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Residency > ITE High Yield > Flashcards

ITE High Yield Flashcards

1
Q

Pneuomcoccal vax recs

A

PPSV-23 given before age 65 for heart, liver, lung disease and smoking

PCV-13 given first; PPSV-23 given 8 weeks after with revax after 5 yrs for splenectomy and IC pts

NORMAL: PCV-13 =»1yr; give next

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2
Q

In males, who can get HPV after 21?

A

MSM

IC

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3
Q

What medication to give to someone accidentally exposed to needle stick w/ HIV?

A

Tenofovir-Emtricitabine + Raltegravir

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4
Q

Guillain-Barre CSF findings

A

WBC:0-5

Glucose: 40-70

Protein: 45-1,000 (abnormal)

*Albuminocytologic dissociation

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5
Q

MI complications

A

hours-days= Reinfarction

hrs-weeks= Ventricular septal rupture

hrs-2weeks= Free wall rupture

hrs-month= Papillary muscle rupture

1 day-3months= Pericarditis

5 days- 3 months= Ventricular aneurysm

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6
Q

Likelihood ratio

A

Sensitivity/(1-specificity)

If looking for NEGATIVE likelihood ratio, use inverse

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7
Q

Odds ratio

A

AD/BC

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8
Q

Experimental Event Rate

A

A/A+B

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9
Q

Control Event Rate

A

C/C+D

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10
Q

RR

A

(A/A+B)/(C/C+D)

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11
Q

Attributable risk

A

EER-CER

or

A/A+B-C/C+D

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12
Q

RR Reduction

A

ARR/CER

or

[(C/C+D)-(A/A+B)]-[(A/A+B)/(C/C+D)]

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13
Q

NNT

A

1/ARR

1/(A/A+B)-(C/C+D)

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14
Q

NNH

A

1/Attributable risk

1/(A/A+B)-(C/C+D)

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15
Q

Ab in PSC

A

Anti-mitochondria antibody

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16
Q

Pt w/ scleroderma who has AKI

A

GIVE ACEI

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17
Q

Ab in MCTD

A

RNP

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18
Q

Eosinophilic esophagitis

A

20 year old male who is having dysphagia

EGD show “trachealization” of esophagus; biopsy w/ >15eos/hpf

Tx: Swallowed and aerosolized steroids; PPI if needed

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19
Q

PPD positivities

A 
>5mm: 
   HIV
   Recent contact w/ TB person
   Nodule or fibrotic changes on Xray
   Organ transplant

> 10mm:
Recent arrival (<5yrs) from high prevalence country
IVDA
Resident/employee of high-risk setting
Mycobacteria lab personnel
Comorbid conditions
Children <4yrs old

> 15:
Everyone else

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20
Q

Lofgren syndrome

A

Person w/ Sarcoidosis who also develops:

Erythema nodosum

Fever

Migratory polyarthralgia

Hilar lymphadenopathy

21
Q

Methods of reducing post radiation lymphedema

A

Maintain good skin hygiene (avoid cuts, bites, scratches)

Treat anything resembling cellulitis

Elevate extremity

Wear compression sleeves

**AVOID PUNCTURING THE SKIN ON THAT SIDE; USE CONTRALATERAL ARM*

22
Q

Diagnosing Takayusu Atereritis

A

MRA

23
Q

Still’s Disease

A

Fever, arthritis, evanescent rash
+/- hepatosplenomegaly, serositis (pericarditis, pleuritis)

  • Is ultimately a diagnosis of exclusion
  • Suspect w/ daily spiking fever, salmon-pink maculopapular eruption, arthritis, leukocytosis, hyperferritinemia

Tx: Supportive; glucorticoids if severe; Kineret (anakinra) if chronic (DMARD)

24
Q

Tactile fremitus in consolidation and effusion

A

Increased= Consolidation

Decreased= Effusion

25
Q

Ranson Criteria

A

Predicts severity of Acute Pancreatitis

At O hours:
Age >55
WBC >16000
Glucose >200
LDH >350
AST >250
At 48 hrs:
Hcrt decrease of 10%
BUN increase by 5 
Calcium <8
pO2 <60mmHg
Base deficit >4meq
Fluid sequestration >6L
26
Q

Cogan’s Syndrome

A

Chronic inflammatory disorder of young adults that includes interstitial kerititis and vestibuloauditory dysfnxn

-Could be due to AI rxn to bones and organs of the inner ear

CFss: Eye redness, photophobia, blurred vision, granular infiltrate in cornea, vertigo, ataxia, nausea, vomiting, hearing loss

-Only need presence of both inner ear and eye symptoms not all of these

***May also have a large vessel vasculitis resembling Takayasu

Tx: Immunosuppressants, meclizine, and eye prednisolone to start

27
Q

Monitoring parameters for trastuzumab

A

Echo q3months; q6months for 2 years following cessation of therapy

28
Q

Fanconi Syndrome

A

General impairment in proximal tubular function leading to urinary wasting of compounds reabsorbed in the proximal tubule

Consequences include hypophosphatemia, osteomalacia, glucouria, hypouricemia, aminoaciduria, and proximal RTA due to loss of bicar

-Serum calcitriol is usually low

**MOST OFTEN SEEN W/ MULTIPLE MYELOMA

29
Q

Sutent

A

Sunitinib

Inhibits multiple tyrosine kinasaes including PDGFR, VEGF, and CSF

-Used for a lot of well-differentiated neuroendocrine tumors

30
Q

Management of PVD

A

Treat like it is CAD

-This means long term aspirin or clopidogrel, statin therapy, and lifestyle modification

31
Q

Latent interferon gamma release assay

A

Includes quantiferon gold examination; used when an initial TST screen is positive

-Can also be used as the initial test in high risk individuals

32
Q

Treatment of vulvar SCC

A

IA: Surgical resection

IB, II: +Sentinel Node Biopsy

Palpable Nodes: Debulking procedures

33
Q

Treatment of TRALI

A

Stop transfusion

Hemodynamic + Ventilation support

34
Q

Docetaxel

A

Microtubule depolymerization inhibition resulting in inhibition of DNA, RNA, and protein synthesis; used in breast cancer and some NSCLC, gastric adenocacrinoma, locally invasive neck cancers

ADRs: Neurotoxicity (Chemotox man), alopecia, rash, fluid retention, diarrhea, neutropenia

35
Q

Lithium monitoring parameters

A

Renal function (Baseline-then every 2-3months during first 6 months of treatment, then every year in pts on stable dose)

Electrolytes

Calcium

Thyroid (same frequency as BUN/Cr)

36
Q

Reactive gastropathy

A

Long term exposure to gastric damaging substances leading to inflammation, some hyperplasia, mucosal edema, proliferation of smooth muscle fibers in the lamina propria, and vascular dilation

-Assoc w/ chronic bile reflux, NSAIDs, alcohol

Tx: Ursodeoxycholic acid, sucralfate

37
Q

Patient who starts HAART and then gets sick

A

Immune Reconstitution Inflammatory Syndrome

-Symptoms will usually be associated w/ whatever opportunistic infection they have

38
Q

Digoxin effects on EKG

A

Sagging ST segment; concave and upward direction

Flattened T wave

Shortened QT interval

PR interval prolongation

Possible U wave

39
Q

Alkalotic urine can produce what stones

A

Calcium oxalate or calcium phosphate

40
Q

Ab to order first for celiac

A

Anti-TTG

41
Q

Microscopic colitis

A

Chronic, nonbloody diarrhea that is water; typically have >5 stools/day

Can also have arthralgia, arthritis, uveitis suggesting AI etiology

Lab: Can have positive RF, ANA, anti-mitochondrial abs, p-ANCA, anti-Saccharomyces cerevisiae antibodies

Definitive dx: Biopsy

Tx: NSAID avoidance; loperamide, budesonide

-Can consider bismuth subsalicylate

42
Q

Minimizing weakness after critical care

A

Awaken

Breathing Coordination w/ daily sedative interruption and ventilator liberation practices

Delirium monitoring and management

Early ambulation

43
Q

Beer potomania

A

Just hyponatremia in alcoholics

44
Q

Cerebral Salt Wasting

A

Possibly due to impaired sympathetic reactivity causing decreased salt reabsorption or possibly due to BNP release w/ brain injuries

CFs: Severe hyponatremia following neurosurgical procedure or event, hypotension, elevated hcrt

Labs: Hyponatremia, Urine Na >40, increased urine osmolality, low serum uric acid

45
Q

CK can be elevated in hypothyroidism

A

Yup

46
Q

5q deletion

A

Myelodysplastic syndrome

47
Q

Integrillin

A

Eptifibatide

-Glycoprotein IIb/IIIa inhibitor

48
Q

Asteatotic dermatitis

A

Common pruritic dermatitis occurring in old people in the extremities usually during cold months

-Patients have severe scaling and superficial fissuring of the skin

“Dry river bed” appearance

Tx: Topical corticosteroids

49
Q

Dermatitis herpetiformis

A

AI cutaneous eruption associated w/ gluten sensitivity; patients have intensely pruritic inflammatory papules and vesicles on forearms, knees, scalp, and butt

Tx: Dapsone, gluten-free diet

Residency (5 decks)

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