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165 Cards in this Set
- Front
- Back
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AV nicking
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HTN - vein discontinuity
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cotton wool spots
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HTN - infarct of nerve fiber layer
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tx for HTN with systolic 120-139
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lifestyle mod
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initial HTN agent for an african american diabetic
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ACEi
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HTN meds shown to reduce morality and morbiity
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beta blockers, thiazides
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what's elevated in and what is treatment for Type I dyslipidemia
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chylobicrons
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what's elevated in and what is treatment for Type IIa dyslipidemia
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LDL
statins, niacin, cholestyramine |
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what's elevated in and what is treatment for Type IIb dyslipidemia
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LDL and VDL
statins, niacin, gemfibrozil |
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what's elevated in and what is treatment for Type III dyslipidemia
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IDL
Gemfibrozil Niacin |
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what's elevated in and what is treatment for Type IV dyslipidemia
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VLDL
niacin, gemfibrozil, statins |
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what's elevated in and what is treatment for Type V dyslipidemia
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VLDL + chylomicrons
(triglycerides) Niacin, Gemfibrozil |
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lipid that gives most CAD risk
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LDL
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at what level does Chol become a CAD risk
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240
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ideal levels of Chol, LDL, TGL
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< 200, 130, 125
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secondary causes of hyperlipidemia
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hypothyroid
chronic liver disease nephrotic diabetes |
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what meds can induce transiet elevations in serum transaminases
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statins and fibrates
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drugs for hyperTGL
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1) niacin
2) gemfibrozil |
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what test need to be run on patients getting statins
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LFTs
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what patient's can't get niacin
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diabetics
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what's the problem with cholestyramine, colestipol? what's their mechanism
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increase TGLs
(they are bil acid-binding resins) |
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type of headache that last for months to years with pain behind the eye
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cluster
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headache
ipsilateral lacrimation, flushing, nasal stiffness |
cluster headache`
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tx for cluster headache
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sumatriptan and inhaled O2
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prophylaxis for cluster headache?
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verapamil daily
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tx for migraine
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dihydroergotamine (DHE) or triptan
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migraine prophylaxis
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1) TCAs, propranolol
2) verapamil, valproate, methysergide |
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diarrhea with fever and blood. which bugs?
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Shigella
Campylobacter Salmonella E coli |
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diarrhea with no fever and no blood. which bugs?
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rotavirus
Norwalk enterotoxic E coli food poisoning (s aureus, c. perfringens) |
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which bugs yield positive fecal leukocytes?
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camylobacter
salmonella shigella enteroinvasive E coli C difficile |
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how to test for c difficile?
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C difficile toxin in stool sample
(10% false negatives, so treat empirically) |
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myalgias, malaise, headache, watery diarrhea, nauseau and vomiting for 48-72 hours
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Norwalk, rotavirus
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diarrhea after eating domestic fowl and their eggs
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salmonella
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tx for salmonella
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cipro
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diarrhea with tenesmus
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shigella
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treatment for shigella
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bactrim
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abdominal pain, nausea, vomiting, diarrhea that starts within 6 hours of exposure and resolves within 24 hours
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staph aureus
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tx for campylobacter
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erithromycin
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crampy abdominal pain with diarrhea (vomiting and fever rare), resolving within 24 hours
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clostridium perfringens
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tx for giardia
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metronidazole
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new tx for IBS?
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tegaserod
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bilious vomit
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obstruction distal to ampulla of vater
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vomiting of undigested food
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esophageal problem
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projectile vomiting
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increased intracranial pressure
or pyloric stenosis |
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electrolyte abnormality induced by vomiting?
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hypokalemia with metabolic acidosis
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rx for nausea/vomiting
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prochlorperazine and promethazine
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cause of radiculopathy
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compression of nerve root by extruded disk
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back pain caused by activity and relieved by rest or spinal flexion
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neurogenic cluadication in lumbar spinal stenosis
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leg pain on back extension; worse with standing or walking, relief with bending or sitting
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spinal stenosis
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back pain worsened by sitting, driving, lifting, coughing, sneezing
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disc herniation
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bilateral sciatica, saddle anesthesia over buttocks
low back pain, LE weakness bowel/bladder dysfunction impotence |
Cauda equina syndrome
SURGICAL EMERGENCY |
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tx for cauda equina
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SURGERY ASAP
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forward slipping of cephalad vertebra on caudad vertebra
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spondylolisthesis
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hip flexion root
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L2
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knee extension root
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L3
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ankle dorsiflexion root
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L4-5
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great toe dorsiflexion root
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L5
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ankle plantar flexion root
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S1
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patella reflex root
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L4
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achilles reflex root
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S1
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pain at radial aspect of the wrist, especially with pinch gropping, likely radiating to elbow or thumb
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De Quervain's disease, due to inflammation of abductor pollicis longus and extensor pollicis brevis
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treatment for de Quervains
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thumb spica splint and NSAIDS
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pain caused to patient when the patient clenches the thumb under the other fingers when making a fist and you ulnarly deviate the writst
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De Quervain's disease
(=Finkelstein's test) |
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Tinel's sign
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tapping median nerve - carpal tunnel
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joint space narrowing
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osteoarthritis
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colles fracture
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distal radius
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diagnosis of osteoporosis
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DEXA scan
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red, painful eye
sudden decrease in visual acuity seeling halos nausea and vomiting |
closed angle glaucoma - emergency because of very rapid increase in IOP
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tx for acute angle-closure glaucoma
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Rx: pilocarpine, IV acetazolamide, oral glycerin
Surgery: laser or iridectomy |
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rx for open-angle glaucoma
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beta blocker
alpha agonist carbonic anhydrase inhibitor prostaglandin analogue |
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sudden, transient monocular loss of vision
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Amaurosis fugax
due to emboliation of cholesterol plaque from carotids, causing retinal ischemia CAROTID U/S needed!! |
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sequelae of apnea
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increased pulmonary vascular resistance
pulmonary HTN systemic HTN |
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tx for narcolepsy
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ritalin (methylphenidate)
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drugs that induce hearing loss
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aminoglycosides
furosemide ethacrynic acid cisplatin quinidine |
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fluctuating unilateral hearing loss
sensoe of pressure/fullness in ear tinnitus vertigo |
Meniere's disease
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tx for Meniere's disases
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vertigo: salt restriction and meclizine
hearing loss: progressive |
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in a drinker:
nystagmus ataxia ophthalmoplegia confusion |
Wernicke's encephalopathy
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in a drinker:
confabulation memory disorder |
Korsakoff's psychosis
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driker with macrocytic anemia
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folate deficiency
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AST-ALT ration 2:1
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alcoholism
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screening for HTN
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every 2 years starting at 18
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screening for hyperlipidemia
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nonfasting total chol and HDL every 5 years after 20
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CRC screening
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FOB + sigmoid every 5 year starting at 50
or FOB and colonoscopy every 10 year FAP - gene test at 10, colectomy if positive or colonoscopy every 1 to 2 years at puberty HNPCC: genetic test at 21, if positive colonoscopy every 2 years until 40 and then every year |
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breast ca screening
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mammogram every 1 to 2 years at 40, every year at 50
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Cervical ca screening
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within 3 years of first sex or 21.
If two consecutive negative, then every 3 years until 35 and 5 years until 65 |
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influenza vaccine
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adults >50, or younger with risk factors
health care workers 2nd 3rd trimester |
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pneumococcal polysaccharide vaccine
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adults >65
sicklers immunodeficiencies or crhonic women with high risk pregnancies one dose (second dose 5 years later for high risk) |
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Td vaccine
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booster every 10 years
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shingles vaccine
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adults > 60
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wide P wave in lead II or diphasic P in V1
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left atrial enlargement
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tall P wave in II or diphasic P wave in V1
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right atrial enlargement
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criteria for LVH
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S >30 in V1 or V2
R >26 in V5 or V6 |
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criteria for RVH
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R >7 in V1
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large R waves and ST segment depressions in V1 or V2
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posterior wall MI
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ST elevations in I aVL, V5, V6
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lateral wall MI (circumflex artery)
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ST elevations in V1 to V4
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anterior wall MI (LAD)
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ST elevations in II, II, aVF
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inferior wall MI (terminal branches of r or l coronary artery
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diffuse ST elevations
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pericarditis
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Peaked Ts
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early MI (pre infarction)
hyperkalemia hypermagnesemia |
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T wave inversion
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MI
pericarditis cardiomyopathy, etc |
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red man syndrome
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vancomycin
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coverage by first generation cephalosporins
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gram positives
Proteus, Klebsiella E coli |
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coverage by second generation cephalosporins
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gram positives
Proteus, Klebsiella, E coli Hemophilus, enterobacter |
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coverage by third generation cephalosporins
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gram positives
Proteus, Klebsiella, E coli Hemophilus, enterobacter gram negative can cross BBB |
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which cephalosporins can cross BBB
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third and fourth
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coverage by fourth generation cephalosporins
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gram positives
Proteus, Klebsiella, E coli Hemophilus, enterobacter gram negative cross BBB pseudomonas, neisseria, MSSA |
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is tetracycline static or cidal
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static
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are macrolides static or cidal
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static (but can be cidal at high doses)
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antibiotic used for prophylaxis in sicklers
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penicillin
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antibiotic for dental infections
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penicillin V
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antibiotic for syphillis
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penicillin G
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is penicillin static or cidal
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cidal
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are cephalosporins static or cidal
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cidal
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which generation? cefazolin
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first
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which generation? cephalexin
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first
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which generation: cefaclor
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second
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which generation cefoxitin
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second
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which generation cefuroxime
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second
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which generation ceftriaxone
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third
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which generation? cefotaxime
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third
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which generation? cefepime
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fourth
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what are imipenem and cilastatin used together for?
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penicillin resistants, pseudomonas, anaerobes, eneterobacter
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use of aztreonam
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pseudomonas and serratia
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treatment of choice for legionella
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erithromycin
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who can't get erithromycin
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liver failure patients
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are aminoglycosides static or cidal
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cidal
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causes gray baby sundrome and aplastic anemia
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chloramphenicol
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are fluoroquinolones cidal or static
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cidal
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antibiotic that can damage cartilage in growing kids
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fluoroquinolones
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side effect of INH
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drug-induced hepatitis, B6 deficiency
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side effect of ethambutol
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optic neuritis
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what antibiotic can G6PD patients not get?
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sulfonamides
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antibiotic that causes disulfiram-like reaction with alcohol
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metronidazole
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S1
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mitral valve closure
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S2
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aortic valve closure
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between S1 and S2
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systole
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cause of paradoxical splitting of S2
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aortic stenosis, LBBB, hypertension
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grade 4 murmur
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loud, associated with a thrill
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grade 5 murmur
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heard with steth off chest partially
(6 is steth off entirely) |
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loud, high pitched breath sounds, with longer expiratory phase, heard in central areas
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bronchial breath sounds
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breath sounds that sound like lower pitch snoring
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Rhonchi
due to high mucus in large airways, as in chronic bronchitis |
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asymmetric DTRs
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corticospinal tract dysfunction/UMN lesion
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pronator drift
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motor weakness
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normal reflexes grade
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2
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biceps reflex root
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C5
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brachioradialis reflex root
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C6
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triceps reflex root
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C7
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grade for able to move against gravity not resistance
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3
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UMN or LMN? spasticity
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upper
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UMN or LMN? babinski
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upper
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UMN or LMN? flaccid paralysis
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LMN
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UMN or LMN? flaccid paralysis
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LMN
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UMN or LMN? muscle atrophy
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LMN
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UMN or LMN? fasciculations
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LMN
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elevated AFP
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HCC
nonseminomatous germ cell tumors cirrhosis hepatitis (more specific to HCC and NSGCT if very high) |
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tx for PSVTs
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vagal maneuvers
IV adenosine |
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tx for AFib
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beta blocker
DC cardioversion anticoagulation |
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tx for A fltter
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(like Fib)
beta blocker DC cardioversion anticoagulation |
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tx for VT
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IV amiodarone if stable
DC cardioversion if unstable |
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tx for VFib
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immediate defibrillation and CPR
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sensitivity
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A/ (A+C)
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specificity
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d/(b+d)
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PPV
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a/(a+b)
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NPV
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d/(c+d)
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type 1 error
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null rejected wrongly (false-positive)
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type 2 error
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null not rejected wrongly (false negative)
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