Term
| First line tx for Dysmenorrhea? |
|
Definition
|
|
Term
| Second line tx for Dysmenorrhea? |
|
Definition
| Mefenamic acid, Progestin-containing IUD |
|
|
Term
| Leading cause of absenteeism in women <30y/o? |
|
Definition
| pelvic pain occurring around menses |
|
|
Term
|
Definition
| HiB, strep pyogenes, strep pneumo, staph aureus, |
|
|
Term
| 3 y /o pt presents with stridor, labored breathing, dysphagia, drooling, he is anxious and is in the tripod position. What condition do you suspect? |
|
Definition
|
|
Term
| What is the general treatment for epiglottitis? |
|
Definition
Intubate all pts and Admit to ICU
Empiric Anti-microbial therapy |
|
|
Term
| First-line treatment for epiglottitis? |
|
Definition
| Cefotaxime or Ceftriaxone or Ampicillin/Sulbactam |
|
|
Term
| Second-line treatment for Epiglottitis? |
|
Definition
| Ampicillin and Chloramphenicol |
|
|
Term
| An AA male pt presents with a pustular rash on their chin and jaw line. There are multiple small pustule lesions with an erythematous base and a hair through the center. What condition do you suspect? |
|
Definition
|
|
Term
| MC pathogenic cause of Folliculitis? |
|
Definition
Staph Folliculitis
MRSA
Pseudomonal |
|
|
Term
| How is Staph folliculitis treated? |
|
Definition
| Mupirocin or Dicloxacilin |
|
|
Term
| Tx for MRSA folliculitis? |
|
Definition
|
|
Term
| If folliculitis is severe or persistent, what anti-biotic should you use? |
|
Definition
|
|
Term
| What are AA male pts particularly susceptible to due to their hair type? |
|
Definition
| pseudofolliculitis barbari, folliculitis |
|
|
Term
| Pt c/o bloating and belching with abdominal pain, what condition might you suspect? |
|
Definition
|
|
Term
| What gastritis condition is usually due to a defective pylorus, protracted exposure to bile or pancreatic juice? |
|
Definition
|
|
Term
| What gastritis condition is described as a stress ulceration or rxn to a hemodynamic d/o? |
|
Definition
|
|
Term
| What is infectious gastritis commonly due to? |
|
Definition
|
|
Term
| What are the risk factors for gastritis? |
|
Definition
H. pylori
NSAIDs
>60y/o
exposure to alcohol, chemical, drugs |
|
|
Term
| Pt presents with mild epigastric pain, c/o bloating and belching, and urea breath test is positive. What condition do you suspect? |
|
Definition
|
|
Term
| What is the confirmatory test for gastritis? |
|
Definition
|
|
Term
| First-line tx for gastritis? for H. pylori? |
|
Definition
H2 blocker or PPI
H. Pylori: triple therapy = PPI + Clarithromycin + Metronidazole |
|
|
Term
| Pt presents with urethritis, copious d/c, urinary urgency and frequency as well as dysuria. On further testing you find gram-neg diplococci. What is your first-line tx? |
|
Definition
|
|
Term
| A pregnant pt presents with gonorrhea, what is the TOC? |
|
Definition
|
|
Term
|
Definition
| Ceftriaxone + Doxycycline |
|
|
Term
| A 17 y/o male present with c/o a sore throat following a (oral) sexual encounter. How can you confirm it's gonorrhea? |
|
Definition
| Gram stain = Gram neg diplococci |
|
|
Term
What med is contraindicated in pregnancy?
a) Ceftriaxone
b) Erythromycin
c) Tetracycline |
|
Definition
|
|
Term
What med is contraindicated in pregnancy?
a) Ceftriaxone
b) Erythromycin
c) Doxycycline |
|
Definition
|
|
Term
| Why is tetracycline contraindicated in children? |
|
Definition
| Tetracycline causes discoloration of teeth |
|
|
Term
| What is a dietary contraindication when taking indomethicin? |
|
Definition
|
|
Term
| 1st line tx for acute gouty attack? |
|
Definition
|
|
Term
| 1st line tx for chronic gout? |
|
Definition
| Allopurinol (decreases serum uric acid levels) |
|
|
Term
| If pt with chronic gout has renal impairment, what is the 1st line tx? |
|
Definition
| Febuxostat (xanthine oxidase inhibitor) |
|
|
Term
| 2nd line tx for an acute gouty attack? |
|
Definition
| colchicine or triamcinolone (kenalog) or prednisolone |
|
|
Term
| What lab can help identify gout? |
|
Definition
| elevated serum uric acid levels |
|
|
Term
| 2nd line tx for chronic gout? When should they be used? |
|
Definition
| Uricosuric agents (Probenecid or Sulfinpyrazone - Use if refractory/allergic to allopurinol |
|
|
Term
| What supportive care can be given in an acute gouty attack? |
|
Definition
|
|
Term
| Are cluster HA more predominant in males or females? |
|
Definition
|
|
Term
| First line tx for Cluster HA acute attack? |
|
Definition
| Vasocontrictor - O2 and Zolmitriptan |
|
|
Term
| 2nd line tx for Cluster HA acute attack? |
|
Definition
|
|
Term
| What separates a cluster HA from a migraine? |
|
Definition
Migraines are bilat, have photophobia, aura and throbbing
Cluster HA are unilat, w/out photophobia |
|
|
Term
| What are the SE of Zolmitriptan? |
|
Definition
|
|
Term
| A 28y/o male presents to the ER with excruciating unilateral sharp pain that has lasted for approximately 30 min and awoke him from his sleep tonight. This has occurred previously this week, but it lasted for only 20 min and then went away. With the episodes he noticed that his nose ran and his eye watered on the same side as his pain. What condition do you suspect? What is your initial treatment for an acute attack? |
|
Definition
| Cluster HA; O2 and zolmitriptan |
|
|
Term
| What is the diagnostic criteria for Cluster HA? |
|
Definition
At least 5 attacks (severe unilateral orbital, supraorbital, or temporal pain lasting 15–180 minutes)
w/one of the following:
Conjunctival injection or lacrimation, eyelid edema
Ipsilateral nasal congestion and/or rhinorrhea
Forehead or facial sweating
Ipsilateral miosis or ptosis |
|
|
Term
| What is the 1st line tx for prophylaxis of a Cluster HA? |
|
Definition
|
|
Term
| 2nd line tx for an acute attack of cluster HA? Adverse effects of this tx? |
|
Definition
| Lidocaine 4% intranasally - AE = lightheadedness, nervousness |
|
|
Term
| What is the most accurate test to determine if herpes virus is present in fluid? |
|
Definition
|
|
Term
| What are the possible SE from anti-virals used to treat genital herpes? |
|
Definition
| Fatigue, Headache, Nausea and vomiting, Rash, Seizures, Tremor |
|
|
Term
| What med can be used in post-herpetic neuralgia to assist with pain management? |
|
Definition
|
|
Term
| How can you differentiate Chicken pox from a reactivation of herpes zoster? |
|
Definition
| herpes zoster follows along a dermatome (can be bilat) |
|
|
Term
| What can be ordered to diagnose herpes zoster reactivation? What will you see? |
|
Definition
Tzank smear, PCR analysis
multinucleated giant cells with intralesional inclusion, lymphatic infiltration of sensory ganglia with focal hemorrhage and nerve cell destruction |
|
|
Term
| What can secondary bacterial infections of herpes zoster reactivation be treated with? |
|
Definition
| Silver sulfadiazine topically or systemic antibiotics |
|
|
Term
| What OTC can be used to diminish the burning and itching associated with herpes zoster reactivation? |
|
Definition
| Calamine lotion or colloidal oatmeal |
|
|
Term
| What can be used to prevent herpes zoster reactivation? Who should it be used in? |
|
Definition
|
|
Term
| What condition is described as chronic inflammatory dermatosis that primarily affects intertriginous areas? |
|
Definition
|
|
Term
| What areas of the body are affected by HIDRADENITIS SUPPURATIVE? |
|
Definition
| axillae, groin, peritoneum, and inframammary region |
|
|
Term
| A 26 y/o female pt present with a firm, painful nodule in her groin region. The nodule began as tenderness and itching in her groin. She is currently menstruating. What condition do you suspect? How do treat this condition (in general)? |
|
Definition
| HIDRADENITIS SUPPURATIVE; Oral antibiotics |
|
|
Term
| What oral antibiotics are used for hidradenitis suppurative? |
|
Definition
Tetracycline
Doxycycline
Minocycline
Amoxicillin |
|
|
Term
| During Hurley stage 1 of hidradenitis suppurative what is the treatment? |
|
Definition
| Topical antibiotic of antibacterial |
|
|
Term
| During Hurley stage 2 or 3 of hidradenitis suppurative what is the treatment? |
|
Definition
| Oral antibiotics + topical antibiotics |
|
|
Term
| What general lifestyle changes can help prevent hidradenitis suppurative? |
|
Definition
Smoking cessation
Weight Loss reduces severity
Loose fitting clothing
Cool environments |
|
|
Term
| What can be used to assess the MI risk of a pt? |
|
Definition
|
|
Term
| What level of total serum cholesterol is considered hypercholesterolemia? |
|
Definition
| Serum Cholesterol > 200 mg/dl |
|
|
Term
| What are the cardiac risk factors? |
|
Definition
Smoking
HTN
Age (Men > 45y/o; Women>55y/o)
HDL <40mg/dl
MI or Stroke in 1st degree relative |
|
|
Term
| What lifestyle mods can be used to reduce cholesterol? |
|
Definition
Less fat intake (higher intake of HDL)
Regular Activity |
|
|
Term
| 1st line meds for hypercholesterolemia? |
|
Definition
| Statins - Fluvastatin, Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin |
|
|
Term
| What are the contraindications to statin use? |
|
Definition
Active or Chronic Liver Disease
Pregnancy/Breastfeeding |
|
|
Term
| What meds can interact with statins and possibly increase the risk of Myositis? |
|
Definition
|
|
Term
| 2nd line tx for hypercholesterolemia? |
|
Definition
Ezetimibe, Cholestyramine, Colestipol, Colesevelam
Niacin - Increases HDL (Don't use with diabetics)
Gemfibrozil and Fenofibrate (don't use with statins) |
|
|
Term
| What type of monitoring should be done with statin use? |
|
Definition
| Monitor lipid panel every 6 - 8 wks until goals are met |
|
|
Term
| What BP is considered Pre-HTN? |
|
Definition
120 - 139 systolic
80 - 89 diastolic |
|
|
Term
| What BP is considered stage 1 HTN? |
|
Definition
140 - 159 systolic
90 - 99 diastolic |
|
|
Term
| What BP is considered stage 2 HTN? |
|
Definition
>160 systolic
>100 diastolic |
|
|
Term
| What is medicine selection when treating HTN based on? |
|
Definition
| concomitant conditions and other meds |
|
|
Term
|
Definition
| Thiazide diuretics, ACE inhibitors, ARBs, Renin Inhibitor, CCB, B-blockers |
|
|
Term
| What conditions can diuretics worsen? |
|
Definition
|
|
Term
| In what conditions should beta-blockers not be used? |
|
Definition
| Reactive airway dz (asthma, COPD), heart block, bradycardia, diabetes and peripheral vascular dz |
|
|
Term
| In what conditions should diltiazem or verapamil be used with caution in? |
|
Definition
| heart failure or heart block |
|
|
Term
| What disease can ACEI worsen? |
|
Definition
| bilateral renal vascular disease |
|
|
Term
| How often should a HTN pt be monitored? What labs should be done at least once a year? |
|
Definition
| every 3 - 6 mon; U/A, Cr and K |
|
|
Term
| What med can be given to tx influenza? In what populations should this med be given? What is the time frame for giving it? |
|
Definition
| Tamiflu; elderly or those at a higher risk of complications; Given if pt has had sx for less than 48hrs |
|
|
Term
| When is f/u with the flu needed? |
|
Definition
| Pts with risk factors should follow up in 2-3 days, particularly those with pulmonary diseases |
|
|
Term
| What is the general tx for interstitial cystitis? |
|
Definition
No definitive treatment- pharmacological therapy is aimed at managing sx
Biofeedback bladder training |
|
|
Term
| What meds are used in the tx of interstitial cystitis? |
|
Definition
Oxybutynin (decreases frequency)
Doxepin (decreases frequency) |
|
|
Term
| What conditions are contraindications for oxybutynin use? What conditions should oxybutynin be used with caution? |
|
Definition
CI - Acute angle glaucoma
Used w/caution in - Urinary retention, hepatic/renal impairment, bladder obstruction, GERD, HTN, cardiac dz, hyperthyroidism |
|
|
Term
| What are the contraindications of Doxepin? |
|
Definition
glaucoma, urinary retention, acute recovery MI
(also avoid abrupt withdrawl) |
|
|
Term
| What are the causes of IBS? |
|
Definition
| Increased stress, motor abnormalities, visceral hypersensitivity, post-gastroenteritis/infection, |
|
|
Term
|
Definition
diarrhea - Immodium
constipation - Milk of Magnesia/Metamucil etc |
|
|
Term
| What home remedies can be used in the tx of IBS? |
|
Definition
| peppermint, herbs, acupuncture, hypnosis etc |
|
|
Term
|
Definition
| Loperamide or SSRIs (ex. Alosetron) |
|
|
Term
| What is the treatment for constipation IBS? |
|
Definition
Methscopolamine (anti-cholinergics)
Milk of Magnesia (Osmotic laxatives)
Lubiprostone |
|
|
Term
| What are most cases of laryngitis associated with? |
|
Definition
|
|
Term
| What condition is described as inflammation, erythema and edema of the mucosa of the larynx and/or vocal cords? |
|
Definition
|
|
Term
| Pt presents with hoarseness, that began with throat tickling, fever, dysphagia and mild cough. What condition do you suspect? |
|
Definition
|
|
Term
| What are some underlying causes of pharyngitis? |
|
Definition
Viral infections
misuse or abuse of voice
bacterial infections (rare)
fungal infections (rare)
inhaling irritating substances
aspiration of caustic chemicals
GERD
inhaled steroids (such as those used in asthma tx)
vocal cord nodules
retropharyngeal abscess
neuromuscular d/o (ex. myasthenia gravis)
2ndary Syphillis left untreated
leprosy
laryngeal TB |
|
|
Term
| What is the general treatment for an uncomplicated acute case of laryngitis? |
|
Definition
| usually self-limiting, vocal rest, avoid smoking and alcohol, use cool mist humidifier, increase fluid intake, use steam inhalations |
|
|
Term
| What are the 1st line tx for laryngitis? |
|
Definition
| Analgesics, antipyretics and cough suppressants |
|
|
Term
| What are the 2nd line tx for laryngitis? |
|
Definition
inhaled corticosteroids (allergy induced)
PPI (GERD)
Fluconazole (candidal laryngitis) |
|
|
Term
| What are some CAM tx for laryngitis? |
|
Definition
| Echinacea, eucalyptus, hot lemon and honey tea, vitamin C and zinc |
|
|
Term
| What is the MCC of laryngotracheobronchitis? |
|
Definition
| Croup is MC caused by viral respiratory infection (parainfluenza is MC pathogen, adenovirus, RSV and rhinovirus) |
|
|
Term
| What imaging can be done to verify a dx of laryngotracheobronchitis? What do they show? |
|
Definition
| PA and lateral neck X-ray; show "steeple", "hourglass" or "pencil point" sign |
|
|
Term
| Is mild laryngotracheobronchitis an inpatient or outpatient? |
|
Definition
|
|
Term
| Main general tx for mild croup? |
|
Definition
Keep child calm (limit amt of tests and procedures)
Cool dry air helps open airway
Fluid intake increased |
|
|
Term
|
Definition
| Nebulized epinephrine (0.05ml/kg/dose) and dexamethasone (IM usually) |
|
|
Term
| When should a croup pt be admitted? |
|
Definition
| If signs of respiratory distress |
|
|
Term
| What is the best way to prevent the transmission of croup? |
|
Definition
Wash hands
Parainfluenza vaccination |
|
|
Term
| What is the mainstay tx for low back pain? |
|
Definition
|
|
Term
| What meds can be used in the tx of low back pain after NSAIDs? |
|
Definition
Muscle relaxants
Opioid Analgesics (can be considered)
Steroids |
|
|
Term
| What are the SE of Opioids? |
|
Definition
dependance
sedation
constipation
decreased rxn time
nausea
cloudy judgement |
|
|
Term
| In what type of low back pain would steroids be most useful? |
|
Definition
|
|
Term
| What pathogen causes Lyme disease? |
|
Definition
|
|
Term
| What is the vector for borrelia burgdorferi? |
|
Definition
| ticks - MC tickborne infection in the US and Europe |
|
|
Term
| What are the S & S of a disseminated Lyme infection? |
|
Definition
| facial palsies, joint pain, orchitis, hepatitis, iritis, pericarditis, > 1 organ involvement |
|
|
Term
| What is the 1st line tx for Erythema migrans? |
|
Definition
Doxycycline (CI in pregnant or breastfeeding females and children)
Amoxicillin |
|
|
Term
| When should a pt with lyme disease be admitted? |
|
Definition
| When infection has complications such as carditis or meningitis |
|
|
Term
| 2nd line tx for Lyme disease? |
|
Definition
|
|
Term
| If a pregnant pt presents with erythema migrans, what should the tx be? |
|
Definition
| Parenteral Amoxicillin or Erythromycin |
|
|
Term
| What is the MC complication of acute otitis media? |
|
Definition
|
|
Term
| What is chronic mastoiditis usually associated with? |
|
Definition
| cholesteatoma or chronic ear dz |
|
|
Term
| If acute otitis media persist for more then 2 weeks, what should you suspect? |
|
Definition
|
|
Term
| What imaging is characteristic of mastoiditis? |
|
Definition
| clouding of mastoid air cells or coalescence of air cells |
|
|
Term
| What are the MC pathogens causing mastoiditis? |
|
Definition
Strep pneumo
Strep pyogenes
Grp A B-Strep
Staph aureus
M catarrhalis
H influenza
Pseudomonas aeruginosa (becoming more prevalent) |
|
|
Term
| What is the general tx for mastoiditis? |
|
Definition
| admit, IV antibiotics, ENT referral |
|
|
Term
| What is the general tx for mastoiditis? |
|
Definition
| admit, IV antibiotics, ENT referral |
|
|
Term
| 1st line tx for acute Mastoiditis? |
|
Definition
| IV 3rd generation Cephalosporin (Rocephin) |
|
|
Term
| 1st line tx for chronic mastoiditis? |
|
Definition
|
|
Term
| If mastoiditis is chronic or unresponsive to antibiotic tx, what should be suspected? How should it be treated? |
|
Definition
| Psuedomonas inf; Tx with Zosyn piperacillin/tazobactam |
|
|
Term
| When are the precautions of use of Rocephin in adults? |
|
Definition
| Adjust dose if renal impairment is present |
|
|
Term
| What must be monitored with Zosyn? |
|
Definition
| baseline and periodic monitoring of CBCs and LFTs |
|
|
Term
| 2nd line drug for mastoiditis? |
|
Definition
|
|
Term
| What is a complication of using Clindamycin? |
|
Definition
|
|
Term
| 17y/o pt presents with fever, HA, nuchal rigidity, altered mental status, petechiae or purpuric rash, and Kernig's/Brudzinski's sign. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with fever, nuchal rigidity, altered mental status. What condition do you suspect? |
|
Definition
|
|
Term
| Which is more life threatening, viral or bacterial meningitis? How can you differentiate between the two? |
|
Definition
| Bacterial (true emergency); CSF fluid analysis |
|
|
Term
| What are the MC bacterial pathogens causing bacterial meningitis? |
|
Definition
| H. influenza, N. meningitidis, S. pneumo |
|
|
Term
| Treatment for bacterial versus viral meningitis? |
|
Definition
Bacterial - Antibiotics
Viral - Supportive tx |
|
|
Term
| What condition is described as excessive menstrual flow? |
|
Definition
|
|
Term
| What are some causes of menorrhagia? |
|
Definition
Hypothyroidism
Endometrial proliferation/excess/hyperplasia
local factors (abnormal hormone levels, polyps, fibroids)
Coagulation d/o |
|
|
Term
| First-line med should be used for control of acute menorrhagia with SEVERE bleeding? |
|
Definition
|
|
Term
| First-line med for acute control of LESS severe bleeding from menorrhagia? |
|
Definition
|
|
Term
| First-line med to PREVENT heavy bleeding in subsequent cycles? |
|
Definition
|
|
Term
| Second-line meds for menorrhagia? |
|
Definition
| Naproxen, Mefenamic acid, ibuprofen (Non-steroidal prostaglandin-synthetase inhibitors) |
|
|
Term
| When should imaging be performed with a migraine type complaint? |
|
Definition
- New onset in pt over 50y/o
- Change in HA pattern
- Atypical pattern of sx
- Prolonged or bizzarre aura |
|
|
Term
| 1st line tx for mild to moderate migraine? |
|
Definition
combo of acetaminophen, ASA and caffeine
OR 5-HT-1 agonists (triptans) |
|
|
Term
| DOC in status migrainous? |
|
Definition
| Ergotamines (Dihydroergotamine) |
|
|
Term
| Contraindications to 5-HT-1 agonist? |
|
Definition
Coronary heart disease, peripheral vascular disease, uncontrolled HTN, complex migraine
SHOULD NOT be used within 24hrs of ergot derivative or other triptans |
|
|
Term
| 2nd-line tx of severe migraine? |
|
Definition
|
|
Term
| What pathogen causes Molluscum Contagiosum? |
|
Definition
|
|
Term
| Pt presents with c/o a rash that developed afer her son had a similar one. The rash is located on her left forearm and shoulder. The rash is made of flesh colored, pearly, dome-shaped papules with central umbilication. What condition do you suspect? |
|
Definition
|
|
Term
| First-line meds for mulluscum contagiosum? |
|
Definition
| Cantharidin, Cimetidine, Imiquimod |
|
|
Term
| When is Imiquimod cream contraindicated? |
|
Definition
|
|
Term
| What surgical or other procedures can be used in the tx of mulluscum contagiosum? |
|
Definition
Cryotherapy
Currettage
Incision & expression of central particle |
|
|
Term
| What pathogen causes Mono? |
|
Definition
|
|
Term
| What is the "classic triad" of Mono sx? |
|
Definition
| malaise, HA, low-grade fever |
|
|
Term
| When should you admit a Mono pt? |
|
Definition
| If airway obstruction or splenic rupture |
|
|
Term
| When should imaging be used in mono? |
|
Definition
U/S to confirm splenomegaly
CT if splenic rupture is suspected |
|
|
Term
| What is the prognosis of mono? |
|
Definition
| S & S will last for months |
|
|
Term
|
Definition
Acetaminophen
NSAIDs
Lozenges
Gargling with 2% lidocaine solution |
|
|
Term
| First-line tx for motion sickness? |
|
Definition
Dimenhydrinate (Dramamine)
Meclizine (Antivert)
Cyclizine (Marezine) |
|
|
Term
| What is the dosage for Dimenhydrinate (Dramamine) in children 6 - 12y/o? |
|
Definition
|
|
Term
| What SE can anti-histamines cause in kids? |
|
Definition
|
|
Term
| When is the peak incidence of motion sickness in children? When is it rarest? |
|
Definition
Peak = 3 - 12 y/o
Rarest = <2y/o |
|
|
Term
| What SE are more common in elderly with tx of motion sickness? |
|
Definition
|
|
Term
| What motion sickness meds are safe to use in pregnancy? |
|
Definition
|
|
Term
| What are the risk factors for MI? |
|
Definition
Increasing age
HTN
Tobacco/alcohol/drug abuse
DM
family hx
dyslipidemia
early CAD
sedentary lifestyle |
|
|
Term
| What monitoring must be done if an MI is suspected? |
|
Definition
|
|
Term
| During pregnancy labs and monitoring that can mimic an MI include? |
|
Definition
ST depression
Increased CK-MB
Mild increase in troponin I |
|
|
Term
| When does Troponin rise after MI? How long does it remain elevated? |
|
Definition
Rises - 3 to 6 hrs after MI onset
Lasts - 7 to 10 days |
|
|
Term
| When does CK-MB rise following an MI? How long does it remain elevated? |
|
Definition
Rise - 3 to 4 hrs after onset
Last - 2 to 3 days |
|
|
Term
| What is myoglobin a marker for? |
|
Definition
|
|
Term
| When does myoglobin rise after an MI? How long does it stay elevated? |
|
Definition
Rises - 2 hrs after MI
Lasts - 24 hours |
|
|
Term
| Following an MI, what is the O2 sat goal? |
|
Definition
|
|
Term
| If pt has been given 3 doses of nitro for their MI sx and still has pain, what should be done? |
|
Definition
|
|
Term
| What med should be given for a STEMI? |
|
Definition
| thienopyridine (anti-platelet agent) |
|
|
Term
| What is the prevalence of obesity in the US? |
|
Definition
|
|
Term
| What BMI is considered class I obesity? |
|
Definition
|
|
Term
| What BMI is considered class 2 obesity? |
|
Definition
|
|
Term
| What BMI is considered class 3 obesity (morbid obesity)? |
|
Definition
|
|
Term
| When should meds for obesity be considered? |
|
Definition
| consider after 6 mon of general conservative tx |
|
|
Term
| What BMI qualifies for surgical measures? |
|
Definition
BMI > 40
OR BMI > 35 w/ comorbidities |
|
|
Term
| First-line tx for weight loss? |
|
Definition
|
|
Term
| With what med should the concomitant use of Orlistat be cautioned with? Why? |
|
Definition
| Metformin - Increases risk of developing lactic acidosis |
|
|
Term
| What are the contraindications to Orlistat use? |
|
Definition
Breastfeeding
Chronic malabsorption syndrome
Cholestasis
Anorexia
Bulimia |
|
|
Term
| What meds does Orlistat interact with? |
|
Definition
|
|
Term
| What is the 2nd line tx for weight loss? |
|
Definition
|
|
Term
| What conditions are contraindicated with Phentermine? |
|
Definition
Pregnancy
breastfeeding
CVD
arteriosclerosis
mod-sev HTN
glaucoma
hx of drug abuse |
|
|
Term
| What meds are contraindicated with Phentermine? |
|
Definition
MAOIs w/in 14 days
Sibutramine
Anorexiants
Stimulants |
|
|
Term
| What meds are contraindicated with Phentermine? |
|
Definition
MAOIs w/in 14 days
Sibutramine
Anorexiants
Stimulants |
|
|
Term
| What are some precautions when using Phentermine? |
|
Definition
|
|
Term
| In which pts is use of Phentermine cautioned? |
|
Definition
|
|
Term
| With weight loss meds, when should you f/u? |
|
Definition
|
|
Term
| When should meds be used for weight loss? |
|
Definition
| After 6 mon of diet and exercise has failed |
|
|
Term
| What condition is described as a chronic fungal infection of the fingernails or toenails? |
|
Definition
|
|
Term
| What are the risk factors for onychomycosis? |
|
Definition
Older age
Tinea pedis
CA
DM
Peripheral Vascular Dz
Psoriasis
Cohabitation with others who have onychomycosis
Immunodeficiency
Swimming
Smoking |
|
|
Term
| With what labs can onychomycosis be confirmed? |
|
Definition
KOH prep of nail clippings
Histologic exam of nail clippings |
|
|
Term
| With the tx for onychomycosis, what labs must you do to monitor the SE of the anti-fungals? |
|
Definition
|
|
Term
| If onychomycosis is on the dominant hand only, what is the most likely pathogen? |
|
Definition
|
|
Term
| Which type of pathogen causes onychomycosis that involves more than one infected site? |
|
Definition
|
|
Term
| What is the MC pathogen causing onychomycosis in people older than 60y/o? |
|
Definition
|
|
Term
| What med is used to tx onychomycosis? |
|
Definition
| Terbinafine OR Itraconazole |
|
|
Term
| What are the contraindications for using oral anti-fungals? |
|
Definition
Hepatic Dz
Pregnancy
current CHF or Hx of CHF
Porphyria |
|
|
Term
| What imaging is best for viewing Osgood-Schlatter Dz? What will you see on the imaging studies? |
|
Definition
| Lateral Knee Radiographs - prominent tuberocity, separation of ossicles or calcification |
|
|
Term
| What is the tx for Osgood-Schlatter's dz? |
|
Definition
| RICE, NSAIDs, PT (can improve stability and flexibility and prevent reoccurrences) |
|
|
Term
| What are the causes of osteoporosis? |
|
Definition
| Aging and Hypoestrogenemia |
|
|
Term
| What are the NON-modifiable risk factors for osteoporosis? |
|
Definition
Advanced age (>65y/o)
Female gender
Caucasian or Asian ethnicity
Fam Hx of osteoporosis
Hx of atraumatic fx |
|
|
Term
| What are the modifiable risk factors for osteoporosis? |
|
Definition
Low body wt
Ca or Vit D Def
Inadequate physical activity
Cigarette Smoking
Excessive alcohol intake
Meds (Corticosteroids, Thyroid Hormone Replacement, medroxyprogesterone acetate, heparin) |
|
|
Term
| What is the gold standard for measuring bone mineral density? |
|
Definition
| DEXA scan - radiograph of the lumbar spine/hip |
|
|
Term
|
Definition
| Bisphosphonates (Alendronate) |
|
|
Term
| 2nd line tx for osteoporosis? |
|
Definition
| Raloxifene (Selective Estrogen Receptor Modulator) |
|
|
Term
| When should a pt with osteoporosis be referred to Endo? |
|
Definition
| If pt experiences recurrent bone loss refractory to tx or fractures |
|
|
Term
| What are the risk factors for necrotizing otitis externa in adults? |
|
Definition
Advanced Age
DM
Debilitating Dz
AIDs |
|
|
Term
| What are the risk factors for necrotizing otitis externa in children? |
|
Definition
Leukopenia
Malnutrition
DM
DI |
|
|
Term
| What is the tx for necrotizing otitis media? |
|
Definition
| Admit, Parenteral antipseudomonal antibiotics |
|
|
Term
| What is the tx for OE resistant to meds? |
|
Definition
|
|
Term
| What is the MC cause for childhood visits to a physician? |
|
Definition
|
|
Term
| What is the MC bacterial pathogen in OM? |
|
Definition
|
|
Term
| Why are children more susceptible to OM than adults? |
|
Definition
|
|
Term
| What med is first-line for OM treatment in pts >3mo old? |
|
Definition
| Amoxicillin or Amoxicillin/clavulanate |
|
|
Term
| What med is first-line for OM treatment in pts >6mo old? |
|
Definition
|
|
Term
| If pt has symptoms of OM after 48 - 72 hrs of tx, what should be done? |
|
Definition
| switch to broad spectrum antibiotic |
|
|
Term
| If the child's TM is ruptured with OM, what pt instructions should be given? |
|
Definition
|
|
Term
| What are the serious complications of OM? |
|
Definition
Mastoiditis (MC complication)
Meningitis
Brain Abscess |
|
|
Term
|
Definition
|
|
Term
| MCC of CHRONIC paronchia? |
|
Definition
|
|
Term
| Risk factors for paronchia? |
|
Definition
| Diabetic and Immunocompromised pt |
|
|
Term
| A 40 y/o diabetic pt presents with a sore on her toe. It is painful, erythematous and edematous. The sore is located on her 3rd digit around the edge of the nailbed. Pus is present. What condition do you suspect? |
|
Definition
|
|
Term
| What is the DOC for Paronchia? |
|
Definition
|
|
Term
| What pathogen is commonly associated with chronic paronchia? What med should be used to treat it? |
|
Definition
| Primarily fungal, tx with topical miconazole and add oral anti-fungal if needed |
|
|
Term
| A 18y/o male presents with fever and difficulty swallowing and talking . On PE you note a collection of pus between the anterior and posterior tonsillar pillars and the superior pharyngeal constrictor muscles. What condition do you suspect? |
|
Definition
|
|
Term
| What usually precedes a peritonsillar abscess? |
|
Definition
| Pharyngitis or tonsillitis |
|
|
Term
| 1st line tx for Peritonsillar abscess? |
|
Definition
|
|
Term
| If pt is allergic to PCN, what is the 1st line tx for peritonsillar abscess? |
|
Definition
| Erythromycin or Cephalexin |
|
|
Term
|
Definition
|
|
Term
| What is the common cause of chronic pharyngitis? |
|
Definition
| Most likely non-infectious, instead a result of post-nasal d/c of chronic allergic rhinitis or reflux |
|
|
Term
| What bacterial pathogens are MC responsible for acute pharyngitis? |
|
Definition
Grp A B-menolytic Strep
N. gonorrhoeae
C. Diptheria |
|
|
Term
| What viral pathogens are MC responsible for acute pharyngitis? |
|
Definition
Rhinovirus
Adenovirus
Parainfluenza virus |
|
|
Term
| 1st line tx for pharyngitis? |
|
Definition
Usually viral so supportive
If bacterial PCN or Amoxicillin |
|
|
Term
| A pt with a sore throat, hoarseness, swollen lymphnodes, erythematous pharynx presents back to your after tx with Amoxicillin. She came to you b/c she now has a rash. What pathogen might be causing her sore throat and new rash? |
|
Definition
| EBV - if Amoxicillin is used to tx, can cause rash |
|
|
Term
| What is the BEST treatment for pharyngitis if a rapid strep test is pos? Why? |
|
Definition
| PCN - only treatment proven to prevent rheumatic fever |
|
|
Term
| If pt with pharyngitis has PCN allergies, what is the first-line treatment? |
|
Definition
| Erythromycin OR Cephalexin |
|
|
Term
| What test can be done to confirm your suspicion of pinworms? Describe positive results. |
|
Definition
| Adhesive tape test - pos if on microscopy ova are present on tape |
|
|
Term
| first-line tx for Pinworms? |
|
Definition
|
|
Term
| second-line tx for pinworms? |
|
Definition
|
|
Term
| What is the DOC for pneumonia? |
|
Definition
| Azithromycin, Clarithromycin, Erythromycin |
|
|
Term
| In which sex is pneumonia MC? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What condition is described as an acute or chronic inflammation of the rectum? |
|
Definition
|
|
Term
| What are the risk factors for the development of proctitis? |
|
Definition
Anal Intercourse
Pelvic radiation
Rectal Injury
Rectal med use
Jewish descent |
|
|
Term
| What are the infectious causes of proctitis? |
|
Definition
Gonorrhea/Chlamydia
Syphillis
HSV2
LGV
Chancroid
CMV
HPV |
|
|
Term
| If proctitis is caused by gonorrhea, what med is used to treat it? If allergy to first choice, what should be used? |
|
Definition
| Ceftriaxone (if allergy use azithromycin) |
|
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