Nplex 2: Misc Flash Cards

Front 1

What are some drugs according that cause tardive dyskinesia

Back 1

Most of the drugs are neuroleptics and antiemetics:

Prochlorperazine

Metoclopramide

Hydroxyzine

Front 2

If you have a penicillin allergy, which antibiotic group is safe to use

Back 2

macrolides (Azithromycin)

Front 3

Which 2 antibiotics are not suitable for children

Back 3

Fluorquinolones (Ciprofloxacin): Teeth discoloration

Tetracycline (Doxycyclin): Connective tissue effects

Front 4

Along with an anthrax vaccine, which antibiotics are routinely prescribed against an anthrax exposure

Back 4

Fluoroquinolone

Doxycyclin or penicillin

Front 5

Which antibiotic group is prescribed via IV for an acute appendicitis

Back 5

Cephalosporins (cefotaxamine)

Front 6

Which antidepressant causes an increased risk of cardiotoxicity

Back 6

Tricyclic antidepressants: Amitriptyline

Front 7

Which antidepressants should you NOT give to someone experiencing symptoms of mania

Back 7

SSRI's (Fluoxetine) and Atypical heterocyclics (Bupropion)

Front 8

Which 2 antidepressants can cause a hypertensive crisis (not with each other though)

Back 8

Phenelzine with the consumption of cheese and wine (foods containing tyramines, tryptophans)

Amitriptylline with clonidine

Front 9

Which antidepressant has the longest half life

Back 9

Fluoxetine: 48-72 hours

Front 10

Yohimbe is an alpha-2-adrenergic receptor antagnost just like which antidepressant

Back 10

Trazadone

Front 11

Drugs that decrease dopamine have what effect on the pituitary

Back 11

Hyperprolactinemia

(i.e Risperidone)

Front 12

Risperidone causes what potentially fatal condition

Back 12

Torsade de points arrhythmia

Front 13

Which 2 pharmaceutical agents should you avoid if you have a thyroid condition

Back 13

Amiodarone

Lithium (hypothyroidism only)

Front 14

Which pharmaceuticals interact with Lithium

Back 14

Potentiates toxicity: Carmbamazepine and diuretics

Neuroleptics: encephalopathy

NSAIDS and a decreased salt intake also cause toxicity by reducing lithium excretion

Front 15

Which botanical interacts with Buspirone

Back 15

Piper methysticum (Kava Kava)

Front 16

In an emergency disaster, how many days or food/water should you have prepared. How many gallons of water per person

Back 16

3-5 days, 5 gallons of water per person

Front 17

What is the difference between major depressive disorder and dysthymic disorder

Back 17

major depressive disorder is usually episodic (single episode or recurring episodes separated by months), dysthymic disorder has lasted for more than 2 years

Front 18

What determines a good prognosis with a MI

Back 18

Early reperfusion with preserved left ventricular function and no arrhythmias

Front 19

What botanical interacts with Digoxin

Back 19

Glycyrrhiza, depletes magnesium which increases Digoxins toxicity

Front 20

Which botanical is used to treat bradycardia

Back 20

Glycyrrhiza and Rosmarinus (not on BP)

Front 21

What is the treatment for Atrial fibrillation/Atrial flutter

Back 21

Aspirin, warfarin, or heparin and cardioversion with amiodarone. A-Fib/flutter can generate blood clots due to the chaotic rhythm of the atrial contraction

Front 22

What is the treatment for Supraventricular tachyarrhythmia

Back 22

IV magnesium, berbeine, ice to face/chest, amiodarone

Front 23

What are the signs/symptoms of Premature ventricular contraction (specifically, ECG)

Back 23

Early [QRS] (either wide, inverted or upright), opposite T waves, no P waves,

Front 24

What is the treatment for PVC

Back 24

Magnesium, lidocaine (if serious, unresponsive), Beta and Calcium channel blockers

Front 25

How is endocarditis diagnosed and if the patient has a prosthetic heart valve, which Antibiotic do they receive

Back 25

Blood cultures an an ECHO

Vancomycin (IV)

Front 26

Which botanicals interact with Clonidine

Back 26

Mnemonic: Saw DoGGY

Saw palmetto, Dong quai, Ginseng, Garlic, Yohimbe

Front 27

What is the triple antibiotic therapy for H. pylori

Back 27

MAT PP's

2 of these antibiotics (Metronidazole, Amoxicillin, Tetracycline) + a PPI (Omepraxole)

Front 28

Prochlorperazine interacts with which botanicals

Back 28

Dong quai, hypericum, kava, gotu kola, valerian,

Front 29

Phenobarbital depletes what nutrients

Back 29

Vitamin D, Vitamin K, Calcium, Folic acid, Biotin

Front 30

Modafinil interacts with what botanicals

Back 30

Yohimbe and Ephedra

Front 31

Name 2 schedule III drugs

Back 31

Hydrocodone and codeine

Front 32

High doses of mebendazole can cause what toxic disorder

Back 32

Toxic epidermal necrolysis

Front 33

Name 4 schedule II drugs

Back 33

Methylphendidate, Dextroamphetamine, Morphine and Oxycodone

Front 34

If you have this allergy ______ you should not take Celecoxib, Glyburide, Sulfasalazine, prochlorpeazine

Back 34

Sulfa/sulfites allergy

Front 35

Methocarbamol is derived from ____ which is often used as an expexctorant

Back 35

Guaifenesin

Front 36

Which form of Juvenile Rheumatoid arthritis has the poorest prognosis

Back 36

JVA with a polyarticular onset with +RF

Front 37

What are the triad of signs and symptoms of Intussusception, and how is it evaluated

Back 37

Abdominal pain, vomiting and a "sausage-shaped" RUQ mass

Evaluate with a barium enema

Front 38

Subglottic and glottic narrowing with tracheal edges obscured from edema is caused by what condition

Back 38

This is a "Steeples sign" which is characteristic of Croup

Front 39

Thumbprint sign is seen on a lateral cervical plain film for which condition

Back 39

Epiglottitis

Front 40

What is the Jones criteria used to diagnose and what are some of the criterias

Back 40

Acute Rheumatic Fever

Major criteria [CHANCE]

-CHorea

-Arthritis

-Nodules

-Carditis

-Erythema marginatum

DX: 2 major OR 1 major + 2 minor PLUS evidence of a recent strep infection

Front 41

Anti-DNAse-B and an ASOT test are used to diagnose what condition

Back 41

Rheumatic fever

Front 42

Which amino acid is conditionally essential for neonates

Back 42

Arginine

Front 43

Which ortho test is performed to help detect congenital hit dislocation

Back 43

Ortolani's or Barlows: (+) finding is a loud, palpable hip click

Front 44

What is the gold standard for diagnosing pyloric stenosis

Back 44

Abdominal ultrasound

Front 45

Which method definitively diagnoses Hirchsprungs disease

Back 45

Rectal bx

Front 46

Which condition is there a continuous (systole and diastole), "machinery" S2 murmur , bounding peripheral pulses, widened pulse pressure

Back 46

Patent ductus arteriosus

[You patent a machine that bounds up a wide hill lol]

Front 47

If you have an 18 year old female with Turners syndrome with a hx of hypertension and upon evaluation you report that her BP is higher in the upper extremity, diminished femoral pulses, and chest plain films shows an E shaped aorta and cardiomegaly, what is the most likely diagnosis

Back 47

Coarctation of the Aorta

Front 48

A 12 year old male with Downs syndrome presents to your office for a continued care for a common congenital heart defect. As expected, upon auscultation you find a holosystolic murmur 3rd L ICS as well as marked LE edema due to CHF hat he developed before he was 2months old. Which condition does he have

Back 48

Ventricular septal defect

Front 49

Name all of the heart abnormalities associated with a tetralogy of fallot

Back 49

PROVe

1. Pulmonary stenosis

2. Right ventricular hypertrophy

3. Overriding aorta

4. Ventricular septal defect

Front 50

Which amino acids are beneficial for those with Huntingtons, Anorexia and Schizophrenia

Back 50

The branched chain amino acids valine (neurologic dysfunction), leucine (pellagra), isoleucine (muscle tremors)

Front 51

Which amino acid is CI in people with SLE

Back 51

Tryptophan, as it can cause auto-IgG formation. Additionally it may also promote bladder cancer in individuals who are B6 deficienct

Front 52

Which amino acid is CI with antipsychotic drugs......BUT is supportive for the treatment of Schizophrenia

Back 52

Glycine

Front 53

Which amino acid is essential in PKU

Back 53

Tyrosine

Front 54

Which amino acid is found in human milk and helpful in bile production

Back 54

Taurine

Front 55

2G of GABA helps increase what

Back 55

Plasma growth hormone levels

Front 56

What is the richest nontoxic source of isoflavones

Back 56

Pueraria lobata (Kudzu) root

Front 57

Which botanical may exacerbate an AI condition

Back 57

Astragalus membranaceus root

Front 58

This pulmonary botanical contains cardiac glycosides which may potentiate the activity of other cardiac glycoside containing botanicals (i.e digitalis)

Back 58

Asclepias tuberosa

Front 59

Which botanicals cause photosensitivity

Back 59

Furanocoumarins, Ginkgolic acids

ie Ginkgo, Ligustrum porteri, Lomatium dissectum, (spoiled) medicago sativa

Front 60

Botanicals that act as bitter digestive stimulants should not be prescribed to patients with what conditioms

Back 60

Active duodenal ulcers, hyperchlorhydria, GERD, biliary obstruction, acute diarrhea, cholelithiasis

Front 61

Which botanicals may inhibit thyroid function

Back 61

Allium cepa/sativum: Inhibits Iodine uptake

Melissa officinalis

Lycopus virginicus

Front 62

Which part of centella asiatica is used medicinally

Back 62

The whole herb

Front 63

Name all of the botanicals on the BP that contain pyrrolizidine alkaloids

Back 63

Cineraria maritima (dusty miller) leaf

Symphytum officinale

Eupatorium perfoliatum

Eupatorium purpureum

Tussilago farfara

SN: Effort should be made to prevent the extraction of PA's

-Acidic:Lipid

-Alkaline: aqueous

Front 64

Commiphora molmol (myrrh) vs. Commiphora mukul (guggul)

Back 64

molmol: Antimicrobial

mukul: hypolipidemic

Front 65

The anti-cholinergic botanicals interact with what drugs

Back 65

TCA's, amantadine, quinidine, phenothiazine antipsychotics

Front 66

Chroni high doses of equisetum arvense may cause what nutrient deficiency

Back 66

Thiamine

Front 67

What are the drug interactions with Fucus versiculosis

Back 67

Amiodarone, lithium, levothyroxine

Front 68

What are the drug interactions with ganoderma

Back 68

Potentiates reserpine, amphetamine

Theoretical: barbiturates, anticoagulants, statins and immunesuppressants

Front 69

Which part of the botanical is used for Grindelia? Hops?

Back 69

Grindelia= flower bud

Hops= strobile

Front 70

Caution should be used with what botanical whose volatile oil is said to be a "kidney irritative"

Back 70

Juniperus communis- the savin oil of Juniperus is actually the toxic volatile oil that may damage the kidneys

Front 71

What is the only way to efficiently extract tannins

Back 71

Hot aqueous i.e Tea

Front 72

What are 2 methods used to extract volatile oils

Back 72

Steam distillation or solvent extraction

Front 73

Water soluble botanicals

Back 73

Asclepias tuberosa

Uva-ursi

Capsella

Euphrasia

Galium

Gentian

Harpagophytum

Prunus serotina

And laxatives, polysaccharide containing botanicals

Front 74

Cyanogenic glycosides are found in what botanical also containing phytoestrogenic lignans

Back 74

Flax usutatissimum

Front 75

Drugs that cause hypokalemia

Back 75

Diuretics, corticosteroids, antiarrhythmic agents, cardiac glycosides

Front 76

Besides Vitex-agnus-castus, what is another pituitary balancing botanical

Back 76

Verbena officinalis Leaf

Front 77

Miasms

Back 77

Psoric: Itchy vesicles with an odor, anxiety, lacks stamina, >cold, >night

Syphilitic: Chancre, destruction, phobias, tendency to alcoholism

Sycotic [Medorrhinum]: Warts, hypertrophy, water retention, excess

Front 78

When to repeat a homeopathic remedy

Back 78

-Prolonged aggravation with slow improvement

-Proving the remedy

Front 79

New symptoms reappear

Back 79

Retake the case

Front 80

Which lab do you use to assess for gangrene

Back 80

CPK for myonecrosis

Front 81

Which part of the medulla is associated with pheochromocytoma

Back 81

Adrenal Medulla

Front 82

How would you evaluate for Addisons disease

Back 82

Primary Addisons: High ACTH, low urinary cortisol levels

Front 83

How would you evaluate for Hyperandrogenism

Back 83

Urinary 17-ketosteroid and serum DHEA

Serum testosterone

Front 84

What is the dexamethasone suppression test

Back 84

Cushings: High morning cortisol

Normal: Low morning cortiso

Front 85

What are the short acting insulins

Back 85

Think: Short RAIL

Regular Insulin

Aspart

Inhaled (0.05,g/kg body weight, 10min )

Lispro

Dosage: 5-10 units

Front 86

Long acting insulins

Back 86

NPH

Glargine

Detemir (0.1-0.2)

Front 87

Which peripheral insulin sensitizing drug can cause or worsen CHF

Back 87

Rosiglitazone

Front 88

Osteoporosis, Osteopenia and T-scores

Back 88

<1.0 Norma;

T-score 1.0 -- 2.5 defines osteopenia.

T-score >2.5 suggests osteoporosis.

Front 89

How would you evaluate for osteoporosis

Back 89

Elevated urinary N-telopeptide (pagets also)

(nml calcium, pth, phosp tests)

DEXA, or quantitative CT

**Osteopenia only detected by plain films when there is a 30-50% loss

Front 90

How would you evaluate for Pagets disease of bone

Back 90

N-Telopeptide

deoxypyridinoline levels

Complete neuro and MSK exam with gait analysis

(bowlegs)

Plain films: axial skeleton (but thickening of vertebra)

Front 91

What is the sequela of Pagets disease of bone

Back 91

cauda equina syndrome, cranial nerve compression syndrome or nerve root compression syndromes

Gout (increased risk)

CHF (due to hypervascularity)

Front 92

Adverse effects of colchicine

Back 92

Severe diarrhea

Skin sloughing off (IV)

Aplastic anemia (long term)

Front 93

Radiographic findings for Osteomyelitis

Back 93

Subchondral cysts on one side of the joint, sclerosis and buttressing (syndesmophyte formation)

Front 94

SEQ of osteomyelitis

Back 94

Squamous Cell Carcinoma (Marjolins ulcer) or amputation

Front 95

Chest pain? You need to r/o these conditions

Back 95

MI

Cardiac tamponade

Pulmonary embolism

Aortic dissection

Front 96

Pulmonary embolism differentials

Back 96

MI

Costochondritis

Anxiety

Pleurisy

PUD

Aortic aneurysm

Pneumothorax

esophageal disorders

Pericarditis

Front 97

Holosystic murmur

Back 97

Ventricular septal defect

Front 98

RX's for CHF

Back 98

Nitroglycerin

Ace inhibitors

Cardiac glycosides

Beta blockers

Diuretics

Front 99

Botanicals for HTN

Back 99

Rauvolfia

Viscum

Viburnum

Tilia

Veratrum

Front 100

Split S2

Back 100

Atrial septal defect

**also has a pulmonary artery dilation

Front 101

RX's for diverticulitis

Back 101

Cephalosporins + Metronidazole

Front 102

Diarrhea emergency med administration

Back 102

Child: 20ml/kg for 1 hr (nml saline or ringers)

Older Child: 30ml/kg for 1 hr (nml saline or ringers)

Charcoal: 500-1000TID

Front 103

Name all of the bloody diarrheas!

Back 103

Shigella: Can cause meningismus, reiters, conjunctivitis, seizures. Diarrhea with mucus, pus and blood

Yersenia: "appendicitis-like" pain

EHEC (0157:H7): Most common cause of HUS. DX with stool culture and toxin assay.

Campylobacter jejuni: Most common cause of bloody diarrhea. DX stool culture and gram stain "gull wing". Tx with erithromycin. Can cause septic arthritis, conjunctivitis

C. Difficle: Pseudomembranosis colitis

Front 104

Treatment for EHEC and Clostridium perfor.

Back 104

Supportive therapies, NO ANTIBIOTICS

Front 105

Which antibiotic causes prolonged QT and is safe to use in pregnancy and while nursing

Back 105

Erithromycin