryngoscopy
When do pts. get Tetanus immune globulin?
Unknown, incomplete, or lack of primary tetanus immunization
Many painful papules ulcerated + inguinal bubo. Dx?
Chancroid (Haemophilus ducreyi)
A sick boy presents with 12-hr Hx of HA, stiff neck, F to 104°F, lethargy. Next he begins vomiting and gets petechial rash from head to feet followed rapidly by the formation of necrotizing purpura. Then he develops shock, cardiac arrest, and dies. Dx?
Meningococcemia
Bones, Stones, Moans, Groans. Dx?
HYPER-Ca+
Mainstay Tx of Sinusitis <10 days
PO Analgesics
What is Ciguatera Poisoning and how is it treated?
- 2nd MC fish-borne toxin (grouper, red snap, barra)
- Support, Atropine, Mannitol
Tx for Polycystic Kidney Disease
ACEIs or ARBs
Decreased fremitus is found in:
Pneumothorax
What is a RF for endometriosis?
Nulliparity
What cardiac med is known to cause clinically significant hypothyroidism?
Amiodarone
Hypoparathyroidism presents with what abnormalities?
- ↓ Ca+
- HIGH Phosphorus
Facial muscle movements (except chewing) and closing eyes is what cranial nerve?
CN VII (Facial)
Endoscopy is ordered and results show several large, SHALLOW ulcerations. What is the Dx and Initial treatment?
- CMV Esophagitis
- Gangciclovir
Abdominal cramps and watery diarrhea after eating a plate of unrefrigerated meat and vegetables. Dx?
Clostridium perfringens
Pt. with advanced AIDS complicated by toxoplasmosis presents with AMS, recent onset of seizures, and focal neurologic deficits. What diagnostic studies is most helpful?
Brain MRI
Tx for Pemphigus Vulgaris
1st- admit + HIGH steroids
2nd- Methotrexate
Molluscum Contagiosum MC patho
Pox virus
Tx for Rosacea
Metronidazole
At what age is Varicella Zoster vaccine given?
50 yo
What reaction is a delayed, cell-mediated morbiliform rash like Erythema Multiforme?
Type IV
What is monitored while on Olanzapine? Why?
- Lipids
- Can cause DM and hyperchol.
What asthma med causes candidiasis?
Fluticasone
MC non-viral STI in the world
Trichomonas
What med stops lactation and is also used for prolactinoma?
Cabergoline (“STOP the cab!”)
Mgmt for Molar Pregnancy
Get it out! Dilation and curettage.
Best to Dx Bronchiectasis
CT scan
14yo girl has been diagnosed with primary amenorrhea. Pelvic US reveals an absent uterus. Genetic testing confirms a 46,XX karyotype. What is the most likely diagnosis?
Mullerian dysgenesis
58yo postmeno. woman presents with painless vaginal bleeding. Her last menses was 5 yrs ago. She reports that her Pap smears have always been normal; the last one was 1 yr ago. What is the next step in management?
Transvaginal ultrasound
In a pt. with active or reactive TB, what is the GOLD Dx?
Acid-Fast Smear (AFB) and Sputum Culture
Newborn in respiratory distress. CXR shows fluid in pulm fissures and infiltrates. Dx?
Transient Tachypnea
Sxs of either Chlamydia or Gono. How best do we choose an answer based on tool for Dx?
Always with one with PCR, even if in urine.
Tx for Pyelonephritis
FQ**»_space; Bactrim
Tx for Guillain-Barre
Plasmapheresis, IVIG
“Gonz Is Pig!”
Tx for Myasthenia Gravis
Ach-Esterase Inh: “-mine” “make Mya mine!”
Acute: Plasmaph. or IVIG. “Is Pig”
What antiepileptic drug is CI in pregnancy?
Valproate
MC pathos of GBS and Bell Palsy
GBS: Camp
BP: HSV
Tx for Intracerebral Hemorrhage
CCB Nicardipine
How do we Dx Acute Hep B?
Core Antibodies
Esophageal CA is MC a complication of ______ or ______.
GERD or Barrett’s
Eating improperly refrigerated foods may lead to:
Bacillus cereus
Tx for C. Diff
PO Vanco* or PO Metro
MCC (not patho) of Pancreatic CA
Smoking
Tx for Aortic Stenosis
- IVF
- Replacement
1st line Tx for CHRONIC Stable Angina that is NOT Nitro
BB
MC ligament injury of an ankle sprain
Anterior TaloFibular Lig. (ATFL)
MC nerve compressed in Carpal Tunnel
Median