Usmle Step 3 Hy Deck 2

Front 1

Rat bite fever Rx

Back 1

Penicillin G or tetracycline

Front 2

Post chemo fever Rx

Back 2

hospitalize ---> broad spectrum abx (Augmentin or cipro) ---> if no response: antifungal

Front 3

Bacteremia in a baby

1) Rx
2) Bugs you are trying to cover

Back 3

Rx = ampicillin + cefotaxime

Coverage: Group B strep, Listeria, E. coli

Front 4

Hep. B window period, what do you check?

Back 4

Core Ag and IgM Ab +

Note surface antigen and surface antibody cancel each other out and can not be used for detection in window period

Front 5

Which generation of antibiotic is cefaDROXIL (Duricef)

Back 5

First Generation Cephalosporin

Front 6

Which generation of antibiotic is cefaLEXIN (Keflex)

Back 6

First Generation Cephalosporin

Front 7

Which generation of antibiotic is cefaLOTIN (Keflin)

Back 7

First Generation Cephalosporin

Front 8

Which generation of antibiotic is cefaZOLIN (Ancef)

Back 8

First Generation Cephalosporin

Front 9

Which generation of cephalosporin?
cefaDROXIL
cefaLEXIN
cefaLOTIN
cefaZOLIN

Back 9

First generation

Front 10

Second generation antibiotics w/o anerobic coverage

Back 10

ceFALCOR (Keflor)
ceFUROXIMINE (Zinacef)

Front 11

Second generation Cephalosporin with anerobic coverage

Back 11

cefoTETAN
ceFOXITIN

Front 12

Which generation of antibiotic is cefoTETAN

Back 12

Second generation antibiotics with anaerobic coverage

Front 13

Which generation of antibiotic is ceFOXITIN

Back 13

Second generation antibiotics with anerobic coverage

Front 14

ceFIXIME
cefoTAXIME

Back 14

Third generation cephalosporin w/o psuedomonal coverage

Front 15

Thrid generation cephalosporins w/ antipseudomonal coverage

Back 15

cefoPERAZONE (Cefobid)
cefTAZIDIME (Fortaz)

Front 16

Methylene chloride (paint remover) intox. can cause?

How do you detect it?

Back 16

carbon monoxide poisoning

Use CO-oxymeter

Front 17

CD4 < 200...Next Step?

Back 17

PCP prophylaxis with TMP/SMX, pentamidine (esp for pregnant women), dapsone or atovaquone

Front 18

CD4 < 50 ...Next Step?

Back 18

MAI prophylaxis = azithromycin weekly

Front 19

Toxo Ig G + and CD4 < 100 ... Next Step

Back 19

TMP/SMX OR dapsone + pyrimethamine + leucovorin (folinic acid)

Front 20

TB contact OR PPD > 5 mm + HIV

Back 20

INH + vit B6 for 9 m

Front 21

Vaccines to give HIV patient

Back 21

Pneumococcal q 5 y.
Influenza q 1 y.
Hepatitis B

Front 22

Mefloquine S.E.
Is an anti-malarial used for prophylaxis and treatment (2nd line to chloroquine)

Back 22

Bradycardia
Neuropsychiatric symptoms
Prolonged QT

Front 23

Causes(6) of avascular necrosis of femoral head and how to dx?

Back 23

Causes:
Pancreatitis
Alcoholism
Fat embolus
Sickle cell anemia
Air emboli
Steroids

Dx = MRI, SPECT

Front 24

Pyogenic granuloma Rx

Back 24

shave, electrodesiccate base, send it to pathology for evaluation

Front 25

Osler-Weber-Wendu

aka Hereditary Hemorrhagic Telangiectasia

Back 25

Epistaxis

+ GI bleeding,

+ Polycystic kydneys

Front 26

Von-Hippel-Lindau dis.

Back 26

Cavernous hemangiomas (blood vessel tumor - does not regress unlike capillary hemangiomas)

+ Hemangioblastomas in CNS & retina,

+ Renal cell ca

Front 27

Sturge Weber Syndrome Symptoms(3)

Back 27

facial port wine stain

+seizure

+ocular changes

Front 28

Caplan syndrome

Back 28

Rheumatoid nodules in the lungs (RA + pneumoconiosis)

Rx: steroids, if unresponsive DMARDs

Front 29

Felty syndrome

Back 29

splenomegaly

+neutropenia

+severe R.A.

Front 30

Ash leaf macules (hypopigmented), calcified intracranial nodules, cortical tubers, epilepsy, low inteligence, adenoma sebaceum

Back 30

Tuberous sclerosis

Front 31

Chronic pruritic papulovesicular lesions on extensor surfaces, posterior hairline

Name?

Treatment?

Back 31

Dermatitis herpetiformis, associated with celiac disease

Rx = Dapsone

Front 32

Pemphigus vulgaris Rx

Back 32

Rx = immediate high dose corticosteroid

Nikolsky positive

Front 33

Vitiligo Rx

Back 33

Topical Steroids and Phototherapy

Front 34

Blistering in a sun exposed area + milia

Name?

Dx?

Back 34

Porphyria cutanea tarda

Dx = urine prophirin level + hepatitis panel

Front 35

Hypertensive urgency in pregnancy Rx

Back 35

Hydralazine & Labetalol

Front 36

Aortic dissection rx?

Back 36

Nitroprusside + labetalol/metoprolol

Front 37

Achantosis nigricans causes (4)

Back 37

DM
Hypothyroidism
Cushing's
Addison's
Malignancy (gastric carcinoma)
PCOS

Front 38

Vascular tumor, purplish lesions, extravasation of erythrocytes

Back 38

Kaposi Sarcoma

Front 39

Pseudoclaudication + worse with hyperextending movements + better with leaning forward + normal ankle-brachial index

Name?
How to Dx?

Back 39

Lumbar stenosis

Dx = MRI of the lumbar spine

Front 40

Knee ligament injury Dx

Back 40

MRI

Front 41

Erythema Nodosum rx

Back 41

NSAID

Front 42

Melanoma suspicion, next step?

Back 42

Excisional biopsy

Front 43

Miliaria is?

Back 43

Heat rash

Front 44

Name of disease?

Cause?

Treatment?

Back 44

Erythema multiforme minor

Herpes Simplex

Rx: Acyclovir

Front 45

Indinavir (HIV drug) S.E.

Back 45

Kidney Stones

Front 46

Painless, beefy-red lesion

Diagnoses?

Rx?

Back 46

Granuloma inguinale (caused by klepsiella granulomatis)

Rx: TMP/SMX

Front 47

In pheochromocytoma, serotonin syndrome, cocaine Rx?

Back 47

IV phentolamine (alpha 1 blocker - causes vasodilation to lower BP)

Front 48

Doxorubicin (Adriamycin) S.E.

Back 48

cardiac toxicity, myelosuppression

Front 49

Vincristine S.E.

Back 49

motor, sensory and autonomic neuropathy

Front 50

Bleomycin S.E.

Back 50

pulmonary fibrosis

Front 51

Nephritic syndrome + eosinophilia + asthma, p-anca

Disease Name?

Rx?

Back 51

Chrug-Strauss

Rx = steroids, cyclophosphamide, azathioprine

Front 52

Nephritis + Nasal/sinus problems, C-ANCA

Name?

Rx?

Back 52

Wegener granulomatosis

Steroids, Cyclophosphamide, Azathioprine

Front 53

Sarcoidosis Dx =

Back 53

Skin (except for erythema nodosum), Transbronchial lung biopsy

Front 54

How do you decrease risk of aspiration risk during intubation?

Back 54

Cricoid pressure

Front 55

Community acquired pneumonia Rx =

Back 55

Azithromycin OR Levofloxacin

Front 56

Sup. vena cava syndrom due to ca (bronchogenic) Rx?

Back 56

radiation therapy

Front 57

Foreign body aspiration in children Rx?

Back 57

Rigid bronchoscopy
Methylprednisolone
CefaZOLIN

Front 58

Gout Rx
-Over Producers
-Undersecreters?

Back 58

Overproducers = allopurinol

Underexcreters = probenecid

Not for acute gout

Front 59

Cauda equina syndr. suspicion =

Back 59

MRI ASAP!

Front 60

Rash + Joint Pain + 7th Nerve Palsy.... Treatment?

Back 60

Doxycycline or Amoxicillin

Front 61

Cardiac Manifestations or Meningitis or Encephilitis in Lyme Rx?

Back 61

IV Ceftriaxone

Front 62

Weeping, crusting, oozing and draining of skin Rx?

MRSA Rx?

Back 62

Impetigo

Regular Rx: Topic Mucoporin / Bactrin

MRSA: Clindamycin or TMP/SMZ or Deoxycycline

Front 63

Leukocytosis, fever, chills, red hot swollen tender on face.

Diagnosis?

Rx?

Back 63

Diagnosis: Erysipelas (Strep pyogenes)

Treatment:
Oxacillin, CLOX, Dicloxacillin, Naficillin

Front 64

Red hot swollen tender on legs

Diagnosis?
Rx?

Back 64

Diagnosis: Cellulitis

Rx: Oxacillin, Cloxacillin, Dicloxacillin, Naficillin

Front 65

Abscess rx?

Back 65

Oxacillin, CLOX, Dicloxacillin, Naficillin

Front 66

MRSA patients with Erysipelas, Cellulitis or Folliculitis Rx?

Back 66

Vancomycin
Linezolid
Daptomycin
Tigecycline

Front 67

NO MUCUS Involvement! Caused by drugs. Diagnosis?

What do you rule out?

Rx?

Back 67

Diagnosis: Erythema Multiforme

R/o Herpes and mycoplasma

Rx: Prednisone

Front 68

Drugs(5) that cause rash

Back 68

Penecillin

Sulfa Drugs

Allopurinol

Phenytoin

Lamotrigine

NSAID

Front 69

Involves mucus membrane. Drug induced.

Diagnosis?
Rx?

Back 69

Steve-Johnson Syndrome

Rx? IVIG, cyclophosphamide, cyclosporine

Front 70

S.E of Cyclophosphamide

Back 70

Hemorrhagic Cystitis (treat with Mesna)

Front 71

Cisplatin S.E.

Back 71

Ototoxicity, Nephrotoxicity

Front 72

Bleomycin S.E.

Back 72

Pulmonary Fibrosis

Front 73

Vincristine S.E.

Back 73

Peripheral Neuropathy

Front 74

MEN I

Back 74

Pancreatic Tumor
Pituitary Adenoma
HyperParathyroidism

Front 75

MEN IIa

Back 75

Medullary Thyroid Cancer
Adrenal (Phechromocytoma)
Parathyroid Hyperplasia

Front 76

MEN IIb (III)

Back 76

Medulary Thyroid Cancer
Adrenal Pheochromocytoma
Neuroma Mucosal/ Marfanoid

Front 77

PPPirates MAP MAN

MEN I, MEN IIa, MENIIb

Back 77

Pancreatic Tumor
Pituitary Adenoma
HyperParatyhroidism

Medullary Thyroid Cancer
Adrenal Phechromocytoma
Parathyroid Hyperplasia

Medulary Thyroid Cancer
Adrenal Pheochromocytoma
Neuroma Mucosal/ Marfanoid

Front 78

S.E of Statins?

What must you regular check

Back 78

Myositis, Elevated Transaminases

Must constantly check AST/ALT, NOT CPK!

Front 79

S.E of NIACIN?

Back 79

Glucose Intolerance

Elevated Uric Acid

Puritis and erythema (take aspirin)

Front 80

Gemfibrozil S.E. and must be careful co-prescribing with?

Back 80

Increased risk of Myositis when combined with Statin

Front 81

Eiosinophil Casts

Back 81

Allergic Interstetial Nephritis

Front 82

White Casts

Back 82

Pyelonephritis

Front 83

Red Casts

Back 83

Glomerulonephritis

Front 84

Granular Muddy Brown Cast

Back 84

Acute Tubular Necrosis

Front 85

Hyaline Cast

Back 85

Dehydration

Front 86

Broad/Waxy Cast

Back 86

Chronic Renal Disease

Front 87

Mortality Benefit Drugs in CAD

Back 87

B-Blocker
Aspirin
Nitroglycerine
Statins
ACEI

Front 88

Mortality Benefit Drugs in Systolic Dysfunction CHF

Back 88

ACE/ARB
B-Blocker
Spirnolactone
Hydralazine/Nitrates
Implantable Defibrillators

Front 89

Mortality Benefit Drugs in Diastolic Dysfunction CHF

Back 89

B-Blocker
Diuretics

Front 90

CHF Defibrillators Indications

Implatable?

Biventricular?

Back 90

Implanatable: EF<35%

Biventricular: EF<355 & QRS>120ms

Front 91

Diagnosis?

Treatment?

Back 91

Myelofibrosis

Thalidomide/Lenalidomide

Front 92

Angioedema treatment

Back 92

1) Intubate

2) Fresh Frozen Plasma

3) Danzol or Stanzol

Note: Glucocorticoids DONT work

Front 93

Rx for Staph Aureus endocarditis?

Back 93

Oxacillin, Nafacillin, Cefazolin

Front 94

Viridans Endocarditis Rx?

Back 94

Ceftriaxone

Front 95

HACEK Endocarditis Rx?

Back 95

Ceftriaxone

Front 96

Enterococci Endocarditis Rx?

Back 96

Ampicillin & Gentamycin

Front 97

Pear shaped CXR

Back 97

Pericardial effusion (Rx - cardiocentesis)

Front 98

Boot shaped heart CXR

Back 98

Tetralogy of Fallot