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24 Cards in this Set
- Front
- Back
What antibiotics do you use for IE prophylaxis?
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Amoxicillin. If allergic can use Cephalexin, clindamycin, azithromycin or clarithromycin
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Name (6) conditions that require IE prophylaxis prior to a dental extraction?
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1) Prosthetic heart valve
2) previous IE 3) unrepaired cyanotic CHD 4) completed repaired CHD with prosthetic material during the first 6 months after 5) repaired CHD with residual effects at the site of patch/device 6) cardiac transplant recipients who develop cardiac valvulopathy |
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Indications for aortic valve repair in aortic regurg (4)
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1) symptomatic
2) asymptomatic chronic severe with EF <50% 3) chronic severe AR undergoing CABG or AV surgery 4) asymptomatic, normal EF but severe LV dilation |
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TIMI Risk Score for UA/NSTEMI (7)
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1) age _>65
2) _>3 CAD risk factors (high cholesterol, FHx, HTN, DM, smoker) 3) prior stenosis _> 50% 4) aspirin use in last 7 days 5) _>2 anginal events in past 24 hr 6) ST-segment deviation 7) elevated cardiac markers |
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Treatment of choice for MAT
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verapamil
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electrolyte disturbance that will cause prolonged QT
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hypocalcemia
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What do you do with statins pre op?
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Do NOT hold - stopping can precipiate cardiac necrosis. Note you DO hold niacin because of rhabdo risk...
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What do you do with diuretics pre op?
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Hold unless volume overloaded.
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How long do you delay non emergent surgery when someone had a bare metal stent placed?
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30-45 days
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How long do you delay surgery after someone has had a Drug Eluting Stent placed?
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one year
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Describe the Weber exam
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place tuning fork in front of forehead.
If louder in good ear --> sensorineural if louder in bad ear --> conducive |
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Describe the Rhinne test
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place tuning fork on mastoid bone then hold out to ear
It is abnormal if hearing is better while touching and that means conductive loss. If hearing is normal or sensorineural hearing loss is present then it is louder in the air. |
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What are the two main pathogens in acute bacterial sinusitis?
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H. Flu and S. pneumo
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What is the renal value cut off for use of metformin??
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1.4 in women and 1.5 in men
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Name two insulin medications that are oral and are better for post prandial hyperglycemia?
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sulfonylurea and meglitinide
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Which class of diabetes drugs must be avoided in class III and IV heart failure?
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the insulin sensitizors pioglitazone and rosiglitazone (TZDs).
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What class of diabetic agents do not have weight gain?
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incretin memietic agents such as exenatide
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How does exenatide work?
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It is an incretin mimetic, it activates the GLP-1 receptor to allow for increase insulin secretion from beta cells and decreased glucagon secretion
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What are the most limiting side effects of exenatide?
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the GI side effects. It delays gastric emptying.
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What is a long-acting glucagon-like peptide-1 analog that is new?
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Liraglutide
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In what disease is Liraglutide contraindicated?
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Personal or family history of medullary thyroid CA or MEN2
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Name a diabetes medication other than exenatide that does not cause weight gain.
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Sitagliptin (DPP-4 inhibitor)
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Describe the mechanism of action of Pramlintide
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it is an injection to be used pre-meal with insulin, is a synthetic analog of amylin and it DECREASES GLUCAGON SECRETION
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Can amylin analog Pramlintide be used with ah HA1c > 9%?
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No
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