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27 Cards in this Set
- Front
- Back
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How to manage HTN in gout patient? What to avoid? |
ARB (losartan) -avoid HCTZ (increases uric acid), lasix |
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Which drugs cause a photosensitivity reaction? |
HCTZ (thiazides) and sulfas |
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Risk of lyme dz in pregnancy? |
no risk to fetus, only spreads via tick no other fluids |
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When should antiarrhythmic meds be used for afib? |
When rate cannot be adequately controlled, recurent episodes of palpitations -if no other heart dz->flecainide -if LVH or hear failure: amiodarone (or dronedarone) -if CAD w/o CHF: sotalol -refractory: radiofreq cath ablation |
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TMT of prolactinoma? |
Cabergoline vs. bromocriptine (don't need transphenoidal surgery unless it is a pituitary adenoma) |
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Nurse stuck with needle: testing for hep B? |
First check titer of HBsAb (indicates prior immune status if vaccinated): if >10, then no postexposure ppx. If <10 or no h/o vaccination-> check HBsAg: if positive: hepB IG and revaccination w/in 12 hours exposure |
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Pregnant women (prior baby was born preterm at 32wks), she had LEEP before then for CIN=? MGMT? |
Cervical insufficiency in pregnancy -serial u/s to evaluate cervical lenght and cerclage placement if short in 2nd trimester |
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Mgmt of post-stroke patient with HTN? |
HTN <185/105 but >140/90 if received TPA (and strict control w/ iv labetalol/nicardipine) -if no tpa: HTN <220/120 if acute ischemic stroke Remember TPA w/in 4.5hrs after CT head w/o contrast |
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After triple drug therapy for h. pylori, what is followup |
rpt fecal antigen or urea breath test after 4 weeks (not serology since ab will be present for a logn time) |
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differentiate baby diaper rash/dermatitis vs. candidal diaper rash? |
Candida invlves crural folds and has tomato-red plaques w/ satellite papules->give clotrimazole cream |
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MGMT of ASCUS or LSIL? |
IF 21-24 YEARS OLD: rpt PAP in 1 year->if negative or same->rpt pap in 1year->if same coloposcopy, if negative->two more pap smears x2 years->once both negative return to normal screening (if ASC-H or HSIL->colpo) IF 25 or greater: reflex HPV DNA testing->if negative rpt pap and HPV in 3 years (if+->colpo) |
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Differentiate Serotonin syndrome from NMS from anticholinergic tox |
Serotonin: AMS, autonomic dysreg (tachy, sweat, febrile, diarrhea, mydriasis), neurmusc hyper (hyperreflexia, rigidity, tremor, ocular clonus): when mix SSRI w/ MAO (phenelzyine, tanylcypromine) NMS: from dopamin agonists: NO hyperreflexia, bradykinesia, lead pipe Antichol: dry skin, flushing, mydriasis, AMS, fever, urinary retention, slow bowels, tachy |
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11mo girl w/ erythematous blanching scaly rash on abdomen and back and face, family hx similar chronci pruritic rash and allergies=? TMT? |
Atopic Dermatitis (eczema) -causes by heredity, low humidity) -tmt with topical emollients and/or steroid top |
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53yo F w/ 6mos pain/tightness in neck, posterior shoulders, butt worse with exertion, stress, and lack of sleep, has point tenderness and symmetric, normal strength/reflexes=? Testing? TMT? |
Fibromyalgia (must have sx >3mos, normal inflamm markers) -ESR, CBC, THYROID STUDIES 1. lifestyle change w/ aerobic exercise and sleep hygeine 2. TCA or SNRI |
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Patient with asx pulm sarcoidosis TMT? |
No therapy (even if has erythema nodusum and hilar adenopathy) since high rate of spontaneous remission (only if sx then treeat with steroids to prevent dz progression) |
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What are the findings of a cardiac tamponade? |
Beck's Triad: JVD, hypotension, diminished heart sounds/muffled, pulsus paradoxus (inspiratory decrease systolic bp >10) -EKG low voltage QRS complex, electrical alternans -CXR: enlarged cardiac silhouette, water bottle shape -echo w/ RA and RV collapse in diastole |
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What are the guidelines for HTN? |
if Age >60: start tmt at >150/90 w/ goal less than that if age <60, CKD, or DM: start at >140/90 w/ goal less -if black: thiazide or CCB alone or in combo -all others: ACEi or ARB first line |
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What does strict glycemic control do? |
no change macrovascular complications (MI, storke), possible decrease in long term -decrease in microvasc: nephropathy and retinopathy -no change in mortality a1c 6-7, but increase mortality <6 |
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TMT of hyponatremia? |
If symptomatic or severe (<115): correct at 1.5-2mEq per hour for first 3 hrs w/ hypertonic 3% NS (don't let is raise more than 12 in 24hrs though) -oetherwise do 0.9NS |
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Meconium ileus is pathomnenomic for? Findings on XR inheritance? |
Cystic fibrosis (will see dilated gas filled SB loops w/ absent air fluid levels, and GROUND GLASS MASS in R abdomen -Autosomal recessive ask for family hx of recurrent infxns |
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What is unique history in pyloric stenosis? |
they are usually firstborn males |
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Duodenal atresia is associated with what? |
Down's syndrome and polyhydramnios |
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What counseling to patient with Marfan's? |
Avoid strenuous exercise, cross country running |
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Define hypoglycemia? |
glucose <60 |
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TMT of SVT? |
1. IV adenosine or vagal maneuver (carotid sinus massage/vasalva) to unmask the p wave and determine cause of SVT (since can include sinus tach, AVNRT, afib, aflutter) |
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What SPF when? |
SPF 15 for regular daily use SPF 30 for outdoor activites/recreation/constant work |
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22yo M w/ swelling mass on neck in front of hyoid that moves with protrusion of tongue=? |
Thyroglossal duct cyst -do CT scan to delineate it or u/s or thyroid nuclear scan -then excise/surgery |
