Internal Medicine

Front 1

Exanitide

Back 1

use to increase insulin production after metformin + sulf. not enough (consider sitagliptin and vidagliptin as well)

Front 2

TZD

Back 2

rosiglitazone associated w/ cardiac side effects, check liver function and weigh gain

Front 3

DKA Screening

Back 3

Glucose over 350 OR presence of anion gap

Front 4

DKA Dx:

Back 4

triad of hyperglycemia (blood glucose greater than 250 mg/dL), arterial pH less than 7.30, and ketoacidosis (serum bicarbonate less than 15 meq/L and positive serum ketones)

Front 5

DKA Follow-up:

Back 5

Check for any underlying disease process

Front 6

DKA Tx:

Back 6

1 IV 0.9% NaCl w/ insulin drip + fluids 2 After glucose is less than 250, IV 5 or 10% Dextrose to prevent hypoglycemia 3 Monitor K+ levels every hour until stable

Front 7

Gemfibrozil/Fenofibrate

Back 7

Lowers triglycerides 50%, raises HDL 15% but does not lower LDL cholesterol reliably. Caution in patients with renal insufficiency and gallbladder disease

Front 8

Colesevelam hydrochloride

Back 8

Interrupts bile acid reabsorption and reduces LDL cholesterol by 10%-15%. Do not use in patients with triglycerides >300 mg/dL

Front 9

Ezetimibe

Back 9

used in combination with statins, yields an additional LDL reduction of 12%, selectively inhibits the intestinal absorption of cholesterol, contraindicated in active liver disease

Front 10

Galactorrhea

Back 10

1.rule out hypothyroidism (TSH), med interactions 2.pregnancy test 3. check prolactin levels 4. MRI

Front 11

Prolactinoma Tx:

Back 11

1. meds-> bromocryptine, cabergoline (dopamine agonists/reduce tumor size) 2. Surgery 3. Radiation (30% risk of panhypopituarism)

Front 12

Acromegaly DX:

Back 12

1. IGF/somatomedin 2. 100 mg Glucose load test (lack of suppression of GH) 3. MRI (must be hormonal first to prevent false positive)

Front 13

Hypopituitarism Dx:

Back 13

1 Check for low GH after insulin induced hypoglycemia 2 Arginine infusion Tx Cortisol replacement

Front 14

Apoplexy

Back 14

Acute hemorrage of previous pit. adenoma, treat as emergency

Front 15

Diabetes Insipidus Dx:

Back 15

1. Water deprevation test -> normal should have 1200+ urine Osm, DI maintains 300 urine Osm 2. ADH for central vs. nephrogenic DI

Front 16

Diabetes Insipidus TX:

Back 16

Central- 1. Desmopressin 2. Vasopressin Nephrogenic- 1. Hydrochlorothiazide, Amiloride (salt wasting to return balance) 2. NSAIDS

Front 17

Acromegaly Tx:

Back 17

1 Octreotide 2 Bromocriptine (Dopamine Agonist) 3 Surgery

Front 18

SIADH Tx:

Back 18

1 Fluid restriction to 800-1,000ml 2 Demeclocycline

Front 19

SIADH Dx:

Back 19

Na less than 130, Plasm osm less than 270, Rule out TSH, ACTH Causes Sertaline SSRI

Front 20

anteroseptal infarction

Back 20

leads V1–V3

Front 21

lateral and apical infarctions

Back 21

leads V4–V6

Front 22

Fomepizole

Back 22

specific antidote to methanol or ethyl glycol (alcohol dehydrogenase inhibitor)

Front 23

Ipacec

Back 23

cleans stomach if drug was ingested within 1 hour

Front 24

GoLYGHTY

Back 24

clears out the bowels

Front 25

ASA

Back 25

stimulates the brain stem into tachypnea -> respiratory Alkalosis (beware of anion gap)

Front 26

ASA Tx

Back 26

alkalinize the urine w/ bicarb to flush it out the kidneys

Front 27

Yellow halo, Gynecomastia

Back 27

Digoxin Toxicity

Front 28

Spirolactone

Back 28

inhibits renin, decreases afterload

Front 29

Multifocal Atrial Tachy

Back 29

fix the underlying COPD

Front 30

Sulfonurea

Back 30

weight gain, increased insulin resistance, hypoglycemia

Front 31

Tolbutamide

Back 31

only hepatic ex. sulf.

Front 32

Metformin

Back 32

inhibits neoglucogenesis in the liver, start low to avoid GI side effects (Lactic acidosis in Renal Failure), creatinine below 1.6

Front 33

Lispro/Aspart

Back 33

short acting Insulin, 30-60/20-30 min peak, 4-6 hours duration

Front 34

NPH/Lente

Back 34

long acting insulin, 6-12 hour peak, 12-18 hour duration, mix with regular insulin for morning and PM dose

Front 35

Microalbuminurea

Back 35

earliest form of DM nephropathy, protect w/ ACE

Front 36

130/80

Back 36

HTN in DM

Front 37

Cotton wool spots

Back 37

No bleeding, only due to DM

Front 38

Somogyi effect

Back 38

rebound morning hyperglycemia caused by hypoglycemia because of too much insulin at night

Front 39

Dawn effect

Back 39

morning hyperglycemia from too little insulin

Front 40

Honeymoon effect

Back 40

early strong response to insulin causing hypoglycemia in DM1

Front 41

Sulfonurea overdose

Back 41

watch in hospital for 24 hours since the drug is long acting