Medice Exam #4 Review

Front 1

what are the most common organisms for cellulitis

Back 1

• Most common organism: Staph aureus or Group A Strep

Front 2

1st line treatment for cellulitis

Back 2

o 1st line – Anti-staph PCN (Nafcillin), Cafazolin, Ceftriaxone

Front 3

name a complication of cellulitis

Back 3

osteomyelitis

Front 4

If PCN allergic, how do you treat cellulitls

Back 4

allergic to PCN, then Vancomycin or Linezolid

Front 5

how do you trat a subsequent outbreak of cellulitis

Back 5

o Subsequent treatment: Dicloxicillin, Cefalexin

Front 6

describe the presentation of Psoriasis

Back 6

• Swelling, erythematous, scaly white lesions, sharply-demaracated, silvery scales
• Positive Auspitz sign
• Located on palms, soles, scalp, nails

Front 7

name the different types of psoriasis

Back 7

o Psoriasis vulgaris
o Psoriatic arthritis

Front 8

what are topical treatments for psoriasis

Back 8

• Tx. Calcipotriene (Dovonex) or Oraflex cream: topical corticosteroids which normalizes proliferation. Inhibits leukotrines.

Front 9

what do you use for systemic treatment of psoriasis

Back 9

• Use MTX for systemic infection and tegasin

Front 10

Photo therapy is effective in the treatment of psoriasis. TRUE or False

Back 10

TRUE

Front 11

what sre complications found in children with psoriasis

Back 11

arthritis, kids: Guttate (following a URI/strep pharyngitis)

Front 12

what are some agents that can cause a flair up of psoriasis

Back 12

• BB can cause flare, lithium and systemic steroids

Front 13

what is the Koebner phenomena:

Back 13

• Koebner phenomena: lesion after trauma

Front 14

What is the Auspitz sign:

Back 14

after scratching= blood

Front 15

where can candidiasis occur

Back 15

Can occur in the mouth, vagina, intertrigo (under the breast)

Front 16

what test is used to diagnose candidiasis

Back 16

identified by KOH and pseudohyphae

Front 17

what are treatment options for candidiasis

Back 17

topical anti-fungal (Nystatin or –azole cream)

Front 18

what is significant about Oral Candidiasis

Back 18

AIDS-defining condition

Front 19

how do you treat oral candidiasis

Back 19

magic mouthwash (Nystatin, Lidocaine)

Front 20

what is the MCC of Impetigo

Back 20

Staph aureus

Front 21

what are the etiologies of Bullous type and non-bullous impetigo

Back 21

• Bullous type (caused by Staph); non-bullous = honey crusted = strep pyogenes(caused by GABHS or Staph)

Front 22

what is the most common area effected by impetigo

Back 22

face

Front 23

what is the treatment for Non-penicillinase producing impetigo Pen G,

Back 23

Pen G, (DOC for pyogenes)

Front 24

how dou you treat Penicillinase-producing impetigo

Back 24

dicloxacillin, cloxicillin (for severe infection nafcillin or oxacillin)

Front 25

describe the lesions of the vericwlla virus

Back 25

Tear-drop rose petal lesion that starts at the head and descends to trunk and extremities

Front 26

what is the TX for peds with vericella

Back 26

supportive, calamine lotion

Front 27

what is the TX for adults with vericella

Back 27

acyclovir (can be used reduce the duration)

Front 28

how dou you treat complicated cases of vericella

Back 28

refer to Dermatology

Front 29

What are the stages of acne

Back 29

Mild, moderate, & severe acne

Front 30

what population developes Acne fulminans

Back 30

(seen in teenage boys)

Front 31

when do you see Tropical acne

Back 31

(usually seen with folliculitis)
o On the trunk and buttocks in tropical climates

Front 32

what is, and when dou you see Acne excoriee

Back 32

Mild acne usually in young women. Usually seen in patients with OCD

Front 33

All acne drugs are teratogenic. TRUE or FALSE

Back 33

TRUE(all acne meds are teratogenic agents)

Front 34

what are some treatment options for Mild acne

Back 34

Tx with topical antibiotics (clindamycin, erythromycin)
Benzoyl peroxide gels Topical retinoids (ex. Adapaline)

Front 35

what are some treatment options for moderate acne

Back 35

Oral antibiotics are added to above regimen
Most affective antibiotic: Minocycline or Doxycycline
Dosage is tapered as acne lessens

Front 36

what is a hormonal treatment optiotion for females with moderate acne

Back 36

In females, moderate acne can be controlled with oral estrogens

Front 37

What are treatment options for severe acne

Back 37

Treat with above + Isotretinoin (Accutane)

Front 38

What 2 drug should not be combined in the treatment of acne, and why

Back 38

Do not give tetracycline and accutane together (can get pseudotumor cerebri)

Front 39

What is Myasthenia Gravis

Back 39

An autoimmune disorder against acetylcholine receptors that effects the proximal muscles,

Front 40

what are some of the manifestations of My asthenia Gravis

Back 40

Fluctuating muscle weakness
Causes ptosis, diplopia, dysphagia
Activity increases weakness of affected muscles; improves with rest

Front 41

How is MG diagnosed

Back 41

Diagnosis confirmed by edrophonium, electromyography, serum testing of AcH

Front 42

How is MG treated

Back 42

oxygen, neostigmine, severe MG (high dose steroids)

Front 43

What is Guillain-Barre

Back 43

A polyradiculoneuropathy of ascending semetric weakness

Front 44

what will the CSF in MG show CSF show

Back 44

high protein, normal glucose and cell count

Front 45

How do you treat GB

Back 45

Consult neurology
Tx. Plasmpheresis

Front 46

In Bacterial Meningitis, what will the CSF show

Back 46

low glucose, elevated protein, and markedly elevated opening pressure

Front 47

What is the most common treatment of bacterial meningitis

Back 47

Most common treatment is Ceftriaxone 2 g IV Q12hr

Front 48

How do you treat BM if PCN alergic

Back 48

treat with Vanco, Rifampin, & Chloramphenicol

Front 49

how does Wernicke Encephalopathy present

Back 49

Ataxia, confusion, nystagmus leads to ophthalmoplegia

Front 50

What is the treatment for W.E.

Back 50

thiamine

Front 51

what is the treatment for Patients that present with AMS

Back 51

narcan, D50, and thiamine

Front 52

What is the Inpatient TX of Diverticulitis

Back 52

Aminoglycoside IV + (Metronidazole or Clindamycin)

Front 53

what is the Outpatient TX for diverticulitis

Back 53

Ampicillin, Bactrim, or Cipro + (Metroniazole or Clindamycin)

Front 54

what are causes of small bowel obstruction

Back 54

1. Adhesion
2. Hernias
3. Volvulus

Front 55

What should you susoect with 1st Trimester Bleeding

Back 55

Threatened abortion

Front 56

What are the conditions that define a threatened abortion

Back 56

Vaginal bleeding in the first 20 weeks
• Cervical os is closed
• If the cervix is dilated, then is an inevitable abortion

Front 57

What are the conditions that define an Incomplete abortion

Back 57

• Partial passage of fetus
• Most common in 6-14 weeks

Front 58

What is the treatment for am incomplete abortion

Back 58

D&C

Front 59

What is a complete abortion

Back 59

Passage of entire fetus before 20 weeks

Front 60

Define a Missed abortion

Back 60

Fetal death at less than 20 weeks without expulsion of fetus

Front 61

Who should recieve the RH D immunoglobulin (Rhogam

Back 61

rH negative women

Front 62

What imaging study is best for Ectopic Pregnancy

Back 62

Ectopic Pregnancy
Ultrasound will show no sac

Front 63

What will HCG readings be in ectopic pregnancy

Back 63

HcG > 1000 suggest ectopic pregnancy

Front 64

What will progesterone levels be in an ectopic pregancy

Back 64

Very low progesterone level suggest ectopic pregnancy

Front 65

How do you treat an ectopic P

Back 65

surgical removal (done via laproscopy)

Front 66

what lab should be drawn post treatment od an ectopic P

Back 66

• Post-abortion, perform serial hcG counts

Front 67

What tests are used to diagnose syphilis

Back 67

Diagnosed by darkfield microscopy, FTA, VDRL, RPR

Front 68

Describe the presentation of Primary syphilis

Back 68

Painless ulcer (chancre)
Bilateral inguinal adenopathy
Usually asymptomatic

Front 69

describe the presentation of secondary syphilis

Back 69

Diffuse rash
Condylomata lata

Front 70

describe the presentation of tertiary syphilis

Back 70

Neurovascular, neurosyphilis
Meningovascular (stroke-like presentation)
Syphilitic aortitis
CN 2,3,7,8 involvement

Front 71

How do you treat syphilis

Back 71

PCN - G

Front 72

What is the treatment for Gonorrhea

Back 72

Ceftriaxone and Doxycycline (to cover for Chlamydia)
• Alt: Spectinomycin

Front 73

What is the etiology and treatment of a Chancroid

Back 73

Caused by Haemophilus Ducreyi
Tx. Macrolide or Rocephin

Front 74

What are treatment options for Chlamydia

Back 74

Doxycycline 100 mg BID x 7 days + Azithromycin 1 gm PO (single dose)
Altneratives: Erythromycin + Ofloxacin

Front 75

What will the discharde of Trichomonas look like

Back 75

Green-yellow discharge

Front 76

Waht will be seen on a saline wet prep with Trichomonas

Back 76

Motile flagella on saline prep

Front 77

What is the treatment of Trichomonas

Back 77

Metronidazole 2 gm PO (single dose)

Front 78

What is the MCC of skin abscess, and how do the lesions appear

Back 78

Staph aureus
Skin lesions are red, hot, and painful
Pus collects within a central space, characterized by fluctuance of the central portion

Front 79

How does Hidradenitis suppurativa present, and how do you treat

Back 79

abscess in the axillae, groin, and vulva
TX: I & D

Front 80

How does Bell’s Palsy present, and how do you treat it.

Back 80

Facial paralysis/droop
Unable to raise eyebrows
TX: supportive

Front 81

How do you treat PCP

Back 81

TX: Bactrim IV

Front 82

If allergic to bactrim how do you treat PCP

Back 82

If allergic to bactrim, treat with Pentamidine with Primaquine or Clindamycin

Front 83

How do you treat Toxoplasmosis

Back 83

Sulfadiazine and Pyrimethimine

Front 84

What are viral Causes of colitis

Back 84

•Viral (CMV)

Front 85

What are protozoal Causes of colitis

Back 85

(Entamoeba histolytica)

Front 86

What are bacterial Causes of colitis

Back 86

Bacterial
Cytoxic (E. Coli 0157:H7, Vibrio, C. Difficile)
o Mucosal (Shigella, Campylobacter, Salmonella, Yersinia, Shigella (TX with Cipro)

Front 87

What causes primary peritonitis and how is it diagnosed

Back 87

Caused by cirrhosis
Most organisms, E. coli, proteus, klebsiella
Diagnosed by paracentesis

Front 88

What causes secondary peritonitis

Back 88

Due to rupture (appendicitis, diverticulitis, cholecystitis)

Front 89

What are etiologies of Atypical pneumonia

Back 89

Legionella, Mycoplasma, Chlymydia, TB, PCP

Front 90

What will a CXR show in Atypical pneumonia

Back 90

bilateral interstitial infiltrates

Front 91

The CXR of Atypical pneumonia caused by Legionella will show ?, and is treated with

Back 91

patchy infiltrates (Tx: Erythromycin)

Front 92

The MCC of Commuinity-aquired pneumonia is

Back 92

Strep pneumo

Front 93

Commuinity-aquired pneumonia is treated with

Back 93

Ceftriaxone + Azithmycin OR Fluoroquinolone

Front 94

Polyarteritis Nodosa presents with

Back 94

Multiple subcutaneous nodules with ulceration occurring on the medial and lateral aspects of the lower extremities

Front 95

Polyarteritis Nodosa is associated with

Back 95

Hep B & C

Front 96

Polyarteritis Nodosa is treated with

Back 96

corticosteroids or immunosuppressive drugs

Front 97

Giant Cell Arteritis
Aka temporal arteritis is
Associated with ?

Back 97

polymyalgia rheumatic (proximal muscle weakness of the shoulder and hip)

Front 98

Giant Cell Arteritis often presents with?

Back 98

Headaches, jaw claudication, scalp tenderness,
Painful, pulseless temporal artery.
Age over 50, elevated ESR

Front 99

How is Giant Cell Arteritis diagnosed and treated?

Back 99

temporal artery biopsy
Tx: prednisone

Front 100

Takayasu is defined as?

Back 100

Large vessel vasculitis
Affects mostly young women
Aka “pulseless disease”

Front 101

Churg-Strauss is also known as?

Back 101

Allergic granulomatosis

Front 102

Churg-Strauss effects what size vessels?

Back 102

Small-to-medium vessel vasculitis

Front 103

Churg-Strauss Classic patient presentation is?

Back 103

middle-aged asthmatic with pulmonary infiltrates, vasculitis and eosinophila

Front 104

Churg-Strauss is diagnosed with, and treated with?

Back 104

Positive P-ANCA
TX: steroids

Front 105

What size vessels are effected by Kawaski Disease

Back 105

Medium-large cell arteritis

Front 106

What age group is MC effected by Kawaski Disease

Back 106

Children less than 5

Front 107

What are physical findings of Kawaski Disease

Back 107

Fever, strawberry tongue, desquamation of the fingers and toes

Front 108

What are complications of Kawaski Disease

Back 108

coronary aneurysms

Front 109

What size vessels are effected by Wegener’s Granulomatosis

Back 109

Medium vessel vasculitis

Front 110

Wegener’s Granulomatosis is diagnosed by?

Back 110

Positive ANCA

Front 111

Wegener’s Granulomatosis is associated with?

Back 111

Recurrent URI and LRI

Front 112

Define Scleroderma

Back 112

A chronic disorder charcterised by difuse fibrosis of the skin and internal orgins

Front 113

Scleroderma is associated with the acronym CREST, what does it stand for

Back 113

Scleroderma
Cutaneous calcinosis
Raynaud’s phenomenon
Esophageal Dysmotiliy
Sclerodactly
Telangiectasias

Front 114

Describe a LeFort I:

Back 114

transverse fracture separates the body of the maxilla from the lower portion pteryoid

Front 115

Describe a LeFort II:

Back 115

LeFort II: a pyramidal fracture of the central maxilla and the palate

Front 116

Describe a Lefort III:

Back 116

Lefort III: cranial-facial disjunction, occurs when the facial skeleton separates from the skull

Front 117

Describe a Lefort IV:

Back 117

Lefort IV: fracture includes the frontal bone and the midface

Front 118

Name the large vessel vasculitides

Back 118

Takayasus, Giant Cell, Polymyalgia Rheumatica, Aortitis

Front 119

Name the medium Vessel vasculitides

Back 119

polyarteritis Nordosa, Churg-Schonlein purpura, Kawasaki Disease

Front 120

Name the small vessel vasculitides

Back 120

wegeners granulomatosis, henoch-shonlein purpura, leukocyto clastic, microscopic polyangitis, cryoglobulinemic, primary angitis of the CNS, vasculitis associated with connective tissue diseases.

Front 121

describe henoch-schonlein purpura

Back 121

small vessel affecting children and young adults. classic trid(Victor) palpable purpura, arthritis, and abdominal pain, fever and glomeruloephritis are common. IgA levels are elevated

Front 122

What is acute retroviral syndrome?

Back 122

A mononucleosis like syndrome that affects > 50% of HIV patients.

Front 123

describe the asymptomatic phase of HIV

Back 123

The part of the disease free from illness, most are unaware of their illness untill the CD4 count falls < 200

Front 124

Name some opportunistic infections associated with HIV

Back 124

MTB, kaposis sarcoma, recurrent bacterial pneumonia, non-hodgkins lymphoma. CMV retinitis, cryptococcus meningitis, CMV esophagitis, CMV colitis, CNS lymphoma.

Front 125

How is early HIV managed

Back 125

H&P every 3-4 months
baseline plasma HIV RNA and CD4 count every 3-4 months

Front 126

What are other studies used to manage early HIV

Back 126

PPD, toxoplasma antibody, LFT, CXR

Front 127

What are vaccine's used to help manage early HIV

Back 127

Pneumococcal , Hep-B(if H-B seroneative), yearly flu vac.

Front 128

What are guidelines to initiate antiviral theropy in the chronically infected.

Back 128

Symptomatic(THRUSH, AIDS)with CD4 any value.

Asynptomatic with CD4 < 200

Asymptomatic with CD4 > 200, with recomendation based on the decline rate of the CD4, HIV RNA plasma levels, and the commitment to long term therapy

Front 129

What is an ACRONYM for the NRTI's

Back 129

L lamivudine
E emtricitabine
A abacavir
D didanosine

S stavudine
T tenofovir
Z zidovudine

Front 130

What is the ACRONYM for the PI's

Back 130

I indinavir
N nelfinavir

S saquinavir
A amprenavir
R retonavir
A atazanavir

(Sara, a girl I used to know)

Front 131

ACRONYM for the NNRTI's

Back 131

E efavirenz
N nevirapine
D delavirdine

(the END in near)