Cardio
What do we use to treat symptomatic bradycardia? What is the correct dose?
Atropine (1 mg every 3 to 5 mins-max total dose is 3 mg)
What is something you should rule out if a patient presents with nausea and vomiting? What's an additional thing if a patient is female?
Small bowel obstruction and Pregnancy
How long can we run a pressor through a peripheral IV? What are some risk factors?
We can run pressors through peripheral IVs for 6-12 hours and maximum up to 24 hours.
This is to limit extravasation into the tissue causing tissue necrosis
This hemolytic anemia is treated with plasma exchange and is classically associated with a pentad including renal failure, neurologic symptoms, fever, and thrombocytopenia.
What is thrombotic thrombocytopenic purpura (TTP)?
Do we treat patients with acute hepatitis C infection?
(Acute: within 6 months)
No
In first 6 months there is a 20-50% chance of spontaneous resolution. Treat Chronic HCV
What are some indications for statin therapy?
1. LDL >190
2. DM age 40-75
3. Pts with clinical ASCVD (MI, PAD, Stroke)
4. Pts age 40-75 with a calculated ASCVD risk>7.5%
Give an example of each class of medication for constipation:
1. Bulking agent
2. Stimulant Laxative
3. Osmotic Laxative
4. Stool Softeners
1. Psyllium Husk
2. Senna, Bisacodyl
3. PEG, Lactulose, Sorbitol, Mag oxide
4. Docusate
What does silicosis increase the risk of?
Silicosis increases the risk of development of TB
A patient with newly diagnosed Burkitt lymphoma develops AKI, hyperkalemia, hyperuricemia, and hypocalcemia 24 hours after starting chemotherapy. Name three core components of the initial management strategy for this condition.
What are IV hydration, rasburicase, and electrolyte management (e.g., treating hyperkalemia)?
When do we treat asymptomatic bacteriuria?
Pregnant women and patients undergoing urologic surgery
How do we raise HDL levels?
1. Smoking cessation
2. Exercise
3. Weight loss
4. Management of high LDL, triglyceride levels, and metabolic syndrome
How many weeks after an episode of acute diverticulitis is colonoscopy contraindicated?
Colonoscopy is contraindicated 4-6 weeks after an episode of acute diverticulitis
What is the definition of a solitary pulmonary module?
(Hint: Size)
Solitary pulmonary nodule is defined as a rounded lesion <3 cm
List which of the medications require bridging for DVT/PE treatment and for how many days?
1. Apixaban
2. Rivaroxaban
3. Dabigatran/Edoxaban
4. Warfarin
Apixaban and Rivaroxaban-no bridging required
Dabigatran/Edoxaban-LMWH or unfractionated heparin required for 5 days at least before
Warfarin-heparin required for 5 days and until INR is 2 for 24 hours
What medication is commonly used for pre-exposure prophylaxis for HIV?
Oral Tenofovir disoproxil fumarate/emtricitabine
What is the most common site of origin of atrial flutter and atrial fibrillation arrhythmias?
Atrial flutter- RA-Cavotricuspid isthmus
Afib: LA-pulmonary veins
What medications do we use for treatment of Hepatitis B?
Entecavir (Nucleoside analog)
Tenofovir (Nucleotide analog)
Interferon
Which lab/study from thoracentesis is the most important in guiding management for empyema and complicate parapneumonic effusions?
Pleural Fluid PH
What do we do in each situation?
1. Supratherapeutic INR but <10
2. Supratherapeutic INR >10 but no bleeding
3. Supratherapeutic INR and life threatening bleeding
1. If INR <10 and no signs of bleeding-warfarin should be withheld until INR reaches therapeutic range
2. If INR >10 without bleeding, Vit K recommended in addition to withholding warfarin
3. INR elevated and life threatening bleeding is present-warfarin is withheld + vit K +PCC
What disease is linked to cannibalistic funeral rituals in Papua New Guinea, causes neurodegeneration, and is always fatal?
Kuru
What is the maximum dose of:
1. Furosemide
2. Bumetanide
3. Torsemide
Furosemide-400 mg daily
Bumetanide-10 mg total daily
Torsemide-200 mg daily
40 mg Furosemide = 20 mg Torsemide =1 mg Bumetanide
What is the Quadruple therapy for H.Pylori treatment?
PPI (Standard dose)
Bismuth Salicylate 300 mg
Tetracycline 500 mg qid
Metronidazole 500 mg qid
How do we differentiate a diagnosis of hemoptysis due to Diffuse Alveolar hemorrhage from other causes like trauma or infection during a bronchoalveolar lavage?
Progressive bloodier return with serial aliquots of saline.
Which Hematologic malignancies have a very high risk of Tumor lysis syndrome? Name 2
1. Burkitt's Lymphoma
2. AML and ALL
3. Diffuse Large B cell lymphoma
4. T-cell Lymphoblastic Lymphoma/Leukemia
what is the GFR cutoff for starting Farxiga (Dapagliflozin) and Jardiance (Empagliflozin) in CKD patients?
Can start if GFR >20
EMPA-Kidney Trial-Can start Empagliflozin with GFR as low as 20
DAPA-CKD-GFR 25 but now subsequent analysis and guidelines-GFR 20